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Study Finds Preschoolers with Autism Vary Greatly in Areas of Progress

Researchers highlight need to tailor therapies to each child’s strengths and challenges; associate early diagnosis with greater function
January 29, 2015

A new study – the largest to track the development of preschoolers with autism – emphasizes the need to tailor therapy to meet each child’s different strengths and challenges.

The study, funded in part by Autism Speaks, found that some preschoolers make great strides in overcoming autism’s core symptoms. Others make significant progress in daily functioning. But the two groups don’t necessarily overlap. In addition, the research associated earlier diagnosis with greater improvements in daily functioning, but not in autism symptoms.

The report appears this week in JAMA Psychiatry. Its Canadian authors are members of the Autism Speaks Baby Siblings Research Consortium.

In their study, the researchers followed autism symptoms and developmental abilities in 421 preschool children from the time of their diagnosis, between age 2 and 4, until age 6.

Over this time, some of the children – about one-fifth of the group – improved significantly in so-called “adaptive function.” The term is a general measure of the ability to function in daily life. These gains tended to be greater among the children who were diagnosed earlier. However, core autism symptoms such as repetitive behaviors and social/communication challenges remained severe in many of the children in this group – regardless of when they were diagnosed.

Another subset of the children – around 10 percent – improved significantly in terms of autism symptoms. However, their reduced symptoms didn’t always come with improved daily function.

The authors conclude: “It is imperative that a flexible suite of interventions that target both autistic symptom severity and adaptive functioning be implemented and tailored to each child's strengths and difficulties."

While the lack of overlap in improved function and symptoms may seem surprising, it’s supported by earlier research, comments developmental pediatrician Paul Wang, Autism Speaks head of medical research. “Behavioral and educational interventions show much less success in improving core autistic symptoms than they do for improving adaptive functioning,” he explains. “Children may improve their language skills and cognitive functioning, but their social challenges often remain severe.” More research is needed, Dr. Wang says, “to figure out how we can improve the core social impairments that are so important for community integration, quality of life and happiness in later years.”

Adds Andy Shih, Autism Speaks senior vice president for scientific affairs: “This study is an important addition to the growing body of research tracking outcomes and the factors that contribute to improved outcomes across the lifespan. We need more studies like this over longer periods of time.” Dr. Shih oversees the Autism Speaks Baby Siblings Research Consortium and helps coordinate its activities.

Read the full study, free of charge, here.

Learn more about Autism Speaks Baby Siblings Research Consortium here.


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