Could My Child Outgrow Autism?

Is It Possible to Outgrow Autism?

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From time to time, stories emerge of individuals who appear to have simply "outgrown" or overcome an early diagnosis of autism. These stories usually relate to one or another therapeutic approach—ABA, Floortime, a change in diet, or some other technique for improving autistic symptoms. Is it really possible for a person to be accurately diagnosed with autism as a young child and then "grow out of" the diagnosis?

Officially, the Answer Is "No"

According to the DSM-5 (the diagnostic manual that currently describes mental and developmental disorders in the United States and many other nations), the answer is no, it is not possible to grow out of autism. In fact, according to the manual, even a person who appears to have few symptoms is still autistic: "Manifestations of the social and communication impairments and restricted/repetitive behaviors that define autism spectrum disorder are clear in the developmental period. In later life, intervention or compensation, as well as current supports, may mask these difficulties in at least some contexts. However, symptoms remain sufficient to cause current impairment in social, occupational, or other important areas of functioning." 

In other words, says the DSM, autistic symptoms start early and continue throughout life, though adults may be able to "mask" their symptoms—at least in some situations. But according to the DSM, it is impossible to "grow out" of autism. In fact, if a person with an autism diagnosis does appear to completely outgrow their early symptoms, they were not properly diagnosed.

Autism Can Be Misdiagnosed

In some cases, a practitioner may put an "autism" label on a child because of behaviors and symptoms that fit the criteria of autism but miss other issues that underlie the behaviors. Not only are many symptoms of autism shared by other related (and unrelated disorders), but some autism-like symptoms may be caused by physical issues that can be addressed. For example:

  • Late or disordered speech, a classic symptom of autism, can be caused by many different issues ranging from Apraxia of Speech to hearing loss. Address the underlying issues, and typical speech may emerge.
  • Sensory challenges can lead to autism-like behavior, but it is very possible to have sensory dysfunction without being autistic. Help a child to manage or avoid sensory assaults, and many of the behaviors will disappear.
  • Some autism-like behaviors can result from allergies, toxins, or food intolerances. If a child is allergic to or intolerant of casein or gluten, for example, removing those items from their diet can have a tremendous positive impact on learning and behavior.
  • In some cases, children are diagnosed with autism when a more appropriate diagnosis might be Obsessive Compulsive Disorder, Social Anxiety, or Non-Verbal Learning Disorder. When that's the case, it's possible for a combination of cognitive therapy and appropriate medication to essentially eradicate the problem.

Treatment Can Radically Improve Symptoms

While children with autism don't appear to just "get better" over time without intervention, most do improve over time with therapies and maturity. Some improve a great deal.

Practitioners of virtually every major autism therapy can tell stories of a child who started out with severe challenges and, over time, built significant skills. In some cases, children are described as "recovered," or "indistinguishable from typical peers." The reality, however, is that most children who appear to be "cured of autism" have either (1) been cured of some physical problem which caused autism-like symptoms or (2) learned coping techniques and behaviors that effectively mask their autism symptoms.

If a person was accurately diagnosed with autism, he will still have the same differences he had as a child. He will almost certainly need at least some support in managing the challenges of modern life. But in some cases, he may be able to "pass" as neurotypical in at least some situations.

Which Children Are Most Likely to Radically Improve?

Every now and then, a child with relatively severe symptoms improves to the point where he or she is able to function effectively over time in a typical school setting. But this is rare. While inclusion may be appropriate for a period of time, most children with severe or even moderate autism find it difficult or impossible to manage increasingly complex demands in the areas of social communication, executive functioning, and abstract reasoning.

The reality is that the children who are most likely to radically improve are those whose symptoms are already relatively mild and do not include issues such as seizures, speech delay, learning disabilities, or severe anxiety. In general, therefore, the children most likely to apparently "defeat" autism are those with normal or above normal IQ's, spoken language skills, and other existing strengths. 

It's important to note, though, that leaving behind an autism spectrum diagnosis isn't the same thing as becoming "normal." Even very high functioning children who appear to "outgrow" their autism diagnosis still struggle with a variety of issues. They are still likely to have sensory challenges, social communication difficulties, anxiety, and other challenges, and may well wind up with diagnoses such as ADHD, OCD, social anxiety, or the relatively new Social Communication Disorder.

What Is the Difference Between "Outgrowing" and "Radically Improving?"

According to the DSM, anyone who was every correctly diagnosed with autism will always be autistic, even they do not appear to have the symptoms of autism. The fact that they are not showing any significant symptoms is a testament to their ability to "mask" or "manage" their challenges. This interpretation is shared by many functional adults who were diagnosed with autism as children. They say "inside I'm still autistic—but I've learned to change my behaviors and manage my feelings." In other words, there is some basic difference that makes autistic people autistic, and that basic difference doesn't go away, even if behavioral symptoms disappear.

Then there are those who have a very different point of view. Their perspective: if a person no longer exhibits sufficient symptoms for an autism diagnosis, then she has outgrown (or been cured of) autism. In other words, the therapies worked and the autism is gone.

Who is right? When symptoms are no longer obvious to an outside observer, have they been "outgrown?" "cured?" "masked?" 

As with so many things related to autism, there is no absolutely correct answer to this question. And the uncertainty extends into the professional realm. Yes, there are practitioners who will remove the autism label, saying "the autism is gone." And yes, there are practitioners who will keep the label, saying "autism never truly disappears, though its symptoms may not be evident." By choosing your practitioner carefully, you may be able to get the answer you prefer!

A Word From Verywell

Parents of children with autism are often overwhelmed with information about "cures" that range from the silly to the extremely risky. These so-called cures are based on theories about autism that are not supported by research. It's very important to differentiate between treatments that can and should help your child, and those that have the potential to harm him or her.

Therapies such as ABA, Floortime, play therapy, speech therapy, and occupational therapy can all make a positive difference for your child, as can medications to mitigate anxiety, manage seizures, and improve sleep. Treatments such as chelation, hyperbaric oxygen chambers, bleach enemas and the like are not only ineffective: they are extremely risky.

While hope (and celebration of small victories) is always important, so, too, is common sense.

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