WHAT'S HAPPENING

NEARLY 4 IN 10 TODDLERS DIAGNOSED WITH AUTISM NO LONGER HAVE IT BY AGE 6

A recent study in JAMA Pediatrics finds that some toddlers diagnosed with autism may outgrow the condition by age six.

This is reassuring news given the startling number of kids currently on the spectrum.

Autism spectrum disorder is characterized by varying degrees of difficulty with social communication and social interactions, repetitive behaviors, and sensory symptoms. It is four times more common in boys than girls

The prevalence of autism continues to rise and more efforts are being made to diagnose kids early so they can get prompt treatment.

Researchers at Boston Children's Hospital wanted to know how many toddlers continue to meet the criteria for autism as they get older. They looked at 213 children who had been diagnosed with autism at 1 to 3 years of age and reevaluated them at 5 to 7 years of age after receiving some form of intervention.

All of the children in the study received interventions based on the diagnosis. The most common intervention used was applied behavior analysis, which is a therapy that focuses on increasing helpful behaviors and decreasing unhelpful ones. Applied behavior analysis can teach people to improve skills in areas like communication, attention, focus, and socializing.

They found that by around age 6, more than a third, almost 40%, of the children no longer met the criteria for autism.

"I think what this shows is the importance of continuing to get developmental follow-up for all children with a young diagnosis of ASD [autism spectrum disorder]," said lead study author Dr. Elizabeth Harstad, a developmental pediatrician at Boston Children's. "I don't want these findings to imply that losing the diagnosis is the best outcome. Children can have a range of wonderful outcomes whether or not they have the diagnosis."

THE LONG VIEW

THE LONG VIEW: The study authors noted the importance of continuing to assess autism throughout a diagnosed child's development.

The findings were published this month in JAMA Pediatrics. The study included 213 children who were diagnosed with autism spectrum disorder (ASD) when they were between the ages of 1 and 3 years old. On average, the children were diagnosed around 2½ years old, and 83% of those in

the study were boys.

"Our research shows how important it is that we monitor kids over time, because some children may really have changes in their social communication and behavioral function."

The kids who outgrew their diagnosis were more likely to be girls or at baseline, to have better communication, self-care, and decision-making skills. But the researchers stress that it's important for children with autism to have ongoing assessments throughout their development because the diagnosis may evolve over time and their treatment needs to evolve with them.

"It is possible that children who no longer have autism at age 6 may have responded better to treatment than children whose autism persisted," study coauthor William Barbaresi, MD, chief of developmental medicine at Boston Children's Hospital, said in a statement. "The findings of the study should cause a very frank reconsideration of the need for far more research to understand if current treatment for autism is working, or if major new efforts to develop treatment approaches are needed."

The findings in this latest study show that parents of children diagnosed with ASD need to remain open-minded, said Dr. Harstad.

"It is important to recognize that diagnoses can evolve as a child develops," she said in a statement. "Our research shows how important it is that we monitor kids over time, because some children may really have changes in their social communication and behavioral function. This underscores the need for continuous assessments and adaptable intervention strategies." •