A study examining children diagnosed with autism spectrum disorder whose social and cognitive symptoms had resolved 4 years later has found that most continued to have emotional and behavioral symptoms that required special educational support.

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The researchers found that almost three quarters of the children continued to need academic support, whether it be in a small class setting or a resource room.

The research, presented at the Pediatric Academic Societies annual meeting in San Diego, CA, aimed to investigate whether any deficits remained after the resolution of early symptoms to the extent that children no longer met the criteria for autism spectrum disorder (ASD).

Data were analyzed for children diagnosed with ASD in 2003-2013 whose symptoms had been found to have resolved around 4 years later upon re-evaluation. A total of 38 children out of 569 diagnosed with ASD in a university-affiliated early intervention program were reviewed by the team led by Dr. Lisa Shulman.

“Autism generally has been considered a lifelong condition, but 7% of children in this [program] who received an early diagnosis experienced a resolution of autistic symptoms over time,” explains Dr. Shulman.

The children participating in the intervention program lived in the Bronx and came from diverse racial, ethnic and socioeconomic backgrounds frequently underrepresented in ASD research. They included Hispanic children (44%), African-American children (10%) and children on Medicaid (46%).

Both the original and follow-up diagnoses were made by a multidisciplinary team, basing their decisions on DSM-IV criteria, the Childhood Autism Rating Scale and the Autism Diagnostic Observation Schedule.

After the initial diagnosis of ASD, clinicians provided the children with interventional treatment and subsequently monitored their responses to it. While most children continued to experience emotional and behavioral symptoms that met the diagnostic criteria for ASD, for some children their symptoms appeared to resolve.

However, after reviewing the data of these 38 children, the researchers found that 92% had experienced different degrees of residual learning impairment, emotional impairment and behavioral impairment. Only three (8%) had no diagnosis at all.

In 68% of the children, the researchers found some form of language or learning disability. Almost half of the children (49%) had externalizing problems such as attention-deficit hyperactivity disorder (ADHD), and 24% had internalizing problems such as obsessive-compulsive disorder (OCD) or anxiety.

Regarding academic support, only around a quarter (26%) of the children studied in mainstream academic settings without support. A total of 21% of the children required teaching in their own self-contained classes while 29% were taught in integrated settings.

“When an early ASD diagnosis resolves, there are often other learning and emotional/behavioral diagnoses that remain,” says Dr. Shulman, associate professor of clinical pediatrics at Albert Einstein College of Medicine. “Understanding the full range of possible positive outcomes in this scenario is important information for parents, clinicians and the educational system.”

Funding for the research was provided by a grant from the Children’s Evaluation and Rehabilitation Center/ Rose F. Kennedy Intellectual and Developmental Disabilities Research Center.

Approximately 1 in 68 children have been identified with ASD in the US. ASD is a developmental disability that is characterized by a set of behaviors often relating to how individuals communicate and interact with other people. As a wide-spectrum disorder, no two people with ASD will have exactly the same symptoms.

Children with ASD are typically diagnosed after the age of 4, although children can be diagnosed effectively as early as the age of 2. Parents of children with ASD often notice a developmental problem such as issues with hearing or vision before the child’s first birthday.

Recently, Medical News Today reported on a study finding that parents’ concerns about their children are key to early autism diagnoses. The earlier a child is diagnosed with ASD, the more likely they are to respond to treatment.