An important question that parents want answered after their child’s diagnosis is what is the child’s prognosisfor the future, whether his or her condition can improve, how he or she will function at school or at work, or if he or she will be independent in his or her life. It is difficult to answer these questions, as each child and his/her development is unique, but research shows that there are some guidelines that will help us in such a prediction:
Severity of symptoms
According to research, children differ in the development of the severity of symptoms. In some children, the symptoms gradually worsen, in another group of children, the severity is kept at about the same level or gradually improves. As they get older, a small proportion of children even no longer completely meets the criteria for autism. However, the results of different studies vary considerably in how many percent of children fall into these groups. In addition to changing the severity of the symptoms, some symptoms often go away over time and new symptoms appear. In general, the higher severity of symptoms in both childhood and adulthood is associated with reduced independence, lower employment, and a weaker ability to form and maintain relationships with other people.
Children with autism who have an average IQ have a better functioning later in life in the field of education, work, and in general life situations in comparison with autistic children with a below-average IQ. However, even children with autism with an average or even above-average IQ show that later in life they do not fulfill their intellectual potential in everyday life to the same extent as children with comparable intellect without autism (e.g., they have good school results but greater problems in creating and maintaining friendships or marriages). Children with autism who have severe intellectual disabilities (IQ˂50) have significant lifelong limitations in all of the aforementioned areas. A higher level of IQ also presupposes a higher effectiveness of therapies.
It turns out that the age in which the child utters first words and uses first sentences are important for a good prognosis. Children who utter their first words at the age of 24 months have significantly better functioning in everyday life as well as a better level of cognitive skills. The later speech skills emerge, the greater the chance that children will later have problems functioning in everyday life.
Appropriate interventions at an early age, preferably between 2-3 years of age, are associated with a significantly better level of cognitive functions, functioning in everyday life, and a degree of independence in later life.
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- Mayo, J., Chlebowski, C., Fein, D.A., Eigsti, I.M. (2013). Age of first words predicts cognitive ability and adaptive skills in children with ASD. Journal of Autism and Developmental Disorders. 43(2):253-264.
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