Autism Improves in Adulthood

Autism Symptoms Get Less Severe With Age, but Disability Remains

Medically Reviewed by Louise Chang, MD on September 27, 2007
From the WebMD Archives

Sept. 27, 2007 -- Most teens and adults with autism have less severe symptoms and behaviors as they get older, a groundbreaking study shows.

Not every adult with autism gets better. Some -- especially those with mental retardation -- may get worse. Many remain stable. But even with severe autism, most teens and adults see improvement over time, find Paul T. Shattuck, PhD, Marsha Mailick Seltzer, PhD, and colleagues at the University of Wisconsin.

Shattuck, Seltzer, and colleagues followed 241 adolescents and adults, ranging in age from 10 to 52, for nearly five years. They used standardized tests to measure their autistic symptoms and maladaptive behaviors.

"For any individual symptom, and there are three dozen or so we looked at, there is always a very small group of people who got worse, a modest group in the middle who were stable, and a majority who showed improvement," Shattuck tells WebMD. "Generally speaking, people who are improving in one area are improving across the board."

Those most likely to improve were those without mental retardation with some degree of language competence.

Autism Services Still Needed in Adulthood

The improvement did not mean that autism went away, or that patients recovered from disabling impairments.

"Pretty much everyone in our study continues to need significant support," says Shattuck, now an assistant professor at the Washington University School of Social Work in St. Louis. "They are profoundly disabled. They are not going out and getting jobs and getting married. They will need significant support for the rest of their lives."

The results, Shattuck argues, show that adults with autism can continue to improve throughout their lives. That's an important fact, as current federal support for people with autism ends after they reach the age of 21.

"This is the time of life when we are pulling the chair out from under people with autism," Shattuck says. "You would expect them to get worse. There is this idea that people with disabilities are frozen in development, so why waste money on them? But if anything, this is a time when we should be providing support and services, because they can change and improve."

Shattuck and Seltzer's work is a breath of fresh air to Caroline I. Magyar, PhD, associate professor at the Strong Center for Developmental Disabilities at the University of Rochester, N.Y. Magyar's specialty is treating teens and adults with autism -- a field often overlooked as research attention has focused on early-childhood autism.

"Based on my experience working with adults with autism, they continue to benefit from many of the same environmental accommodations and supports they had as children," Magyar tells WebMD. "They still require quite a bit of assistance. But many are quite successful when given that support."

Shattuck says that most of the adults in the study grew up at a time when symptoms had to be very severe to get a diagnosis of autism.

Magyar notes that the older individuals in the Shattuck/Seltzer study probably did not receive the early diagnosis and early, intensive treatment available to children with autism in many states.

"You wonder whether their improvement would have been even better if they had that kind of support," Magyar says.

Shattuck, Seltzer, and colleagues report their findings in the October issue of the Journal of Autism and Developmental Disorders.

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SOURCES: Shattuck, P.T. Journal of Autism and Developmental Disorders, October 2007; vol 37: pp 1735-1747. Paul T. Shattuck, PhD, assistant professor, George Warren Brown School of Social Work, Washington University, St. Louis. Caroline I. Magyar, PhD, associate professor, Strong Center for Developmental Disabilities at the University of Rochester, N.Y.

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