Background Although Autism Spectrum Disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a rare event, did they lose the full diagnosis but still suffer significant social and communication impairments or did they lose all symptoms of ASD and function socially within the normal range? Methods The present study documents a group of these optimal outcome individuals (OO group, n=34) by comparing their functioning on standardized measures to age, sex, and nonverbal IQ matched individuals with high-functioning autism (HFA group, n=44) or typical development (TD group, n=34). For this study, ‘optimal outcome’ requires losing all symptoms of ASD in addition to the diagnosis, and functioning within the non-autistic range of social interaction and communication. Domains explored include language, face recognition, socialization, communication, and autism symptoms. Results OO and TD groups’ mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below-average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors. Conclusions Although possible deficits in more subtle aspects of social interaction or cognition are not ruled out, the results substantiate the possibility of optimal outcome from autism spectrum disorders and demonstrate an overall level of functioning within normal limits for this group.

Although Autism Spectrum Disorders (ASD) are generally assumed to be lifelong, we review evidence that between 3% and 25% of children reportedly lose their ASD diagnosis and enter the normal range of cognitive, adaptive and social skills. Predictors of recovery include relatively high intelligence, receptive language, verbal and motor imitation, and motor development, but not overall symptom severity. Earlier age of diagnosis and treatment, and a diagnosis of Pervasive Developmental Disorder-Not Otherwise Specified are also favorable signs. The presence of seizures, mental retardation and genetic syndromes are unfavorable signs, whereas head growth does not predict outcome. Controlled studies that report the most recovery came about after the use of behavioral techniques. Residual vulnerabilities affect higher-order communication and attention. Tics, depression and phobias are frequent residual co-morbidities after recovery. Possible mechanisms of recovery include: normalizing input by forcing attention outward or enriching the environment; promoting the reinforcement value of social stimuli; preventing interfering behaviors; mass practice of weak skills; reducing stress and stabilizing arousal. Improving nutrition and sleep quality is non-specifically beneficial.

Individuals with autism spectrum disorders (ASDs) have significant visuomotor processing deficits, atypical motoric behavior, and often substantial problems connecting socially. We suggest that the perceptual, attentional, and adaptive timing deficiencies associated with autism might directly impact the ability to become a socially connected unit with others. Using a rocking chair paradigm previously employed with typical adults, we demonstrate that typically-developing (TD) children exhibit spontaneous social rocking with their caregivers. In contrast, children diagnosed with ASD do not demonstrate a tendency to rock in a symmetrical state with their parents. We argue that the movement of our bodies is one of the fundamental ways by which we connect with our environment and, especially, ground ourselves in social environments. Deficiencies in perceiving and responding to the rhythms of the world may have serious consequences for the ability to become adequately embedded in a social context.

The authors tested susceptibility to contagious yawning in 120 children, 1-6 years, to identify the time course of its emergence during development. Results indicated a substantial increase in the frequency of contagious yawning at 4 years. In a second study, the authors examined contagious yawning in 28 children with autism spectrum disorders (ASD), 6-15 years. Children with ASD showed diminished susceptibility to contagious yawning compared with 2 control groups matched for mental and chronological age, respectively. In addition, children diagnosed with Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) a milder variant of autism, were more susceptible to contagious yawning than were children diagnosed with full Autistic Disorder. The authors explore the implications of these findings for theories about the development of mimicry and emotional contagion.

Recent negative focus on women's academic abilities has fueled disputes over gender disparities in the sciences. The controversy derives, in part, from women's relatively poorer performance in aptitude tests, many of which require skills of spatial reasoning. We used functional magnetic imaging to examine the neural structure underlying shifts in women's performance of a spatial reasoning task induced by positive and negative stereotypes. Three groups of participants performed a task involving imagined rotations of the self. Prior to scanning, the positive stereotype group was exposed to a false but plausible stereotype of women's superior perspective-taking abilities; the negative stereotype group was exposed to the pervasive stereotype that men outperform women on spatial tasks; and the control group received neutral information. The significantly poorer performance we found in the negative stereotype group corresponded to increased activation in brain regions associated with increased emotional load. In contrast, the significantly improved performance we found in the positive stereotype group was associated with increased activation in visual processing areas and, to a lesser degree, complex working memory processes. These findings suggest that stereotype messages affect the brain selectively, with positive messages producing relatively more efficient neural strategies than negative messages.

Objective Autism spectrum disorders (ASDs) were once considered lifelong disorders, but recent findings indicate that some children with ASDs no longer meet diagnostic criteria for any ASD and reach normal cognitive function. These children are considered to have achieved ‘optimal outcomes’ (OO). The present study aimed to retrospectively examine group differences in the intervention history of children and adolescents with OO and those with high-functioning autism (HFA) Method The current study examined intervention histories in 34 individuals with OO and 44 individuals with HFA (currently ages 8-21), who did not differ on age, sex, nonverbal IQ or family income. Intervention history was collected through detailed parent questionnaires. Results Children in the OO group had earlier parent concern, received earlier referrals to specialists, and earlier and more intensive intervention than those in the HFA group. Substantially more OO children received Applied Behavior Analysis (ABA) therapy than HFA children, although the intensity of ABA did not vary between groups. Children in the HFA group were more likely to have received medication, especially anti-psychotics and anti-depressants. There were no group differences in the percent of children receiving special diets or supplements. Conclusion These data suggest that OO individuals generally receive earlier, more intense interventions and more ABA, while HFA individuals receive more pharmacologic treatments. While the use of retrospective data is a clear limitation to the current study, the substantial differences in reported provision of early intervention, and ABA in particular, are highly suggestive and should be replicated in prospective studies.

This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support and are referred to as having achieved “optimal outcomes” (OO). Performance of 32 individuals who achieved OO, 41 high-functioning individuals with a current ASD diagnosis (HFA), and 34 typically-developing peers (TD) was compared on measures of decoding, reading comprehension, mathematical problem solving and written expression. Groups were matched on age, sex and nonverbal IQ; however, the HFA group scored significantly lower than the OO and TD groups on verbal IQ. All three groups performed in the average range on all subtests measured and no significant differences were found in performance of the OO and TD groups. The HFA group scored significantly lower on subtests of reading comprehension and mathematical problem solving than the OO group. These findings suggest that the academic abilities of individuals who achieved OO are similar to those of their TD peers, even in areas where individuals who have retained their ASD diagnoses exhibit some ongoing difficulty.

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