Understanding Optimal Progress from an Autism Spectrum Disorder: Cognitive, Language, Adaptive and Social Functioning

ASDs are generally considered lifelong disorders; however, emerging literature indicates that a subset of children with a documented ASD lose their symptoms and function in the average range of cognition and behavior. Several studies have provided in-depth descriptions of school-aged children who have demonstrated an “Optimal Outcome” from an early ASD diagnosis. The current study aims to extend this work to an earlier developmental time point, and to understand the clinical significance of this type of outcome during the preschool years. The current study comprehensively describes and compares children who demonstrate an Optimal Outcome by age four years (termed “Optimal Progress,” OP), to age and gender-matched peers with High Functioning Autism (HFA) and Typical Development (TD) in three critical domains (cognitive, adaptive, ASD symptomatology). Results indicate that by age four, the OP group is functioning comparably to TD peers cognitively and adaptively, except for parent-reported daily living skills, which are in the moderately low range. ASD symptoms are largely absent; however, children in the OP group are rated as having more pronounced motor atypicalities than TD peers, and more atypical social communication, which may be driven by differences in listening behaviors. We expect that these children will continue to display strong skills and abilities across domains, and will, over time, become increasingly indistinguishable from their typically developing peers. Future research should seek to continue to expand our understanding of the numerous developmental trajectories possible for children diagnosed with an ASD, with the goal of increasing the likelihood of highly positive outcomes.