Some children outgrow autism, researchers say, but losing the diagnosis doesn’t mean these kids are free of challenges.

Though autism has traditionally been considered a lifelong condition, evidence in recent years suggests that there are children who “recover.” Now, a new study is offering the largest look yet at what happens to kids who no longer qualify for a label on the spectrum.

Researchers looked at clinical records for 569 children diagnosed with autism between 2003 and 2013 when they were 2½ years old, on average. Four years later, they found that 38 of the kids no longer met the diagnostic criteria for autism. Nonetheless, all but three of the children who lost their autism label had other diagnoses and still needed a level of therapy and supports.

“It’s certainly encouraging to confirm that a subset of children with early ASD diagnosis accompanied by developmental delays can in essence recover from the disorder and go on to have typical social and cognitive functioning,” said Dr. Lisa Shulman of the Albert Einstein College of Medicine who led the study published recently in the Journal of Child Neurology. “But by and large, these children continue to struggle with daily life. Almost all of them still have to contend with language and learning disabilities and a variety of emotional and behavioral problems.”

The children whose records were reviewed for the study were all diagnosed at an early intervention program for those with developmental disabilities in the Bronx, N.Y. Researchers said that the vast majority of the kids participated in some type of services like applied behavior analysis or speech or occupational therapy.

Of those who outgrew the autism label, 68 percent had language or learning disabilities, the study found. Meanwhile, 49 percent had attention deficit hyperactivity disorder or similar behavioral issues, about a quarter had a mood, anxiety or obsessive compulsive disorder or selective mutism and a small percentage had a psychotic disorder.

Shulman said the findings prompt several questions.

“Was autism initially over-diagnosed? Are some children better able to respond to intervention? Does the specific intervention the child receives contribute to outcome? Our sense is that some children with ASD respond to intervention while others have unique developmental trajectories that lead to improvement,” she said, noting that the kids who lost their autism diagnosis generally had the least severe symptoms at the outset.

“The message from our study is that some of our kids do amazingly well, but most of them have persistent difficulties requiring ongoing monitoring and therapeutic support,” Shulman said.

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