Can Children with Autism Recover? If So, How?

Abstract

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.

Toward Effective and Preferred Programming: A Case for the Objective Measurement of Social Validity with Recipients of Behavior-Change Programs

“…We are confident that EIBI based on the principles and procedures of behavior analysis works. We still have a lot of refining to do with regard to the most efficacious aspects of EIBI, and we still have not identified all of the moderators of the effects of EIBI (Herbert, Sharp, & Gaudiano, 2002;Rogers & Vismara, 2008;Smith et al, 2006), but the intervention improves the developmental trajectories of those who receive it (Campbell, 2003;Cohen, Amerine-Dickens, & Smith, 2006;Eldevik, Eikeseth, Jahr, & Smith, 2006;Helt et al, 2008;Howard, Sparkman, Cohen, Green, & Stanislaw, 2005;Lovaas, 1987;Morris, 2009, National Institute of Mental Health, 2007Odom et al, 2003;Smith, Groen, & Wynn, 2000). We know much less, however, about the acceptability of various components of EIBI to the children experiencing them (e.g., most-to-least or least-to-most prompting, amount and pace of prompting, amount of teacher directedness during instruction, types of error correction procedures, highly structured versus more naturalistic instructional conditions, types of motivational systems).…”

A case study in the misrepresentation of applied behavior analysis in autism: The gernsbacher lectures

“…I also set aside the literatures on treatment effects on brain structure (G. Dawson, 2008;T. Thompson, 2007b), autism recovery and its mechanisms (Helt et al, 2008), and ABA-EIBI's long-term costs and benefits (Chasson, Harris, & Neely, 2007;J. W. Jacobson & Mulick, 2000).…”

“…For post-1999 reviews of the literature, see Campbell (2003), Eikeseth (2009), Goldstein (2002, Helt et al (2008), Horner, Carr, Strain, Todd, andReed (2002), McConnell (2002), Odom et al (2003), Odom and Strain (2002), Reichow and Wolery (in press), S. J. Rogers andVismara (2008), andSchreibman (2000).…”

“…In autism, most outcomes are gravely suboptimal (Johnson, Myers, & the Council on Children with Disabilities, American Academy of Pediatrics, 2007; T. Smith, 1999;Volkmar, Lord, Bailey, Schultz, & Klin, 2004), and the need for treatment is obvious (Green, 1996;Myers, Johnson, & the Council on Children with Disabilities, American Academy of Pediatrics, 2007). In fact, if left untreated, few children with autism spontaneously recover (Helt et al, 2008). Most of them require intensive services and, as adults, institutionalization, both of which are ultimately more expensive than ABA-EIBI (Bilstedt, Gillberg, & Gillberg, 2005;Howlin, 2005;Howlin, Goode, Hutton, & Rutter, 2004).…”

Does Fever Relieve Autistic Behavior by Improving Brain Blood Flow?

“…Helt and coworkers (Helt et al 2008) reported that significant fevers have improved autistic behavior, citing the sole controlled study (Curran et al 2007). This study was prompted by anecdotal reports (Sullivan 1980;Cotterill 1985;Brown 1999) of dramatic improvements in social interaction and speech-core deficits of autismduring fever.…”