Asperger syndrome natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Prognosis

  • There is some evidence that as many as 20% of children with AS "grow out" of it, and fail to meet the diagnostic criteria as adults.

As of 2006, no studies addressing the long-term outcome of individuals with Asperger syndrome are available and there are no systematic long-term follow-up studies of children with AS. Individuals with AS appear to have normal life expectancy but have an increased prevalence of comorbid psychiatric conditions such as depression and anxiety that may significantly affect prognosis. Although social impairment is lifelong, outcome is generally more positive than with individuals with lower functioning autism spectrum disorders; for example, ASD symptoms are more likely to diminish with time in children with AS or HFA.[1] Although most students with AS/HFA have average mathematical ability and test slightly worse in mathematics than in general intelligence, some are gifted in mathematics[2] and AS has not prevented some adults from major accomplishments such as winning the Nobel Prize.[3]

  • Children with AS may require special education services because of their social and behavioral difficulties although many attend regular education classes. Adolescents with AS may exhibit ongoing difficulty with self-care, organization and disturbances in social and romantic relationships; despite high cognitive potential, most remain at home, although some do marry and work independently. The "different-ness" adolescents experience can be traumatic.[4] Anxiety may stem from preoccupation over possible violations of routines and rituals, from being placed in a situation without a clear schedule or expectations, or from concern with failing in social encounters; the resulting stress may manifest as inattention, withdrawal, reliance on obsessions, hyperactivity, or aggressive or oppositional behavior. Depression is often the result of chronic frustration from repeated failure to engage others socially, and mood disorders requiring treatment may develop.
  • Education of families is critical in developing strategies for understanding strengths and weaknesses;helping the family to cope improves outcome in children. Prognosis may be improved by diagnosis at a younger age that allows for early interventions, while interventions in adulthood are valuable but less beneficial. There are legal implications for individuals with AS as they run the risk of exploitation by others and may be unable to comprehend the societal implications of their actions.

References

  1. Coplan J, Jawad AF (2005). "Modeling clinical outcome of children with autistic spectrum disorders". Pediatrics. 116 (1): 117–22. doi:10.1542/peds.2004-1118. PMID 15995041. Lay summarypress release (2005-07-05).
  2. Chiang HM, Lin YH (2007). "Mathematical ability of students with Asperger syndrome and high-functioning autism". Autism. 11 (6): 547–56. doi:10.1177/1362361307083259. PMID 17947290.
  3. Herera S (2005-02-25). "Mild autism has 'selective advantages'". CNBC. Retrieved 2007-11-14.
  4. Moran M (2006). "Asperger's may be answer to diagnostic mysteries". Psychiatr News. 41 (19): 21.




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