Can autistic traits disappear?

[bookblock]

Can this happen? Our DS (2) has been diagnosed with global development delay and has been showing some red flag signs of autism. On the otherhand, he does things that would indicate he might not have autism. I was wondering (remaining hopeful) that these traits could possible diminish as his development improves. Can GDD cause symptoms that could be mistaken for autism? Thanks in advance.

[WetAugust]

Difficult questions.

Aspergers is a pervasive developmental delay disorder - not sure what the difference is between 'global' and 'pervasive'.

Traits fade rather than disappear as the child learns strategies to overcome then and also due to the general learning process as the child ages.

With Aspergers it's sometimes said that the child functions at approximately 2/3 of their chronological age.

The 'fading' means that the child may not seem as wildly autistic in adulthood as they appear in childhood.

It all depends on which end og the spectrum they lie on and how well the learn to overcome their difficulties.

[siblingrivalry]

Exactly what WetAugust said.
DD has Aspergers and to an outsider, it may seem that some of her traits have 'disappeared' over the years. However, they are still lurking-it's just that she's learned strategies and techniques to deal with them.

If she's under a lot of stress, or excessively anxious, we see these traits reappearing.

[StarlightMcEggsie]

The autism can't disappear, but the child can learn strategies to enable themselves to progress and access the social world.

What you have to remember though is that whilst they can learn the skill, and sometimes become very adept, it takes a lot more energy and concentration as they are applying complex forumula and rules to situations we just intuitively read.

To an outsider the 'presentation' might be similar to a child/adult without autism, but inside them things can be working VERY differently.

[StarlightMcEggsie]

There is also a small amount of research that suggests if a child/adult practises a skill enough it CAN become closer and closer to 'intuitive' though, as the neural pathways for that skill are strengthened.

This is 'one' of the arguments for early intervention in the younger years as the brain is still developing very fast and it's course 'may' be altered depending on the experiences of the child.

This isn't as daft as it sounds as there is plenty of research in the animal world that shows that certain genes and skills can be switched on or off depending on the very early environment, in order to have the best chance of survival.

One of the simplest examples is Piaget's snails, and the person that cruelly kept kittens in stripey boxes for a few weeks post birth.

[troutpout]

Ive always reckoned that ( 15 aspergers/ hfa ) functions about 3 years behind his peers ... Didn't know it was widely accepted though.

He has gone through periods where traits have really diminished. They reapprear in times of stress... Or sometimes when he is concentrating on something else. It's like he takes his eye off the ball....so that idea that he has just learned to cope better fits

[runninggal]

Thats interesting about children with AS functioning at 2/3 of their age. I assume that this means in the areas which are impacted by their ASD, rather than their overall development? Some children that I know are really ahead at school but their social and communication skills are probably at about 2/3 of their peers. DS on the other hand who is currently being assessed struggles at school because of his organisational/language processing/attention issues and has sensory issues. He is 10 but I would find it impossible to say what his overall assessed age could be given that he has such a spiky profile and it wouldnt seem sensible to calculate it

[troutpout]

Yes ds is Ok in most subjects at school ( with lots of help with organisation ).. except English Where the idea of discussing authors intent or how a character may be ' feeling' just passes him by.
No I meant socially... 3 years behind at least.
And emotional maturity or even a sense Of ownership of his Own emotions... ? Well I couldn't even guess it.

[EllenJaneisnotmyname]

I think that's the difference between GDD and ASD, with ASD there are (quite) a few areas that are affected, but the profile can be spiky, with some areas developing normally, maybe some physical milestones, some academic ones that don't involve too much empathy, imagination etc.

With GDD there are at least 2 if not more areas that are developing more slowly than average so a child may not have the spikiness of profile and may be delayed across all areas affected. It's complex, though, as GDD doesn't necessarily mean all things are delayed, just more than one. That's my understanding, anyway.

It could be that the 'autistic traits' are just because your DS hasn't reached the developmental stage that all DC go through that looks autistic, but it could also mean that he will continue to be delayed in those areas, social communication, interaction, imagination etc. A delay is just that though, it's not a complete stop, he should still be developing, just at a different rate to a NT child.

[AlderTree]

Autistic Traits can appear to diminsish as others have said. The danger is that some may then disbelieve the diagnosis is correct because the child appears to be coping and responding in a normal way. Under the surface the difference is still there and again, as said above will reappear at times of stress or new development. We have problems with extreme weather too - if it is too hot, too cold, snowing, really really rainy. The lack of control over the environment or the bodies response to it causes us lots of problems with DS. I expect puberty has a similar effect and any new situations we encounter.

[WetAugust]

Even at 23, DS has times when he simply can't cope. This afternoon was one of them. He's knackered from unreleneting insomnia and desperately trying to finish an essay.
Under this stress, he's become snappy, almost impossible to talk to as he's taking things very literally again, and just looks defeated.
It's easy to forget that they are effectively 'acting' their way through every day as NT behaviour just doesn't come naturally.

[Miggsie]

I think Francesca Happe has the latest thinking on Autism, I'd recommend any of her papers but the most accessible is her Royal Society Lecture
In her latest book she has a graph showing the developmental delay of ASD children and they do progress more slowly that their peers, often about 3-4 years behind emotionally and socially and that they achieve lower social and emotional competence. She also says she has seen ASD children improve on this projected development but only with dedicated skilled intervention over several years (ABA being the main one).

[Davros]

The "spiky profile" in ability/behaviour/skills is the reason (I was told many years ago) for having autism-specific educational settings and sometimes leisure activities. This typical profile and variable ability to learn and generalise skills is (apparently) different to other disabilities.

[EllenJaneisnotmyname]

Davros, that's interesting. The problem I can see is that the spiky profiles can be as individual as the child him/herself. My DS2 is very different to his 'friend' who has a very similar DX, but their 'symptoms' for want of a better word, are almost diametrically opposed. I suppose there may be more similarities with each other than with a child with CP or Down Syndrome, though. Hmmm.

[AlderTree]

Davros that is interesting. Where would anyone find written expert evidence of that? I'm likely to be fighting LEA and school on provision for his education in the near future and if that was available to use it might help.

Miggsie I haven't heard of Francesca Happe. What is her book called?

Sorry to hijack but anyone reading this for the same reasons I am might also like to know.

[AgnesDiPesto]

If its not autism but GDD or speech issue and that resolves then yes.
I met someone who worked at a specialist school and she said often they got children in with autistic traits and speech issues and when the speech improved the autistic traits reduced and sometimes it took several months to work out which were the children with pure speech issues but no autism and which had both as initially they presented very similarly.
So sometimes other issues can mimic autism, but not be autism.
But if the correct dx is autism then I agree you can learn to cope better but you will always be autistic.

[Davros]

I think the NAS has some info on autism specific education. I believe it is the variety/spikeiness in learning that suggests separation, i.e. if you are autistic your "level" of ability is likely to be very varied whereas someone with another disability would be more even. Whether that is true I don't know, maybe it is unfair to those with other disabilities or is an indication that many more have some ASD than otherwise thought. I was told this years ago by a friend who is a parent of a child with ASD and is a GP but I don't know where she got her info but it made sense to me as I could not understand it before that. HTH

[Lotstoshare]

PDD used to be the next step up from ADD or ADHD. Now however it is under the autistic continuum. An ASD. It is possibly a lesser disorder than is Aspergers. One of my sons was diagnosed with PDD or Pervasive Developmental Disorder. Later with Aspergers. Developmental Delay (or GDD in some cases) is something completely different. My sons have different fathers. My second son has DD which is now probably going to be Dyspraxia. All of the above mentioned disorders can share features. This is why diagnosing can be difficult. Some children grow out of their problems but if they don't, a label means that you can access services. Don't be too much in denial that you miss out on whats out there to help.

[bochead]

I had a lovely convo with the SALT from my son's diagnostic team where we agreed the following in plain english rather than horrible professional jargon.

1. DS will always be neurologically different - doesn't mean he's daft.
   
2. His very spikey profile means that as he gets older he's beginning to learn how to harness his strengths to scaffold his weaknesses (eg his amazing memory for detail is being used to remember how to react socially).
   
3. A delay is NOT a halt!!!!!! Does it really matter in the overall scheme of things if he masters a particular life skill at 10 or 15 instead of the usual 5 or 6? Noone who meets him for the first time at age 25 will care.
   

I saw my parents get a really devastating diagnosis for my sibling. I also saw her gradually defy all expectations over the years till by 30 unless you knew her history, you'd have NO idea of just how bloody hard her childhood was. The key lesson I took away is that there isn't a magic bullet, just a LOT of hard work, and plodding and patience, but that there is no way you can tell how any 2 year old will eventually turn out.

I've also begun to realise on the SN journey with my own son, that the initial diagnosis seems to bear far less relation to eventual outcome than the parental ability to fight and access resources for the child concerned, at every single step of the the way. I won't lie and say this doesn't upset me, as at times the energy to continue hassling this prof or that one in order to access the right help simply exhausts me. The whole NHS postcode lottery doesn't help either.

[ilikemysleep]

Bit of clarifying!
PDD-NOS (pervasive developmental disorder not otherwise specified) is used where a child meets criteria in 2 of the three areas of the triad to a level which is affecting their everyday functioing, but doesn't quite reach threshold on the third part of the triad (triad being social interaction, communication and flexible thinking). It doesn't get used very often because no-one knows what it means!

Children with global delay (and specific language difficulties) can indeed present as 'autistic' early on, and this can disappear as they get older (and there is a correlation of learning difficulties and autism as well). This is the primary reason why people are often reluctant to label children below the age of 3 . That is because there are no autistic behaviours per se. For example repetitive questioning might be a sign of autistic anxiety, or might be a sign of a memory problem. Eating a restricted diet might be because of sensory difficulties as part of autism, or might be sensory difficulties as part of verbal dyspraxia, for example. A child having lots of tantrums is showing problems with flexible thinking that might be caused by being autistic, or might be caused by being 2 years old in a confusing world.

The 'driver' in autism is - has to be - a social difficulty. It doesn't matter if DS is lining up his cars if he is also perfectly affectionate, sociable, gives good eye contact etc...the 'red flag' behaviour - lining up cars - is only one piece in a jigsaw and if the other bits of the jigsaw say 'socially appropriate FOR DEVELOPMENTAL LEVEL' then that red flag does not a diagnosis make on its own :)

Hope that makes sense!

[ilikemysleep]

Would like to add - spiky profiles are very common, almost everyone has some level of spikiness. I don't think there is an 'autistic profile' cognitively (and it's my job, so I hope I would know!) - however , where a profile is VERY spiky this will impact on a child's educational needs - but it wouldn't necessarily make them autistic.

It's true to say that children with general learning diffiuclties will score lower across the board cognitively, but they can still have spikes within that.

Francesca Happe is fabulous (especially as her understanding of autism tallies very closely with my own!) do read her stuff if you are interested in fidning out more about autism.