A follow-up study of 201 children with autism in Kyushu and Yamaguchi areas, Japan.

Demello et al. (1992) tracked 201 Japanese children with autism for many years. They wanted to see how social skills changed from childhood to adulthood.

The team used medical records and parent reports to rate adult outcome. They compared results to older Japanese data collected before 1992.

About 4 in 10 teens got better, but 3 in 10 got worse during adolescence.

As adults, more people lived semi-independently than in earlier Japanese reports. Still, most needed some daily support.

Wehman et al. (1989) saw mostly poor adult jobs and friendships in 16 high-IQ autistic people. R’s larger group shows milder outcomes, suggesting earlier Japanese samples were extra severe.

Billstedt et al. (2011) asked autistic adults themselves and found many felt happy despite needing help. R et al. only used doctor ratings, so they may have missed this self-reported well-being.

Gandhi et al. (2022) found over half of Australian autistic adults had poor community inclusion. R’s Japanese cohort looked slightly better, but both studies agree most adults stay dependent on family or services.

Latham et al. (2014) showed 1 in 5 kids diagnosed before age three lost the autism label by school age. This early instability helps explain why R saw such mixed paths during the teen years.

Expect big swings in social skills during adolescence. Plan extra review meetings at ages 12-16. Use both self-ratings and parent reports when you gauge progress, because feelings and observed skills can differ. Target adaptive living goals early; even “good” adult outcomes in Japan still needed day-to-day support.