Developmental and Psychiatric Conditions Among 5-7 Year Old Children with Non-persistent and Persistent Autism.
Nearly three in ten children who lose their toddler autism diagnosis still need services for ADHD, speech disorder, or ID by early elementary years.
01Research in Context
What this study did
The team looked at 5- to 7-year-olds who once had an autism diagnosis.
They asked: who still meets criteria and who no longer does?
Then they counted extra conditions like ADHD, speech disorder, or ID in each group.
What they found
About six in ten kids kept the ASD label.
The rest lost it, but nearly three of those ten still needed help for ADHD, ID, or speech issues.
Children who kept the autism label were almost six times more likely to have extra diagnoses.
How this fits with other research
McDonald (2012) first showed one in five cognitively able kids can move off the spectrum after three years. The new study follows those children longer and maps what problems stay.
Chuang et al. (2025) studied the same age band but counted heart, hormone, and stroke risks instead of developmental ones. Together the papers show the body and the brain both need checks after early ASD diagnosis.
Goldstein et al. (2004) saw ADHD in half of their small PDD sample. The 2026 numbers now prove the link is strongest in children whose autism traits persist, not in those who lose the label.
Why it matters
If a child leaves the autism spectrum, do not close the file. Screen for ADHD, speech, and ID at school entry and write the needed referrals. For kids who keep the diagnosis, expect more co-occurring needs and plan extra assessments from the start.
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02At a glance
03Original abstract
To describe the types and frequency of developmental and psychiatric conditions (DPCs) in early school-age children who were diagnosed with ASD as toddlers and to compare rates of DPCs in children whose ASD persists ("persistent ASD") versus those in whom it does not ("non-persistent ASD"). Children with a clinical ASD diagnosis at 12-36 months old underwent a research assessment at 5-7 years old. Research assessments included measures of ASD symptoms and cognitive and adaptive functioning. A research psychologist assigned an ASD diagnosis (yes or no) based on the child's current functioning. Information about DPCs was obtained from parent and/or research psychologist report. Intellectual disability was defined as cognitive standard score < 70. Of the 213 children diagnosed with ASD at initial clinical assessment, at the research assessment 134 (62.6%) had persistent ASD and 79 (37%) had non-persistent ASD. Overall, the most common DPCs were ADHD (n = 58; 27.2%); speech disorder (n = 46; 21.6%); and intellectual disability (n = 46; 21.6%). Of children with non-persistent ASD, 29.1% had ≥ 1 DPC, and 19% had ADHD. Children with persistent ASD were over 5 times more likely (OR = 5.72) to have an additional DPC, compared to those with non-persistent ASD. Children with non-persistent ASD may manifest several different DPCs, with an increased rate of ADHD compared to population norms. Children with persistent ASD have higher rates of DPCs than those with non-persistent ASD. Follow-up care for children diagnosed with ASD at a young age should include assessment for other DPCs.
Journal of autism and developmental disorders, 2026 · doi:10.1542/PEDS.2019-0811