Do autistic symptoms persist across time? Evidence of substantial change in symptomatology over a 3-year period in cognitively able children with autism.
One in five bright preschoolers with autism can move off the spectrum in three years if intervention starts early.
01Research in Context
What this study did
McDonald (2012) tracked 147 cognitively able children with autism for three years. She used the Social Communication Questionnaire each year to measure core symptoms.
Kids were ages 3–5 at the start. All had IQ scores in the average range.
What they found
Total autism scores dropped steadily. One in five children no longer met autism criteria at year three.
Children who started intervention earlier showed the biggest gains.
How this fits with other research
Skinner et al. (2021) looked at the same population 20 years later and saw the opposite: 99% still needed daily support. The gap comes from IQ range and era. The 2021 group included more severe cases and grew up before early-intervention programs were common.
Harstad et al. (2026) extends the story. Among kids who lost the diagnosis, 37% still needed help for ADHD, language disorder, or learning issues in early elementary school. Symptom remission does not always mean problem-free.
Pine et al. (2006) built the SCQ tool used here. Their work lets us trust the score changes we see.
Why it matters
Early, intense intervention can move some cognitively able children off the autism spectrum within three years. Yet even these “optimal-outcome” kids may need support for attention or language later. Keep monitoring adaptive skills and plan for services beyond autism labels.
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02At a glance
03Original abstract
This study investigated the extent and nature of changes in symptomatology in cognitively able children with autism over a 3-year period. Thirty-seven children diagnosed with an autism spectrum condition involved in an earlier study (M age = 5 years, 7 months) were followed and reassessed 3 years later (M age = 8 years, 4 months). Scores on the Social Communication Questionnaire (SCQ; M. Rutter, A. Bailey, & C. Lord, 2003 ) decreased significantly over time in all symptom domains but especially in the social domain, and correlational findings suggested the presence of 2 distinct developmental trajectories-social communication and repetitive behaviors-that interact across time. Furthermore, 7 children (19% of sample) made substantial changes to the extent that they failed to meet criteria on diagnostic instruments (the Autism Diagnostic Observation Schedule-Generic [ADOS-G; C. Lord, M. Rutter, P. C. DiLavore, & S. Risi, 1999 ] and the SCQ) 3 years later. Children showing diagnostic discontinuity were distinguishable from those who fulfilled ADOS-G criteria only in terms of the age at which they began receiving intervention. The presence of a significant proportion of children showing considerable progress over the 3-year period challenges assumptions of diagnostic continuity and highlights the potential long-term benefits of early intervention.
American journal on intellectual and developmental disabilities, 2012 · doi:10.1352/1944-7558-117.2.156