Child and Adolescent Psychiatric Clinics of North America
Outcome research in Asperger syndrome and autism
Section snippets
Methodologic issues
It is instructive first to consider the methodologic issues that affect any interpretation of the results from this literature. The number of studies is limited and sample sizes are often small; in addition, the subject population is heterogeneous and outcome measures are variable [2]. There are differences in the way subjects are selected (eg, clinic-referred samples who were identified retrospectively versus those who presented at enrollment, and clinic- versus population-based samples).
Outcome in autism
Reports on the long-term outcome of autism emerged as early as the 1950s and 1960s, and were marked by many of the methodologic vulnerabilities described earlier [6]. Two particular findings documented in early studies [7], [8], [9], [10], [11], however, have proved to be fundamental and enduring: (1) Most individuals with autism remain autistic as adolescents or adults; diagnosis is generally stable, whereas outcome is more varied. A poor or very poor outcome is observed in three quarters of
Outcome in Asperger syndrome
Asperger depicted a positive outcome in his initial accounts of his patients, particularly for those who were able to use their special talents or interests to gain employment and integrate socially [21]. In the years to follow, Asperger saw as many as 200 patients with the syndrome and his views were more tempered. The clinical picture was described to be stable, although improvements in functioning occurred through maturational processes. Asperger believed that individuals with this syndrome
Implications for intervention
Individuals with AS show several assets, including good cognitive ability, well developed language skills, and areas of special interest through which they may forge friendships and find satisfying jobs. The indication from descriptive reports, clinical experience, and outcome research, however, is that persons with AS may be less impaired than those with HFA, but still endure a severe developmental disability. A minority of individuals achieves some independence in self-care and gainful
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