Out of the corner of her eye, Matt Tremblay’s mom sometimes catches a glimpse of her son watching TV and excitedly flapping his hands, a behavioral trait associated with autism. But, that is the last characteristic he shows of the neuro-psychological condition. At 17, Matt no longer has autism even according to his psychiatrist.
The Tremblays’ story was featured in the New York Times Magazine alongside other families with kids who’ve seemed to beat the odds and recovered from autism, despite having even severe cases as children. Clinically, these kids are called ‘optimal outcomes’ or OOs and they are now the topic of several important research studies trying to determine the factors that determine who recovers enough to shed the diagnosis and who will not.
Some of those factors are likely genetic. In one study, University of Connecticut clinical psychologist Deborah Fein found that having a relatively higher IQ was associated with optimal outcomes, maybe because these children were better able to learn techniques to help them work around their symptoms.
Many of the children included in the study received loads of specialized therapy including applied behavioral analysis, an intensive technique that works to reward socializing behavior and eliminate unwanted behavior like flapping. But, some children that showed optimal outcomes didn’t use applied behavioral analysis at all.
The fact that some children, somewhere around 3 to 25 percent, can recover from autism to the point of having their diagnosis ’dropped’ while others never improve or adapt, may be further evidence that the disorder is actually multiple conditions:
Scientists suspect that what is called autism may actually be an array of distinct conditions that have different genetic and environmental etiologies but happen to produce similar symptoms. If true, it could help explain why some children progress so much while others don’t.
Hunting down the genes that cause autism, or more accurately, predict who might develop the condition is difficult and complicated work that includes almost 300 genes. Interactions with the environment may also play a significant role, at least for some kids and in some cases. As genetic analysis becomes more sophisticated, some researches hope the information will help tailor treatments to people with different variants of the disease.
But, the same researchers identifying these optimal outcome kids caution parents against developing false hope:
I see a lot of parents of 2-year-olds,” autism expert Catherine Lord says, who have heard stories about kids growing out of autism, and they tell us, ‘I want my kid to be one of those kids…’ When you get too focused on ‘getting to perfect,’ you can really hurt your child. A typical kid fights back against that kind of pressure, but a kid with autism might not. It’s fine to hope — it’s good to hope — but don’t concentrate so much on that hope that you don’t see the child in front of you.