Optimal Outcome in Children with Autism Spectrum Disorders

Optimal Outcome in Children with Autism Spectrum Disorders
By: Marlena N. Smith, B.A.

In a recent study, Kelley, Naigles, and Fein found optimal outcome children with autism spectrum disorders (ASD) to perform at average levels on measures of adaptive functioning, problem behavior, and language and communication. There is a current debate regarding whether children with ASD can lose their diagnoses. To explore this topic, Kelley, Naigles, and Fein compared performances of optimal outcome children with ASD to performances of children with typical development and high functioning ASD.

Participants included 13 optimal outcome children. To be considered optimal outcome, the children must have been previously diagnosed with ASD. Additionally, they had to attend regular classes without an aide, receive minimal services, have average IQ scores, and have lost their ASD diagnosis as indicated by the school system. Fourteen children with high functioning ASD and 14 children with typical development also participated in the study. The participants were matched on gender, age, and non-verbal IQ.

The participants were evaluated using measures of adaptive functioning, problem behaviors, and language and communication. While the optimal outcome group’s performances did not always equal those of the typical development group, the optimal outcome group did score within the average range on all measures. In contrast, the high functioning ASD group demonstrated communication, pragmatic language, social, and behavioral deficits.

A couple distinguishing features were identified between the optimal outcome and high functioning ASD groups. The optimal outcome children were typically diagnosed with ASD earlier than the children with high functioning ASD. Moreover, the optimal outcome children were more likely to have received early intensive applied behavior analysis (ABA) treatment.

Continued efforts to explore optimal outcome in children with ASD are very important. Understanding the degree to which children with ASD can improve and the differences between optimal outcome children and other children with ASD is a step towards ensuring the greatest outcomes for all children with ASD.


Kelley, E., Naigles, L., Fein, D. (2010). An in-depth examination of optimal outcome children with a history of autism spectrum disorders. Research in Autism Spectrum Disorders, 4, 526-538.

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