THE LONG-TERM COURSE OF AUTISTIC DISORDERS - UPDATE ON FOLLOW-UP-STUDIES

The majority of children with autism show deviance and socially or psy chiatrically handicapping conditions throughout life. Only a small pro portion of those with classical childhood autism lead independent adul t lives. Others, particularly those with 'high-functioning' autism and so-called Asperger syndrome will improve enough to live an independen t adult Life. The level of mental retardation and other comorbid condi tions (such as medical syndromes and other neuropsychiatric disorders, including epilepsy) is important in predicting outcome. An IQ below 5 0 around school age predicts severe restriction of social and adaptive functioning in adult life. The absence of communicative speech at 5-6 years of age is indicative of a poorer long-term overall outcome. The re is a clear co-variation between IQ and level of communication, but probably there is some prognostic factor in language development apart from this. Measures of flexibility and cognitive shifting abilities t end to be good predictors of social outcome in a few studies. There is a continued need for prospective, longitudinal studies of children wi th autism spectrum disorders, particularly in Asperger syndrome. The r ole of interventions of various kinds needs to be addressed in such st udies.