Course of infantile-onset autism in adulthood: a survey of longitudinal follow-up-data

The symptoms of infantile autism were first described almost 60 years ago. In contrast to its course in puberty and adolescence, follow-up-data on the late course in adulthood are decidedly sparse. As the outcome of research in the literature, we found 21 methodologically heterogeneous follow-up-stu dies, The arithmetic mean age of all subjects investigated was 24.0 years. The results are supplemented by various case reports and sporadic biographi cal reports by affected persons. On the basis of the available data, the di scontinuous and dynamic changes of course verified in puberty and adolescen ce are not applicable to the third and fourth decades to the same extent. G ains in competence and autonomy appear to develop in the vocational rather than in the domestic sphere. The significantly more favorable courses of th e form described by Asperger are continued in adulthood, The disorder-assoc iated lack of empathy and social interaction is by no means experienced in terms of self-satisfaction by those concerned but rather as a loss. Interpe rsonal sexual needs are expressed by a substantial proportion of autistic a dults. The cumulative mortality rates of the follow-up-studies suggest that the mortality rate among autistic patients is higher than among their non- autistic peers.