Prognosis

ASD is a lifelong neurodevelopmental condition with a highly variable clinical course throughout childhood and adolescence.[123] In general, people with ASD with a higher IQ and language ability in childhood tend to have fewer and less severe symptoms of ASD in adulthood, and are more likely to live independently.[320] However, in high-functioning adults with ASD, better reported quality of life is associated more with family and community support than the extent or severity of core ASD symptoms.[321] Around 9% of children diagnosed with ASD in early childhood no longer meet diagnostic criteria by early adulthood.[322]​ These people are more likely to have higher cognitive skills at age 2, and to have participated in early intervention services.[323] Some children may receive a change in diagnosis, for example from ASD to ADHD or obsessive compulsive disorder. This is more likely in children diagnosed with ASD before 30 months of age.[324]

Many adults with ASD require lifelong full-time care. About 15% of adults with ASD will live independent lives, whereas 15% to 20% will live alone with community support.[123] One meta-analysis found that, in a sample of 828 individuals with ASD, 19.7% had a good long-term outcome, 31.1% a fair outcome, and 47.7% a poor outcome, in terms of global measure of adjustment.[325] Among individuals with ASD who have complex neurologic/medical and neuropsychiatric comorbidities, there is evidence of a twofold higher mortality risk through young adulthood.[326]

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