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Leo Kanner, who first described autism in 1943, later found that outcomes varied from severely incapacitated to college graduation and gainful employment (J Autism Child Schizophr 1971; 1:119). Two recent studies, using 21st-century methods, expand upon phenotypic and genetic aspects of the widely recognized variable course of autism spectrum disorder (ASD).
Szatmari and colleagues repeatedly assessed symptom severity and adaptive functioning in 421 comprehensively diagnosed ASD children (335 boys), starting at ages 2 to 4 years. By age 6, severity lessened in only 11% of the children; the remainder stayed the same or worsened; and adaptive functioning improved in 21%. Later diagnosis, counterintuitively, predicted worse course, as did male …