Mapping the futures of autistic kids | Spectrum
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L.How autism mutations are known to affect the incidence of other mental illnesses related to autism, but a growing body of data links an autism diagnosis to mental health outcomes. Mr and her colleagues have spent years tracking depression, anxiety, and attention-deficit hyperactivity disorder (ADHD) characteristics in children and young adults with autism. They are designed to alert families to signs of problems so that the children can be treated before more serious problems arise.
In a study published in 2020, Lord and her team identified 194 autistic people who had participated in the same longitudinal study that assessed daily living skills. This study also looked at the mental health of participants aged around 2 to 26 years old, although some participants entered the study as young as 12 or 13 years old. Lord and her colleagues found that ADHD, Anxiety, and Depression develop in different but predictable ways in people with autism. The 40 percent of participants who showed significant ADHD characteristics by age 9 had milder ADHD in adulthood, suggesting that those characteristics are likely to wear off in those who have them (although some difficulties may persist). However, the fear was rather persistent: around 74 percent of the participants had a low level of fear from the age of nine to adulthood, the rest, however, were more fearful in childhood and remained so. Significant symptoms of depression, occurring in about 32 percent of participants, tended to subside and reappear during childhood before increasing by the ages of 14 to 20.
Other researchers have found ways to flag those who are most likely to have persistent anxiety. University of Toronto Psychiatrist Danielle Baribeau Had long noticed that autistic children who were unusually tenacious on routines were prone to full-blown clinical anxiety as they got older. For example, Baribeau and her colleagues tested 421 autistic children once a year for eight years for signs of anxiety, beginning at the age of three. They measured children’s insistence on routines three times over the same period. In July 2020, the researchers reported that 95 percent of young children with high “insistence on equality” was very scared through elementary school. “If you have a kid who is really rigid and ‘sticky’, especially if they’re 3 or 4 years old, keep that kid on your radar,” says Baribeau.
But good adaptability by the age of 9 seemed to protect children from serious anxiety or other mental health problems as young adults, Lord found. Feeling able at a young age, Lord says, is a cornerstone of future mental health. “Parents of older children and adults say, ‘I just want my child to be happy,'” says Lord. However, being happy often goes hand in hand with a sense of responsibility and independence.
On the other hand, cChildren with stronger social and cognitive skills can be more prone to certain types of mental health problems, says Stobbe. In his experience, they are often the ones who suffer most from anxiety, depression, and related illnesses, perhaps because they are very aware when others are marginalizing them or perceiving them as different. “A child who is really doing well,” says Stobbe, “[is] at higher risk of, say, bullying or developing concurrent mental health [condition] like depression. ” In a 2010 study of 50 autistic children ages 9-16 who “high” on a global function test, 74 percent had one concurrent psychiatric illness such as depression, anxiety, or behavioral disorders.
However, many uncertainties hold back all of these predictions. McCafferty’s younger son Zach – who also has autism – is a jerk. Zach barely spoke after a severe regression in toddler age and went to a special preschool. But he flourished in elementary school, moved to the regular class and went to middle school honor Society. Now, a middle school graduate, he spends hours replying to volleys of text messages from friends. Zach‘s story, says McCafferty, underscores the limits of a child’s prediction‘s way. “Nobody can say what they are‘we’ll be in a year, let alone 10. “
“If you have a kid who is really rigid and ‘sticky’ … keep that kid on your radar.” Danielle Baribeau
Much of the uncertainty comes from what families do can make a real difference, Lord says. Tailored therapy can help children weather dire prognoses. “Based on the child’s profile, clinicians might suggest, ‘This child needs more structured table-top therapy to improve certain skills.” If the child speaks very well, a more naturalistic, peer-to-peer intervention might be better, ”says Kim. Zach’s therapists recommended “floor time,” when his parents would come with him on the carpet and strengthen his social skills through activities such as sensory play with shaving cream.
Aside from the uncertainty about evolution, there is one conceptual reason why it is difficult to draw a trajectory: measurement. How should progress be measured? Standard measures include assessments of IQ tests and assessments of behavioral and social skills. But people think of success differently. Some define it as independence in adulthood or as the weakening of signs of autism. Others set specific academic or social goals, such as: B. a college education or maintaining close, supportive relationships. “It Really could do puzzles. It could be play chess. It could be playing a video game“Says mr. “It could cook, make sushi.” Finding the ideal course for each child can mean figuring out which course the child would like to follow rather than what their family envisions.
It is important that all of this uncertainty is part of the clinical picture, say experts and families. Gloomy predictions that sound like they are set in stone can undermine families’ motivation to seek the best support. “Especially in the first few years,” says McCafferty, “[you need to] be able to channel all of your energy and use all of your internal resources, attacking everything from sleeping to eating, potty training, driving a car and being in public. You need your energy. For that you need your hope. “
There is almost always hope, even for children who need a lot of support. At 18, Justin still has severe autism, speaks few words, and will likely not be able to live alone. But Justin exceeded expectations in important ways. He can communicate by entering words and symbols on his iPad to say, for example, who he would like to see or what he would like to eat. He also reads first grade and knows how to do a Google search to find out more about topics that pique his interest, such as the Wildwood Boardwalk in New Jersey, which he visited as a young kid. He’s more comfortable going out in public today than he was years ago, and he can navigate large crowds in amusement parks with ease. For the McCaffertys, Justin’s progress shows that no matter how good the science is, no one’s life course is or should be perfectly predictable.
Quote this article: https://doi.org/10.53053/UKPX6543
