Encyclopedia of Autism Spectrum Disorders

Living Edition
| Editors: Fred R. Volkmar

Factors Affecting Outcomes

  • Patricia Howlin
  • Sarah Savage
Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-6435-8_446-3


The outcome for individuals with autism is very variable and depends not only on the characteristics of the individual but on many family and environmental factors and external support systems. Childhood factors that are associated with later outcome include early language development, IQ, severity of autism symptoms, and access to appropriate autism-specific intervention. In adolescence and adulthood, the onset of comorbid mental health problems and the lack of adequate support and interventions are associated with poorer outcomes.

Historical Background

It has been evident since the very earliest follow-up studies of Eisenberg (1956), Rutter et al. (1967), Kanner (1973), and others that outcome in autism is highly variable. Many individuals remain highly dependent on support throughout their lives; others are able to live independently and some go on to make significant achievements. Both Asperger (1944) and Kanner (1971) were struck by the wide heterogeneity in outcome...

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References and Reading

  1. Asperger, H. (1944). “Autistic psychopathy” in childhood (U. Frith, Trans., and annotated in Autism and Asperger syndrome (1991)). In U. Frith (Ed.), Autism and asperger syndrome (1st ed., pp. 37–92). Cambridge: Cambridge University Press.Google Scholar
  2. Bal, V. H., Kim, S. H., Cheong, D., & Lord, C. (2015). Daily living skills in individuals with autism spectrum disorder from 2 to 21 years of age. Autism, 19(7), 774–784.CrossRefGoogle Scholar
  3. Bishop-Fitzpatrick, L., Hong, J., Smith, L. E., et al. (2016). Characterizing objective quality of life and normative outcomes in adults with autism spectrum disorder: An exploratory latent class analysis. Journal of Autism and Developmental Disorders, 46(8), 707–719.CrossRefGoogle Scholar
  4. Croen, L. A., Zerbo, O., Qian, Y., et al. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814–823.CrossRefGoogle Scholar
  5. Eisenberg, L. (1956). The autistic child in adolescence. The American Journal of Psychiatry, 112, 607–612.CrossRefGoogle Scholar
  6. Gillberg, I. C., Helles, A., Billstedt, E., & Gillberg, C. (2016). Boys with Asperger syndrome grow up: Psychiatric and neurodevelopmental disorders 20 years after initial diagnosis. Journal of Autism and Developmental Disorders, 46(1), 74–82.CrossRefGoogle Scholar
  7. Howlin, P., & Magiati, I. (2017). Autism spectrum disorder: Outcomes in adulthood. Current Opinion in Psychiatry, 30(2), 69–76.CrossRefGoogle Scholar
  8. Howlin, P., Moss, P., Savage, S., & Rutter, M. (2013). Social outcomes in mid to later adulthood among individuals diagnosed with autism and average non-verbal IQ as children. Journal of the American Academy of Child and Adolescent Psychiatry, 52(6), 572–581.CrossRefGoogle Scholar
  9. Howlin, P., Moss, P., Savage, S., Tempier, A., & Rutter, M. (2014). Cognitive and language skills in adults with autism: A 40 year follow-up. Journal of Child Psychology and Psychiatry, 55(1), 49–58.CrossRefGoogle Scholar
  10. Kanner, L. (1943). Autistic disturbances of affective contact. The Nervous Child, 2, 217–250.Google Scholar
  11. Kanner, L. (1971). Follow-up study of eleven autistic children originally reported in 1943. Journal of Autism and Childhood Schizophrenia, 1(2), 119–145.CrossRefGoogle Scholar
  12. Kanner, L. (1973). How far can autistic children go in matters of social adaptation? In L. Kanner (Ed.), Childhood psychosis: Initial studies and new insights (pp. 189–213). New York: V. H. Winston.Google Scholar
  13. Kirby, A. V., Baranek, G. T., & Fox, L. (2016). Longitudinal predictors of outcomes for adults with autism spectrum disorder systematic review. OTJR, 36(2), 55–64.PubMedGoogle Scholar
  14. Lever, A. G., & Geurts, H. M. (2016). Age-related differences in cognition across the adult lifespan in autism spectrum disorder. Autism Research, 9, 666–676.CrossRefGoogle Scholar
  15. Lockyer, L., & Rutter, M. (1969). A five- to fifteen-year follow-up study of infantile psychosis. III. Psychological aspects. The British Journal of Psychiatry, 115, 865–882.CrossRefGoogle Scholar
  16. Lord, C., Bishop, S., & Anderson, D. (2015). Developmental trajectories as autism phenotypes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 169(2), 198–208.CrossRefGoogle Scholar
  17. Magiati, I., Tay, X. W., & Howlin, P. (2014). Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: A systematic review of longitudinal follow-up studies in adulthood. Clinical Psychology Review, 34, 73–86.CrossRefGoogle Scholar
  18. Moss, P., Howlin, P., Savage, S., Bolton, P., & Rutter, M. (2015). Self and informant reports of mental health difficulties among adults with autism: Findings from a long-term follow-up study. Autism, 19(7), 832–841.CrossRefGoogle Scholar
  19. Roux, A. M., Shattuck, P. T., Cooper, B. P., et al. (2013). Postsecondary employment experiences among young adults with an autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 52(9), 931–939.CrossRefGoogle Scholar
  20. Russell, A. J., Murphy, C. M., Wilson, E., et al. (2016). The mental health of individuals referred for assessment of autism spectrum disorder in adulthood: A clinic report. Autism, 20(5), 623–627.CrossRefGoogle Scholar
  21. Rutter, M., Greenfield, D., & Lockyer, L. (1967). A five to fifteen year follow-up study of infantile psychosis. II. Social and behavioural outcome. The British Journal of Psychiatry, 113, 1183–1199.CrossRefGoogle Scholar
  22. Steinhausen, H. C., Mohr Jensen, C., & Lauritsen, M. B. (2016). A systematic review and meta-analysis of the long-term overall outcome of autism spectrum disorders in adolescence and adulthood. Acta Psychiatrica Scandinavica, 133(6), 445–452.CrossRefGoogle Scholar
  23. Taylor, J. L., Henninger, N. A., & Mailick, M. R. (2015). Longitudinal patterns of employment and postsecondary education for adults with autism and average-range IQ. Autism, 19(7), 785–793.CrossRefGoogle Scholar
  24. van Heijst, B. F., & Geurts, H. M. (2015). Quality of life in autism across the lifespan: A meta-analysis. Autism, 19(2), 158–167.CrossRefGoogle Scholar
  25. Woodman, A. C., Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2015). Change in autism symptoms and maladaptive behaviors in adolescence and adulthood: The role of positive family processes. Journal of Autism and Developmental Disorders, 45(1), 111–126.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, New York 2018

Authors and Affiliations

  1. 1.Institute of PsychiatryPsychology and Neuroscience King’s CollegeLondonUK