Asperger’s syndrome is an autism spectrum disorder characterized by difficulties in social interaction and communication, as well as restricted interests and repetitive behaviors. Unlike other autism spectrum disorders, people with Asperger’s usually have average or above average intelligence. Asperger’s is typically diagnosed in childhood and was previously considered a lifelong condition. However, some research has suggested that a subset of individuals may “grow out of” or overcome some of the core symptoms of Asperger’s over time. In this article, we will explore the evidence around the idea of “growing out” of Asperger’s syndrome.
What is Asperger’s Syndrome?
Asperger’s syndrome is named after Austrian pediatrician Hans Asperger, who first described a group of children with difficulties in social interaction, restrictive interests, and repetitive behaviors in the 1940s. It is considered an autism spectrum disorder, along with autism, pervasive developmental disorder not otherwise specified (PDD-NOS), and childhood disintegrative disorder. Key features of Asperger’s syndrome include:
- Difficulties with social interaction, such as trouble understanding social cues, lack of eye contact, and challenges forming friendships
- Restricted interests or repetitive behaviors, such as intense preoccupation with a topic, strict adherence to routines, or repetitive motor mannerisms
- Speech and language peculiarities, like formal or pedantic speech
- Difficulty with nonverbal communication, including facial expressions, body language, and gestures
- Clumsiness or awkward motor skills
- Above average intelligence, often with intense focus on specific topics
- Sensitivity to textures, smells, sounds, or other sensory stimuli
Unlike autism, people with Asperger’s typically do not have an intellectual disability or language delay. Asperger’s tends to be diagnosed later than other autism spectrum disorders, usually between the ages of 5 and 9 after social challenges become more apparent in school settings. It occurs more frequently in males than females, at a ratio of approximately 4 to 1.
Is Asperger’s a Lifelong Condition?
Asperger’s syndrome was traditionally considered a lifelong neurodevelopmental disorder with symptoms persisting into adulthood. However, some longitudinal studies have found that a minority of individuals diagnosed with Asperger’s syndrome in childhood no longer meet diagnostic criteria for the disorder later in life. This has led to debate around the idea that a subset of individuals may “grow out of” or overcome Asperger’s syndrome over time.
Several long-term studies have found improvement or remission of symptoms in 14-20% of individuals diagnosed with Asperger’s in childhood. For example, a 2004 study followed 34 individuals with Asperger’s over an 11-year period. By the end of the study, 6 participants (18%) no longer met full diagnostic criteria for the disorder. However, most still had milder symptoms in areas like social interaction.
What Does It Mean to Grow Out of Asperger’s?
When researchers and clinicians state that someone has “grown out of” Asperger’s syndrome, this does not necessarily mean they no longer have any symptoms or challenges related to the disorder. Rather, it generally indicates that their symptoms have improved to the point that they no longer meet formal diagnostic criteria.
Growing out of Asperger’s often involves overcoming some of the core social and communication difficulties associated with the disorder. For example, improved eye contact, social initiation skills, reciprocity in conversation, reading of nonverbal cues, and peer relationship skills. However, most individuals who overcome the diagnosable symptoms of Asperger’s continue to have subtle social and communication challenges compared to neurotypical peers. They are also likely to retain some of the restrictive/repetitive behaviors and sensory sensitivities associated with Asperger’s.
So in summary, growing out of Asperger’s means experiencing enough symptom improvement to lose the formal diagnosis. But it does not equate to becoming neurotypical or gaining skills to the level of peers who never had the disorder. Residual challenges often persist.
What Factors Predict Growing Out of Asperger’s?
Researchers have aimed to identify factors that predict whether an individual with Asperger’s is likely to experience symptom improvement over time. Some patterns have emerged:
Less severe childhood symptoms
Individuals with milder symptoms in childhood seem more likely to experience diagnostic remission of Asperger’s later on. Children who have less severe difficulties with social interaction, communication, and restrictive/repetitive behaviors tend to have better outcomes.
Higher cognitive and language abilities
Children with Asperger’s who have average or high IQs, good verbal skills, and less severe language delays appear more likely to no longer meet diagnostic criteria for the disorder as they mature. Strong intellectual and language abilities may help compensate for social challenges.
Effective early intervention
Individuals who receive effective early intervention for Asperger’s, like applied behavior analysis (ABA) therapy, seem more prone to improvement in symptoms over time. Early intervention during key developmental windows may promote growth.
| Predictors of Growing Out of Asperger’s | Characteristics |
|---|---|
| Milder childhood symptoms | Less impairment in social skills, communication, restrictive/repetitive behaviors |
| Higher cognitive abilities | Average or above average IQ |
| Strong language skills | Less severe language delays, good verbal abilities |
| Effective early intervention | Applied behavior analysis (ABA), speech therapy, social skills training |
Developmental Trajectories in Asperger’s
Regardless of whether an individual grows out of the diagnosis or not, it’s important to understand that developmental trajectories in Asperger’s are variable. Symptoms and abilities can improve, remain stable, or worsen at different points in development for each person. Some key patterns include:
- Language and cognitive skills often improve steadily
- Many social and behavioral challenges peak in late childhood/early puberty
- Restrictive/repetitive behaviors may attenuate in adolescence
- Sensory sensitivities often persist through adulthood
- New challenges can emerge in major life transitions
There is no one set outcome – each person with Asperger’s has a unique course. But early intervention and ongoing support can help maximize opportunities for positive growth.
Does Asperger’s Change the Brain Over Time?
Asperger’s syndrome arises from differences in brain development and neurological connectivity. Research using MRI scans suggests that the brains of individuals with Asperger’s show subtle developmental differences compared to neurotypical peers, especially in regions involved in social cognition.
Interestingly, some studies indicate the brain anatomy of people who grow out of an Asperger’s diagnosis may come to resemble neurotypical controls more over time. For example, a cortical thinning process crucial for rewiring synapses during maturation may be delayed in Asperger’s but normalize in those who improve. While fascinating, research in this area is still limited.
Can Asperger’s Return Later in Life?
For individuals who lose the diagnosable symptoms of Asperger’s syndrome in childhood or adolescence, there is always the possibility of these challenges returning later in life. Times of stress, life changes, or new demands appearing “out of the blue” can be challenging for anyone on the spectrum.
Some key times when Asperger’s symptoms may resurface include:
- Starting college or a first job
- Entering serious romantic relationships
- Transitioning to parenthood
- Coping with death of loved ones
- Developing physical or mental health conditions
- Experiencing major life stressors
Even those who are considered very “high functioning” are not immune to struggles during difficult life periods. Accessing support services and allowing accommodations can help in navigating these transitions.
The Importance of Ongoing Support
Regardless of whether an individual grows out of an Asperger’s diagnosis, ongoing education, accommodations, and acceptance is crucial. There are often continuing challenges with executive functioning, emotion regulation, sensory sensitivity, social nuance, and navigating change. Dropping supports prematurely because someone no longer qualifies for a diagnosis can backfire. Focus should be on addressing each person’s current needs, not just formal diagnostic labels.
Coping Tips for Adults with Asperger’s
For adults on the spectrum, including those who may have lost the Asperger’s diagnosis, the following tips can help manage lingering challenges:
- Seek counseling or join social skills groups to improve communication abilities
- Disclose your condition to employers/colleagues and request accommodations
- Practice self-care, stress management, and relaxation techniques
- Limit sensory input and allow quiet recharging time
- Join Autism/Asperger’s community groups for support
- Consider cognitive behavioral therapy for anxiety or depression
- Use organizational tools and planners to manage executive functioning
- Create advance plans for major life changes and transitions
Conclusion
In summary, a subset of individuals diagnosed with Asperger’s syndrome in childhood may experience improvement in core symptoms over time and no longer meet formal diagnostic criteria. However, this does not mean they become neurotypical. Subtle social and behavioral differences often persist, and supports must remain in place. Each person with Asperger’s has a unique developmental trajectory. With appropriate treatment and accommodations, positive outcomes are possible across the lifespan. But expecting anyone to be “cured” or to “grow out of” an autism spectrum disorder entirely is unrealistic, and dropping supports prematurely is ill-advised.