First, it’s important to highlight that the idea “autism can get worse” maintains a misconception that autism is a disease that develops progressively, and can be scaled from “bad to worse.” This is not the case since autism is a condition affecting the neurological system. And, while we often distinguish between low- and high-functioning autism, that has nothing to do with “bad to worse,” or any aging-specific developments.
Researchers agree that autism spectrum disorder (ASD) doesn’t get worse with age. However, like any behavioral patterns or coping mechanisms, the symptoms of autism can seem to get worse with age without high-quality assessment and diagnosis (or diagnoses), interventions that develop healthier responses, fostering social connections, and integrating coping outlets for inevitable overwhelm. Additional neurodivergent or health issues also affect how a person exhibits ASD, which can also make it seem “worse” until the implementation of expert, evidence-driven support.
However, while the physiological factors that cause autism spectrum disorder may not worsen, an adult or senior with ASD may seem to get worse over time because they may have lacked the education, training, and practices that mitigate disturbing, disruptive, or more destructive expressions of ASD. Similarly, if an adult with ASD transitions to independent living of some kind, but doesn’t have a community or support team to reinforce behavioral strategies and interventions, it may appear their autism is worse.
So, for example, stimming or a meltdown in a young child may seem more manageable because they are physically smaller and able to be physically manipulated into a bedroom for quiet time, while an older teen or adult without healthy coping strategies will seem more “out of control” and even dangerous - despite the fact the behavior or response is identical to when they were younger.
So, while autism may not get worse with age, there are certainly things that can make the symptoms and behaviors associated with autism seem worse.
Early diagnosis and interventions have changed the landscape for individuals with ASD and their families because things like ABA therapy, cultivating neurodivergent awareness in educators, innovative developments in special education, and a more informed culture have made it easier for those with ASD to learn and practice emotional regulation tools and learning strategies.
There is no denying that individuals with ASD fare best when diagnosed early. Ideally, a child should be diagnosed between the ages of two and five, or as soon as ASD symptoms are observed by parents, caregivers, daycare providers, or teachers.
Early diagnosis and intervention allow parents or caregivers to tap into community, district, and private intervention options to help their child learn how to become more independent and regulated when it comes to things like:
Additionally, early diagnosis also helps families access support resources and learning/training opportunities that make daily life easier.
Sometimes, assessments stop with the ASD diagnosis, but that can leave a child inaccurately assessed. For example, children with ASD are more likely to have other conditions or diagnoses at play (co-occurring conditions), such as:
Working with expert physicians, neurologists, and behavioral specialists who specialize in autism is the best way to ensure your child is comprehensively assessed so any additional conditions or diseases can be adequately managed.
Also, increased attention on fostering social connections between children with ASD and their peers (neurodivergent or otherwise) has de-escalated stress for those with ASD and significantly reduced the stigma around the disorder.
The work we do as ABA therapists, teachers, coaches, and parents can only do so much. The skills and techniques your child learns must be supported in real-world environments so they learn from positive reinforcement. By ensuring your child fosters friendships, team associations, and social partnerships that align with their general personality and interests are a tremendous support to them now and for a lifetime.
Similarly, what works for your three-, five-, and seven-year-olds may be different from what they’ll need during adolescence and young adulthood. This is true for all of us, but individuals with ASD and/or other co-occurring diagnoses may require more personalized support than others do.
Depending on their individual strengths and weaknesses, support and accommodations may continue to change and evolve if they step into a more autonomous adult life. The more exposure a developing child and young adult have to various behavioral strategy options, differing support styles and outlets, learning to self-advocate, and a holistically supportive community, the less likely it is that autism symptoms or behavioral responses will manifest more often or become less manageable over time.
As caregiving partners and advocates for the ASD community, we understand the importance of preparing our clients for what is to come and how to best prepare for it. While you may not be able to do this for your child every day (nor should you if they are capable of learning to do it for themselves over time), preparing them for transitions - and brainstorming strategies - is something that can continue along with age- or stage-related transitions, milestones, or potential triggers.
Automatic age- and state-related scenarios that come to mind include:
Just as you used to role-play with your young child, you can engage in similar age-appropriate role-playing to create these conditions or proactively discuss potential real-life scenarios and help your child or loved one develop their response toolkit.
A poor diet, lack of exercise, and other unhealthy lifestyle choices will exacerbate the potential for dysregulation and other unhelpful symptoms/behaviors associated with ASD. While these things are in a parent’s control (up to a certain point) while your child is at home, age-related independence (or resistance to being controlled) can make it impossible for you to manage as they get older.
By trying your best to instill those habits now, showing cause and effect in scenarios where their lack of self-care negatively affected their emotions or behaviors, can help demonstrate the importance of healthy lifestyles for overall well-being.
The good news is that increased attention on ASD has led to an exponential improvement in early childhood diagnosis and intervention. Even so, your child may have different needs as they age. And, inevitable life transitions or age-related triggers (such as puberty, increased independence, and responsibility) can make it seem like they're “getting worse” when, in fact, it’s just a sign that they need extra support to figure out what their needs are now and continue leveraging neural plasticity (the brain’s and neuron’s ability to grow and learn new things).
Schedule a consultation with the Autism Response Team to learn more about how we help individuals and families cultivate the skill sets and personalized toolbox of strategies that last a lifetime. We’re also here to pick up where outdated strategies and coping skills leave off, ensuring people with ASD lead satisfying lives at every age.
