In this last part of our four-part series on Exploring Autism, Professor Tony Attwood discusses prognosis and autism. In the first part of our series, Tony described autism in an historical context. In the second part he shared his observations on how different individuals cope with autism, and the various outcomes of these coping mechanisms. Last week Tony described some conditions that commonly co-occur with autism.
Over 50 years I have been able to maintain contact with autistic children through to their mature years and see retired individuals for a diagnostic assessment. Those who have achieved a diagnosis of autism late in life are often greatly relieved to know why they are different and can now perceive their life through the lens of autism. The diagnosis can help explain why they were bullied and teased at school, their difficulties in making friends and maintaining a long-term relationship and sensory sensitivity.
The majority have described an improvement in their mental health after the age of 50, not necessarily by treatment from health professionals and medication, but discovering strategies themselves through reading, the Internet and experimentation. We are also now exploring the concept of well-being and autism and surveys and clinical experience suggest that wellbeing can be achieved by having time in the day when they are not disturbed within their own private sanctuary, being able to excel in what they enjoy doing, and freedom from sensory pain. These are all achievable.
In my extensive clinical experience, I have known autistic children who have what we describe as autism pure, with no signs of a mood, medical or psychological disorder. By their early twenties they have gradually acquired social abilities to make and keep friends and relationships and achieve successful employment and financial independence. The social puzzle is finally solved. They still have the characteristics of autism, but at a sub-clinical level according to the diagnostic criteria. I estimate that this occurs in about ten per cent of the people on my clinic list. I am prepared to remove the diagnosis of autism, but only with that person’s agreement and for their benefit. Our new conceptualisation of autism is that for a few autistic adults there may be a delay in acquiring specific abilities, not an eternal absence.
Finally, over 50 years I have contributed to the growing literature on autism for professionals, parents, and autistic adults. My original book Asperger’s Syndrome: A Guide for Parents and Professionals was published in 1998 and has sold over half a million copies and been translated into 30 languages. I continue to write guidebooks on autism and books on therapy for anxiety, depression and emotion expression and regulation. There are now hundreds of books published by Jessica Kingsley Publishers in London on many aspects of autism such as catatonia, having an autistic partner and coping with being in prison and aging and autism.