Introduction: Research into autism, based mainly on the categorical model in the Diagnostic and statistical manual of mental disorders, has focused above all on the epidemiology, clinical manifestations, cognitive mechanisms and the biological-environmental determining factors. Yet, little attention has been paid to the developmental trajectories, which play a decisive role when it comes to establishing a medium- and long-term prognosis.
Aims: The purpose of this study is to review the developmental course of children diagnosed with autism who, despite preserving behavioural traits consistent with the initial profile in the medium- and long-term, accomplish a satisfactory social and occupational adaptation, and additionally no longer meet the criteria that gave rise to the initial diagnosis.
Development: A review was conducted of the bibliography on autism focused on the analysis of the development of the clinical manifestations and their repercussions from the earliest ages to adulthood. Likewise, we have also taken into consideration conceptual aspects about autism that facilitate the comprehension and the meaning of the developmental patterns.
Conclusions: Around 20% of the children diagnosed with autism cease to meet the criteria on which their diagnosis was based and, furthermore, achieve a satisfactory social and occupational adjustment. The following were identified as favouring factors: normal intelligence, good level of language and low incidence of 'comorbidities'; conversely, in the series that were reported, early and intensive therapeutic interventions were not shown to be determining factors. Lastly, mention is made of the concept of neurodiversity, where recovery is centred on the optimal development of each individual's capacities within a facilitating environment.
Title: Autismos que se 'curan'.
Introduccion. La investigacion sobre el autismo, basada principalmente en el modelo categorico del Manual diagnostico y estadistico de los trastornos mentales, se ha centrado de forma preferente en la epidemiologia, las manifestaciones clinicas, los mecanismos cognitivos y los determinantes biologicos y ambientales; sin embargo, se ha prestado escaso interes a las trayectorias evolutivas, las cuales son decisivas de cara al pronostico a medio y largo plazo. Objetivo. Revisar el curso evolutivo de niños diagnosticados de autismo que, aun conservando a medio o largo plazo rasgos conductuales acordes con el perfil inicial, alcanzan una adaptacion social y laboral satisfactorias, y ademas dejan de cumplir los criterios que dieron lugar al diagnostico inicial. Desarrollo. Se ha revisado la bibliografia sobre el autismo centrada en el analisis de la evolucion de las manifestaciones clinicas y de su repercusion desde las primeras edades hasta la edad adulta. Asimismo, se han tomado en consideracion aspectos conceptuales sobre el autismo que facilitan la comprension y el significado de los patrones evolutivos. Conclusiones. Alrededor del 20% de los niños diagnosticados dejan de cumplir los criterios en los que se baso el diagnostico y, ademas, alcanzan un ajuste social y laboral satisfactorio. Como factores favorecedores se identifica: inteligencia normal, buen nivel de lenguaje y baja incidencia de 'comorbilidades'; por el contrario, en las series notificadas no se señalan como factores determinantes las intervenciones terapeuticas precoces e intensivas. Por ultimo, se menciona el concepto de neurodiversidad, donde la recuperacion se centra en el desarrollo optimo de las capacidades de cada individuo en un entorno facilitador.