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Do you think that the prognosis of a child with a disability can be estimated at a very young age?

Discussion in 'General Autism Discussion' started by Chrysanthemum, Jan 16, 2020.

  1. Chrysanthemum

    Chrysanthemum Active Member

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    Do you think that the prognosis of a child with a disability, especially those with either an autism spectrum disorder or difficulties with language (or both), can be estimated at a very young age (at 5 or below)?

    Personally, I absolutely don’t believe so because I think that just because a child doesn’t develop certain skills at the expected time doesn’t mean he or she will never develop them, but on the other hand I guess it is possible at times that development in the future may be slower than expected, and think that only time can really reveal the future of a very young child. However, I do believe that therapies or extra support when indicated are of somewhat importance for a child to reach his or her full potential (for example, because I had quite significant speech delay, I had speech therapy from about 4 years old to a teenager, and I do wonder whether my language would have been less developed had I not gotten it).
     
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  2. Judge

    Judge Well-Known Member V.I.P Member

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  3. dragonfire42

    dragonfire42 Perpetual outsider

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    I agree, I don't think the prognosis of a very young child can be determined very well. So much can change (or stay the same), sometimes in unexpected ways, between childhood and adulthood. Add into that the fact that adulthood requires quite a different set of skills and stuff from childhood (I, for example, appeared quite high-functioning until I was thrust out into the world of adulthood), and I doubt an accurate prognosis can really be made.
     
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  4. Chrysanthemum

    Chrysanthemum Active Member

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    I agree that a medical professional may have much more experience and knowledge to guide him or her in whether or not a prognosis could be made.

    However, unless the condition being assessed is for example a genetic disorder or disease that invariably results in extremely similar types and severities of symptoms, or unless all children with autism or language difficulties who have shown a particular’s child’s (who has autism or language difficulties) symptoms have turned out extremely similar in their “functioning” or language or social interaction skills etc as an adult, I do wonder how can a prognosis really be made?

    Also, while in the context of autism or language delay, there may have been correct prognoses in the past, have there been no wrong prognoses (not just in a very young child, but also in a child older than 5)?
     
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  5. Judge

    Judge Well-Known Member V.I.P Member

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    I'm not arguing your point. Just pointing out that the CDC feels to the contrary.
     
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  6. Chrysanthemum

    Chrysanthemum Active Member

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    OK, thanks for the link to the article and your point.

    However, I just read the CDC article in full and couldn't see that the article implies that a full prognosis for a young child (e.g. their "functioning" level as an adult) for their future can be made, just that according to the CDC, "By age 2, a diagnosis by an experienced professional can be considered very reliable." I read that to mean that according to the CDC, "by age 2", a diagnosis of Autism Spectrum Disorder "by an experienced professional” “can be considered very reliable."

    Edit: I just realized that in the DSM-V ASD has "functioning levels", maybe the "functioning level" is part of the diagnosis and maybe the CDC means that the "functioning level" is also "very reliable", I'm not really sure what they mean now though.
     
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  7. Judge

    Judge Well-Known Member V.I.P Member

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    Point taken. However that's a question for the CDC. Whether such statements were intended to convey what you call a "full prognosis" or not I can't tell. I'm just passing along their line of thinking on the issue in general. With particular regard to age rather than the overall scope of their diagnosis.

    I suppose you'd have to pin them down on the context of what they mean in terms of a "reliable" diagnosis by an experienced professional.
     
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  8. Chrysanthemum

    Chrysanthemum Active Member

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    Thanks, I have just contacted the CDC about what they mean by that (and about if the "functioning level" is also reliable, whether it is reliable as in that is the child's functioning level at the time, or "reliable" as in he or she is likely to retain the same functioning level as an adult).
     
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  9. Judge

    Judge Well-Known Member V.I.P Member

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    Good deal! Hope you let us know what their response is.

    We pay their salaries, so they should provide a more concise explanation. Perhaps more context as well. ;)

    It does seem questionable though if such a diagnosis implies an implicit understanding of the amplitude of so many potential traits and behaviors which may not be so evident at say two years of age.
     
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  10. GadAbout

    GadAbout Well-Known Member

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    If we may consider another disorder that has sometimes had prognosis incorrectly assigned -

    we now hear of the occasional Downs syndrome child who attends college!

    If all Downs children were institutionalized as once was routine, it is unlikely that any of them would have gone so far.

    Now by analogy - with suitable upbringing and support, possibly the sky's the limit for a child with autism, if that is the only variable. (Birth complications and other factors might alter the outcome.)

    jmho
     
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  11. Fino

    Fino Alex V.I.P Member

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    I believe all predicting of the future is questionable.
     
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  12. Chrysanthemum

    Chrysanthemum Active Member

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    Fino, I agree with that.

    I appreciate the analogy.

    Something different, as you probably know, in autism from Down’s syndrome is that someone with autism may or may not have intellectual disability, while from what I have read with Down’s syndrome intellectual disability (usually mild to moderate) is present (I know there is also something called Mosaic Down’s Syndrome where only some cells are affected, I am not sure whether or not intellectual disability is always present in that), also people with Down’s syndrome do not necessarily have impairments in social interaction.

    Part of the reason I thought of this question is because of my own experience of language delay as a young child (however I don’t remember my time as my young child), and also because of a kind of prognosis (e.g. academic-wise) given to my parents when I was much older than 5, which I think was a bit low, although I believe I was assessed to be “high-functioning”. However, I do not want to take away that it is possible that some children’s later development may be slower than expected even as adult (whether that is due to very high expectations or relatively quick or good development as a young child, however I have not witnessed or heard of the previous firsthand), or that even for those who have a normal or above normal IQ those with a condition may have challenges as a teenager or adult perhaps unanticipated by themselves or their parents.
     
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  13. Judge

    Judge Well-Known Member V.I.P Member

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    In giving this thread more thought, I had forgotten about something we've discussed in other threads over the years. That many of us manifest our autistic traits and behaviors in something less than an entirely linear manner.

    In my own case I had enough of them by the age of six to motivate my parents to have medical doctors examine me. Though that was at a time decades before Dr. Asperger's research was formally recognized. They said I was "just fine". And by the age of twelve even more traits and behaviors occurred, along with more difficulties in social interactions with my peers. In my late teens and early 20s my comorbid conditions began to manifest themselves as well.

    With such professional scrutiny at the tender age of two, I don't think anyone could accurately predict how I might turn out as a functional adult. Though I'd still welcome any professional comment on this issue given how positive the CDC appears in claiming accurately diagnosing ASD itself, and at such an early age. For all we know such comments as published were not intended to imply an ability to predict a much broader and long term prognosis for much of anyone.
     
    Last edited: Jan 17, 2020
  14. Streetwise

    Streetwise very cautious contributor V.I.P Member

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    I think if you looked at an FMRI and the area on the brain was Black !then that would mean there won’t be any growth ,There will be adaptation of the other areas to compensate,Whether the adaptation will mean fluent speech would be True only to the individual case.
     
  15. Bolletje

    Bolletje Overly complicated potato V.I.P Member

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    I don’t even know what my own ASD will be like in ten years or so, and I’m 33 years old.
     
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