Outcome in autism

Until relatively recently, the vast majority of literature on autism has focused on children. There are numerous books exploring the causes of autism, the implications for families, therapeutic interventions, and training and educational programmes. In contrast, there has been remarkably little written about outcome in adulthood. Moreover, when autism in adults is described, the picture is often far from reassuring. Accounts of individuals with autism are frequently found in books or reports dealing with ‘challenging behaviours’, leaving many families to fear that all that may be expected in adulthood is the development of aggressive, self-injurious or disruptive behaviours. On the other hand, there is an increasing number of impressive personal narratives documenting how – often against tremendous odds – individuals have fought against, and to a considerable extent overcome, their early difficulties. Amongst the most prominent of these autobiographical accounts are those of Gunilla Gerland (1997), Temple Grandin (1995), Liane Holliday Willey (1999), Wendy Lawson (1998, 2002) and Donna Williams (1992, 1994). Occasionally, too, there are reports of young people who, although remaining generally disabled, may show remarkable skill in isolated areas such as art, music or calculations (Hermelin 2001, Wiltshire 1987).