Does Autism Get Worse With Age?

Your child has just been diagnosed with autism. Will the condition get worse as your child grows older?

Every child with autism is different, and no two children have the same path through life. While your child may develop in one way, another child with autism may develop differently.

But understanding what autism looks like throughout the lifespan and what researchers know (and do not know) about how autism works can help you plan for the future. 

Autism Signs in Infants

As any new parent knows, tiny babies require around-the-clock care. Sometimes, they seem incapable of communicating more than the need to sleep, eat, and stay clean. But your new baby’s brain is growing and changing every day. Sometimes, those changes can indicate autism. 

Most children with autism show symptoms by age 12 to 18 months. But the changes can be incredibly subtle and easy to miss. New parents may be so focused on keeping their babies healthy that the tiny cues pass by unnoticed. 

For example, researchers have spotted autism markers in boys as young as 2 to 6 months. But those markers involve where the tiny babies look when presented with a human face. Instead of staring deep into eyes, they tend to look up slightly. This is a cue you (or anyone) might miss. 

Recognizable symptoms in children up to age 1 year include:

• Few facial expressions. Your child may not smile or show joy.
• Reduced eye contact. Your child may not meet you in the eyes. 
• Lack of nonverbal engagement. Your child may not point, wave, or reach for you. 
• Slow verbal development. Your child may not babble or mimic sounds. Your child may also show no reaction when you say their name. 

You may notice these signs if you have another child in the home. Side-by-side comparisons of your children could help these subtle differences to stand out. You may also notice that your child seems different from others you see in play dates and family gatherings. 

Autism Signs in 2-Year-Old Children 

As your child grows older, autism signs may be easier for you to see. Where you may spend time guessing and wondering if your infant has autism, you may be able to see how your child differs, and your doctor may be able to confirm your suspicions. 

A neurotypical child at age 2 years can:

• Say sentences consisting of a few words.
• Follow simple instructions.
• Clap, laugh, and wave.
• Connect with other children through games and mimicry. 

A child with autism at age 2 years may:

• Speak very little or not at all. 
• Have a small social circle. 
• Repeat behaviors or sounds.
• Enjoy routines and get upset at disruptions. 

These differences are stark, and they are somewhat easy to test for. This is the age at which doctors begin to screen for autism. 

No blood test or brain scan can diagnose autism. Instead, doctors rely on observations and skills testing to detect the disorder. An infant can’t always participate in a skills test, but a toddler can. 

If your child is diagnosed at age 2 years, it doesn’t necessarily mean that the disorder worsened brain health between infancy and this age. Instead, it could mean that your child has always had autism, but there was no way to confirm that until your child got older. 

There is one potential exception. Some children seem neurotypical up to age 2 years, and they then experience a regression. Skills they developed fade away, and they fold back into themselves and withdraw from those they love. Researchers don’t know why autism regression happens. 

Autism Signs in Children Ages 3 to 5 Years

At every checkup, your child is screened for autism symptoms. Some children are newly diagnosed at age 3 to 5 years, and others have already been diagnosed and are simply being monitored. 

Common autism signs in older children include a lack of:

• Outward signs of compassion. Your child may not seem to understand how you think or feel. The child may prefer to be alone, even if that hurts your feelings. 
• Emotional awareness. Your child may not be able to tell you how they feel. 
• Spontaneity. Your child likes routines and feels upset if they are broken. 
• Variety. Your child likes a narrow set of topics and isn’t interested in broadening interests. 

At first glance, these symptoms seem more severe than those you might notice in a younger child. But appearances can be deceiving. 

As your child ages, expectations around behavior broaden. We assume that our children will be more flexible, interested, and engaged with the world as they grow. A child who doesn’t develop in this way is noticeable. You aren’t observing a deepening of autism severity. You’re simply noticing how autism is changing the way your child develops. 

Children diagnosed with autism at a young age can begin early intervention therapy. Sometimes that helps them manage autism symptoms. And sometimes children seem to age out of some autism signs altogether. 

Researchers say that about 30% of children with autism have less-severe symptoms at age 6 years than they did at age 3 years. No one is sure why some children seem to improve dramatically while others do not. But it is an encouraging sign that seems to indicate that autism doesn’t worsen with age. 

Autism Signs in Teenagers

By the time your child is ready to enter high school, you may have been dealing with autism symptoms for years as a family. But if your child was just diagnosed for the first time as a teenager, you’re not alone. 

Some families don’t see clear behavior signs linked to autism until the teen years. You may have noticed that your child is a little different from other children. You may have been working with a doctor to find the cause for some time. It may be that your child reaches a developmental milestone in which you can finally pinpoint exactly what sets your child apart. 

Common autism signs in teenagers include:

• Rigidity. Your child likes routines, including where they sit in the classroom. Your child likes rules to be followed exactly, and any schedule change causes trauma. 
• Focus. Your child has a specific set of interests (such as a sports team) and will discuss those interests at length. 
• Poor communication skills. Your child has an unusual way of making eye contact (too much or too little), talks too loudly, or stands too close to others while talking. Your child may also say things that hurt another’s feelings and may not understand why the other person is upset. 
• Lack of nonverbal skills. Your child may not understand facial expressions.

Again, these symptoms should not be used as an indication that autism is worsening. Instead, think of these signs as indications of how autism changes the way your child deals with specific challenges that appear throughout the lifespan. 

Some children, about 10% of those with autism, have symptoms that improve dramatically during the teen years. But most have symptoms that stick with them as they age. They may not see a worsening of signs, but they may not get spontaneously better either.  

Most experts believe that autism persists throughout the lifespan, but your child’s symptoms may improve with age. There’s a lot you can do as a parent to ensure that your child has the happiest, healthiest future possible. 

Parents can:

• Advocate. Work with a professional to get a clear diagnosis. With it, ensure that your child has all of the support needed to stay healthy and engaged. 
• Contract. Find a professional that can offer appropriate therapy for your child. The sooner that work starts, the better. 
• Learn. Find out what your child needs and how you can offer it in a supportive way. Change your routines as needed to help your child.
• Explain. Be your child’s voice, as needed. Help extended family members with terminology and appropriate conversation topics. Shut down bullies. 
• Love. Your child needs you, even if it’s not easy to express that with words. 

While autism may not worsen throughout the lifespan, your child may always need the special help only a parent can provide. 

Will Autism Worsen During Adulthood?

Autism is a lifelong condition that will not disappear as your child becomes an adult. Some symptoms, including social struggles and the need to repeat behaviors, will stay with your child forever. 

Your child’s therapy, especially when started early in life, may help. Your child may pick up coping strategies that could help to manage — but not eliminate — symptoms that could impair your child’s adulthood. 

For example, your child might learn how to disclose autism to strangers and people in power. These skills could be helpful while your child is in school. But when your child enters the workforce, they could be even more important tactics. 

While it’s uncommon for people with autism to develop new symptoms later in life, the lessons your child learns in therapy could also be put to use if new problems appear. 

You know your child best, and you know what will be helpful as your child grows. Don’t be afraid to get therapy now so your child picks up crucial lessons that could last throughout their lifespan.

References

When Do Children Usually Show Symptoms of Autism? (January 2017). National Institutes of Health. 

Classic Sign of Autism Appears in Early Infancy, Study Says. (November 2013). Spectrum News. 

Learn the Signs of Autism. Autism Speaks. 

Milestone Checklists. Centers for Disease Control and Prevention. 

Signs of Autism. National Autism Association. 

Signs of Autism in Children. (April 2019). NHS. 

Autism Severity Can Change Substantially During Early Childhood. (May 2020). ScienceDaily.

Late Autism Diagnosis: Older Children and Teenagers. (September 2021). Raising Children Network. 

Growing Up Together: Teens with Autism. Autism Society. 

Long-Term Studies Track How Autism Changes with Age. (May 2013). Spectrum News. 

Signs and Symptoms of Autism Spectrum Disorders. (March 2021). Centers for Disease Control and Prevention. 

When Children With Autism Become Adults. (February 2013). World Psychiatry.