Editorial Perspective: Another look at 'optimal outcome' in autism spectrum disorder.

Some children diagnosed with autism may no longer meet the criteria for autism as they grow up - their symptoms may improve significantly or disappear. Researchers are calling this 'loss of autism diagnosis' instead of 'optimal outcome' because good life outcomes can happen whether autism features remain or not. Success should be measured by independence, life skills, communication, relationships, and work opportunities.

This editorial discusses the concept of 'optimal outcome' in autism spectrum disorder, where individuals who showed autism symptoms in childhood may no longer meet diagnostic criteria by adolescence. The authors propose replacing the term 'optimal outcome' with 'loss of autism diagnosis' (LAD) to better reflect that excellent life outcomes can occur regardless of whether autism features persist. The paper emphasizes that positive outcomes should be measured across multiple domains including autonomy, daily living skills, communication, relationships, and employment, rather than focusing solely on symptom presence or absence.

May influence how clinicians discuss long-term autism outcomes with families. Suggests need for comprehensive outcome measures beyond symptom presence. Could impact diagnostic practices and treatment goal-setting by emphasizing functional outcomes across multiple life domains.

This is an editorial perspective rather than empirical research. No specific study methodology, sample size, or data analysis is provided. The discussion is theoretical and based on existing literature rather than new findings.

This paper addresses the hypothesis that autism spectrum disorder features follow multiple long-term developmental trajectories, including an absence of symptoms that were present in childhood, by the time of adolescence. In early work on this topic, this circumstance was called an 'optimal outcome'. To better reflect the reality of multiple excellent outcomes regardless of whether autism spectrum disorder features are present or absent, including autonomy, daily living skills, communication skills, and relationships and employment/activities outside the home, the terminology 'loss of autism diagnosis' (LAD) has been proposed as a substitute. The paper also contextualizes an LAD outcome within research, practice and advocacy.