At present, there is no cure for autism. Nor do children outgrow it. But the capacity to learn and develop new skills is within every child.

With time, children with autism mature and new strengths emerge. Many children with autism seem to go through developmental spurts between ages 5 and 13. Some spontaneously begin to talk-even if repetitively-around age 5 or later. Some, like Paul, become more sociable, or like Alan, more ready to learn. Over time, and with help, children may learn to play with toys appropriately, function socially, and tolerate mild changes in routine. Some children in treatment programs lose enough of their most disabling symptoms to function reasonably well in a regular classroom. Some children with autism make truly dramatic strides. Of course, those with normal or near-normal intelligence and those who develop language tend to have the best outcomes. But even children who start off poorly may make impressive progress. For example, one boy, after 9 years in a program that involved parents as co-therapists, advanced from an IQ of 70 to an IQ of 100 and began to get average grades at a regular school.

While it is natural for parents to hope that their child will "become normal," they should take pride in whatever strides their child does make. Many parents, looking back over the years, find their child has progressed far beyond their initial expectations.

Can Adults with Autism Live Independent Lives?

The majority of adults with autism need lifelong training, ongoing supervision, and reinforcement of skills. The public schools' responsibility for providing these services ends when the person is past school age. As the child becomes a young adult, the family is faced with the challenge of creating a home-based plan or selecting a program or facility that can offer such services.

In some cases, adults with autism can continue to live at home, provided someone is there to supervise at all times. A variety of residential facilities also provide round-the-clock care. Unlike many of the institutions years ago, today's facilities view residents as people with human needs, and offer opportunities for recreation and simple, but meaningful work. Still, some facilities are isolated from the community, separating people with autism from the rest of the world.

Today, a few cities are exploring new ways to help people with autism hold meaningful jobs and live and work within the wider community. Innovative, supportive programs enable adults with autism to live and work in mainstream society, rather than in a segregated environment.

By teaching and reinforcing good work skills and positive social behaviors, such programs help people live up to their potential. Work is meaningful and based on each person's strengths and abilities. For example, people with autism with good hand-eye coordination who do complex, repetitive actions are often especially good at assembly and manufacturing tasks. A worker with a low IQ and few language skills might be trained to work in a restaurant sorting silverware and folding napkins. Adults with higher-level skills have been trained to assemble electronic equipment or do office work.

Based on their skills and interests, participants in such programs fill positions in printing, retail, clerical, manufacturing, and other companies. Once they are carefully trained in a task, they are put to work alongside the regular staff. Like other employees, they are paid for their labor, receive employee benefits, and are included in staff events like company picnics and retirement parties. Companies that hire people through such programs find that these workers make loyal, reliable employees. Employers find that the autistic behaviors, limited social skills, and even occasional tantrums or aggression, do not greatly affect the worker's ability to work efficiently or complete tasks.

Like any other worker, program participants live in houses and apartments within the community. Under the direction of a residence coach, each resident shares as much as possible in tasks like meal-planning, shopping, cooking, and cleanup. For recreation, they go to movies, have picnics, and eat in restaurants. As they are ready, they are taught skills that make them more personally independent. Some take pride in having learned to take a bus on their own, or handling money they've earned themselves. Job and residence coaches, who serve as a link between the program participants and the community, are the key to such programs. There may be as few as two adults with autism assigned to each coach. The job coach demonstrates the steps of a job to the worker, observes behavior, and regularly acknowledges good performance. The job coach also serves as a bridge between the workers with autism and their co-workers. For example, the coach steps in if a worker loses self-control or presents any problems on the job. The coach also provides training in specific social skills, such as waving or saying hello to fellow workers. At home, the residence coach reinforces social and self-help behaviors, and finds ways to help people manage their time and responsibilities.

At present, about a third of all people with autism can live and work in the community with some degree of independence. As scientific research points the way to more effective therapies and as communities establish programs that provide proper support, expectations are that this number will grow.