There is some evidence that kids with ASPERGERS may see a lessening of symptoms as they mature. Up to 20% of kids may no longer meet the diagnostic criteria as grown-ups, although social and communication difficulties may persist. As of 2006, no studies addressing the long-term outcome of people with ASPERGERS are available and there are no systematic long-term follow-up studies of kids with ASPERGERS.
People with ASPERGERS appear to have normal life expectancy, but have an increased prevalence of comorbid psychiatric conditions (e.g., major depressive disorder, anxiety disorder) that may significantly affect prognosis.
Although social impairment is life-long, the outcome is generally more positive than for people with lower functioning autism spectrum disorders. For example, autism spectrum disorders (ASD) symptoms are more likely to diminish with time in kids with ASPERGERS (AS) or high functioning autism (HFA). Although most students with AS/HFA have average mathematical ability and test slightly worse in mathematics than in general intelligence, some are gifted in mathematics. ASPERGERS has not prevented some grown-ups from major accomplishments such as winning the Nobel Prize.
Kids with ASPERGERS may require special education services because of their social and behavioral difficulties, although many attend regular education classes. Teens with ASPERGERS may exhibit ongoing difficulty with self care, organization and disturbances in social and romantic relationships. Despite high cognitive potential, most young adults with ASPERGERS remain at home, although some do marry and work independently.
Anxiety may stem from (a) preoccupation over possible violations of routines and rituals, (b) being placed in a situation without a clear schedule or expectations, or (c) concern with failing in social encounters. The resulting stress may manifest as inattention, withdrawal, reliance on obsessions, hyperactivity, or aggressive or oppositional behavior.
Depression is often the result of (a) chronic frustration from repeated failure to engage others socially, and (b) mood disorders requiring treatment may develop. Clinical experience suggests the rate of suicide may be higher among teens with ASPERGERS, but this has not been confirmed by systematic empirical studies.
Education of families is critical in developing strategies for understanding strengths and weaknesses. Helping the family to cope improves outcomes in ASPERGERS kids. Prognosis may be improved by diagnosis at a younger age that allows for early interventions, while interventions in adulthood are valuable, but less beneficial.