Abstract: Research has followed a group of youth with a history of autism spectrum disorder (ASD), who no longer have symptoms of the disorder and who have typical language, social, cognitive and adaptive skills (dubbed an “optimal outcome,” OO). Behaviorally, these individuals are indistinguishable from those with a history of typical development. Studies of head circumference in OO suggest enlarged brain volumes between ages one to two years, indicating early brain differences in OO that are consistent with an ASD diagnosis at that time. Furthermore, studies have reported functional (task-based MRI, resting-state MRI) and structural (DTI) brain differences in youth with OO. Across all methods, results suggest neural compensation rather than normalization. We suggest that these neural patterns are markers of functional plasticity, potentially suggesting an extended period of neural reorganization. Grounded by a comparison with the dyslexia literature, the discussion will highlight individual differences in plasticity that may underlie the striking developmental behavioral trajectory of OO.