Adults With Autism and Associated Disorders and the Impact on Their Lives
As young adults with ASD (Autism Spectrum Disorder) leave high school and try to start their journey to adulthood they face many hurdles. There is a significant number of these young adults who lower chances at employment, secondary education or living on their own.
Autism and its effect on children has been studied closely since it was first diagnosed in the 1940's. research, however, needs to be done for how this will affect the children as they become adults. Previous studies have focused primarily on children and before it was identified as its own disorder doctors referred to it as childhood psychosis.
What research that has been done has only focused on the 20's and 30's so there is limited information about what happens when they reach mid to late adulthood. And with all the research done since the 1960's only 20% of Autistic adults live independently or semi-independently. Citing very few children with an IQ below 75 live independently as adults (Howlin & Moss, 2012).
There seems to be a connection between the severity of early autistic symptoms and later outcomes. Interventions for autistic adults remains limited at best. Most adults with ASD have no access to a specialist unless they are supported by mental health services and even then it is inadequate. This group also shows an increase in medication use as they become adults with antipsychotics and antidepressants being the most common ones prescribed.
Mental health issues are seen in lower IQ adults with ASD. Emotional and psychiatric problems can have a negative impact on general functioning. And studies have shown an increased rate of health problems in these people (gastric and digestive problems, muscular and sensory abnormalities, and more susceptible to infections). Between 11% and 39% of Autistics also develop epilepsy. This is related to lower IQ, sex (it is higher in women) poor language skills and greater behavioral disturbances.
As more children with ASD (Autistic Spectrum Disorder) move toward adulthood a need for an increase in services and support in work, education and social participation are also increasing. Studies conducted have shown a need for ASD specific supports and staff training. This includes targeted help for difficulties with social communication and repetitive behaviors.
Co-existing health and mental health conditions are common among people with ASD. Yet studies conducted thus far neither assess for them nor report them when identified (Shattuck, et al, 2012a). Deficits in the maturation of character in adults with ASD have been found to show a high rate of personality disorders as categorized by the DSM-IV. Unfortunately, there is an obstacle to an understanding of personality in relation to the disorders found with ASD. Of the 47 children studied, 25.9% showed paranoid disorder and 11.1% showed Schizophrenic.
In addition, ASD children were found to have significantly increased cerebral volumes compared to traditionally developing children. This structural difference suggests that ASD children have abnormal brain developmental process early in their clinical course (Sparks, et al, 2002). When ADHD and ASD patients were studied together, it was found that both groups were highly similar in severity of oppositional defiance disorder and conduct disorder symptoms. And they both shared a high propensity to anxiety (Gadow, et al, 2009).
National, state, and local policymakers have been working hard to meet the needs of the growing numbers of young children identified as having an ASD. Unfortunately, there are minimal services for those children after they reach 18. And once they leave high school, it is even harder on these young adults. Couple that with the majority of research done on ASD focuses on children, it creates a nightmare for young adults trying to transition into after school (Taylor & Seltzer, 2011). A few years immediately following the exit from high school are pivotal for all youths. A negative transition can set the stage for a path with developmental, health, and social difficulties.
Youth with ASD are vulnerable during this time because of their challenges with communication, social interaction and a greater reliance on others for aid. They are also troubled with co-existing mental health or health problems. These people are individual that typically need help from multiple service providers to meet their many needs. To that end there is a need for case management and care coordination for this population (Shattuck, 2012b).
Sadly, the study has found that 39.1% of all youths received none of the available services post-high school. Even those adults who still live with their parents, those who lived in households of $25,000 a year or less were less apt to have medical insurance or access to services in the community. In addition, many services and case management are provided through state mental retardation and developmental disabilities departments and qualifying for them as an adult is very difficult. Many Medicaid home and community-based service waiver programs require a level of care determination that emphasizes functional impairment and self-care skills (Shattuck, 2011).
Severity of impairment and presence of co-existing conditions have significant implications for service needs. The evidence based on services for adults with ASD is inadequate and is unable to meet the needs of this growing population.
Gadow, K.D., DeVincent, C.J., Schneider, J. (2009). Comparative Study of Children With ADHD Only, ASD & ADHD and Chronic Multiple Tic Disorder and ADHD. Journal of Attention Disorders, 12(5). https://doi.org/10.1177/1087054708320404
Howlin,P. & Moss, P. (2012). Adults With Autism Spectrum Disorders. The Canadian Journal of Psychiatry,57(5). http://www.thecjp.ca
Shattuck, P.T., Roux, A.M., Hudson, L.E., Taylor, J.L., Maenner, M.J., Trani, J-F. (2012a). Services for Adults With an Autism Spectrum Disorder. The Canadian Journal of Psychiatry, 57(5). http://www.thecjp.ca
Shattuck, P.T., Narendorf, S.C., Cooper, B., Sterzing, P.R., Wagner, M. & Taylor, J.L. (2012b). Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder. Pediatrics,129(6). Doi: 10.1542/peds.2011-2864
Shattuck, P.T., Wagner, M., Narendorf, S., Sterzing, P., & Hensley, M. (2011). Post-High School Service Use Among Young Adults With an Autism Spectrum Disorder. Archives of Pediatrics and Adolescent Medicine,165 (2). http://www.archpediatrics.com
Sparks, B.F., Friedman, S.D., Shaw, D.W., Aylward, E.H., Echelard, D., Artru, A.A., Maravilla, K.R…Dager, S.R. (2002).Brain structural abnormalities in young children with ASD. Neurology,52(2). https://doi.org/10.1212/wnl.59.2.184
Taylor, J.L. & Seltzer, M.M. (2011), Employment and Post Secondary Educational Activities for Young Adults with Autism Spectrum Disorders During Transition to Adulthood. Journal of Autism and Developmental Disorders, 41(5). http://doi.org/10.1007/s10803-010-1070-3