Autism Spectrum Disorder and Issues Impairing Employment
Autistic Spectrum Disorders are a complex pervasive neurodevelopmental condition associated with lifelong difficulties. these difficulties cross social, emotional and behavioral domains. The lastest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) finally put all aspects of autism under one umbrella of autistic spectrum disorder. Since this happened questions have been raised if this has helped by moving toward a broader categorization of the disorder is clinically useful (Montgomery et al, 2016).
This study examines the experiences of families of young adults on the autism spectrum to better understand the dynamics leading to poor young adult outcomes. The autistic spectrum disorder is a neurodevelopmental condition that involves social communication deficits and restricted, repetitive behaviors and interests. In recent years there has been an increase in reports of autistic spectrum disorder in the US but this is felt to be due to the broadening of the definition of the disorder and an increase in awareness.
After exiting high school they lose entitled education and other special services and are thrust into a less secure adult landscape. There are few services available and nearly impossible to access. Each state has a different group of adult programs and agencies that families must navigate to get help. Research on young adults with autistic spectrum disorder is dismal.
There are limited services, restricted inclusion in community activities and decreased likelihood of living independently when compared to other young adults with learning or emotional disabilities. Over 50% of participants in the study have no employment two years after high school. There is also a decline in vocational involvement over time and isn’t just a temporary disruption at transition. While they attend high school for 12 years they are more often to earn a certificate of attendance than an actual diploma. This adds to the restriction of available employment.
In this study parental accounts often included the entire autistic spectrum disorder journey. The transition after finishing high school is often stated as being overwhelming. Most state and federal programs don’t begin until 21 and even then they are sporadic at best in who and what they allow in these programs. Autistic spectrum disorder with higher IQs often doesn’t qualify for assistance despite the significant challenges they face. And those who had medical/mental health issues qualified but were then difficult to place.
And most agencies are chronically underfunded bureaucracies with low pay and high turnover of staff, not to mention the incompetent staff. One parent was told their child could work in a laundry room folding. But due to seizures, she is unable to drive and closest one is located 23 miles away with no public transit from the place she lives to the place she is supposed to find work at (Anderson et al, 2018).
Some children with high-functioning autistic spectrum disorder have been noted clinically to produce accounts and responses akin to confabulations (unconsciously filling in gaps in memories with fabricated facts and experiences) in neurological patients. Neurological confabulation is typically associated with abnormalities of the frontal lobes and related structures. Some forms have also been linked with the atypical development of the frontal lobes and impaired performance on source monitoring and executive tasks. This begs the question of the possibility of confabulation in autism less related to social factors and more impaired source memory or poor executive function.
Cognitive impairments attempt to explain the core behavioral symptoms of the disorder. However, there are a number of behavioral features not consistent with the core autistic spectrum. In fact, some of the first clinical accounts of autism note the occurrence of confabulation. And while there are some similarities between confabulators there is still a wide variety of them.
It has been assumed that at least some level of these phenomena has been witnessed in experimental tasks that tap executive or meta-cognitive aspects of memory. False positives on recall of word lists, willing to answer a question even when they can’t possibly know, overconfidence with memory performance, reality monologue deficits are all seen with confabulation.
In autism, there has been reported evidence of altered memory function. They tend to show weakness when remembering information in context. Autistic spectrum disorder patients tend to have confabulation in everyday life. It is a term that describes a family or memory error, for example, poor test performance may indicate a predisposing factor or mediating factor of a casual one. While being an unreliable witness is not universal in autism it certainly can be in a subset of autistic spectrum disorder people (Spitzer et al, 2017).
Autistic spectrum disorder patients have difficulties with an inhibition-a mental force that imposes restraint on behavior or other mental processes such as desire. For individuals with the autistic spectrum disorder, this can include inhibiting action one’s own point of view and distractions that may interfere with a response. The association between autistic spectrum disorder and inhibitory control, especially in adulthood is unclear.
The autistic spectrum disorder is an umbrella term of neurodevelopmental conditions defined by two classes of symptoms. One is social communication difficulties and repetitive behavior and narrow interests. The theory of the mind says this could be due to the inability to inhibit one’s point of view-preventing them from considering the possibility of another’s view being considered.
There is some thought that the theory of the mind deficits are secondary to dysfunction of executive function. A study examined a large number of adults with autistic spectrum disorder monitoring brain activity during go/no-go tasks and although behaviors were not different the activity in the brain associated with the behavioral inhibition was reduced in those with autism. This led the study to conclude that deficits in adults with autism remain significant and further research needs to be done in the neurobiology of the inhibition network in adulthood. Further research is also needed as autistic spectrum disorder individuals often have a co-morbidity of ADHD as seen as 28.2% to 78% of autistic spectrum disorder patients. The current research not only draws attention to a deficit in inhibitory control but also raises several important questions like how does this inhibition deficit contribute to clinical impairment on a daily basis (Uzefovsky et al, 2016).
Anderson, C., Lupfer, A., & Shattuck, P.T. (2018). Barriers to receipt of services for young adults with autism. Pediatrics, 141 (s4). American Academy of Pediatrics.
Montgomery, C.B. et al. (2016). Do adults with high functioning autism or Asperger syndrome differ in empathy and emotional recognition? Journal of Autistic Developmental Disorders, 46(6).
Spitzer, D. et al. (In press). Confabulation in children with autism. CORTEX. Institute of Cognitive Neuroscience. University College London.
Uzefovsky, F. et al. (2016). Brief Report: The Go/No-Go task online: Inhibitory control deficits in Autism in a large sample. Journal of Autism Developmental Disorders, 46(8).