Assistance for Young Adults With Autism Declines After High School


It has been estimated that one in every 110 children will be diagnosed with an autism spectrum disorder. Most children are diagnosed early and treatment begun even in preschool. But a new study indicates that once a child reaches adolescence and young adulthood, the options for services begins to dwindle.

After High School, Case Management and Medical Service Use Declines

Until now, there has been very little research to better understand what happens to adolescents with autism once they reach young adulthood, a period in which youth are especially vulnerable due to communication challenges and limited ability to engage in social interaction.

Paul T. Shattuck PhD of Washington University and colleagues analyzed data from a telephone questionnaire that surveyed parents and guardians of 410 young adults between the ages of 19 and 23 years with an autism spectrum disorder. These surveys were conducted between April 2007 and February 2008. The survey asked questions about the patient’s use of medical, mental health and case management services.

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About two-fifths of youths, or about 39 percent, had not received any assistance services after age 18. Only about 41.9 percent were receiving case management services, down from 63.6% who had a case manager during their high school years. The biggest decrease was found to be in speech therapy services – only 9.1% of young adults were getting speech therapy after high school versus 74.6% during high school even though as many as 21% of the surveyed patients were considered nonverbal. Mental health service use also declined from 46.2% to 35%.


Risk factors for the decline in assistance service use were race and income. The odds of African American youths not receiving services was 3.31 times lower than whites. Those with income less than $25,000 were 5.96 times less likely to use services after high school than those whose income was more than $75,000.

Those with higher functional skills were also less likely to use medical services or case management. The researchers suggest that this is likely attributable to the fact that some states provide adult mental disabilities services that require demonstration of functional impairment.

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“Rates of service disengagement are high after exiting high school. Disparities by race and socioeconomic status indicate a need for targeted outreach and services” as well as a need for further research into access barriers, the authors conclude.

Autism Speaks has introduced a new tool to assist families on the transition of their autistic child from adolescence to adulthood. The “Transition Tool Kit” is a comprehensive resource for the “14 to 21 age group” that focuses on facilitating a youth with disabilities into the post-schooling environment, such as college, vocational education, and employment. It also offers legal and medical advice as well.

Parents can download the tool kit directly from the Autism Speaks website, or can fill out an order form for a complimentary hard copy to be sent to their home. Because the transition process is different in each state, the agency has also developed timelines and resource listings specific to your family’s state of residence.

Source reference:
Shattuck PT, et al "Post-high school service use among young adults with an autism spectrum disorder" Arch Peds Adolesc Med 2011; 165(2): 141-146.