Comparing Rates of Psychiatric and Behavior Disorders in Adolescents and Young Adults with Severe Intellectual Disability with and without Autism

Eight males and four females with an Autism Diagnostic Interview-Revised (ADI-R) diagnosis of autism (mean age of 16.3 years) and severe intellectual disability (IQ < 40) were individually matched to controls on the basis of chronological age, gender, and nonverbal IQ. The dependent measure was the Diagnostic Assessment for the Severely Handicapped-II, which is used to screen for psychiatric and behavior disorders in lower-functioning individuals. Participants with autism showed significantly greater disturbances as measured by the Diagnostic Assessment for the Severely Handicapped-II total score and seven of 13 subscales. They also averaged 5.25 clinically significant disturbances compared with 1.25 disturbances for participants without autism. Specific vulnerabilities to anxiety, mood, sleep, organic syndromes, and stereotypies/ tics were found in the participants with comorbid autism.     

Psychopathology in Adults with Autism and Intellectual Disability

There have been few studies of psychopathology in adult with autism. This study examined psychiatric co-morbidity in 147 adults with intellectual disability (ID) and autism and 605 adults with ID but without autism. After controlling for the effects of gender, age, psychotropic medication and level of ID, people with autism and ID were no more likely to receive a psychiatric diagnosis than people with ID only. People with autism were less likely to receive a diagnosis of personality disorder. These findings cast doubts on the hypothesis that adults with ID and autism are more vulnerable to certain psychiatric disorders than non-autistic adults with ID.     

Nonverbal Social Skills of Adults with Mild Intellectual Disability Diagnosed with Depression

Depression is one of the most common psychiatric disorders in adults with intellectual disability (ID), yet little is known about depressive behaviors in an ID population. This study examined the nonverbal social skills of 18 adults with mild ID diagnosed with depression and a matched sample of adults with mild ID without depression. Nonverbal social skills were coded from videotapes of actual social interactions. Results indicate that adults with mild ID diagnosed with depression evidence a profile of maladaptive nonverbal social skills including limited body movement, a restricted range of facial expressions, infrequent smiling, speaking in a flat and quiet voice, and taking a long time to respond to the questions or comments of a social partner. Findings from this study have implications for enhancing the early detection and diagnosis of depression and guiding theories of and treatments for depression in an ID population.     

A Communication Course for Adults with Profound Intellectual Disability and Physical Disabilities

From September to December 1989 Ipswich TAFE (an adult education facility near Brisbane, Queensland) hosted a Communication Course for five adults who each have a profound intellectual disability and physical disability (in the UK this is the equivalent of profound and multiple learning difficulties). None of the five students possess skills of intentional communication. The course is believed to be the first one of its kind in Australia and was of an experimental nature. The course content is described. The main aim of this presentation is to share information and to invite collaboration from others in similar areas of work.     

Psychopathology in Children and Adolescents with Autism Compared to Young People with Intellectual Disability

Autism is a neurodevelopmental disorder with a specific pattern of behavioural, communication and social problems. Additional mental health problems are often poorly understood and undetected. This study investigates the level and pattern of emotional and behavioural problems in young people with autism compared with children with intellectual disability (ID). Subjects were 381 young people with autism and a representative group of 581 Australian young people with ID aged 4–18 years. Parents/carers provided details of the emotional and behavioural problems of their child using the Developmental Behaviour Checklist (DBC-P). Young people with autism were found to suffer from significantly higher levels of psychopathology than young people with ID. The implications of this finding are discussed.     

A Systematic Review and Meta-analysis of Social Skills Training for Adults with Autism Spectrum Disorder

Journal of Autism and Developmental Disorders - This systematic review and meta-analysis is the first to evaluate the effects of group-based social skills training (SST) on parent-report social...     

Sleep Disturbances in Adults with Autism Spectrum Disorders and Severe Intellectual Impairments

Sleep disturbances are a significant problem for persons with developmental disabilities. These problems occur at a higher rate than what is observed in the typically developing population, and persons with Autism Spectrum Disorders (ASD) appear to be at a higher risk than individuals with other developmental disabilities. However, another major risk is intellectual disability (ID). These two groups of disorders overlap to a substantial degree. Thus, persons with ASD and ID appear to be particularly susceptible to sleep disturbances. These sleep problems can have serious consequences beyond sleep, particularly with respect to increased challenging behaviors and as an impediment to learning. Despite these concerns, adults with ASD and ID have been largely neglected with respect to the study of these nocturnal difficulties. In this report, 168 adults with ASD and ID were compared to 166 adults with ID alone in regard to sleep disturbance and related difficulties. Individuals in the ASD group presented with much higher rates of sleep disturbances, and greater severity of sleep disorder was related to the expression of more serious challenging behaviors. The implications of our results are discussed for future assessment and treatment of these disorders.     

Comparison of Adaptive Functioning Measures in Adolescents with Autism Spectrum Disorder Without Intellectual Disability

Journal of Autism and Developmental Disorders - There is limited literature examining the adaptive functioning of adolescents with autism spectrum disorder (ASD). This study aimed to (a) document...     

Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning Autism

The effectiveness of a social skills training group for adolescents with Asperger syndrome and high-functioning autism (AS/HFA) was evaluated. Parents of six groups of adolescents (n = 46, 61% male, mean age 14.6) completed questionnaires immediately before and after the 12-week group. Parents and adolescents were surveyed regarding their experience with the group. Significant pre- to post-treatment gains were found on measures of both social competence and problem behaviors associated with AS/HFA. Effect sizes ranged from .34 to .72. Adolescents reported more perceived skill improvements than did parents. Parent-reported improvement suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.     

Depression and Anxiety Symptoms in Children and Adolescents with Autism Spectrum Disorders without Intellectual Disability

Recent studies have shown that rates of depression and anxiety symptoms are elevated among individuals with autism spectrum disorders (ASDs) of various ages and IQs and that depression/anxiety symptoms are associated with higher IQ and fewer ASD symptoms. In this study which examined correlates of depression and anxiety symptoms in the full school-age range of children and adolescents (age 6-18) with ASDs and IQs ≥ 70 (n = 95), we also observed elevated rates of depression/anxiety symptoms, but we did not find higher IQ or fewer ASD symptoms among individuals with ASDs and depression or anxiety symptoms. These findings indicate an increased risk for depression/anxiety symptoms in children and adolescents with ASDs without intellectual disability, regardless of age, IQ, or ASD symptoms.     

Identification of Post-Traumatic Stress Disorder in Individuals with Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Introduction: autism spectrum disorder (ASD) and intellectual disability (ID) seem to influence the risk of and vulnerability to exposure to trauma and adverse events. While assessment of a psychiatric disorder in ASD and ID generally is challenging, identification of post-traumatic stress disorder (PTSD) seems particularly so, and knowledge does not seem easily accessible. Methods: This article provides a systematic review of studies describing trauma reactions in individuals with both ASD and ID, including studies involving any single case with the combination of ASD, ID, and PTSD. To systematically explore PTSD symptom presentation in the group, all reported symptoms from studies were assigned by DSM-5 criteria. Results: Eighteen studies met the inclusion criteria, eight group studies and 10 case studies. Assessment methodology in studies varied, as did the format of symptom report. DSM-5 criteria provided a useful framework for integrating findings across studies, indicating that PTSD may be identified in individuals with ASD and ID. However, symptoms involving alterations in arousal and negative alterations in thought and behavior seem more easily identified than symptoms of reexperiencing and avoidance. Conclusions: There is an urgent need to identify behavioral equivalents to PTSD symptoms in this group, making it possible to identify warning signs of trauma and abuse even if such incidents are not known to family or professional carers.     

Assessing the Dim Light Melatonin Onset in Adults with Autism Spectrum Disorder and No Comorbid Intellectual Disability

This study assessed melatonin levels and the dim light melatonin onset (DLMO) in adults with Autism Spectrum Disorder (ASD) and also investigated the relationships between melatonin and objectively measured sleep parameters. Sixteen adults with ASD (ASD-Only), 12 adults with ASD medicated for comorbid diagnoses of anxiety and/or depression (ASD-Med) and 32 controls participated in the study. Although, the timing of the DLMO did not differ between the two groups, advances and delays of the melatonin rhythm were observed in individual profiles. Overall mean melatonin levels were lower in the ASD-Med group compared to the two other groups. Lastly, greater increases in melatonin in the hour prior to sleep were associated with greater sleep efficiency in the ASD groups.