Employment and Post-Secondary Educational Activities for Young Adults with Autism Spectrum Disorders During the Transition to Adulthood

This report describes the post-high school educational and occupational activities for 66 young adults with autism spectrum disorders who had recently exited the secondary school system. Analyses indicated low rates of employment in the community, with the majority of young adults (56%) spending time in sheltered workshops or day activity centers. Young adults with ASD without an intellectual disability were three times more likely to have no daytime activities compared to adults with ASD who had an intellectual disability. Differences in behavioral functioning were observed by employment/day activity group. Our findings suggest that the current service system may be inadequate to accommodate the needs of youths with ASD who do not have intellectual disabilities during the transition to adulthood.     

Science, Technology, Engineering, and Mathematics (STEM) Participation Among College Students with an Autism Spectrum Disorder

Little research has examined the popular belief that individuals with an autism spectrum disorder (ASD) are more likely than the general population to gravitate toward science, technology, engineering, and mathematics (STEM) fields. This study analyzed data from the National Longitudinal Transition Study-2, a nationally representative sample of students with an ASD in special education. Findings suggest that students with an ASD had the highest STEM participation rates although their college enrollment rate was the third lowest among 11 disability categories and students in the general population. Disproportionate postsecondary enrollment and STEM participation by gender, family income, and mental functioning skills were found for young adults with an ASD. Educational policy implications are discussed.     

Psychopathological symptoms associated with psychosocial functioning in children and adolescents with autism spectrum disorders and their typically developing peers

Children and adolescents with autism have increased prevalence of psychosocial disabilities. Studies in autism indicate that key psychosocial factors including adaptive functioning, school absence, special needs education, frequency of peer socialization and participation in organized leisure activities may differ in their relationship with autistic, internalizing and externalizing symptoms, but the findings are so far mixed. Therefore, we examined if these measures of psychosocial functioning displayed specific associations with autistic, internalizing and/or externalizing symptoms in 61 children with autism aged 7–14 years compared to 61 typically developing controls. Multiple linear regression analyses across all participants showed that lower adaptive functioning, frequency of peer socialization and participation in leisure activities were driven by more social communication problems and not internalizing, externalizing or autistic-like symptoms including rigidity, stereotypy and sensory sensitivity. Notably, increased school absence was specifically driven by more internalizing symptoms and not autistic or externalizing symptoms. These associations were observed across all participants, both children with autism and their typically developing peers, and therefore appear to be dimensional and general in nature. Within the autism group, children who received special needs education displayed fewer social communication problems compared to those who attended regular education, while a developmental history of social interaction problems was related to lower adaptive functioning. Our findings suggest that social communication problems are more critical for psychosocial functioning than other autistic-like behaviors, internalizing or externalizing symptoms but that efforts to reduce school absence specifically need to target internalizing symptoms and not autistic-like or externalizing symptoms.     

Identifying early intervention targets for children with autism in inclusive school settings

This study assessed play and social behavior of young children with autism in inclusive school settings to identify important targets for intervention. Data were collected for five children with autism and for typically developing peers. All children with autism received intervention in one-on-one settings but did not have individual education plan goals that provided systematic intervention for developing play and social skills in their school settings. Results indicated the children with autism and their typically developing peers played with a comparable number of stimulus items (e.g., toys), but the children with autism engaged in these activities for shorter durations. Both children with autism and their typically developing peers engaged in similar levels of social interaction with adults. However, the children with autism rarely or never engaged in social interactions with their peers, whereas the typically developing peers frequently engaged in social interactions with other children. The results suggest important targets for intervention.     

Characteristics of social skills for adults with intellectual disability,autism and PDD-NOS

Social skills deficits and excesses are defining characteristics of intellectual disability (ID). Despite this, there is an unfortunate lack of research on the patterns and profiles of social behavior, particularly with adults who are severely intellectually disabled. This paper provides an analysis of social skill patterns for adults living in residential programs in the southeastern United States using the Matson Evaluation of Social Skills for Individuals with sEvere Retardation (MESSIER) as the dependent variable. A diagnosis of an autism spectrum disorder (ASD) was associated with more serious social disability. Items that were most commonly noted as problematic for individuals with ASD included preferring to be alone, avoiding eye contact, and exhibiting peculiar or odd mannerisms. Additionally, the presence of blindness and motoric impairment was associated with a higher degree of social skills impairment. The implications of these data for assessment, treatment, and future research are discussed.     

Peer Relationships and Social and Recreational Activities Among Adolescents and Adults with Autism

In this study, we investigate peer relationships and participation in social and recreational activities among 235 adolescents and adults with autism who live at home. The prevalence of having friendships, peer relationships, and participating in social and recreational activities were all low and comparable to previous research. Both individual and environmental factors were investigated as predictors of having peer relationships and participation in social and recreational activities. Having peer relationships was predicted by individual characteristics (younger age, and less impairment in social interaction skills), but not by characteristics of the environment. Greater participation in social and recreational activities was predicted by characteristics of the individual with autism (greater functional independence, less impairment in social interaction skills, higher levels of internalizing behaviors) and characteristics of the environment (greater maternal participation in social and recreational activities, greater number of services received, and inclusion in integrated settings while in school).     

A systematic review of social participation for adults with autism spectrum disorders: Support,social functioning,and quality of life

A systematic review of the literature was conducted to investigate what is currently known about support for social participation for adults with autism spectrum disorders (ASD). A computerized database search followed by hand searching was conducted to locate empirical studies published after 1995 in peer-reviewed journals that described social participation or social support for adults with ASD. 14 studies were identified, evaluated for strength of evidence, and organized into topical themes. These studies focused on support for social participation from two perspectives: social functioning and quality of life (QoL). Supporting social functioning and social participation is important, as this is one route through which individuals with ASD may be able to form relationships and establish natural support networks, which can in turn contribute to QoL. In addition, working to improve social skills is of key importance as social functioning heavily impacts outcomes in a variety of areas. Social participation, social functioning, and QoL for adults with ASD appear to be facilitated through informal social support from social networks, participation in social skills groups, and membership in support groups.     

Health Concerns and Health Service Utilization in a Population Cohort of Young Adults with Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) have many health needs that place demands on the health service sector. This study used administrative data to compare health profiles in young adults 18–24 years of age with ASD to peers with and without other developmental disability. Young adults with ASD were more likely to have almost all the examined clinical health issues and health service use indicators compared to peers without developmental disability. They were more likely to have at least one psychiatric diagnosis, and visit the family physician, pediatrician, psychiatrist, and emergency department for psychiatric reasons, compared to peers with other developmental disability. Planning for the mental health care of transition age adults with ASD is an important priority for health policy.     

Predictors of sustainable work participation of young adults with developmental disorders

For individuals with autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) work participation is a challenge, as shown by their low employment rates. The aim of this study was to investigate which factors predict work participation, finding work as well as maintaining employment, of young adults with ASD as well as ADD. We obtained data on 563 individuals with ASD and/or ADD, aged 15–27 years. The follow-up period ranged from 1.25 to 2.75 years. Being male (for ADD), living independently (for ASD), expecting to be able to work fulltime (for ASD and ADD), high perceived support from parents and perceived positive attitude of parents regarding work (for ASD and ADD) and perceived positive attitude of social environment (for ADD) predicted finding work by the young adult, while being male (for ADD) and higher age (for ASD and ADD) and positive attitude of social environment regarding work (for ASD) predicted maintaining employment. Both personal and social factors predict work outcome and should be taken into account when supporting individuals with DD in their transition to work.     

College Students’ Openness Toward Autism Spectrum Disorders: Improving Peer Acceptance

One probable consequence of rising rates of autism spectrum disorder diagnosis in individuals without co-occurring intellectual disability is that more young adults with diagnoses or traits of ASD will attend college and require appropriate supports. This study sought to explore college students’ openness to peers who demonstrate ASD-characteristic behaviors. Results showed a significant difference in openness between students who had a first-degree relative with an ASD (n = 18) and a gender-matched comparison group of students without such experience (F = 4.85, p = .035). Engineering and physical science majors did not demonstrate more overall openness. Universities should make efforts to prevent social isolation of students with ASD, such as programs to educate students about ASD and supports to ease college transition.     

Social Skills Training for Young Adults with High-Functioning Autism Spectrum Disorders: A Randomized Controlled Pilot Study

Despite the psychosocial difficulties common among young adults with autism spectrum disorders (ASD), little to no evidence-based social skills interventions exist for this population. Using a randomized controlled trial (RCT) design, the current study tested the effectiveness of an evidence-based, caregiver-assisted social skills intervention known as PEERS for Young Adults with high-functioning young adults with ASD (ages 18-23) using self- and caregiver-report measures. Results revealed that treated young adults reported significantly less loneliness and improved social skills knowledge, while caregivers reported significant improvements in young adults' overall social skills, social responsiveness, empathy, and frequency of get-togethers. Results support the effectiveness of using this caregiver-assisted, manualized intervention for young adults with ASD.     

Social Network Changes Over the School Year Among Elementary School-Aged Children with and Without an Autism Spectrum Disorder

This study examined the stability of children’s social networks and friendship features over one academic school year. Differences in the social network salience between typically developing children, children with an autism spectrum disorder (ASD), and children with a non-ASD disability were explored. As a whole, social network salience increased for all students across the school year; however, children in the upper grades had higher social network salience as the school year progressed than those in the younger grades. Compared to children with a non-ASD disability and typically developing children, children with ASD had significantly lower social network salience and received significantly fewer friendship nominations and more non-preferred nominations across the school year. While these data suggest that children’s social networks and patterns of peer relationships are relatively stable over time, school-based interventions that foster social development and peer engagement are still needed for children with ASD.     

Improving Social Skills in Adolescents and Adults with Autism and Severe to Profound Intellectual Disability: A Review of the Literature

Social skills are important treatment targets for individuals with autism spectrum disorders (ASD) across the lifespan. However, few treatments are available for adolescents and adults with ASD who also have severe to profound intellectual disability (S/PID). Several social skill interventions have been described that may improve social skills in this population, including video modeling, developmental, peer-mediated, behavioral, and structured teaching interventions. However, significant challenges in research design and methodology exist across these studies. This paper reviews research examining social skill interventions for youth and adults with ASD and S/PID and points out weaknesses and challenges in this literature. We propose a developmental framework of adapting early childhood interventions for use with youth and adults with ASD and S/PID as one starting point for intervention development.     

A comparison of social skills profiles in intellectually disabled adults with and without ASD

The purpose of this study was to systematically examine the social-skills profiles among adults with autism spectrum disorders (ASD) and intellectual disability (ID). Using one-way multivariate analysis of variance (MANOVA), three groups (autism, pervasive developmental disorder-not otherwise specified [PDD-NOS], and ID only) were compared on seven global measures of social behavior. There were 72 individuals in each group matched on level of ID, verbal ability, age, and gender. Distinctions were noted in the areas of positive social behaviors and negative nonverbal social behaviors. Those with autism displayed the greatest deficits in these areas, followed by those with PDD-NOS. The results support the notions that social impairment remains a distinct feature of ASD in adults with ID, that autism and PDD-NOS are two conditions on the same spectrum, and that this spectrum is relevant for adults with ID. Implications of the results and directions for future research are discussed.     

The Gap Between Adaptive Behavior and Intelligence in Autism Persists into Young Adulthood and is Linked to Psychiatric Co-morbidities

For individuals with autism spectrum disorder (ASD), long-term outcomes have been troubling, and intact IQ has not been shown to be protective. Nevertheless, relatively little research into adaptive functioning among adults with ASD has been completed to date. Therefore, both adaptive functioning and comorbid psychopathology were assessed among 52 adults with ASD without intellectual disability (ID). Adaptive functioning was found to substantially lag behind IQ, and socialization was a particular weakness. Comorbid psychopathology was significantly correlated with the size of IQ-adaptive functioning discrepancy. These findings emphasize key intervention targets of both adaptive skill and psychopathology for transition-age youth and young adults with ASD, as well as the need for ongoing monitoring of anxiety and depression symptoms during this developmental window.     

Factors associated with quality of life in individuals with autism spectrum disorders: A review of literature

This review study was conducted to synthesize the existing research on the level of quality of life (QoL) in individuals with autism spectrum disorders (ASD) and the factors associated with their QoL. A total of 16 studies were included for this review. This study found that (a) the majority of the individuals with ASD had poor QoL; (b) behavior problems and leisure activities were associated with the QoL of the majority of adults with ASD; (c) autism severity, age, behavior problems, social skills, adaptive behavior, education, and comorbid psychiatric conditions were associated with the QoL of the majority of children with ASD. These findings may provide critical information to parents/caregivers of individuals with ASD and practitioners providing services to them.     

Behavior Problems,Psychiatric Symptoms,and Quality of Life for Older Adults With Intellectual Disability With and Without Autism

The evidence base on outcomes associated with autism in older adulthood is limited. The expected increase in the prevalence of older adults with autism highlights the need to describe their profiles and service needs. Adults 50 years or older with an intellectual disability (ID) and the triad of impairments characteristic of autism spectrum disorders (ASD) were compared to peers with ID only, and younger adults with ASD and ID. After accounting for ability differences, older adults with ASD did not differ from those with ID in terms of behavior problems, psychiatric disorder, and quality of life. Any differences in the skills of adults with ASD were associated with decreased adaptive skills, and not the presence of ASD per se.     

Cooperative learning and social acceptance of children with mild intellectual disability

The effects of the participation of non-disabled children in a cooperative learning programme on their social acceptance of classmates with mild intellectual disability was examined. A sample of 24 children with mild intellectual disability in the 9–11-year-old age-range was identified from educational psychologists' case records. All of the children were receiving mainstreaming special education programmes at the time of the study. Twelve of the children had previously attended special education classes, while the remainder had always attended regular classes. Half of the children's regular classes were randomly assigned to either receive an experimental cooperative learning programme or to serve as control classrooms. The non-disabled children in the experimental classes showed significant increases in their social acceptance (sociometric ratings) of the children with mild intellectual disability, both immediately following the programme and 5 weeks later, but no such increases were evident in the children in the control classrooms. This pattern held for both the former special class pupils and the children with mild intellectual disability who had never attended special classes. The results confirm the usefulness of cooperative learning strategies for enhancing the social acceptance of children with mild intellectual disability in mainstreaming special educational programmes, regardless of the nature of their previous special educational provisions.     

Health-related quality of life and its determinants among adults with autism

The purpose of this study was to determine health-related quality of life (HRQOL) among adults with autism, and compare it to the HRQOL of the general adult population in the United States (US). Factors predicting HRQOL of adults with autism were also identified. A cross-sectional online survey was conducted to gather study information. From adults with autism registered with the Interactive Autism Network (IAN), those aged 18 years and above and having the capacity to self-report were identified and approached for study participation. The final sample included 291 adults with autism. One-way t-test revealed adults with autism to have significantly lower physical and mental HRQOL than their counterparts in the US population. Using linear regression analysis, modifiable factors including social support and coping along with other socio-demographic and medial characteristics were identified as significant predictors of physical and mental HRQOL. Greater perceived adequacy of social support from friends and family was associated with better HRQOL, while greater use of maladaptive coping was associated with lower HRQOL. Clinicians and other health interventionist should consider assessing these factors among adults with autism, and provide necessary capabilities to these adults with the aim of improving their HRQOL.     

Mothers of adolescents and adults with autism: parenting multiple children with disabilities

We examined types of disabilities in siblings from a large sample of families of adolescents and adults with autism spectrum disorders (ASD) and the impact of another child with a disability on maternal and family well-being. The most frequent disabilities in siblings were attention and hyperactivity (4.6%) and autism spectrum (2.4%) disorders and psychiatric (2.1%) and learning (2.0%) disabilities. Mothers parenting another child with a disability (in addition to the child with ASD) had higher levels of depressive symptoms and anxiety and lower family adaptability and cohesion compared with mothers whose only child with a disability had ASD (matched on child age and family size). Findings are discussed with respect to understanding the needs of such families, including service provision.