Developmental Trajectories in Adolescents and Adults With Autism: The Case of Daily Living Skills

Waisman Center, University of Wisconsin-Madison, WI 53704, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 7.26). 06/2012; 51(6):622-31. DOI: 10.1016/j.jaac.2012.03.001
Source: PubMed


This study aimed to investigate the longitudinal course of daily living skills in a large, community-based sample of adolescents and adults with autism spectrum disorders (ASD) over a 10-year period.
Adolescents and adults with ASD (n = 397) were drawn from an ongoing, longitudinal study of individuals with ASD and their families. A comparison group of 167 individuals with Down syndrome (DS) were drawn from a linked longitudinal study. The Waisman Activities of Daily Living Scale was administered four times over a 10-year period.
We used latent growth curve modeling to examine change in daily living skills. Daily living skills improved for the individuals with ASD during adolescence and their early 20s, but plateaued during their late 20s. Having an intellectual disability was associated with lower initial levels of daily living skills and a slower change over time. Individuals with DS likewise gained daily living skills over time, but there was no significant curvature in the change.
Future research should explore what environmental factors and interventions may be associated with continued gains in daily living skills for adults with ASD.

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    • "Strikingly, IQ was not a significant predictor of later adaptive behavior in any domain, despite the wide variance in cognitive abilities . This is in contrast to prior longitudinal research demonstrating that lower IQ is associated with slower adaptive gains (Freeman et al. 1999; Green and Carter, 2014; Smith et al. 2012). The discrepancy in findings may be attributable to the inclusion of youth with ID in previous longitudinal samples. "
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    ABSTRACT: This study characterizes longitudinal change in adaptive behavior in 64 children and adolescents with autism spectrum disorder (ASD) without intellectual disability evaluated on multiple occasions, and examines whether prior estimate of executive function (EF) problems predicts future adaptive behavior scores. Compared to standardized estimates for their developmental stage, adaptive behavior in most participants was impaired and did not improve over time. Prior EF predicted later adaptive behavior in daily living skills and socialization domains after controlling for age and IQ. Self-monitoring behaviors robustly predicted later adaptive behavior in all domains (d = 0.60-0.94). Results support targeting treatment of adaptive skills in ASD, as well as the importance of assessing for EF problems that may contribute to adaptive behavior difficulties.
    Journal of Autism and Developmental Disorders 09/2015; DOI:10.1007/s10803-015-2584-5 · 3.06 Impact Factor
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    • "Maenner et al. 2013), which was equally high in the current study (Cronbach's a = .91). The W-ADL has been used in other studies with adolescents and adults with ASD (Smith et al. 2012; Taylor et al. 2014). "
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    ABSTRACT: Most research on mental health in individuals with autism spectrum disorder (ASD) and intellectual disability (ID) has focused on deficits. We examined individual (i.e., sociocommunicative skills, adaptive behavior, functional cognitive skills) and contextual (i.e., home, school, and community participation) correlates of thriving in 330 youth with ID and ASD compared to youth with ID only, 11-22 years of age (M = 16.74, SD = 2.95). Youth with ASD and ID were reported to thrive less than peers with ID only. Group differences in sociocommunicative ability and school participation mediated the relationship between ASD and less thriving. Research is needed to further elucidate a developmental-contextual framework that can inform interventions to promote mental health and wellness in individuals with ASD and ID.
    Journal of Autism and Developmental Disorders 03/2015; 45(8). DOI:10.1007/s10803-015-2412-y · 3.34 Impact Factor
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    • "The linkage between the deviation from the normal trajectory of brain growth and the severity of disease suggests a contribution of these changes to the clinical phenotype [26]. Modest improvements in communication [33-35], reciprocal social interactions [36], and restrictive, repetitive behaviors and interests [12,36] evident during the transition from childhood to adolescence, from adolescence to adulthood, and in adulthood define the behavioral trajectories of development and maturation of individuals with autism [35,37,38]. One may assume that the age-dependent alterations of neuronal growth in the subcortical structures, the cerebellum, and the brainstem are integral components of brain pathology that may contribute to different clinical manifestations of autism at different stages of life. "
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    ABSTRACT: Several morphometric studies have revealed smaller than normal neurons in the neocortex of autistic subjects. To test the hypothesis that abnormal neuronal growth is a marker of an autism-associated global encephalopathy, neuronal volumes were estimated in 16 brain regions, including various subcortical structures, Ammon's horn, archicortex, cerebellum, and brainstem in 14 brains from individuals with autism 4 to 60 years of age and 14 age-matched control brains. This stereological study showed a significantly smaller volume of neuronal soma in 14 of 16 regions in the 4- to 8-year-old autistic brains than in the controls. Arbitrary classification revealed a very severe neuronal volume deficit in 14.3% of significantly altered structures, severe in 50%, moderate in 21.4%, and mild in 14.3% structures. This pattern suggests desynchronized neuronal growth in the interacting neuronal networks involved in the autistic phenotype. The comparative study of the autistic and control subject brains revealed that the number of structures with a significant volume deficit decreased from 14 in the 4- to 8-year-old autistic subjects to 4 in the 36- to 60-year-old. Neuronal volumes in 75% of the structures examined in the older adults with autism are comparable to neuronal volume in age-matched controls. This pattern suggests defects of neuronal growth in early childhood and delayed up-regulation of neuronal growth during adolescence and adulthood reducing neuron soma volume deficit in majority of examined regions. However, significant correction of neuron size but limited clinical improvements suggests that delayed correction does not restore functional deficits.
    03/2014; 2(1):28. DOI:10.1186/2051-5960-2-28
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