Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research, 2(2), 109-118

Utah Autism Research Program, Department of Psychiatry, University of Utah, 650 Komas Dr., Ste. 206, Salt Lake City, UT 84108, USA.
Autism Research (Impact Factor: 4.53). 04/2009; 2(2):109-18. DOI: 10.1002/aur.69
Source: PubMed

ABSTRACT Previous studies found substantial variability in adult outcome for people with autism whose cognitive functioning was within the near-average and average ranges. This study examined adult outcome for 41 such individuals (38 men and 3 women) originally identified through an epidemiological survey of autism in Utah. Mean age at the time of their previous cognitive assessment was 7.2 years (SD=4.1, range=3.1-25.9 years) and at follow-up was 32.5 years (SD=5.7 years, range=22.3-46.4 years). Outcome measures included standardized assessments of diagnostic status, cognitive ability, and adaptive behavior. Additional information collected concerned demographic variables, indicators of independence, social relationships, medical and psychiatric conditions, and social service use. Outcomes for this sample were better than outcomes described in previous work on individuals with similar cognitive functioning. For example, half of the participants were rated as "Very Good" or "Good" on a global outcome measure. As in previous studies, there was considerable variability in measured cognitive ability over time. Over half of the sample had large gains or losses of cognitive ability of greater than 1 standard deviation. Cognitive gain was associated with better outcome, as was better adaptive functioning. While all participants had baseline IQs in the nonimpaired range, there was limited evidence to support the use of other early childhood variables to predict adult outcome.

Download full-text


Available from: William R Jenson, Sep 03, 2015
    • "Thus, a significant proportion of adults in the community, including at university or college, may have ASD and may be undiagnosed. While social-communication deficits and repetitive behaviours tend to improve over time (Howlin and Moss 2012), they nevertheless continue into adulthood (Seltzer et al. 2004), and few adults with ASD, including those with good language and cognitive abilities, have good employment or educational outcomes (Farley et al. 2009; Magiati et al. 2014; Seltzer et al. 2004). Most individuals remain dependent on family support, with at least half remaining in the family home (Farely et al. 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Little research directly examines the needs of post-secondary students with ASD. The experiences and support needs of 23 students with ASD enrolled in two universities and four colleges, and 15 family members were explored in 15 semi-structured focus groups. Thematic analysis identified five themes: core ASD features, co-morbid conditions, transition, disclosure, and services and support. Most students felt educationally but not socially supported; most families felt support was poor in both areas. Transition from secondary school was often unplanned, and disclosure of diagnosis usually occurred after enrolment, often following a significant problem. Many parents provided substantial student support. Thus disclosure of ASD diagnosis and meeting the individual needs of these students are important considerations as higher education enrolments increase.
    Journal of Autism and Developmental Disorders 07/2015; DOI:10.1007/s10803-015-2535-1 · 3.06 Impact Factor
    • "To this aim, several valid and reliable instruments are available for evaluating the core behavioral features of ASD [e.g., the Autism Diagnostic Observation Schedule-2 (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R); Lord et al. 1994, 2012] and can be used for clinical purposes (Matson et al. 2011, 2012). However, the evaluation of adaptive behavior is also useful for diagnostic classification and treatment planning (Carter et al. 1998; Farley et al. 2009; Klin et al. 2007). The assessment of adaptive behavior is intended to determine individual abilities in everyday life in terms of functional communication, socialization, and daily living skills (Schalock et al. 2010; Tassé et al. 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: We investigated which item subsets of the Vineland-II can discriminate low-functioning preschoolers with ASD from matched peers with other neurodevelopmental disorders, using a regression analysis derived from a normative sample to account for cognitive and linguistic competencies. At variance with the typical profile, a pattern with Communication more impaired than Socialization was observed. The source of the frequently reported Socialization delay in ASD appears to be in Playing and Imitating skills only, not in other social adaptive behavior skills. The combination of item subsets Playing, Following instructions, Beginning to talk, and Speech skills provided the best discrimination between the two clinical groups. Evaluation of the Vineland-II score on item content categories is a useful procedure for a more efficient clinical description.
    Journal of Autism and Developmental Disorders 07/2015; DOI:10.1007/s10803-015-2533-3 · 3.06 Impact Factor
  • Source
    • "Outcomes in the Howlin study were classified based on performance IQ. Ranges were informed by additional studies reporting adult outcome by IQ (Cederlund et al. 2008; Engstrom et al. 2003; Farley et al. 2009; Gillberg and Steffenburg 1987; Howlin et al. 2000, 2004; Larsen and Mouridsen 1997; Rumsey et al. 1985; Szatmari et al. 1989) "
    [Show abstract] [Hide abstract]
    ABSTRACT: Novel management strategies for autism spectrum disorder (ASD) propose providing interventions before diagnosis. We performed a cost-effectiveness analysis comparing the costs and dependency-free life years (DFLYs) generated by pre-diagnosis intensive Early Start Denver Model (ESDM-I); pre-diagnosis parent-delivered ESDM (ESDM-PD); and the Ontario Status Quo (SQ). The analyses took government and societal perspectives to age 65. We assigned probabilities of Independent, Semi-dependent or Dependent living based on projected IQ. Costs per person (in Canadian dollars) were ascribed to each living setting. From a government perspective, the ESDM-PD produced an additional 0.17 DFLYs for $8600 less than SQ. From a societal perspective, the ESDM-I produced an additional 0.53 DFLYs for $45,000 less than SQ. Pre-diagnosis interventions targeting ASD symptoms warrant further investigation.
    Journal of Autism and Developmental Disorders 05/2015; DOI:10.1007/s10803-015-2447-0 · 3.06 Impact Factor
Show more