Services for Adults With an Autism Spectrum Disorder

Assistant Professor, Brown School of Social Work, Washington University, St Louis, Missouri.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.55). 05/2012; 57(5):284-91.
Source: PubMed


The need for useful evidence about services is increasing as larger numbers of children identified with an autism spectrum disorder (ASD) age toward adulthood. The objective of this review was to characterize the topical and methodological aspects of research on services for supporting success in work, education, and social participation among adults with an ASD and to propose recommendations for moving this area of research forward. We reviewed the literature published in English from 2000 to 2010 and found that the evidence base about services for adults with an ASD is underdeveloped and can be considered a field of inquiry that is relatively unformed. Extant research does not reflect the demographic or impairment heterogeneity of the population, the range of services that adults with autism require to function with purposeful lives in the community, and the need for coordination across service systems and sectors. Future studies must examine issues related to cost and efficiency, given the broader sociopolitical and economic context of service provision. Further, future research needs to consider how demographic and impairment heterogeneity have implications for building an evidence base that will have greater external validity.

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Available from: Anne M Roux, Feb 09, 2015
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    • "High-functioning young adults with an autism spectrum disorder (ASD) have a high unemployment rate (50–75 %) (Hendricks 2010; Liptak et al. 2011; Volkmar et al. 2009) that may be partially explained by the unavailability of services to support obtaining employment (Gerhardt and Lainer 2011; Higgins et al. 2008). Thus, there is a clear need to develop novel evidence-based vocational services for these individuals (Shattuck et al. 2012b). A recent Autism Speaks stakeholder meeting identified the job interview as a major barrier to obtaining work for highfunctioning adolescents and adults with ASD (Autism Speaks 2012). "
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    ABSTRACT: Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not controls with ASD. We conducted a brief survey with 23 of 26 participants from this study to evaluate their vocational outcomes at 6-month follow-up with a focus on whether or not they attained a competitive position (employment or competitive volunteering). Logistic regression indicated VR-JIT trainees had greater odds of attaining a competitive position than controls (OR 7.82, p \ 0.05). Initial evidence suggests VR-JIT is a promising intervention that enhances vocational outcomes among young adults with high-functioning ASD.
    Full-text · Article · May 2015 · Journal of Autism and Developmental Disorders
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    • "Published online in Wiley Online Library ( DOI: 10.1002/aur.1433 © 2014 International Society for Autism Research, Wiley Periodicals, Inc. RESEARCH ARTICLE INSAR [Shattuck et al., 2012b "
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    ABSTRACT: Adults with autism spectrum disorder (ASD) face substantial challenges accomplishing basic tasks associated with daily living, which are exacerbated by their broad and pervasive difficulties with social interactions. These challenges put people with ASD at increased risk for psychophysiological distress, which likely factors heavily into social functioning for adults with ASD, as suggested by a growing literature on stress in children that indicates that children with ASD have differential responses to stress than healthy children. We hypothesized that adults with ASD and without intellectual disability (n = 38) would experience more stress than healthy volunteers (n = 37) and that there would be an inverse relationship between stress and social functioning in individuals with ASD. Baseline, semi-structured interview data from a randomized controlled trial of two treatments for adults with ASD were used to assess differences in stress between adults with ASD and healthy volunteers and to assess the relationship between stress response and social functioning in adults with ASD. Findings indicate that adults with ASD experience greater perceived and interviewer-observed stress than healthy volunteers and that stress is significantly related to social functioning in adults with ASD. These findings highlight the role of stress in adult functioning and outcomes and suggest the need to develop and assess treatments designed to target stress and coping in adults with ASD. Autism Res 2014, ●●: ●●–●●. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.
    Full-text · Article · Dec 2014 · Autism Research
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    • "A handful of longitudinal studies have demonstrated the many challenges youth with HFASD encounter once they become adults. Despite having intact cognitive skills, the large majority of adults and adolescents with HFASD continue to struggle with finding meaningful and gainful employment, as well as some degree of autonomy and independence in their lives [14]. For example, in a study examining outcomes of 19 men with HFASD, half had been educated in a special autism class, 5% had obtained independent employment, 16% worked in sheltered or voluntary jobs, and 11% were in full time education. "
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    ABSTRACT: Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD.
    Full-text · Article · Sep 2014
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