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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    • "Comparative studies have suggested that individuals with ASD had less residential independence than adults with Down syndrome (Esbensen et al. 2010) and youth with other educational classifications including intellectual disabilities, traumatic brain injury, learning disabilities, speech-language impairments, sensory impairments, or emotional disturbances (*Newman et al. 2011). Related to residential independence, daily living skill independence was shown to increase in adolescence and early adulthood, but leveloff and then begin to decline around 30 years of age in a longitudinal trajectory analysis (Smith et al. 2012). Because many adults with ASD live in supported settings and have limited engagement in employment, they may have minimal motivation or need to expand or even maintain their skills and independence over time. "
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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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    • "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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