Journal of Autism and Developmental Disorders

, Volume 40, Issue 12, pp 1431–1446 | Cite as

Changes in the Autism Behavioral Phenotype During the Transition to Adulthood

Original Paper

Abstract

We examined whether exiting high school was associated with alterations in rates of change in autism symptoms and maladaptive behaviors. Participants were 242 youth with ASD who had recently exited the school system and were part of our larger longitudinal study; data were collected at five time points over nearly 10 years. Results indicated overall improvement of autism symptoms and internalized behaviors over the study period, but slowing rates of improvement after exit. Youth who did not have an intellectual disability evidenced the greatest slowing in improvement. Lower family income was associated with less improvement. Our findings suggest that adult day activities may not be as intellectually stimulating as educational activities in school, reflected by less phenotypic improvement after exit.

Keywords

Autism spectrum disorder Transition to adulthood Maladaptive behaviors Autism symptoms 

References

  1. Aman, M. G., Lam, K. S. L., & Collier-Crespin, A. (2003). Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio. Journal of Autism and Developmental Disorders, 33, 527–534.CrossRefPubMedGoogle Scholar
  2. Benson, P. R. (2006). The impact of child symptom severity on depressed mood among parents of children with ASD: The mediating role of stress proliferation. Journal of Autism and Developmental Disorders, 36, 685–695.CrossRefPubMedGoogle Scholar
  3. Billstedt, E., Gillberg, I. C., & Gillberg, C. (2007). Autism in adults: Symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed since childhood. Journal of Child Psychology and Psychiatry, 48, 1102–1110.CrossRefPubMedGoogle Scholar
  4. Bouma, R., & Schweitzer, R. (1990). The impact of chronic childhood illness of family stress: A comparison between autism and cystic fibrosis. Journal of Clinical Psychology, 46, 722–730.CrossRefPubMedGoogle Scholar
  5. Bruininks, R. H., Woodcock, R. W., Weatherman, R. F., & Hill, B. K. (1996). Scales of independent behavior revised. Rolling Meadows, IL: Riverside Publishing.Google Scholar
  6. Bryk, A. S., & Raudenbush, S. W. (1987). Application of hierarchical linear models to assessing change. Psychological Bulletin, 101, 147–158.CrossRefGoogle Scholar
  7. Bryson, S. E., & Smith, I. M. (1998). Epidemiology of autism: Prevalence, associated characteristics, and implications for research and service delivery. Mental Retardation and Developmental Disabilities Research Reviews, 4, 97–103.CrossRefGoogle Scholar
  8. Donovan, A. M. (1988). Family stress and ways of coping with adolescents who have handicaps: Maternal perceptions. American Journal on Mental Retardation, 92, 502–509.PubMedGoogle Scholar
  9. Dumas, J. E., Wolf, L. C., Fisman, S. N., & Culligan, A. (1991). Parenting stress, child behavior problems, and dysphoria in parents of children with autism, Down syndrome, behavior disorders, and normal development. Exceptionality, 2, 97–110.CrossRefGoogle Scholar
  10. Eaves, L. C., & Ho, H. H. (2008). Young adult outcomes of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 739–747.CrossRefPubMedGoogle Scholar
  11. Esbensen, A. J., Seltzer, M. M., & Krauss, M. W. (2008). Stability and change in health, functional abilities, and behavior problems among adults with and without Down syndrome. American Journal on Mental Retardation, 113, 263–277.CrossRefPubMedGoogle Scholar
  12. Fecteau, S., Mottron, L., Berthiaume, C., & Burack, J. A. (2003). Developmental changes of autistic symptoms. Autism, 7, 255–268.CrossRefPubMedGoogle Scholar
  13. Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33, 365–382.CrossRefPubMedGoogle Scholar
  14. Francis, D. J., Fletcher, J. M., Stuebing, K. K., Davidson, K. C., & Thompson, N. M. (1991). Analysis of change: Modeling individual growth. Journal of Consulting and Clinical Psychology, 59, 27–37.CrossRefPubMedGoogle Scholar
  15. Galambos, N. L., Barker, E. T., & Krahn, H. J. (2006). Depression, self-esteem, and anger in emerging adulthood: Seven-year trajectories. Developmental Psychology, 42, 350–365.CrossRefPubMedGoogle Scholar
  16. Gillberg, C., & Steffenburg, S. (1987). Outcome and prognostic factors in infantile autism and similar conditions: A population-based study of 46 cases followed through puberty. Journal of Autism and Developmental Disorders, 17, 273–287.CrossRefPubMedGoogle Scholar
  17. Glutting, J. J., Adams, W., & Sheslow, D. (2000). Wide range intelligence test. Wilmington, DE: Wide Range.Google Scholar
  18. Gurney, J. G., Fritz, M. S., Ness, K. K., Sievers, P., Newschaffer, C. J., & Shapiro, E. G. (2003). Analysis of prevalence trends of autism spectrum disorder in Minnesota. Archives of Pediatrics and Adolescent Medicine, 157, 622–627.CrossRefPubMedGoogle Scholar
  19. Hastings, R. P. (2003). Child behaviour problems and partner mental health as correlates of stress in mothers and fathers of children with autism. Journal of Intellectual Disability Research, 47, 231–237.CrossRefPubMedGoogle Scholar
  20. Hastings, R. P., & Brown, T. (2002). Behavior problems of children with autism, parental self-efficacy, and mental health. American Journal on Mental Retardation, 107, 222–232.CrossRefPubMedGoogle Scholar
  21. Hill, A., Bolte, S., Petrova, G., Beltcheva, D., Tacheva, S., & Poustka, F. (2001). Stability and interpersonal agreement of the interview based diagnosis of autism. Psychopathology, 34, 187–191.CrossRefPubMedGoogle Scholar
  22. Hollander, E., Phillips, A. T., & Yeh, C. C. (2003). Targeted treatments for symptom domains in child and adolescent autism. Lancet, 362, 732–734.CrossRefPubMedGoogle Scholar
  23. Holroyd, J., & McArthur, D. (1976). Mental retardation and stress on the parents: A contrast between Down’s syndrome and childhood autism. American Journal on Mental Deficiency, 80, 431–436.Google Scholar
  24. Howlin, P. (2005). Outcomes in autism spectrum disorders. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders, vol. 1: Diagnosis, development, neurobiology, and behavior (3rd ed., pp. 201–220). Hoboken, NJ: Wiley.Google Scholar
  25. Howlin, P., Alcock, J., & Burkin, C. (2005). An 8 year follow-up of a specialist supported employment service for high-ability adults with autism or Asperger syndrome. Autism, 9, 533–549.CrossRefPubMedGoogle Scholar
  26. Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45, 212–229.CrossRefPubMedGoogle Scholar
  27. Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and developmental receptive language disorder A follow-up comparison in early adult. II: Social, behavioural, and psychiatric outcomes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 561–578.CrossRefGoogle Scholar
  28. Lecavalier, L. (2006). Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, 36, 1101–1114.CrossRefPubMedGoogle Scholar
  29. Lecavalier, L., Leone, S., & Wiltz, J. (2006). The impact of behaviour problems on caregiving stress in young people with autism spectrum disorders. Journal of Intellectual Disability Research, 50, 172–183.CrossRefPubMedGoogle Scholar
  30. Liptak, G. S., Benzoni, L. B., Mruzek, D. W., Nolan, K. W., Thingvoll, M. A., Wade, C. M., et al. (2008). Disparities in diagnosis and access to health services for children with autism: Data from the national survey of children’s health. Journal of Developmental and Behavioral Pediatrics, 29, 152–160.CrossRefPubMedGoogle Scholar
  31. Lord, C., & Bailey, A. (2002). Autism spectrum disorders. In M. Rutter & E. Taylor (Eds.), Child and adolescent psychiatry (pp. 664–681). Oxford: Blackwell Scientific.Google Scholar
  32. Lord, C., Pickles, A., McLennan, J., Rutter, M., Bregman, J., Folstein, S., et al. (1997). Diagnosing autism: Analyses of data from the autism diagnostic interview. Journal of Autism and Developmental Disorders, 27, 501–517.CrossRefPubMedGoogle Scholar
  33. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.CrossRefPubMedGoogle Scholar
  34. Lounds, J., Seltzer, M. M., Greenberg, J. S., & Shattuck, P. T. (2007). Transition and change in adolescents and young adults with autism: Longitudinal effects on maternal well-being. American Journal on Mental Retardation, 112, 401–417.CrossRefPubMedGoogle Scholar
  35. Luckasson, R., Borthwick-Duffy, S., Buntinx, W. H. E., Coulter, D. L., Craig, E. M., Reeve, A., et al. (2002). Mental retardation: Definition, classification, and systems of supports (10th ed.). Washington, DC: American Association on Mental Retardation.Google Scholar
  36. Marmot, M., Ryff, C. D., Bumpass, L. L., Shipley, M., & Marks, N. F. (1997). Social inequalities in health: Next questions and converging evidence. Social Science and Medicine, 44, 901–910.CrossRefPubMedGoogle Scholar
  37. Mawhood, L., Howlin, P., & Rutter, M. (2000). Autism and developmental receptive language disorder—a comparative follow-up in early adult life. I: Cognitive and language outcomes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 547–559.CrossRefGoogle Scholar
  38. McGovern, C. W., & Sigman, M. (2005). Continuity and change from early childhood to adolescence in autism. Journal of Child Psychology and Psychiatry, 46(4), 401–408.CrossRefPubMedGoogle Scholar
  39. Piven, J., Harper, J., Palmer, P., & Arndt, S. (1996). Course of behavioral change in autism: A retrospective study of high-IQ adolescents and adults. Journal of the Academy of Child and Adolescent Psychiatry, 35, 523–529.CrossRefGoogle Scholar
  40. Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
  41. Rodrigue, J. R., Morgan, S. B., & Geffken, G. R. (1990). Families of autistic children: Psychological functioning of mothers. Journal of Clinical Psychology, 19, 371–379.Google Scholar
  42. Ryff, C. D., & Singer, B. H. (2008). Know thyself and become what you are: A eudaimonic approach to psychological well-being. Journal of Happiness Studies, 9, 13–39.CrossRefGoogle Scholar
  43. Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism and Developmental Disorders, 33, 565–581.CrossRefPubMedGoogle Scholar
  44. Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Kring, S., Bolt, D., et al. (2007). Changes in autism symptoms and maladaptive behaviors among adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747.CrossRefPubMedGoogle Scholar
  45. Shea, S., Turgay, A., Carroll, A., Schulz, M., Orlik, H., Smith, I., et al. (2004). Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics, 114, 634–641.CrossRefGoogle Scholar
  46. Shea, V., & Mesibov, G. B. (2005). Adolescents and adults with autism. In F. R. Volkmar, R. Paul, A. Klin, & D. J. Cohen (Eds.), Handbook of autism and pervasive developmental disorders, vol. 1: Diagnosis, development, neurobiology, and behavior (3rd ed., pp. 288–311). Hoboken, NJ: Wiley.Google Scholar
  47. Shepperdson, B. (1995). Two longitudinal studies of the abilities of people with Down’s syndrome. Journal of Intellectual Disability Research, 39, 419–431.CrossRefPubMedGoogle Scholar
  48. Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. Oxford, England: Oxford University Press.Google Scholar
  49. Sparrow, S. S., Carter, A. S., & Cicchetti, D. V. (1993). Vineland screener: Overview, reliability, validity, administration, and scoring. New Haven: Yale University Child Study Center.Google Scholar
  50. Taylor, J. L. (2009). The transition out of high school and into adulthood for individuals with autism and for their families. International Review of Research in Mental Retardation, 38, 1–32.CrossRefGoogle Scholar
  51. Taylor, J. L., & Seltzer, M. M. (2010). The transition to adulthood for individuals with ASD and their families. In P. Howlin (Chair), What really matters: Measuring outcome and addressing the needs of adolescents and adults with ASD. Invited Educational Symposium conducted at the International Meetings for Autism Research, Philadelphia, PA.Google Scholar
  52. Thomas, K. C., Ellis, A. R., McLaurin, C., Daniels, J., & Morrissey, J. P. (2007). Access to care for autism-related services. Journal of Autism and Developmental Disorders, 37, 1902–1912.CrossRefPubMedGoogle Scholar
  53. Tobing, L. E., & Glenwick, D. S. (2002). Relation of the childhood autism rating scale-parent version to diagnosis, stress, and age. Research in Developmental Disabilities, 23, 211–223.CrossRefPubMedGoogle Scholar
  54. Tomanik, S., Harris, G. E., & Hawkins, J. (2004). The relationship between behaviours exhibited by children with autism and maternal stress. Journal of Intellectual and Developmental Disability, 29, 16–26.CrossRefGoogle Scholar
  55. Tonge, B. J., & Einfeld, S. (2003). Psychopathology and intellectual disability: The Australian child to adult longitudinal study. International Review of Research in Mental Retardation, 26, 61–91.CrossRefGoogle Scholar
  56. Wheaton, B., & Gotlib, I. H. (1997). Trajectories and turning points over the life course: Concepts and themes. In I. H. Gotlib & B. Wheaton (Eds.), Stress and adversity over the life course: Trajectories and turning points (pp. 1–28). UK: Cambridge Press.CrossRefGoogle Scholar
  57. Wolf, L. C., Noh, S., Fisman, S. N., & Speechley, M. (1989). Psychological effects of parenting stress on parents of autistic children. Journal of Autism and Developmental Disorders, 19, 157–166.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Julie Lounds Taylor
    • 1
    • 2
  • Marsha Mailick Seltzer
    • 3
  1. 1.Vanderbilt Kennedy CenterNashvilleUSA
  2. 2.Department of PediatricsVanderbilt University School of Medicine and the Monroe Carrell Jr. Children’s Hospital at VanderbiltNashvilleUSA
  3. 3.Waisman CenterUniversity of Wisconsin-MadisonMadisonUSA

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