Advertisement

Science China Life Sciences

, Volume 58, Issue 10, pp 1010–1015 | Cite as

Autism spectrum disorders in adolescence and adulthood: Long-term outcomes and relevant issues for treatment and research

  • Allison B. RattoEmail author
  • Gary B. Mesibov
Open Access
Review

Abstract

The advances in research and treatment of autism spectrum disorders (ASD) over the past three decades have focused largely on early childhood and school-age years. Although ASD is a lifelong condition, there has been relatively little attention paid to ASD during the adolescent and adulthood periods. As the population of those with ASD continues to rise and age, the need to provide research and treatment for this group has become increasingly evident. This paper reviews the current literature available on symptoms, functioning, and treatment of adolescents and adults with ASD, as well as the unique issues that arise for individuals with ASD after childhood. Adulthood outcomes for ASD are generally poor, even for those with average to above average cognitive ability. Further research and additional clinical resources are needed for this rapidly increasing group.

Keywords

autism spectrum disorder (ASD) adolescence adulthood developmental trajectory 

References

  1. 1.
    Newschaffer CJ, Croen LA, Daniels J, Giarelli E, Grether JK, Levy SE, Mandell DS, Miller LA, Pinto-Martin J, Reaven J, Reynolds AM, Rice CE, Schendel D, Windham GC. The epidemiology of autism spectrum disorders. Ann Rev Public Health, 2007, 28: 235–258CrossRefGoogle Scholar
  2. 2.
    Rice C. Prevalence of autism spectrum disorders: Autism and developmental disabilities monitoring network, United States, 2006. Surveil Sum, 2009, 58: 1–20Google Scholar
  3. 3.
    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders-text Revision. (4th ed, text revision). Washington, DC: American Psychiatric Association, 2000Google Scholar
  4. 4.
    McGovern CW, Sigman M. Continuity and change from early childhood to adolescence in autism. J Child Psychol Psychiat, 2005, 46: 401–408CrossRefPubMedGoogle Scholar
  5. 5.
    Eaves LC, Ho HH. Young adult outcome of autism spectrum disorders. J Aut Dev Disord, 2008, 38: 739–747CrossRefGoogle Scholar
  6. 6.
    Engstrom I, Ekstrom L, Emilsson B. Psychosocial functioning in a group of Swedish adults with Asperger syndrome or high-functioning autism. Autism, 2003, 7: 99–110PubMedGoogle Scholar
  7. 7.
    Howlin P, Goode S, Hutton J, Rutter M. Adult outcome for children with autism. J Child Psychol Psychiat, 2004, 45: 212–229CrossRefPubMedGoogle Scholar
  8. 8.
    Kobayashi R, Murata T, Yoshinaga K. A follow-up study of 201 children with autism in Kyushu and Yamaguchi areas, Japan. J Aut Dev Disord, 1992, 22: 395–411CrossRefGoogle Scholar
  9. 9.
    Farley MA, McMahon WM, Fombonne E, Jenson WR, Miller J, Gardner M, Block H, Pingree CB, Ritvo ER, Ritvo RA, Coon H. Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Aut Res, 2009, 2: 109–118CrossRefGoogle Scholar
  10. 10.
    Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS. Trajectory of development in adolescents and adults with autism. Ment Retard Dev Disabil Res Rev, 2004, 10: 234–247CrossRefPubMedGoogle Scholar
  11. 11.
    Nordin V, Gillberg C. The long-term course of autistic disorders: Update on follow-up studies. Acta Psych Scand, 1998, 97: 99–108CrossRefGoogle Scholar
  12. 12.
    Piven J, Harper J, Palmer P, Arndt S. Course of behavioral change in autism: A retrospective study of high-IQ adolescents and adults. J Am Acad Child Adoles Psychiat, 1996, 35: 523–529CrossRefGoogle Scholar
  13. 13.
    Shattuck PT, Seltzer MM, Greenberg JS, Orsmond GI, Bolt D, Kring S, Lounds J, Lord C. Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. J Aut Dev Disord, 2007, 37: 1735–1747CrossRefGoogle Scholar
  14. 14.
    Billstedt E, Gillberg IC, Gillberg C. Autism after adolescence: Population based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. J Aut Dev Disord, 2005, 35: 351–360CrossRefGoogle Scholar
  15. 15.
    Seltzer MM, Krauss MW, Shattuck PT, Orsmond G, Swe A, Lord C. The symptoms of autism spectrum disorders in adolescence and adulthood. J Aut Dev Disord, 33, 2003: 565–581CrossRefGoogle Scholar
  16. 16.
    Ballaban-Gil K, Rapin I, Tuchman R, Shinnar S. Longitudinal examination of the behavioral, language, and social changes in a population of adolescents and young adults with autistic disorder. Pediatr Neurol, 1996, 15: 217–223CrossRefPubMedGoogle Scholar
  17. 17.
    Cederlund M, Hagberg B, Billstedt E, Gillberg IC, Gillberg C. Asperger syndrome and autism: A comparative longitudinal follow-up study more than 5 years after original diagnosis. J Aut Dev Disord, 2008, 38: 72–85CrossRefGoogle Scholar
  18. 18.
    Billstedt E, Gillberg IC, Gillberg C. Autism in adults: symptoms patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood. J Child Psychol Psychiat, 2007, 48: 1102–1110CrossRefPubMedGoogle Scholar
  19. 19.
    Golan O, Baron-Cohen S, Hill J. The Cambridge Mindreading (CAM) face voice battery: Testing complex emotion recognition in adults with and without Asperger syndrome. J Aut Dev Disord, 2006, 36: 169–183CrossRefGoogle Scholar
  20. 20.
    Happé F, Booth R, Charlton R, Hughes C. Executive function deficits in autism spectrum disorder and attention-deficit/hyperactivity disorder: Examining profiles across domains and ages. Brain Cogn, 2006, 61: 25–39CrossRefPubMedGoogle Scholar
  21. 21.
    Landa RJ, Goldberg MC. Language, social, and executive functions in high-functioning autism: A continuum of performance. J Aut Dev Disord, 2005, 35: 557–573CrossRefGoogle Scholar
  22. 22.
    Luna B, Doll SK, Hegedus SJ, Minshew NJ, Sweeney JA. Maturation of executive function in autism. Biol Psychiat, 2006, 61: 474–481CrossRefPubMedGoogle Scholar
  23. 23.
    Ozonoff S, McEvoy R. A longitudinal study of executive function and theory of mind development in autism. Dev Psychopathol, 1994, 6: 415–431CrossRefGoogle Scholar
  24. 24.
    Sparrevohn R, Howie PM. Theory of mind in children with autistic disorder: Evidence of developmental progression and the role of verbal ability. J Child Psychol Psychiat, 1995, 36: 249–263CrossRefPubMedGoogle Scholar
  25. 25.
    Baron-Cohen S, Jolliffe T, Mortimore C, Robertson M. Another advanced test of theory of mind: Evidence from very high functioning adults with autism or Asperger syndrome. J Child Psychol Psychiat, 1997, 38: 813–822CrossRefPubMedGoogle Scholar
  26. 26.
    James IA, Mukaetova-Ladinska E, Reichelt FK, Briel R, Scully A. Diagnosing Aspergers syndrome in the elderly: A series of case presentations. Int J Geriatr Psychiatry, 2006, 21: 951–960CrossRefPubMedGoogle Scholar
  27. 27.
    Muller E, Schuler A, Burton BA, Yates G. Meeting the vocational support needs of individuals with Asperger syndrome and other autism spectrum disabilities. J Voc Rehab, 2003, 18: 163–175Google Scholar
  28. 28.
    Moxon L, Gates D. Children with autism: Supporting the transition to adulthood. Educ Child Psychol, 2001, 18: 28–40Google Scholar
  29. 29.
    Nuehring ML, Sitlington PL. Transition as a vehicle: Moving from high school to an adult vocational service provider. J Disabil Policy Studies, 2003, 14: 23–35CrossRefGoogle Scholar
  30. 30.
    Garcia-Villamisar D, Hughes C. Supported employment improves cognitive performance in adults with autism. J Intell Disabil Res, 2007, 51: 142–150CrossRefGoogle Scholar
  31. 31.
    Keel JH, Mesibov GB, Woods AV. TEACCH-supported employment program. J Aut Dev Disord, 1997, 27: 3–9CrossRefGoogle Scholar
  32. 32.
    Mawhood L, Howlin P. The outcome of a supported employment scheme for high-functioning adults with autism or Asperger syndrome. Autism, 1999, 3: 229–254CrossRefGoogle Scholar
  33. 33.
    Smith MD, Coleman D. Managing the behavior of adults with autism in the job setting. J Aut Dev Disord, 1986, 16: 145–154CrossRefGoogle Scholar
  34. 34.
    Schaller J, Yang NK. Competitive employment for people with autism: Correlates of successful closure in competitive and supported employment. Rehab Couns Bull, 2005, 49: 4–16CrossRefGoogle Scholar
  35. 35.
    Hurlbutt K, Chalmers L. Adults with autism speak out: Perceptions of their life experiences. FOCUS, 2002, 17: 103–111Google Scholar
  36. 36.
    Jennes-Coussens M, Magill-Evans J, Koning C. The quality of life of young men with Asperger syndrome. Autism, 2006, 10: 403–414CrossRefPubMedGoogle Scholar
  37. 37.
    Lasgaard M, Nielsen A, Eriksen ME, Goossens L. Loneliness and social support in adolescent boys with autism spectrum disorders. J Aut Dev Disord, 2010, 40: 218–226CrossRefGoogle Scholar
  38. 38.
    Muller E, Schuler A, Yates GB. Social challenges and supports from the perspective of individuals with Asperger syndrome and other autism spectrum disabilities. Autism, 2008, 12: 173–190CrossRefPubMedGoogle Scholar
  39. 39.
    Abrahams BS, Geschwind DH. Advances in autism genetics: On the threshold of a new neurobiology. Nat Rev Genetics, 2008, 9: 341–355CrossRefPubMedGoogle Scholar
  40. 40.
    Danielsson S, Gillberg IC, Billstedt E, Gillberg C, Olsson I. Epilepsy in young adults with autism: A prospective population-based follow- up study of 120 individuals diagnosed in childhood. Epilepsia, 2005, 46: 918–923CrossRefPubMedGoogle Scholar
  41. 41.
    Rossi PG, Posar A, Parmeggiani A. Epilepsy in adolescents and young adults with autistic disorder. Brain Dev, 2000, 22: 102–106CrossRefGoogle Scholar
  42. 42.
    Ghaziuddin M, Ghaziuddin N, Greden J. Depression in persons with autism: Implications for research and clinical care. J Aut Dev Disord, 2002, 32: 299–306CrossRefGoogle Scholar
  43. 43.
    Tantam D. Psychological disorder in adolescents and adults with Asperger syndrome. Autism, 2000, 4: 47–62CrossRefGoogle Scholar
  44. 44.
    Stokes MA, Kaur A. High-functioning autism and sexuality: A parental perspective. Autism, 2005, 9: 266–289CrossRefPubMedGoogle Scholar
  45. 45.
    Ousley OY, Mesibov GB. Sexual attitudes and knowledge of high-functioning adolescents and adults with autism. J Aut Dev Disord, 1991, 21: 471–481CrossRefGoogle Scholar
  46. 46.
    van Bourgondien M, Reichle NC, Palmer A. Sexual behavior in adults with autism. J Aut Dev Disord, 1997, 27: 113–125CrossRefGoogle Scholar
  47. 47.
    Koller R. Sexuality and adolescents with autism. Sexual Disabil, 2000, 18: 125–135CrossRefGoogle Scholar
  48. 48.
    Mesibov GB. Sex education for people with autism: Matching programs to levels of functioning. Paper presented at the meeting of the National Society for Children and Adults with Autism, Omaha, NE, 1982Google Scholar
  49. 49.
    Servais L. Sexual health care in persons with intellectual disabilities. Ment Retard Dev Disabil Res Rev, 2006, 12: 48–56CrossRefPubMedGoogle Scholar
  50. 50.
    Petersilia JR. Crime victims with developmental disabilities: A review essay. Crim Just Beh, 2001, 28: 655–694CrossRefGoogle Scholar
  51. 51.
    Cashin A, Newman C. Autism in the criminal justice detention system: A review of the literature. J Forensic Nurs, 2009, 5: 70–75CrossRefPubMedGoogle Scholar
  52. 52.
    Langstrom N, Grann M, Ruchkin V, Sjöstedt G, Fazel S. Risk factors for violent offending in autism spectrum disorder: A national study of hospitalized individuals. J Interpers Violence, 2009, 24: 1358–1370CrossRefPubMedGoogle Scholar
  53. 53.
    Newman SS, Ghaziuddin M. Violent crime in Asperger syndrome: The role of psychiatric comorbidity. J Aut Dev Disord, 2008, 38: 1848–1852CrossRefGoogle Scholar
  54. 54.
    Mayes TA. Persons with autism and criminal justice: Core concepts and leading cases. J Pos Beh Interventions, 2003, 5: 92–100CrossRefGoogle Scholar
  55. 55.
    Solomon M, Goodlin-Jones BL, Anders TF. A social adjustment enhancement intervention for high functioning autism, Asperger’s syndrome, and pervasive developmental disorder NOS. J Aut Dev Disord, 2004, 34: 649–668CrossRefGoogle Scholar
  56. 56.
    Duncan AW, Klinger LG. Autism spectrum disorders: Building social skills in group, school, and community settings. Social Work Groups, 2010, 33: 175–193CrossRefGoogle Scholar
  57. 57.
    Reichow B, Volkmar FR. Social skills interventions for individuals with autism: Evaluation for evidence-based practices within a best evidence synthesis framework. J Aut Dev Disord, 2010, 40: 149–166CrossRefGoogle Scholar
  58. 58.
    Tse J, Strulovtich J, Tagalakis V, Meng L, Fombonne E. Social skills training for adolescents with Asperger syndrome and high-functioning autism. J Aut Dev Disord, 2007, 37: 1960–1968CrossRefGoogle Scholar
  59. 59.
    Turner-Brown LM, Perry TD, Dichter GS, Bodfish JW, Penn DL. Brief report: Feasibility of social cognition and interaction training for adults with high functioning autism. J Aut Dev Disord, 2008, 38: 1777–1784CrossRefGoogle Scholar
  60. 60.
    Williams S, Keonig K, Scahill L. Social skills development in children with autism spectrum disorders: A review of the intervention research. J Aut Dev Disord, 2007, 37: 1858–1868CrossRefGoogle Scholar
  61. 61.
    Cobb S, Beardon L, Eastgate R, Glover T, Kerr S, Neale H. Applied virtual environments to support learning of social interaction skills in users with Asperger’s syndrome. Digital Creativity, 2002, 13: 11–22CrossRefGoogle Scholar
  62. 62.
    Parsons S, Leonard A, Mitchell P. Virtual environments for social skills training: Comments from two adolescents with autistic spectrum disorder. Comput Educ, 2006, 47: 186–206CrossRefGoogle Scholar
  63. 63.
    Rajendran G, Mitchell P. Computer mediated interaction in Asperger’s syndrome: The Bubble Dialogue program. Comput Educ, 2000, 35: 189–207CrossRefGoogle Scholar
  64. 64.
    Bellini S. The development of social anxiety in adolescents with autism spectrum disorders. Autism, 2006, 21: 138–145Google Scholar
  65. 65.
    Farrugia S, Hudson J. Anxiety in adolescents with Asperger syndrome: Negative thoughts, behavioral problems, and life interference. FOCUS, 2006, 21: 25–35Google Scholar
  66. 66.
    Kuusikko S, Pollock-Wurman R, Jussila K, Carter AS, Mattila ML, Ebeling H, Pauls DL, Moilanen I. Social anxiety in high-functioning children and adolescents with autism and Asperger syndrome. J Aut Dev Disord, 2008, 38: 1697–1709CrossRefGoogle Scholar
  67. 67.
    White SW, Roberson-Nay R. Anxiety, social deficits, and loneliness in youth with autism spectrum disorders. J Aut Dev Disord, 2009, 39: 1006–1013CrossRefGoogle Scholar
  68. 68.
    White SW, Albano AM, Johnson CR, Kasari C, Ollendick T, Klin A, Oswald D, Scahill L. Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism. Clin Child Family Psych Rev, 2010, 13: 77–90CrossRefGoogle Scholar

Copyright information

© The Author(s) 2015

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations