Abstract
Background
Quality of life (QoL), social-emotional and occupational functioning are often diminished in young autistic adults. Measuring these constructs as vocational training outcomes may inform future programming and relevancy of measures.
Methods
This pilot study analyzed changes in social-emotional functioning and QoL during the involvement at a vocational program for autistic adults using the WHOQOL-BREF, a modified version of the Birchwood- Social Functioning Scale (SFS-m) and a piloted measure. Participants completed these self-reported questionnaires upon admission and at 3 months.
Results
Significant change was found on the SFS-m and two WHOQOL-BREF domains: psychological and environmental.
Conclusions
This pilot study suggests that autistic adults, similar in characterization, can self-report using these QoL and social measures; further, these measures are sensitive to certain changes over time in such group programs.
Notes
When the paired t-test analysis was run using the dropped participant’s unfinished totaled score at Time 2, the overall change over time was not found to be significant (t(6) = −1.04, p = 0.34).
Although nP recruits both cognitively able autistic individuals as well as autistic individuals with intellectual disability, at the time of data collection, only cognitively able individuals were admitted during the time of data collection.
References
APA. (2013). DSM-5 table of contents. American Psychiatric Publishing. https://doi.org/10.1002/ejoc.201200111.
Ayres, M., Parr, J. R., Rodgers, J., Mason, D., Avery, L., & Flynn, D. (2018). A systematic review of quality of life of adults on the autism spectrum. Autism, 22(7), 774–783. https://doi.org/10.1177/1362361317714988.
Balfe, M., & Tantam, D. (2010). A descriptive social and health profile of a community sample of adults and adolescents with Asperger syndrome. BMC Research Notes, 3(300).
Barneveld, P. S., Swaab, H., Fagel, S., Van Engeland, H., & De Sonneville, L. M. J. (2014). Quality of life: A case-controlled long-term follow-up study, comparing young high-functioning adults with autism spectrum disorders with adults with other psychiatric disorders diagnosed in childhood. Comprehensive Psychiatry, 55(2), 302–310. https://doi.org/10.1016/j.comppsych.2013.08.001.
Bastiaansen, J. A., Thioux, M., Nanetti, L., Van Der Gaag, C., Ketelaars, C., Minderaa, R., & Keysers, C. (2011). Age-related increase in inferior frontal gyrus activity and social functioning in autism spectrum disorder. Biological Psychiatry, 69, 832–838. https://doi.org/10.1016/j.biopsych.2010.11.007.
Birchwood, M., Smith, J., Cochrane, R., Wetton, S., & Copestake, S. (1990). The social functioning scale. The development and validation of a new scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry, 157, 853–859.
Bishop-Fitzpatrick, L., Mazefsky, C. A., & Eack, S. M. (2018). The combined impact of social support and perceived stress on quality of life in adults with autism spectrum disorder and without intellectual disability. Autism, 22(6), 703–711. https://doi.org/10.1177/1362361317703090.
Bosc, M. (2000). Assessment of social functioning in depression. Comprehensive Psychiatry, 41(1), 63–69. https://doi.org/10.1016/S0010-440X(00)90133-0.
Chan, E. H. C., Kong, S. D. X., Park, S. H., Song, Y. J. C., Demetriou, E. A., Pepper, K. L., Glozier, N., Hickie, I. B., & Guastella, A. J. (2019). Validation of the social functioning scale: Comparison and evaluation in early psychosis, autism spectrum disorder and social anxiety disorder. Psychiatry Research, 276, 45–55. https://doi.org/10.1016/j.psychres.2019.03.037.
Chandler, S., Charman, T., Baird, G., Simonoff, E., Sych, F. R. C. P., Loucas, T. O. M., Meldrum, D., Scott, M., & Pickles, A. (2007). Validation of the social communication questionnaire in a population cohort of children with autism Spectrum disorders. Journal of American Academy of Child and Adolescent Psychiatry, 46(10), 1324–1332. https://doi.org/10.1097/chi.0b013e31812f7d8d.
Constantino, J. N., & Gruber, C. P. (2012). Social Responsiveness Scale—Second Edition (SRS-2). Torrance, CA: Western Psychological Services.
Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., Metzger, L. M., Shoushtari, C. S., Splinter, R., & Reich, W. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.
Croen, L. A., Zerbo, O., Qian, Y., Massolo, M. L., Rich, S., Sidney, S., & Kripke, C. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814–823. https://doi.org/10.1177/1362361315577517.
Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 739–747. https://doi.org/10.1007/s10803-007-0441-x.
Garcia-Villamisar, D., & Hughes, C. (2006). Supported employment improves cognitive performance in adults with autism. Journal of Intellectual Disability Research, 51(2), 142–150. https://doi.org/10.1111/j.1365-2788.2006.00854.x.
Gilotty, L., Kenworthy, L., Sirian, L., Black, D. O., & Wagner, A. E. (2002). Adaptive skills and executive function in autism Spectrum disorders. Child Neuropsychology, 4, 241–248. https://doi.org/10.1076/chin.8.4.241.13504.
Graham Holmes, L., Zampella, C. J., Clements, C., McCleery, J. P., Maddox, B. B., Parish-Morris, J., Udhnani, M. D., Schultz, R. T., & Miller, J. S. (2020). A lifespan approach to patient-reported outcomes and quality of life for people on the autism Spectrum. Autism Research, 13(6), 970–987. https://doi.org/10.1002/aur.2275.
Harper, A., Power, M., Orley, J., Herrman, H., Schofield, H., Murphy, B., Metelko, Z., Szabo, S., Pibernik-Okanovic, M., Quemada, N., Caria, A., Rajkumar, S., Kumar, S., Saxena, S., Chandiramani, K., Amir, M., Bar-On, D., Tazaki, M., Noji, A., et al. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558. https://doi.org/10.1017/S0033291798006667.
Hesselmark, E., Plenty, S., & Bejerot, S. (2014). Group cognitive behavioural therapy and group recreational activity for adults with autism spectrum disorders: A preliminary randomized controlled trial. Autism, 18(6), 672–683. https://doi.org/10.1177/1362361313493681.
Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208(3), 232–238. https://doi.org/10.1192/bjp.bp.114.160192.
Hong, J., Bishop-Fitzpatrick, L., Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2016). Factors associated with subjective quality of life of adults with autism Spectrum disorder: Self-report versus maternal reports. Journal of Autism and Developmental Disorders, 46, 1368–1378. https://doi.org/10.1007/s10803-015-2678-0.
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45(2), 212–229.
Knüppel, A., Telléus, G. K., Jakobsen, H., & Lauritsen, M. B. (2018). Quality of life in adolescents and adults with autism spectrum disorder: Results from a nationwide Danish survey using self-reports and parental proxy-reports. Research in Developmental Disabilities, 83, 247–259. https://doi.org/10.1016/j.ridd.2018.09.004.
Lawer, L., Brusilovskiy, E., Salzer, M. S., & Mandell, D. S. (2009). Use of vocational rehabilitative services among adults with autism. Journal of Autism and Developmental Disorders, 39(3), 487–494. https://doi.org/10.1007/s10803-008-0649-4.
Lawrence, D. H., Alleckson, D. A., & Bjorklund, P. (2010). Beyond the roadblocks: Transitioning to adulthood with Asperger’s disorder. Archives of Psychiatric Nursing, 24(4), 227–238. https://doi.org/10.1016/j.apnu.2009.07.004.
Leifker, F. R., Patterson, T. L., Heaton, R. K., & Harvey, P. D. (2011). Validating measures of real-world outcome: The results of the VALERO expert survey and RAND panel. Schizophrenia Bulletin, 37(2), 334–343. https://doi.org/10.1093/schbul/sbp044.
Levy, A., & Perry, A. (2011). Outcomes in adolescents and adults with autism: A review of the literature. Research in Autism Spectrum Disorders, 5(4), 1271–1282. https://doi.org/10.1016/j.rasd.2011.01.023.
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., Dilavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. https://doi.org/10.1023/A:1005592401947.
Magiati, I., Wei, X., & Howlin, P. (2014). Cognitive, language, social and behavioural outcomes in adults with autism spectrum disorders: A systematic review of longitudinal follow-up studies in adulthood. Clinical Psychology Review, 34(1), 73–86. https://doi.org/10.1016/j.cpr.2013.11.002.
Mason, D., McConachie, H., Garland, D., Petrou, A., Rodgers, J., & Parr, J. R. (2018). Predictors of quality of life for autistic adults. Autism Research, 11(8), 1138–1147. https://doi.org/10.1002/aur.1965.
Mason, D., Mackintosh, J., McConachie, H., Rodgers, J., Finch, T., & Parr, J. R. (2019). Quality of life for older autistic people: The impact of mental health difficulties. Research in Autism Spectrum Disorders, 63, 13–22. https://doi.org/10.1016/j.rasd.2019.02.007.
Mawhood, L., & Howlin, P. (1999). The outcome of a supported employment scheme for high-functioning adults with autism or Asperger syndrome. Autism, 3(3), 229–254. https://doi.org/10.1177/1362361399003003003.
McConachie, H., Mason, D., Parr, J. R., Garland, D., Wilson, C., & Rodgers, J. (2018). Enhancing the validity of a quality of life measure for autistic people. Journal of Autism and Developmental Disorders, 48(5), 1596–1611. https://doi.org/10.1007/s10803-017-3402-z.
McConachie, H., Wilson, C., Mason, D., Garland, D., Parr, J. R., Rattazzi, A., Rodgers, J., Skevington, S., Uljarevic, M., & Magiati, I. (2020). What is important in measuring quality of life? Reflections by autistic adults in four countries. Autism in Adulthood, 2(1), 4–12. https://doi.org/10.1089/aut.2019.0008.
Moss, P., Mandy, W., & Howlin, P. (2017). Child and adult factors related to quality of life in adults with autism. Journal of Autism and Developmental Disorders, 47(6), 1830–1837. https://doi.org/10.1007/s10803-017-3105-5.
Ne’eman, A. (2010). The future (and the past) of autism advocacy, or why the ASA’s magazine, the advocate, Wouldn’t publish this piece. Disability Studies Quarterly, 30(1). https://doi.org/10.18061/dsq.v30i1.1059.
Pellicano, E., Dinsmore, A., & Charman, T. (2014). What should autism research focus upon? Community views and priorities from the United Kingdom. Autism, 18(7), 756–770. https://doi.org/10.1177/1362361314529627.
Poustka, F., & Constantino, J. N. (2008). Assessing Autistic Traits: Cross-Cultural Validation of the Social Responsiveness Scale ( SRS ). Autism Research, December, 354–363. https://doi.org/10.1002/aur.49.
Rutter, M., Bailey, A., Lord, C., & Ph, D. (2003). The Social Communication Questionnaire. WPS Publishing.
Seltzer, M. M., Shattuck, P., Abbeduto, L., & Greenberg, J. S. (2004). Trajectory of development in adolescents and adults with autism. Mental Retardation and Developmental Disabilities Research Reviews, 10(4), 234–247. https://doi.org/10.1002/mrdd.20038.
Taylor, J. L., McPheeters, M. L., Sathe, N. A., Dove, D., Veenstra-VanderWeele, J., & Warren, Z. (2012). A systematic review of vocational interventions for young adults with autism spectrum disorders. In Pediatrics. https://doi.org/10.1542/peds.2012-0682.
Tobin, M. C., Drager, K. D. R., & Richardson, L. F. (2014). A systematic review of social participation for adults with autism spectrum disorders: Support, social functioning, and quality of life. In Research in Autism Spectrum Disorders (Vol. 8, Issue 3, pp. 214–229). https://doi.org/10.1016/j.rasd.2013.12.002.
Van Heijst, B. F. C., & Geurts, H. M. (2015). Quality of life in autism across the lifespan: A meta-analysis. Autism, 19(2), 158–167. https://doi.org/10.1177/1362361313517053.
Walsh, L., Lydon, S., & Healy, O. (2014). Employment and vocational skills among individuals with autism Spectrum disorder: Predictors, impact, and interventions. Review Journal of Autism and Developmental Disorders, 1, 266–275. https://doi.org/10.1007/s40489-014-0024-7.
Wechsler, D. (2011). Wechsler Abbreviated Scale of Intelligence--Second Edition (WASI-II). In Wechsler Abbreviated Scale of Intelligence--Second Edition (WASI-II). citeulike-article-id:6135820.
Wehmeyer, M. L., & Schalock, R. L. (2001). Self-determination and quality of life: Implications for special education services and supports. Focus on Exceptional Children, 33(8), 1–16. https://doi.org/10.17161/foec.v33i8.6782.
Wei, X., Wagner, M., Hudson, L., Yu, J. W., & Shattuck, P. (2015). Transition to adulthood: Employment, education, and disengagement in individuals with autism Spectrum disorders. Emerging Adulthood, 3(1), 37–45. https://doi.org/10.1177/2167696814534417.
WHO. (2012). WHOQOL user manual. https://doi.org/10.1007/SpringerReference_28001.
Yang, Y. C., Boen, C., Gerken, K., Li, T., Schorpp, K., & Harris, K. M. (2016). Social relationships and physiological determinants of longevity across the human life span. Proceedings of the National Academy of Sciences of the United States of America, 3, 578–583. https://doi.org/10.1073/pnas.1511085112.
Acknowledgments
Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award Number UL1TR001105. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Thank you to Brittany Mulkey, SSP for assistance on statistical analyses and to the World Health Organization and M. Birchwood for the development and access to the outcome measures.
Funding
This study was funded by The National Center for Advancing Translational Sciences of the National Institutes of Health under award Number UL1TR001105. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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Material preparation, data collection, and analysis were performed by Michelle R. Kandalaft and Kilee M. DeBrabander. The first draft of the manuscript was written by Michelle R. Kandalaft and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Michelle R. Kandalaft is the owner and psychologist of Spectra Therapies (Dallas, TX), and a Professional Advisory Committee Member of nonPareil Institute (Plano, TX), Community Homes for Adults, Inc. (CHAI; Dallas, TX), and Segue Center (Dallas, TX). Kilee M. DeBrabander has no conflicts of interest to declare.
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Kandalaft, M.R., DeBrabander, K.M. Brief report: Changes in quality of life and social functioning during vocational program – a pilot study of autistic adults. J Autism Dev Disord 51, 3774–3781 (2021). https://doi.org/10.1007/s10803-020-04821-9
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DOI: https://doi.org/10.1007/s10803-020-04821-9