Skip to main content
SpringerLink
Log in

Autism Spectrum Disorder in Adolescents and Adults: An Introduction

  • Chapter
  • First Online:
Adolescents and Adults with Autism Spectrum Disorders

  • 197 Accesses

Abstract

Leo Kanner’s classic description of autism appeared eight decades ago. Although the pace of research has increased dramatically, research specifically focused on adolescents and adults remains limited in many respects. Numerous outcome studies have been conducted and suggest potential for markedly improved outcome with intervention. Unfortunately, studies on adults after early adulthood are sparse and, for old age, almost nonexistent, reflecting a lack of support for research in this population. This is in stark contrast to other developmental disorders in which considerable information on adult life is often available. This book summarizes work across areas, focusing on what is known and not yet known, highlighting important areas for future research. While overall outcome has improved, a small group of individuals remain in need of high levels of adult care. For all individuals, the field requires new approaches to both research and clinical service.

The authors gratefully acknowledge the support of Judy Jones and the staff at Springer as well as the support of Podles at Yale University and Eileen Farmer at Southern Connecticut State University for their assistance in manuscript preparation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder (4th ed.). Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder (5th ed.). Author.

    Book  Google Scholar 

  • Anderson, G., & Maes, M. (2014). Redox regulation and the autistic spectrum: Role of tryptophan catabolites, immuno-inflammation, autoimmunity and the amygdala. Current Neuropharmacology, 12(2), 148–167. https://doi.org/10.2174/1570159X11666131120223757

    Article  PubMed  PubMed Central  Google Scholar 

  • Aragon-Guevara, D., Castle, G., Sheridan, E., et al. (2023). The reach and accuracy of information on autism on TikTok. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-023-06084-6

  • Billstedt, E., Gillberg, I., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35(3), 351–360.

    Google Scholar 

  • Billstedt, E., Gillberg, I., & Gillberg, C. (2011). Aspects of quality of life in adults diagnosed with autism in childhood: A population-based study. Autism, 15(1), 7–20. https://doi.org/10.1177/1362361309346066

    Article  PubMed  Google Scholar 

  • Brugha, T. S., Tyrer, F., Scott, F., Bankart, M. J., Cooper, S. A., & McManus, S. (2014). The epidemiology of autism spectrum disorders in adulthood. In F. R. Volkmar, B. Reichow, & J. C. McPartland (Eds.), Adolescents and adults with autism spectrum disorders. Springer.

    Google Scholar 

  • Cook, A., Ogden, J., & Winstone, N. (2018). Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings. European Journal of Special Needs Education, 33(3), 302–315. https://doi.org/10.1080/08856257.2017.1312797

    Article  Google Scholar 

  • Edelson, S. M., Nicholas, D. B., Stoddart, K. P., Bauman, M. B., Mawlam, L., Lawson, W. B., et al. (2021). Strategies for research, practice, and policy for autism in later life: A report from a think tank on aging and autism. Journal of Autism and Developmental Disorders, 51(1), 382–390. https://doi.org/10.1007/s10803-020-04514-3

    Article  PubMed  Google Scholar 

  • Eigsti, I. M., Stevens, M. C., Schultz, R. T., Barton, M., Kelley, E., Naigles, L., et al. (2016). Language comprehension and brain function in individuals with an optimal outcome from autism. NeuroImage Clinical, 10, 182–191. https://doi.org/10.1016/j.nicl.2015.11.014

    Article  PubMed  Google Scholar 

  • Eigsti, I. M., Fein, D., & Larson, C. (2023). Editorial perspective: Another look at ‘optimal outcome’ in autism spectrum disorder. Journal of Child Psychology & Psychiatry & Allied Disciplines, 64(2), 332–334. https://doi.org/10.1111/jcpp.13658

    Article  Google Scholar 

  • Farley, M. A., McMahon, W. M., Fombonne, E., Jenson, W. R., Miller, J., Gardner, M., Block, H., Pingree, C. B., Ritvo, E. R., Ritvo, R. A., & Coon, H. (2009). Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research, 2(2), 109–118. https://doi.org/10.1002/aur.69

    Article  PubMed  Google Scholar 

  • Fein, D., Barton, M., Eigsti, I. M., Kelley, E., Naigles, L., Schultz, R. T., et al. (2013). Optimal outcome in individuals with a history of autism. Journal of Child Psychology & Psychiatry & Allied Disciplines, 54(2), 195–205. https://doi.org/10.1111/jcpp.12037

    Article  Google Scholar 

  • Fombonne, E. (2023). Editorial: Is autism overdiagnosed? Journal of Child Psychology & Psychiatry & Allied Disciplines, 64(5), 711–714. https://doi.org/10.1111/jcpp.13806

    Article  Google Scholar 

  • Fusar-Poli, L., Brondino, N., Politi, P., & Aguglia, E. (2022). Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. European Archives of Psychiatry and Clinical Neuroscience, 272, 187–198. https://doi.org/10.1007/s00406-020-011890w

    Article  PubMed  Google Scholar 

  • Gibbs, V., Aldridge, F., Chandler, F., Witzlsperger, E., & Smith, K. (2012). An exploratory study comparing diagnostic outcomes for autism spectrum disorders under DSM-IV-TR with the proposed DSM-5 revision. Journal of Autism and Developmental Disorders, 42(8), 1750–1756. https://doi.org/10.1007/s10803-012-1560-6

    Article  PubMed  Google Scholar 

  • Gillberg, C., Billstedt, E., Sundh, V., & Gillberg, I. C. (2010). Mortality in autism: A prospective longitudinal community-based study. Journal of Autism & Developmental Disorders, 40(3), 352–357. https://doi.org/10.1007/s10803-009-0883-4

    Article  Google Scholar 

  • Graham Holmes, L., Zampella, C. J., Clements, C., McCleery, J. P., Maddox, B. B., Parish-Morris, J., et al. (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

  • Green, J., & Garg, S. (2018). Annual research review: The state of autism intervention science: Progress, target psychological and biological mechanisms and future prospects. Journal of Child Psychology & Psychiatry & Allied Disciplines, 59(4), 424–443. https://doi.org/10.1111/jcpp.12892

    Article  Google Scholar 

  • Howlin, P. (2014). Outcomes in adults with autism Spectrum disorders. In F. Volkmar, S. Rogers, R. Paul, & K. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders (4th ed.). Wiley.

    Google Scholar 

  • Howlin, P. (2021). Adults with autism: Changes in understanding since DSM-III. Journal of Autism & Developmental Disorders, 51(12):4291-4308. https://doi.org/10.1007/s10803-020-04847-z

  • Huang, Y., Arnold, S. R. C., Foley, K. R., & Trollor, J. N. (2020). Diagnosis of autism in adulthood; A scoping review. Autism, 24(6), 1311–1327. https://doi.org/10.1177/13623613200903128

    Article  PubMed  Google Scholar 

  • Ingersoll, B., Wainer, A., Volkmar, F. R., Paul, R., Rogers, S. J., & Pelphrey, K. A. (2014). The broader autism phenotype. In F. Volkmar, S. Rogers, R. Paul, & K. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders (4th ed.). Wiley.

    Google Scholar 

  • Irvine, C. A., Eigsti, I. M., & Fein, D. A. (2016). Uh, um, and autism: Filler disfluencies as pragmatic markers in adolescents with optimal outcomes from autism spectrum disorder. Journal of Autism & Developmental Disorders, 46(3), 1061–1070. https://doi.org/10.1007/s10803-015-2651-y

  • Jackson, S. L., & Volkmar, F. R. (2019). Diagnosis and definition of autism and other pervasive developmental disorders. In F. Volkmar (Ed.), Autism and the pervasive developmental disorders (3rd ed., pp. 1–24). Cambridge University Press.

    Google Scholar 

  • Jensen, C. M., Steinhausen, H. C., & Lauristen, M. B. (2014). Time trends over 16 years in incidence-rates of autism spectrum disorders across the lifespan based on nationwide Danish register data. Journal of Autism and Developmental Disorders, 44(8), 1808–1818. https://doi.org/10.1007/s10803-014-2053-6

    Article  PubMed  Google Scholar 

  • Jokiranta-Olkoniemi, E., Gyllenberg, D., Sucksdorff, D., Suominen, A., Kronstrom, K., Chudal, R., et al. (2021). Risk for premature mortality and intentional self-harm in autism spectrum disorders. Journal of Autism & Developmental Disorders, 51(9), 3098–3108. https://doi.org/10.1007/s10803-020-04768-x

    Article  Google Scholar 

  • Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.

    Google Scholar 

  • Kanner, L. (1971). Follow-up study of eleven autistic children originally reported in. Journal of Autism & Childhood Schizophrenia 1971, 1(2), 119–145. https://doi.org/10.1007/BF01537953

    Article  Google Scholar 

  • Kanner, L., Rodriguez, A., & Ashenden, B. (1972). How far can autistic children go in matters of social adaptation? Journal of Autism & Childhood Schizophrenia, 2(1), 9–33. https://doi.org/10.1007/BF01537624

    Article  Google Scholar 

  • Lockyer, L., & Rutter, M. (1969). A five- to fifteen-year follow-up study of infantile psychosis. British Journal of Psychiatry, 115(525), 865–882. https://doi.org/10.1192/bjp.115.525.865

  • Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., et al. (2022). The lancet commission on the future of care and clinical research in autism. Lancet, 399(10321), 271–334. https://doi.org/10.1016/s0140-6736(21)01541-5

    Article  PubMed  Google Scholar 

  • Lunsky, Y., Lai, M. C., Balogh, R., Chung, H., Durbin, A., Jachyra, P., et al. (2022). Premature mortality in a population-based cohort of autistic adults in Canada. Autism Research, 15(8), 1550–1559. https://doi.org/10.1002/aur.2741

  • Lupindo, B. M., Maw, A., & Shabalala, N. (2022). Late diagnosis of autism: Exploring experiences of males diagnosed with autism in adulthood. Current Psychology, 42, 24181–24197. https://doi.org/10.1007/s12144-022-03514-z

  • Magiati, I., & Howlin, P. (2019). Adult life for people with autism spectrum disorders. In F. R. Volkmar (Ed.) Autism and the pervasive developmental disorders (3rd ed.). Cambridge University Press.

    Google Scholar 

  • Mahjouri, S., & Lord, C. E. (2012). What the DSM-5 portends for research, diagnosis, and treatment of autism spectrum disorders. Current Psychiatry Reports, 14(6), 739–747. https://doi.org/10.1007/s11920-012-0327-2

    Article  PubMed  Google Scholar 

  • Mason, D., Stewart, G. R., Capp, S. J., & Happé, F. (2022). Older age autism research: A rapidly growing field, but still a long way to go. Autism in Adulthood: Challenges and Management, 4(2), 164–172. https://doi.org/10.1089/aut.2021.0041

    Article  PubMed  Google Scholar 

  • Matson, J. L., Belva, B. C., Horovitz, M., Kozlowski, A. M., & Bamburg, J. W. (2012). Comparing symptoms of autism spectrum disorders in a developmentally disabled adult population using the current DSM-IV-TR diagnostic criteria and the proposed DSM-5 diagnostic criteria. Journal of Developmental and Physical Disabilities, 24(4), 403–414. https://doi.org/10.1007/s10882-012-9278-0

    Article  Google Scholar 

  • McDonald, T. A. M., & Scudder, A. (2023). Mind the NIH-funding gap: Structural discrimination in physical health-related research for cognitively able autistic adults. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-022-05856-w

  • McPartland, J., Reichow, B., & Volkmar, F. (2012). Sensitivity and specitifity of proposed DSM-IV diagnostic criteria for autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 51(4), 368–383. https://doi.org/10.1016/j.jaac.2012.01.007

    Article  Google Scholar 

  • McQuaid, G. A., Lee, N. R., & Wallace, G. L. (2022). Camouflaging in autism spectrum disorder: Examining the roles of sex, gender identity, and diagnostic timing. Autism, 26(2), 552–559. https://doi.org/10.1177/13623613211042131

    Article  PubMed  Google Scholar 

  • Moulton, E., Barton, M., Robins, D. L., Abrams, D. N., & Fein, D. (2016). Early characteristics of children with ASD who demonstrate optimal Progress between age two and four. Journal of Autism and Developmental Disorders, 46(6), 2160–2173. https://doi.org/10.1007/s10803-016-2745-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Mukaetova-Ladinska, E., Perry, E., Baron, M., & Povey, C. (2012). Aging in people with autistic spectrum disorder. International Journal of Geriatric Psychiatry, 27(2), 109–118. https://doi.org/10.1002/gps.2711

    Article  PubMed  Google Scholar 

  • National Institute for Health and Clinical Excellence. (2012). Autism: Recognition, referral, diagnosis and management of adults on the autism spectrum (NICE Clinical Guideline 142). National Institute for Health and Clinical Excellence.

    Google Scholar 

  • National Research Council. (2001). Educating young children with autism. National Academy Press.

    Google Scholar 

  • Orinstein, A. J., Suh, J., Porter, K., De Yoe, K. A., Tyson, K. E., Troyb, E., et al. (2015). Social function and communication in optimal outcome children and adolescents with an autism history on structured test measures. Journal of Autism & Developmental Disorders, 45(8), 2443–2463. https://doi.org/10.1007/s10803-015-2409-6

    Article  Google Scholar 

  • Perkins, E. A., & Friedman, S. L. (2012). Introduction to the special issue on aging and end of life. American Journal on Intellectual and Developmental Disabilities, 117(6), 439–441. https://doi.org/10.1352/1944-7558-117.6.478

    Google Scholar 

  • Piven, J., & Rabins, P. (2011). Autism spectrum disorders in older adults: Toward defining a research agenda. Journal of the American Geriatrics Society, 59(11), 2151–2155. https://doi.org/10.1111/j.1532-5415.2011.03632.x

    Google Scholar 

  • Rogge, N., & Janssen, J. (2019). The economic costs of autism spectrum disorder: A literature review. Journal of Autism and Developmental Disorders, 49(7), 2873–2900. https://doi.org/10.1007/s10803-019-04014-z

  • Rosen, N. E., Lord, C., & Volkmar, F. R. (2021). The diagnosis of autism: From Kanner to DSM-III to DSM-5 and beyond. Journal of Autism and Developmental Disorders, 51(12), 4253–4270. https://doi.org/10.1007/s10803-021-04904-1

    Article  PubMed  PubMed Central  Google Scholar 

  • Saban-Bezalel, R., Zachor, D. A., & Ben-Itzchak, E. (2022). Relationship between cognitive ability and predictors for age at the time of autism spectrum disorder diagnosis. Psychiatry Research, 315, 114696. https://doi.org/10.1016/j.psychres.2022.114696

    Article  PubMed  Google Scholar 

  • Schopler, E., & Mesibov, G. (1983). Autism in adolescents and adults. Springer.

    Book  Google Scholar 

  • 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 & Developmental Disorders, 33(6), 565–581. https://doi.org/10.1023/b:jadd.0000005995.02453.0b

    Google Scholar 

  • Shattuck, P. T., Roux, A. M., Hudson, L. E., Taylor, J. L., Maenner, M. J., & Trani, J. F. (2012). Services for adults with an autism spectrum disorder. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 57(5), 284–291. https://doi.org/10.1007/s11920-020-1136-7

    Google Scholar 

  • Solomon, C. (2020). Autism and employment: Implications for employers and adults with ASD. Journal of Autism & Developmental Disorders, 15(11), 4209-4217. https://doi.org/10.1007/s10803-020-04537-w

    Google Scholar 

  • Stagg, S. D., & Belcher, H. (2019). Living with autism without knowing: Receiving a diagnosis in later life. Health Psychology and Behavioral Medicine, 7(1), 348–361. https://doi.org/10.1080/21642850.2019.1684920

    Article  PubMed  PubMed Central  Google Scholar 

  • Stoddart, K. P., Burke, L., Muskat, J., Duhaime, S., Accardi, C., Burnh Riosa, P., & Bradley, E. A. (2013). Diversity in Ontario's youth and adults with autism spectrum disorders: Complex needs in unprepared systems. The Redpath Centre. https://doi.org/10.13140/2.1.3994.0165

    Google Scholar 

  • Sucksmith, E., Roth, I., & Hoekstra, R. A. (2011). Autistic traits below the clinical threshold: Re-examining the broader autism phenotype in the 21st century. Neuropsychology Review, 21(4), 360–389. https://doi.org/10.1007/s11065-011-9183-9.

  • Vincent, A., Da Fonseca, D., Baumstarck, K., Charvin, I., Alcaraz-Mor, R., & Lehucher-Michel, M. P. (2020). The quality of life and the future of young adults with Asperger syndrome. Disability & Rehabilitation, 42(14), 1987–1994. https://doi.org/10.1080/09638288.2018.1544297

    Article  Google Scholar 

  • Vivanti, G., Yerys, B. E., & Salomone, E. (2019). Psychological factors in autism spectrum disorders. In F. Volkmar (Ed.), Autism and the pervasive developmental disorders (3rd ed., pp. 61–89). Cambridge University Press.

    Google Scholar 

  • Volkmar, F. R., Klin, A., Schultz, R., Bronen, R., Marans, W. D., Sparrow, S., & Cohen, D. J. (1996). Asperger’s syndrome. Journal of the American Academy of Child & Adolescent Psychiatry, 35(1), 118–123. https://doi.org/10.1097/00004583-199601000-00020

    Google Scholar 

  • Volkmar, F. R., Reichow, B., & Doehring, P. (2011). Evidence-based practices in autism: Where we are now, and where we need to go. In B. Reichow, P. Doehring, D. V. Cicchetti, & F. R. Volkmar (Eds.), Evidence-based practices and treatments for children with autism (pp. 365–391). Springer.

    Chapter  Google Scholar 

  • Volkmar, F. R., Woodbury-Smith, M., Macari, S. L., & Oien, R. A. (2021). Seeing the forest and the trees: Disentangling autism phenotypes in the age of DSM-5. Development and Psychopathology, 33(2), 625–633. https://doi.org/10.1017/S0954579420002047

    Article  PubMed  Google Scholar 

  • Whitney, D. G., Schmidt, M., & Haapala, H. (2021). Polypharmacy is a risk factor for mortality, severe chronic kidney disease, and liver disease among privately insured adults with cerebral palsy. Journal of Managed Care & Specialty Pharmacy, 27(1), 51–63. https://doi.org/10.18553/jmcp.2021.27.1.051

  • Wolff, L. E., Brown, J. T., & Bork, G. R. (2009). Students with Asperger syndrome: A guide for college personnel. APC Publishing.

    Google Scholar 

  • Yuenn, R. K. C., Szatmari, P., & Vorstman, J. A. S. (2019). The genetics of autism spectrum disorders. In F. R. Volkmar (Ed.), Autism and the pervasive developmental disorders (3rd ed., pp. 112–128). Cambridge University Press.

    Google Scholar 

Download references

Acknowledgement

The authors gratefully acknowledge the support of Judy Jones and the staff at Springer as well as the support of Podles at Yale University and Eileen Farmer at Southern Connecticut State University for their assistance in manuscript preparation.

Author information

Authors and Affiliations

  1. Child Study Center, Yale University, Southern Connecticut State University, New Haven, CT, USA

    Fred R. Volkmar

  2. University of Connecticut Health Center, Farmington, CT, USA

    Brian Reichow

  3. Child Study Center, Yale University, Yale Center for Brain and Mind Health, New Haven, CT, USA

    James C. McPartland

Authors
  1. Fred R. Volkmar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian Reichow
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James C. McPartland
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fred R. Volkmar .

Editor information

Editors and Affiliations

  1. Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    Fred R. Volkmar

  2. A.J. Pappanikou Center for Excellence in Developmental Disabilities, UConn Health, University of Connecticut, Farmington, CT, USA

    Brian Reichow

  3. Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    James C. McPartland

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Volkmar, F.R., Reichow, B., McPartland, J.C. (2024). Autism Spectrum Disorder in Adolescents and Adults: An Introduction. In: Volkmar, F.R., Reichow, B., McPartland, J.C. (eds) Adolescents and Adults with Autism Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-46463-8_1

Download citation

Publish with us

Policies and ethics

Search

Navigation