Skip to main content
SpringerLink
Log in

Adults with Autism: Outcomes, Family Effects, and the Multi-Family Group Psychoeducation Model

  • Autism Spectrum Disorders (D Mandell, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Although an increasing number of individuals with autism spectrum disorders are entering adulthood, currently there are few evidence-based programs for individuals later in the life course. In this paper we present an overview of recent research on outcomes for adolescents and adults with ASD and highlight the role of the family for individuals with ASD during the transition to adulthood. We also discuss multi-family group psychoeducation as a promising model for use with individuals with ASD who are transitioning to adulthood.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. • Centers for Disease Control and Prevention (CDC). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, United States, 2008. Morbidity and Mortality Weekly Report Surveillance Summaries. 2012; 61:1–18. This paper highlights the high prevalence of autism spectrum disorders among children in the US (1 in 88). The children in this study were eight years old in 2008 and are now entering the adolescent period.

  2. Seltzer MM, Shattuck P, Abbeduto L, et al. The trajectory of development in adolescents and adults with autism. Ment Retard Dev Disabil Res Rev. 2004;10:234–47.

    Article  PubMed  Google Scholar 

  3. Shattuck PT, Roux AM, Hudson LE, et al. Services for adults with an autism spectrum disorder. Can J Psychiatr. 2012;57:284–91.

    Google Scholar 

  4. U.S. Department of Health & Human Services. The 2010 Interagency Autism Coordinating Committee Strategic Plan for Autism Spectrum Disorder Research-January 19, 2010. 2010. Retrieved February 8, 2010, from http://iacc.hhs.gov/strategic-plan/2010/print_version.jsp.

  5. Arnett JJ. Adolescent storm and stress, reconsidered. Am Psychol. 1999;54:317–26.

    Article  PubMed  CAS  Google Scholar 

  6. Arnett JJ. Emerging adulthood: A theory of development from the late teens through the twenties. Am Psychol. 2000;55:469–80.

    Article  PubMed  CAS  Google Scholar 

  7. Lounds J, Seltzer MM, Greenberg JS, et al. Transition and change in adolescents and young adults with autism: Longitudinal effects on maternal well-being. Am J Ment Retard. 2007;112:401–17.

    Article  PubMed  Google Scholar 

  8. Howlin P, Alcock J, Burkin C. An 8 year follow-up of a specialist supported employment service for high-ability adults with autism or Asperger syndrome. Autism. 2005;9:533–49.

    Article  PubMed  Google Scholar 

  9. Howlin P, Moss P. Adults with autism spectrum disorders. Can J Psychiatr. 2012;57:275–83.

    Google Scholar 

  10. Levy A, Perry A. Outcomes in adolescents and adults with autism: A review of the literature. Res Autism Spectr Disord. 2011;5:1271–82.

    Article  Google Scholar 

  11. • Shattuck PT, Wagner M, Narendorf S, et al. Post-high school service use among young adults with an autism spectrum disorder. Arch Pediatr Adolesc Med. 2011;165:141–6. This paper discusses the loss of multiple services for individuals with autism following their exit from the high school service system.

    Article  PubMed  Google Scholar 

  12. Lawer L, Brusilovskiy E, Salzer MS, et al. Use of vocational rehabilitative services among adults with autism. J Autism Dev Disord. 2009;39:487–94.

    Article  PubMed  Google Scholar 

  13. Taylor JL, Seltzer MM. Employment and Post-Secondary Educational Activities for Young Adults with Autism Spectrum Disorders During the Transition to Adulthood. J Autism Dev Disord. 2010; 41:566–74. PubMed: 20640591; PMC #3033449.

    Google Scholar 

  14. •• Shattuck PT, Narendorf SC, Cooper B, et al. Postsecondary education and employment among young with an autism spectrum disorder. Pediatr. 2012;129:1042–9. Using national data, this paper reports on postsecondary outcomes (e.g., education, employment) for young adults with autism.

    Article  Google Scholar 

  15. Taylor JL, Seltzer MM. Changes in the Autism Behavioral Phenotype During the Transition to Adulthood. J Autism Dev Disord. 2010;40:1431–46.

    Article  PubMed  Google Scholar 

  16. Smith LE, Maenner MJ, Seltzer MM. Developmental trajectories in adolescents and adults with autism: The case of daily living skills. J Am Acad Child Adolesc Psychiatr. 2012;51:622–31.

    Article  Google Scholar 

  17. Zimmerman MA, Warschausky S. Empowerment theory for rehabilitation research: Conceptual and methodological issues. Rehabil Psychol. 1998;43:3–16.

    Article  Google Scholar 

  18. Duarte CS, Bordin IA, Yazigi L, et al. Factors associated with stress in mothers of children with autism. Autism. 2005;9:416–27.

    Article  PubMed  Google Scholar 

  19. Montes G, Halterman JS. Psychological functioning and coping among mothers of children with autism: A population-based study. Pediatr. 2006;119:1040–6.

    Article  Google Scholar 

  20. Hastings RP, Kovshoff H, Ward NJ, et al. Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism. J Autism Dev Disord. 2005;35:635–44.

    Article  PubMed  Google Scholar 

  21. Herring S, Gray K, Taffe J, et al. Behavior and emotional problems in toddlers with pervasive developmental disorders and developmental delay: Associations with parental mental health and family functioning. J Intellect Disabil Res. 2006;50:874–82.

    Article  PubMed  CAS  Google Scholar 

  22. Smith MD, Philippen LR. Community integration and supported employment. In: Zager D, editor. Autism spectrum disorders: Identification, education, and treatment. Mahwah, NJ: Lawrence Erlbaum Associates; 2005. p. 493–514.

    Google Scholar 

  23. Shattuck PT, Seltzer MM, Greenberg JS, Orsmond GI, Bolt D, Kring S, et al. Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. J Autism Dev Disord. 2007;13:129–35.

    Google Scholar 

  24. Smith LE, Hong J, Seltzer MM, Greenberg JS, Almeida DM, Bishop S. Daily experiences among mothers of adolescents and adults with ASD. J Autism Dev Disord. 2010;40:167–78.

    Article  PubMed  Google Scholar 

  25. Smith LE, Seltzer MM, Greenberg JS. Daily health symptoms of mothers of adolescents and adults with fragile X syndrome and mothers of adolescents and adults with autism spectrum disorder. J Autism Dev Disord. 2012;42:1836–46.

    Article  PubMed  Google Scholar 

  26. • Seltzer MM, Greenberg JS, Hong J. Maternal cortisol levels and child behavior problems in families of adolescents and adults with ASD. J Autism Dev Disord. 2010;40:457–69. This paper documents significant hypoactivation of cortisol in mothers of an adolescents and adults with ASD, highlighting the impact of chronic stressful caregiving on the physiology of parents.

    Article  PubMed  Google Scholar 

  27. Hasting RP, Lloyd T. Expressed emotion in families of children and adults with intellectual disabilities. Ment Retard Develop Disabilities Res Rev; 13: 339–345.

  28. Hastings RP, Daley D, Burns C, et al. Maternal distress and expressed emotion: Cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities. Am J Ment Retard. 2006;111:48–61.

    Article  PubMed  Google Scholar 

  29. Baker BL, Heller TL, Henker B. Expressed emotion, parenting stress, and adjustment in mothers of young children with behavior problems. J Child Psychol Psychiatry. 2000;41:907–15.

    Article  PubMed  CAS  Google Scholar 

  30. Greenberg JS, Seltzer MM, Hong J, et al. Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. Am J Ment Retard. 2006;111:229–49.

    Article  PubMed  Google Scholar 

  31. Baker JK, Smith LE, Greenberg JS, et al. Change in maternal criticism and behavior problems in adolescents and adults with autism across a seven-year period. J Abnorm Psychol. 2011;120:465–75.

    Article  PubMed  Google Scholar 

  32. Smith LE, Greenberg JS, Seltzer MM, et al. Symptoms and behavior problems of adolescents and adults with autism: Effects of mother-child relationship quality, warmth, and praise. Am J Ment Retard. 2008;113:378–93.

    Article  Google Scholar 

  33. Cox MJ, Paley B. Families as systems. Annu Rev Psychol. 1997;48:243–67.

    Article  PubMed  CAS  Google Scholar 

  34. Dixon L, Adams C, Lucksted A. Update on family psychoeducation for schizophrenia. Schizophr Bull. 2000;26:5–20.

    Article  PubMed  CAS  Google Scholar 

  35. McFarlane WR, Dixon L, Lukens E. Family psychoeducation and schizophrenia: A review of the literature. J Marital Fam Ther. 2003;29:223–45.

    Article  PubMed  Google Scholar 

  36. Colom F, Vieta E, Sánchez-Moreno J, et al. Group psychoeducation for stabilised bipolar disorders: 5-year outcome of a randomised clinical trial. Br J Psychiatry. 2009;194:260–5.

    Article  PubMed  CAS  Google Scholar 

  37. Milklowitz DJ, George EL, Richards JA, et al. A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. Arch Gen Psychiatry. 2003;60:904–12.

    Article  Google Scholar 

  38. Fristad MA, Goldberg-Arnold JS, Gavazzi SM. Multi-family psychoeducation groups in the treatment of children with mood disorders. J Marital Fam Ther. 2003;29:491–504.

    Article  PubMed  Google Scholar 

  39. Sanford M, Boyle M, McClearly L, et al. A pilot study of adjunctive family psychoeducation in adolescent major depression: Feasibility and treatment effect. J Am Acad Child Adolesc Psychiatr. 2006;45:386–95.

    Article  Google Scholar 

  40. Bengtson VL, Schrader SS. Parent–child relationship. In: Mangon DJ, Peterson WA, editors. Research instruments in social gerontology, vol. 2. Minneapolis: University of Minnesota Press; 1982. p. 115–85.

    Google Scholar 

  41. Magaña AB, Goldstein MJ, Karno M, et al. A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatr Res. 1986;17:203–12.

    Article  Google Scholar 

  42. Gurney J, Fritz M, Ness K, et al. Analysis of prevalence trends of autism spectrum disorder in Minnesota. Arch Pediatr Adolesc Med. 2003;157:622–7.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This project was supported by grant 1UL1RR025011 from the Clinical & Translational Science Award (CTSA) program of the National Center for Research Resources, National Institutes of Health. This research also was supported by Autism Speaks (7523) and by NIH grants R01 AG08768 and P30 HD03352. We are extremely grateful to the families who participated in this study; without their generous commitment, our research would not be possible.

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave. Waisman Center, Madison, WI, 53705, USA

    Leann E. Smith, Jan S. Greenberg & Marsha R. Mailick

Authors
  1. Leann E. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan S. Greenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marsha R. Mailick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leann E. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, L.E., Greenberg, J.S. & Mailick, M.R. Adults with Autism: Outcomes, Family Effects, and the Multi-Family Group Psychoeducation Model. Curr Psychiatry Rep 14, 732–738 (2012). https://doi.org/10.1007/s11920-012-0328-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11920-012-0328-1

Keywords

Search

Navigation