Autism in the Long-Term: Life After 18

By: Redmond Roxas

Eighteen. For most teenagers, it marks the beginning of their journey into adulthood, an important milestone ushering in a new chapter in people’s lives--one of great independence and responsibility. However, for the 1 in 68 children diagnosed with Autism, eighteen brings with it feelings of uncertainty and apprehension as they prepare to enter a world that no longer regards them as dependent minors, but as independent adults.

The American Psychiatric Association’s DSM-5, the primary diagnostic manual of mental health professionals in the US and other countries, consolidates the symptoms of Autism spectrum disorder [ASD] into two categories. The first category states the presence of “Persistent deficits in social communication and social interaction,” such as the reduced capacity to understand and reciprocate emotions or the inability to hold normal conversation with others. The second category states the presence of “Restricted, repetitive patterns of behavior, interests, or activities,” such as a profound obsession with personal routines and an inability to self-regulate one’s actions upon exposure to an external stimuli (APA, 2013). In a society where success is highly dependent on an individual’s ability to form connections with others, adolescents with ASD begin to find themselves at a significant disadvantage as they get ever closer to adulthood.

So what solutions exist? Unlike disorders such as depression and bipolar, the efficacy of pharmaceutical medication on ASD symptoms have been mixed. In most instances, the choice to medicate is driven by a need to reduce latent symptoms such as irritability. However, the high risk for side effects make the decision to use medication dependent on the severity of such symptoms (Ameis et al., 2013). By and large, the most effective treatment for ASD is behavioral therapy derived from the principles of Applied Behavioral Analysis [ABA]. ABA and its derivatives, directly target symptoms of ASD through an extensive regime of therapeutic techniques designed to improve an individual’s cognitive and social skills. Many individuals that undergo ABA experience significant improvements in cognition and behavior, leading to better outcomes with respect to adapting to adulthood (Howard et al., 2005; Ratto & Mesibov, 2015). However, successful outcomes of ABA is highly dependent on how soon an individual can be diagnosed and treated. Unlike those who have been doing ABA since early childhood, the success rates of individuals who begin therapy during adolescence are much lower (Ratto & Mesibov, 2015).

Since the effectiveness of ABA is so heavily dependent on early diagnoses, there remains a significant segment of individuals who continue to suffer from ASD symptoms. As a result, many families (such as yours truly) are pushed to plan ahead for decades of continued care and treatment for their sons and daughters. Fortunately, the passing of recent legislation such as the ABLE act--which allows families to create a tax-exempt savings account for the care of their disabled child--has made planning ahead less financially burdensome. State and privately-funded agencies also provide services such as work programs and behavioral therapy, developing critical skills for those wanting to live more independent lives. In the face of ongoing government budget cuts and stagnating wages, continued advocacy for the development of such programs alongside broader efforts to promote Autism awareness to the public has become more important than ever.

Because as our children grow up, so should we.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

Ameis, S. H., Corbett-Dick, P., Cole, L., & Correll, C. U. (2013). Decision making and antipsychotic medication treatment for youth with autism spectrum disorders: Applying guidelines in the real world. Journal Of Clinical Psychiatry, 74(10), 1022-1024.

Howard, J., Sparkman, C., Cohen, H., Green, G., & Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, 359-383.

Ratto A B, Mesibov G B. (2015).  Autism spectrum disorders in adolescence and adulthood: Long-term outcomes and relevant issues for treatment and research.Science China Life.

For more information about the ABLE Act

Link: https://www.congress.gov/bill/113th-congress/house-bill/647/text