4. ASD in Adolescents & Adults Flashcards
Describe the “diagnostic crisis” of the “lost generation”.
Experts now believe that thousands of people are living with autism but don’t know it, especially females
Why do females on the spectrum tend to go undiagnosed? (2)
1) they have grown to effectively mask their social-communication difficulties by self-teaching themselves social skills over the years. Females have greater motivation to fit in
2) They go undiagnosed because we still don’t know much about the female presentations of autism, we think they are just being shy. the diagnostic criteria is still heavily male biased and constitutes more stereotypical male behavior.
Even though some females on the spectrum have self-taught themselves social skills quite successfully, why is this underdiagnosis problematic?
- because it still takes a toll on them. when they get home, they will likely go into a quiet dark room, won’t speak to anyone, or experience some kind of meltdown. if they were diagnosed earlier, they might not have to pretend and struggle so much. May think they are just unlikeable, and may lead to other associated mood conditions.
- strain on families without the right support
- offers closure for the individual himself/herself
What are the positive aspects of transition to adulthood in ASD individuals? (2)
1) majority show overall reduction in autism symptomatology (decrease in RRBs, improvements in social interactions when language improves)
2) decrease in problem behaviors (eg. self injurious behavior, aggression)
3) cognitive intellectual functioning generally stable, some overall improvements in language
What are the negative aspects of transition to adulthood in ASD individuals? (4)
society hasn’t really caught up with these positive changes. little support mechanism for them
1) low rates of social inclusion and employment. adult day activities are lower quality/less structured than educational activities in school. Doing less well even compared with individuals with ID or other developmental disorders
2) increase in mental health problems. frequency of major psychiatric disorders (anxiety, depression, OCD) often related to environmental pressures (eg. college, jobs, leaving home, loss of family members)
3) very few complete higher education
4) poor physical health and higher mortality. cannot convey their discomfort to the doctors.
Describe the field in ASD research in adulthood.
Quantity and quality of intervention research is still poor. Most research trials stop at 5-6 years old.
For ASD individuals, even if they were coping fine in primary school, why is transition to secondary school a huge struggle for them?
Biological changes and adolescence kicking in. Things really start to break down due to little fit with the environment. Primary school environment is more supportive. In secondary school, they keep changing classes and have much bigger schools, less contact with same teachers, no form teacher. more pressure to make friends. hormones are changing
What are some key developmental goals in adolescence?
- successful transition to secondary schooling
- academic achievement
- involvement in CCA
- forming close friendships
- forming a cohesive sense of self-identity
What are some key developmental goals in adulthood?
- finding a place in society
- taking responsibility for yourself (career, parenthood, sexual experiences, money)
- managing separation from parents
What are some key developmental goals in middle adulthood?
- finding a place in society
- ageing (accepting changes in appearance and health)
- keeping old friends and making new ones
- money management
- experience death of people close to you, especially parents
- passing on knowledge, skills, and values to next generation
Compare the prevalence of ASD vs the Prevalence of diagnosis
ASD condition > diagnosed
How might missed diagnosis link to the history of Autism understanding?
Diagnostic criteria were not as inclusive before because understanding of spectrum was not that known yet. Health professionals and educators did not have the relevant training and knowledge, Hence, many were not picked up and left undiagnosed, especially those that are cognitively and verbally able.
What is the general prevalence of ASD in each cohort? What does this suggest?
1%. Suggests that we don’t have an ASD epidemic! the rates are not actually rising. just that knowledge and criteria has broadened. we are getting better at identifying it and how it presents differently in different people
ASD diagnosis was associated with ____, _____, __________, ___________.
- being male
- single
- social disadvantage
- lower education
Accurately predicting pathways and later outcomes is challenging. So far, what is the best that we can do?
We can educate parents that studies looking at trajectories over time show that those who use their interests and passion for their work can achieve great things. Environmental support or acceptance will be helpful. Cannot guarantee anything but early indicators like speech can provide some context for parents. Predict based on clusters of parents. Can’t predict how a child can turn out because it depends on so many factors.
