Outcomes in Adolescents and Adults with Autism

Background:

Outcome for adolescents and adults with autism is an important area of research. Studies have examined a number of domains including diagnostic severity, cognitive functioning, language and academic performance, behavioral functioning and social outcomes. The literature suggests that outcomes for this population are highly variable and dependent on factors such as IQ, language development, additional psychopathology and access to services. However, there are a number of limitations to this research. Studies have largely evaluated high-functioning individuals with autism, have examined one aspect of outcome (i.e. cognitive outcome or psychopathology) rather than providing a comprehensive evaluation and have utilized a range of methodologies making comparison of results difficult. These studies have also spanned a wide-time period and, therefore, do not accurately reflect the outcomes for more recent cohorts of individuals with earlier and more comprehensive diagnosis and service provision.

Objectives:

The current study is a retrospective longitudinal study that examines the developmental, psychological and behavioral profiles as well as changes in service utilization in a population of adolescents and adults with autism. The study examined the adolescent’s/adult’s current level of functioning. The information collected on the individual’s cognitive, language and academic level and autism severity rating will be used to create the developmental outcome categories of good, fair or poor. The information gathered on the individual’s level of adaptive and maladaptive behavior and service level will be used to create the social outcome categories of good, fair or poor. This information will be coded by two raters and reliability in ratings will be determined. The current study will also examine relevant predictors of the adolescent’s/adult’s current outcome categories. In order to address this research question, the variables derived from the individual’s clinical files, including intake and discharge information, and information from the service interview will be considered as predictors for discriminant functional analysis to predict categorical outcome groups.

Methods:

This study followed a high needs group of adolescents/adults who received comprehensive services through an Ontario specialized intensive tertiary-care program for children and youth with extreme forms of autism. These individuals received a comprehensive evaluation including an assessment of diagnostic severity, cognitive, language and academic functioning, adaptive behavior, social outcomes and comorbid psychopathology. This information was collected using a standard battery of standardized measures that is developmentally appropriate for all participants. In addition, longitudinal data was available on all participants from earlier assessments conducted prior to entering and while in the treatment program. Information on the services and supports these individuals and their families received prior to, during and after exiting the program, was also assessed.

Results:

Preliminary results from 17 participants suggest that the cognitive profile remains stable across time. The majority of individuals made substantial gains in receptive language and domestic skills in programming and maintain these gains at follow-up. In addition, autism symptomatology decreased or remained stable. Further data is being collected and analyzed.

Conclusions:

Initial results suggest that these individuals maintain and continue to acquire skills. Further analyses of developmental profiles, outcomes categories and predictors will be discussed.