Young Adults with Autism: What Happens After High School?

Background: There is a dearth of nationally representative data on the prevalence and correlates of service use and functional outcomes among young adults with ASDs. Basic descriptive data on the prevalence and patterns of service use and related outcomes is necessary for planning by policy makers and administrators. Knowledge of the correlates of service use and related outcomes can help identify underserved populations and plan targeted services. If there are significant disparities, despite similar levels of need, then new strategies are needed for improving access. Estimates of service use and correlates will help clinicians, service providers, and family members be more informed and better prepared as they try to help teens with ASDs navigate the transition from adolescence to young adulthood.

Objectives: The aim of this study is to examine the prevalence and correlates of service engagement and functional outcomes during the first six years after exiting high school.

Methods: Data for this report came from the National Longitudinal Transition Study 2 (NLTS2), a 10-year prospective study being conducted by SRI International for the U.S. Department of Education that is following more than 11,000 youth enrolled in special education as they age into young adulthood. The study included 922 youth enrolled in the special education autism category at the start of data collection in 2001. Analyses for this paper are based on data from wave 4, collected in 2007 and 2008, which included 680 youth with an ASD. Of these, 406 had exited high school by wave 4. Weighted estimates generalize to the national population of youth who had been receiving special education services for a given age range and disability type. Use of these data is governed by a data use agreement with the U.S. Department of Education and was approved by the Washington University Institutional Review Board.

Results: Overall rates of service use during the prior 12 months were 22.6% for medical services, 32.5% for mental health, 39.5% for case management, and 8.9% for speech therapy. Almost half (43.2%) had not received any of these services during the prior 12 months. Lack of any services was more likely among households with income less than $25,000 as compared to those with incomes greater than $50,000. The adjusted odds of not receiving any services were 2.73 times higher for females, and 3.09 times higher for African American compared to white youth. Fully 48% of youth had neither a competitive job nor engagement in any type of post-secondary education or job training. The likelihood of no job or education was higher among youth from poorer households. Approximately 40% of youth had no social contact with peers during the previous 12 months. Among youth capable of responding, 40% responded never, rarely, or sometimes when asked how often they felt hopeful about their own future.

Conclusions: There are significant disparities by race and socioeconomic status in post-high school service access and engagement in work and education among youth with autism.