A Preliminary Investigation of the Perspectives of Young Men with ASD and/ or ADHD and Their Caregivers about Conscript Military Service (CMS)/ National Service (NS)

Background: Transition to adulthood can be challenging for many individuals with ASD and/or ADHD. In a number of countries, including Singapore, Conscript Military Service (CMS) or National Service (NS; hereafter referred to as NS) is compulsory for young adult men. For many men with or without ASD/ADHD, NS can be a rewarding, yet challenging experience. With approximately 1% of the population having ASD and more males than females being diagnosed, an increasing number of males with ASD and/or ADHD are likely to serve, but very little is known about their and their caregivers’ perspectives.

Objectives: (i) to explore the men’s and their caregivers’ perceived opportunities and challenges in being enlisted for NS; (ii) to examine factors that may affect perceived NS-related distress in men with ASD/ADHD; and (iii) to explore perceived support needed from family, school, and Ministry of Defence (MINDEF) before NS in order to better support them in the transition to and during NS. 

Methods:  Participants included 42 caregivers and 17 15- to 19-year-old men with ASD/ADHD who were eligible for NS enlistment in Singapore. They were surveyed on their attitudes towards NS, perceived readiness, and perceived support needed for transition to NS. Measures of ASD and ADHD symptoms, emotional and behavioural issues, and perceived NS-related distress were administered in pen-and-paper or online format. Responses to open-ended questions were analysed thematically. Responses to close-ended questions and checklists were analysed quantitatively. Correlation and regression analyses examined factors that might explain reported NS-related distress. 

Results:  Most caregivers appreciated the benefits of serving NS, but did not wish their sons to face the potential challenges without the necessary support. 83% of the caregivers would want their sons to complete NS if their skills and strengths, as well as their needs, were carefully considered during placement– this figure was 53% when the young men themselves were asked.

A number of common themes relating to perceived opportunities and challenges were identified. NS was thought to potentially increase opportunities for social integration and to possibly enhance functional outcomes. However, there were many concerns about how others’ limited understanding and unhelpful reactions towards their sons with ASD/ADHD might exacerbate the challenges. Common themes related to concerns centred on lack of appropriate support or management and limited awareness of ASD or ADHD in the community.

Men with ASD/ADHD who reported more emotional and behavioural issues were more concerned about NS, felt less prepared for it and reported more pre-enlistment distress than men with fewer emotional and behavioural difficulties. Participants perceived preparing men with ASD/ADHD for NS as an important collaborative effort and placed similar emphasis on the role that each of the stakeholders (family, school, MINDEF) could play.

Conclusions: Caregivers and men with ASD/ ADHD articulate their need for more information about the support currently available for young men with ASD/ ADHD before and during NS, and strongly advocate a more coordinated collaboration amongst families, schools and NS-related organizations to facilitate transition to NS for men with ASD/ADHD before actual enlistment takes place.