Health Outcomes of Adults with ASD

Background: Little research has focused on the health outcomes of adults with ASD. The research that has been done has had either very high or very low rates of comorbid intellectual disabilities, as well as an oversampling of young adults (Croen et al., 2015; Fortuna et al., 2016). Additionally, because of the chart review design of these studies, the age, stability, and method of diagnosis was often unknown.

Objectives: The aim of this study was to characterize the health status of adults diagnosed with an ASD as children by providing descriptive data on prevalence rates for a wide variety of health conditions, as well as to compare these rates to nationwide norms for age-matched participants from the 2015 National Health Interview Survey (National Center for Health Statistics, 2015).

Methods: Caregivers of adults with ASD (N = 268; 213 males, 55 females) completed a survey on the adult’s health status. The survey requested diagnostic information on 38 conditions. Adults with ASD (21-50 years; M = 34.99) were diagnosed during childhood between 1970 and 1999 through the UNC TEACCH Autism Program. Health prevalence rates were compared to an age-matched normative sample (N = 16,168; 21-50 years; M = 35.59).

Results: Adults with ASD reported significantly fewer cases of arthritis (ASD: 4%; US: 10%; p =.002), lower back pain (ASD: 4%; US: 27%; p < .001), migraines (ASD: 9%; US: 18%; p < .001), ulcers (ASD: 2%; US: 4%; p <.04), and cancer (ASD: 0.7%; US: 2.5%; p = .05) than the comparison sample. Additionally, adults with ASD reported significantly more cases of high cholesterol (ASD: 22%; US: 14%; p < .001), diabetes (ASD: 6%; US: 4%; p =.02), inflammatory bowel disease (ASD: 3%; US: 1%; p < .001), heart disease (ASD: 2%; US: 0.8%; p = .05), and epilepsy (ASD: 24%; US: 2%; p < .001). Comparable rates of obesity (ASD: 28%; US: 32%; p = .07), hypertension (ASD: 13%; US: 16%; p = .08), heart attacks (ASD: 0.4%; US: 0.5%; p = .50), and asthma (ASD: 10%; US: 13%; p = .11) were observed, although several results trended towards significance.

Conclusions: Similar to research by Croen et al. (2015), this study found significantly higher rates of many diagnoses including high cholesterol, diabetes, heart disease, inflammatory bowel disease, and epilepsy. Additionally, results found that diagnoses principally dependent on client self-report of pain experience (arthritis, lower back pain, migraines, and ulcers) occurred at significantly lower rates than in the normative sample. The unique social communication deficits present in ASD may prevent the proper reporting of pain experience leading to these lower rates of diagnosis. Future work should explore alternative ways of assessing pain for adults with ASD to examine whether adults with ASD genuinely experience fewer pain disorders or are underdiagnosed for these disorders. Additionally, more attention needs to be given to the increased cardiovascular and gastroenterology health risks seen in adults with ASD in order to further document this risk, investigate the source of risk, and develop treatments.