Transcript Transitioning to Adulthood with an Autism Spectrum Disorder

Megan Farley, Ph.D.
[email protected]
October 28, 2011
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I have current grant funding to study autism
from Autism Speaks, a non-profit foundation
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I have no current consulting, drug company
or stock relationships.
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Review common features of autism spectrum
disorders (ASD) in “high-functioning” adults
Things to consider while providing treatment
Therapeutic approaches
Resources for adults with ASD and for you
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All ASDs:
 1% from UK Nat’l Health Service study (2009)
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Approximately 4 times more common in
males than females
Spectrum of Severity for Pervasive
Developmental Disorders
Less
Impairment
Pervasive
Developmental
Disorders
NOS
More
Impairment
Asperger’s
Syndrome
Autism with
no Mental
Retardation
Autism with
Mental
Retardation
Biologically-based neurodevelopmental
disorders
 Highly heritable
 Exact cause unknown in most cases
 Approx 10% are accounted
for by identifiable
conditions (Fra X,
Tuberous Sclerosis,
Rett’s)
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Symptoms that may change with development,
e.g. gaze aversion improves
Improvements noted in adolescence for subgroup
Seizure onset in infancy or adolescence for 20%
Co-occurring psychiatric conditions in ~60%
Lifelong condition, despite common reduction in
symptoms of autism over time
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Social interaction
Communication
Restricted interests and repetitive behaviors
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Sensory sensitivities
Emotional reactivity
Low adaptive functioning compared to IQ
Problems organizing environment, time
Sleep difficulties
Black-and-white thinking
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Integrity, honesty, guilelessness
Attention to detail
Accuracy
Intense interests
Ability to see unique solutions
Visual learning
Excellent memory
Interest in people
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Dating
Finding work
Self-advocacy
Changes to existing
environment, schedule
Using mass transit
Meeting new friends, socializing
Understanding different expectations held by
people in similar roles (e.g., professors)
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Most adults with ASD are unemployed or
underemployed
Most adults with ASD live with parents,
siblings, or older relatives
IDEA transition requirements are generally
poorly implemented for people with ASD
SOURCE: Gephardt, P.F. (2009). The current state of services for adults
with autism. Arlington, VA: Organization for Autism Research.
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ASDs are complex, and it can be difficult to
manage all of the competing challenges a
client faces.
Determine what you are addressing:
 Comorbid psychiatric condition
 Skills deficit
 Supporting problem-solving (e.g., self-disclosure,
services navigation, environmental changes)
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Cognitive Behavioral Therapy for Adult
Asperger Syndrome (Gaus, 2007)
Medications may be indicated
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Preparing for Life: The Complete Guide for
Transitioning to Adulthood for Those with
Autism and Asperger's Syndrome by Jed Baker
Video (self and other)
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Living Well on the Spectrum by Valerie Gaus
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Asperger’s Syndrome: an owner’s manual 2.
for older adolescents and adults. By Ellen S. H.
Korin
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Counseling strategies usually best focused on
teaching a functional skill rather than
developing insight
Visual supports when possible
Scripts for dealing with certain
social situations
Concrete rules about social
behavior
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Concrete descriptions of emotions, including
the range of emotions
Specific strategies for emotional coping
(mindfulness, guided imagery, progressive
relaxation, breathing exercises, using sensory
objects)
A comprehensive plan for helping skills
generalize to other settings (communitybased when possible)
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“Go-to” people in different settings
Rehearsed scripts
Visual calendars and PDAs with automatic
reminders
Exploration of autism, self-identify and selfacceptance through books, support groups,
and Internet chat rooms
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Adapted from Ozonoff, Dawson, and McPartland (2002)
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Medication or monitoring of mood
Educational accommodations in college
Organizational systems for paperwork
Internet shopping
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Adapted from Ozonoff, Dawson, and McPartland (2002)
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Transition Tool Kit
Autism in the Workplace
Legal Appeals
Family Services Resources Guide by state
Social Networks
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Eligibility-based, not an entitlement
Social Supplement Income
Vocational Rehabilitation Services
Continuing education
Campus-based centers for students with
disabilities
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Plan early – work towards work
Department of Workforce Services
Vocational Rehabilitation
 IPE – Individualized Plan for Employment
 Assessment/Eligibility
 Some training support
 Counseling
 Medical/Psychological treatment
 Assistive technology
 Job placement
 Follow-up services
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Comorbid psychiatric conditions are treatable
Apply for SSI if needed
Vocational Rehabilitation
Self-disclosure
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Plan early – work towards work
Department of Workforce Services
Vocational Rehabilitation
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IPE – Individualized Plan for Employment
Assessment/Eligibility
Some training support
Counseling
Medical/Psychological treatment
Assistive technology
Job placement
Follow-up services
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Neurodiversity Movement
Concern about language and attitudes
regarding “curing” or “defeating” autism
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Books:
 Asperger’s on the Job by Rudy Simone
 Students with Asperger Syndrome: A Guide for
College Personnel by L. Wolf, J. Brown, and G.R.K.
Bork
 Ask and Tell: Self Advocacy and Disclosure for
People on the Autism Spectrum edited by S. Shore
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Websites:
 The Autistic Self-Advocacy Network (ASAN) -
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www.autisticadvocacy.org
Wrong Planet at www.wrongplanet.org
www.neurodiversity.com
www.aspergeradults.ca
Achieving in Higher Education with Autism/Devel
Disab. – http://aheadd.org/blog/
www.autismafter16.com