Childhood and Adulthood Predictors of Community Participation by Autistic Adults With and Without Intellectual Disability.
Lauren A Cameron, Bruce J Tonge, Patricia Howlin and 3 others
PMID 39716253WHAT IT FOUND
Autistic adults participated most in shopping and family outings, but half always needed a carer present.
Living in supported accommodation was the strongest predictor of lower community participation frequency. Childhood autism symptoms predicted reduced adult participation, but only weakly.
Key findings
01Half of the participants always engaged in community activities with support from a parent or carer, while only 17.5% did so independently.
02Living in supported accommodation was the only significant predictor of lower community participation frequency in the final regression model.
03Greater difficulty with social interaction and communication in adulthood was associated with decreased frequency and variety of community participation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size for regression analyses was small (n = 82 for participation, n = 74 for full models), limiting statistical power. The study did not ask participants whether they desired more independent participation or what barriers prevented it. The Index of Community Involvement may not capture modern forms of participation, such as online gaming or special interest groups, potentially underestimating engagement. The study did not assess whether participation was meaningful or self-directed versus organized by carers. Data was collected from a cohort recruited in 1991, so diagnostic criteria and service availability have changed significantly since childhood.
Declared interests
Bruce Tonge, Stewart Einfeld, and Kylie Gray are authors of the Developmental Behaviour Checklist (DBC2) used in the study. All royalties received from this measure fund ongoing research. The study was funded by the Australian Research Council.
The easy way to misread this
Do not interpret the association between childhood autism symptoms and adult participation as causal or strong. While correlations were significant, childhood symptoms did not remain significant predictors in regression models when controlling for adulthood factors, particularly living arrangements. The strongest predictor of low participation was current living situation, not early developmental history.