How do autistic people fare in adult life and can we predict it from childhood?
Gordon Forbes, Rachel Kent, Tony Charman and 3 others
PMID 36519265WHAT IT FOUND
Only 5% of autistic young adults lived independently, and many needed support from family or services.
Childhood IQ and adaptive skills could forecast living situation and employment, but not mental health or friendships.
Key findings
01In young adulthood, 68% had any close friend, 36% were in competitive employment or education, 34% were not in education, employment or training, and 5% lived independently.
02Childhood IQ predicted living situation well, IQ and autism traits predicted employment only modestly, and prediction of friendships, anxiety and depression was poor.
03Childhood adaptive functioning, especially daily living skills, was linked to adult living situation, physical health, anxiety and depression; language added little after other factors.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The adult outcomes were parent-reported, not self-reported, because many participants could not complete self-report measures, so mental health and quality of life may be under-reported. Parents may have had less contact with their adult children, which can make anxiety, depression and quality of life harder to observe. Only 121 of 158 children with baseline assessments had adult parent-report data, and loss to follow-up was related to socioeconomic status and neighbourhood deprivation. The analysis tested many outcomes and predictors without correction for multiple hypothesis tests, so some significant associations could be chance. The predictive models were corrected for optimism, which can hide small effects in a sample of this size. Follow-up occurred before the COVID-19 pandemic, so current transition and support conditions may differ. The cohort was mostly male and had a wide range of IQ and communication abilities, so findings may not apply evenly to all autistic people. The study did not test an intervention, so it cannot show that changing IQ, autism traits, adaptive functioning or language would improve adult outcomes.
Declared interests
The supplied text does not include an author conflict-of-interest or funding statement. The publication metadata lists research support from a non-U.S. government source.
The easy way to misread this
Do not use childhood IQ, autism traits, adaptive scores or language scores to promise an individual autistic person a particular adult outcome for mental health, friendships or quality of life. The overall prediction for these outcomes was poor, so the findings describe average trends, not certainties.