Limited Discrepancy Between Cognitive Ability and Daily Living Skills in Autism: A Longitudinal Study From Ages 2-25.
Elaine B Clarke, Catherine Lord, Vanessa H Bal
Most autistic people with average or higher IQ had daily living skills in line with their cognitive ability over 23 years.
Where a gap existed, it grew gradually. Adult employment, living status, and well-being did not differ between the two groups.
Key findings
157.4% of participants had IQ and daily living skill scores within one standard deviation of each other across ages 2 to 25. The remaining 42.6% showed a gap that was within one standard deviation at ages 2 to 5 and grew to one to two standard deviations by ages 9 to 25.
2Participant race was the only early childhood characteristic that predicted which trajectory group a person fell into. Autism features and nonverbal IQ at age 2 did not.
3No significant differences between the two groups in adult employment, education, living status, friendships, romantic relationships, well-being, or internalizing and externalizing symptoms.
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What it does not show
The sample of 92 was large enough to detect only fairly large differences between the two groups; smaller associations would have been missed. Twenty-six participants were never diagnosed with autism across repeated assessments, so the sample includes people with non-spectrum developmental delay. Few female participants, limiting the ability to examine sex-based differences. Attrition was higher for participants from minority racial and ethnic backgrounds, and data at later timepoints were sparse (only 10 participants at age 21, 30 at age 25). The Vineland Adaptive Behavior Scales may not be ideal for measuring daily living skills in adults; its items are weighted toward childhood and adolescence, and its age-equivalent scores become sparser with increasing age. Adult milestones were measured as binary (employed or not, living independently or not), which does not capture the range of real-world arrangements. The cohort was enrolled in the early 1990s, when autism awareness and diagnostic practices were different, so these participants may not represent how autism is identified today. Data on services and interventions received were limited, so the study could not examine whether support was associated with trajectory group.
Declared interests
Funded by the National Institute on Aging (R01-AG080599) and the Autism Science Foundation. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the null adult outcome comparison as evidence that daily living skills do not matter for autistic adults. The sample was large enough to detect only fairly large differences between the two groups, the outcome measures were binary (employed or not, living independently or not), and the authors state that the absence of a group difference does not mean the discrepancy is inconsequential.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →