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The Long-Term Outcomes for People with Autism Spectrum Disorder

"What are some of the long term outcomes for people with ASD level 1 or high functioning autism? I'd like to know what to expect when my 7 y.o. son becomes an adult and leaves the nest."

The long term outcomes for those with High-Functioning Autism (HFA) and Asperger's depends on the severity of their symptoms, their baseline IQ, their ability to communicate, and what kinds of interventions and support they receive. 
 
Those who come from supportive families, retain a reasonable sense of self-esteem, and become relatively well-educated, stand a good chance of getting into solid relationships, finding good jobs, and having a normal life.

In other cases, the symptoms of the disorder are severe enough to affect speech and interpersonal relationship, or the individual’s IQ is low enough to impair their ability to find a good job, leaving them with a low paying job or on disability.

Because some individuals on the autism spectrum suffer from depression and OCD as adults, these secondary characteristics can negatively impact how the individual develops and grows into adulthood. Several research studies have looked at outcomes in people on the spectrum. In one study, outcome was looked at in a cross section of people with the disorder. 
 
After a five year follow-up using specific outcome criteria, the outcome was found to be good in 27% of cases. However, in 26% of cases, the individual maintained a very restricted life, with no consistent job record - and few friends.

Another study looked at outcomes in those on the spectrum to see which factors were more related to a poor or good outcome over time. It was found that language and communication skills were the greatest predictor of good outcome, with social interaction skills being a secondary predictor. 
 
The actual symptoms (e.g., ritual behaviors and obsessions) were less likely predictors of outcome. The study indicated that early intervention directed at improving communication was a good idea.

Finally, researchers studied an eight year follow-up of a specialized job program for those with HFA and Asperger's to see if such a program helped improve job outcome. For those with an IQ of 60+, approximately 68 percent of clients found employment. 
 
Of the 192 jobs found, most of the jobs were permanent contract work, and most involved administrative, technical or computing work. The study indicated that programs like these can be helpful in improving career outcome in people with the disorder.





==> Videos for Parents of Children and Teens with ASD


PARENTS' COMMENTS:

•    Anonymous said... Depends on many things. Will they have something to medically help them in the future? Did they attend enough social skills classes to learn how to cope and such? Did their parents facilitate them "fitting into" society rather than making tons of exceptions for them? Many questions.
•    Anonymous said... I am HF autistic, never attended a social skills class, never had any assistance, and now am approaching 28 years old. I am married, have 2 children and have a full time job in real estate. My eldest is HF autistic too, we are teaching him HTML programming at the moment as he loves computer games. Eventually I want to teach him C++ and the like so he can make his own games. Our youngest is suspected to be on the spectrum also but he hasn't beed diagnosed yet (he's 2)
•    Anonymous said... It takes the dedication of a parent, caregiver. I always wondered that same question. I asked some specialists, doctors, and even with all the advances in therapy , it still comes down to many factors. My kids have jobs, and are in college. I was never able to rely on a school system to do the work, and get the therapy the needed. Being creative, with social skills is a must.
•    Anonymous said... my aspergers husband has been married to me for 48 yrs,his obsession is buses,so he is a bus driver,our oldest a/s daughter trained as legal sec but through mental healtth probs cant work at moment,younger a/s daughter is a rep for a charity,my a/s sister in law is an author,many books published,luckily most of mine have done o,k,both daughters lead independant lives,
•    Anonymous said... My aspie husband functions fine but does struggle to keep a job, his bosses love him as he is a hard worker, but he quits because he has never found a boss he likes and doesn't always understand why they don't do things his way. I work with lots of people with disabilities and most adults with aspergers cope better as adults than as children.
•    Anonymous said... My hubby has the perfect engineering job. Suits him and his skills perfectly. I have to manage alot of the other parts of life (social, not black and white issues). In his defense he has learned as we have gone on (from a counselor and myself) how to deal with them too. The right employment, support, and taught skills make all the difference.
•    Anonymous said... My son was just diagnosed (finally) with aspergers on last Tuesday..he's six and we really need to get him into social skills classes. Any recommendations on where those classes would be or where we should start? The school IEP we setup includes him going to social group 30 mins a week but that's it socially...
•    Anonymous said... Things seem to have turned out ok for Bill Gates.

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Gender Differences in High-Functioning Autism

"It seems that there are more boys than girls with the high functioning version of autism. Is this true? If so, what accounts for the difference?"

Interestingly, different research studies list the ratio of males to females with High-Functioning Autism (HFA) as being anywhere from 4-10 to 4-1 (i.e., some research suggests that for every 4 males, there is 1 female).

Other studies suggest that the male population is much higher (8-10) relative to females. Obviously, much research is needed in this area.

As there is no known specific cause of autism as yet, researchers don’t know why there seems to be such a diagnostic difference between boys and girls.

A couple things could account for this difference:
1. There could be a hereditary or structural difference in boys that account for such a difference. There are other disorders associated mostly with boys (e.g., hemophilia) that have been found to be related to the genetic basis of the disease.

2. There could be a difference in the way society and therapists diagnose HFA in boys and girls. The behavioral expectations between boys and girls are such that boys are less likely than girls to be “diagnosed” with shyness - and could instead be diagnosed with a mild form of autism. Because the symptoms of HFA aren’t as readily diagnosable as some diseases, mistakes in diagnosis are very possible.

3. Girls with the disorder tend to be safeguarded and nurtured by their “neurotypical” friends who may assist them to deal with challenging interpersonal situations. 

4. Acceptance from peers can cover up many of the problems a girl on the autism spectrum has, so she isn’t recognized by parents, teachers, and other adults. Thus, they are not as likely to suggest psychological and social evaluations.

5. Females on the autism spectrum aren't usually aggressive once they get upset; instead, they tend to be withdrawn and may very easily "fly under the radar" in classrooms and other interpersonal situations (i.e., they often “shutdown” rather than “meltdown”).

As one lady with Asperger's stated: "I am a 50 year old female. My mother was told that I could not start kindergarten when I was 5 years old because I 'was not social enough'. I was held back, even though, at age 7, I was 'still not social enough'. Well, I didn't want to go over and initiate conversation and play tea with the other girls; I thought I was going to school to read BOOKS not socialize. Things haven't changed. After getting my Univ. of WA degree in American history at the age of 47, I was diagnosed at the time with Aspergers. What a relief as I suffered for decades and knew it wasn't 'just shyness'. Girls are 'quiet' sufferers and can frequently be suicidal when socializing is so important with girls and when getting jobs. I am glad I decided to go to college late in life; I had myself diagnosed and a thicker skin by then - I didn't care about social stuff when in college."

6. Females with the disorder can communicate their feelings in a calmer way as compared to their male counterparts.





As a side note, there have been several studies linking HFA and Asperger's in adults with gender identity disorder (i.e., a disorder where an individual feels like they are actually a member of the opposite gender they appear to be).

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