By Antonio F. Pagán, PhD, Katherine A. Loveland, PhD, and Killian Rainey Hughes, PhD
Transition to Adulthood for Autism
While various causes have been proposed, for young adults with autism spectrum disorder (ASD), a lack of tailored services, social skill difficulties, co-occurring mental health needs, and difficulties with executive functioning play a large role in these transition difficulties. Knowing where the difficulties exist may help clinicians and other service providers improve outcomes before, during, and after the transition to adulthood.
What Helps: Parents
When working with your young adult with autism during the transition to adulthood, it can be helpful to consider the difficulties they are experiencing in the context of a broader society that is experiencing difficulty with transitioning to adulthood. Specifically, be patient with your adult as they navigate finding full-time employment and completing post-secondary education (if they decide to pursue this), as many young adults from the general population struggle to complete these goals. Also, allow your young adult to define what adulthood means to them, including having conversations with your young adult about what they may want to do when they are older. It is very important to recognize that young adults with autism are developing more slowly than peers in social-emotional domains; this means that they may not be ready for adult activities such as going to college, living independently, or working a full time job on the same schedule as neurotypical peers. Small steps with support are often helpful in reaching goals, such as living at home while attending community college with a reduced course load, or working part time.
What Helps: Young Adults
When working with young adults with ASD who are transitioning to adulthood, it can help to ensure that they set realistic goals and have support in reaching them. Setting shorter and longer term goals, planning, and initiating new activities can be hard for people with autism, who tend to prefer things to stay the same. Programs that focus on these goals can be helpful to support the transition to adulthood for young adults with ASD and their parents. The UTHealth Launching! program provides individual coaching that is built upon an evidence-based intervention called Motivational Interviewing (MI). Recent adaptations of MI (Frelink and Embregts, 2013) suggest several modifications that can be helpful for all people working with and helping young adults with the transition to adulthood.
What Helps: Practitioners:
Often physicians and other health providers have difficulty communicating well with individuals with autism, who may become anxious and find it hard to express themselves. When this happens the patient may feel unheard, and quality of care is reduced if the provider is not able to adjust to the patient’s communication style. For example, because people with autism tend to interpret what you say literally, it is better to avoid figurative language, sarcasm, or jokes.
Some recommendations (Frelink and Embregts, 2013), include:
Summary
Difficulties during the transition to adulthood are a normal experience for young adults with ASD. Helping young adults reach their full potential is the goal of Launching! to Adulthood programs at the UTHealth Houston Department of Psychiatry and Behavioral Sciences. The program runs through the Lifespan Autism Clinic and has been adapted for various groups of individuals, including Spanish speakers and for the military/veteran community. The reader is encouraged to call the department front desk at 713-486-2700 to speak with a representative who can connect you to the appropriate services.
References
Borrelli, B., Tooley, E. M., & Scott-Sheldon, L. A. (2015). Motivational interviewing for parent-child health interventions: a systematic review and meta-analysis. Pediatric Dentistry, 37(3), 254-265.
Frielink, N., & Embregts, P. (2013). Modification of motivational interviewing for use with people with mild intellectual disability and challenging behaviour. Journal of Intellectual and Developmental Disability, 38(4), 279-291.