Autism in Adulthood
How relevant is diagnosis to our focus on adult Autism? For a diagnosis of Autistic Disorder (classic Autism) at least, the behavioural symptoms must be present before age three. Age of onset may be later for some of the rarer forms of Autism. And critical symptoms of some less severe forms of Autism, such as what we used to call Asperger’s, may not have become clear until adolescence or adulthood.
Pediatricians and psychiatrists in the past may have been reluctant to pronounce a diagnosis of Autism out of consideration for the parents’ feelings or because such a label was thought to close doors to service rather than open them. Many of today’s adults who probably had key symptoms of Autism in early childhood were given other labels or described as having “autistic tendencies”.
The disabilities of Autism are lifelong and there is no known cure, though careful training and sensitive support can bring improvements. Autistic traits usually persist into adulthood, but with a wide range of outcomes. Some adults with ASD achieve college degrees and function independently. Most diagnosed with classic Autism may not develop functional language and communication and may have poor daily living skills throughout their lives. Some adults with Autism who live without support may be reclusive or eccentric. Some may be labeled with obsessive-compulsive disorder, schizoid personality, simple schizophrenia, affective disorder, mental retardation or brain damage.
Those who probably had classic Autism as children may suffer from general assumptions that they have a poor prognosis as adults. It may not seem to professionals and policy-makers that they are worth much in resources. In recognizing other subtypes of Autism Spectrum Disorder, we may tend to overlook the needs of adults with the most severe forms of the disorder.
By adulthood, in any case, the original symptoms of Autism may be masked by the person’s life and treatment experiences, the effects of drugs, and her/his own efforts to cope with the disorder. Each person of whatever age should be considered as a unique individual. This is especially true of adults who were diagnosed with Autism as children. Their challenges cannot be understood purely and simply in terms of Autism. On the other hand, knowledge of the Autism and past treatments may help in assessing their abilities and challenges as adults and in considering helpful approaches—including adult versions of therapies and strategies that may have been mainly designed for children, but too recently for today’s adults when they were children.
In our view, far too little attention is paid to adult Autism as a general category of disability or to individual adults who have the symptoms of Autism. Yet adults with Autism are said to have normal life expectancy. It would be prudent as well as humane to assess each person’s needs and abilities as part of individual plans for supports that will enable them to use their abilities, realize their dreams, and attain the best possible quality of life.A new journal launched in 2019, Autism in adulthood, is welcomed for drawing attention to adult issues, partly by encouraging joint research projects that combine the points of view of professionals and of adults on the spectrum. It also supports more sensitive use of ableist language.
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