Megan Farley, Ph.D.megan.farley@hsc.utah.eduOctober 28, 2011

I have current grant funding to study autism from Autism Speaks, a non-profit foundation

I have no current consulting, drug company or stock relationships.

Review common features of autism spectrum disorders (ASD) in “high-functioning” adults

Things to consider while providing treatment

Therapeutic approachesResources for adults with ASD and

for you

All ASDs: 1% from UK Nat’l Health Service study

(2009)Approximately 4 times more

common in males than females

LessImpairment

MoreImpairment

Spectrum of Severity for Spectrum of Severity for Pervasive Developmental Pervasive Developmental

DisordersDisorders

Autism with no Mental Retardation

Autism withMental

Retardation

Asperger’sSyndrome

PervasiveDevelopmental

DisordersNOS

Biologically-based neurodevelopmental disorders

Highly heritableExact cause unknown in most casesApprox 10% are accounted for by identifiable conditions (Fra X, Tuberous Sclerosis, Rett’s)

Symptoms that may change with development, e.g. gaze aversion improves

Improvements noted in adolescence for subgroup

Seizure onset in infancy or adolescence for 20%

Co-occurring psychiatric conditions in ~60%

Lifelong condition, despite common reduction in symptoms of autism over time

Social interactionCommunicationRestricted interests and repetitive

behaviors

Sensory sensitivitiesEmotional reactivityLow adaptive functioning compared

to IQProblems organizing environment,

timeSleep difficultiesBlack-and-white thinking

Integrity, honesty, guilelessnessAttention to detailAccuracy Intense interestsAbility to see unique solutionsVisual learningExcellent memory Interest in people

Dating Finding work Self-advocacy Changes to existing environment, schedule Using mass transit Meeting new friends, socializing Understanding different expectations

held by people in similar roles (e.g., professors)

Most adults with ASD are unemployed or underemployed

Most adults with ASD live with parents, siblings, or older relatives

IDEA transition requirements are generally poorly implemented for people with ASD

SOURCE: Gephardt, P.F. (2009). The current state of services for adults with autism. Arlington, VA: Organization for Autism Research.

ASDs are complex, and it can be difficult to manage all of the competing challenges a client faces.

Determine what you are addressing: Comorbid psychiatric condition Skills deficit Supporting problem-solving (e.g., self-

disclosure, services navigation, environmental changes)

Cognitive Behavioral Therapy for Adult Asperger Syndrome (Gaus, 2007)

Medications may be indicated

Preparing for Life: The Complete Guide for Transitioning to Adulthood for Those with Autism and Asperger's Syndrome by Jed Baker

Video (self and other)

Living Well on the Spectrum by Valerie Gaus

Asperger’s Syndrome: an owner’s manual 2. for older adolescents and adults. By Ellen S. H. Korin

Counseling strategies usually best focused on teaching a functional skill rather than developing insight

Visual supports when possibleScripts for dealing with certain social situationsConcrete rules about social behavior

Concrete descriptions of emotions, including the range of emotions

Specific strategies for emotional coping (mindfulness, guided imagery, progressive relaxation, breathing exercises, using sensory objects)

A comprehensive plan for helping skills generalize to other settings (community-based when possible)

“Go-to” people in different settingsRehearsed scriptsVisual calendars and PDAs with

automatic remindersExploration of autism, self-identify

and self-acceptance through books, support groups, and Internet chat rooms Adapted from Ozonoff, Dawson, and McPartland

(2002)

Medication or monitoring of moodEducational accommodations in

collegeOrganizational systems for

paperwork Internet shopping

Adapted from Ozonoff, Dawson, and McPartland (2002)

Transition Tool KitAutism in the WorkplaceLegal AppealsFamily Services Resources Guide by

stateSocial Networks

Eligibility-based, not an entitlementSocial Supplement IncomeVocational Rehabilitation ServicesContinuing educationCampus-based centers for students

with disabilities

Plan early – work towards work Department of Workforce Services Vocational Rehabilitation

IPE – Individualized Plan for Employment Assessment/Eligibility Some training support Counseling Medical/Psychological treatment Assistive technology Job placement Follow-up services

Comorbid psychiatric conditions are treatable

Apply for SSI if neededVocational RehabilitationSelf-disclosure

Plan early – work towards work Department of Workforce Services Vocational Rehabilitation

IPE – Individualized Plan for Employment Assessment/Eligibility Some training support Counseling Medical/Psychological treatment Assistive technology Job placement Follow-up services

Neurodiversity MovementConcern about language and

attitudes regarding “curing” or “defeating” autism

Books: Asperger’s on the Job by Rudy Simone Students with Asperger Syndrome: A

Guide for College Personnel by L. Wolf, J. Brown, and G.R.K. Bork

Ask and Tell: Self Advocacy and Disclosure for People on the Autism Spectrum edited by S. Shore

Websites: The Autistic Self-Advocacy Network

(ASAN) - www.autisticadvocacy.org Wrong Planet at www.wrongplanet.org www.neurodiversity.com www.aspergeradults.ca Achieving in Higher Education with

Autism/Devel Disab. – http://aheadd.org/blog/

www.autismafter16.com