Brain Development Across The Lifespan In Asd
ASD is a lifelong neurodevelopmental disorder. Brain imaging studies offer the opportunity for greater understanding of brain development and associated behavioral difficulties across the lifespan of people with ASD, which may contribute to the development of age-appropriate treatments.158 For example, there is accumulating longitudinal evidence of abnormal, age-related changes in the brain anatomy of individuals with ASD in comparison to typically developing individuals, particularly in frontotemporal and striatal regions in early childhood159161 and adolescence.162 Furthermore, there is increasing cross-sectional evidence of region-specific and age-related changes in the brain structure of people with ASD from childhood to adulthood across a number of areas associated with ASD symptoms, including parameters of volume and surface-based measures of cortical thickness and surface area . Earlier brain imaging investigations in people with ASD suggested that macrocephaly may be a risk factor in the development of ASD.167 However, more recent investigations in larger samples have questioned this168 and suggested that true brain overgrowth occurs only in a small subgroup of ASD children.158,169
Future developmental investigations are warranted to enable better understanding of brain, cognition, and behavior in people with ASD across the lifespan, identify biomarkers, and develop effective age-appropriate, personalized treatments.
Signs Of Autism With Lower Support Needs In Adults
Most of the time, prominent symptoms of ASD are diagnosed in young children around toddler age.
If youre an adult who hasnt been diagnosed with autism, but you believe you may be on the spectrum, its possible that you may be considered autistic with lower support needs. In the past, this has been referred to as high-functioning autism.
Following are signs of autism in adults:
Research Question : Primary Test Of Treatment Effect
To answer our first research question, we examined differences in change between the two groups from pre-intervention to post-intervention on engagement in work, engagement in meaningful activities, and behavior problems. Shown in Table are means and standard deviations for both groups over time. Results for the interaction of group by time for engagement, including effect sizes, are also shown in Table . Based on self-reported engagement in work activities, there was an increase in work-related activities for the intervention group over the 6-month intervention period , compared to no change in work in the control group , F=3.22, p=.081 , although this was not statistically significant at the p=.05 level. Descriptively, the change in work-related activities for the intervention group over the 6-month period means that participants moved, on average, from minimal to diverse job exploration before intervention to diverse job exploration and working for pay 1-2 times per week, on average, after intervention . Further, a difference of one-half of a standard deviation has been used to indicate clinically significant change . The standard deviation in engagement in work in the overall sample at baseline was 1.78 , indicating that the almost 1-point change in work engagement over the 6-month period, though not statistically significant at the p< .05 level, represents a clinically meaningful difference in work-related activities.
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Communication And Social Symptoms
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Pragmatic Language Most individuals on the autism spectrum have difficulty communicating with other people. This often becomes apparent during early childhood. Any delays in speech development and nonverbal communication should be evaluated by a qualified specialist.
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Eye Contact and Nonverbal Communication Poor and avoidance of eye contact are common symptoms among those with autism. Other non-verbal communication difficulties may include recognizing and using facial expressions, physical gestures, and overall body language.
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Tone of Voice Some people with autism may have difficulty regulating or modulating their tone of voice. As a result, they may speak too loudly, too quietly, and/or with a monotone voice.
What Role Do Genes Play
Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, then the other will be affected between 36 to 95 percent of the time. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder also increases. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons . Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social communication skills or engage in repetitive behaviors. Evidence also suggests that emotional disorders such as bipolar disorder and schizophrenia occur more frequently than average in the families of people with ASD.
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Finding Resources And Support
It can be stressful to go through the process of pursuing an adult autism diagnosis but its likely more challenging to live your whole life without one, trying to adapt on your own.
Dr. Ferrari recommends looking for community resources and trying to connect with other people who have autism. This can help you feel less alone and recognize your potential, and can also encourage you to become a self-advocate who speaks up for yourself and your needs.
Its important that people with autism at all stages, including adults, have the opportunity for an excellent quality of life, including having meaningful work and quality relationships, she says. It can be really empowering to get a diagnosis that allows you to see your differences as strengths.
Autism Spectrum Disorder In Teenagers & Adults
A greater number of children identified with ASD has led to a growing interest in the transition to adolescence and adulthood. For most young people, including those with ASD, adolescence and young adulthood are filled with new challenges, responsibilities, and opportunities. However, research suggests fewer young people with ASD have the same opportunities as their peers without ASD.
- High rates of unemployment or under-employment
- Low participation in education beyond high school
- Majority continue to live with family members or relatives
- Limited opportunity for community or social activitiesnearly 40% spend little or no time with friends
In addition, individuals with ASD may experience changes in their ASD symptoms, behaviors, and co-occurring health conditions during adolescence and young adulthood. These changes can affect their ability to function and participate in the community.
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Signs Of High Functioning Autism In Adults
Estimates show that at least 5 million adults in the United States live with an autism spectrum disorder. This developmental condition can affect a whole range of social skills.
However, not everyone living with autism receives a diagnosis. This can have a serious impact on your quality of life and mental health. Recognizing the signs of high functioning autism ensures that you get the help and support that you need.
So how might high functioning autism be affecting you? Read on to find out some common autism symptoms in adults and teenagers.
Is Neurodivergent The Same As Autism
According to a 2015 article titled “The Myth of the Normal Brain: Embracing Neurodiversity” by Dr. Thomas Armstrong, Ph.D., neurodiversity is a term originally coined in the late 1990s by Australian sociologist, Judy Singer and New York journalist Harvey Blume, who wrote a 1998 article on neurodiversity in The Atlantic.
Armstrong, author of the 2011 book The Power of Neurodiversity: Unleashing the Advantages of Your Differently Wired Brain, explains in his article that the word neurodiversity was initially created “to articulate the needs of people with autism who did not want to be defined by a disability label, but wished to be seen instead as neurologically different.”
Today autism spectrum disorder, ADHD, and dyslexia are all considered neurodiverse conditions.
As Nicole Baumer, MD, and Julia Frueh, MD, point out in their 2021 article for Harvard Medical Schools Harvard Health Publishing, while the concept of neurodiversity began within the autism rights community, it has now grown beyond to also encompass other neurological conditions such as ADHD.
Today autism spectrum disorder, dyslexia, and attention deficit hyperactivity disorder are all considered neurodiverse conditions.
Neurodiversity is the idea that people experience and interact with the world around them in many different ways there is no one right way of thinking, learning, and behaving, according to Baumer and Frueh.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world. NINDS and several other NIH Institutes and Centers support research on autism spectrum disorder.
NIH participates in the Interagency Autism Coordinating Committee , a Federal advisory committee that is designed to coordinate Federal efforts and provide advice on issues related to ASD. The committee is composed of representatives from various U.S. Department of Health and Human Services agencies, the Department of Education, and other governmental organizations, as well as public members, including individuals with ASD and representatives of patient advocacy organizations. One responsibility of the IACC is to develop a strategic plan for ASD research, which guides research programs supported by NIH and other participating organizations.
More information about research on ASD supported by NINDS and other NIH Institutes and Centers can be found using NIH RePORTER , a searchable database of current and past research projects supported by NIH and other federal agencies. RePORTER also includes links to publications and resources from these projects.
Anxiety Depressive And Mood Disorders
Croen et al. carried out a study with a large group of adults with ASD to examine the frequency of psychiatric and medical conditions. The study reported comparable results to Tyler et al. , as adults with ASD had significantly increased rates of all major psychiatric disorders, including depression, anxiety, bipolar disorder, obsessive-compulsive disorder, and suicide attempts. Nearly all medical conditions were significantly more common in adults with ASD, including sleep disorders, seizure, obesity, and diabetes. There were increased risks of immune conditions and gastrointestinal disorders among men with ASD only, whereas risk of stroke was elevated among women with ASD only.
Wallace et al. used parental report measures to examine the association between executive function problems and comorbid anxiety and depression in adults with ASD. Flexibility problems were associated with anxiety-related symptoms, while metacognition difficulties were associated with depression symptoms and impaired adaptive functioning. These persistent problems are predictors of broader functioning and therefore remain an important treatment target among adults with ASD. The influence of EF problems on comorbid anxiety and depression in this sample was also independent of the influence of age, IQ, and comorbid ADHD symptoms.
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Success In Autistic Adults
Some adults with diagnosed autism are moderately to highly successful people. Some are happily married and partnered, and many are fully employed.
Some have even become role models for young adults on the spectrum who hope to live full, independent lives. Just a few such role models include:
- Temple Grandin, animal husbandry expert, author, and public speaker
- Stephen Shore, author, musician, professor, public speaker
- John Elder Robison, author, and public speaker
- Dan Ackroyd, actor, singer, radio personality
- Daryl Hannah, actor
These individuals, in addition to some others, are active autism advocates. Many speak publicly about their experiences and offer resources and insights to autistic adults and their family members.
Day Programs For Graduates Who Remain At Home
Easterseals services for younger adults can offer respite for family members responsible for a relative with ASD who lives at home.
Easterseals day programs are designed for people with autism whose primary needs are for socialization, recreation and community involvement. While people with ASD participating in day programs might need some supervision, they need only minimal assistance with activities of daily living . Read frequently asked questions about Easterseals’ adult day services.
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Tips For Working With Adults On The Autism Spectrum: Conclusion
Adults with ASD are amazing individuals with varied:
- physical and cognitive abilities
Working with individuals on the spectrum can be challenging at times, although it mostly can be worthwhile and wonderful. Adults with ASD, no matter the support they have from loved ones, can use an extra empathetic and caring person in their lives.
Brittany Cerny
Master of Education | Northeastern State University
Behavior and Learning Disorders | Georgia State University
Why Is Clarity Of Diagnosis Important In Asd
Although ASD is a common neurodevelopmental disorder, at the moment clear biomarkers are not yet available, and so ASD is defined and diagnosed on the basis of behavior.58,59 The diagnosis of ASD has been revised over the last 35 years, and early brain imaging as well as genetic and behavioral investigations of ASD have contributed to significant advances in our understanding of ASD. However, the results of some early studies were contrasting, which may have been contributed to, in part, by the inclusion of people with unclear diagnoses of ASD.59,60
Hence, standardized assessment measures of ASD were developed that enabled behavioral observations of the individual and collection of collateral developmental history from a parent or carer to be quantified and used in addition to diagnostic classification systems.59 As ASD is diagnosed behaviorally at present, clarity of assessment and diagnosis is important to better understand associations between brain, behavior, and health in people with ASD across the lifespan and enable inclusion of accurately categorized participants in large multisite studies.59,61 Better understanding of brain, behavior, and diagnosis in people with ASD will, in turn, lead to future development of age-appropriate and targeted treatments58 and thus improved services for people with ASD. As such, the next section will review changes in diagnostic practice in ASD.
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Understand And Respect Boundaries
Setting and maintaining boundaries will be a beneficial move when working with autistic adults. Not only do you need to set boundaries of your own, whether those be verbal or physical, but you also need to understand your clients boundaries.
Many individuals with autism spectrum disorder experience sensory overload from stimuli that many other individuals would find comfortable. It is important to understand some people on the autism spectrum do not enjoy common physical gestures such as:
- pats on the back
- being physically close in proximity
When beginning work with your client, ask them or one of their loved ones what their preferences are. During this conversation, go ahead and set your own boundaries.
If a lack of boundaries becomes an issue for either party, writing a social story or making a boundary contract might be beneficial.
Oftentimes, those with an autism diagnosis thrive when given:
Setting specific expectations and boundaries might help your client feel safe and secure and have a better understanding of what the daily routine looks like.
Just remember that they arent the only ones who need to keep appropriate boundariesyou do as well!
What Are The Benefits Of An Adult Having An Autism Diagnosis
If you think that you might be autistic yourself, or you think an adult family member or friend may be on the autism spectrum but they have never had a formal assessment or diagnosis, you might question whether there is any point in doing so now, particularly if autism does not seem to be impacting on functional skills or daily living activities.
Ultimately, this is a personal decision. Many adults on the spectrum who do not have a formal diagnosis have fulfilling employment, maintain happy and meaningful relationships, and enjoy a good quality of life.
At the same time, some adults who have not been formally diagnosed can find life challenging in terms of how they connect and engage with others, or in maintaining consistent and meaningful employment, and as a consequence might feel isolated, confused and frustrated, and may be unsure as to why. This can ultimately impact on health, wellbeing and quality of life.
Some adults who have not been formally diagnosed can find life challengingand as a consequence might feel isolated, confused and frustrated, and may be unsure as to why.
Therefore, while it is a personal decision to seek an autism assessment, there may be a number of benefits to be gained from having a diagnosis of autism, regardless of the stage of life at which it occurs:
Many adults on the spectrum who do not have a formal diagnosis have fulfilling employment, maintain happy and meaningful relationships, and enjoy a good quality of life.
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Tip : Manage Anxiety And Depression
Some people find that anxiety and depression go hand in hand with symptoms of ASD. For example, difficulty relating to others can lead to feelings of anxiety. Increased anxiety can, in turn, make it even harder to communicate. You might even feel so flustered that you cant form sentences.
Feelings of isolation can also trigger depression. But there are steps you can take to manage your mood and improve how you feel.
Stay active. Exercise is good for the mind and eases stress. Some studies show that vigorous exercise can be especially useful for helping adults with ASD manage aggression. Find an aerobic exercise that fits neatly into your routine and wont potentially throw your schedule into chaos. It may be something as simple as going for daily walks or runs. Make sure its something you enjoy, so youre more likely to stick to it.
Rely on close friends. Socializing can also be good for your mood, as long as the people youre with dont stress you out. Find people who share your interests. Thanks to the Internet, its easy to find people in your local area who share your interests. If possible, look for conventions or other gatherings where people who share your hobby come together and interact in person.
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