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I think this age group is sometimes misunderstood more than any other.
Why?
  • Well, it is rare that you see an 18 year old person with autism with motor stereotypies, strange vocalizations, etc that we often see in younger children.
  • Oftentimes, these particular characteristics are what the rest of the world recognizes as “autism.”
  • However, young adults have just as many, if not more, challenges that require intervention. Probably one of the most important is related to the fact that oftentimes they do not “look” like a child/person with autism.
  • Individuals with mild to moderate autism usually have developed compensatory methods by this developmental phase. For instance, most can allow eye contact at least to some degree. Because they may look “typical” they are misunderstood.
  • Even parents forget that it may still be difficult for their loved one to negotiate even the simplest social interaction.
  • Young adults with autism have the added pressure of thinking about living independently, and are at risk for co-morbid mood disturbances.
  • Even caretakers who are well-educated in autism sometimes forget that an individual with autism still needs a specific type of learning.
  • No matter what age, the severity/level of autism will likely dictate the necessary learning style. If discrete trial behavioral training was necessary as a child, it is still the preferred method.
  • In other words, there is far less “incidental learning” in this population. For example, when my typical child was a teenager/young adult, he was not literally taught to shave, wash a car, iron his clothes, etc. He was able to repeatedly observe the act(s) and then replicate them.
  • However, an individual with autism continues to perform best with step by step training. Even in very bright, gifted individuals, the everyday tasks of living independently can be daunting.  

 

For young adults, we offer...

  • Social skills training in this age group. Typically the groups are comprised of only two or three individuals, and co-ed groups are preferred.
  • One of the more interesting “serendipitous” findings has been utilizing an older child/young adult as a “co-leader” with the younger groups or even in individual therapy with a younger child with autism or related social communication disorder.
  • Research is currently underway regarding the efficacy of such, but anecdotally, this method has thus far worked beautifully!!
  • Children who are seen weekly with minimum interaction have engaged easily with an older “Aspie” (their term) because they someone inherently know they understand their unique challenges.
  • Likewise, this “mentoring” process appears to be beneficial for the older children who engage in a few therapy sessions with the younger child(ren).
  • For example, they have expressed increased feelings of empathy and increased leadership skills.
  • We also offer (or identify and refer) intervention and assessment of Self-Management skills, which assists with the ability to choose or make a decision.
  • Functional Communication skills: Functional communication skills are forms of behavior that express needs, wants, feelings, and preferences that others can understand. When individuals learn functional communication skills, they are able to express themselves without resorting to problem behavior or experiencing communication breakdown.
  • Life Skills: Money management, time management, etc.
  • Recreation/Leisure Skills: Identifying meaningful activities outside work or school
  • Social Competence: refers to the social, emotional, and cognitive skills and behaviors that are needed for successful social adaptation.
  • Pre-Vocational Assessment: Tests used to identify one’s knowledge, preferences, personality “fit” to the workplace
  • Oftentimes, an updated psychological evaluation is needed to apply for:
    • Vocational Rehabilitation Services
    • SSI benefits
    • And/or to identify college and/or employment accommodations
  • We work collaboratively with service agencies designed to support independent living.
  • We typically make contact with the various colleges’ disability offices in order to address any specific needs, such as the need for a private dorm room, a buddy system, preferential registration, etc.
  • One of the most important accommodations we have found is to have an actual person at the college designated as the individual’s advocate.
  • Accommodations at this level are the student’s responsibility and the student is required to contact each professor with their specific needs. Of course, by definition these interactions are difficult for an individual with an ASD diagnosis.
  • And “for the record” I am proud of our local colleges here in Louisiana, as most have been extremely accommodating when presented with specific needs supported by data.
  • “KUDOS” in particular to Centenary University and Louisiana Tech University!  

The following theoretical information may be a repeat of information found in alternate website sections; however, this particular information is important in understanding the specific challenges of the young adult stage.

 

Autism Includes Dysfunction In
the Processing of Stimuli

Individuals with autism receive sensory stimuli although the input strength and the processing of the stimuli is different. Common patterns include picking out one detail and assigning a literal meaning to it.

They may have difficulty in understanding the stimuli in a meaningful way. They perceive things but are less proficient in making the connection between things, people and events.

Their world can be scary….and it can be a like a state of chaos with a myriad of disjointed impressions.

Because of their difficulties in attaching meaning to perceptions, it is very difficult for them to gain insight into their surroundings.

Such difficulties impact their relationships with people, verbal (linguistic) and non-verbal (gestures, understanding of facial expressions) communication, and their reaction to change.

Currently there are three mainstream theories that try to explain autism, to include the Theory of Mind (T.O.M) Theory, the Central Coherency Theory and Executive Function Theory.

The Theory of Mind means “having a theory of consciousness” and involves the understanding that every person has their own thoughts and perceptions that are separate to another’s thoughts and perceptions. This understanding makes it possible to view matters from a different perspective than others, and it often regarded as the most important prerequisite for the development of social insight and abilities. Individuals with autism have a poorly developed theory of mind and therefore have difficulty experiencing the world in any other way except from their own perspective.

Central Coherency Theory refers to the tendency of people to gather information together in order to attach meaning to it. This appears to be problematic for people with autism, as they tend to focus more on details and consequently lose the overview. This phenomenon can present itself with disturbed sensory perceptions.

Executive Function is connected to organization and planning of behavior. When the executive function doesn’t work properly, then the brain processes impact complex behavior.  Complex behavior is necessary in situations that demand fast and flexible reactions.

Keeping these three theories in mind, what are some specific challenges for students with autism in higher education or pursuing career paths?

Independence Level: Their level of independence is typically lower than their peers. More importantly, they oftentimes fail to realize this point, as they live sheltered in their parent’s home and/or under the umbrella of other safety nets. And naturally, what they don’t know, they cannot report…and cannot ask for help for things that are unknown to them.  Parents also may underestimate the impact of lower functioning in a college setting, as their child may have performed without problems in the high school setting.

Sustained Concentration and Attention: Like “typical” students, problems with distraction and concentration increase in a large educational setting (especially a university setting). Previous compensatory methods no longer work in classes with 100+ students. These problems are also tied to hyperarousal levels, the difficulty of seeing the broader perspective, and in the inability to see the connection in matters. In other words, all incoming stimuli tend to receive equal importance and thus the incoming stimuli constantly demands attention. Very bright students with ASD oftentimes report they have difficulty knowing “what not to study.” They have no filter to disregard irrelevant information. Tests are difficult due to the rubric of language. The “and’s and the’s” in a multiple choice question might be given the same weight as the subject matter. Concentration problems worsen due to poor filtering and attention to the information at hand.

Problems with Organization: There is generally less insight into general principles and therefore difficulties with meaningful arrangement in ordering information. With organization skills, individuals with autism tend to have a need for placing things in order. Young adults with autism usually find that the systems they previously used no longer work in a university setting when there are no supports in place. Organization is inherently difficult due to sensory-motor planning anomalies,  and organization requires a more long-term, forward-thinking process at the college level. For example, one chooses a major; core classes are taken, and then classes specific to their major become more intense. Negotiating this scheduling is difficult especially for young adults with autism who are more involved in the “here and now” with little regard to future consequences.

Restricted Interests: Individuals with autism tend to have restricted patterns of thinking. This pattern influences planning, delineation of future actions, and the initiation of starting a course of action. It also influences impression formation and tends to disregard the steps needed for future action. All of these factors are required to follow-through a field of study and actually graduate and/or choose a career path. Oftentimes individuals with autism are “experts” in their restricted topics of interest, and thus, they tend to over-estimate their general ability in all topics.

Communication Difficulties: Individuals with autism tend to engage in concrete thought processes rather than symbolic thought. Difficulty with symbolic thought has a direct negative impact on the ability to communicate, as effective communication requires the ability to think in symbols. Additionally, individuals with autism tend to have limited skills and limited need for social reciprocity, which also impacts communication. For instance, there tends to be less inclination to exchange, and “typical” individuals learn about themselves through their interaction and mutual stimulation with others.

Mood Concerns: Stress is defined as any situation that requires us to adapt to change. In autism, the ability in routine transitioning is often impaired, which increases stress levels. The cumulative impact of stress can have serious negative consequences in terms of mental and physical health and overall well-being. 

Sense of Belonging: The normal developmental phase of feeling a sense of belonging usually starts in adolescence in typically developing individuals, who learn about their own identity via this sense of belonging. However, individuals with autism often report that they feel different than their peers from an early age. They also generally do not possess the need to belong to groups. These factors are compounded when others fail to understand how autism impacts their functioning and behavior. For instance, rigidity can be perceived as unmotivated or unwillingness and idiosyncratic language/communication can be seen as odd and eccentric. Latency in responding can be perceived as laziness, and limited social reciprocity can be mistaken for rudeness (or worse.)  It is easy to see why a “sense of belonging” is a foreign concept to young adults with autism.

Click here for a great site for transition services, research, and resources.

 

Services in Adulthood

Psychological evaluations can assist with employment, in terms of identifying interests and abilities.

Counseling assists with the job search via role modeling, organizational skills with resumes, and identification of placement opportunities within the community.

Psychological assessment assists with accommodations, identify the need for specific areas of coaching, and/or follow-up support.

Information regarding support needs are explored, such as socialization and leisure opportunities throughout the community, residential options and independent living supports, and the need for behavioral supports in an independent living situation. 

A behavioral plan usually involves a functional assessment of the targeted behavior, formalizing of a plan that is approved by the individual’s multidisciplinary team and training/implementation of the plan with direct care workers. Typically the plan requires some type of ongoing monitoring and data collection.


Workplace Tips for Individuals with Autism Spectrum Disorders

  • Ask advice from your supervisor about what, how and who you need to inform about your disability, what your job experience location needs to take into account and what sort of supervision is optimal for you.

  • Consider telling the people you're working with about your limitations. Explain to them about information processing and communication deficits and offer them ways to best communicate with you.

  • Look in time for a suitable supervisor with specific autism support/supervision experience.

  • Look for a suitable work experience placement. Think about transport to and from the workplace also.

  • Think of the necessity of: quiet workplace, fixed place of work, fixed times for work deliberation.

  • Clarify any questions regarding workplace /job expectations

  • Make arrangements about attendance and what to do in the case of absence.

  • Find out about breaks and arrange a room where you can rest.

  • Arrange your work experience over short periods. Think also about part-time work experience.

  • Make arrangements about regular feedback. Think of a regular 10 minute chat with a fixed supervisor to discuss progress and to plan activities in advance.

  • Make arrangements about communication of information. For example, ask if email is available and appropriate since that medium allows time to organize responses, reduces social anxiety, etc. 

  • Organize help with reporting and correspondence if needed.

  • Arrange access to a voice recorder to directly record notes, appointments, notes. In this way you can keep a check on your activities.

  • Consider a “buddy” or workplace acquaintance with whom you can regularly exchange experiences.


Of course, the clinic also provides a wide arrange of psychological and mental health services, to include cognitive-behavioral therapy for depression and anxiety, adult and children services and evaluations, as well as consultation in schools, IEP support, etc. Please email info@AutismDiagnosticCenter.com for questions regarding your specific need.



No Referral Needed

DISCLAIMER: Autism is a complex disorder. The information presented here is designed for informational purposes only and is presented as a public service. The contents of this web site are not medical, legal, or technical advice and must not be construed as such. Dr. Marsiglia’s “opinions” are based on research but are nonetheless opinions only. The information contained herein is not intended to substitute for informed professional diagnosis, advice or therapy. The website information is not for diagnosis or treatment without personal consultation.


 

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