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Developmental Trajectories in Adolescents and Adults With Autism: The Case of Daily Living Skills

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Objective

This study aimed to investigate the longitudinal course of daily living skills in a large, community-based sample of adolescents and adults with autism spectrum disorders (ASD) over a 10-year period.

Method

Adolescents and adults with ASD (n = 397) were drawn from an ongoing, longitudinal study of individuals with ASD and their families. A comparison group of 167 individuals with Down syndrome (DS) were drawn from a linked longitudinal study. The Waisman Activities of Daily Living Scale was administered four times over a 10-year period.

Results

We used latent growth curve modeling to examine change in daily living skills. Daily living skills improved for the individuals with ASD during adolescence and their early 20s, but plateaued during their late 20s. Having an intellectual disability was associated with lower initial levels of daily living skills and a slower change over time. Individuals with DS likewise gained daily living skills over time, but there was no significant curvature in the change.

Conclusions

Future research should explore what environmental factors and interventions may be associated with continued gains in daily living skills for adults with ASD.

Section snippets

Daily Living Skills in Individuals With ASD

Daily living skills constitute a critical domain of adaptive behaviors, which are defined as behaviors necessary for age-appropriate, independent functioning in social, communication, daily living, or motor areas. Past research suggests that the development of daily living skills may be particularly challenging for individuals with ASD. Children with autism often have significant impairments in daily living skills compared with well-matched controls,9, 10 and as early as 36 months of age such

Present Study

The primary aim of the present study was to investigate the longitudinal course of daily living skills in a large, community sample of adolescents and adults with ASD. Daily living skills were measured on four occasions over a 10-year period, allowing for an examination of linear and curvilinear change. Furthermore, due to the wide range of ages of participants in our study (10–52 years at Time 1), we were able to explore the effects of the age of the individual with ASD (termed “child age”) in

Autism Sample Participants

Participants were drawn an ongoing, multi-wave, longitudinal study of 406 individuals with ASD and their families, the Adolescents and Adults with Autism study (AAA).21 The present study focused on four of eight points of data collection, Times 1, 4, 7, and 8. Families were recruited via agencies, schools, diagnostic clinics, and media announcements. At entry into the AAA study, families met three criteria: the family included a child 10 years of age or older; the child had received a diagnosis

Primary Aim: Daily Living Skills in Adolescents and Adults With ASD

Activities of daily living were assessed at 4 time points (Times 1, 4, 7, and 8) in the ASD sample. We present means, standard deviations, ranges, and intercorrelations among study variables in Table 2. Figure 1 depicts a mixed-effects regression model showing individual scores by age and intellectual disability status. By the end of the study, the average score for the group was 20.59 (SD = 8.08) on a scale in which a score of 34 reflects complete independence. Only 16.5% of the sample had

Discussion

The present study used LGC modeling to investigate trajectories of daily living skills for adolescents and adults with ASD. Past research examined trajectories of daily living skills for individuals with ASD during childhood and early adolescence but not across adolescence and adulthood. In contrast, the present study included a large, community-based sample of individuals with ASD with a wide age range (10–52 years), which enabled us to examine the influence of age as well as ID status on

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    An interview with the author is available by podcast at www.jaacap.org.

    This research was supported by National Institute of Health (NIH) grants R01 AG08768 (M.M.S.), T32 HD07489 (M.M.S.), and P30 HD03352 (M.M.S.).

    The authors are extremely grateful to the families who participated in this study; without their generous commitment, this research would not have been possible.

    Disclosure: Drs. Smith, Maenner, and Seltzer report no biomedical financial interests or potential conflicts of interest.

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    Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.