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Tuesday, March 21, 2017

Autistic Aging

When disabled people reach their 22d birthday, they no longer qualify for services under IDEA. ... People in the disability community refer to this point in life as “the cliff.” Once autistic people go over the cliff, they have a hard time getting services such as job placement, vocational training, and assistive technology. IDEA entitles students to transition planning services during high school, but afterwards, they have to apply as adults and establish eligibility for state and federal help. One study found that 39 percent of young autistic adults received no service at all, and most of the rest got severely limited services.
Elizabeth A. Wise, Marcia D. Smith, and Peter V. Rabins have an article at The Journal of Autism and Developmental Disorders titled "Aging and Autism Spectrum Disorder: A Naturalistic, Longitudinal Study of the Comorbidities and Behavioral and Neuropsychiatric Symptoms in Adults with ASD."

 The abstract:
Little is known about Autism Spectrum Disorder (ASD) in persons over age 50. In a retrospective, naturalistic review of 74 individuals aged 30 and older meeting DSM-5 criteria for ASD, the point prevalence of behavioral and neuropsychiatric symptoms (BNPS) declined significantly for 12 of 13 BNPS over a mean of 25 years while many other features of ASD remained stable. GI disorders (68.9%) and seizure disorders (23%) were common, and 25.7% of the sample had a BMI >30. Females were more likely to engage in screaming (p < 0.05) and oppositional behavior (p < 0.05). Current age did not have a significant effect on BNPS prevalence.
From the article:
Older adults in this cohort required a high level of support as ascertained by their treatment plans. We were unable to determine staffing levels when people entered the program, so we cannot comment on change in need for supervision over time, but it appears that the majority of people in this cohort required intensive staff support throughout, many for over 30 years. This observation is notable for several reasons. For one, it reiterates the relative stability of ASD over adulthood. Second, programs geared toward older adults with ASD—similar to those in this cohort—will need to provide levels of individual support described in this sample. The high prevalence of dental, dermatological, musculoskeletal problems, and seizures encountered in this cohort also points to the need for careful attention to those conditions, in addition to disorders that are common in the general population as people age. Moreover, it is worth noting that almost one-third of the sample require sedating medication to tolerate medical or dental care.