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Autism beyond School-Age: Characterization, Intervention, and Community Support
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Autism beyond School-Age: Characterization, Intervention, and Community Support

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "School Health".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 11209

Special Issue Editors

Dr. B. Blair Braden

E-Mail Website
Guest Editor
College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA
Interests: autism; aging; neuroimaging; cognition; sex differences; genomics; mindfulness
Dr. Leslie C. Baxter

E-Mail Website
Guest Editor
Mayo Clinic Scottsdale, Phoenix, AZ 85013, USA
Interests: autism; aging; neuroimaging; neuropsychology; brain mapping
Dr. Nicole L. Matthews

E-Mail Website
Guest Editor
Southwest Autism Research & Resource Center (SARRC), Phoenix, AZ 85006, USA
Interests: autism screening and diagnosis throughout the lifespan; transition to adulthood; adaptive functioning; quality of life throughout the lifespan; telehealth assessment

Special Issue Information

Dear Colleagues,

The vast majority of autism spectrum disorder (ASD) research has focused on young and school-aged children, yet ASD is firmly understood as a lifelong condition. More than 50,000 American teens with ASD become adults every year. A paucity of research beyond school-age leaves much uncertainty in the way ASD core symptoms, co-occurring conditions, and potential behavioral and biological vulnerabilities manifest in transition-age, young adult, and older adults. Furthermore, the body of literature on effective interventions and community support for autistic individuals beyond school age is nascent. In this Special Issue, we welcome submissions that aim to: (1) characterize ASD on behavioral and/or biological levels, (2) investigate feasibility, acceptability, or efficacy of interventions, or (3) identify effective community support models for transition-age, young adults, or older adults with ASD.

Dr. B. Blair Braden
Dr. Leslie C. Baxter
Dr. Nicole L. Matthews
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autism
  • adult
  • adolescent
  • transition
  • diagnosis
  • mental health
  • cognition
  • adaptive functioning
  • brain imaging
  • health care

Published Papers (6 papers)

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Research

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11 pages, 429 KiB  
Article
Benefit or Problem: Exploration of How Response Options Affect Self-Reported Behaviors and Interests in Autistic Adults
by Hyein Lee, Nikita Jadav, Ellen Wilkinson and Vanessa H. Bal
Healthcare 2024, 12(9), 911; https://doi.org/10.3390/healthcare12090911 (registering DOI) - 27 Apr 2024
Viewed by 178
Abstract
Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current [...] Read more.
Assessment of restricted, repetitive behaviors (RRB) in autism evaluations often assumes that these behaviors negatively impact the individual. Qualitative studies of first-person accounts indicate the negative impact of the stigma associated with RRBs but also provide insights into the positive aspects. The current study explores how framing response options as negative (i.e., level of problem associated with occurrence) or positive (i.e., level of benefit associated with occurrence) affects RRB self-reports in autistic adults. Sixty-six autistic adults aged 18–59 filled out the Repetitive Behavior Scale-Revised (RBS-R) and a modified RBS-R+, assessing problems and benefits of reported behaviors, respectively. There was a moderate to strong correlation between the forms, each assessing problems and benefits in terms of the number of behaviors endorsed (r = 0.746) and the levels of benefits and problems (r = 0.637). Autistic adults reported a higher number of RRBs in the form that assessed problems, but the number of behaviors was comparable between the forms when counting in the response option of the occurrence of behavior without having a benefit. Despite some variability in the level of problems and the benefits across the subdomains of RRB, autistic adults largely rated comparable levels of associated benefits and problems, highlighting the complexity of RRBs as having both positive and negative impacts. Future screening and diagnostic tools for adults should aim to assess both positive and negative aspects of autistic features to afford a more nuanced understanding of individual experiences while still yielding diagnostically relevant information. Qualitative studies are needed to better understand the complex experiences associated with these behaviors; however, it may be important to ensure that options for endorsement of behaviors without a specific benefit are also needed to ensure some behaviors (e.g., self-injurious behaviors) are not missed. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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14 pages, 1346 KiB  
Article
Trajectories of Competitive Employment of Autistic Adults through Late Midlife
by Emily J. Hickey, Leann Smith DaWalt, Jinkuk Hong, Julie Lounds Taylor and Marsha R. Mailick
Healthcare 2024, 12(2), 265; https://doi.org/10.3390/healthcare12020265 - 20 Jan 2024
Viewed by 718
Abstract
Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study’s aims [...] Read more.
Autistic adults experience challenges in maintaining employment; however, little is known about patterns of competitive employment through late midlife. This longitudinal study examined the change in hours of competitive employment for a cohort of autistic adults over a 22-year period. The study’s aims were to provide a fine-grained analysis of competitive employment patterns, to determine whether there was age-related change, and to test whether trajectories differed between those with and without intellectual disability (ID). Using an accelerated longitudinal design, trajectories of hours of competitive employment were estimated from young adulthood through late midlife in a community-based cohort (n = 341; 1327 observations). Results indicated a significant curvilinear trajectory of age-related change in hours of competitive employment, with differences between those with and without ID. For those without ID, the number of competitive employment hours increased from young adulthood until early midlife, then leveled off and decreased into late midlife. For those with ID, engagement in competitive employment was low throughout. Although competitive employment is just one option for vocational engagement, it is a goal often articulated by autistic adults who seek entry into the general workforce. The present research reveals their degree of engagement in the competitive workforce across the decades of adulthood. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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19 pages, 1171 KiB  
Article
Alexithymia in Adult Autism Clinic Service-Users: Relationships with Sensory Processing Differences and Mental Health
by Emily Josyfon, Debbie Spain, Charlotte Blackmore, Declan Murphy and Bethany Oakley
Healthcare 2023, 11(24), 3114; https://doi.org/10.3390/healthcare11243114 - 07 Dec 2023
Viewed by 1304
Abstract
Mental health difficulties commonly co-occur with autism, especially in autistic people accessing clinic services, impacting substantially on quality-of-life. Alexithymia (difficulty describing/identifying feelings) and sensory processing differences are prevalent traits in autism that have been associated with depression/anxiety in autistic community samples. However, it [...] Read more.
Mental health difficulties commonly co-occur with autism, especially in autistic people accessing clinic services, impacting substantially on quality-of-life. Alexithymia (difficulty describing/identifying feelings) and sensory processing differences are prevalent traits in autism that have been associated with depression/anxiety in autistic community samples. However, it is important to better understand interrelationships between these traits in clinical populations to improve identification of service-user needs. In this study, 190 autistic adults (65.3% male), seen in a tertiary autism clinic, completed self-report measures of alexithymia (20-item Toronto Alexithymia Scale), sensory processing differences (Adolescent/Adult Sensory Profile) and depression/anxiety (Hospital Anxiety and Depression Scale). Multiple linear regression models and mediation analyses were used to examine associations between alexithymia, sensory processing differences, and depression/anxiety severity. Across the sample, 66.3% of individuals (N = 126) were classified as alexithymic (score ≥ 61). Total alexithymia and difficulty describing/identifying feelings were significantly associated with depression severity (β = 0.30–0.38, highest p < 0.002), and difficulty identifying feelings was significantly associated with anxiety severity (β = 0.36, p < 0.001). Sensory processing differences were also significantly associated with depression severity (β = 0.29, p = 0.002) and anxiety severity across all models (β = 0.34–0.48, highest p < 0.001) Finally, difficulty describing/identifying feelings partially mediated the relationships between sensory processing differences and both depression/anxiety severity. Overall, these results highlight that interventions adapted for and targeting emotional awareness and sensory-related uncertainty may improve mental health outcomes in autistic service-users. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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Review

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13 pages, 489 KiB  
Review
Barriers to Oral Health Care for Autistic Individuals—A Scoping Review
by Jayne Jones, Elysa Roberts, Deborah Cockrell, Denise Higgins and Dileep Sharma
Healthcare 2024, 12(1), 103; https://doi.org/10.3390/healthcare12010103 - 02 Jan 2024
Cited by 2 | Viewed by 1239
Abstract
Background: Challenges in providing adequate dental care for individuals with Autism Spectrum Disorder (ASD) are recognised by parents, caregivers, and dental practitioners, leading to a higher prevalence of unaddressed dental needs. This scoping review aims to explore existing research on the obstacles to [...] Read more.
Background: Challenges in providing adequate dental care for individuals with Autism Spectrum Disorder (ASD) are recognised by parents, caregivers, and dental practitioners, leading to a higher prevalence of unaddressed dental needs. This scoping review aims to explore existing research on the obstacles to oral health care as perceived by individuals with ASD, as reported by their parents, caregivers, and dental professionals. Methods: Systematic searches were conducted in DOSS, Medline, and PubMed databases using relevant keywords to identify relevant studies. Barriers identified within these studies were then categorised based on themes identified. Results: The initial search yielded a total of 254 studies. Following the removal of duplicates and screening of titles and abstracts, 47 studies were further assessed against predetermined criteria, ultimately resulting in the inclusion of 16 articles in this scoping review. The identified barriers were grouped into five overarching themes: challenges in accessing appropriate care (n = 8), negative past experiences (n = 5), parental perceptions of the impact of ASD (n = 8), clinician bias (n = 2), and clinician education (n = 7). Conclusions: The findings of this review highlight the obstacles faced by individuals with ASD in obtaining routine oral health care. These results underscore the imperative for the development, testing, and implementation of tailored interventions focused on autism, as well as their integration into educational curricula for dental practitioners at various educational levels. This approach aims to enhance the delivery of equitable oral health care to individuals with ASD, starting from undergraduate through to postgraduate dental education. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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16 pages, 2314 KiB  
Review
Research Mapping of Trauma Experiences in Autism Spectrum Disorders: A Bibliometric Analysis
by Osvaldo Hernández-González, Andrés Fresno-Rodríguez, Rosario Elena Spencer-Contreras, Raúl Tárraga-Mínguez, Daniela González-Fernández and Francisca Sepúlveda-Opazo
Healthcare 2023, 11(9), 1267; https://doi.org/10.3390/healthcare11091267 - 28 Apr 2023
Cited by 1 | Viewed by 1915
Abstract
The number of research related to traumatic experiences in people with autism spectrum disorder (ASD) has grown exponentially, yet there are no bibliometric studies in this field. This article aimed to analyze the literature related to trauma and ASD published in Web of [...] Read more.
The number of research related to traumatic experiences in people with autism spectrum disorder (ASD) has grown exponentially, yet there are no bibliometric studies in this field. This article aimed to analyze the literature related to trauma and ASD published in Web of Science (WoS). Papers on trauma and ASD were retrieved from the WoS. Analysis and visualization of selected documents were performed using MS Excel (v16.0), VOS viewer (version 1.6.15), and R package (Biblioshiny, version 2.0). A total of 147 articles were included in this study. The results showed that production has been increasing over the last few years. Among the countries identified, the USA published the largest number of articles. Arvid Nikolai Kildahl, Sissel Berge Helverschou, and Liliana Dell’Osso were the authors with the most number of publications on this topic, and Autism was the most productive journal. The main research topics associated with ASD were post-traumatic stress and traumatic experiences in childhood. This bibliometric study contributes to understanding research trends on trauma and ASD by evaluating relevant publications in the last decades. The results of this bibliometric analysis can serve as a basis and orientation for new studies. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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Other

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22 pages, 985 KiB  
Viewpoint
Where Do Neurodevelopmental Disorders Go? Casting the Eye Away from Childhood towards Adulthood
by Giulia Antolini and Marco Colizzi
Healthcare 2023, 11(7), 1015; https://doi.org/10.3390/healthcare11071015 - 02 Apr 2023
Cited by 10 | Viewed by 5108
Abstract
Neurodevelopmental disorders (NDDs) encompass a group of complex conditions with onset during the early developmental period. Such disorders are frequently associated with a number of neuropsychiatric features, the most prevalent ones being autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, communication and specific learning [...] Read more.
Neurodevelopmental disorders (NDDs) encompass a group of complex conditions with onset during the early developmental period. Such disorders are frequently associated with a number of neuropsychiatric features, the most prevalent ones being autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, communication and specific learning disorders, and motor disorders. These conditions are characterized by wide genetic and clinical variability, and although they were previously conceptualized as childhood-limited disorders, NDDs are progressively being recognized as persistent conditions with a potentially relevant impact on the quality of life and overall functioning during adult life. In addition, emerging evidence seems to point towards the hypothesis of a neurodevelopmental continuum, according to which NNDs could portray different time-dependent outcomes, depending on the severity of the altered brain development. Despite representing lifelong phenotypes, they are often not promptly identified and/or managed in adulthood. In this regard, specific guidelines on clinical and therapeutic approaches for these conditions have not yet been delineated. In this view, future research investigations should be encouraged to broaden available knowledge, characterize the clinical course of NDDs across an individual’s lifespan, and better understand the patterns of aging-related concerns in adults with an NDD diagnosis. Additionally, considering the difficulties many young adults encounter while transitioning from childhood to adult mental health services, new, specific programs should be developed and existing programs should be implemented to improve the transition process and for the management of NDDs in adulthood. Full article
(This article belongs to the Special Issue Autism beyond School-Age: Characterization, Intervention, and Community Support)
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