Autism in Adulthood: Clinical and Demographic Characteristics of a Cohort of Five Hundred Persons with Autism Analyzed by a Novel Multistep Network Model

Abstract

<jats:p>Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in communication and relational skills, associated with repetitive verbal and motor behaviors, restricted patterns of interest, need for a predictable and stable environment, and hypo- or hypersensitivity to sensory inputs. Due to the challenging diagnosis and the paucity of specific interventions, persons with autism (PWA) reaching the adult age often display a severe functional regression. In this scenario, the Regional Center for Autism in Adulthood in Turin seeks to develop a personalized rehabilitation and enablement program for PWA who received a diagnosis of autism in childhood/adolescence or for individuals with suspected adulthood ASD. This program is based on a Multistep Network Model involving PWA, family members, social workers, teachers, and clinicians. Our initial analysis of 500 PWA shows that delayed autism diagnosis and a lack of specific interventions at a young age are largely responsible for the creation of a “lost generation” of adults with ASD, now in dire need of effective psychosocial interventions. As PWA often present with psychopathological co-occurrences or challenging behaviors associated with lack of adequate communication and relational skills, interventions for such individuals should be mainly aimed to improve their self-reliance and social attitude. In particular, preparing PWA for employment, whenever possible, should be regarded as an essential part of the intervention program given the social value of work. Overall, our findings indicate that the development of public centers specialized in assisting and treating PWA can improve the accuracy of ASD diagnosis in adulthood and foster specific habilitative interventions aimed to improve the quality of life of both PWA and their families.</jats:p>

Expanding the clinical phenotype of the ultra‐rare Skraban‐Deardorff syndrome: Two novel individuals with WDR26 loss‐of‐function variants and a literature review

“…Concerning patient's perspective with health outcome, a complete habilitative daily program, based on behavioral therapy in a small ASD group, has been provided from Adult autism center and Social Agency to improve social skill but very little improvement has been obtained, so the treatment was further based on care and support (Keller et al, 2020).…”

Gray matter abnormalities follow non-random patterns of co-alteration in autism: Meta-connectomic evidence

“…Autism spectrum disorder (ASD) is the diagnostic label that refers to a set of neurodevelopmental conditions characterized by impairment in social abilities, repetitive behaviors, restricted interests and abnormal sensory processing ( American Psychiatric Association, 2013 ). This cluster of conditions reports clinical features persisting throughout the lifespan ( Brighenti et al, 2018 , Keller et al, 2020 , Lord et al, 2018 ) and afflicting approximately 1 in 54 children aged 8 years ( Baio et al, 2018 ).…”

The Alteration of Chloride Homeostasis/GABAergic Signaling in Brain Disorders: Could Oxidative Stress Play a Role?

“…The fact that dysfunctions in GABAergic signaling are a common pathogenetic trait shared by a large array of brain disorders highlights the presence of psychopathological and neurological co-occurrences in many neurodevelopmental disorders. Transition of persons with ASD to adulthood is often accompanied by high rates of psychiatric comorbidities [ 150 ]. In prefrontal cortical regions, parvalbumin-expressing GABAergic interneurons normally mature during adolescence, and are particularly affected during their development by oxidative stress, neuroinflammation and NMDAR hypofunction [ 78 ]; in fact, in patients with schizophrenia, autism and bipolar disorders, they exhibit a pattern of gene expression typical of immature cells [ 151 ].…”