Support for adults with autism spectrum disorder without intellectual impairment: Systematic review

Abstract

Adults with autism spectrum disorder without intellectual impairment may benefit from a range of support services. This article presents the results of a systematic review assessing the effectiveness of supportive interventions for adults with autism spectrum disorder without intellectual impairment. A total of 32 studies were included; most focused on younger male participants. Although evidence was lacking for most types of intervention, employment programmes and social skills training were found to be effective for more proximal outcomes such as social skills. Evidence that any intervention improves mental health or well-being was very limited. Most interventions focused on mitigating specific deficits, rather than on providing broader support. Further research is needed on the effectiveness of supportive interventions such as advocacy and mentoring.

Accelerating research on treatment and services for transition age youth and adults on the autism spectrum

“…This extreme shift is often referred to as the “service cliff” (Roux et al, 2015). Existing services for adults frequently only enroll those with more significant needs such as intellectual disability, psychiatric disorders, or medical problems (Lorenc et al, 2017). Individuals with autism spend significantly more time of life within the adult service system compared to the child system.…”

“…The authors reported that meta-analyses could not be conducted due to the heterogeneity of intervention content, outcomes, and outcome measures. Even more concerning was that few studies used validated measurement tools (Lorenc et al, 2017). This same challenge of lack of consistency across outcomes and measurement tools has been reported in numerous review articles.…”

Information, Advocacy and Signposting as a Low-Level Support for Adults with High-Functioning Autism Spectrum Disorder: An Example from the UK

“…Adults with autism spectrum disorder (ASD) who do not have an associated learning disability—so called ‘high functioning’ individuals (Lorenc et al 2016 )—are at risk of experiencing negative outcomes across a number of domains of life and to “function well below the potential implied by their normal range intellect” (Marriage et al 2009 ). Adults with high functioning autism spectrum disorder (HFASD) have been found to experience poor and comorbid physical and mental health issues (Mazurek and Kanne 2010 ; Hofvander et al 2009 ; Howlin and Moss 2012 ; Lake et al 2014 ; Lugnegård et al 2011 ; Mattila et al 2010 ; Gotham et al 2015 ); high unemployment, underemployment, and workplace discrimination (Baldwin and Costley 2016 ; Gotham et al 2015 ; Howlin and Moss 2012 ; Smith et al 2012 ; Taylor and Seltzer 2011 ; Lake et al 2014 ); limited meaningful social and romantic relationships (Baron-Cohen and Wheelwright 2003 ; Farley et al 2009 ; Jennes-Coussens et al 2006 ; Tobin et al 2014 ); and struggle to gain autonomy and independence in their lives (Renty and Roeyers 2006 ; Lake et al 2014 ; Howlin and Moss 2012 ).…”

“…Low-level support broadly concerns any non-intensive service aiming to provide general support, which is not directed at treating a clinical problem or deficit, to people in their everyday lives (Lorenc et al 2016 ). The focus of low-level support can be wide ranging and can be delivered through a variety of settings, such as health services, social care, the community, and telephone and internet based services (Lorenc et al 2016 ).…”

“…A recent systematic review, however, of the current state of knowledge concluded that there is little or no evidence relating to many low-level strategies for supporting adults with HFASD (Lorenc et al 2016 ). As such, this paper will contribute to the existing literature regarding the efficacy of low-level supports for adults with HFASD.…”