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Øverland E, Hauge ÅL, Orm S, Øie MG, Skogli EW, Pellicano E, Andersen PN. "I have to charge my social battery": Perspectives from autistic young adults on Quality of Life. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1369-1381. [PMID: 38629698 DOI: 10.1177/13623613241245578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
LAY ABSTRACT In this study we have asked a group of autistic young adults to describe what is important for their quality of life. The 14 participants (aged 21-29 years) were recruited from a 10-year follow-up study of autistic people. During interviews, our participants described the importance of having relationships with family, friends and pets. Having meaningful activities and being able to immerse themselves in particular interests was also reported to be important for a good quality of life. Interests had also guided their choice of what to study and what to do for work. They also spoke of how communication problems with professionals, bullying and sensory and emotional overload could have a negative impact on quality of life. Future interventions should focus on how professionals can help autistic people to connect to people/animals and meaningful activities, as the participants described this as important for having a good quality of life. These findings may be helpful in enhancing how passions and interests can be seen as opportunities for both academic and work careers for autistic people. Future research and interventions should also look at the communication barriers between autistic people and professionals, and how two-way understanding can be improved.
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Affiliation(s)
- Elisabeth Øverland
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Stian Orm
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Erik Winther Skogli
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
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Braverman Y, Edmunds SR, Hastedt I, Faja S. Mind the Gap: Executive Function Is Associated with the Discrepancy Between Cognitive and Adaptive Functioning in Autistic Children Without Cognitive Delay. J Autism Dev Disord 2024:10.1007/s10803-024-06354-x. [PMID: 38778001 DOI: 10.1007/s10803-024-06354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/25/2024]
Abstract
Adaptive functioning is central to autistic individuals' independence and well-being. However, autism spectrum disorder (ASD) is associated with poor adaptive functioning, even in the absence of cognitive delays or deficits. This study examined how age and executive function associate with adaptive functioning-particularly the gap between cognitive and adaptive functioning. We addressed our research questions separately for a school-age (N = 101 ages 7-12) cohort and a preschool (N = 48 ages 2 and 4) cohort of autistic children without cognitive delays. Both cohorts of parents reported on their children's adaptive and executive functioning skills. The difference between adaptive and cognitive skills was computed for each participant. For each cohort, we evaluated whether adaptive skills decline with age. Next, we measured, in each cohort, whether children's executive function corresponded with this gap between their adaptive and cognitive skills. Adaptive functioning did not decline relative to cognitive ability in the younger cohort, but the gap was present in the school-age cohort. Yet, reduced executive function consistently corresponded with a greater cognitive-adaptive gap in socialization domains for both preschool and school-age children. Targeting EF, specifically emotional control, during preschool years may support both adaptive functioning and social connectedness for autistic children without cognitive delays.
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Affiliation(s)
- Yael Braverman
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Sarah R Edmunds
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Psychology & Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Ingrid Hastedt
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Susan Faja
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
- Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Two Brookline Place, Brookline, MA, 0244, USA.
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Teh SE, Vo LTV, Bal VH. Factors that Influence the Daily Living Skills of Autistic Adults: The Importance of Opportunity. J Autism Dev Disord 2023:10.1007/s10803-023-06154-9. [PMID: 37914836 DOI: 10.1007/s10803-023-06154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/03/2023]
Abstract
While existing literature has demonstrated that Daily Living Skills (DLS) performance of autistic individuals is lower than what is expected of their age and cognitive abilities, limited studies have examined DLS in autistic adults. This study aimed to understand the influence of intellectual function (IQ) and contextual factors (i.e., provision of opportunities) on autistic individuals' DLS performance. Participants included 33 autistic individuals ranging in age from 16 to 35 years. Their caregivers were administered the Vineland Adaptive Behavior Scales, 3rd edition's (Vineland-3) caregiver interview form. A novel coding system was developed to capture the frequency of reasons for participants' non-performance of DLS tasks, based on caregiver's report. "Target" scores reflecting expected possible score if reasons for nonperformance could be addressed were computed. Qualitative analysis of parental responses indicated that, for adults with average or higher IQ, lack of opportunity to learn and/or implement the skill was the most frequent reason for not performing DLS. Lack of opportunity was also the second most common reason provided for adults with NVIQ below 85, following cognitive ability. Taking into account reasons for nonperformance, "Target" scores were, on average, 7.65 points higher for the NVIQ ≥ 85 group. These findings highlight a need for multi-dimensional assessment to go beyond individual strengths and difficulties to also include contextual factors that may influence adults' skill acquisition and performance. It is essential that clinicians ensure that adequate opportunities for learning and performance are available to promote acquisition of important DLS.
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Affiliation(s)
- Shin Er Teh
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA
| | - Le Thao Vy Vo
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA
- Western New England University, Springfield, MA, USA
- Rutgers Center for Adult Autism Services, New Brunswick, NJ, 08901, USA
| | - Vanessa H Bal
- Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, New Brunswick, NJ, USA.
- Rutgers Center for Adult Autism Services, New Brunswick, NJ, 08901, USA.
- Applied Psychology, 604 Allison Road, Piscataway, NJ, 08854, USA.
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Andersen PN, Orm S, Fossum IN, Øie MG, Skogli EW. Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study. BMC Psychiatry 2023; 23:149. [PMID: 36894901 PMCID: PMC9996871 DOI: 10.1186/s12888-023-04635-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults. METHODS A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis. RESULTS The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not. CONCLUSION Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.
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Affiliation(s)
- Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Department of Psychology, Inland Norway University of Applied Sciences, Holsetgata, Norway.,Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
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Øverland E, Hauge ÅL, Orm S, Pellicano E, Øie MG, Skogli EW, Andersen PN. Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol. Front Psychiatry 2022; 13:1058601. [PMID: 36506426 PMCID: PMC9732257 DOI: 10.3389/fpsyt.2022.1058601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction This study aims to investigate self-perceived quality of life, daily functioning, and the use of compensatory strategies in emerging adults with autism. Methods and analysis Participants will be recruited from the Lillehammer Neurodevelopmental 10-year follow-up study (LINEUP), with the aim of 15 individual in-depth interviews. Subsequently, two focus groups with clinicians will be invited to reflect on the themes found in the individual interviews. All interviews will be recorded and analyzed using reflexive thematic analysis. Ethics and dissemination The study is approved by the Regional Committee for Medical Research Ethics in South-East Norway. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations. To reach the broader autistic and autism communities, the findings will be shared with the Autism Society at national and local meetings, in their membership magazine, and on their social media channel.
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Affiliation(s)
- Elisabeth Øverland
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Åshild Lappegard Hauge
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Jonker F, de Looff P, van Erp S, Nijman H, Didden R. The adaptive ability performance test (
ADAPT
): A factor analytic study in clients with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:3-12. [PMID: 36288909 PMCID: PMC10091746 DOI: 10.1111/jar.13044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 09/20/2022] [Accepted: 10/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The adaptive ability performance test (ADAPT) was developed to assess adaptive skills in individuals with intellectual disabilities and borderline intellectual functioning, with or without mental disorders. As a follow-up to earlier research on the ADAPT, a factor analytic study was conducted. METHOD One thousand and sixty six ADAPTs from clients with (suspected) intellectual disabilities or borderline intellectual functioning and 129 ADAPTs from participants from the general population were collected along with other characteristics (e.g., IQ, psychiatric classifications, living situation). RESULTS An exploratory factor analysis (EFA) was performed and resulted in good fit indices. Subsequent confirmatory factor analysis (CFA) and multigroup CFA showed acceptable to good fit indices. This resulted in an instrument with eight factors and 62 items. CONCLUSION Factor analytic results suggest that the ADAPT is a valid instrument that measures adaptive skills in individuals with intellectual disabilities or borderline intellectual functioning.
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Affiliation(s)
- Femke Jonker
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Ermelosche Psychologen Praktijk Ermelo The Netherlands
| | - Peter de Looff
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Forensic Psychiatric Institute Fivoor Den Dolder The Netherlands
| | - Sara van Erp
- Methodology and Statistics Utrecht University The Netherlands
| | | | - Robert Didden
- Behavioural Science Institute Radboud University Nijmegen The Netherlands
- Trajectum Zwolle The Netherlands
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Tomaszewski B, Klinger LG, Pugliese CE. Self-Determination in Autistic Transition-Aged Youth without Intellectual Disability. J Autism Dev Disord 2022; 52:4067-4078. [PMID: 34536165 PMCID: PMC8930783 DOI: 10.1007/s10803-021-05280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
Self-determination refers to an individual's capacity and opportunities to act as a causal agent in their own lives to make choices, decisions, and set goals. The current study examined self- and parent-reports of the AIR Self-Determination Scale in transition-aged autistic youth (Based on stakeholder preferences, we use identity-first(autistic) or neutral language (on the autism spectrum) (Bottema-Beutel in JAMA 3:18-29, 2020)). Autistic youth completed depression and executive function measures, and parents rated their child's social-communication and executive function difficulties. Despite differences between youth and parent reports, both youth and their parents reported lower self-determination skills (capacity) than opportunities to practice self-determined behaviors. Both depression and executive function skills were related to self-determination capacity, highlighting potential intervention targets for transition-aged youth to facilitate increased self-determination and potentially improved adult outcomes.
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Affiliation(s)
- Brianne Tomaszewski
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA.
| | - Laura G Klinger
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7180, Chapel Hill, NC, 27599-7180, USA
| | - Cara E Pugliese
- Center for Autism Spectrum Disorders, Division of Pediatric Neuropsychology, Children's Research Institute, Children's National Hospital, Washington, USA
- Department of Psychiatry, Behavioral Sciences & Pediatrics, The George Washington University School of Medicine, 15245 Shady Grove Rd., Suite 350, Rockville, MD, 20850, USA
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