Post-High School Daily Living Skills in Autism Spectrum Disorder

J Am Acad Child Adolesc Psychiatry. 2021 Aug;60(8):978-985. doi: 10.1016/j.jaac.2020.11.008. Epub 2020 Nov 18.

Abstract

Objective: Daily living skills (DLS) are a predictor of positive outcomes in youths with autism spectrum disorder (ASD), yet little is known about trajectories of DLS in adults with ASD. This study investigated the impact of high school exit on participants' trajectories of daily living skills age equivalent (DLS-AE) scores from ages 2 to 26 and the relationship between DLS-AE trajectories and employment and education outcomes.

Method: Participants were 98 adults with ASD drawn from an ongoing longitudinal study. The Vineland Adaptive Behavior Scales were administered 8 times from ages 2 to 26. Employment and education data were compiled from parent report demographic forms.

Results: DLS-AE trajectories modestly increased with age before exiting school, at which point DLS-AE trajectories plateaued, then declined. A significant (p < .01) decrease occurred in the slope of DLS-AE trajectories following school exit. High DLS-AE scores predicted participation in postsecondary education (χ25 [n = 73] = 27.83, p < .001). Autism symptom severity predicted participation in employment (χ25 [n = 58] = 27.54, p < .001).

Conclusion: These findings provide evidence that DLS decline in adults with ASD, specifically after school exit, and highlight the importance of DLS in normative adult outcomes. Future work should examine the trajectories of DLS in middle and later adulthood and consider intervention targets for bolstering DLS following school exit.

Keywords: adaptive function; adulthood; autism spectrum disorder; daily living skills; developmental trajectories.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Autism Spectrum Disorder*
  • Child
  • Child, Preschool
  • Humans
  • Longitudinal Studies
  • Schools
  • Young Adult