Teen Years

The dominant theme of the teen years is to plan an appropriate transition to adult life in the community. Areas of concern may include

Transition Planning

By law, people with disabilities are entitled to an appropriate, free, and individualized education until the age of 22 years. IDEA specifies that transition planning should begin at 16 years of age. However, many states have legislation (which can provide more than IDEA) to start preparing for transition to adulthood earlier.

During the transition period, social skills, leisure skills, daily-living tasks, selfcare, and hygiene issues, in addition to certain academic subjects, should be addressed in preparation of moving into the adult world. In addition, older teens with ASD need to transition to adult medical and behavioral health professionals. They will need to understand their diagnosis and participate in health care visits depending on their language abilities and judgment.

Self-determination

Quality of life can be improved significantly by teaching teens and their families the values of self-determination. Teens need to learn to make responsible decisions, including those that will determine how and where they will live as an adult. They must also learn how to seek the support needed to reach their goals.

Behavioral Challenges

The teenage years may be a time of changing behavior patterns for those with ASD, just as they are for those who do not have ASD. New behavioral challenges arise from frustration when teens are having problems communicating in a positive way or are challenged by the changing social rules of adolescence. It is also important to understand that teens with ASD have typical physical sexual development and may need to learn what sexual behaviors are appropriate in public settings compared with private settings.

Adult Years

Many adults with ASD and typical cognitive abilities complete high school and attend college. Some may marry and have families. More children are being diagnosed and receiving appropriate interventions earlier and may therefore be better prepared for adult responsibilities. It is also important to emphasize that adults with ASD can continue to improve in language, social interactions, and problem-solving. The treatment strategies used for children with ASD should continue throughout adulthood. Areas of concern may include

Employment

Current data indicate that fewer adults with ASD are employed in competitive jobs. Many will need job coaching and a supportive work environment, and some may need continual close supervision for successful employment. It is probable that there are many adults with ASD who are working successfully in the community. Better understanding of the symptoms of ASD in adults will help identify where adults with ASD are living and working and how to better meet the needs of teens and young adults as they transition to adult services.

Independent Living

Success in independent living is more likely for people who have learned tools for effective communication during their school years. Self-help skills are also critical to successful independent living as an adult. If an adult cannot live independently because of the social problems associated with ASD or the associated intellectual disability, caregivers (usually parents) should make a plan for other long-term care and living arrangements. One possibility is a group home. Group homes should look and function as close to typical homes as possible. They should be staffed by individuals who are experienced and sensitive to the unique needs of adults with ASD. It is very important that the environment is highly structured, safe, supervised, and predictable. At the same time, the adult’s right for self-determination must be upheld as much as possible.

It may be challenging to balance safety and independence.