Background
Earlier reports from different parts of the world reported fair to poor outcome of ASD in adolescence and young adult life. Method: Eighty children diagnosed as ASD from a public clinic and a day care centre for adolescent made the study sample. 59, (73%) of sample’s mothers were contacted by telephone 10-15 year after diagnoses to assess their children general social functioning and behaviour. Children were not seen or examined. Results: Sample mean age was 17.3 year–St Dev. 4.8 year, and mean age at diagnosis was 3.2 year. Male, female ratio was 4:1. Almost all attended day care programs for ASD and 10% are in regular school. A quarter of cases had friends and all were living with their families. None are married or hold a regular job. Researcher scored more small gains while mothers reported more substantial gains. Discussion and conclusion: 10-15 year outcome of children with ASD showed mixed results. Parents reported considerable benefits in social adjustment in half of the sample in comparison in quarter by independent researcher. Reasons for such difference were discussed. In future, we need to expand the follow up duration and use measurable parameters to assess benefits. Keywords: ASD; Adolescence; Young adult; Outcome; Social; Bahrain Introduction Today adolescents and young adult persons with Autism Spectrum Disorder (ASD) enjoy better opportunities than their predecessors. They have a better chance to be diagnosed early, receive special education, behavioural intervention, early school education and live with their families rather than institutions. The beginning of adulthood often involves significant changes in educational, vocational, housing, and interpersonal domains and the development of new roles and identity formation. Such changes are especially more stressful for adolescents with ASD and their families due to inherent difficulty of coping with change for persons with ASD. Additionally, the heterogeneity of ASD may make it challenging for families to develop clear expectations for the future. Finally, there are an increasing number of individuals with autism spectrum disorders entering adulthood; it is still unclear how the disorder impacts individuals later in the life course. Earlier reports from Europe, North America and Japan regarding adolescents with ASD revealed poor social adjustment for the majority [1-5]. Many remained in institutions for mentally ill people, lived in isolation, with very low work capacity skills level. Some studies identified good intellectual ability and the presence of speech at age 6 year

Keywords

ASD; Adolescence; Young adult; Outcome; Social; Bahrain

Introduction

Today adolescents and young adult persons with Autism Spectrum Disorder (ASD) enjoy better opportunities than their predecessors. They have a better chance to be diagnosed early, receive special education, behavioural intervention, early school education and live with their families rather than institutions.

The beginning of adulthood often involves significant changes in educational, vocational, housing, and interpersonal domains and the development of new roles and identity formation. Such changes are especially more stressful for adolescents with ASD and their families due to inherent difficulty of coping with change for persons with ASD. Additionally, the heterogeneity of ASD may make it challenging for families to develop clear expectations for the future. Finally, there are an increasing number of individuals with autism spectrum disorders entering adulthood; it is still unclear how the disorder impacts individuals later in the life course.

Earlier reports from Europe, North America and Japan regarding adolescents with ASD revealed poor social adjustment for the majority [15]. Many remained in institutions for mentally ill people, lived in isolation, with very low work capacity skills level. Some studies identified good intellectual ability and the presence of speech at age 6 year were found to be good prognostic factors [2,6] and associated with better outcome. Many received medications and up to 40% developed seizures disorders after puberty [7]. Little is known about the social functioning of young adult and older individuals with ASD. Treatment for people with ASD has advanced in recent years and this needs to be taken into account when interpreting results from such studies.

Most cases reported in the above studies were diagnosed in the 70’s and 80’s of the last century, with varied intellectual cognitive abilities and age of diagnosis. Furthermore, they were a heterogeneous group of multiple neuro-developmental diagnoses, different level of function and age at diagnosis. It was not clear what type of interventions was received and whether all of them treated in the same way.

Therefore, the conclusion remarks of these studies; should be taken with caution and may not be relevant to recently diagnosed cases. Recent outcome studies used prospective design and focused on benefits of certain programs and intervention of short duration [813].

The purpose of the present study was to assess the global functioning and behavior of a cohort of ASD patients diagnosed in childhood and were later examine into their adolescence and young adult life in a developing country.

Methods

Bahrain is an archipelago situated in the Arabian Gulf region, east of Saudi Arabia. It covers an area of approximately 765 Km2and has an estimated population of 1.33 million in 2013. Annually, nearly 30 new cases of suspected ASD are diagnosed in Childhood Adolescent Psychiatric Unit (CAPU) in the Psychiatric Hospital, Bahrain. The prevalence of ASD was reported the 4.3 per 10000 populations by onetime registry method [14]. The diagnosed cases were referred to three major community rehabilitation centres under the umbrella of Bahrain Association of Intellectual Disabilities and Autism (BAIDA), (Al Wafer centre, Al Rashad centre and the Youth Club depending on their age group). The centres utilize Applied Behaviour Analysis–Sensory Integration–Miller Method, diet restriction program and social and leisure activities as intervention for their clients.

Design

Cross-sectional, prospective design study.

Sample

All cases of children diagnosed with Autism Spectrum disorder in the year 2005–2006 according to DSM-IV Revised criteria and attended (CAPU) and others with the same diagnosis enrolled in Al Rashad Center for autism at the time of data collection constitute the study sample, n=80 [15].

Fifty-nine (73.8%) parents, mostly mothers, were contacted and interviewed over the telephone. Twenty-one families could not be reached, because of change of contact numbers. None refused to participate. The missed families did not differ from those contacted by mean age–sex distribution or social class. There were no exclusion criteria. Al Rashad center is day care center for adolescents with ASD (age 12–21 year).

Procedures

The families of identified sample were contacted by telephone 10-15 years after diagnosis of autistic disorder. A special data collection form was designed for the study in order to provide structure to the interviews. The form contains demographic of parents and cases, history of use of rehabilitation services, history of other treatment methods, the current general social functioning and behaviour. The researcher, who was independent to cases, also asked the parents, Center’s staff and examined cases files to determine the benefits gained over the study period.

Parent’s social class was constructed following a modified version of Redlech and Hollangshead five level scale [16].

Research approval was obtained from the Management Board Committee, BAIDA and ethical committee secondary care, Ministry of Health, Kingdom of Bahrain. Participation was voluntary and no participant was forced to participate in the interviews. By agreeing to participate in the interviews subjects consented the use of the data for scientific purposes only.

Analysis

Data were entered into SPSS version 22 for analyses. Analyses were primarily descriptive; Chi square was used to assess statistical differences wherever applicable using 0.05 level as significant. Due to small numbers, social classes were grouped into two groups, high (Class 1+2+3) and low Class 4+5), and benefits into two groups, no change or little benefits verses major benefits.

Results

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For full article follow below link:
https://www.omicsgroup.org/journals/outcomes-for-adolescents-and-young-adults-with-autism-spectrum-disordersgeneral-social-functioning-2165-7890-1000187

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