Developmental Lifespan Stages of ASD

Autism Spectrum Disorder Transitional Lifespan Stages

Colleen Pauley American College of Education SPED5053 Developmental Characteristics of Exceptional Learners Dr. Valdez January 19, 2024

Introduction

Autism spectrum disorder (ASD) is increasing in prevalence. As more children with autism enter schools, educators need to have an adept understanding of their various needs. One way to foster a deeper understanding of diverse needs presented by students with ASD is to pursue an understanding of their developmental lifespans, as the disorder will not go away once they reach adulthood. Social deficits are observed across the lifespan; children are especially impacted. Comorbid conditions are observed across each developmental stage. It is classified as a developmental disorder because symptoms typically appear within the first 2 years of life. It is difficult to generalize traits of those with a spectrum disorder due to the various ways the disorder can present in each individual and in each stage of life. The characteristics described in this presentation can vary from individual to individual; they are merely the most commonly associated characteristics observed. Individuals with ASD experience symptoms differently depending on a number of individual factors.

Developmental Lifespan Stages

birth - 3 years old

3 years old - 17 years old

17 years old - retirement

retirement - death

birth - 3 years old

• A brief overview

This is the most common developmental stage to be diagnosed with ASD. Identification most commonly occurs between the ages of 2 and 3 years of age. Common characteristics demonstrated during this stage that would lead to the identification of ASD can include: - by 9 months: avoiding eye contact, unresponsive to someone calling their name, lack of facial expressions to indicate emotional state. - by 12 months: insufficient use of gestures, lack of participation in simple games requiring interaction - by 15 months: no engagement in shared interests with others, - by 18 months: the absence of pointing to show something to others - by 24 months: failure to notice when others are injured or upset - by 36 months: failure to notice or attempt to play with other children (CDC, 2023)

3 years old - 17 years old

• A brief overview

Diagnosis during the preschool stage can be difficult, even though earlier diagnoses provide opportunities to provide early intervention services (Billeiter & Froiland, 2022). Common characteristics demonstrated during this stage that would lead to the identification of ASD can include: - language delays: persistent deficits across settings - social deficits: insufficient use of gestures, lack of participation in simple games requiring interaction - behavioral issues: refusals to engage in nonpreferred activities, or exceptional latency before following directives; can be more severe depending on the severity of deficits in communication skills - restrictive or repetitive behaviors: the absence of pointing to show something to others - atypical interests: may demonstrate perseverating on objects or activities of interest such as calendars, maps, street lamps, etc. - intense emotional reactions: prolonged and extended reactions that may seem to be out of proportion with the antecedent event. - comorbidities are common - comorbid conditions are likely to present during this stage, most commonly ADHD (Amancio de Lima et al., 2022). (National Institute of Mental Health, 2023).

17 years old - retirement

• A brief overview

Diagnosis during this stage is difficult. Due to ASD being classified as a developmental disorder, there is a lack of established criteria for diagnosing adults with this disorder (Smith, 2023). Common characteristics exhibited during this stage can include: - a variety of symptoms: social symptoms, repetitive behaviors, executive functioning deficits - misdiagnosis: anxiety, ADHD, or depression are often diagnosed at this stage rather than ASD - mental health challenges: 50 - 70% of young adults report experiencing one or more episodes of major depression and anxiety. - prevalence of comorbidities: higher incidence of comorbidities compared to neurotypical individuals at this stage of life - atypical interests: may demonstrate perseverating on objects or activities of interest such as calendars, maps, street lamps, etc. - employment challenges: many are unemployed or underemployed - independent living challenges - barriers are especially indicated in cases of late or undiagnosed individuals. (Autism Research Institute, 2021).

retirement - death

• A brief overview

Many individuals at this stage of life have gone undiagnosed, and have developed ways to "mask" their symptoms (Smith, 2023). Common characteristics exhibited during this stage can include: - cognitive challenges: early research implies the elderly with ASD are more likely to experience cognitive disorders including Alzheimer's disease (Moore, 2022). - mental health challenges: 50 - 70% of young adults report experiencing one or more episodes of major depression and anxiety. - physical health challenges: higher incidence of gastrointestinal issues, osteoporosis, heart disease and more. - less prone to aggression: individuals in this stage are less likely to exhibit aggressive behavior - alienation - this applied to many stages, and it can be more prominent during this stage of life - more research needed: there are very few studies focused on this developmental stage, further research is needed.

Comprehensive Details of Developmental Stages

birth - 3 years old

3 years old - 17 years old

17 years old - retirement

retirement - death

birth - 3 years old: a closer look

This developmental disorder manifests early in a child’s development before they are school-aged (Amancio de Lima et al., 2022). This is a common developmental stage to be diagnosed with ASD, most frequently between the ages of two and three years old. Earlier diagnoses can occur if caregivers or doctors notice developmental delays in speech, a notable preference for solitary play, or insufficient eye contact. Persistent deficits in social communication and interaction across various environments, coupled with restrictive and repetitive patterns of behavior, serve as initial indicators of the disorder (Zauderer, 2023). Early diagnosis makes a difference for individuals with ASD.

birth - 3 years old: a closer look (continued)

Once a diagnosis is made, early intervention services can be sought out and provided such as behavioral and speech therapy. Early intervention services have been shown to lead to substantial improvements in language, cognitive functioning, as well as adaptive behavior (Billeiter & Froiland, 2022). Common characteristics observed in this stage include language delays and behavioral issues, potentially resulting from a deficit in effective communication or in an attempt to meet sensory needs. It is noteworthy to mention that certain individuals may experience delays in one or multiple of these domains. Behavioral issues are usually present by twelve to eighteen months of age. It can be difficult to diagnose prior to eighteen months of age (Zauderer, 2023).

3 years old - 17 years old: a closer look

During the preschool years, persistent language delays and social deficits, along with behavioral issues persist, with the added difficulty of attentional challenges during nonpreferred tasks. ASD children suffer from social isolation, the risk of exploitation, loneliness, and feelings of insecurity. They may also demonstrate deficits in self-advocacy skills, coping skills, and self-awareness. Individuals with ASD often present with comorbid issues. For school-aged children with ASD, ADHD is a very common comorbid condition (Amancio de Lima et al., 2022).

3 years old - 17 years old: a closer look (cont'd)

In this atypical spectrum disorder, a range in intellectual aptitude is common. IQ scores can vary greatly in this spectrum disorder. Research has shown that higher IQs in children with ASD often correlate to improved social skills (Billeiter & Froiland, 2022). Children at this stage often demonstrate difficulty with social interaction, changes to routine, atypical interest in objects, remarkably strong reactions to sensory stimuli, repetitive behaviors or language, and intense and extended emotional reactions. Individuals may demonstrate significant strength in one area while displaying great difficulty in another area. Many demonstrate difficulty in recognizing the meaning of facial expressions and body language and creating meaningful relationships with their peers. At this stage, it is common for students to struggle to comprehend figurative language, sarcasm, or humor (National Institute of Mental Health, 2023). There have been several studies that demonstrate a large percentage of adolescents and young adults with ASD meet the psychiatric criteria for other comorbid conditions including ADHD and anxiety (Alfulayyih & Troop, 2023).

17 years old - retirement: a closer look

Due to ASD being a spectrum disorder, adults with ASD can present symptoms in a variety of ways. The level of impairment varies (Lewis, 2018). Adults with ASD often have symptoms that can be misdiagnosed as different mental health disorders like anxiety, ADHD, or depression. When medication has been used, it has shown a reduction in the severity of irritability, aggression, repetitive behavior, hyperactivity, attention problems, anxiety, and depression (National Institute of Mental Health, 2023). Adults are more likely to continue living with family into adulthood, which further suggests an increased need for community and government support to provide more opportunities to access independent living. This trend further supports the need for increased community and governmental assistance, with the aim of offering more paths for achieving independence.

17 years old - retirement: a closer look (cont'd)

In a study on young adults with autism, researchers discovered that 50-70% of those included in the survey had experienced one or more episodes of major depression and anxiety. The prevalence of comorbid medical conditions is higher among individuals with ASD in comparison to those who are neurotypical. The presence of these comorbidities presents another barrier to independent living and impedes access to the community. This prevalence further highlights the need to treat ASD individuals through a holistic lens and treat the “whole person” rather than attribute all their difficulties to the spectrum disorder. (Alfulayyih & Troop, 2023). Many adults with ASD are unemployed or underemployed. Adults with ASD encounter challenges when seeking, maintaining, and achieving success in the workplace. These individuals commonly experience difficulties arising from the social expectations and formal atmosphere ubiquitous within the work setting. (Alfulayyih & Troop, 2023).

17 years old - retirement: a closer look (cont'd)

Adults with ASD may engage in behaviors that an employer might find undesirable such as a rigid adherence to their schedule, ritualistic activities, obsessive behaviors, and other common atypical behavior associated with ASD. Most individuals with ASD who are 40 years old and older have experienced the absence of a diagnosis or latency of diagnosis which subsequently impacted the support available to them as they were developing (Autism Research Institute, 2021). Many adults with ASD also meet the criteria for other comorbid mental health conditions and are more likely to have accompanying diagnoses of depression or bipolar disorder. Adults on the spectrum exhibit social symptoms, repetitive behaviors, and executive function deficits (Autism Research Institute, 2021). Some medications have been found to improve difficulties with irritability, aggression, repetitive behavior, hyperactivity, attention issues, as well as anxiety and depression (National Institute of Mental Health, 2023).

retirement - death: a closer look

Early research suggests that individuals with ASD may be partially protected against age-related cognitive decline, but the research is in its infancy. Elderly people with ASD experience more cognitive challenges in their everyday lives. Research suggests that elderly individuals with ASD are more likely to encounter physical and mental health challenges compared to neurotypical peers aged sixty-five years and older (Moore, 2022). Some of these conditions include gastrointestinal issues, social isolation, osteoporosis, and cognitive disorders, including Alzheimer’s disease.

retirement - death: a closer look (continued)

The symptoms observed in elderly individuals with Autism Spectrum Disorder (ASD) may not align with those typically seen in children with ASD. Moreover, for individuals who have remained undiagnosed, there is a lack of established criteria for diagnosing adults with this disorder, as it is predominantly classified as a developmental disorder (Smith, 2023). Those diagnosed as adults are less likely to exhibit aggressive behavior. Many older adults with ASD have developed ways to “mask” their symptoms due to having been provided next to no support throughout their development, as ASD was only widely recognized in the 1970s (Smith, 2023). More research is needed on this developmental stage, as most of the research is aimed at children and adolescents. Research has observed that recognizing the feelings of others, expressing one’s own feelings, making friends, planning, anxiety, and sensory issues are common during this stage (Smith, 2023).

Discussion

It is crucial to have a comprehensive understanding of the developmental lifespan and transition stages of a student with Autism Spectrum Disorder (ASD) for the purpose of designing an appropriate program that can effectively prepare them for the challenges they may encounter in their future pursuits. These programs may involve teaching social communication and language skills, addressing behaviors that hinder daily functioning, and fostering the development of strengths while imparting crucial life skills for independent living (National Institute of Mental Health, 2023). By anticipating the difficulties these individuals will likely encounter throughout their development, educators can provide individuals with the tools that will enable them to remove or ascend those barriers.

Reflection

Understanding the lifespan and transitional stages of students diagnosed with Autism Spectrum Disorder (ASD) is of paramount importance in order to personalize educational and community support to their unique needs. Recognizing and addressing their developmental needs at different stages enables the implementation of targeted interventions, fostering a supportive environment that bolsters both academic and social success. According to the Individuals with Disabilities Education Act (IDEA), transition plans must be put into effect during the Individualized Education Program (IEP) cycle when a student reaches the age of 16. These plans are specifically designed to aid their transition from childhood to adulthood, taking into consideration their individual strengths, interests, and aspirations for the future. The ultimate objective of these transition plans is to equip students with the skills necessary to operate as independent adults and encourage their active involvement in postsecondary educational pursuits.

References

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