Transition experiences of young adults on the autism spectrum in Australia: a mixed-methods analysis

Transition experiences of young adults on the autism spectrum in Australia: a mixed-methods analysis

The shift from high school to adulthood encompasses adult responsibilities in employment, post-secondary education, independent living, and overall good social relationships recognised as traditional demographic markers of a successful transition and better quality of life. Navigating these adult roles and responsibilities are associated with increased independence that requires adjusting to new settings. As difficulty coping with change is a hallmark of Autism Spectrum Disorder, the normative challenges and change associated with the transition to adulthood are compounded with multiple difficulties unique to an Autism Spectrum Disorder diagnosis.

Over the last decade, Australia has seen an increase in the number of children and adolescents diagnosed with Autism Spectrum Disorder. The implication for the future is that there would be an increase in the number of young adults on the autism spectrum requiring adult support services and interventions. Within an ecological systems perspective, young adults on the autism spectrum interact with family, school, and support systems as they transition to adulthood. A systems analysis therefore provided a holistic perspective of the successes and challenges during the transition period first hand from key stakeholders. As such, the overall aim of the present program of research was to implement a mixed-methods design to explore the barriers and facilitators to a successful transition to adulthood for young adults on the autism spectrum in Australia.

Collectively, qualitative findings from Study 1 and Study 2 highlighted five main themes of Embracing ASD Differences, Social Interaction, Functional Independence, Support experiences, and Employment as areas of importance associated with successful and unsuccessful transition. A longitudinal case series analysis in Study 3 extended the qualitative findings from Study 1 and Study 2 and provided further evidence for the role of risk and protective factors during the transition period. Targeted transition planning and interventions, parental involvement in transition planning, work experience placements, and support from service providers appeared to be protective factors for those young adults who experienced a successful transition. Lower functional independence, co-occurring depression and anxiety, limited social skills, and communication challenges emerged as risk factors. Finally, Study 4 provided a comprehensive insight of successes and challenges within current Australian disability infrastructure from the perspectives of support providers. Success in support provision included effective communication and Autism Spectrum Disorder specific knowledge. Challenges included organisational influences of school systems and service provider infrastructure.

The first unique contribution of this thesis is to provide key insider perspectives towards the implementation of a specialist Autism Spectrum Disorder model of support within the National Disability Insurance Scheme. Second, the awareness of a strengths and abilities perspective at a systemic level is necessary to embrace a shift from a deficit and impairment lens towards the inclusion of young adults on the autism spectrum in all aspects of adult and community life. Finally, this program of research extends the current literature on risk and protective factors during the transition period. Collectively, understanding the range of outcomes for the young adult population on the autism spectrum, and their parents’ perceptions is of significance to key stakeholders in tailoring service delivery to meet the unique needs of these individuals.