To systematically examine the patterns of psychiatric comorbidity and functioning in clinically referred adults with autism spectrum disorders (ASD). Psychiatrically referred adults with and without ASD were compared on measures assessing for psychiatric comorbidity and psychosocial functioning. Sixty-three adults with ASD participated in the study (mean age: 29 ± 11 years). Adults with ASD in their lifetime suffered from a higher burden of psychiatric disorders (6 ± 3.4 vs. 3.5 ± 2.7; p < 0.001) including major depressive disorder and multiple anxiety disorders, and were functionally more impaired with a significant proportion having received both counseling and pharmacotherapy. Adults with ASD have high levels of psychiatric comorbidity and dysfunction comparable to a clinically referred population of adults without ASD.
Current reviews of the caregiver intervention literature have focused primarily on the outcomes of interventions for caregivers and general methodological limitations of individual studies (i.e., sampling and recruitment issues, adequacy of outcome measures, and generalization issues). Little attention has been paid to the specific factors affecting the therapeutic process, including the intensity and integrity of the interventions used. The purpose of this review is to examine closely the content and process of Alzheimer's disease (AD) caregiver interventions. We describe the types of interventions currently in use, factors affecting intervention outcomes, and we conclude with specific recommendations for the application of intervention technology and for the documentation of intervention research.
The effectiveness of teaching Alzheimer's disease subjects to use a prosthetic memory aid when conversing with familiar partners was evaluated. Effects of the training of three topics by caregivers was assessed in daily probes with the experimenter and twice weekly probes with a familiar conversational partner. All 3 subjects learned to use the memory aid with both conversational partners and improved the quality of their conversational content. Subjects made significantly more statements of fact and fewer ambiguous utterances after training on each topic according to a multiple baseline design. All subjects also generated novel, untrained statements in conversations with both partners. Treatment effects were maintained at high levels throughout training and at 3‐ and 6‐week followup sessions. Naive judges rated baseline and posttreatment conversational samples as significantly improved on all eight conversational dimensions.
Interpersonal communication has been described as a critical tool for life adjustment, linking people to their environment.1 When communication disorders are present these links can be easily broken. Communication disorders form a diverse group of conditions that vary in terms of type, severity, and co-occurrence with other symptoms that limit mobility, vision, endurance, or cognition. Although communication disorders affect people of all ages, the prevalence and complexity of these conditions increase with age, and may be characterized by a stable, recovering or degenerative course. Disabilities associated with communication disorders may best be viewed as a dynamic process that varies over time instead of as a single static event that remains constant. Two broad trajectories of disability and aging have been described2 and can be applied to those with communication disorders. The disability with aging group includes people who live most of their lives without disability and either experience the subtle communication problems associated with age or the onset of conditions such as stroke that occur most commonly in old age. The aging with disability group includes people who either have lifelong or early onset communication disorders as a result of cerebral palsy or multiple sclerosis (MS) and age in the context of the already-existing disability. Regardless of the trajectory, the burden of communication disorder is cumulative; it grows with age and has important implications for health care providers. This article describes various communication disabilities associated with aging and how these disabilities affect important functions such as access to health care and maintenance of social roles. Suggestions that preserve and enhance communication function in older adults are also provided in this article.
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