The health status of adults on the autism spectrum

Croen, Lisa; Zerbo, Ousseny; Qian, Yinge; Massolo, Maria L.; Rich, Steve; Sidney, Stephen; Kripke, Clarissa

doi:10.1177/1362361315577517

Cited by 856 publications

(938 citation statements)

References 54 publications

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“…15 A similar review of electronic health records by Croen and colleagues found that young adults with ASD experience increased rates of seizures, hypertension, dyslipidemia, sleep disorders, and nearly all psychiatric disorders compared to controls. 34 We similarly found higher rates of seizure disorder across all age groups and found high rates of depression, hypertension and allergies in young adults with ASD, although these approached the prevalence of the general population in our older age groups.…”

Section: Discussionsupporting

confidence: 58%

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Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation

et al. 2015

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BACKGROUND: Children and adolescents with autism spectrum disorder (ASD) have many well-known health concerns, yet health conditions in adults with ASD remain poorly defined. OBJECTIVE: To examine health conditions and functional status in adults with ASD and identify factors associated with health and functional status across age cohorts. DESIGN AND SUBJECTS: We collected cross-sectional data from 255 adult subjects aged 18 to 71 years with ASD using the Rochester Health Status Survey IV (RHSS-IV), a 58-item validated survey instrument. We used the National Health and Nutritional Examination Survey and National Health Interview Survey to provide comparative prevalence rates in the general population. RESULTS: Compared to the general population, young adults aged 18-29 with ASD had a substantially higher prevalence of seizure disorder (11.2 % vs. 1.4 %; p= 0.002), depression (16.4 % vs. 6.4 %; p=0.007), hypertension (12.9 % vs. 6.3 %; p=0.05), and allergies (39.7 % vs. 8.4 %; p<0.001). In contrast, young adults with ASD had considerably lower rates of sexually transmitted illness (STI) (0.9 % vs. 4.3 %; p=0.03), tobacco use (5.2 % vs. 31.9 %; p<0.001), and alcohol misuse (0.9 % vs. 11.9 %; p<0.001). Adults 40 and over with ASD also had higher rates of seizure disorder (29.2 % vs. 1.7 %; p < 0.001), lower tobacco use (2.8 % vs. 24.5 %; p<0.001), and lower alcohol misuse (1.4 % vs. 18.2 %; p<0.001) compared to the general population. Amongst the 55 % of participants with a documented IQ score, 91 % had an intellectual disability (IQ < 70). Within the cohort aged 40 years old and older, only 54.2 % were independent with eating, 43.0 % independent with dressing, and 43.1 % independent with bathing. Lower IQ and depression were associated with lower functional status. CONCLUSIONS: Adults with ASD have a high prevalence of seizure disorders and depression, but low rates of STIs, tobacco use, and alcohol misuse. Within our cohort, the majority of older adults with ASD required some assistance with activities of daily living.

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Section: Discussionsupporting

confidence: 58%

“…14,15,33,34 Most notably, we found a considerably higher prevalence of seizure disorders in adults with ASD in all age groups compared to the general population. We also found higher rates of depression, hypertension, and allergies in young adults with ASD, which approached the prevalence of the general population in our older age groups.…”

Section: Discussionmentioning

confidence: 56%

Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation

et al. 2015

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“…Although most autistic adults may not be seeking healthcare to address or Btreat^autism, they still require care for non-autism-related health issues and co-occurring conditions, such as seizures, anxiety, sleep disturbances, and gastrointestinal disorders. [6][7][8] Autistic adults face many barriers to receiving healthcare. A majority of…”

Section: Introductionmentioning

confidence: 99%

The Development and Evaluation of an Online Healthcare Toolkit for Autistic Adults and their Primary Care Providers

et al. 2016

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BACKGROUND:The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum. OBJECTIVE: Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. DESIGN: Toolkit development included cognitive interviewing and test-retest reliability studies. Evaluation consisted of a mixed-methods, single-arm pre/postintervention comparison. PARTICIPANTS: A total of 259 autistic adults and 51 primary care providers (PCPs) residing in the United States. INTERVENTIONS:The AASPIRE Healthcare toolkit includes the Autism Healthcare Accommodations Tool (AHAT)-a tool that allows patients to create a personalized accommodations report for their PCP-and general healthcare-and autism-related information, worksheets, checklists, and resources for patients and healthcare providers. MAIN MEASURES: Satisfaction with patient-provider communication, healthcare self-efficacy, barriers to healthcare, and satisfaction with the toolkit's usability and utility; responses to open-ended questions. KEY RESULTS: Preliminary testing of the AHAT demonstrated strong content validity and adequate test-retest stability. Almost all patient participants (>94 %) felt that the AHAT and the toolkit were easy to use, important, and useful. In pre/post-intervention comparisons, the mean number of barriers decreased (from 4.07 to 2.82, p < 0.0001), healthcare self-efficacy increased (from 37.9 to 39.4, p = 0.02), and satisfaction with PCP communication improved (from 30.9 to 32.6, p = 0.03). Patients stated that the toolkit helped clarify their needs, enabled them to self-advocate and prepare for visits more effectively, and positively influenced provider behavior. Most of the PCPs surveyed read the AHAT (97 %), rated it as moderately or very useful (82 %), and would recommend it to other patients (87 %). CONCLUSIONS: The CBPR process resulted in a reliable healthcare accommodation tool and a highly accessible healthcare toolkit. Patients and providers indicated that the tools positively impacted healthcare interactions. The toolkit has the potential to reduce barriers to healthcare and improve healthcare self-efficacy and patient-provider communication.KEY WORDS: autism; adults; community-based participatory research; primary care; healthcare interactions.

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“…3 Authors of recent studies have indicated that adults with ASD also have elevated rates of psychiatric and major medical conditions. 4 Although the use and cost of health care services have been shown to be significantly elevated in adolescents with ASD, 5 robust estimates of the prevalence of medical and psychiatric conditions among adolescents and young adults with ASD are lacking.…”

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confidence: 99%

Psychiatric and Medical Conditions in Transition-Aged Individuals With ASD

et al. 2018

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BACKGROUND AND OBJECTIVES:Children with autism spectrum disorder (ASD) have a variety of medical and psychiatric conditions and an increased use of health care services. There is limited information about the prevalence of psychiatric and medical conditions in adolescents and young adults with ASD. Our objective was to describe the frequency of medical and psychiatric conditions in a large population of diverse, insured transition-aged individuals with ASD.

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The health status of adults on the autism spectrum

Cited by 856 publications

References 54 publications

Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation

Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation

The Development and Evaluation of an Online Healthcare Toolkit for Autistic Adults and their Primary Care Providers

Psychiatric and Medical Conditions in Transition-Aged Individuals With ASD

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