From Childhood to Adulthood: Long-Term Expectations

In this chapter, we'll take on the question families ask most often but is hardest to answer: "What kind of life will my child have when they grow up?" To be honest, there's no single, definite answer to this question; but the long-term research data we have can offer a realistic frame.

Factors That Shape Long-Term Outcomes

Research consistently points to a few factors that shape how someone functions in adulthood: the level of verbal language measured in early childhood (Chapter 9), cognitive capacity (Chapter 18), access to early and intensive intervention (Chapter 20), and adaptive behavior skills (Vineland-3, Chapter 17). None of these factors determines destiny on its own; but they do give a sense of the general trends.

Autism in Adulthood: A Range of Life Paths

The lives of autistic adults, just as in childhood, are enormously varied. Some adults live fully independently, go to university, build careers, marry, and have children. Some live meaningful, satisfying lives with partial support (semi-independent living arrangements, job coaching). And some need intensive support throughout their lives and live in family or residential care settings. This variety is the adult reflection of the spectrum of severity levels we covered in Chapter 5.

Being Diagnosed for the First Time in Adulthood

As we noted in Chapter 3, there are many people today who are diagnosed with ASD for the first time in adulthood, having gone unnoticed in childhood (especially among girls and women, because of the camouflaging we covered in Chapter 11). For these people, the diagnosis often brings deep relief: "Now I understand why I felt different all those years" is a common experience among many who are diagnosed as adults. If you or a family member notice ASD traits in yourselves in adulthood, it may help to see a clinician experienced in adult ASD assessment.

Balancing Hope and Realism

In writing this chapter, our aim is neither to make overly optimistic promises nor to create despair. The truth is this: with early and appropriate support, many children reach a place far better than what was predicted at the time of diagnosis; at the same time, each child's journey is their own, and it isn't possible to predict from today, with certainty, "exactly what kind of adult they will become." As hard as that uncertainty is, it also means that progress is possible at any age.