FROM: http://effectivehealthcare.ahrq.gov/sear...uctID=1196

Interventions for Adolescents and Young Adults With
Autism Spectrum Disorders

Structured Abstract

Objectives. We systematically reviewed evidence on therapies for adolescents and young adults (ages 13 to 30) with autism spectrum disorders (ASD). We focused on the outcomes, including harms and adverse effects, of interventions addressing the core symptoms of ASD; common medical and mental health comorbidities occurring with ASD; the attainment of goals toward functional/adult independence; educational and occupational/vocational attainment; quality of life; access to health and other services; and the transitioning process (i.e., process of transitioning to greater independent functioning). We also addressed the effects of interventions on family outcomes including parent distress and satisfaction with interventions.

Data sources. We searched MEDLINE® via PubMed, PsycINFO®, the Educational Resources Information Clearinghouse, and the Cumulative Index of Nursing and Allied Health Literature databases as well as the reference lists of included studies.

Review Methods. We included studies published in English from January 1980 to December 2011. We excluded intervention studies with fewer than 20 adolescents or young adults with ASD or fewer than 20 parents or family members of such individuals and studies lacking relevance to ASD treatment.

Results. We identified 32 unique studies, most of which were poor quality. Five studies, mostly of medical interventions, were fair quality, and none were good. In the behavioral literature, studies of group- and computer-based interventions reported short-term gains in social skills.
Two poor-quality studies of educational interventions reported some gains in vocabulary and reading. Four small studies investigated disparate interventions addressing highly specific adaptive/life skills with some positive results in studies typically of short duration. Studies of vocational interventions, all of poor quality, reported that on-the job supports may promote employment in the community. Little evidence supports the use of medical interventions in adolescents and young adults with ASD; however, antipsychotic medications and serotonin
reuptake inhibitors were associated with improvements in specific challenging behaviors. Similarly, little evidence supports the use of allied health interventions including facilitated communication.

Conclusions. Few studies have been conducted to assess treatment approaches for adolescents and young adults with ASD, and as such there is very little evidence available for specific treatment approaches in this population; this is especially the case for evidence-based approaches to support the transition of youth with autism to adulthood. Of the small number of studies available, most were of poor quality, which may reflect the relative recency of the field. Five studies, primarily of medical interventions, had fair quality. Behavioral, educational, and adaptive/life skills studies were typically small and short term and suggested some potential improvements in social skills and functional behavior. Small studies suggested that vocational
programs may increase employment success for some individuals. Few data are available to support the use of medical or allied health interventions in the adolescent and young adult vii population. The medical studies that have been conducted focused on the use of medications to address specific challenging behaviors, including irritability and aggression, for which effectiveness in this age group is largely unknown and inferred from studies including mostly
younger children.

wow, no responses yet, I am surprised.

Sad, isn't it - no one wants to know nothing ...

I feel like this is very relevant to us. There are not very many quality research studies out there which test effectiveness of interventions with adolescents or young adults (or adults) on the spectrum <-----clearly a relevant age range for AFF, and something we can all probably relate to.

This is something we can use to take action:
What do we know about ourselves and our needs?
What types of interventions or programs would help us?

We can help design a good intervention or autist oriented program....the 'scientists' are obviously not having much luck.

This post was last modified: 08-31-2012 10:08 PM by sg1008.

*bumP*

PEOPLE---do you not see how we can use this info to our advantage?

A) Form an international IRB (review board).
B) Form a research team.
C) CONDUCT QUALITY RESEARCH
D) SUBMIT FINDINGS TO DIFFERENT JOURNALS UNTIL WE CAN GET SOMETHING PUBLISHED

People people, do you not see the advantageous state we are in??

We could change the course of research for adolescent and adult autists for years to come. Child and genetic research are dominated by auspeaks and their brigade, but adolescents? adults? This is [less contaminated] turf. We can OWN this.

I can't really think of anything to add to the discussion at the moment. I'll post when I think of something to say.

Two items:
We've got that AASPIRE study - see here
There's a cooperation between the MPI and a group of autistic adults (in Germany, though). But there's a page in English.

Unfortunately, the scientific community is not optimistic about interventions unless they are implemented in early childhood, preferably before the age of 3 when the mind is far more adaptable than it is even in mid to late childhood.  I think this fuels the lack of interest in later interventions.  

That being said, there should be greater efforts to provide help for adolescents and adults that is proven to be effective.  

It sounds like they simply need to do more thorough research on the effectiveness of current interventions, am I right?  It would be a good starting point before looking at what other interventions might be useful.

excelente

Thank you for the resources!

I only just saw this today.  I feel that we autistics need to take a pretty long run-up at things like skill-building.  Speaking personally, just going over something with me once will not sink in.  Preferably, I like to make a list with all the dot points and then refer to the list regularly while doing the task.  After a while it will become automatic, and I will then never forget it, and perform the task perfectly from then on.  It's not that we're stupid, but very systematic.  But I notice that NTs only need to have something shown to them once and they seem to "get it", if not perfectly, at least to a level that is acceptable to the rest of the community.  So short-term studies I feel are going to be bound to be not very good.  
Alison

You could ask aspies about their long-term experiences with different types of intervention even in a short-term study.

I like the idea of an autistic-led research organisation.  Obviously we would have an autistic-centered set of standards for "success" instead of a shrink-centered or marketing-centered standard.

Ask autistics?  ASK AUTISTICS?  Are you mad?!  Everybody and Autism Speaks knows that AUTISTICS can't speak for themselves!!!  We are poor benighted tragedies who will forever live with carers, unable to pick our own noses!!!
Alison (and yes, I AM kidding, before anybody jumps on me from a high place with a knitting needle...)     

This post was last modified: 09-02-2012 11:51 PM by Alison.

That could be a longitudinal study design where participants from an intervention are observed one week after intervention, then again in one month after intervention, then again in 1 year after intervention, then again in 3 years after intervention. (for example)

This post was last modified: 09-03-2012 05:25 AM by sg1008.

I'm not sure you could control for enough variables in a short-term study that measures long-term outcome, unless you used just one therapist, or one computer program.  Unless all therapists were shown to be administering therapy in a comparable way, it wouldn't work, but if you used just one therapist, you're only looking at how the therapy administered by that therapist works.  Something like a computer program would have to be used consistently over time, and unless one plans to be giving data later I doubt one would have a record of program use.  

You really need a long-term study that starts out with the intent of measuring the long-term outcomes of a particular therapy.  Besides, like SG stated, you'd need to take data in intervals to get a clear picture of how subjects progress.  Perhaps benefits decline after a certain period of time, or perhaps they don't begin to show until much later.