Healthcare, Safety, and Wellness

There has been very little research into the long-term health outcomes of individuals with ASD. Adults on the spectrum live an average life expectancy, and there is no known association between ASD and any specific adult-onset disease. However there are features of living with ASD that have important implications for health and wellness. These fall into four categories:

  • Co-occurring conditions.  Also known as "co-morbidity," this term refers to the simultaneous occurrence of two or more independent clinical diagnoses. We know from children with ASD, that there are a number of chronic conditions that are more common among those with ASD than the general population, including: anxiety, depression, epilepsy, ADHD, Tourette Syndrome, and gastrointestinal issues.  These conditions do not abate in adulthood, and any one of them is a serious health concern that will require ongoing management by healthcare professionals and a supportive team. At a minimum, an adult patient with ASD and any of these conditions who is striving towards independence will need to manage prescription refills and maintain a proper dosing schedule. This can be challenging for someone with executive function difficulties. Moreover, the long-term side effects of some of the drugs typically prescribed to the ASD population, specifically psychotropic medications, are not known.

  • Lifestyle factors. The foundation for good health is the same for individuals with ASD as the rest of us. Exercise, diet, moderation, and stress management are all important features of a 

  • Lack of education regarding ASD among providers of adult healthcare. Healthcare, especially primary care, relies heavily upon effective, honest communication. Adults with ASD need the same information as other young people about the negative effects of alcohol and drug use, diet, exercise, and sexuality -- difficult topics in the best of circumstances. Conversely, to use their limited time well, physicians need patients to be forthcoming with their questions and concerns.  Ironically, the greatest healthcare challenge faced by adults with ASD may be helping healthcare providers to become comfortable caring for them. While pediatricians have become familiar with autism and other neurodevelopmental differences, the adult healthcare world has yet to receive systematic education about how to serve individuals with sensory, communication, and/or social differences. In fact, when surveyed, providers have shared that the two groups for whom they feel the least comfortable providing care are individuals who use alternative or augmentative communication and those who have multiple disabilities. Other barriers to accessing healthcare services may include filling out forms, navigating the social norms of the healthcare environment, and managing the sensory demands of health services facilities.

  • Safety concerns. People with ASD are seven times more likely to have an encounter with law enforcement than the average person. During late adolescence, it is important to build on earlier safety education and to develop a positive relationship with local first responders. As young people with ASD experience greater independence, they are more likely to find themselves in novel situations. Rehearsing strategies to manage anxiety and ask for help can provide an individual on the spectrum with the tools they need to manage unexpected events. Tragically, people with developmental disabilities are far more likely to be the victims of crime or exploitation than they are to be the cause of an altercation.

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Healthcare, Safety, and Wellness
healthy life. Adults with ASD, however, may face unique challenges in addressing these issues. For example, sensory differences may limit food choices or complicate hygiene.  Low muscle tone, anxiety, and difficulty understanding the social cues used by team member to communicate the next play, may all combine to make sports an unlikely choice for the use of leisure time. To find solutions that support good health, however, it is helpful to guard against the assumption that autism itself is the reason why someone makes a particular lifestyle choice. For example, a preference for sedentary activities is not a known feature of ASD. Instead, it may indicate difficulty accessing alternatives. According to researcher Scott Michael Robinson, “A major barrier to the attainment of healthy physical well-being by autistic adults is lack of supportive recreational and physical activity programs…. Consequently, autistic adults may become isolated from the community and may focus their pastimes exclusively on solo hobbies despite potential interests in participating in community recreational activities. This situation often becomes naturalized as a false belief that all autistic people have a strong aversion to participating in social recreational opportunities, a misperception that may then deter community organizations from modifying their recreational programs to enable autistic people to participate."

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