Teaching Skills to Adolescents Using Applied Behavior Analysis

Applied behavior analysis is a systematic approach to teaching skills to adolescents with an autism spectrum disorder (ASD). Approaches to skill-building can be applied to teach academic, behavioral, adaptive living, and social skills. When teaching skills, consideration of the skills to be taught, the level at which that skill should be performed, and the value of that skill to the individual is necessary. Assessment requires identifying skills that are valued by the communities in which the individual participates and serve to increase independent functioning. Skill development programs require a generalization component to ensure that acquired skills are demonstrated across settings, people, and materials. Prompting can serve as an important means of supporting errorless learning. However, prompts must be faded quickly to prevent prompt-dependency. Fluency in skill development is a means of measuring automaticity in learned skills that support maintenance, generalization, and endurance of learned skills post-training.

Employment Training for Young Adults with Autism Spectrum Disorder

Despite legislation to improve post-school outcomes for young adults with autism spectrum disorder, they experience poorer employment outcomes than their peers without disabilities. Data indicate persons with ASD experience lower employment rates, earn less money, work fewer hours, are less engaged in their communities, and live independently less frequently than their peers without disabilities. Furthermore, the earnings of individuals with ASD lag behind earnings of their peers both with and without disabilities. In order to help improve employment outcomes for youth with ASD, this chapter describes the characteristics contributing to employment of individuals with ASD, the factors influencing employment of individuals with ASD, and the research related to evidence-based practices for young adults with ASD.

Executive Functions in Adolescents with Autism Spectrum Disorder

This chapter reviews strengths and weaknesses in executive function (EF) domains, including inhibition, working memory, flexibility, fluency, and planning, in adolescents (age 13–19) with autism spectrum disorder (ASD). Given the dramatic developmental changes in the brain regions that support EF during the period of adolescence, it is critical to evaluate which EF abilities show a distinct profile during this period. As this chapter will demonstrate, youth with ASD show deficits across all domains of EF, particularly in complex tasks that include arbitrary instructions. We describe the fundamental measures for assessing skills in each domain and discuss limitations and future directions for research, as well as clinical implications of these findings for working with youth with ASD.

Conclusion

Adolescents and young adults with autism spectrum disorders face a multitude of challenges and are experiencing poor life outcomes. This book has summarized the research on practices designed to mitigate these challenges and to improve their life outcomes. There are two recurrent and interconnected themes that have been present throughout the book. The first is that there is immense heterogeneity across individuals with ASD. The second is that the tools for improving outcomes for this population exist, but they may not have been systematically researched with this population. Given the current outcomes for this population, continued research all areas is essential for discovering approaches that will improve the outcomes and quality of life for young adults with ASD. This chapter summarizes the book and provides suggestions for future research.

Cognitive Behavioral Approaches for Treating Adolescents with Autism Spectrum Disorder

Cognitive behavior therapies (CBT) are empirically supported interventions that have been used to successfully treat many forms of psychopathology among children, adolescents, and adults. Developed in the 1960s and 1970s, CBT is an evidence-based amalgamation of cognitive and behavioral therapy components that aim to address maladaptive thoughts, emotions, and behaviors to promote symptom reduction through a collaborative therapeutic relationship. CBT has also been adapted for individuals with Autism Spectrum Disorder (ASD); however, the primary focus of most treatment studies to date has focused on children with ASD and co-occurring anxiety. CBT programs for other psychiatric comorbid conditions in ASD are now emerging. Specific adaptations to traditional CBT, practical implications for clinicians, and suggestions for future directions for research will be highlighted.

Supporting College Students with Autism Spectrum Disorder

College represents an opportunity to move toward independence while also participating in a supportive learning environment. Young adults with ASD are attending college in increasing numbers, but the research concerning their experiences is mixed. Most individuals report academic success, which may be reflective of a sampling bias. However, many of these individuals still report difficulties with the social aspects of academics (i.e. group work). They also report difficulties following lectures, managing their time, and participating in the social aspects of college. Choosing a college is particularly important for this group, as colleges vary in the types of support offered to students with ASD.

Managing Challenging Behavior in Adolescents with Autism Spectrum Disorder

The term “challenging behavior” describes a wide range of behaviors that may be harmful to an individual and that pose significant risks related to health, emotional distress, or exclusion from community settings. Challenging behaviors occur at high rates among individuals with autism spectrum disorder (ASD). Some forms of challenging behavior include: aggression, self-injurious behavior (SIB), stereotypical behavior, pica, and vomiting/rumination. Functional behavioral assessment (FBA) is the process of gathering and interpreting data related to the underlying function of a behavior. Interventions that target the function of a behavior are more effective and efficient. Behavioral treatment methods for challenging behavior are based on operant principles of reinforcement and punishment. Several common treatment methods are described. Suggestions for the assessment and treatment of challenging behaviors are outlined.

Anxiety in Adolescents and Adults with Autism Spectrum Disorder

Adolescents and adults with ASD are at high risk for clinically significant symptoms of anxiety. Accurate symptom identification and differential diagnosis can be challenging due to the similarity of presentation of many anxiety and ASD symptoms. Although there are no gold-standard tools for assessment of anxiety in individuals with ASD, clinicians are encouraged to use a comprehensive multi-informant, multi-modal assessment approach. Research supports the use of cognitive behavioral therapy (CBT) for treatment of anxiety in ASD, particularly in high-functioning adolescents. ASD-specific treatment modifications may be helpful for achieving optimal treatment response. There is limited available evidence regarding the effectiveness or potential adverse effects of pharmacological treatments for anxiety in this population. Future research is needed to understand the etiology and mechanisms of anxiety in individuals with ASD and to examine short- and long-term efficacy and effectiveness of a range of treatments.

The Challenge of Entering Adulthood for Individuals with Autism Spectrum Disorder

There is a tremendous amount of variation (heterogeneity) in terms of both symptom presentation and functional ability in individuals with autism spectrum disorder (ASD). The challenges faced by adolescents and emerging adults with ASD can be better understood by considering the unique sociocultural changes that most individuals experience within these stages. In general, adolescents and young adults with ASD have poor social relationship, employment, post–secondary, and independent living outcomes. Additional research efforts, particularly large-scale studies, are needed to better understand the experiences and outcomes of adolescents and young adults with ASD.

Supporting Strong Transitions for Adolescents with Autism Spectrum Disorder

A principle purpose of special education is to prepare students with disabilities to flourish in adulthood. The constellation of coursework, extracurricular activities, social events, and other school activities offered across the grade span is all aimed at equipping students with the skills, knowledge, experiences, and connections they need to attain their post-school goals. The poor outcomes being experienced by young adults with ASD are not intrinsic to the disorder. With appropriate transition planning and services, individuals with ASD can also expect to achieve these desired post-school outcomes. This chapter highlights the research concerning evidence-based secondary transition practices and how they can be applied when providing services to individuals with ASD.