Adulthood most often appears complex, confusing, even overwhelming for adolescents. It is even more so for those identified as having an autistic disorder. Contemplating the tasks inherent to late adolescence and moving onto becoming an adult is a process frequently compounded by psychological turmoil and sometimes even the source of emergent psychiatric illness.
The objective of this paper is to examine the developmental framework and the bio-psychosocial issues involved in the transition to adulthood in general and from the perspective of ASD in particular. Existent obstacles, pitfalls, areas of service need, lacunae, as well as personal and wide-ranging risks involved in this process are highlighted. Some forensic aspects are mentioned, in view of the author’s longstanding membership of the Faculty of Forensic Psychiatry of the Royal Australian and New Zealand College of Psychiatrists.
The author discusses multi-dimensional factors at play in transitioning to adulthood, including educational, vocational, interpersonal, psycho-sexual, familial, existential and socio-economic aspects. Their specific impact across the various levels of the ASD-spectrum severity is scrutinized.
The current support systems in Western Australia and their shortcomings are touched upon. Most importantly, the author’s in-depth clinical experience of nearly two decades in a busy psychiatric consulting practice in Perth, Western Australia, yields numerous de-identified case reports and illustrations to exemplify the issues discussed.
Conclusion: The challenging process of transition to adulthood is potentially the hardest task during the lifetime of an individual with an autistic disorder, as well as for their families, caregivers, health professionals and clinicians involved in their care, rehabilitation providers and wider social systems alike. The aim of this paper and review is to stimulate enhanced awareness in the field of autism interventions, not only in early childhood, but at the end of adolescence as well. Across most countries and jurisdictions, there is a significant need for much improved resource allocation, more streamlined support systems and renewed collaboration across multiple discplines to facilitate a better overall quality of life for people with ASD.