Autism and career: a qualitative analysis of work-related experiences and needs of individuals with Autism-Spectrum-Disorders

Despite their often high intellectual potential persons with high-functioning autism are commonly affected by unemployment. In an open survey we asked 102 recently diagnosed adult patients for their education and employment history as well as their occupational experiences and wishes. Written descriptions of 29 patients, who had answered the open questions completely, were systematically analysed using qualitative content analysis. Analysis of education and employment histories revealed that most of the participants were well-educated; nevertheless, 45 % were unemployed at the time of the survey. Analysis of the occupational experiences revealed that difficulties are mainly associated with the core symptoms of autism spectrum disorders (ASD) and neuropsychological deficits. Additional factors including lack of support and acceptance by the occupational environment as well as unsuitable institutional support measures can lead to increased psychological strain. Analysis of wishes revealed a concrete need for autism-specific support measures. In a joint research project aiming at the vocational integration of individuals with ASD, a supported employment program is currently under development

The Investigation and Differential Diagnosis of Asperger Syndrome in Adults

Background: As a result of the increased public interest in autism spectrum disorders (ASD), certain core manifestations of ASD-impaired social interaction and communication, bizarre interests-are now commonly recognized as being typical of autism, not only in children, but in adults as well. More often than before, general practitioners, neurologists, and psychiatrists find themselves being asked whether a patient is suffering from previously unrecognized Asperger syndrome (AS). The prevalence of ASD is estimated at 1%, and the ratio of diagnosed to undiagnosed cases at about 3:2. Little is known about the diagnostic evaluation of AS in adulthood. Methods: We selectively searched the Medline database for pertinent literature, paying special attention to diagnostic manuals and to the guideline of the United Kingdom's National Institute for Health and Care Excellence (NICE). Results: Centrally important aspects of the diagnosis of AS include an assessment of the patient's ability to assume the emotional perspectives of others, non-verbal modes of expression, repetitive behavior patterns, and childhood social behavioral history. The autism quotient (AQ) is now established as a simple but nonspecific screening test. Up to 70% of all affected adults have comorbid disturbances, most often depression and anxiety disorders. The differential diagnosis includes personality disorders, anxiety disorders, obsessive-compulsive disorder, and attention deficit-hyperactivity disorder. The diagnostic assessment should proceed in stepwise fashion, starting from simple screening in primary care and then moving on to evaluation of the suspected diagnosis by a mental health care specialist, followed by extensive further investigation in an outpatient clinic specifically devoted to patients with autism spectrum disorders. Conclusion: The diagnostic assessment of autism in adults requires knowledge of the core and accompanying manifestations of autism and of their differential diagnoses. More research is needed for the development of further screening tests and the precise determination of diagnosis rates, differential diagnoses, and comorbidities

Sex-Related Cognitive Profile in Autism Spectrum Disorders Diagnosed Late in Life: Implications for the Female Autistic Phenotype

Females with high-functioning ASD are known to camouflage their autistic symptoms better than their male counterparts, making them prone to being under-ascertained and delayed in diagnostic assessment. Thus far the underlying cognitive processes that enable such successful socio-communicative adaptation are not well understood. The current results show sex-related differences in the cognitive profile of ASD individuals, which were diagnosed late in life exclusively. Higher verbal abilities were found in males (n = 69) as opposed to higher processing speed and better executive functions in females with ASD (n = 38). Since both sexes remained unidentified during childhood and adolescence, these results are suggestive for sex-distinctive cognitive strategies as an alternative to typically-developed reciprocal social behavior and social mimicry in high functioning ASD