Skip to main content
×
×
Home

Autistic spectrum disorder without intellectual impairment in adult mental health services – fostering new perspectives and enhancing existing services

  • N. Crowley (a1), H. O’Connell (a1) and M. Gervin (a1)
Abstract

Autistic spectrum disorder (ASD) is a neuro-developmental disability with multi-systemic impacts. Individuals with ASD without intellectual impairment (DSM-V) or Aspergers (DSM-IV) are often particularly vulnerable to mental health problems such as anxiety disorders including social phobia and generalised anxiety disorder, depressive disorders and psychosis. Adults with ASD without intellectual impairment suffer higher rates of physical and psychiatric morbidity, display a poorer ability to engage with treatment and have a lower chance of recovery compared with the general population. It is widely acknowledged that adults with suspected ASD without intellectual impairment and co-morbid mental health problems are often not best supported through adult mental health services and often require more tailored supports. This review seeks to (a) increase awareness in the area of undiagnosed cases of ASD without intellectual impairment in adult mental health settings and (b) highlights the importance of identifying this population more efficiently by referring to best practice guidelines. The value of future research to examine the benefit of having a team of specialist staff within adult mental health teams who have received ASD training and who are supported to work with the ‘core difficulties’ of ASD is discussed and a model for the same is proposed. It is proposed that a specialist team could form a ‘hub’ for the development of expertise in ASD, which when adequately resourced and funded could reach across an entire region, offering consultancy and diagnostic assessments and interventions.

Copyright
Corresponding author
*Address for correspondence: N. Crowley, Psychology, HSE Dublin Mid Leinster, Bridge Street, Portlaoise, Laois, Tullamore, Ireland (Email: niall.crowley@hse.ie)
References
Hide All
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association: Washington, DC.
Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, Kurzius-Spencer M, Zahorodny W, Robinson Rosenberg C, White T, Durkin MS, Imm P, Nikolaou L, Yeargin-Allsopp M, Lee LC, Harrington R, Lopez M, Fitzgerald RT, Hewitt A, Pettygrove S, Constantino JN, Vehorn A, Shenouda J, Hall-Lande J, Van Naarden Braun K, Dowling NF (2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ, 67, 1–23.
Binnie, J, Blainey, S (2013). The use of cognitive behavioural therapy for adults with autism spectrum disorders: a review of the evidence. Mental Health Review Journal 18, 93104.
Bishop-Fitzpatrick, L, Minshew, NJ, Eack, SM (2013). A systematic review of psychosocial interventions for adults with autism spectrum disorders. Journal of Autism Development Disorders 43,, 687694.
British Columbia Ministry of Health Planning (2003). Standards and Guidelines for the Assessment and Diagnosis of Young Children with Autism Spectrum Disorder in British Columbia: An Evidenced-Based Report. Canada.
Department of Education and Science (2001). The Report of the Task Force on Autism: Educational Provision and Support for Persons With Autistic Spectrum Disorders. Stationary Office: Dublin. (https://www.sess.ie/sites/default/files/Autism%20Task%20Force%20Report.pdf).
Expert Group on Mental Health Policy (2006). Vision for Change. Stationary Office: Dublin.
Fitzgerald M (2012). Schizophrenia and autism/asperger’s syndrome: overlap and difference. Clinical Neuropsychiatry 9, 171–176.
Gillberg IC, Gillberg C (1989). Asperger syndrome–some epidemiological considerations: a research note. Journal of child psychology and psychiatry 30, 631–638.
Kočovská E, Biskupstø R, Carina Gillberg I, Ellefsen A, Kampmann H, Stórá T, Billstedt E, Gillberg C (2012). The rising prevalence of autism: a prospective longitudinal study in the Faroe Islands. Journal of autism and developmental disorders 42, 1959–1966.
Kiyoharu, T, Tsuyoshi, K (2014). Autism spectrum disorder among first-visit depressed adult patients: diagnostic clues from backgrounds and past history. General Hospital Psychiatry 36, 737–742.
Lehnhardt, FG, Gawronski, A, Volpert, K, Schilbach, L, Tepest, R, Vogeley, K (2012). Psychosocial functioning of adults with late diagnosed autism spectrum disorders–a retrospective study. Fortschritte der Neurologie-Psychiatrie 80, 8897.
Moseley, DS, Tonge, BJ, Brereton, AV, Einfeld, SL (2011). Psychiatric comorbidity in adolescents and young adults with autism. Journal of Mental Health Research in Intellectual Disabililities 4, 229243.
National Autistic Society (2003). National Autistic Plan for Children (NAPC): Plan for the Identification, Assessment, Diagnosis and Access to Early Intervention For Pre-School and Primary School Aged Children With Autism Spectrum Disorders (ASD). The National Autistic Society: London.
National Autism Services Review Group (2012). National Review of Autism Services Past, Present and Way Forward. (https://www.hse.ie/eng/services/publications/Disability/autismreview2012.pdf). Accessed 17 June 2016.
National Council Special Education (2016). An evaluation of education provision for students with autism spectrum disorder in Ireland. (http://ncse.ie/wp-content/uploads/2016/07/5_NCSE-Education-Provision-ASD-Students-No21.pdf).
National Institute for Health and Clinical Excellence (2012). Autism spectrum in adults: diagnosis and management. NICE guideline (CG142).
O’Rourke, L (2016). Psychiatric and physical comorbidity in adults with autism spectrum disorder. Unpublished MD Thesis. Dublin: Royal College of Surgeons in Ireland.
Russell, AJ (2016). The mental health of individuals referred for assessment of autism spectrum disorder in adulthood: a clinic report. Autism 20, 623–627.
Scottish Intercollegiate Guidelines Network (SIGN) (2016). Assessment, diagnosis and interventions for autism spectrum disorders. SIGN: Edinburgh (SIGN publication no. 145). (http://www.sign.ac.uk/assets/sign145.pdf). Accessed 17 June 2016.
Tantam, D, Prestwood, S (1999). A Mind of One’s Own: A Guide to the Specific Difficulties And Needs Of The More Able Person With Autism Or Asperger Syndrome, 3 rd edn. National Autistic Society: London.
Taylor, JL, McPheeters, ML, Sathe, NA, Dove, D, Veenstra-Vanderweele, J, Warren, Z (2012). A systematic review of vocational interventions for young adults with autism spectrum disorders. Pediatrics 130, 531538.
The Psychological Society of Ireland Autism Spectrum Disorders Special Interest Group (2010). Best Practice Guidelines for the Assessment and Diagnosis of Autistic Spectrum Disorders for children and adolescents (birth to 18 years). The Psychological Society of Ireland. (http://www.psihq.ie/ page/file_dwn/102/Autism%20Spectrum%20Disorders%20-%20 Best%20Practice%20Guidelines.pdf). Accessed 23 May 2016.
Walters, S, Loades, M, Russell, A. (2016). A systematic review of effective modifications to cognitive behavioural therapy for young people with autism spectrum disorders. Review Journal of Autism and Developmental Disorders 3, 137153.
White, SW, Ollendick, TH, Bray, BC (2011). College students on the autism spectrum: prevalence and associated problems. Autism 15, 683701.
Wing L, Gould L (1979). Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. Journal of autism and developmental disorders 9, 11–29.
Wong, C, Odom, SL, Hume, KA, Cox, AW, Fettig, A, Kucharczyk, S, Brock, ME, Plavnick, JB, Fleury, VP, Schultz, TR (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: a comprehensive review. Journal of Autism and Developmental Disorders 45, 19511966.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed