Launching Your Autistic Youth to Successful Adulthood. Katharina Manassis

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What is required for my youth to live independently?

       How do you decide on the best living arrangements with your youth?

       How do you judge the degree of support your youth needs?

       What about having your youth live with a family member?

       Will my son or daughter ever marry?

       Take-home pearls

       11. Resilience, Realistic Hope, and Avoiding Burnout

       Transition to adulthood is a family affair

       Recognizing burnout

       Helpful actions and attitudes to reduce burnout

       Attending to your partner

       Helping your autistic youth’s siblings cope

       Your youth’s place in the family and resilience

       Course corrections on the road to adulthood

       Finding realistic hope

       Take-home pearls

       Bibliography

       Index

      “When my son left high school, it was as though he fell off the face of the earth.”

      My comment in an autism-focused parents’ group

      Have you had this experience? Are you worried about the possibility of this occurring? What will happen when all your child’s familiar teachers, educational assistants, coaches, and friends disappear after graduation? Who will replace them in the adult world? How will your child manage this drastic change? How will you?

      If you are the parent of a youth with autism spectrum disorder (ASD) and these questions are looming in your mind, you are not alone. The transition from high school to adulthood is one of the most challenging times for these youth (Coury et al. 2014). Development often plateaus or even regresses at this point; family relationships may become strained. Comfortable school routines are lost, and supports for the next phase of life may be lacking or inadequate.

      How can you launch your youth into successful adulthood, allowing them to cope now and in the distant future when you are gone? Answering this question is the focus of the book you hold in your hands.

      You may wonder how I came to write this book, and why I urge you to read it. There are two main reasons. First, I wish this book had been available when my son was in high school. My son is a funny and affectionate but severely learning disabled young man on the autism spectrum. He is squarely in the middle of that spectrum: not intellectually disabled, but at the lower end of what is considered normal intelligence quotient (IQ); verbal but not able to express himself in writing; able to learn basic rules of appropriate social behavior, but unlikely to think about how his behavior affects others unless prompted to do so. Before he graduated, I could have used some advice about helping him navigate the next phase of his life. Instead, information provided was often incorrect or not applicable to him. When I shared my frustrations with friends, they replied, “You should write a book about this!” so eventually I did.

      Second, as a child psychiatrist, I saw more autistic youth with difficulty at this time of life than I expected. In my suburban private practice, I took referrals from local pediatricians. Prior to my arrival, these pediatricians had been the main child mental health resource in our area, so they knew a great deal about psychological difficulties such as anxiety, attention problems, and depression. They considered these problems “simple,” so rarely referred to me for them. On the other hand, they considered youth on the autism spectrum “complex,” especially as they approached adulthood. The doctors relied on me to provide expertise regarding these youth, even though I had little training in this field. I learned a great deal as I tried to help these youth and their families. One important lesson was that, with the right guidance, parents could make a positive difference. This book was written to provide that guidance.

      This book addresses challenges faced by a broad range of youth on the autism spectrum. Examples include youth with a variety of intellectual abilities, social abilities, and levels of independence. Admittedly, my experience with autistic youth who are nonverbal or have severe intellectual disabilities is limited. However, to say that I am targeting only a “high-functioning” population is also incorrect.

      Autism has recently been defined as being on a spectrum (American Psychiatric Association 2013) to accurately represent the diversity of people with this diagnosis. I don’t know where your child falls on that spectrum. What I do know is that saying someone is high functioning because their IQ falls above a certain arbitrary point is unfair. In my opinion, if you cannot figure out what to say on the telephone after “Hello,” or cannot look people in the eye when applying for a job, or are unable to sit in class because you need to flap or pace about, you are not high functioning regardless of IQ. The research supports this idea: one of the hallmarks of autism is that functioning in day-to-day activities is often significantly lower than IQ, and the bigger the discrepancy, the more likely youth are to suffer mental health problems (Kraper et al. 2017).

      To address the breadth of the autism spectrum, I have indicated in each chapter which ideas pertain to higher-functioning youth and which ones to lower-functioning youth. If your youth is at neither extreme, both may be relevant.

      Family circumstances and jurisdiction also affect autistic youths’ experiences transitioning to adulthood. My son grew up in a single-parent family (I am widowed) with an older, neurotypical sibling in a middle-class suburb just outside Toronto in Canada. If he had grown up in a two-parent, divorced, or blended family, in different economic circumstances, or in a country which did not have universal health care, his transitional experience would have been quite different. Programs supporting people with disabilities and their families at home, at school, and at work also differ from one jurisdiction to another.

      Recognizing this issue, I have included examples with different family compositions, and tried to indicate when you may need to adapt my advice to your local jurisdiction. If you are not sure if a suggestion

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