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Psychiatry Newsletter - Adults and ASD

Hopkins BrainWise - Summer 2011

Adults and ASD

Date: July 15, 2011

Dr. Peter Rabins
"Patients have been sent to us with the old label of 'mentally retarded' whose primary problem is really ASD", say Peter Rabins

What happens to adults with autism spectrum disorder? Do their problems in communicating ease? How do they cope with the aging process? Do most get along in life or barely get by? If they need help, what’s best to do?

In 1943, when America’s—and Hopkins’—first child psychiatrist, Leo Kanner, published the monograph that established autism as a childhood psychiatric illness, the idea of adults with the disorder wasn’t in mind. Children Kanner studied were so severely ill that concern was channeled into doing anything to make their young lives better.

But change has come in the last decade, says Peter Rabins, a professor and specialist in geriatric psychiatry. “That’s partly because of autism’s newer place as part of a spectrum of disorders. Now we see more adult patients with milder illness,” he says. Also, with the growing idea that therapies can help children (article, left), and that adult brains may be plastic enough to benefit from therapy, the need to look into that is stronger.

And that’s what’s beginning at Hopkins. Because adults with ASD are presently in health care’s cloud of unknowing, that group first needs better defining, says Rabins. Recently, he, Kostas Lyketsos and Eric Samstad surveyed patients at a unique clinic that for some 25 years has treated the psychiatric problems of those with “intellectual disabilities.” About 10 percent, they found, have autism disorders. “Patients have been sent to us with the old label of ‘mentally retarded’ whose primary problem is really ASD,” says Rabins. “Their intellect isn’t impaired.”

And in looking into those patients’ situations, the researchers saw, for example, that either illiteracy or psychiatric disorders or both appear to hamper an otherwise independent life. “We can target those problems,” says Rabins. 

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