Changes in Social Activities for Youth with Autism Spectrum Disorders during the Transition to Adulthood

Background: Although low rates of social participation are common among youth with autism spectrum disorders (ASD), it is not known how leaving high school impacts their social/recreational activities, or whether changes in social activities have mental health implications.

Objectives: This study uses a longitudinal design to examine changes in social/recreational participation for youth with ASD from before to after high school exit. We also examined whether changes in activities were related to internalizing symptoms.  

Methods:  Participants were 33 youth with ASD and their families. Data were collected two times: when youth were in their last year of high school, and 6-12 months after high school exit. Youth averaged 18.8 years of age at the start of the study (range = 17-22). Most (84.8%) were male and the majority was white non-Hispanic (90.9%). Just over 30% had an intellectual disability. Parent respondents included 29 mothers and 4 fathers, who were generally well-resourced (although 25% had incomes < $40,000).

At both time points, parents reported how often their son/daughter participated in 10 activities (from 0 = less than yearly/never to 4 = several times a week). Activities were grouped into three areas: unstructured social activities (social time with relatives, friends/neighbors, or with people from school/work); structured social activities (religious services, church social events, formal/informal recreational activities, playing sports with others); and other activities (working on hobbies, travel, exercise). Average participation and a count of the number of activities were calculated for each area. Internalizing symptoms were measured both times using Achenbach’s Adult Behavior Checklist.

Results: The most common activity was participating in a formal or informal recreational activity (e.g., bowling, movies) and the least common was playing sports with others. Most youth spent some unstructured social time with classmates, co-workers, friends, or neighbors, but few did this regularly. For example, when in high school, 55% of youth spent some time with people from school/work outside of school/work hours, but only 15% did this once a week or more.

Youth in their last year of high school, on average, participated in 7.7 activities; this average decreased to 7.0 activities after exit, t(32)=2.8, p<.01. There were no differences in the amount of unstructured social activities or “other,” primarily non-social activities, ts(32)=.06 and .24, respective, p=ns. There was a significant decline in structured social activities after high school – both in average amount of participation and in number of activities, ts(32)=3.10 and 2.97, respectively, ps<.01. The extent of decline in structured social activities was marginally related to internalizing problems when youth were out of high school, Spearman rho=-.33, p=.07. Youth who had a greater drop in structured social activities were more likely to have borderline or clinical-level internalizing symptoms.

Conclusions:  In addition to difficulties obtaining vocational/educational activities, our findings suggest that many youth with ASD lose some structured social activities after high school. This loss of activities might be related to internalizing problems. Further analyses will continue to examine the relations between changes in social and recreational activities during the transition to adulthood and mental health.