Money Matters: Risks of Limited Money Understanding Among Adults with ASD

Background:

Money management is a unique adulthood need for some individuals with ASD. Money appears to be a difficult concept for many adults with ASD to understand and manage with extensive consequences of incompetence, and yet it remains largely unrecognised on the evidence base of supportive services. Patterns of money spending and financial management of adults with ASD including impulsive spending, poor planning, and obsessive saving and monitoring of money may be associated with repetitive patterns of behaviour characteristic of autism, executive function deficits and mental health comorbidities. However, individual personalities, experiences and media influences may also contribute to financial habits with learned money skills and changes in monetary patterns possible with effective support. Currently, informal support efforts from family members may be meeting the financial and money management needs of adults with ASD. Formal support services may be essential when family support is unavailable. Limited understanding of money and the inability to manage it may place adults with ASD at risk of harm.

Objectives:

To explore the monetary competencies and financial patterns of behaviour of adults with ASD.

Methods:

Using mixed methods, 74 adults with ASD (19-65 years of age), recruited from a London clinic, completed the Camberwell Assessment of Need for Adults with Developmental and Intellectual Disabilities (CANDID) and 49 family members participated in semi-structured, face-to-face interviews to explore the capabilities and support needs of adults with ASD. SPSS was used to analyse quantitative data and thematic analysis conducted with qualitative information.

Results:

Money budgeting difficulties were reported by adults with ASD as a high and unmet need on the CANDID, and monetary limitations and consequences were widely expressed and described in interviews. Problems with financial literacy and skills ranged from basic understanding of the monetary value of paper money and coins, difficulty with maths and counting change, to the inability to accomplish routine tasks of bill paying, to complex tasks such as budgeting and banking. Money management difficulties included the inability to budget or pay bills, over or underspending, lending or giving money away, and difficulty understanding credit cards and money. Some adults with ASD had experienced financial abuse and exploitation. Many had their money and spending monitored or managed by family members. The inability to think ahead, or to anticipate future needs, and difficulties in prioritising and decision-making, were key concerns of family members for adults with ASD who had some control over their finances. The need for financial support and money management, particularly with reference to the future, was frequently stated by, and about adults with ASD. However, who would assume this responsibility, family or formal support services was vague.

Conclusions:

Limitations in financial understanding may impede adults with ASD from making decisions as informed consumers, and place them at risk of harm and exploitation without adequate and effective support. An unmet need in the area of money management may significantly impact the safety and wellbeing of an adult with ASD.