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Importance: Autistic youth who graduate with a high school diploma may experience challenges in acquiring functional skills for everyday independence. Few studies have focused on how their functional and self-management skills change during the transition to adulthood. Objective: To examine cross-sectional differences and longitudinal changes in the functional and self-management skills of transition-age autistic youth. Design: Exploratory longitudinal study (18-mo follow-up). Setting: Community. Participants: Autistic high school students who graduated with a high school diploma and their parents (N = 50). Outcomes and Measures: Pediatric Evaluation of Disability Inventory–Computer Adaptive Test (ASD). Results: Older youth (ages 18–20 yr) had significantly lower normative Social/Cognitive and Responsibility domain scores (i.e., self-management) than youth ages 14–17 yr. Approximately 2 yr later, youth in both age groups significantly improved in scaled scores on the Daily Activities and Responsibility domains. Conclusions and Relevance: Autistic youth's functional and self-management skills fell below those of nonautistic peers; however, these skills do change over time and are therefore appropriate targets for intervention. Plain-Language Summary: The findings of this study highlight the importance of focusing on the functional and self-management skills of autistic youth as part of their transition to adulthood. Occupational therapists can play a valuable role in helping autistic youth to achieve independence as adults by assessing their functional needs and strengths and by providing client-centered interventions. The findings of this study highlight the valuable role that occupational therapists can play in helping autistic youth to achieve independence as adults by assessing their functional needs and strengths and by providing client-centered interventions. [ABSTRACT FROM AUTHOR]

In this study we examined differences in social support and coping between mothers of adolescents and adults with an autism spectrum disorder (ASD) in Taiwan and the United States and to investigate the effects of social support and coping strategies on family adaptation and maternal well-being. Participants were 76 Taiwanese mothers who had at least one son or daughter with an ASD (10 years old and older), and a comparison group of 325 mothers in the United States matched on the age range of the child with an ASD. Mothers completed self-administered, written questionnaires and participated in an interview. Taiwanese mothers reported significantly greater use of problem-focused and emotion-focused coping strategies than did mothers in the United States. For Taiwanese families, greater use of problem-focused coping strategies was associated with lower levels of depressive symptoms and anxiety. Emotion-focused coping mediated the relationships between ethnicity/culture and several outcome measures: family adaptability, family cohesion, and maternal depressive symptoms. The higher levels of emotion-focused coping in Taiwanese mothers appeared to account for their lower levels of family adaptability and cohesion and higher levels of maternal depressive symptoms. The results from this cross-cultural study helped determine the role of social support and coping strategies in family adaptation and maternal well-being in families of individuals with an ASD in each culture. Implications for service delivery are discussed. (Contains 5 tables and 5 figures.)

Importance: Limited research has described the timing of acquisition of the broad range of skills required for the transition to adulthood. Objective: To describe the timing of the shift of responsibility for daily tasks from parent to child. Design: This study used an existing data set of parent responses to 49 items in the Responsibility domain of the Pediatric Evaluation of Disability Inventory Computer Adaptive Tests. Participants: A U.S. nationally representative sample of 2,205 typically developing children and youth ages 0 to 20 yr. Outcomes and Measures: Descriptive analyses focused on two ages: (1) starting age (when >50% of parents reported their child was taking at least some responsibility for a task) and (2) full responsibility age (when >50% of parents reported their child was taking full responsibility for the task). Results: The process of shifting responsibility for daily life tasks from parent to child typically occurred over a long period. Many task items had an interval of 5 yr from starting age to full responsibility age; the longest interval was 15 yr. Youth began assuming responsibility for more complex tasks and tasks that involved more risk at ages 10 to 15. Conclusions and Relevance: Results can serve as a reference for the timing of the transition to greater self-management of daily life tasks across childhood and adolescence. Timing of responsibility shifts may reflect a combination of development of underlying capacities and social transitions. Executive functioning may be especially relevant for management of the more complex tasks required in daily life in adulthood. What This Article Adds: The transfer of responsibility for managing tasks of daily life from parents to children often extends over a period of many years. Clinicians may find the results helpful when discussing the future with parents of young people with disabilities and other chronic conditions and the tasks that their children must learn to manage for independent living as an adult. [ABSTRACT FROM AUTHOR]

Importance: No study has directly investigated which variables are associated with the shift of responsibility for managing daily tasks from parent to child in the transition to adulthood. Objective: To examine characteristics associated with responsibility for managing daily life tasks in youth with and without disabilities. Design: A secondary data analysis of parent-report data on typically developing (TD) youth and youth with disabilities. Setting: An online panel that has regularly participated in online surveys. Participants: A nationally representative sample of 2,205 TD U.S. children and youth, ages 0 to 20 yr, 11 mo (about 100 children per age year) and a sample of 617 children and youth with disabilities, ages 0 to 20 yr, 11 mo. Outcomes and Measures: The dependent variable was the Responsibility domain scaled score (from the Pediatric Evaluation of Disability Inventory–Computer Adaptive Test), which reflects the extent to which responsibility for daily tasks has shifted from parent to youth. Results: Youth with higher levels of responsibility were older in age, reported to be more focused, and youngest in birth order (TD, R 2 =.79; disability, R 2 =.35). Youth with developmental delay, intellectual disability, autism spectrum disorder, or orthopedic or movement impairments had assumed less responsibility. Conclusions and Relevance: Other personal characteristics in addition to disability may have important influences on parents' decision making as they prepare their children to manage daily life tasks. What This Article Adds: Clinicians who work with adolescents in the process of transition to adulthood need to consider the potential influence of the personal characteristics, such as birth order and child temperament, on preparation for adulthood. [ABSTRACT FROM AUTHOR]

ABSTRACT. The use of current adaptive behavior measures in practice and research is limited by their length and need for a professional interviewer. There is a need for alternative measures that more efficiently assess adaptive behavior in children and youth with autism spectrum disorders (ASDs). The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) is a computer-based assessment of a child's ability to perform activities required for personal self-sufficiency and engagement in the community. This study evaluated the applicability, representativeness, and comprehensiveness of the Daily Activity, Social/Cognitive, and Responsibility domains for children and youth with an ASD. Twenty professionals and 18 parents provided feedback via in-person or virtual focus groups and cognitive interviews. Items were perceived to represent relevant functional activities within each domain. Child factors and assessment characteristics influenced parents' ratings. In response to feedback, 15 items and additional directions were added to ensure the PEDI-CAT is a meaningful measure when used with this population. [ABSTRACT FROM AUTHOR]