Social determinants of behavioral health (SDBH) can have a significant impact on young adults on the autism spectrum, especially as they enter adolescence and young adulthood. Research indicates that most graduates with autism and other learning differences will have a difficult time following high school for almost any outcome – working, continuing school, living independently, socializing and participating in the community, and staying healthy and safe (Thompson 2018). Repeated social failures may generalize to all events and can develop into a passive, failure-prone attributional style consistent with learned helplessness and depression (Abramson et al. 1978). These symptoms only intensify during the transition to adulthood.
Society has begun to embrace the unique characteristics and strengths that belong to individuals on the autism spectrum and those with learning differences. One has to look no further than Netflix to see an explosion of television shows and documentaries that warm our hearts and enrich our understanding of neurodiverse children and adults. Even still, many societal conditions exist that impact the mental, physical, and emotional health of individuals on the autism spectrum – workplace discrimination, academic and school supports that fall short of what a person needs to succeed, community programs that can be overwhelming for adults with social anxiety and fears, inaccessible clinical services for those in lower socioeconomic groups, late or missed diagnoses for young women on the spectrum… just to name a few.
At the College Internship Program (CIP), one of the first things shared aloud with prospective families and students is this: obstacles exist in life and, in all likelihood, you and your family may have faced more obstacles than other people your age. When you leave this program, you will have a sense of what you want to do with your life. You will be prepared to face challenges head on by forming a path that is marked by self-awareness and self-determination.
How can a young person with autism or learning differences begin to carve a path for him/her/their self, a path of productivity and purpose?
Young adults with autism or learning differences should prepare a plan to address the challenges brought on by social determinants by focusing on several key domains of their lives: academic, career, independent living and wellness skills, and social-emotional health.
Academics – know what you need and how to ask. Self-advocacy paves the way for accommodations and support. Whether it be a college exam or a Learner’s Permit test, you must be the voice behind your accommodations. Put them in writing, role play with a trusted friend, speak to your instructor and then verify that the instructor followed through in putting the plan in place. It is important to assist young adults in all areas of post-secondary learning. Asking the DMV for testing accommodations can be just as daunting as asking a professor for extended time on an exam! Students must understand what they need in order to succeed. Transferring individualized education plans to post-secondary settings and mastering executive function skills needed for studying and classroom preparation are all part of the work it takes to succeed in a post-secondary education.
Careers – know when to whom and how to self-disclose. Grab all the literature that you can on resume writing, current interview formats, workplace attire, and job application trends. For example, many businesses are now asking applicants to participate in group interviews, oftentimes over a computer screen. Social nuances of workplace communication aren’t easy to navigate for individuals on the spectrum. At CIP, students do a deep dive into these and many other workplace scenarios in workshops such as: Critical Thinking and Problem Solving, Job Application and Resume Support, etc. Many young adults recognize that they have to work hard to overcome the assumptions and stereotypes that come with their diagnosis. Ask a social skills coach to role-play various workplace scenarios with you: what do you bring to your first workplace potluck, what does small talk around the water cooler really look like, and what will the job force look like in 2020 and beyond? Many can relate to the embarrassing Zoom backgrounds or noises that we have finally learned to work around or at least laugh about.
Independent living and wellness skills: master your routine. Before succeeding in a career, one needs to know how to navigate a day. The common phrase, every successful day begins with a well-made bed is a great starting point. Develop a morning and evening routine, learn to navigate your local grocery store, plan 21 meals for the week, develop an exercise and sleep routine, and use a HALT check (am I Hungry, Angry, Lonely, or Tired?) to monitor needs on a moment by moment basis.
Social and Emotional Health: understand your diagnosis and develop a well-rounded plan. Create a support team and become part of a community that embraces you and supports your wellness routines or coping skills. A support team may include psychiatrists, therapists, life coaches, parents, peers, and trusted mentors.
A young woman was recently coached through a difficult pandemic-related workplace situation. As an employee at an assisted living facility, she learned that close to 120 employees and residents had tested positive for COVID-19. With a roommate’s health to consider, along with her own, she began the delicate process of sending inquiries to her employer. How was the situation being managed? What safeguards were being put in place to address the outbreak? What was she expected to do as she returned to work? Was she entitled to a leave of absence? Situations like this one are difficult to navigate, let alone in a pandemic situation and for a young woman who struggles with the nuances of workplace communication. It took an effortful strategy and a support team to put together email communications and phone calls in order to obtain the information she needed and in order to make an informed decision about whether she should return to work. This young woman had a trusted team of individuals that she could lean on. She had developed a voice when it came to self-advocacy and was able to obtain the answers that she needed in order to make a decision, confidently, and with self-assurance.
With support, forethought, and determination, young people can lead a life marked by passion and productivity. There is much to contribute and even more for society to gain when young people on the autism spectrum are embraced and encouraged as they forge unique paths toward development and growth.
Jenna Knauss, MS, LMFT, is Program Director at The College Internship Program.