Potential for Life Skills Growth in Adults With Profound Autism.

Abstract

Purpose: Research on autistic adults has expanded rapidly in recent years. However, few studies focus on adults with profound autism, despite this subgroup having substantial support needs across the life course. Daily living skills (DLS)-including personal care, household chores, and community tasks-are closely tied to independence and service needs in adulthood. The current study applied an item-level coding framework to informant-report DLS data to identify intervention targets for this population.

Method: Parents and staff members of 36 autistic adults (m_age = 35.23 [5.31], 19.4% female, 77% White) who met profound criteria (m_{verbal IQ} = 19.56 [13.17] m_{nonverbal IQ} = 25.0 [19.14]) completed the Vineland adaptive behavior scales, third edition (VABS-3) caregiver interview. A coding scheme developed by Teh and colleagues (2023) was applied to DLS items scored as "never or seldom" completed independently to characterize why skills were not achieved.

Results: Patterns of reasons why skills were not achieved differed significantly across DLS domains (i.e., Personal, Domestic, Community; χ²(10) = 137.99, p < .001). Domestic skills were significantly more likely to be rated "Able-Reminded," while Community skills were significantly more likely to be rated "Unable-Cognitive." Many unachieved skills reflected modifiable barriers (e.g., limited opportunities for learning, reliance on prompts) rather than inability, highlighting concrete targets for improving life skills in adults with profound autism.

Conclusion: Autistic adults with profound autism retain meaningful potential for continued growth in DLS in adulthood. Item-level analysis of adaptive behavior may pinpoint intervention targets that are not apparent from summary scores alone.