AUTISM IN ADOLESCENTS AND ADULTS CURRENT ISSUES IN AUTISM Series Editors: Eric Schopler and Gary B. Mesibov University of North Carolina School of Medicine Chapel Hill, North Carolina AUTISM IN ADOLESCENTS AND ADULTS Edited by Eric Schopler and Gary B. Mesibov AUTISM IN ADOLESCENTS AND ADULTS Edited by Eric Schopler and Gary B. Mesibov University of North Carolina School of Medicine Chapel Hill, North Carolina SPRINGER SCIENCE+BUSINESS MEDIA, LLC Library of Congress Cataloging in Publication Data Main entry under title: Autism in adolescents and adults. (Current issues in autism) Includes bibliographical references and index. 1. Autism. 2. Adolescent psychopathology. 3. Autism-Patients-United States- Services for. 1. Schopler, Eric. II. Mesibov, Gary B., 1945- . III. Series. [DNLM: 1. Autism-In adolescence. 2. Autism-In adulthood. WM 203.5.A9375] RJ506.A9A9224 1982 616.89'82 82-22314 ISBN 978-1-4757-9347-5 ISBN 978-1-4757-9345-1 (eBook) DOI 10.1007/978-1-4757-9345-1 109876543 © 1983 Springer Science+Business Media New York Originally published by Plenum Press, New York in 1983 Softcover reprint ofthe hardcover 1st edition 1983 Ali rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher Printed in the United States of America Contributors WAYNE V. ADAMS • Alfred I. duPont Institute, Child Diagnostic and Development Clinic, P.O. Box 269, Wilmington, Delaware 19899 VICTOR L. BALDWIN • Teaching Research Infant and Child Center, Monmouth, Oregon 97361 MARIE M. BRISTOL • Carolina Institute for Research on Early Edu cation of the Handicapped, Frank Porter Graham Child Develop ment Center, University of North Carolina, Chapel Hill, North Carolina 27514 JAY BUCKLEY • Teaching Research Infant and Child Center, Monmouth, Oregon 97361 JOANNA S. DALLDORF • Biological Sciences Research Center, Uni versity of North Carolina School of Medicine, Chapel Hill, North Carolina 27514 MARIAN K. DEMYER • Institute of Psychiatric Research, Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, Indiana 46223 MARGARET AVERY DEWEY • 2301 Woodside Road, Ann Arbor, Michigan 48104 JUDITH E. FAVELL • Western Carolina Center, Morganton, North Carolina 28655 H. D. BUD FREDERICKS • Teaching Research Infant and Child Center, Monmouth, Oregon 97361 v vi CONTRIBUTORS LAWRENCE A. FROLIK • School of Law, University of Pittsburgh, Pitts burgh, Pennsylvania 15260 PEG GOLDBERG • Institute for Psychiatric Research, Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana 46233 GARY W. LA VIGNA • 1596 E. Cipres Street, Camarillo, California 93010; formerly of Jay Nolan Center, Newhall, California 91321 AMY L. LETTICK • Benhaven, New Haven, Connecticut 06511 SIDNEY M. LEVY • Department of Special Education, George Peabody College, Vanderbilt University, Nashville, Tennessee 37203 CATHERINE LORD • Department of Psychology, Glenrose Hospital, Ed monton, Alberta, Canada T56 OB7 MARY B. MELONE • Benhaven, New Haven, Connecticut 06511 GARY B. MESIBOV • Division TEACCH, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514 WILLIAM MOORE • Teaching Research Infant and Child Center, Mon mouth, Oregon 97361 PATRICIA J, O'NEILL • St. Paul Program for Autistic Children and Social Development, St. Paul, Minnesota 55119 CLARA CLAIBORNE PARK • 29 Hoxsey Street, Williamstown, Massa chusetts 02167 ERIC SCHOPLER • Division TEACCH, Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27514 DAVID V. SHESLOW • Child Diagnostic and Development Clinic, Alfred I. duPont Institute, Wilmington, Delaware 19899 JERRY L. SLOAN • Southeastern TEACCH Center, Wilmington, North Carolina 28401 KATHLEEN STREMEL-CAMPBELL • Teaching Research Infant and Child Center, Monmouth, Oregon 97361 PAUL WEHMAN • Division of Educational Services, Virginia Common wealth University, Richmond, Virginia 23284 LORNA WING • MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, Camberwell, London SE5 8AF, England Preface The state of North Carolina has had a longstanding concern and com mitment to the understanding and treatment of autistic, communications handicapped children and their families. This commitment found expres sion in the only comprehensive statewide program for families confronted with this disability, Division for the Treatment and Education of Autistic and related Communication handicapped CHildren (Division TEACCH). Our program staff has been privileged to respond to this commitment by developing and providing the needed services, and to engage in research informed by our clinical experience. Although many of the problems con cerning these developmentally disabled children remain to be solved, substantial progress has been made during this past decade of collabo ration among professionals, parents, and their government representa tives. The TEACCH staff has resolved to mark the effectiveness of this collaboration by holding a series of annual conferences focused on the several major issues confronting these children and their families. The conferences are held in order to bring together the best research knowl edge available to us from throughout the country, and to encourage par ticipation by the different professional disciplines and concerned parents. In addition these annual meetings form the basis for a series of books based on the conference theme. These books are, however, not merely the published proceedings of the presented papers: some chapters are expanded from conference presentations and many others were solicited from experts in the related areas of research and their service application. Each volume is intended to provide the most current knowledge and professional practice available. vii viii PREFACE Our first conference was held in Greensboro, North Carolina, in 1979. Most of the chapters have been prepared since that time. Our theme, "Autism in Adolescents and Adults" is especially timely, as the chronic nature of autism had been either ignored or misunderstood in the past. This volume provides an overview of the historical context of the autistic disorder, a series of chapters on the handicaps and needs presented by the children, their families, and their community programs. We were fortunate in obtaining contributions from many outstanding experts whose work is generated from different regions and interests. However, they all share what we believe to be valuable information useful to all of us concerned with the emerging adulthood of people with autism. Most of all, we dedicate this series to the many families and young adults whose heroic struggles have informed our work, and to their rep resentatives in the North Carolina General Assembly and the state agen cies who have responded to their needs. Eric Schopler Gary B. Mesibov Acknowledgments It is our pleasure to acknowledge the many sources of help we have had during various phases of this project. First, our thanks to Peter Coogan, who helped with the arrangements for the conference that was the starting point for this book. We would also like to acknowledge the secretarial and typing assistance from Cindy Fesmire and Raymina Y. Mays. The editorial assistance of Judy Davis has been invaluable in strengthening many of the individual chapters. We would also like to thank our many thoughtful and creative colleagues in the TEACCH program for their stimulating work and thoughts about the older age group. Finally, and most important, the book would not have materialized without the families of the autistic adolescents and adults in North Car olina. They both sensitized us to the importance of this topic and provided us with many valuable insights. E.S. G.B.M. ix