a group of young adults bonding and socializing, illustrating how community empowers individuals with ASD in young adulthood

Autism Spectrum Disorder (ASD) in Young Adulthood: Navigating Co-Occurring Diagnoses and Finding Empowerment through Community

Est. reading time: 6 mins
Posted Under: Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW

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Autism Spectrum Disorder, or ASD, is a type of neurodivergence that impacts the way individuals interact, communicate, and learn. An estimated 2.21% of the adult population in the United States has a diagnosis of Autism Spectrum Disorder (ASD), and the CDC reports about 1 in 36 children have autism.

ASD is not a mental health condition – it is a form of neurodivergence with both benefits and challenges. However, there are a number of co-occurring psychiatric disorders that individuals with ASD commonly face. These include anxiety disorders, mood disorders, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and oppositional defiant disorder (ODD).

Individuals diagnosed with ASD may also have a lower “distress tolerance”, or, in other words, higher sensitivities, to the world around them than their neurotypical counterparts. This can lead to discomfort with loud noises, high levels of stress, and sudden changes in their environment – all qualities that are pretty common in the typical life of a young adult navigating university life or their first job.

We met with The Dorm Clinical Coaches Miguel Edwards and Maddox Emerick to better understand how individuals with an ASD diagnosis can navigate the challenges of young adulthood, build community, and gain new skills in a supported environment.

With the right support, they explain, clients can learn to navigate their surroundings with more ease and freedom. In other words, “therapists can work to integrate a client’s needs into the way that they want to live their life,” says Maddox. 

Key Article Takeaways: 

Autism Spectrum Disorder (ASD) is a form of neurodivergence that can be diagnosed after about 18 months in infants. However, for individuals on the more neurotypical end of the spectrum it may go undetected into young adulthood.

ASD often co-occurs with several other psychiatric diagnoses, including OCD, anxiety, social anxiety and ADHD. Clinicians at The Dorm use several evidence-based modalities to treat ASD, including RO-DBT, a treatment targeted at over-control.

Our therapists recommend group therapy for clients with ASD to promote social skills. Groups for clients with ASD include: Radically Open Dialectical Behavior Therapy (RO-DBT), Executive Function Life Skills, Social skills Group, Artful Communication.

Diagnosing Autism in Young Adults

The timeline of being diagnosed with autism is different for everyone. For some, diagnosis can happen early in life, as early as 18 months. Other individuals may be able to get by without a diagnosis until early adulthood, when, as responsibilities increase, indicators of ASD may become more evident. 

A diagnosis is helpful for many young adults because it opens up an opportunity for therapeutic intervention and management, whereas moving forward in life without an accurate diagnosis can create a debilitating transition to adulthood. 

After working with ASD clients for over a decade, Clinical Coach Miguel Edwards notes that puberty is a time where marked changes in symptoms tend to occur. This developmental curve is a time of social-emotional and hormonal change that brings all sorts of emotion for any adolescent or teen. Research shows that this time brings increased reactivity and sensitivity to stress for those with ASD

Miguel also emphasized the importance of remembering that autism in young adults exists on a spectrum, so no client is the same when it comes to how symptoms will be expressed. 

With ASD, there are a variety of different presentations and as professionals we have to adapt to each client’s individuality – this is the definition of meeting somebody where they’re at – something that we pride ourselves on at The Dorm,” he explains.

ASD Terminology & Treatment at The Dorm 

The terminology for ASD has changed and developed over time. Before the latest addition of the DSM, there was a differentiation between autism and Asperger’s syndrome. Now, the DSM-5 uses three levels of autism to diagnose the severity of each individual’s impairment. At The Dorm, we work with clients at Level 1 ASD. Our clients with ASD are often seeking treatment to gain the skills they need to thrive within their communities and achieve their life goals. 

Maddox explains that for a therapist at The Dorm, “the importance is to meet each client where they’re at, and the goal is to offer support in terms of learning the nuances of being an adult.”

In short, a therapist’s goal is to work with clients to meet their individual needs while still holding them accountable for trying out new learned in therapy within our community setting.

Co-Occurring Disorders with ASD in Young Adults

A number of psychiatric diagnoses tend to co-occur for clients with ASD. Additionally, there can tend to be overlapping symptoms of both autism and some of the more social-focused forms of neurodivergence. For example, challenges with social skills and reading social cues can also be common in ADHD and Social Anxiety Disorder. These skills bleed over into being able to hold a job, communicate effectively, and/or maintain romantic and familial relationships.

At The Dorm, Maddox tends to see autism co-occur with OCD symptoms. He facilitates a group called Radically Open Dialectical Behavior Therapy (RO-DBT), a therapeutic modality that was developed to treat disorders characterized by over-control, with the goal of increasing social connectedness to create change in treatment. 

Because autism can create a level of cognitive rigidity, RO-DBT can help with alleviating obsessive compulsive cycles and high levels of anxiety caused by uncontrollable changes in an individual’s environment, such as a sudden change in lighting, temperature, or noise level.

A Community Model of Care

Since 2009, The Dorm has promoted a unique model of care that is heavily grounded in community. All individual and group sessions center around a community hub, The Clubhouse, which offers a place for winding down, socializing, and attending extracurricular clubs or social activities between individual and group therapy sessions. This space is guided by licensed therapists and community managers, and offers a place for young adults with ASD to practice the skills they’re learning during treatment.

The Clubhouse Community 

“A big piece of the puzzle,” as Maddox puts, “is that we foster an organic social environment that is safe for clients to explore social connection. They can use The Clubhouse as a tool for practicing what they learn. They can interact with people who aren’t necessarily in their inner circle. Holistically, the model of The Dorm helps people with autism and really it benefits everybody due to the natural inherent element of serving as a stepping stone to the real world.”

Group Therapy Options at The Dorm for Young Adults with ASD 

In addition to the clubhouse model, our robust group programming schedule serves the dual purpose of psychoeducation and fostering relationships with the guidance of licensed clinicians. Below, Maddox and Miguel reflect on the specific groups that they’ve seen benefit clients with ASD at The Dorm: 

  • Radically Open Dialectical Behavior Therapy (RO-DBT) Group: This group is designed for people who have over-control, or, for clients with ASD, this can be cognitive rigidity. This group is great for developing skills that increase openness to ways of interacting that may not be comfortable or picking up on cues without saying everything they think. Further, it supports developing a flexibility that is needed in order to be an adult going through the world and not feel completely overwhelmed with the day to day as well as processing.
  • Executive Function Life Skills Group: This group is designed to help clients gain the highly important life skills that help you stay organized, assist in scheduling and managing your time, and the flexibility needed to successfully function as an adult. 
  • Social Skills Group: This group focuses on interacting and externalizing behaviors. It helps clients to increase their ability to have easeful and productive relationships and communication skills.
  • Artful Communication Group: This group helps with being able to practice communicating with other people. Such as being able to actively listen and respond, knowing what to share and not to share, and gauging what might be appropriate or not depending on the level of intimacy with the other person. Being able to express oneself in a concise way and engage in effective communication is a skill that will assist them greatly as they navigate adult relationships.

In terms of group facilitation for clients with ASD, Miguel explains:

“When clients with ASD are in the group, it’s important to make sure: 

  1. they get the information in a way they understand and 
  2. they can communicate back with you in a way that you understand. 

If there is a lack of understanding between group members or leaders, you want to reframe to give them an opportunity to express themselves in a different way. Communicating with them in a way that allows them to feel safe and trust that they can express themselves is going to be transformational for them.”

Moving Forward with ASD in Young Adulthood

In conclusion, our key takeaway is that autism is extremely individualized and there is no one-size-fits-all approach to managing co-occurring mental health challenges and improving social or executive functioning skills. The Dorm model recommends holistic care in approaching treatment, including targeted individual therapy, group therapy, and community building all with a focus on the client’s needs and long-term goals.

As Miguel puts it, “You need to approach treatment with time, patience, and consistency. Also, the earlier clients with ASD can integrate into a community or school that works for them, and are given new options in life, the better. People with ASD struggle with rigidity so if, as a therapist, you can help them open up to see 10 different options in their future instead of just one, that is a worthwhile step for treatment. It’s really about helping clients find their own voice and seeing their future more clearly.”

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