Study on Autism and quality of life

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Autistic people vary widely in their quality of life, a new study shows. Some report shortcomings in their physical health and school achievement, among other areas, but many do not.

Autistic people often report having a lower quality of life than non-autistic people do, a trend driven in part by social isolation and a diminished belief in their own capabilities, according to a study published earlier this year. They are also more likely to have anxiety or depression, which can impact a person’s ability to function in society and achieve life goals.

The new work suggests that anxiety and depression, not autism traits, explain why many autistic people score lower than non-autistic people across various measures of quality of life.

Loth and her team analyzed survey data from 344 people with autism and 229 without autism who are part of a larger long-term European study2. Adults completed a 26-item questionnaire about their physical health, psychological health, social relationships and opportunities for leisure activities. For children and teenagers in the study, parents completed a 45-item questionnaire that assesses physical and psychological comfort, risk avoidance, academic achievement and the availability of an adult to talk to about problems.

In every area, autistic people reported worse outcomes than non-autistic people, the study found. Two key areas showed the most dramatic group differences: Autistic adults reported higher levels of physical pain than non-autistic adults, and autistic children and teenagers lagged most behind their non-autistic peers in school achievement.

These differences did not reflect every autistic participant’s experience, though. On an individual level, almost half of the autistic adults reported levels of psychological health and satisfaction with friendships on par with those of non-autistic adults, and about 55 percent of autistic adults reported having similar opportunities for leisure activities as non-autistic adults.

Loth’s team also examined data on autism traits, as measured by a 65-item survey on social-communication abilities; parent reports on sensory-processing differences in the children and teenagers; and data on the participants’ self- or parent-reported depression and anxiety traits.

Autism traits did not significantly predict adult participants’ quality of life, but depression severity did. Depression and anxiety predicted a lower quality of life for children and teenagers in multiple areas, as did social-communication difficulties. The work was published in October in Autism.

Questionnaires may focus on areas, such as personal relationships, that autistic respondents do not necessarily think of as important factors contributing to their quality of life, Loth says. Because most tools, including the ones in this study, were developed for non-autistic people, they may not accurately capture what autistic people see as a good life for themselves.

To get a better look at these subjective questions, her team is interviewing autistic people about which areas covered by existing quality-of-life questionnaires are most important to them, and whether any key areas are missing from the surveys.

They also plan to examine not just how autism traits, anxiety and depression contribute to quality of life, but also the reverse.