What to Know About Autism and Life Expectancy

https://www.verywellmind.com/what-to-know-about-autism-and-lower-life-expectancy-6748941

Autistic people have significantly lower life expectancies than the rest of the population. In 2022, the average global life expectancy is approximately 72 years old. For autistic people, though, the average life expectancy ranges from 39.5 years to 58 years.

Some of the psychological stressors that autistic people experience are a result of existing in a world that has not been designed to meet their needs. Society is set up with various behavior expectations that are challenging, uncomfortable, or even impossible for some autistic people, such as eye contact, sitting still in appointments and meetings, and using nonverbal communication in conversations. Navigating systems designed for neurotypical people is stressful for neurodivergent people, particularly autistics, and this chronic stress contributes to differences in life expectancy.

This article further explores the connection between autism and lower life expectancy.

One major contributor to life expectancy differences for autistic versus non-autistic people is comorbid genetic and medical conditions. Compared to non-autistic people, autistics are at higher risk for several genetic disorders that are linked to shorter life expectancy, including Down syndrome, muscular dystrophy, and Fragile X syndrome.

Autistic people are additionally more likely to experience neurological disorders such as epilepsy and hydrocephalus, sleep disorders, and gastrointestinal disorders.

Autistic people are also at higher risk for mental health issues compared to those who are not autistic. This includes anxiety, depression, psychotic disorders, and trauma disorders. This added risk for mental health diagnoses means that autistic people are at higher risk than non-autistic people of suicide.

This manifests not only in societal expectations but in “treatments” that are often recommended for autistic people. For example, many autistic people who received applied behavioral analysis (ABA) treatment report that the emphasis on compliance and eliminating autistic behaviors is traumatic and abusive.

Autistic people present in a wide variety of ways, and no two autistic people are alike. Sometimes, autistic people are identified in terms of their “functioning.” Functioning labels are not specific diagnoses but are intended to determine how much support an individual needs in their daily life and survival.

Some researchers and providers attempt to differentiate levels of autism, identifying how expansive an individual’s support needs are. This system is limited, as individuals might have strengths and weaknesses in different areas rather than easily fitting into one category. Additionally, illness, stress, or burnout can cause someone’s level or presentation to change day to day or even hour to hour.

At the same time, some autistic people might require high support throughout their lifetime. Research has shown that those with higher support needs have shorter life expectancies than those with fewer support needs. Those who are able to manage independently live, on average, almost 20 years longer than those who require substantial support.

In addition, those who require ongoing support are at risk for abuse and maltreatment by caregivers. This increased risk for abuse likely contributes to lower life expectancy for autistic people with high support needs.

For children, autism can be diagnosed by a psychologist, psychiatrist, or developmental specialist. For adults, autism can be diagnosed by psychologists or psychiatrists with appropriate training. Autism is diagnosed through a psychological evaluation, which has multiple components and may include:

- Diagnostic or Intake Interview: An appointment with the evaluator during which they ask extensive questions about history, symptoms, et cetera.
- Collateral Interviews: Some evaluations include interviews with a parent or caregiver in an effort to gather more early developmental information and history of symptoms. This is not always available.
- The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2): The ADOS-2 involves having an individual answer questions and complete tasks to determine whether their presentation is consistent with autism.
- Autism Spectrum Rating Scale (ASRS): An observational measure completed by parents and teachers to provide information about a child’s behaviors. This data is compared to autistic and non-autistic children to determine whether the child’s presentation is consistent with autism.
- The Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2): The MIGDAS-2 is an interview assessment that asks about various life experiences and symptoms often seen in autistic individuals.
- The Diagnostic Interview for Social and Communication Disorders (DISCO): The DISCO uses narrative interview format to get information about communication skills and styles. It can be administered to children or adults.

Autistic people who receive appropriate support may experience lower stress and decreased risk for stress-related illness, mental health issues, and earlier death. As such, identifying appropriate coping or treatment can be important in addressing lower life expectancy.

As autism is a neurodivergence and not a mental illness, it is not something that needs to be “cured” or “fixed,” but appropriate support can increase quality of life.

The goal of treatment must be to help the autistic person identify coping and communication skills that are healthy and appropriate rather than to make them behave in neurotypical ways, as this masking can cause stress and burnout.

Autistic people might benefit from individual therapy to address any comorbid mental health conditions, like trauma disorders, depression, or anxiety. They might also find support in group therapy or support groups, where they can connect with people they relate to and who have had similar experiences.

Typically, autism does not require medication intervention, but autistic people who have other mental health diagnoses might require medication for those conditions.

Autistic people have shorter life expectancy than non-autistic people, partially due to higher risk for genetic and medical issues and partially due to the stress of existing in a world not built for you. Access to appropriate supports can help mitigate this effect. It can also improve quality of life and help individuals manage any comorbid conditions.