Service Needs Across the Lifespan for Individuals with Autism.
Autism services drop sharply after high school, so start adult transition planning early.
01Research in Context
What this study did
Fedoroff et al. (2016) tracked services for students with autism. They looked at how much help kids got during high school and after graduation.
The study used records from across the United States. It counted therapy, school help, and other supports year by year.
What they found
Help faded each year of high school. After the diploma, it fell off a cliff.
Students without intellectual disability lost the most. Their unmet needs jumped the highest.
How this fits with other research
Cox (2012) warned that adults with autism are 'system orphans.' Paul’s numbers now prove that warning was spot-on.
Whaling et al. (2025) asked moms and dads what the cliff feels like. Parents told the same story: services stop, bills rise, stress spikes.
Chamak et al. (2016) followed 76 French adults. Two-thirds still lived in facilities and relied on aging parents. The cliff Paul saw at 18 stayed steep at 40.
Billstedt et al. (2005) tracked 120 adults for over a decade. Only four lived on their own. Early talk and IQ helped, yet most still lacked supports. Together these studies turn Paul’s snapshot into a lifelong pattern.
Why it matters
Start transition plans by age 14, not 18. List every service the child gets now. Match each one to an adult source: college disability office, vocational rehab, Medicaid waiver. Write the plan into the IEP and the discharge summary. Invite adult agencies early so the cliff becomes a ramp.
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02At a glance
03Original abstract
The present longitudinal study investigated changes in service receipt and unmet service needs spanning 14 years before and after high school exit in a large community-based sample of individuals with autism spectrum disorder (ASD) (n = 204), of whom 59% had co-occurring intellectual disability (ID). Using multilevel models, potential discontinuity of service patterns at the point of high school exit was examined, as well as the rate of change in services received and needed during the high school years and into the post-high school period. Differences between those with and without ID were probed. Study findings indicated that overall, sample members experienced a reduction in receipt of services during high school, particularly for those without co-occurring ID. After high school exit, sample members experienced a decline in services received; for those without ID, there was a continuous rate of loss of services after leaving high school but for those with ID, there was a sharp decline in services received. Unmet service needs increased right after high school exit for both those with and without ID. These patterns reflect loss of entitlement for services that accompanies high school exit, and the limited availability of adult services for individuals with ASD. This study documented not only the post-high school service cliff that has been the subject of much concern, but also that the loss of services begins long before high school exit and that subgroups of the population with ASD are particularly vulnerable. Autism Res 2019, 12: 911-921. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this research, we studied changes in the number of services received before and after high school exit in a large sample of individuals with autism spectrum disorder (ASD). With each passing year during high school, individuals with ASD received fewer services. At the time of high school exit, there was a sharp drop in the number of services received, particularly for those with co-occurring intellectual disability. This study found not only that there is a post-high school service cliff, but also that the loss of services begins long before high school exit.
Journal of autism and developmental disorders, 2016 · doi:10.1007/s10803-016-2787-4