Friendship, Employment, and Well-Being in Adults with Autism Spectrum Disorder

Long-term outcomes for Autism Spectrum Disorder (ASD) vary. This study assessed friendship, employment, and well-being in adults with ASD in Bahrain, diagnosed 20 years prior. The objective was to determine the levels of friendship, employment opportunities, and general well-being of a cohort of participants with ASD from childhood to adulthood in an Arabic country. A cross-sectional study traced young adults diagnosed with ASD in childhood (n=81/114; 81% response rate). Caregivers (mostly mothers) provided information via interview on a fact sheet covering demographics, diagnosis age, comorbidities (epilepsy, intellectual disability [ID], family mental illness), relationships, employment, education, medication use, and living situation. The study was conducted from November 2022 to January 2023; the setup was the centers for the Bahraini Association for Intellectual Disability and Autism. Outcomes were notably poor. Only 3 participants (3.7%) were employed, and only 6 (7.4%) had completed high school or higher education. While 12 participants (14.8%) reported a relationship lasting over one year, none were married. All individuals lived with family and utilized rehabilitation services. Significant comorbidities and challenges were prevalent: 42 (51.9%) used medication. Comorbid ID was highly prevalent (31 participants, 37%). The cohort showed poor long-term prognoses, particularly regarding relationships and employment. Almost half had inferior outcomes. ASD combined with ID constituted a distinct group with lower outcomes. Future research should focus specifically on ASD groups without ID and compare outcomes to the general population.