Using State Administrative Data to Examine Aspects of Autistic Adult Life: A Comparative Analysis of Identification,...

Existing outcomes research on autistic adulthood focuses primarily on certain aspects of adult life (e.g., employment) and is limited by methods that are often not representative of whole populations. In the current study, we aimed to use available state administrative data to examine frequencies of receiving state identification, voting, marriage/partnership, and parenting.

In this cross-sectional, population-based study, we accessed Utah state administrative data for 7404 autistic adults born from 1970 to 2002 and matched 1:3 to non-autistic adults (N = 22,213). We identified proportions of documentation of ever achieving each outcome (state identification, voting, marriage/partnership, parenting) and differences by group, sex, race, ethnicity, and co-occurring intellectual disability.

Autistic adults were less likely to have state identification (54.9% vs. 97%, p < 0.001) and to vote (39.4% vs. 51.9%, p < 0.001). However, among only those who had state identification, autistic adults were more likely to vote (55.2% vs. 53.1%, p < 0.05). Autistic males were more likely than autistic females to have state identification and equally likely to vote. Autistic females were more likely than males to be married/partnered and to have offspring. We also observed that married/partnered autistic adults were more likely to divorce than married/partnered non-autistic adults (21.0% vs. 6.1%, p < 0.001). When they had offspring, autistic adults had slightly fewer children on average than non-autistic adults (1.69 vs. 2.00, p < 0.001). There were also racial and ethnic group differences among autistic adults across outcomes. In a subset of the data, individuals with co-occurring intellectual disability were less likely than other autistic Utahns to achieve each studied outcome.

We found significant differences, indicating that autistic adults are less engaged in multiple aspects of adulthood than their non-autistic peers. Findings point to the need for efforts to better support autistic adult self-determination and to address barriers to achieving the studied outcomes, when desired by autistic individuals.

Why is this an important issue?: Studies on autistic adult outcomes usually focus on certain areas of adulthood, such as employment. There are also very few studies that have looked at adult outcomes for a whole U.S. state population of autistic adults. State-wide administrative data can be a useful resource to use to see if autistic adults have had access to the same opportunities as non-autistic adults.What was the purpose of this study?: The purpose of this study was to use statewide data to look at how many autistic adults have state identification, have voted, have been married or partnered, and have been parents. And we wanted to see if those findings differed between autistic and non-autistic adults. We also wanted to see if there were differences in the autistic population based on sex, race, ethnicity, and co-occurring intellectual disability.What did the researchers do?: The researchers accessed Utah state administrative data for 7404 autistic adults and 22,213 non-autistic adults, born from 1970 to 2002. We looked to see if individuals ever had state identification (driver's license or state ID), ever voted, ever married or partnered, and ever had offspring (children). Then we compared autistic and non-autistic groups, autistic males and females, and autistic adults based on race and ethnicity to look for any differences.What were the results of the study?: Autistic adults were less likely than non-autistic adults to have state identification and to vote. However, having state identification was very important for voting. When we looked at everyone who had state identification, autistic adults with identification were more likely to vote. Autistic males were more likely than autistic females to have identification, and they were equally likely to vote. Autistic females were more likely than autistic males to be married/partnered and to parent. We also observed that married/partnered autistic adults were more likely to divorce than non-autistic adults. Autistic adults had slightly fewer children on average than non-autistic adults. There were also racial and ethnic group differences across outcomes. Whether or not autistic adults had co-occurring intellectual disability also made a difference.What do these findings add to what was already known?: There was very little research about how common these outcomes are for autistic adults. This study adds new knowledge about similarities and differences in state identification, voting, marriage, and parenting for autistic adults.What are potential weaknesses in the study?: We were restricted in this study to the available data. We do not know about autistic people who did not have a medically documented diagnosis. We also were unable to look at potential differences related to LGBTQ+ identity or co-occurring conditions. The results might look different in other states.How will these findings help autistic adults now or in the future?: Our findings suggest that there may be reduced opportunity for autistic adults to achieve some adult outcomes, and further limited opportunities for some subgroups of autistic adults. Understanding these group differences can help direct advocacy and development of new resources to support autistic adults.