Social disadvantage and exclusion: adults with autism lag far behind in employment prospects.

t has been almost 70 years since Kanner first described the condition he named early inI fantile autism. In the intervening decades, there have been many thousands of articles published on autism, many changes in how we have come to understand this disorder, and many dollars spent on research into possible causes, mechanisms, diagnostic processes, and potential interventions. However, although autism is (almost always) a life-long condition, the vast majority of these publications have focused on children. Several recent studies have highlighted the imbalance in childversus adult-based autism research, with only a tiny proportion of published articles on autism relating to adults. Of particular concern is the negligible amount of research focusing on interventions for adults. For example, a review by Bishop-Fitzpatrick et al. found that of 1,217 publications involving adults, there were only 13 studies of adequate methodologic quality that evaluated psychosocial interventions. The lack of methodologically sound adult research also has been highlighted in reviews by the U.K. National Institute for Health and Care Excellence and the U.S. Agency for Healthcare Research and Quality. Even epidemiologic research in adults is limited and it is only within the past few years that any attempt has been made to collect systematic data on adult prevalence rates. These (not surprisingly) are just as high as in children (i.e., around 1%), but the adult prevalence study of Brugha et al. also has been important in drawing attention to the very poor social status of adults with autism, including those of normal intellectual ability. Educational attainments are very poor and they are more likely to be within the lowest quintiles for social deprivation. These adults also tend to be very poorly served by