A Literature Analysis On The Quality Of Life In Adults With Autism

Psych Educ, Document ID: 2022PEMJ0, doi: 10.5281/zenodo.7152894, ISSN 2822-4353
Research Article
Balbin et al.
2/12
A Literature Analysis on the Quality of Life in Adults with Autism
Ma. Veronica D. Balbin*, Ashlee Nelle L. Corpus, Godfrey F. Magtibay, Miles Justine C. Rivera,
Gwyneth Phoebe Santos, Jigo Rafael C. Catamio
For affiliations and correspondence, see the last page.
Abstract
The primordial purpose of the contents of this study is to systematically analyze preceding research
works concerning the quality of life of adults who are on the autism spectrum and generate a
substantial remark as to how social themes and facets affect the status quo. This analysis has
attempted to tackle important and notable elements in the foregoing while being guided by the four
domains of the quality of life, namely physical, psychological, social, and environmental domains
as enumerated by the World Health Organization (2012). As stated by the methods of this study, a
semi-systematic approach has been observed throughout this research in order to present relevant
facts from various reliable sources with the integration of the analysis of the researchers as they
discuss the key elements of this study; as well as the attempt to analyze the domains of this research
by content analysis as we ascertain and narrate what particular component of a domain needs more
attention from concerned family members, corporations, institutions, and organizations. Garnering an
ample amount of relevant literature, the researchers have found probable grounds to ascertain that
society as a whole must cooperate in order to improve the quality of life of adults with Autism
Spectrum Disorder.
Keywords: Quality Of Life (QoL), Autism Spectrum Disorder (ASD), Physical Domain,
PsychologicalDomain, Social Domain, Environmental Domain
Introduction
What does it mean to live a “good life”?
Responsibility and independence are the qualities most
adults are expected to possess. The ability to control
and manage one’s own life without having to depend
on the assistance of others is a developing process that
continues through childhood and into adulthood. Being
able to make major life decisions and taking
responsibility for one’s actions may provide a sense of
security and liberty that most adults achieve to have.
However, these expectations on adults can be difficult
to grasp for people who are diagnosed with Autism
Spectrum Disorder (ASD) especially with their
impairment in social, occupational, or other important
areas of functioning. Study shows that the deficits in
social cognition and motor function explains the poor
social functioning of adults with ASD (Bishop-
Fitzpatrick et al., 2017). Along with this impairment is
their experience of widespread problems with social
integration, daily living skills, education, employment,
and independent living. In 2020, nearly half of 25-
year-olds with ASD never had a job and most young
adults with ASD do not receive healthcare for years
upon stopping to see pediatricians (Autism Speaks,
2020).
Majority of the studies focused more on children
regarding Autism Spectrum Disorder (ASD), leading
to the lag behind studies conducted on adults with
ASD. In addition to this, current research evidence
about adults with ASD is limited by small sample sizes
and its ‘high functioning’ participants (Levy & Perry,
2011). In line with the limited number of research
pertaining to the living experience of adults with ASD,
recent studies describe the Quality of Life (QoL) of
these individuals which is defined by the World Health
Organization (WHO) as the perception of an
individual on their position in life within the context of
culture and value system that they live in and with
relation to their goals, expectations, standards, and
concerns (WHOQOL, 2012).
According to research, individuals of all ages with
ASD have an overall lower QoL when measured with
tools designed for the general population (Holmes,
2020). In the same study, it is also reported that
women with ASD have greater challenges, including
sleep quality, anxiety and social isolation, than men
with ASD. Researchers also found that anxiety and
depression explain the lower quality of life in adults
with ASD than the general population (Oakley at al.,
2020). Study also shows that there is interplay between
the domains of QoL, resilience, and QoL levels and
building interventions to target these factors will be a
promising solution to improve the QoL of adults with
ASD (Brinkhof et al., 2021). Hence, it is important to
identify the aspects of the life of adults with ASD that
mostly contributes to their lower level of QoL in order
to develop an appropriate support for them.
Researchers need a deeper understanding of what
matters to adults with ASD and to recognise each
individual’s circumstances to support the improvement

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of their QoL. This may generate matters with which
QoL domain is most impacted, why, and what kind of
aid could be most suitable for these individuals.
In this research, potential themes of QoL are
investigated including variables and domains related to
the QoL of adults with ASD to determine which
domain has the most negative impact on their lives.
Also, cases that exhibit significant problems on the
most negatively impacting domain of QoL on adults
with ASD will be presented to provide evidence to
support the analysis. Lastly, plausible interplay
between the domains of QoL on adults with ASD will
also be investigated.
The researchers aim to acknowledge the challenges of
adults with ASD and find the commonalities in themes
to reveal the domain of QoL that has the most negative
impact on the lives of adults with ASD and whether
interplay between the domains exist. In relation to this,
this study reviews evidence about the QoL for adults
with ASD through literature review and content
analysis. Lastly, it seeks to determine potential
strategies that will help adults with ASD to cope with
the most challenging aspect of their lives.
This study aims to answer the following research
questions:
1. What are the common themes of Quality of
Life in adults with Autism Spectrum Disorder
and how do these affect the level of their
Quality of Life?,
2. Which domain of Quality of Life has the most
negative impact on adults with Autism
Spectrum Disorder, and
3. What are the courses of action to improve the
Quality of Life of adults with Autism Spectrum
Disorder?
Research Gap
In Adults with Autism, there is an unequal amount of
research between adults and children, not only in
western research, but also in the localized Filipino
setting. Health services research specifically, is lacking
for Adults with Autism, this includes problems
exhibited in their health, aging, transition period,
treatment options, and life span. (Murphy, 2016). The
lack of literature studies contribute to how society
disregards and caters more to children not necessarily
to adults, making the case for the research to focus
more on adults instead of children. In the Philippines,
Adults with Autism are shamed by society, they are
neglected of their basic rights such as to an education
when notified of their exceptionality, and even in the
workforce wherein certain privileges such as benefits
and pay already puts them at a disadvantage. (Gohu,
2022). Moreover, society’s expectations towards
adults such as the likes of being independent, being
able to meet societal rules and norms quickly becomes
a whole lot more difficult when these expectations are
not met. In corroboration to this, the Quality of Life of
Adults with Autism are significantly lower than that of
developing adults. (Ayres, 2017).
Methodology
This research will utilize a semi-systematic approach
on literature review to collect and synthesize previous
research in a more or less systematic way. Through the
integration of findings and perspectives from many
empirical findings, this method can address research
questions appropriate for the topic.
Content Analysis will also be applied to identify,
analyze, and report patterns in the form of themes
within a text. (Braun & Clarke, 2006). This method
will determine the similarities and contradictions
among the reviewed text. Moreover, it can also aid the
researchers to interpret data and add their own
interpretations to discuss significant findings in
relation to the literature.
Results and Discussion
It is fundamental in, and generally expected from adult
individuals to possess certain capabilities that enable
them to support themselves and succeed in life. These
capabilities help adults land a job, provide needs for
their children, manage household on their own, and
even contribute in various ways to their community.
When these skills are not honed well, or lack thereof,
there can be limited freedom in maximizing available
resources in the community. Areas like health,
education, and economic vitality can be compromised.
According to The Science of Adult Capabilities (2022),
numerous studies from neuroscience and psychology
shows us that there is a set of core capabilities that
adults utilize in order to manage their lives, work, and
parenting effectively. These core capabilities include,
but are not limited to planning, focus, self-control,
awareness, and flexibility. These capabilities comprise
the umbrella of self-regulation and executive function.

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Practicing self-regulation enables us to be aware of
using the right skills at the right time, as well as
managing our responses to our environment. This
gives us a sense of balance in responding and acting in
the most appropriate manner. In executive functioning,
this refers to our higher-order brain functioning which
is highly necessary in executing, and performing tasks.
Managing one’s time well, planning, organizing, and
executing complex activities well are some
illustrations of our brain-based functions. When it
comes to individuals with autism, such executive
function skills are one of the challenges they
encounter. While this feature does not fall under the
diagnostic criteria for autism, executive functioning
challenges are still found to be associated
(Willoughby, 2016).
Given the autistic individuals’ deficits which are the
basics of social interactions, their everyday life,
especially in adults with autism is presumed to be even
more challenging compared to non-autistic adults.
Some of the autistic individuals’ adult capabilities are
deficient. To illustrate, self-regulation in individuals
can sometimes be more challenging depending on the
situation and context. It is natural, and even automatic
and easier for some, to pick up nonverbal cues and act
accordingly. Managing emotions and resisting less
appropriate responses to a colleague at work can be
difficult, but being capable of doing so means having
awareness and self-control. Deficits in social-
emotional reciprocity and failure to initiate or respond
to social interactions in individuals with autism make
such everyday scenarios to be extra challenging.
Moreover, social support in children, although may not
always be adequate, is normally present. But in
comparison to adults, a different and much less
support is present, given that adults are supposed to
have acquired enough knowledge and capability to be
independent. Hence, this paper chose to focus on
analyzing the quality of life adults with autism have.
This includes how they manage living as adults
compared to non-autistic adults, given that general
factors affecting one’s life (i.e. society in general;
existing stigma on autism) come into play. In one of
the reports concerning the stigma in people with
autism, according to Salamon (2018), 72 percent of the
psychological distress reported in 111 adults with
autism was linked to social stigma, which includes
discrimination and rejection as per British researchers.
Individuals with autism reported that they are treated
as if they are not smart and will not be hired in jobs.
Furthermore, the same report shows that people with
autism spectrum disorder are more prone to anxiety,
depression, and suicide than the general population as
established by a prior research. With the existence of
these in society, as for non-autistic individuals, certain
coping strategies are made. Therefore, we could be
wondering how adults with autism are able to cope
with their external world, while managing and trying
to achieve good social relationships or interactions as a
whole. In terms of coping, in a study about
understanding camouflaging as a response to autism-
related stigma done by Perry et al., (2021), this is one
coping strategy that autistic people use, which refers to
masking or hiding their social difficulties. It was
discussed that the two broad reasons for camouflaging
are to fit into the non-autistic world, and to maintain
relationships. This can also include techniques in
appearing to be socially competent, where one plans
out how his or her actions and expressions should be,
even rehearsed dialogues and eye contact (Bargiela et
al., 2016, as cited in Perry et al., 2021) An example
from the research of Hull et al., (2017), they found that
people with autism used camouflaging because of the
eagerness to associate and to connect with others, as
well as to avoid exclusion and discrimination.
Camouflaging is one of the contributing risk factors of
mental health problems in adults with autism who do
not have intellectual disability. These existing
challenges that people face in society in general,
brings a greater challenge for autistic adults who
struggle to achieve belongingness, and apply certain
coping strategies at the same time. Various internal
and external factors affect the way autistic adults live,
and in different aspects of their lives comes different
levels of difficulty. Even in terms of community
mobility, which is something that is easier to be
maximized by people, there are existing barriers for
autistic adults. Usage of cars, public transport, and the
whole concept of community mobility, which
comprises a whole step-by-step journey, to meet
certain needs are reported by autistic individuals to be
less accessible (Wilson et al., 2021).
The researchers present the following evidence and
analyses on different themes that are negatively
affecting the quality of life of adults with autism.
Relationships
It is a known fact that relationships have a great impact
towards Adults with Autism, whether it be
relationships with parents, friends, love interests, co-
workers or simply, acquaintances. According to Reid
(2022), relationships are made more difficult when
reading social cues, examples of this includes
misinterpreting sarcasm and taking things literally, this
is even made more difficult when neurotypical people
respond negatively towards Adults with Autism when
mistakes are made. Social cues also include being

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irritated over a facial expression or misreading
someone’s mood. In addition, the desire for
consistency can also be affected. According to the
same literature by Reid, in dealing with romantic
partners, the sense of spontaneity may not respond
well to Adults with Autism since they don’t
necessarily respond well to unscheduled events, this
can make certain individuals frustrated and filled with
anxiety.
Moreover, Adults with ASD have been found to
struggle with comprehending the means of
communication and interpreting linguistic sources
including Abstract Language. For these individuals,
Social Language Processing is a challenge because of
their delay in language development or verbal
intelligence. The results of a recent study revealed the
lack of an underlying organizational structure in
managing the increase of processing loads (Williams
et al., 2015). Due to this, the personal relationships and
sex life of individuals with ASD are at risk.
Despite their awareness of their social disability, adults
with ASD still perceive their social deficits to impact
negatively on their quality of life. This suggests that
they need support to maintain social functioning, such
as applying relationship treatment programs to keep
their relationship as well as adapt to the society (Lin,
2014). Furthermore, according to Moss et al (2017) a
table has shown that 62% of adults with ASD are very
poor in the adult social outcome rating.
Adjustments
Having the capability to adapt easily to one’s
environment is an essential part of an individual’s
survival. Different age groups have different
requirements to meet, for example, children must learn
how to socialize in a playgroup without prolonged
assistance of parents, or learn to bond with their
teachers and see them as second parents in the school
setting. As an individual grows and matures, different
milestones are expected to be achieved. Included in
these milestones are the ways a person adjusts and
adapts to new experiences and environments, which
serve as the link in achieving a certain milestone.
Individuals belonging under the autism spectrum
disorder are known to have unique characteristics,
which means unique experiences and different levels
of functioning are present. But commonly, all children
and adults with autism experience adjustments that are
far different and a lot more complicated than those of
non-autistic population. Things become more
challenging and exhausting when adults with autism
are undiagnosed, or even overlooked or misdiagnosed
by psychiatrists, which occurs often in patients (Takara
et al., 2015). According to the same journal, ASD
patients are often misdiagnosed with other psychiatric
comorbidities, which is sometimes caused by difficulty
in getting the accurate information of the patients’
developmental history, or even lack of experience
among the psychiatrists diagnosing the ASD in autistic
adults. A possible cause could also be milder or
atypical traits are exhibited in contrast to the
prominent symptoms of the existing comorbidities.
This is one of the primary factors that lead to a more
challenging daily adjustment to autistic adults. Since
adults are more exposed to the outside world, working,
or in the process of applying or seeking for jobs, and
basically surviving the environment beyond one’s
comfort requires conscious efforts and decisions.
These can be disorienting for undiagnosed autistic
adults. Another illustration, according to Sebater
(2021), some adults with autism who are highly
functional may have no idea that they have the
condition. Some are working with actual jobs and are
independent people, but instances also occur wherein
certain mistakes can sometimes make them feel that
they are failing. Therefore, problems with
relationships, socialization, hypersensitivity to
different stimuli, and experiences of anxiety can
seriously affect and limit their lives. Unawareness of
their own situation, and of their family members
prevents opportunities for psychological attention and
assistance in adjusting to their surroundings. Some
other factors that hinder autistic adults’ attempt to fit
in the environment are the present limitations as they
transition to adult life. For example, according to
Thompson et al., (2018), there is a poor vocational and
educational outcome sustained across the lifespan of
those ASD individuals with average or above average
intellectual capacities. Funding limitations for services
and professionals for training adults with ASD are
encountered as well. Hence, these result in having a lot
of young people with ASD, including their families, to
experience high levels of unmet needs. Additionally,
there is a struggle in maneuvering how these young
individuals with ASD will transition to adult life by
themselves. Moreover, included also in the same study
are family relationships which can majorly affect
transitioning to adult life. It is also concerning that
parental expectations for transitioning well are lower
for parents with ASD children than those parents of
children with other intellectual or multiple disabilities.
In terms of physical adjustments, almost every part of
the environment of individuals with ASD are affected.
In the study of Roberston & Simmons (2015) on
sensory experiences of adults with autism spectrum
disorder, their participants described the extremely

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debilitating effects that negative sensory experiences
could have. Some of these were nausea from the strong
smell of food, or physical pain with light hugs from
people, and even becoming immobile when high-
frequency or low-frequency noises are present. The
presence of these sensory issues hinder lots of daily
activities and responsibilities especially in workplaces.
And in the context of work satisfaction and work
performance, perceptions in these are also affected by
the physical or sensory environment, social
interactions, and attitudes of adults with ASD. And
given the differences in individuals under this
spectrum, different levels and types of adjustment vary
as well.
Individuals need proper guidance on how they can
manage being independent outside their world of
comfort. Coping and adapting to changes are
necessary, but for some, like individuals with ASD,
this can be confusing and extra challenging. For
instance, adapting to a new work environment with a
new group of people to socialize with, for non-autistic
people, this may take a while as they get to know these
new workmates. But for adults with ASD, picking up
the confidence to approach them or to know the best
way to do so is not the first step, but rather surpassing
the barrier first, which is to understand emotional and
social cues. Lack of proper guidance starting from
their childhood, or remaining undiagnosed as they
grow contribute to the difficulties in the transition
process and adult life of people with ASD.
Philippine Government and NGOs
Since the year 2008, a total of twenty-six bills have
been filed in the Senate of the Philippines by different
senators, some either finished their term or simply
passed away. Of all the twenty-six bills filed for more
than a decade, not even a single document has passed
the concerned committee for its discussion and
legislation (Senate Legislative Library, 2022). Truly
there are laws for the handicapped such as RA 7277 or
the Magna Carta for Disabled Person, but legislations
like RA 7277 do not provide ample measure and
attention for adults with ASD since they are
generalized laws for several types of disorders and
disabilities; the specificity of the concern and the goal
to alleviate the problems being faced particularly by
adults with autism are both missing in the context of
laws such as RA 7277, let alone the fact that the
contents of such laws do not really serve the benefit of
current stakeholders since most of them were
legislated during the late 20th century and did not have
the opportunity even for revision or amendment
anymore. It is significant for each adult with autism to
receive ample and sustainable assistance most
especially from the government since it is a guaranteed
Constitutional right (De Leon, 2005). While this might
be the ideal, or perhaps even worse to consider it
unrealistic, scenario for the demography of autistic
adults, the national government seems to forget its
primary duty to its stakeholders particularly those who
have special needs. To give illustration, a senate bill
was introduced by the late Sen. Defensor-Santiago
dated 12 October 2008 which aims to have an in-depth
study about autism and other related issues under the
auspices of the Department of Health; however, in
spite of its noble intentions, it is still under discussion
for customary reasons (Senate Bill 2940, 2008).
Another exemplification is the senate bill filed by Sen.
Antonio Trillanes which is supposed to guarantee a
creation of a commission for persons with autism in
order to pacify their special needs in the society
(Senate Bill 3037, 2009). This, like Senate Bill 2940
filed a year earlier, has suffered the same fate by
sitting on the desk of the senators and being stuck
inside their office drawers for a very long time without
the assurance of getting it, among other laws
pertaining to ASD concerns, back for oral arguments
and future legislation. The supposedly only hope for
people with autism is the legislation of the recent
House Bill 1433, also known as Autism Care Act,
authored by Senator Leila De Lima. However, due to
political issues, Senator De Lima was hindered by the
administration, both in the executive and legislative, to
function properly as a senator which resulted in the
pending status of the aforementioned senate bill.
The discussion together with the process of legislation
of bills is just one concern, what should bother us
more is the arrangement of the people who are
discussing and legislating these bills. When we tackle
the issues in the Senate, we would of course normally
touch the House of the Representatives. During the last
Congress before the 2022 Local and National
Elections, there have been one hundred and thirty-four
partylists in the House of Representatives that are
mandated to serve the sector of the society which they
are representing (Altatis, 2019). Of all the elected
partylists on the 18th Congress, none was for the
service of people with autism. We would now
automatically question the partylist system in the
legislative department because the necessary aid from
the government for people who are suffering a mental
disorder such as Autism Spectrum Disorder is being
deprived from those who are actually in need of it.
There are, however, partylists that garnered seats in the
House while having vague, questionable intentions as
to who they are representing. To demonstrate further,
during the previous elections, a group named Abang

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Lingkod who is supposed to represent farmers had
seized one seat in the Congress. In an investigation in
2012, the group was questioned and disqualified by the
Commission on Elections because its nominees are not
true representatives of farmers, but are rich and
influential businessmen in the local corporate arena
(Mayen, 2012). The said partylist does not, in any
way, actually have an intention to serve its
stakeholders and lobby different house bills in the
Congress for the benefit of the ones they are allegedly
representing (Karapatan, 2012). Another example is
the Anti-Crime and Terrorism Community
Involvement and Support Partylist or ACT-CIS who,
while bearing the title of an anti-terrorist organization,
does not actually represent any vulnerable or
marginalized member of the society (Tiangco, 2019).
This begs the question - if questionable partylists such
as the aforementioned groups can be given the
opportunity to have a seat in the House of
Representatives, why don’t we have any partylist to
represent those who are suffering from mental
disorders? At present, the only partylist which seems
to be concerned of the issues revolving around the
Autism Spectrum Disorder is the Akbayan partylist by
lobbying for House Bill no. 6934 also known as
National Autism Care Plan Act that established a
national program for early screening and detection of
autism, protection of people with autism from
discrimination in schools, colleges, universities, and
training institutions, as well as special protection
during emergencies and disasters, and the creation of
the Autism Council of the Philippines under the
Department of Health that will develop and implement
a sustainable, long-term Philippine Autism Plan. The
bill also mandates for hospitals and medical centers the
inclusion of PhilHealth assistance for patients with
ASD.
Now that we have an idea on the issues in the
government pertaining to the problems of persons with
mental disorders, it is necessary to discuss the role of
the Non-Government Organizations or NGOs in the
country. Through the efforts of several mental health
groups in the country especially MentalHealhtPH, the
first mental health act was legislated dated 2 May 2017
(Santos, 2017). This speaks of the determination of
mental health NGOs particularly in their objective to
include the legislative body in promoting and pushing
for noble advocacies, and in elevating the platform of
discourse in the national level. Adults with autism are
now being catered to in the workplace without the fear
of being discriminated against and excluded from the
ranks of laborers. A PWA’s goal of being independent
is also turning into a reality, as more businesses warm
up to PWAs in the workforce. In 2016, retail giant SM
initiated a workplace inclusion program for PWAs in
17 stores nationwide, in partnership with the Autism
Society Philippines or ASP (Babao, 2019). Even small
businesses welcome PWAs into their little teams.
Puzzle Gourmet Store & Café, a family business in
Quezon City, was established to give their brother an
opportunity to experience work. Since then, they have
been accepting interns diagnosed with ASD (PEP
Lifestyle, 2017). In terms of search for job
opportunities, Autism Society Philippines, through its
program Autism Works Open House, is also providing
work information for families with members that have
autism who are interested in being employed to a
company that is welcoming workers who belong to the
spectrum (Adel, 2018). As workplaces in the country
are working on their inclusivity for people with
autism, the Association for Adults with Autism
Philippines went ahead and built ‘A Special Place’ —
a soon-to-rise 9,000-sq.m. residential community in
Alfonso, Cavite. It will accommodate adults with
autism, other people with special needs, and family
members who wish to live with their loved ones. It’s a
safe, nurturing, and sustainable community where
adults with ASD can thrive independently and receive
appropriate health, educational, vocational, and
wellness services (Losorata, 2018).
Threats
ASD in adults brings increased risk in various physical
and health threats. An adult with ASD can face
multiple challenges in his life such as exploitation,
bullying, and alcohol abuse (Minot, 2021). Individuals
with ASD are likely susceptible to exploitation due to
their inability to recognize that offenders are
intentionally deceiving them at their expense.
Deception can also be a tool to lure people with ASD
towards dangerous activities.
Aside from issues in physical threats - comorbidity of
disorders in particular - such as Anxiety, Depression,
Epilepsy, Attention Deficit Hyperactivity Disorder
(ADHD), Schizophrenia, Obsessive Compulsive
Disorder (OCD), and Bipolar Disorder, the attention of
concerned individuals must also see the physical
domain wherein adults who have ASD are having
trouble with. Most common illnesses which can be
seen to autistic adults are gastrointestinal problems
such as chronic constipation, abdominal pain,
gastroesophageal reflux, and bowel inflammation. A
documentation by Autism Services of Saskatoon
(2022) has shown that adults with ASD are also
suffering from sleep dysfunction and sensory
integration dysfunction which affect the basic senses
including movement and proprioception. The same

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journal suggests that both hypersensitivity and
hyposensitivity are correlated to autism; wherein
hypersensitivity is the inability to tolerate wearing
tight clothing and being touched, and hyposensitivity
might be apparent in a person’s increased tolerance of
pain or a constant need for sensory stimulation. In
addition, there is also an increased risk of immune
disorders such as allergies or asthma, metabolic
disorders such as diabetes, heart disease, and obesity
(Croen et al., 2015).
One dominant concern among adults with autism is the
motor problem which includes balance and
coordination. While these are visible during adulthood,
one must understand that the problems on the physical
domain of adult ASD did spring up since the early
years of infancy. For example, Furuta, et al., (2012)
demonstrated in their study that the gastrointestinal
problems which are tied to people with autism can be
mitigated as early as childhood. Sarris (2018) narrated
that motor problems often start during infancy and
have only persisted when an individual with autism
has reached adulthood. Aside from these medical
findings, the advancement in the field of physical
therapy is shedding a new light so that innovative
methods can be utilized to treat several underlying
conditions under the physical domain which affect the
QoL of adults with ASD. A web journal by Autism
Connect (2020) suggests that coordination therapy
helps improve the necessary body muscles to enhance
balancing and limb coordination, while increasing the
stamina also aids the individual in his overall physical
welfare. Elemy (2020) asserts that while postural
issues are common among the autism spectrum, it is
easier to treat this specific problem during adolescence
to adulthood through various therapy programs since
the human body has been partially or completely
developed depending on the person’s age and because
postural control do not seem to immediately or
gradually improve until 12 years old and above.
Moreover, adults with ASD are also at risk for motor
disorders such as cerebral palsy (Croen et al., 2015).
Threats to adults with ASD need to be identified
through the life experiences of these individuals to be
able to train them in becoming vigilant.
Opportunities
According to one research, it has stated that around
half of the participants are currently unemployed,
while those who are employed only live with small
salaries (Lin, 2014). In addition to that, because of the
housing, taxation, and other local policies, most of the
adults with ASD often experience risk factors like
chemical exposure as well as lack of access to care.
Also, due to them living in minor areas, medical
specialists are less likely to execute their practices in
lower-income areas (Anne, 2018).
Nowadays, adults with ASD are still facing challenges
in the workplace. Recent study shows that individuals
with ASD that have graduated for two years have no
job experience and are struggling to find the suitable
workplace for them (Arky, 2021). However, despite
this challenge, non-government organizations are
building programs that are suited for PWDs such as
adults with ASD in order to provide them a positive
QoL. For instance, Project Inclusion, an NGO based in
the Philippines, is offering job opportunities to PWDs
and training regarding Autism Sensitivity.
On the other hand, organizations have provided
employment support to adults with ASD. Despite
having particular difficulties in the workplace, NGOs
are training these individuals in interviewing
techniques, customer relations, socialising, and
understanding different organizational cultures
(Matusiak, 2021).
In an episode of GMA News’ (2017) Reel Time
featuring Vico Cham, a Filipino adult who is under the
autism spectrum, his life as an employee was filmed to
show his capabilities as a Graphics and Admin
Assistance despite his exceptionality. It also features
the Project Inclusion campaign that aims to support
Persons With Disability to have long-term and gainful
employment to give them a positive QoL. Vico has a
close relationship with his co-worker, Rose, who
guides Vico on his work and keeps him in following
his routine. He was hired based on his ability, so
despite his social and behavioral struggles, he still
became productive and sociable with the people in his
workplace. The most effective factor that led to the
steady employment of Vico is the employees’ training
on Autism Sensitivity wherein his co-workers were
given an understanding of how to approach individuals
with ASD. “You’re missing half of your life,” says
Judy Santiago when asked to describe her experience
of socializing with Vico because she has observed that
people with ASD like Vico can be detail-oriented, a
trait that most of them would often neglect. Vico’s
experience with Project Inclusion is an indication that
employment is a major contributor to the QoL of
adults with ASD.
The career paths suggested for adults with ASD who
possess characteristics such as innovative thinking,
sustained focus, attention to detail, and superior
memory includes IT careers, Journalism, Animal
Science, Photography, Librarian, Science and

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Technology Research, Manufacturing, and Accounting
(Drake, 2022).
Treatments & Needs
Unfortunately, there is no cure for individuals who are
diagnosed with autism spectrum disorder. But Osborn
(2021) stated that there are several ways to help
improve the quality of life of a person with ASD;
therapy and medication.
The following are the different approaches to help in
treating autism:
a. Applied Behavior Analysis (ABA)
This therapy contains a reward system that helps
therapists elicit a positive behavior from their patient.
According to WebMD Editorial Contributors (2021), it
is designed to improve social skills as well as
emotional skills. As the patient continues to undergo
ABA, they will soon learn the social dos and don’ts to
be better prepared for real life situations.
b. Cognitive Behavioral Therapy (CBT)
This is a type of therapy that is effective in helping the
patient to recognize certain emotions of others and
oneself and learn how to cope better in social
situations. Based on an article written by Davis (2022),
CBT rests on the assumption that the reason why
individuals with ASD are behaving negatively with
their surroundings is due to their way of thinking as
well as interpretation on life events. Thus, CBT is a
form of psychotherapy that can help the person
implement new ways to behave positively by changing
their thought patterns.
c. Social Skills Training (SST)
It is without a doubt that people with autism tend to
have difficulties when it comes to socializing with
others. Some of them prefer to be with a familiar,
while others don’t know how to initiate a conversation.
Therefore, most individuals with ASD tend to become
lonely and depressed due to this challenge. However,
with the help of SST they will slowly be able to learn
the basic social skills, such as starting a conversation,
understanding one’s emotion, as well as sense of
humor (Osborn, 2021). This training is best effective
by gathering a group of other ASD individuals and
making them practice interacting with one another.
d. Sensory Integration Therapy (SIT)
All of us have the five senses, we can see, hear, taste,
smell, and touch at the same time. But when it comes
to people with autism, they can only do the five senses
one at a time. The main purpose of this therapy is to
help the individuals use all their senses together, by
doing physical activities and exercises in order to
effectively use their sensory information. In addition to
that, SIT has been claimed to improve repetitive
behavior and challenging behavior (RaisingChildren
Website, 2022).
e. Occupational Therapy (OT)
When it comes to describing an adult, the first word
you will think of is “being independent.” However, it
is not in this case. People with ASD tend to have
learning disabilities, developmental delay, sensory
processing disorder, and many others. Therefore, the
OT is responsible to aid in fundamental skills that are
needed in our daily lives. Some of them will think that
the therapy is essential in building skills such as
cooking, cleaning, dressing, and etc. While others say
it helps them to manage their stress, physical stamina,
as well as increase participation in recreational
activities (Rudy, 2020)
f. Speech Therapy
Socializing with others, doesn’t necessarily mean you
are speaking to them verbally. Communication can be
either speaking, writing, body language, hand gestures,
sign language, and so much more. But not every
individual is facing the same dilemma as the other,
because communication varies from one person to
another. A few of them don’t have the ability to talk,
while others want to talk, but have some difficulties in
holding a conversation. According to the Autism
Speaks Website (n.d.), the individuals will learn how
to strengthen their mouth, jaw, and neck muscles, use a
speech app on a device, match emotions with the right
facial expression, and many more activities to improve
their communication skills.
g. Medication
According to Osborn (2021), he stated that medication
does not cure autism, but it might help with certain
symptoms of autism.
To name a few: Antipsychotics (to treat psychotic
experiences), Antidepressants (treatment for
depression), Stimulants (for ADHD and narcolepsy),
and Anticonvulsants (treatment for epilepsy).

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Conclusion
The four domains namely, Physical, Psychological,
Environmental, and Social Domains have shown
different facets of problems faced by Adults with
Autism. Firstly, Physical Domain exhibits problems
from motor skills, the unknown reason of comorbid
physiological problems such as ASD being prone to
gastrointestinal diseases. Secondly, Psychological
Domain shows problems in emotional cues, deep
empathy and feelings for others, in addition,
psychiatric disorders such as ADHD, depression and
anxiety disorders are clearly seen. Thirdly,
Environmental Domain displays problems in
unemployment, security, perception, social care and
participation in leisure activities. Lastly, Social
Domain which primarily affects the communication
and behavioral traits of Adults with Autism. These
problems include the environment is not being
inclusive and supportive and the lack of knowledge of
how people treat Adults with Autism. (ABC 10 UP,
2015). According to Geurts, H. & Van Heijst, BF.
(2014) Autism is a lifelong neurodevelopmental
disorder which has a huge impact on their quality of
life. Unfortunately, the developmental trajectory of
quality of life is not yet well understood. Problems that
are introduced from the four domains may interplay
and overlap with one another. When one problem
arises from a specific domain, it is inevitable to not
affect the other domains as well. The researchers were
able to provide sufficient information regarding
specific problems from the domains stated, mainly
about problems with Relationships, Adjustments,
Governments and NGOs, Threats, Opportunities, and
Proper Treatments. Understanding factors associated
with quality of life among adults with autism can
contribute to addressing their needs. Hence, the
researchers recommend that adults with autism engage
in activities that could be helpful with their
exceptionalities, these include therapy, peer
counseling, and recreational activities. Additionally,
legislations that are specific, well defined, and action
oriented must be strictly executed to improve the
situation of adults with autism. Lastly, proper
treatments must be accessible for those who are in dire
need of these services and adults with exceptionalities,
like adults with autism, must always be prioritized and
taken care of.
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Affiliations and Corresponding Information
Ma. Veronica Balbin
National University - Fairview, Philippines
Ashlee Nelle Corpus
Godfrey Magtibay
Miles Justine Rivera
Gwyneth Phoebe Santos
Jigo Rafael Catamio, MAEd, RGC

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