A - 61 Lifelong Intellectual Developmental Disorder and Autism Spectrum Disorder Diagnosed in Early Adulthood: Implications for a Patient Residing in Frontier America

Abstract Objective Individuals residing in frontier America often lack access to specialized medical care. Obstacles to receiving accurate diagnosis and intervention of neuropsychological conditions in childhood is common and individuals and families may have difficulty in adapting to the implications of such diagnoses later in life. Methods This 18-year-old Caucasian male from frontier Kansas first presented for neurological or neuropsychological workup in adulthood. History was noteworthy for premature birth, late attainment of milestones, respiratory conditions resulting in multiple instances of cardiac arrest, and facial dysmorphism. Education was attended remotely due to risk of respiratory infection. Parents reported several atypical traits, including hyperfixation on automobiles, high pain threshold, and low frustration tolerance resulting in outbursts. Patient was considered socially and academically delayed, which parents attributed to remote school attendance. No support services were in place. Results Neuropsychological evaluation showed FSIQ = 71 and pronounced executive dysfunction. Parental questionnaire evidenced deficits in adaptive functioning, most pronounced in self-direction and social skills. Patient and parents denied significant concerns on behavioral health questionnaire. Paraeducator endorsed concerns in atypicality, attention/learning problems, and functional communication. Conclusions This young man’s presentation and estimated cognitive and functional abilities are consistent with mild intellectual developmental disorder and autism spectrum disorder. On feedback, this information was distressing to parents; capabilities in some complex tasks may have masked his deficits. Although parents were resistant to findings, it is believed these labels will assist in explaining abnormal behaviors, attaining services, and facilitating genetic testing and related medical care.