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Jones DR, Botha M, Ackerman RA, King K, Sasson NJ. Non-autistic observers both detect and demonstrate the double empathy problem when evaluating interactions between autistic and non-autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2053-2065. [PMID: 38149622 PMCID: PMC11308351 DOI: 10.1177/13623613231219743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
LAY ABSTRACT The "double empathy problem" refers to breakdowns in communication and understanding that frequently occur between autistic and non-autistic people. Previous studies have shown that autistic people often establish better rapport and connection when interacting with other autistic people compared to when interacting with non-autistic people, but it is unclear whether this is noticeable to non-autistic observers. In this study, 102 non-autistic undergraduate students viewed and rated video recordings of "get to know you" conversations between pairs of autistic and non-autistic adults. Sometimes the pairs were two autistic people, sometimes they were two non-autistic people, and sometimes they were "mixed" interactions of one autistic and one non-autistic person. Observers tended to rate non-autistic participants and their interactions the most favorably, but-consistent with the "double empathy problem"-they rated mixed interactions between autistic and non-autistic people as the least successful. They also perceived that only non-autistic people disclosed more when interacting with a non-autistic conversation partner. Autistic participants' partners in the conversations tended to evaluate them more favorably than did outside observers, suggesting that personal contact may facilitate more positive evaluations of autistic people. Furthermore, observers expressed less social interest in participants than did the autistic and non-autistic participants in the interactions. Together, these findings suggest that non-autistic observers both detect and demonstrate some aspects of the double empathy problem.
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Kim SY, Song DY, Bottema-Beutel K, Gillespie-Lynch K. Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:798-815. [PMID: 37886792 DOI: 10.1177/13623613231205915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
LAY ABSTRACT How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people's behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.
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Affiliation(s)
| | - Da-Yea Song
- Seoul National University Bundang Hospital, South Korea
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Muraškaitė I, Žardeckaitė-Matulaitienė K. The effect of autism phenotype and diagnosis disclosure on students' desire for social distance from autistic peers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241230128. [PMID: 38411107 DOI: 10.1177/13623613241230128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
LAY ABSTRACT Autistic students experience loneliness, rejection from peers, which might negatively affect both their well-being, as well as academic results. Others have studied this topic, however, the existing research does not analyze the desire for social distance from autistic female students in higher education. The goal of this study was to evaluate whether the way autism is expressed and disclosing the autism diagnosis had an effect on students' willingness to interact with autistic male and female students. We also analyzed participants' knowledge about autism, contact with autistic people in the past and its pleasantness in relation to their willingness to interact with autistic students described in the scenarios of the present study. We found that students were less willing to interact with autistic male students compared to autistic female students, as well as with autistic students whose diagnosis was not disclosed compared to autistic students whose diagnosis was disclosed to the raters. In addition, students who reported more pleasant contact with autistic individuals in the past were more willing to socially interact with autistic students if their diagnosis was disclosed. Students with higher knowledge of autism expressed greater willingness to interact with autistic males and autistic students regardless of diagnosis disclosure. Findings suggest that autistic males and individuals who prefer not to disclose their diagnosis are more vulnerable to social exclusion. More subtle expressions of autism need to be researched further.
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Solís García P, Real Castelao S, Barreiro-Collazo A. Trends and Challenges in the Mental Health of University Students with Disabilities: A Systematic Review. Behav Sci (Basel) 2024; 14:111. [PMID: 38392464 PMCID: PMC10886039 DOI: 10.3390/bs14020111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
This systematic review examines mental health in university students with disabilities, focusing on increasing prevalence and associated challenges. Following the PRISMA protocol for study selection and analysis, it aims to analyze problem prevalence and risk factors, explore support strategies and available resources, and identify gaps and areas for improvement in care and access to mental health services for disabled university students. This review includes 16 articles that met the established criteria. The findings reveal higher mental health issue prevalence in these students compared to non-disabled peers, highlighting the need for specific, tailored interventions. Improvement areas in general inclusion measures to prevent high-risk situations and intervention responses to discomfort and existing mental health problems are discussed. The importance of a holistic approach to ensure their overall well-being and academic success in an inclusive educational environment is emphasized.
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Brandsen S, Chandrasekhar T, Franz L, Grapel J, Dawson G, Carlson D. Prevalence of bias against neurodivergence-related terms in artificial intelligence language models. Autism Res 2024; 17:234-248. [PMID: 38284311 DOI: 10.1002/aur.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024]
Abstract
Given the increasing role of artificial intelligence (AI) in many decision-making processes, we investigate the presence of AI bias towards terms related to a range of neurodivergent conditions, including autism, ADHD, schizophrenia, and obsessive-compulsive disorder (OCD). We use 11 different language model encoders to test the degree to which words related to neurodiversity are associated with groups of words related to danger, disease, badness, and other negative concepts. For each group of words tested, we report the mean strength of association (Word Embedding Association Test [WEAT] score) averaged over all encoders and find generally high levels of bias. Additionally, we show that bias occurs even when testing words associated with autistic or neurodivergent strengths. For example, embedders had a negative average association between words related to autism and words related to honesty, despite honesty being considered a common strength of autistic individuals. Finally, we introduce a sentence similarity ratio test and demonstrate that many sentences describing types of disabilities, for example, "I have autism" or "I have epilepsy," have even stronger negative associations than control sentences such as "I am a bank robber."
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Affiliation(s)
- Sam Brandsen
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Tara Chandrasekhar
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Jordan Grapel
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - David Carlson
- Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina, USA
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Birnschein AM, Ward OF, McClain AB, Harmon RL, Paisley CA, Stevens M, Tomeny TS. Qualitative Ascriptions of Autistic Behavior by Non-Autistic College Students. J Autism Dev Disord 2024:10.1007/s10803-024-06248-y. [PMID: 38280138 DOI: 10.1007/s10803-024-06248-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 01/29/2024]
Abstract
In studies that assess perceptions of autistic people by non-autistic people, researchers often ask participants to review vignettes depicting fictional autistic characters. However, few studies have investigated whether non-autistic peers accurately identify these hypothetical individuals as being on the autism spectrum. Accurately ascribing autism as a cause of depicted behaviors likely influences perceptions about autistic peers. In this study, 469 college students (Mage = 18.62; 79.3% female) ascribed cause(s) of an autistic peers' behaviors as depicted in a written vignette. We reviewed and categorized open-ended responses into 16 categories. Non-autistic college students primarily attributed an autistic vignette character's behavior to non-autistic origins. The most commonly ascribed causes of behavior were: attention-deficit/hyperactivity disorder (55.4%), inattention symptoms (20.9%), autism (12.8%), generalized anxiety disorder (11.7%), hyperactivity (11.3%), an unspecified diagnosis (10.7%), an environmental influence (9.6), anxiety or insecurity (8.3%), irritability or anger or annoyance (6.0%), social anxiety disorder (5.3%), and learning disorder (5.1%). Additional ascribed causes include other mental health diagnoses; environmental stressors; and cognitive, emotional, behavioral, biological, or personality characteristics/etiologies. Non-autistic young adults may not always recognize their autistic peers as autistic, which may affect acceptance and inclusion. Future anti-stigma interventions should assess the impact of helping non-autistic peers to accurately identify and better understand behaviors associated with autism. Additionally, autism-focused researchers using vignettes should assess participants' awareness of the character as autistic and interpret their findings with this in mind.
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Affiliation(s)
- Allison M Birnschein
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA.
| | - Olivia F Ward
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
| | - Amaya B McClain
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
| | - Rachel L Harmon
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
| | - Courtney A Paisley
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
- Children's Hospital Colorado, Aurora, CO, 80045, USA
| | - Michelle Stevens
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
| | - Theodore S Tomeny
- Department of Psychology, The University of Alabama, Box 870348, Tuscaloosa, AL, USA
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7
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Scheeren AM, Olde Dubbelink L, Lever AG, Geurts HM. Two validation studies of a performance validity test for autistic adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-13. [PMID: 38279835 DOI: 10.1080/23279095.2024.2305206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
In two studies we examined the potential of a simple emotion recognition task, the Morel Emotional Numbing Test (MENT), as a performance validity test (PVT) for autism-related cognitive difficulties in adulthood. The aim of a PVT is to indicate non-credible performance, which can aid the interpretation of psychological assessments. There are currently no validated PVTs for autism-related difficulties in adulthood. In Study 1, non-autistic university students (aged 18-46 years) were instructed to simulate that they were autistic during a psychological assessment (simulation condition; n = 26). These students made more errors on the MENT than those instructed to do their best (control condition; n = 26). In Study 2, we tested how well autistic adults performed on the MENT. We found that clinically diagnosed autistic adults and non-autistic adults (both n = 25; 27-57 years; IQ > 80) performed equally well on the MENT. Moreover, autistic adults made significantly fewer errors than the instructed simulators in Study 1. The MENT reached a specificity of ≥98% (identifying 100% of non-simulators as non-simulator in Study 1 and 98% in Study 2) and a sensitivity of 96% (identifying 96% of simulators as simulator). Together these findings provide the first empirical evidence for the validity of the MENT as a potential PVT for autism-related cognitive difficulties.
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Affiliation(s)
- Anke M Scheeren
- Dutch Autism & ADHD Research Center, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Linda Olde Dubbelink
- Dutch Autism & ADHD Research Center, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Anne Geeke Lever
- Dutch Autism & ADHD Research Center, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Hilde M Geurts
- Dutch Autism & ADHD Research Center, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
- Dr. Leo Kannerhuis, autism clinic, Amsterdam, the Netherlands
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8
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Taresh SM, Morett LM, Zaid SM, Roslan S, Taresh Taleb M, Song P, Ahmad NA, Noman S. Preschool teachers' knowledge, beliefs, and self-efficacy concerning autism: A parallel mixed-methods study of an intervention to improve autism identification. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:239-253. [PMID: 37982401 DOI: 10.1177/13623613231211850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
LAY ABSTRACT Preschool teachers can play a critical role in early detection of autism. Equipping preschool teachers with prerequisite knowledge and skills would allow them to identify children with probable autism and referral to diagnostic services. This study aimed to investigate the impact of an educational module (EMiASD) that prepared preschool teachers to identify autism symptoms. The sample included 144 preschool teachers, of which 120 were stratified and randomly assigned to an intervention arm receiving training in EMiASD (n = 60) or a comparison arm receiving standard training (n = 60) using a parallel mixed-methods design. Responses to open-ended questions about video case studies revealed improvement in the identification of autism symptoms in preschool teachers in the intervention arm, in contrast to preschool teachers in the comparison arm. Moreover, significant changes in knowledge, belief, and self-efficacy about autism favoured EMiASD. Overall, these results demonstrate the influence of EMiASD in the Yemeni cultural context.
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Affiliation(s)
| | | | | | | | | | - Pu Song
- Guiyang Preschool Education College, China
| | | | - Sarah Noman
- Faculty of Medicine & Health Sciences, Universiti Putra Malaysia
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Araujo AGR, da Silva MA, Bandeira PFR, Gillespie-Lynch K, Zanon RB. Stigma and knowledge about autism in Brazil: A psychometric and intervention study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:215-228. [PMID: 37128155 DOI: 10.1177/13623613231168917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
LAY ABSTRACT To promote the full inclusion of autistic people, we must change the knowledge and attitudes of non-autistic individuals. Unfortunately, access to autism information and support remains limited in Brazil, and stigma is also common. Brazilian researchers reached out to a researcher in the United States to co-develop Brazilian surveys to measure autism stigma and knowledge. Together, they made Brazilian versions of stigma and knowledge surveys which autistic people in the United States had helped make. They also adapted an online autism training used in other countries with help from three Brazilian autistic people and the mother of an autistic child. They used the new measures to see if the autism training improved autism stigma and knowledge among Brazilians. The surveys, called EARPA and ECAT in Brazil, were translated into Portuguese in a previous study. In the first study in this article, 532 Brazilians completed the stigma measure and 510 completed the knowledge measure. The researchers used exploratory graph analysis, which uses the connections between items in a survey to understand which items belong together. Seventy-nine Brazilians participated in the training. They were mostly white, female university students. The EGA showed that the stigma survey measured one big idea while the knowledge survey measured four ideas: diagnosis/cause; socio-communicative development; stimming and special interests; and autism in adulthood. Both scales are promising and may be helpful in future Brazilian and cross-cultural studies about autism. Participants reported more knowledge and less stigma after the autism training, which has been found in other countries too.
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Kim SY, Gillespie-Lynch K. Do Autistic People's Support Needs and Non-Autistic People's Support for the Neurodiversity Movement Contribute to Heightened Autism Stigma in South Korea vs. the US? J Autism Dev Disord 2023; 53:4199-4213. [PMID: 36071317 PMCID: PMC9450814 DOI: 10.1007/s10803-022-05739-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/21/2022]
Abstract
We examined stigma towards vignette characters representing diverse autistic characteristics (social, non-speaking, or repetitive interests or restricted behaviors; RIRB) among 259 South Korean and 240 American participants (age range = 18 ~ 74). Within each domain, participants were randomized to read a vignette depicting low or high support needs. Koreans reported greater stigma towards autistic characteristics and less awareness of and support for the neurodiversity movement than Americans. Autistic characters' support needs and rater characteristics (autism knowledge, neurodiversity endorsement, and contact quantity) predicted stigma in at least one domain, and after accounting for these variables, participants' nationality was suggestively associated only with stigma towards social characteristics and RIRB. Findings highlight the need for culturally adapted-training that provides contact with diverse autistic people.
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Affiliation(s)
- So Yoon Kim
- Department of Teacher Education, Duksung Women's University, 33, Samyang-ro 144-gil, Dobong-gu, Seoul, 01369, Republic of Korea.
| | - Kristen Gillespie-Lynch
- Department of Psychology, College of Staten Island, Staten Island, 2800 Victory Blvd, Staten Island, NY, 10314, USA
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Jones DR, Sasson NJ. A mixed method comparison of stigma toward autism and schizophrenia and effects of person-first versus identity-first language. Front Psychiatry 2023; 14:1263525. [PMID: 37965364 PMCID: PMC10641499 DOI: 10.3389/fpsyt.2023.1263525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction While stigma toward autistic individuals has been well documented, less is known about how autism is perceived relative to other stigmatized disabilities. As a highly stigmatized condition with similar social cognitive features to autism, schizophrenia may offer a useful comparison for stigma. Previous studies have found that autistic people may be perceived more favorably than those with schizophrenia, but little is known about the underlying volitional thoughts that contribute to differences in how these conditions are perceived. Methods The present study utilizes a mixed-methods approach, allowing for a detailed understanding of how young adults perceive different diagnostic labels. 533 college undergraduates completed questionnaires reflecting their perceptions of one of eight diagnostic labels: four related to autism (autism, autistic, autism spectrum disorder, or Asperger's), two related to schizophrenia (schizophrenia or schizophrenic), and two related to an unspecified clinical condition (clinical diagnosis or clinical disorder). Participants also completed an open-ended question regarding their thoughts about, and exposure to, these labels. Responses were compared across broader diagnostic categories (autism, schizophrenia, general clinical condition), with thematic analysis used to assess the broader themes occurring within the open-ended text. Results While perceptions did not differ significantly for person-first and identity-first language within labels, several differences were apparent across labels. Specifically, quantitative results indicated greater prejudice towards autism and schizophrenia than the generic clinical condition, with schizophrenia associated with more perceived fear and danger, as well as an increased preference for social distance, compared to autism. Patterns in initial codes differed across diagnostic labels, with greater variation in responses about autism than responses about schizophrenia or the general clinical condition. While participants described a range of attitudes toward autism (patronizing, exclusionary, and accepting) and schizophrenia (fear, prejudice, and empathy), they refrained from describing their attitudes toward the general clinical label, highlighting the centrality of a cohesive group identity for the development of stigma. Finally, participants reported a number of misconceptions about autism and schizophrenia, with many believing features such as savant syndrome to be core characteristics of the conditions. Conclusion These findings offer a more detailed account of how non-autistic individuals view autism and may therefore aid in the development of targeted programs to improve attitudes toward autism.
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Rivera RA, Bennetto L. Applications of identity-based theories to understand the impact of stigma and camouflaging on mental health outcomes for autistic people. Front Psychiatry 2023; 14:1243657. [PMID: 37743980 PMCID: PMC10511883 DOI: 10.3389/fpsyt.2023.1243657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Autistic people have long been conceptualized from a deficit-based model of disability, but recent self-advocates and scholars have asserted the importance of recognizing autism as both a disability and an important part of a person's social identity. The autistic identity is subject to specific stigma and stressors beyond everyday discrimination and prejudice, which can have many downstream implications on mental health and well-being. Prior research on camouflaging has explained both quantitatively and qualitatively how autistic people conform to norms and mask their autistic traits to better fit in with non-autistic societal standards. Given this paradigm shift in understanding autistic peoples' lived experiences, researchers must also begin to reshape the theories guiding their work in order to improve diagnosis, intervention, and supports. This review examines the extant research on identity-related stigma and camouflaging and their subsequent impacts on mental health outcomes in autism. A model is proposed integrating identity-based theories-specifically the social model of disability, social identity theory, and minority stress model-to explain relationships across research areas and better explain the experiences of autistic people. We discuss how identity-based theories can be applied in autism research to better understand the impacts of stigma and camouflaging on autistic peoples' lived experiences and reduce disparities in their mental health outcomes.
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Affiliation(s)
- Rachel A. Rivera
- Department of Psychology, University of Rochester, Rochester, NY, United States
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Hotez E, Giwa Onaiwu M. A Neurodiversity-Oriented Approach to Address Autism Wandering as a "Problem Behavior" in Pediatrics. Cureus 2023; 15:e40862. [PMID: 37492814 PMCID: PMC10363653 DOI: 10.7759/cureus.40862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 07/27/2023] Open
Abstract
Pediatricians are frequently tasked with addressing autism "problem behaviors," including wandering, defined as leaving the safety of a responsible person's care or a safe area (alternatively referred to as elopement). In the following commentary, we - as autism researchers and individuals with lived experience - discuss the prevalence and public health consequences of wandering. We conceptualize wandering in the context of "problem behaviors" for autistic individuals and describe the current state of the evidence on wandering prevention and intervention. We emphasize that pediatricians have a unique opportunity to optimize their efforts to address wandering - as well as related "problem behaviors" - utilizing a neurodiversity orientation. This will allow them to enact approaches that address the potential upstream mechanisms underlying wandering to make these efforts more effective and provide critical assistance to families. In this manuscript, we provide recommendations to pediatricians to more effectively address the mechanisms underlying and exacerbating these challenges to improve the health, well-being, and quality of life of autistic children and their families. In particular, we recommend that pediatricians focus efforts toward 1) addressing the link between chronic stress and "problem behaviors"; 2) engaging individuals, caregivers, and families as experts in their health and development; and 3) collaborating with the systems and sectors relevant to autistic individuals and their families.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, USA
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14
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Hotez E, Chua KJ, Samras N, Smith AM, Kuo A. Preliminary Pilot-Testing of Social Determinants of Health Screener for Individuals With Intellectual and Developmental Disabilities in Med-Peds. Cureus 2023; 15:e38541. [PMID: 37273312 PMCID: PMC10239263 DOI: 10.7759/cureus.38541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
In the United States, one in six children has an intellectual and/or developmental disability (I/DD), including attention deficit hyperactivity disorder (ADHD), autism, cerebral palsy, learning disabilities, seizures, and developmental delays, with or without intellectual impairment. Individuals with I/DDs experience disproportionate rates of immune, metabolic, cardiovascular, and neurological disorders, as well as anxiety, depression, functional somatic symptoms, and other co-occurring physical and mental health conditions. During the coronavirus disease 2019 (COVID-19) pandemic, having an I/DD emerged as one of the strongest predictors of contracting and dying from COVID-19. These findings spurred increased attention toward the myriad health inequities affecting this population well before the pandemic. While inequities for individuals with I/DD can be traced to many factors, social determinants of health (SDOH) - the underlying social, economic, and environmental conditions that lead to poor health outcomes and high healthcare costs - are key contributors. Our interdisciplinary combined internal medicine and pediatrics (Med-Peds) team of physicians, psychologists, and researchers within a large, diverse, academic health system aimed to pilot-test the implementation of a five-item SDOH screener within a Med-Peds specialty clinic focused on the developmental needs of individuals with I/DD and their families (Leadership Education in Neurodevelopmental Disabilities {LEND}) and a general primary care practice (PCP). The SDOH screener tested in this initiative includes five items from the Accountable Health Communities (AHC) Health-Related Social Needs Screening Tool (HRSN) assessing social isolation, food insecurity, transportation, and paying for basic needs, such as housing and medical care. In this study, we describe the process of implementing this screener and collecting initial pilot data from 747 patients between October 2022 and April 2023 across the LEND and the primary care practice. We also highlight the challenges and opportunities identified during the mid-way point of implementation and pilot testing. The results of this pilot study revealed low response rates among SDOH screeners, spurring several measures to increase uptake, including increasing the accessibility of the screener and ensuring the screener results in effective referrals. We call on additional Med-Peds healthcare teams without universal SDOH screening protocols in place - particularly those serving the I/DD population - to consider adopting these practices.
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Affiliation(s)
- Emily Hotez
- General Internal Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
| | - Kristine J Chua
- General Internal Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
| | - Nathan Samras
- General Internal Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
| | - Andrew M Smith
- General Internal Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
| | - Alice Kuo
- General Internal Medicine, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, USA
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15
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Dwyer P, Mineo E, Mifsud K, Lindholm C, Gurba A, Waisman T. Building Neurodiversity-Inclusive Postsecondary Campuses: Recommendations for Leaders in Higher Education. AUTISM IN ADULTHOOD 2023; 5:1-14. [PMID: 36941859 PMCID: PMC10024274 DOI: 10.1089/aut.2021.0042] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Patrick Dwyer
- Center for Mind and Brain, UC Davis, Davis, California, USA
- Department of Psychology, UC Davis, Davis, California, USA
- Address correspondence to: Patrick Dwyer, MA, PhD Candidate, Center for Mind and Brain, UC Davis, 267 Cousteau Place, Davis, CA 95618, USA
| | - Erica Mineo
- College of Biological Sciences, UC Davis, Davis, California, USA
| | - Kristin Mifsud
- Department of Political Science, UC Davis, Davis, California, USA
| | | | - Ava Gurba
- Department of Neurobiology and Behavior, Stony Brook University, Stony Brook, New York, USA
| | - T.C. Waisman
- Adapt Coaching & Training, Vancouver, British Columbia, Canada
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16
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Hotez E, Shea L. Prioritizing Social Determinants of Health in Public Health Surveillance for Autism. Pediatrics 2023; 151:190524. [PMID: 36700338 DOI: 10.1542/peds.2022-059541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 01/27/2023] Open
Affiliation(s)
- Emily Hotez
- Department General Internal Medicine, Health Services Research, University of California, Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
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17
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Waisman TC, Williams ZJ, Cage E, Santhanam SP, Magiati I, Dwyer P, Stockwell KM, Kofner B, Brown H, Davidson D, Herrell J, Shore SM, Caudel D, Gurbuz E, Gillespie-Lynch K. Learning from the experts: Evaluating a participatory autism and universal design training for university educators. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:356-370. [PMID: 35652315 DOI: 10.1177/13623613221097207] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Autistic university students have many strengths. They also go through difficulties that professors may not understand. Professors may not understand what college life is like for autistic students. They might judge autistic students. A team of autistic and non-autistic researchers made a training to help professors understand autistic students better. This training also gave professors ideas to help them teach all of their students. Ninety-eight professors did an online survey before the autism training. They shared how they felt about autism and teaching. Before our training, professors who knew more about autism appreciated autism more. Professors who thought people should be equal and women also appreciated autism more. Then, 89 of the professors did our training and another survey after the training. This helped us see what they learned from the training. They did one more survey a month later. This helped us see what they remembered. Our training helped professors understand and value autism. It also helped them understand how they can teach all students better. The professors remembered a lot of what we taught them. This study shows that a training that autistic people helped make can help professors understand their autistic students better.
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18
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Rothman EF, Holmes LG, Brooks D, Krauss S, Caplan R. Reasons for alcohol use and non-use by underage U.S. autistic youth: A qualitative study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:213-225. [PMID: 35499489 PMCID: PMC9626389 DOI: 10.1177/13623613221091319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT What is already known about the topic? Hazardous alcohol use is when a person's drinking puts them at increased risk for negative events (e.g. health problems or car crashes). Some studies show that autistic people may be at greater risk for hazardous alcohol use than non-autistic people, while other studies have found that hazardous alcohol use is less common among autistic people than non-autistic people. We need to learn why autistic underage youth choose to drink alcohol or not. The goal of this study was to learn from US autistic youth about their attitudes and behavior related to alcohol. Forty autistic youth aged 16-20 years old were interviewed.What this article adds? Youth described several reasons why they choose to drink alcohol, including feeling like non-autistic people are more accepting when drinking, that it puts them in a less irritable or bored mood, helps them cope with problems, and helps them fit in. Reasons for not drinking alcohol include worries about becoming addicted, medication interactions, not liking the taste, fear of experiencing hangover and other health problems, and concern about acting foolish when drunk.Implications for practice, research, or policy Results reveal that hazardous alcohol use in autistic adults could have its roots in underage experiences that give autistic youth temporary relief from social anxiety, feeling lonely, and challenges with sensory processing. Right now, there are no evidence-based alcohol prevention programs in the United States for autistic people. One or more such programs may be needed. The results from this study could be used to adapt existing programs for non-autistic youth to the unique needs and risk factors of autistic youth.
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19
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Oredipe T, Kofner B, Riccio A, Cage E, Vincent J, Kapp SK, Dwyer P, Gillespie-Lynch K. Does learning you are autistic at a younger age lead to better adult outcomes? A participatory exploration of the perspectives of autistic university students. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:200-212. [PMID: 35404160 DOI: 10.1177/13623613221086700] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
LAY ABSTRACT People learn they are autistic at different ages. We wanted to know if telling kids they are autistic earlier helps them feel better about their lives when they grow up. We are a team of autistic and non-autistic students and professors. Seventy-eight autistic university students did our online survey. They shared how they found out they were autistic and how they felt about being autistic. They also shared how they feel about their lives now. Around the same number of students learned they were autistic from doctors and parents. Students who learned they were autistic when they were younger felt happier about their lives than people who learned they were autistic when they were older. Students who learned they were autistic when they were older felt happier about being autistic when they first found out than people who did not have to wait as long. Our study shows that it is probably best to tell people they are autistic as soon as possible. The students who did our study did not think it was a good idea to wait until children are adults to tell them they are autistic. They said that parents should tell their children they are autistic in ways that help them understand and feel good about who they are.
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Affiliation(s)
- Tomisin Oredipe
- College of Staten Island, The City University of New York, USA
| | - Bella Kofner
- College of Staten Island, The City University of New York, USA
| | - Ariana Riccio
- The Graduate Center, The City University of New York, USA
| | | | | | | | | | - Kristen Gillespie-Lynch
- College of Staten Island, The City University of New York, USA.,The Graduate Center, The City University of New York, USA
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20
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Perceptions of Behaviors Associated with ASD in Others: Knowledge of the Diagnosis Increases Empathy and Improves Perceptions of Warmth and Competence. Eur J Investig Health Psychol Educ 2022; 12:1594-1606. [DOI: 10.3390/ejihpe12110112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/15/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
Individuals with Autism Spectrum Disorder (ASD) often exhibit atypical social behaviors that some may perceive as odd or discomforting. Given that ASD is largely invisible, it may be difficult to understand why a person is displaying these atypical behaviors, leading to less favorable attitudes. The current study aimed to examine if having an explanation for an individual exhibiting behaviors associated with ASD could improve perceptions of warmth and competence, as well as the amount of empathy felt towards the individual. Participants (n = 82) were presented with a scenario involving two people, one of whom exhibited behaviors consistent with ASD. ASD diagnosis information was manipulated, such that half of the participants were told that the target was diagnosed with ASD, and the other half were given no diagnostic information. Afterwards, participants rated the target. Results indicated that having an explanation for the ASD-related behaviors led to higher ratings of warmth and competence and greater feelings of empathy. Furthermore, empathy mediated the relationship between having the diagnostic information and target ratings. Thus, having an explanation for someone’s behavior may lead to greater feelings of empathy and improve perceptions and understanding. This has important implications for improving education and awareness about behaviors associated with ASD as well as for making the decision of whether or not to disclose one’s diagnosis.
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21
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Chiri G, Bergey M, Mackie TI. Deserving but not entitled: The social construction of autism spectrum disorder in federal policy. Soc Sci Med 2022; 301:114974. [PMID: 35452891 DOI: 10.1016/j.socscimed.2022.114974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
Public policies play an influential role in shaping public opinion about health conditions, who is affected by them, and potential pathways for identification and intervention. This study draws upon a social constructionist perspective of policy design and disability to examine how autism spectrum disorder (ASD) has been framed in United States federal legislation. Qualitative content analysis of autism legislation passed between 1973 and 2019 indicates that policies reinforced ASD as a largely medicalized, neurobiological condition of childhood; this was reflected in both the policy aims, sources of knowledge and groups prioritized to address ASD; and the symbolic or material resources committed (or not committed) by enacted federal legislation to specific constituencies. Policy aims of early ASD legislation were symbolic in nature, focusing predominantly on framing children with ASD as a group worthy of public recognition. More recent legislation, in contrast, conferred material resources - albeit in targeted ways. Funding for surveillance and medical research on causation, early detection, treatment, and health professional training were prioritized with little attention to either service delivery needs of individuals with ASD and their families, supports over the lifecourse, or the social factors influencing ASD.
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Affiliation(s)
- Giuseppina Chiri
- RTI International, Center for the Health of Populations, Waltham, MA, USA.
| | - Meredith Bergey
- Department of Sociology and Criminology, Villanova University, Villanova, PA, USA
| | - Thomas I Mackie
- Department of Health Policy and Management, School of Public Health, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, USA
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22
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Turnock A, Langley K, Jones CR. Understanding Stigma in Autism: A Narrative Review and Theoretical Model. AUTISM IN ADULTHOOD 2022; 4:76-91. [PMID: 36605561 PMCID: PMC8992913 DOI: 10.1089/aut.2021.0005] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The experience of stigma by autistic people is relatively understudied, despite contributing to a range of poor outcomes and having an overarching impact on well-being. The current review of the literature synthesizes research to determine what is currently known and presents a theoretical model of autism stigma. Autism stigma is primarily influenced by a public and professional understanding of autism in combination with interpretation of visible autistic traits. Moderating factors include the quality and quantity of contact with autistic people, cultural factors, sex and gender, individual differences, and diagnostic disclosure. Stigma can reduce well-being as well as increase the presence of camouflaging behaviors, which mask autistic traits. Caregivers of autistic people can experience stigma by association, that is, affiliate stigma, which can impact their own well-being. A variety of interventions and approaches to reduce stigma are discussed, including "autism friendly" spaces, positive media representation, educational and psychosocial training for the public and professionals, as well as cultural and systemic shifts that foster inclusivity and recognize neurodiversity.
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Affiliation(s)
- Alice Turnock
- School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom
| | - Kate Langley
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Catherine R.G. Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom.,Address correspondence to: Catherine R.G. Jones, PhD, School of Psychology, Cardiff University, Park Place, Cardiff CF10 3AT, United Kingdom
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23
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O'Connor C, Seery C, Young C. How Does It Feel to Have One's Psychiatric Diagnosis Altered? Exploring Lived Experiences of Diagnostic Shifts in Adult Mental Healthcare. Front Psychiatry 2022; 13:820162. [PMID: 35222120 PMCID: PMC8873081 DOI: 10.3389/fpsyt.2022.820162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Though the socio-emotional significance of psychiatric diagnoses and the frequency of transitions between diagnostic classifications are widely acknowledged, minimal research reveals how "diagnostic shifts" are subjectively experienced by psychiatric service-users. AIM This study investigated how adult service-users make sense of diagnostic shifts and their impacts on one's life. METHODS Twenty-seven people with self-reported experiences of diagnostic shifts opted into this qualitative study. Virtual narrative interviews invited participants to share their "diagnosis stories." Interview transcripts were analyzed using narrative thematic analysis to identify common and divergent experiences across participants. RESULTS Diverse experiences of diagnostic shifts were related: diagnostic shifts could both promote and undermine clinical trust, therapeutic engagement and self-understanding. The analysis suggested that shared and divergent experiences could be attributed to two dimensions of narratives: participants' Interpretations of Diagnostic Shifts and Diagnosis-Specific Factors. Regarding the former, analysis produced a typology of three possible interpretations of diagnostic shifts, which were linked with consistently different antecedents, experiences and consequences. The latter dimension captured how experiences of diagnostic shifts also hinged on the unique meanings ascribed to the specific diagnoses gained and lost, particularly in relation to their perceived severity, stigma, personal associations, and related communities. CONCLUSIONS Findings revealed how diagnostic shifts can be experienced as both traumatic and life-enhancing, depending on their social and subjective context. Understanding the range and predictors of variable experiences of diagnostic shifts is vital for sensitive clinical practice and communication.
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Affiliation(s)
| | - Christina Seery
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Claire Young
- School of Psychology, University College Dublin, Dublin, Ireland
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24
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Han E, Scior K, Avramides K, Crane L. A systematic review on autistic people's experiences of stigma and coping strategies. Autism Res 2021; 15:12-26. [PMID: 34881514 DOI: 10.1002/aur.2652] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/17/2021] [Accepted: 11/28/2021] [Indexed: 11/08/2022]
Abstract
Autism can be understood as a concealable stigmatized identity. This is the first systematic review to synthesize the literature on autistic people's experiences of stigma and coping strategies. 2877 studies were screened and 27 were included in this review. The reviewed literature demonstrates that autistic individuals are acutely aware of being stereotyped, judged, and discriminated by others. Autistic people also show signs of internalizing stigma, rendering them more vulnerable to low self-worth and poorer mental health. To manage the impact of stigma, the included studies suggest that autistic individuals may use these strategies: concealment and camouflaging, selective disclosure and self-advocacy, as well as positive reframing and reconstructing identity. However, the evidence is limited and mixed in terms of how helpful and effective these strategies are. Future studies should include autistic populations with a wider range of intellectual abilities and explore interventions that can support autistic people in managing stigma to supplement interventions that seek to reduce stigma towards autistic people. The power of language in perpetuating and challenging stigma also has important implications for research and practice, underscoring the need for researchers and practitioners to reflect carefully on the messages they are communicating about autism.
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Affiliation(s)
- Emeline Han
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, London, UK
| | - Katrina Scior
- Research Department of Clinical, Educational and Health Psychology, UCL Division of Psychology and Language Sciences, London, UK
| | - Katerina Avramides
- Department of Psychology and Human Development, UCL Institute of Education, London, UK
| | - Laura Crane
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, London, UK
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25
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Chinese College Students' Knowledge of Autism Spectrum Disorder (ASD) and Social Distance from Individuals with ASD: The Mediating Role of Negative Stereotypes. J Autism Dev Disord 2021; 52:3676-3685. [PMID: 34453227 DOI: 10.1007/s10803-021-05252-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 12/20/2022]
Abstract
This study investigated whether negative stereotypes are responsible for the effect of ASD knowledge on social distance from individuals with ASD among college students. A sample of 869 neurotypical Chinese college students completed a cross-sectional survey to assess social distance, ASD knowledge, and negative stereotypes. Pearson correlation analysis yielded significant correlations between social distance, ASD knowledge, and negative stereotypes. Multiple mediation analysis showed that negative stereotypes mediated the link between social distance and ASD knowledge. Specifically, greater ASD knowledge predicted reduced social distance through decreased stereotyping related to dangerousness, personal responsibility for the disorder, and discontinuity, but also predicted greater social distance through increased stereotyping related to social inappropriateness. The findings deepen our understanding of the association between ASD knowledge and social distance by revealing the mediating role of negative stereotypes, and provide information that can help improve anti-stigma initiatives in college settings.
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26
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Kim SY, Cheon JE, Gillespie-Lynch K, Kim YH. Is autism stigma higher in South Korea than the United States? Examining cultural tightness, intergroup bias, and concerns about heredity as contributors to heightened autism stigma. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:460-472. [PMID: 34325559 DOI: 10.1177/13623613211029520] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Misunderstandings about autism may be more common in South Korea than the United States. Koreans often have clear ideas about how people should act. Another way of saying this is that Korea has a tight culture. Americans are looser, meaning people are freer to act as they like. Autistic people often do not act as people expect them to. This makes autistic people stand out. Autistic people may stand out more in tight cultures like South Korea. We studied how people in South Korea and the United States feel about autism. We wanted to see why Korean people might reject autistic people more than people in the United States do. American and Korean people did online surveys. Koreans said they did not want to get close to autistic people more than Americans did. People who understood autism and had met and liked autistic people wanted to get closer to autistic people. We were surprised to learn that Americans said having an autistic brother or sister makes it harder to find a romantic partner more than Korean people did. People who believed that autism makes it harder for family members to find love did not want to get very close to autistic people. Koreans said people should act as expected more than Americans did. People who believed that acting as expected was important did not want to get very close to autistic people. Teaching people that there are many ways of being a good person may help them understand and appreciate autistic people.
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27
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Do Implicit and Explicit Racial Biases Influence Autism Identification and Stigma? An Implicit Association Test Study. J Autism Dev Disord 2020; 51:106-128. [PMID: 32415531 DOI: 10.1007/s10803-020-04507-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Are implicit and explicit biases related to ASD identification and/or stigma? College students (N = 493) completed two IATs assessing implicit stigma and racial biases. They evaluated vignettes depicting a child with ASD or conduct disorder (CD) paired with a photo of a Black or White child. CD was more implicitly and explicitly stigmatized than ASD. Accurately identifying ASD was associated with reduced explicit stigma; identifying CD led to more stigma. Participants who identified as White implicitly associated the White child with ASD and the Black child with CD. A trend in the reverse direction was observed among Black participants. Implicit and explicit biases were unrelated. Findings highlight a need for trainings to ameliorate biases favoring one's in-group.
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