Estimating life expectancy and years of life lost for autistic people in the UK: a matched cohort study

SpeechMatch-A novel digital approach to supporting communication for neurodiverse groups

Communication can be a challenge for a significant minority of the population. Those with intellectual disability, autism, or Stroke survivors can encounter significant problems and stigma in their communication abilities leading to worse health and social outcomes. SpeechMatch (https://www.speechmatch.com/) is a digital App which is a pragmatic mobile language training platform that teaches individuals to "match" critical components of conversation and looks to provides subjects with immediate visual feedback to shape identification and expression of emotion in speech. While it has been used in autistic people there has been no systematic exploration of its strengths and weaknesses. Further, it's potential to afford improvements in communication to other vulnerable groups such as intellectual disability or Stroke survivors has not been explored. This study looked to understand acceptability from people with intellectual disability and/or autism and those recovering from a stroke on the utility and scope of SpeechMatch using co-production techniques using experts by experience and a mixed methods evaluation. Results across four domains suggest high acceptability levels but highlighting needs for platform capabilities improvement and better user engagement. The study outlines a vital and essential aspect for improving SpeechMatch. It gives a template for evidenced based quality improvement of similar devices.

Characteristics and primary care experiences of people who self-report as autistic: a probability sample survey of adults registered with primary care services in England

OBJECTIVES

Little is known about adults who self-report as autistic. This study aimed to profile the demographic characteristics, long-term health conditions and primary care experiences of adults who self-report as autistic (including those with and without a formal diagnosis).

DESIGN/SETTING

A nationally representative cross-sectional survey of adults registered with National Health Service (NHS) General Practitioner (GP) surgeries in England.

PARTICIPANTS

623 157 survey respondents aged 16 and over, including 4481 who self-report as autistic.

OUTCOMES

Weighted descriptive statistics, with 95% CIs. Logistic regression modelling adjusted for age, gender, ethnicity and area-level deprivation compared those who self-report as autistic with the rest of the population.

RESULTS

A total of 4481 of the 623 157 survey participants included in the analysis self-reported autism, yielding a weighted proportion estimate of 1.41% (95% CI 1.35% to 1.46%). Adults self-reporting as autistic were more likely to be younger, male or non-binary, to identify as a gender different from their sex at birth, have a non-heterosexual sexual identity, be of white or mixed or multiple ethnic groups, non-religious, without caring responsibilities, unemployed, live in more deprived areas and not smoke. All chronic conditions covered were more prevalent among adults self-reporting as autistic, including learning disability, mental health conditions, neurological conditions, dementia, blindness or partial sight and deafness or hearing loss. Adults self-reporting as autistic were also less likely to report a positive experience of making an appointment (adjusted OR (aOR) 0.90, 95% CI 0.82 to 0.98) and navigating GP practice websites (aOR 0.78, 95% CI 0.70 to 0.87) and more likely to report seeking advice from a friend or family member prior to making an appointment (aOR 1.25, 95% CI 1.14 to 1.38) and having a preferred GP (aOR 2.25, 95% CI 2.06 to 2.46). They were less likely to report that their needs were met (aOR 0.73, 95% CI 0.65 to 0.83).

CONCLUSIONS

Adults self-reporting as autistic have a distinctive sociodemographic profile and heightened rates of long-term conditions. They report challenges in both accessing primary care and having their needs met when they do. These findings should inform future care initiatives designed to meet the needs of this group.

Improving Diagnostic Procedures in Autism for Girls and Women: A Narrative Review

Biases exist in the diagnostic process for autism spectrum disorder (henceforth "autism"), which result in some girls and women being diagnosed later or missed entirely. Current diagnostic tools may not capture the full range of behavioural presentations of autism, leading to under-identification. This review explores why these biases may occur, and how diagnostic procedures could be adapted to better identify autistic girls and women. We recommend that diagnostic assessments are adjusted to capture a broader range of behavioural exemplars of autism; that camouflaging of autistic traits is taken into account; and that care is taken to ensure co-occurring mental health conditions do not overshadow autism diagnosis. We offer recommendations, building on gold-standard diagnostic guidelines, for how diagnostic procedures can be improved for girls and women.