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Cross L, Belshaw F, Piovesan A, Atherton G. Game Changer: Exploring the Role of Board Games in the Lives of Autistic People. J Autism Dev Disord 2024:10.1007/s10803-024-06408-0. [PMID: 38967700 DOI: 10.1007/s10803-024-06408-0] [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: 05/14/2024] [Indexed: 07/06/2024]
Abstract
This mixed methods paper reports findings from three studies examining the overlap between autism and hobbyist board gaming. The first was a quantitative survey of over 1600 board gamers, showing that autistic individuals are overrepresented in this hobby compared to the general population and that autistic traits measured by the AQ are significantly elevated amongst board gamers. Study 1 also assessed gamers' motivations and preferences and reported key differences as well as similarities between autistic and non-autistic gamers. The second was a qualitative study that reported the results of 13 interviews with autistic individuals who are hobbyist board gamers. Using Interpretive Phenomenological Analysis (IPA), four key themes were uncovered, including a preference for systemising, escapism and passions, the social lubrication effect of games and difficulties with deception. In the third, 28 autistic individuals were introduced to board games in groups of 5-10 over an afternoon. Subsequent focus groups were then analysed using IPA. This analysis uncovered themes around how board games are challenging but encouraged growth and how they were an alternative vehicle for forging social relationships. Through this paper, we discuss how and why board games may be a popular hobby amongst the autistic population, and its potential utility for improving autistic wellbeing.
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Affiliation(s)
- Liam Cross
- Department of Psychology, University of Plymouth, Plymouth, PL4 8AA, UK
| | - Francesca Belshaw
- Department of Psychology, Edge Hill University, Liverpool, L39 4QP, UK
| | - Andrea Piovesan
- Department of Psychology, Edge Hill University, Liverpool, L39 4QP, UK.
| | - Gray Atherton
- Department of Psychology, University of Plymouth, Plymouth, PL4 8AA, UK
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2
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Lases MN, Bruins J, Scheepers FE, van Sambeek N, Ng F, Rennick-Egglestone S, Slade M, van Balkom IDC, Castelein S. Is personal recovery a transdiagnostic concept? Testing the fit of the CHIME framework using narrative experiences. J Ment Health 2024:1-9. [PMID: 38945156 DOI: 10.1080/09638237.2024.2361225] [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: 06/27/2023] [Accepted: 03/23/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Personal recovery is operationalized in the CHIME framework (connectedness, hope, identity, meaning in life, and empowerment) of recovery processes. CHIME was initially developed through analysis of experiences of people mainly with psychosis, but it might also be valid for investigating recovery in mood-related, autism and other diagnoses. AIMS To examine whether personal recovery is transdiagnostic by studying narrative experiences in several diagnostic groups. METHODS Thirty recovery narratives, retrieved from "Psychiatry Story Bank" (PSB) in the Netherlands, were analyzed by three coders using CHIME as a deductive framework. New codes were assigned using an inductive approach and member checks were performed after consensus was reached. RESULTS All five CHIME dimensions were richly reported in the narratives, independent of diagnosis. Seven new domains were identified, such as "acknowledgement by diagnosis" and "gaining self-insight". These new domains were evaluated to fit well as subdomains within the original CHIME framework. On average, 54.2% of all narrative content was classified as experienced difficulties. CONCLUSIONS Recovery stories from different diagnostic perspectives fit well into the CHIME framework, implying that personal recovery is a transdiagnostic concept. Difficulties should not be ignored in the context of personal recovery based on its substantial presence in the recovery narratives.
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Affiliation(s)
- Mitch N Lases
- Lentis Research, Lentis Psychiatric Institute, Groningen, the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - Jojanneke Bruins
- Lentis Research, Lentis Psychiatric Institute, Groningen, the Netherlands
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Floortje E Scheepers
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Nienke van Sambeek
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | | | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord University, Bodø, Norway
| | - Ingrid D C van Balkom
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, the Netherlands
| | - Stynke Castelein
- Lentis Research, Lentis Psychiatric Institute, Groningen, the Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
- Rob Giel Research Centre, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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Lee EAL, Scott M, Black MH, D'Arcy E, Tan T, Sheehy L, Bölte S, Girdler S. "He Sees his Autism as a Strength, Not a Deficit Now": A Repeated Cross-Sectional Study Investigating the Impact of Strengths-Based Programs on Autistic Adolescents. J Autism Dev Disord 2024; 54:1656-1671. [PMID: 36745275 PMCID: PMC9900207 DOI: 10.1007/s10803-022-05881-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 02/07/2023]
Abstract
Recent studies have reported that strengths-based programs, leveraging autistic adolescents' abilities and interests, could improve their skills and facilitate social engagement. However, little is known about the long-term impact of strengths-based approaches. This study aimed to explore the long-term outcomes of community strengths-based programs designed to support autistic adolescents in developing interests and skills in Science, Technology, Engineering, Arts, and Mathematics (STEAM) and the factors influencing their participation in these programs. A repeated cross-sectional survey study over three years recruited 52 parents in 2018, 52 parents in 2019, and 38 parents in 2020. Results highlighted the positive impact of these programs on autistic adolescents' health and well-being, social relationships and interactions, self-confidence and self-esteem, sense of belonging, and activities and participation. Five key elements influencing participation included the enthusiasm of the participants, their self-perception, the approach of the programs, the learning environment, and the attitudes of the mentors. This study implies that strengths-based approaches to intervention and support for autistic adolescents in a supported environment are a social model solution that could potentially have positive participant outcomes. Findings from this study could provide a framework underpinning future strengths-based interventions.
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Affiliation(s)
- Elinda Ai Lim Lee
- School of Allied Health, Curtin University, Perth, WA, Australia.
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia.
| | - Melissa Scott
- School of Allied Health, Curtin University, Perth, WA, Australia
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
| | - Melissa H Black
- School of Allied Health, Curtin University, Perth, WA, Australia
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Emily D'Arcy
- School of Allied Health, Curtin University, Perth, WA, Australia
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
- Autism CRC, Brisbane, Qld, Australia
| | - Tele Tan
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
- School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Perth, WA, Australia
| | | | - Sven Bölte
- School of Allied Health, Curtin University, Perth, WA, Australia
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, WA, Australia
- Curtin Autism Research Group, Curtin University, Perth, WA, Australia
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Chen YWR, Ng DY, Tseng MH, Bundy A, Cordier R. The impact of coping behaviors on perceived competence and social anxiety in the everyday social engagement of autistic adolescents. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1268-1279. [PMID: 37776008 DOI: 10.1177/13623613231196773] [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: 10/01/2023]
Abstract
LAY ABSTRACT Individuals who cope well with challenges may engage in social situations more successfully. We examined how well autistic adolescents coped, depending on how competent they felt and how much anxiety they experienced during social activities. We included 133 individuals (82 autistic, 51 neurotypical) between the ages of 10 and 16 years. Participants carried a mobile device that prompted them seven times a day for 7 days to record what they were doing, how competent they felt and how much anxiety they experienced. We used the Coping Inventory to understand how well participants coped with environmental challenges and met their needs for growth. Autistic adolescents were more likely than neurotypical peers to feel anxious while doing activities with adults. Autistic adolescents who had more difficulty coping with challenges were more likely to feel anxious when doing leisure activities with peers. Interestingly, autistic adolescents who coped better with challenges tended to feel less competent in social situations. However, those better able to meet their needs for growth tended to perceive their social competence positively. These findings can help practitioners develop strategies and programs to reduce the negative social experiences of autistic adolescents by helping them cope better.
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Affiliation(s)
| | | | - Mei-Hui Tseng
- National Taiwan University, Taiwan
- National Taiwan University Hospital, Taiwan
| | | | - Reinie Cordier
- Northumbria University, UK
- Curtin University, Australia
- University of Cape Town, South Africa
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5
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Pezzimenti F, Durrani E, Zheng S, Adams RE, Bishop SL, Taylor JL. Perspectives on Employer-Initiated Terminations Among Young Adults on the Autism Spectrum. J Autism Dev Disord 2024; 54:1332-1343. [PMID: 36626010 PMCID: PMC9838300 DOI: 10.1007/s10803-022-05884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 01/11/2023]
Abstract
Job instability is high among autistic adults, with employer-initiated terminations a common reason for job loss. The current study used qualitative methods to code reasons that autistic adults identified for their employer-initiated termination. From 315 autistic individuals ages 18-35 who completed an online survey, 93 (29.5%) reported having been terminated from a job. These individuals were asked about the reasons for their termination and responses were coded into thematic categories. Common reasons included work performance, social difficulties, attendance, and mental health challenges. Adults were more likely to attribute terminations to internal causes (related to the individual) than to external causes (environment-related). A good fit between workplace, individual preferences, skills, and abilities is likely key to promoting job continuity for autistic adults.
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Affiliation(s)
- Florencia Pezzimenti
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eman Durrani
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shuting Zheng
- Weill Institute for Neurosciences, Department of Psychiatry and Behavior Sciences, University of California, San Francisco, CA, USA
| | - Ryan E Adams
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Somer L Bishop
- Weill Institute for Neurosciences, Department of Psychiatry and Behavior Sciences, University of California, San Francisco, CA, USA
| | - Julie Lounds Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.
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Parenteau CI, Lampinen LA, Ghods SS, Taylor JL, Adams RE, Bishop SL, Zheng S. Self-reported Everyday Sources of Happiness and Unhappiness in Autistic Adults. J Autism Dev Disord 2024; 54:1538-1548. [PMID: 36689096 PMCID: PMC9869319 DOI: 10.1007/s10803-023-05892-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Daily mood can be influenced by a range of experiences. Identifying everyday life experiences that make autistic adults happy and unhappy holds potential to foster positive mood and tackle mental health problems amongst this group. METHODS A total of 293 autistic adults between the ages of 18 to 35 years old (mean age of 26.51 years old (SD = 4.62); 43.3% female gender, 4.8% nonbinary) provided open-text responses regarding everyday sources of happiness and unhappiness. Using an iterative process of inductive coding, 14 happy themes and 22 unhappy themes of mood-changing life experiences were identified based on self-report qualitative data. RESULTS Common themes across the happy and unhappy domain involved social partners, social interactions, and engagement in recreational and employment activities, with additional distinct themes specific to happy or unhappy mood. Top themes identified in the happy domain emphasizes encouraging quality relationships and positive interactions with others and cultivating supportive work/societal environments to build a sense of achievement and value. Meanwhile, emotional tolls accompanied negative relationships and interactions, underscoring the necessity to provide autistic adults with conflict resolution and coping skills to increase feelings of happiness. CONCLUSION Overall, the wide range of sources of happy and unhappy everyday experiences highlights the importance of considering personal preferences in engagement with others and activities in treatment.
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Affiliation(s)
- China I Parenteau
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA.
| | - Linnea A Lampinen
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Sheila S Ghods
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | | | - Ryan E Adams
- Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Somer L Bishop
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
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Adams RE, Lampinen L, Zheng S, Sullivan V, Taylor JL, Bishop SL. Associations between social activities and depressive symptoms in adolescents and young adults with autism spectrum disorder: Testing the indirect effects of loneliness. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:461-473. [PMID: 37212127 DOI: 10.1177/13623613231173859] [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: 05/23/2023]
Abstract
LAY ABSTRACT Previous studies have found that social activities and depressive symptoms in adolescents and young adults with autism spectrum disorder are related. To better understand the relationship between these issues, this study examined the frequency of various types of social activities as well as if the participants felt that the frequency of time spent in the activity met their personal needs. In addition, the role of loneliness was tested as a possible way to understand the relationship between activities and depressive symptoms. To test these ideas, 321 participants who were recruited from the Simons Foundation Powering Autism Research for Knowledge (SPARK) research match registry and completed online measures of social activities, depressive symptoms, and loneliness. While the specific pattern was different for individual activities, it was found that those who felt that their current frequency of activities did not meet their needs had higher rates of depressive symptoms than those who felt they did meet their needs. Also, loneliness helps to understand relationship between social activities and depressive symptoms. The findings were discussed in light of previous study findings, interpersonal theories of depression, and clinical implications.
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Affiliation(s)
- Ryan E Adams
- Cincinnati Children's Hospital Medical Center, USA
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8
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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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9
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Farrell C, Slaughter V, McAuliffe T, Mulvihill A. Participation and Experiences in Extracurricular Activities for Autistic and Neurotypical Children. J Autism Dev Disord 2023:10.1007/s10803-023-06142-z. [PMID: 37831305 DOI: 10.1007/s10803-023-06142-z] [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: 09/15/2023] [Indexed: 10/14/2023]
Abstract
Participation in Organised Extracurricular Social Activities (OESA) can provide positive outcomes for children. This study investigated whether children aged 4 to 12 years diagnosed with autism differ in their OESA participation and experience compared to neurotypical peers. Parents of autistic children (n = 35) and those of neurotypical peers (n = 171) responded to questions that asked them to reflect on their child's participation and experiences in OESAs. Parents of autistic children reported significantly less OESA participation compared to parents of neurotypical children. Additionally, when evaluating factors that facilitated OESA participation, parents of autistic children rated their child's individual abilities and behaviour, the OESA's features, and the social environment less positively, compared to parents of neurotypical children. OESA participation and experiences differ for autistic and neurotypical children. This study identifies factors that can be adjusted to mitigate this difference.
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Affiliation(s)
- Callyn Farrell
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
- School of Psychology, The University of Queensland, St. Lucia Campus, Level Three, McElwain Building, Brisbane, QLD, 4072, Australia.
| | - Virginia Slaughter
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Tomomi McAuliffe
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Aisling Mulvihill
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
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10
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Ludlow AK, Osborne C, Keville S. Selective Mutism in Children With and Without an Autism Spectrum Disorder: The Role of Sensory Avoidance in Mediating Symptoms of Social Anxiety. J Autism Dev Disord 2023; 53:3891-3900. [PMID: 35904647 DOI: 10.1007/s10803-022-05674-0] [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] [Accepted: 07/03/2022] [Indexed: 10/16/2022]
Abstract
The present study addressed the different contributors to social anxiety in children with Selective Mutism (SM), with and without co-occurring Autism Spectrum Disorder (ASD) (SM + ASD). Seventy-five parents completed an online composite questionnaire consisting of the symptoms of SM and ASD, anxiety and sensory measures. The results found the SM + ASD group showed significantly higher levels of social anxiety and sensory avoidance compared to the SM only group. However, a simple mediation model revealed sensory avoidance to be a mediator of this relationship between the diagnosis and social anxiety.. Therefore, higher levels of sensory avoidance may help to differentiate social anxiety between the groups and may also be a sign of ASD in children with SM who have and/or are yet to receive an ASD diagnosis.
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Affiliation(s)
- Amanda K Ludlow
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK.
| | - Clarissa Osborne
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK
| | - Saskia Keville
- School of Psychology, Geography and Sports Sciences, University of Hertfordshire, College Lane, AL10 9AB, Hatfield, UK
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McDonald TAM, Lalani S, Chen I, Cotton CM, MacDonald L, Boursoulian LJ, Wang J, Malow BA. Appropriateness, Acceptability, and Feasibility of a Neurodiversity-Based Self-determination Program for Autistic Adults. J Autism Dev Disord 2023; 53:2933-2953. [PMID: 35618972 PMCID: PMC9934918 DOI: 10.1007/s10803-022-05598-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
Published self-determination programs do not adequately address the needs of autistic adults. We designed a multi-component self-determination program, grounded in the neurodiversity paradigm, to help autistic adults achieve goals to improve their quality of life. The first phase involved 5 days of psychoeducation, practice, and social events; the second phase included 3 months of telecoaching; and the third phase included follow-up. Thirty-four university students coached 31 autistic adults on three evolving goals. On average, participants completed one goal per week. Most participants were satisfied with the program. We found that the program was appropriate, acceptable, and feasible. This program is a promising approach to helping autistic adults gain self-determination skills and improve their quality of life.
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Affiliation(s)
- T A Meridian McDonald
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA.
| | - Salima Lalani
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
| | - Ivy Chen
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
- Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Claire M Cotton
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
| | - Lydia MacDonald
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
| | - Lana J Boursoulian
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
| | - Jiahao Wang
- Faculty of Sciences, University of Sydney, Sydney, NSW, 2218, Australia
| | - Beth A Malow
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118 Medical Center North, Nashville, TN, 37235, USA
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Dell'Osso L, Amatori G, Muti D, Giovannoni F, Parri F, Violi M, Cremone IM, Carpita B. Autism Spectrum, Hikikomori Syndrome and Internet Gaming Disorder: Is There a Link? Brain Sci 2023; 13:1116. [PMID: 37509046 PMCID: PMC10377367 DOI: 10.3390/brainsci13071116] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/18/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study is to review the available literature investigating the relationship between hikikomori, a pathological condition characterized by severe social withdrawal or isolation, autism spectrum disorder (ASD) and Internet gaming disorder (IGD). Studies on the relationship between ASD and IGD have found significant positive correlations between these two conditions. Individuals with ASD would appear to be at risk of developing a problematic use of the Internet, which, to the right extent, would represent a useful tool for social interaction and cognitive development. Even subjects with hikikomori, in whom rarefied interpersonal relationships and social isolation could be balanced by the use of online connections, appear to be at high risk of developing IGD. On the other hand, the finding of significant autistic traits in populations with hikikomori could lead to considering this psychopathological condition as a particular presentation of autism spectrum, a hypothesis that requires further investigation.
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Affiliation(s)
- Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giulia Amatori
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Dario Muti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Federico Giovannoni
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Francesca Parri
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Ivan Mirko Cremone
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Schmidt MM, Lee M, Francois MS, Lu J, Huang R, Cheng L, Weng Y. Learning Experience Design of Project PHoENIX: Addressing the Lack of Autistic Representation in Extended Reality Design and Development. JOURNAL OF FORMATIVE DESIGN IN LEARNING 2023; 7:1-19. [PMID: 37360548 PMCID: PMC10195660 DOI: 10.1007/s41686-023-00077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/28/2023]
Abstract
This paper presents Project PHoENIX, which stands for Participatory, Human-centered, Equitable, Neurodiverse, Inclusive, eXtended reality. The project aims to co-produce research with autistic users to create a virtual reality (VR) environment that is highly usable, accessible, and sensitive to the needs and preferences of these individuals. Project PHoENIX utilizes participatory design within a learning experience design (LXD) frame to locate autistic people, their caregivers, and providers centrally in the processes of immersive technology design and development, as well as research design and execution. An overarching literature review on VR and autism and issues of limited design precedent of VR environments with autistic participants is provided, as well as details on the Project PHoENIX design framework, project description, and project design outcomes. Details are provided on how the online VR environment was co-designed and co-developed through collaborative research with autistic stakeholders while being sensitive to their needs and preferences. Research findings and implications are discussed regarding the design process, constraints, principles, and insights. The paper concludes by discussing lessons learned and how this project can provide much-needed design precedent for advancing the field towards a more inclusive, human-centered, and neurodiverse VR research and development paradigms.
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Affiliation(s)
| | | | | | - Jie Lu
- University of Florida, Gainesville, USA
| | - Rui Huang
- University of Florida, Gainesville, USA
| | - Li Cheng
- University of Florida, Gainesville, USA
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14
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Ashburner J, Tomkins V, Bobir N, Jones J, Smith D, Hautsalo J, Swift E. Co-Design and Co-Production of a Goal Setting Tool for Autistic Adolescents and Adults. AUTISM IN ADULTHOOD 2023; 5:37-50. [PMID: 36941852 PMCID: PMC10024266 DOI: 10.1089/aut.2021.0067] [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: 11/12/2022]
Abstract
Background A review of existing tools suggested a need for a goal setting tool for autistic people that (1) addresses the heterogeneity of autistic people to the greatest degree possible; (2) addresses a broad range of goals in areas including self-care and home living, and social, community, educational, and employment participation; (3) incorporates autism-specific adaptations such as visual supports; (4) facilitates the initial identification of goals; and (5) enables the prioritization of goals. Aim This project aimed to develop a picture-based card-sort goal setting tool with relevant and comprehensible goal cards using a co-design and co-production process. Methods The first three of four phases of participatory action research (PAR) used to develop the tool are presented, including (1) initial design by autistic people and professional practitioners, and co-production with an autistic graphic designer; (2) survey of 15 autistic people and 11 family members to evaluate and refine the goals, pictures, and wording; (3) second survey of 23 autistic people and 19 family members to re-evaluate and re-refine the goals, pictures, and wording. Results Responses to open-ended survey questions recommended changing many of the pictures and some of the words on the goal cards. As the majority of respondents rated each of the 72 goals as important, they were all retained. The mean percentage approval of the pictures improved from 78% for survey 1 to 86% for survey 2. The mean percentage approval of the wording improved from 87% for survey 1 to 97% for survey 2. Conclusions The use of a co-design and co-production methodology over three phases of PAR involving autistic people and their families resulted in many refinements to the goal cards. These iterations in the design process maximized the extent to which the goal cards are easily understood and relevant to the needs of autistic people.
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Affiliation(s)
- Jill Ashburner
- Autism Queensland Limited, Sunnybank, Australia
- The School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Victoria Tomkins
- Autism Queensland Limited, Sunnybank, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Natasha Bobir
- Autism Queensland Limited, Sunnybank, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Judy Jones
- Autism Queensland Limited, Sunnybank, Australia
| | - David Smith
- Autism Queensland Limited, Sunnybank, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Jermu Hautsalo
- Autism Queensland Limited, Sunnybank, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Elena Swift
- Autism Queensland Limited, Sunnybank, Australia
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15
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Cai RY, Gibbs V, Love A, Robinson A, Fung L, Brown L. "Self-compassion changed my life": The self-compassion experiences of autistic and non-autistic adults and its relationship with mental health and psychological wellbeing. J Autism Dev Disord 2023; 53:1066-1081. [PMID: 35904649 DOI: 10.1007/s10803-022-05668-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/24/2022]
Abstract
Self-compassion is a gentle way of relating to oneself, linked to a host of mental health benefits in non-autistic people. Although many autistic individuals report high anxiety and depression symptoms, no research to-date has examined the self-compassion experiences of autistic individuals and determined if self-compassion is associated with psychopathology. Therefore, the purpose of the current study was to address this research gap. The participants (153 autistic and 93 non-autistic adults) completed on online survey and 11 autistic participants were also interviewed. Autistic participants reported significantly lower self-compassion than non-autistic adults, and in both groups, those with higher self-compassion reported higher psychological wellbeing and lower depression symptoms. Demographic predictors of self-compassion were identified. These findings have both clinical and research implications.
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Affiliation(s)
- Ru Ying Cai
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia.
- School of Psychological Sciences, Monash University, 3168, Clayton, VIC, Australia.
| | - Vicki Gibbs
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, 2050, Camperdown, NSW, Australia
| | - Abigail Love
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
| | - Ainslie Robinson
- Aspect Research Centre for Autism Practice, Autism Spectrum Australia, 14 Aquatic Drive, 2086, Frenchs Forest, NSW, Australia
| | - Lawrence Fung
- Department of Psychiatry & Behavioral Sciences, Stanford University, 94305, Stanford, CA, USA
| | - Lydia Brown
- Melbourne School of Psychological Sciences, University of Melbourne, 2010, Parkville, VIC, Australia
- North Eastern Rehabilitation Centre, Healthscope Hospitals, 3079, Ivanhoe, VIC, Australia
- Office of the Provost, School of Science, Health and Engineering, La Trobe University, 3083, Bundoora, VIC, Australia
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16
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“I Always Knew I Was Different”: Experiences of Receiving a Diagnosis of Autistic Spectrum Disorder in Adulthood—a Meta-Ethnographic Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00356-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
AbstractA broadening of diagnostic criteria and increased awareness of autism has led to a large number of individuals whose difficulties remained undetected until adulthood. This systematic review aimed to synthesise empirical evidence of the experience of individuals who received their diagnosis of autism in adulthood. Eight studies met the inclusion criteria. A meta-ethnographic approach was used to synthesise the findings. Analysis revealed two meta-themes: feeling “like an alien” and the “not guilty” verdict, each with three associated subthemes. The findings indicate the need for timely diagnosis and provision of post-diagnostic support to alleviate the mental health implications of not having a framework to understand one’s experiences and to support the process of adjustment to the diagnosis.
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17
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Crompton CJ, Hallett S, Axbey H, McAuliffe C, Cebula K. 'Someone like-minded in a big place': Autistic young adults' attitudes towards autistic peer support in mainstream education. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:76-91. [PMID: 35249357 PMCID: PMC9806484 DOI: 10.1177/13623613221081189] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
LAY ABSTRACT Autistic young people may struggle in mainstream schools and feel disconnected from their peers and their school. We know that autistic adults can benefit from spending time with other autistic people, but we don't know if this is the case for younger autistic people. We conducted interviews with 13 autistic young adults in the United Kingdom who recently left mainstream schooling. We asked them if they would have been interested in being involved in autistic peer support when they were at school, and if so, what that peer support should look like. Results indicated that autistic young people were enthusiastic about the idea of peer support. They thought it was important that peer support was flexible to suit their needs at different times, as well as inclusive, positive, and embracing neurodiversity. They also discussed the potential benefits and difficulties of having a peer support system within a school setting. This adds to the growing body of research on the potential benefits of autistic-autistic interactions on autistic people's well-being and sense of belonging. Findings can be used to help design pilot peer support projects in schools that can be tested to see how effective they are.
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18
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Chan DV, Doran JD, Galobardi OD. Beyond Friendship: The Spectrum of Social Participation of Autistic Adults. J Autism Dev Disord 2023; 53:424-437. [PMID: 35079929 PMCID: PMC8788910 DOI: 10.1007/s10803-022-05441-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 02/04/2023]
Abstract
Difficulties with social interactions and communication that characterize autism persist in adulthood. While social participation in adulthood is often marked by social isolation and limited close friendships, this qualitative study describes the range of social participation activities and community contacts, from acquaintances to close relationships, that contributed to connection from the perspective of 40 autistic adults. Qualitative data from interviews around social and community involvement were analyzed and revealed five main contexts where social participation occurred: vocational contexts, neighborhoods, common interest groups, support services and inclusive environments, and online networks and apps. Implications for practice to support a range of social participation include engaging in newer social networking avenues, as well as traditional paths through employment and support services.
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Affiliation(s)
- Dara V Chan
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA.
- , Campus Box 7250, Chapel Hill, NC, 27599, USA.
| | - Julie D Doran
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA
| | - Osly D Galobardi
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA
- Essential Counseling and Therapeutic Services, PLLC, Chapel Hill, NC, USA
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19
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A Model of Psychosexual Wellbeing for Autistic and Neurotypical Adults in the United States. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09764-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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20
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Callahan R, Kail B, Lerman DC, Johnson-Patagoc K, Whitcher D. Teaching Adults with Neurodevelopmental Disabilities to Interact Successfully with Others in a Virtual Format. Behav Anal Pract 2022; 15:1279-1295. [PMID: 35281673 PMCID: PMC8896411 DOI: 10.1007/s40617-022-00681-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 12/15/2022] Open
Abstract
As a result of the COVID-19 pandemic, individuals with neurodevelopmental disabilities (NDD) are engaging more with others in virtual group formats for social, educational, and professional reasons. This study extends prior research by evaluating the efficacy of common behavioral interventions, including behavioral skills training, provided via group video conferencing to teach skills that are important when interacting with others in a virtual format. Four adults with NDD were taught to use their cameras and microphones appropriately and to make encouraging statements to one another while discussing current events and social skills-based lessons via Zoom™. Two of the three skills increased and maintained for all participants even after the experimenter faded the contingencies for appropriate responding. The third skill maintained after the experimenter arranged for the response to produce natural consequences. Tests for generalization across group leads and activities yielded promising results. Findings suggest that adults with NDD benefit from group-based telehealth services to improve skills needed to interact successfully with others in a virtual format.
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Affiliation(s)
| | | | - Dorothea C. Lerman
- University of Houston, Clear Lake, 2700 Bay Area Blvd, Houston, TX 77058 USA
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21
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Bertilsdotter Rosqvist H, Hultman L, Hallqvist J. Knowing and accepting oneself: Exploring possibilities of self-awareness among working autistic young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221137428. [DOI: 10.1177/13623613221137428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Autistic people have historically been described as incapable of developing a deeper sense of self-awareness, and autistic understandings of self-awareness have been largely disregarded. The aim of this study is to explore the way young autistic adults try to understand their functionality and who they are, or to develop their sense of self-awareness, in work and in private life contexts. In 12 qualitative interviews conducted with four autistic adults without learning difficulties, we identified a rich set of reflections on knowing and accepting oneself. The overarching theme of self-knowledge has three subthemes: learning from previous experiences, learning about oneself by securing the support of others, and understanding and accepting autistic functionality. The strategy of self-knowledge was used by these young adults to help them achieve functional lives in the work and private domains. Our results show that young autistic adults both actively explore and develop their self-awareness. We suggest that it is important for practitioners and employers working with autistic individuals to engage with their journeys of self-awareness as a vital part of understanding and supporting them. Lay abstract When researchers and professionals talk about autism, they commonly point out problems and risks with autism or being autistic. Several interventions are based on the idea of the problems and risks of autism. Another way of talking about autism is to point out autistic people’s strengths and strategies which they use to handle barriers and problems in their lives in order to live good lives on their own terms. In this article, the researchers explore how autistic young adults formulate their own difficulties, strengths and support needs in order to get right support from support people. To be able to formulate this, autistic people need to get to know oneself and one’s own way of functioning. Autistic own self-knowledge must be central when formal support people, such as social workers, formulate support and interventions aimed at helping autistic people, in order for the support/intervention to be helpful.
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22
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Simpson K, Clark M, Adams D. Profiles and predictors of thriving in children on the autism spectrum. Child Care Health Dev 2022; 48:693-701. [PMID: 35067966 DOI: 10.1111/cch.12974] [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: 08/16/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Thriving is defined as the growth of attributes that mark a flourishing, healthy individual and include Competence, Confidence, Connectedness, Character, Caring and Contribution to self, family, community and civil society. Thriving has been linked to positive youth outcomes in neurotypical children and adolescents but has rarely been explored for individuals on the autism spectrum. METHOD This study explored the profiles and predictors of parent-reported thriving in 111 school children on the autism spectrum, aged 6 to 14 years. RESULTS Parents rated children as having relative strengths in the Caring and Connectedness dimensions and relative challenges in the Competence dimension. Stronger thriving outcomes were consistently predicted by stronger socialization scores; however, the other predictors of outcome differed by dimensions. CONCLUSION The current findings provide insight into the individual and contextual factors that predict thriving in children on the autism spectrum. As research into thriving is in its infancy, more work is needed to understand how child, family and contextual factors relate to thriving in individuals on the autism spectrum to foster positive outcomes.
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Affiliation(s)
- Kate Simpson
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute for Educational Research, Griffith University, Brisbane, Queensland, Australia
| | - Megan Clark
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute for Educational Research, Griffith University, Brisbane, Queensland, Australia
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Brisbane, Queensland, Australia.,Griffith Institute for Educational Research, Griffith University, Brisbane, Queensland, Australia
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23
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Experiences of Friendships for Individuals on the Autism Spectrum: A Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00332-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractFriendships are vital to mental health and well-being. Understanding autistic individuals’ lived experiences of friendship is necessary to support friendship development. A scoping review exploring autistic individuals’ experiences of friendship was undertaken to understand their perspectives of friendship. Electronic database and manual reference searches identified twenty-two studies exploring autistic perspectives of friendship. Results were synthesised using a meta-ethnographic approach across the lifespan. Findings highlight the common and unique experiences of friendship among autistic individuals. While autistic individuals defined friendship based on homophily and propinquity, similar to non-autistic individuals, unique challenges including friendship insecurity, monotropism and efforts to conform to neurotypical social norms, leading to anxiety, were experienced by autistic individuals.
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24
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Hume R. Show Me the Real You: Enhanced Expression of Rogerian Conditions in Therapeutic Relationship Building with Autistic Adults. AUTISM IN ADULTHOOD 2022; 4:151-163. [PMID: 36605974 PMCID: PMC9645675 DOI: 10.1089/aut.2021.0065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Research in psychotherapy and counseling theory has shown the importance of a strong therapeutic relationship. However, in the context of working with autistic adults, the relationship appears to be de-emphasized, or "different approaches" are recommended without specifying these. Neglect of relationship building may contribute to autistic adults' negative experiences with health care professionals identified in previous studies. Methods I interviewed 17 autistic adults about their relationship building experiences with a wide range of professionals primarily from mental and medical health backgrounds. I also interviewed two mental health counselors and one psychologist who had experience working with this client group and had been recommended by autistic participants. I elicited best practice recommendations from all participants. I analyzed the data in an interpretive-interactionist framework and present them through creative analytic practice. Findings I address one major theme in this article: the importance of Rogerian/person-centered relationship conditions. All had to be practiced in an enhanced way: (1) Enhanced congruence could be demonstrated through therapist self-disclosure and refraining from phony relationship building "techniques" such as vocal adjustments. (2) Enhanced empathy could be demonstrated through genuine listening and accurate interpretation; however, interpretation needed to be phrased tentatively. (3) Enhanced unconditional positive regard could be demonstrated through explicit verbal expression, practical demonstration, and remembering. Conclusions Results largely mirrored research with non-autistic populations: different approaches were not needed for relationship building. Participants emphasized the importance of Rogers' person-centered conditions and described pivotal relationship building moments associated with enhanced expression of these conditions.
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Affiliation(s)
- Romy Hume
- Department of Critical Studies in Education, Faculty of Education and Social Work, The University of Auckland, Auckland, New Zealand
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25
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Pearson A, Rees J, Forster S. "This Was Just How This Friendship Worked": Experiences of Interpersonal Victimization Among Autistic Adults. AUTISM IN ADULTHOOD 2022; 4:141-150. [PMID: 36605970 PMCID: PMC9645672 DOI: 10.1089/aut.2021.0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background The victimization of autistic people by familiar others (interpersonal victimization) is an understudied phenomenon despite suggestions that prevalence rates may be disproportionately high. We know very little about the way autistic people perceive these experiences, and how to support them. The aim of the current study was to explore experiences of interpersonal victimization among autistic adults from their own perspective. Methods We recruited 43 autistic adults to take part in a qualitative online study, and asked about their experiences of being victimized or taken advantage of by people they know in the past. We analyzed their comments at the semantic level using inductive thematic analysis, from a critical realist perspective. Results We identified two key themes in the data. The first theme, "cycles of victimization" highlighted the occurrence of polyvictimization in the sample. The second ("perceptions of victimization") focused on how these experiences were related to difficulties with trust (of both self and others), the recognition of victimization, and heightened compliance. The participants expressed difficulty with saying no to people, and found it difficult to identify when someone had negative or manipulative intentions. Conclusions Our findings suggest that autistic adults experience victimization from a range of close others, and may find it difficult to recognize when someone is acting in an abusive manner. Many participants had experienced heightened compliance in response to unreasonable requests from others, however, reasons for this were varied (e.g., fear and desire to avoid confrontation) and require further investigation. These findings have implications for developing supports that enable autistic adults to recognize their own boundaries and advocate for themselves, in addition to helping them to recognize what a healthy relationship looks like.
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Affiliation(s)
- Amy Pearson
- Faculty of Health and Wellbeing, School of Psychology, University of Sunderland, Sunderland, United Kingdom
| | - Jon Rees
- Faculty of Health and Wellbeing, School of Psychology, University of Sunderland, Sunderland, United Kingdom
| | - Samantha Forster
- School of Social Sciences, University of Sunderland, United Kingdom
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26
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Parker KJ. Leveraging a translational research approach to drive diagnostic and treatment advances for autism. Mol Psychiatry 2022; 27:2650-2658. [PMID: 35365807 PMCID: PMC9167797 DOI: 10.1038/s41380-022-01532-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 01/01/2023]
Abstract
Autism spectrum disorder (ASD) is a prevalent and poorly understood neurodevelopmental disorder. There are currently no laboratory-based diagnostic tests to detect ASD, nor are there any disease-modifying medications that effectively treat ASD's core behavioral symptoms. Scientific progress has been impeded, in part, by overreliance on model organisms that fundamentally lack the sophisticated social and cognitive abilities essential for modeling ASD. We therefore saw significant value in studying naturally low-social rhesus monkeys to model human social impairment, taking advantage of a large outdoor-housed colony for behavioral screening and biomarker identification. Careful development and validation of our animal model, combined with a strong commitment to evaluating the translational utility of our preclinical findings directly in patients with ASD, yielded a robust neurochemical marker (cerebrospinal fluid vasopressin concentration) of trans-primate social impairment and a first-in-class medication (intranasal vasopressin) shown in a small phase 2a pilot trial to improve social abilities in children with ASD. This translational research approach stands to advance our understanding of ASD in a manner not readily achievable with existing animal models, and can be adapted to investigate a variety of other human brain disorders which currently lack valid preclinical options, thereby streamlining translation and amplifying clinical impact more broadly.
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Affiliation(s)
- Karen J Parker
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
- Department of Comparative Medicine, Stanford University, Stanford, CA, 94305, USA.
- California National Primate Research Center, Davis, CA, 95616, USA.
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27
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Cola M, Zampella CJ, Yankowitz LD, Plate S, Petrulla V, Tena K, Russell A, Pandey J, Schultz RT, Parish-Morris J. Conversational adaptation in children and teens with autism: Differences in talkativeness across contexts. Autism Res 2022; 15:1090-1108. [PMID: 35199482 PMCID: PMC9167260 DOI: 10.1002/aur.2693] [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] [Received: 07/16/2021] [Revised: 01/04/2022] [Accepted: 02/14/2022] [Indexed: 11/06/2022]
Abstract
Successful social communication is complex; it relies on effectively deploying and continuously revising one's behavior to fit the needs of a given conversation, partner, and context. For example, a skilled conversationalist may instinctively become less talkative with a quiet partner and more talkative with a chattier one. Prior research suggests that behavioral flexibility across social contexts can be a particular challenge for individuals with autism spectrum condition (ASC), and that difficulty adapting to the changing needs of a conversation contributes to communicative breakdowns and poor social outcomes. In this study, we examine whether reduced conversational adaptation, as measured by talkativeness, differentiates 48 verbally fluent children and teens with ASC from 50 neurotypical (NT) peers matched on age, intelligence quotient, and sex ratio. Participants completed the Contextual Assessment of Social Skills with two novel conversation partners. The first acted interested in the conversation and talked more (Interested condition), while the second acted bored and talked less (Bored condition). Results revealed that NT participants emulated their conversation partner's behavior by being more talkative in the Interested condition as compared to the Bored condition (z = 9.92, p < 0.001). In contrast, the ASC group did not differentially adapt their behavior to the Bored versus Interested context, instead remaining consistently talkative in both (p = 0.88). The results of this study have implications for understanding social communication and behavioral adaptation in ASC, and may be valuable for clinicians interested in improving conversational competence in verbally fluent individuals with autism. LAY SUMMARY: Social communication-including everyday conversations-can be challenging for individuals on the autism spectrum. In successful conversations, people tend to adjust aspects of their language to be more similar to their partners'. In this study, we found that children and teens with autism did not change their own talkativeness in response to a social partner who was more or less talkative, whereas neurotypical peers did. These findings have clinical implications for improving conversational competence in verbally fluent individuals with autism.
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Affiliation(s)
- Meredith Cola
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- La Salle University, Department of Psychology, 1900 W Olney Ave, Philadelphia, PA 19141
| | - Casey J. Zampella
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
| | - Lisa D. Yankowitz
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- University of Pennsylvania, Department of Psychology, 3720 Walnut St, Philadelphia, PA 19104
| | - Samantha Plate
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- University of Pittsburgh, Department of Psychology, 210 S. Bouquet St, Pittsburgh, PA 15213
| | - Victoria Petrulla
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
| | - Kimberly Tena
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
| | - Alison Russell
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
| | - Juhi Pandey
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- Perelman School of Medicine of the University of Pennsylvania, Department of Psychiatry, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Robert T. Schultz
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- Perelman School of Medicine of the University of Pennsylvania, Department of Pediatrics, 3400 Civic Center Blvd, Philadelphia, PA 19104
| | - Julia Parish-Morris
- Children’s Hospital of Philadelphia, Center for Autism Research, 2716 South St, Philadelphia, PA 19104
- Perelman School of Medicine of the University of Pennsylvania, Department of Psychiatry, 3400 Civic Center Blvd, Philadelphia, PA 19104
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Seers K, Hogg R. “Fake it ‘till you make it”: Authenticity and wellbeing in late diagnosed autistic women. FEMINISM & PSYCHOLOGY 2022. [DOI: 10.1177/09593535221101455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The diagnosis of autism spectrum condition (ASC) in women is increasing, prompting research into the gendered experience and presentation of female ASC. To complement this growing body of research, the current study utilised a qualitative approach informed by a feminist disability framework to explore how the intersecting dimensions of difference, gender, and ASC influence autistic women’s subjectivity and wellbeing. Drawing on the experiences of eight late-diagnosed autistic women, thematic analysis highlighted experiences of early marginalisation, challenges of living outside gendered social norms, the psychological and emotional consequences of masking, and the impact of diagnosis on subjectivity, identity, and wellbeing. Participants developed their authenticity and personhood within a performative social context that required masking of the self, a complex process with wide-ranging consequences. Findings also highlight the importance of acceptance, representation, and community for the wellbeing of autistic women. This research challenges the dominant, masculinised construction of ASC. It highlights the need for the ontological status of ASC to be reconceptualised to incorporate diverse experiences of the condition across the gender spectrum. Future research should explore how psychology can facilitate this reconceptualisation.
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Espelöer J, Proft J, Falter-Wagner CM, Vogeley K. Alarmingly large unemployment gap despite of above-average education in adults with ASD without intellectual disability in Germany: a cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2022; 273:731-738. [PMID: 35567615 PMCID: PMC10085916 DOI: 10.1007/s00406-022-01424-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/22/2022] [Indexed: 12/28/2022]
Abstract
For individuals with autism spectrum disorder (ASD), both getting access to as well as staying in the labor market are very challenging. However, the detailed educational, vocational, and employment characteristics of persons with ASD without intellectual disabilities are not yet studied. We conducted a retrospective study on a sample of 232 clinically late-diagnosed adults with ASD without intellectual disabilities. Data were compared to the general German population obtained from the public database of the German Federal Employment Agency. Results showed that the majority of persons with ASD graduated from high school and obtained a university entrance qualification (ASD: 50.4%; general population: 32.5%). Also, lower rates of basic secondary education were found in the ASD sample (ASD: 16.5%, general population: 29.6%). Significantly less individuals with ASD completed vocational training (40.1%) in comparison to the German population (56.3%). Despite the above-average level of education, the unemployment rate of the sample substantially exceeds that of the general population by the factor 5 (ASD: 25.2%; general population: 5.2%). Periods of unwanted unemployment of persons with ASD lasted on average 23 months with interpersonal problems being the main reason for contract termination. A higher level of educational qualification does not protect against a higher risk of unemployment for individuals with ASD presumably due to autism-specific interpersonal difficulties. Data emphasize the necessity to develop and spread both specific employment support activities for individuals with ASD as well as adequate awareness raising strategies. Funded by a public grant of the "Landschaftsverband Rheinland (LVR)".
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Affiliation(s)
- Julia Espelöer
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
| | - Julia Proft
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | | | - Kai Vogeley
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
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30
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Bambara LM. Appreciating Individual Differences: A Response to Beechey and Keates. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1604-1606. [PMID: 35263557 DOI: 10.1044/2021_jslhr-21-00630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Linda M Bambara
- Department of Education and Human Services, Lehigh University, Bethlehem, PA
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31
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Kuo AA, Hotez E, Rosenau KA, Gragnani C, Fernandes P, Haley M, Rudolph D, Croen LA, Massolo ML, Holmes LG, Shattuck P, Shea L, Wilson R, Martinez-Agosto JA, Brown HM, Dwyer PSR, Gassner DL, Onaiwu MG, Kapp SK, Ne'eman A, Ryan JG, Waisman TC, Williams ZJ, DiBari JN, Foney DM, Ramos LR, Kogan MD. The Autism Intervention Research Network on Physical Health (AIR-P) Research Agenda. Pediatrics 2022; 149:e2020049437D. [PMID: 35363290 DOI: 10.1542/peds.2020-049437d] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda. METHODS Development of the research agenda involved an iterative and collaborative process between the AIR-P Advisory Board, Steering Committee, and Autistic Researcher Review Board. The methodology consisted of 3 phases: (1) ideation and design, (2) literature review and synthesis; and (3) network engagement. RESULTS Six core research priorities related to the health of autistic individuals were identified: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) health systems and services, (4) gender, sexuality, and reproductive health, (5) neurology, and (6) genetics. Specific topics within each of these priorities were identified. Four cross-cutting research priorities were also identified: (1) neurodiversity-oriented care, (2) facilitating developmental transitions, (3) methodologically rigorous intervention studies, and (4) addressing health disparities. CONCLUSIONS The AIR-P Research Agenda represents an important step forward for enacting large-scale health-promotion efforts for autistic individuals across the lifespan. This agenda will catalyze autism research in historically underrepresented topic areas while adopting a neurodiversity-oriented approach to health-promotion.
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Affiliation(s)
- Alice A Kuo
- Departments of Medicine and
- Pediatrics
- Graduate School of Education and Information Studies, University of California, Los Angeles, Los Angeles, California
| | | | - Kashia A Rosenau
- Graduate School of Education and Information Studies, University of California, Los Angeles, Los Angeles, California
| | | | | | | | - Dawn Rudolph
- Association of University Centers on Disabilities, Silver Spring, Maryland
| | - Lisa A Croen
- Kaiser Permanente Northern California, Los Angeles, California
| | - Maria L Massolo
- Kaiser Permanente Northern California, Los Angeles, California
| | | | | | - Lindsay Shea
- AJ Drexel Autism Institute, Philadelphia, Pennsylvania
| | | | | | | | - Patrick S R Dwyer
- Center for Mind and Brain
- Department of Psychology, University of California Davis, Davis, California
| | - Dena L Gassner
- School of Social Work, Adelphi University, Garden City, New York
- Department of Health Sciences, Towson University, Towson, Maryland
| | | | - Steven K Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Ari Ne'eman
- Harvard University, Cambridge, Massachusetts
| | - Jacalyn G Ryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - T C Waisman
- University of Calgary, Calgary, Alberta, Canada
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Brain Institute
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, Tennessee
| | - Jessica N DiBari
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | - Dana M Foney
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
| | | | - Michael D Kogan
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
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32
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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
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33
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van den Heuvel RM, Wensing M, Geurts HM, Teunisse JP. The Social Support Network of Adults with an Autism Spectrum Condition: An Exploration Using the Network in Action-Questionnaire. J Autism Dev Disord 2022; 53:1974-1988. [PMID: 35182260 PMCID: PMC10123042 DOI: 10.1007/s10803-022-05467-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
Actively involving the network during treatment, as recommended in Autism Spectrum Condition (ASC) guidelines, can be facilitated with the Network in Action-Questionnaire (NiA-Q), which identifies the current and potential sources of social support. The aims of this study were to (1) examine the factor structure of the NiA-Q and (2) to explore the self- and proxy-report on the social network. Before the start of treatment in a mental health institution, 193 adults with an ASC diagnosis and 84 proxies completed the NiA-Q. Factor analysis showed two factors: positive social support and interpersonal distress. Self- and proxy-report on the NiA-Q did not differ for most variables, except for social network wishes. The NiA-Q provides a basis for network involvement and strengthening.
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Affiliation(s)
- Rinske M van den Heuvel
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands. .,HAN University of Applied Sciences, Nijmegen, The Netherlands. .,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - Michel Wensing
- General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Hilde M Geurts
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan-Pieter Teunisse
- Leo Kannerhuis, Youz (Parnassia Group), Stationsweg 49, 6861 EE, Oosterbeek, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
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34
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Jones M, Falkmer M, Milbourn B, Tan T, Bölte S, Girdler S. The Core Elements of Strength-Based Technology Programs for Youth on the Autism Spectrum: A Systematic Review of Qualitative Evidence. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00302-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractStrength-based programs that incorporate technology have gained increasing popularity as an approach to improve outcomes for individuals with autism spectrum disorder (ASD). Despite this, the core elements of strength-based technology programs remain poorly described. This study aimed to identify the core elements of strength-based technology programs for youth with ASD through a systematic review of the literature. Electronic databases were searched for qualitative studies delivering strength-based technology-driven interventions to youth on the spectrum. Ten of the 874 studies identified met the criteria. Qualitative analysis revealed three core elements of strength-based technology programs for this population: mutual respect, demonstrating skills, and interests. The findings underpin the design of future strength-based technology programs for youth with ASD.
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Gronewold J, Engels M. The Lonely Brain - Associations Between Social Isolation and (Cerebro-) Vascular Disease From the Perspective of Social Neuroscience. Front Integr Neurosci 2022; 16:729621. [PMID: 35153690 PMCID: PMC8834536 DOI: 10.3389/fnint.2022.729621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
The current COVID-19 pandemic led to a considerable reduction in in-person social contacts all over the world. In most individuals, reduced social contacts lead to the perception of social isolation causing feelings of loneliness, which are experienced as stressful. Experiencing social distress due to actual or perceived social isolation has been associated with negative health outcomes such as depression, (cerebro-) vascular disease and mortality. Concrete mechanisms behind this association are still a matter of debate. A group of researchers around Hugo Critchley with special contributions of Sarah Garfinkel and Lisa Quadt proposes a framework for the underlying brain-body interactions including elements from models of social homeostasis and interoceptive predictive processing that provides important insights and testable pathways. While in a previous publication, we reviewed literature on the observed association between social isolation and stroke and coronary heart disease, we now extent this review by presenting a comprehensive model to explain underlying pathomechanisms from the perspective of social neuroscience. Further, we discuss how neurodivergent people, e.g. autistic individuals or persons with attention deficit disorders, might differ in these pathomechanisms and why they are especially vulnerable to social isolation. Finally, we discuss clinical implications for the prevention and therapy of (cerebro-) vascular diseases.
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Affiliation(s)
- Janine Gronewold
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Miriam Engels
- Institute of Medical Sociology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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36
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Cola M, Yankowitz LD, Tena K, Russell A, Bateman L, Knox A, Plate S, Cubit LS, Zampella CJ, Pandey J, Schultz RT, Parish-Morris J. Friend matters: sex differences in social language during autism diagnostic interviews. Mol Autism 2022; 13:5. [PMID: 35012645 PMCID: PMC8751321 DOI: 10.1186/s13229-021-00483-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Autistic individuals frequently experience social communication challenges. Girls are diagnosed with autism less often than boys even when their symptoms are equally severe, which may be due to insufficient understanding of the way autism manifests in girls. Differences in the behavioral presentation of autism, including how people talk about social topics, could contribute to these persistent problems with identification. Despite a growing body of research suggesting that autistic girls and boys present distinct symptom profiles in a variety of domains, including social attention, friendships, social motivation, and language, differences in the way that autistic boys and girls communicate verbally are not yet well understood. Closely analyzing boys' and girls' socially-focused language during semi-structured clinical assessments could shed light on potential sex differences in the behavioral presentation of autistic individuals that may prove useful for identifying and effectively supporting autistic girls. Here, we compare social word use in verbally fluent autistic girls and boys during the interview sections of the ADOS-2 Module 3 and measure associations with clinical phenotype. METHODS School-aged girls and boys with autism (N = 101, 25 females; aged 6-15) were matched on age, IQ, and parent/clinician ratings of autism symptom severity. Our primary analysis compared the number of social words produced by autistic boys and girls (normalized to account for differences in total word production). Social words are words that make reference to other people, including friends and family. RESULTS There was a significant main effect of sex on social word production, such that autistic girls used more social words than autistic boys. To identify the specific types of words driving this effect, additional subcategories of friend and family words were analyzed. There was a significant effect of sex on friend words, with girls using significantly more friend words than boys. However, there was no significant main effect of sex on family words, suggesting that sex differences in social word production may be driven by girls talking more about friends compared to boys, not family. To assess relationships between word use and clinical phenotype, we modeled ADOS-2 Social Affect (SA) scores as a function of social word production. In the overall sample, social word use correlated significantly with ADOS-2 SA scores, indicating that participants who used more social words were rated as less socially impaired by clinicians. However, when examined in each sex separately, this result only held for boys. LIMITATIONS This study cannot speak to the ways in which social word use may differ for younger children, adults, or individuals who are not verbally fluent; in addition, there were more autistic boys than girls in our sample, making it difficult to detect small effects. CONCLUSIONS Autistic girls used significantly more social words than boys during a diagnostic assessment-despite being matched on age, IQ, and both parent- and clinician-rated autism symptom severity. Sex differences in linguistic markers of social phenotype in autism are especially important in light of the late or missed diagnoses that disproportionately affect autistic girls. Specifically, heightened talk about social topics could complicate autism referral and diagnosis when non-clinician observers expect a male-typical pattern of reduced social focus, which autistic girls may not always exhibit.
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Affiliation(s)
- Meredith Cola
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- Department of Psychology, La Salle University, 1900 West Olney Ave, Philadelphia, PA 19141 USA
| | - Lisa D. Yankowitz
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- Department of Psychology, University of Pennsylvania, 3720 Walnut St, Philadelphia, PA 19104 USA
| | - Kimberly Tena
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Alison Russell
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Leila Bateman
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Azia Knox
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Samantha Plate
- Department of Psychology, University of Pittsburgh, 210 S. Bouquet St, Pittsburgh, PA 15213 USA
| | - Laura S. Cubit
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Casey J. Zampella
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, 2716 South St, Philadelphia, PA 19104 USA
- Department of Psychiatry, Perelman School of Medicine of the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
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Schott W, Tao S, Shea L. Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum. Autism Res 2022; 15:70-85. [PMID: 34854249 PMCID: PMC8812993 DOI: 10.1002/aur.2644] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/19/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023]
Abstract
Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008-2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. LAY SUMMARY: Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries.
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Affiliation(s)
- Whitney Schott
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, 3020 Market Street, Ste 560, Philadelphia, PA 19104
| | - Sha Tao
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, 3020 Market Street, Ste 560, Philadelphia, PA 19104
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, 3020 Market Street, Ste 560, Philadelphia, PA 19104
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Cameron LA, Borland RL, Tonge BJ, Gray KM. Community participation in adults with autism: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:421-447. [PMID: 34907624 DOI: 10.1111/jar.12970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/07/2021] [Accepted: 11/09/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND This systematic review aimed to explore how adults with autism participate in the community, the impact of community participation on quality of life and mental health, and factors that support and hinder participation. METHOD A systematic review was conducted including studies published from inception to 17 January 2021. RESULTS Sixty-three reports were included, reporting on 58 studies. Solitary activities, organised group activities, community activities, religious groups and online social participation were identified. The relationship between community participation and quality of life was examined. Barriers and facilitators to increased community participation were identified. Most studies had a moderate to high risk of bias. CONCLUSION Adults with autism participate in a range of independent and community activities. The impact of community participation on quality of life and mental health warrants further exploration. Future studies should find effective ways of supporting adults with autism to participate in the community.
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Affiliation(s)
- Lauren A Cameron
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Ross L Borland
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Bruce J Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Kylie M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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Chen YL, Martin W, Vidiksis R, Patten K. "A different environment for success:" a mixed-methods exploration of social participation outcomes among adolescents on the autism spectrum in an inclusive, interest-based school club. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:738-747. [PMID: 37547547 PMCID: PMC10402833 DOI: 10.1080/20473869.2021.2001729] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 08/08/2023]
Abstract
Background: Adolescents on the autism spectrum often experience challenges participating socially in inclusive education. The majority of school-based social supports focuses on social skills training, although research shows that students on the spectrum prefer activity-based social groups over social instructions. Thus, activity-based school clubs incorporating student interests may support social participation. Method: This mixed-methods study explored the preliminary social participation outcomes of adolescents on the spectrum in an inclusive Maker Club at three public schools. The quantitative phase examined longitudinal social behavior rates throughout the school club among students (n = 12). The qualitative phase interviewed six teachers in three schools (n = 6) to explore teacher perceptions of student social outcomes compared to general classrooms and program outcomes associated with the programs. Results: Mixed-effects modeling revealed increased social response rates and social reciprocity over time in both students on the spectrum and non-autistic peers without any group differences. Teachers reported that students on the spectrum engaged more socially than in general classrooms and attributed the positive outcomes to activities encouraging shared interests and the flexible social environment. Conclusions: Inclusive school clubs incorporating shared interests and joint activities among students may socially support students on the spectrum in inclusive education.
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Affiliation(s)
- Yu-Lun Chen
- Occupational Therapy, New York University Steinhardt School of Culture Education and Human Development, New York, NY, USA
| | - Wendy Martin
- Center for Children and Technology, Education Development Center, New York, NY, USA
| | - Regan Vidiksis
- Center for Children and Technology, Education Development Center, New York, NY, USA
| | - Kristie Patten
- Occupational Therapy, New York University Steinhardt School of Culture Education and Human Development, New York, NY, USA
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40
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Gillespie-Smith K, Hendry G, Anduuru N, Laird T, Ballantyne C. Using social media to be 'social': Perceptions of social media benefits and risk by autistic young people, and parents. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 118:104081. [PMID: 34507053 DOI: 10.1016/j.ridd.2021.104081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
Autistic individuals are reported to struggle with aspects of social interaction. Past research has shown that social media use can help to facilitate social functioning, however, the perceptions of risks and benefits when engaging on social media platforms remains unclear. The current study aimed to explore perceptions of social media participation in terms of online risk and online relationships in both autistic young people and parents. Eight autistic young people and six parents of autistic young people took part in semi-structured interviews, with the resultant data being transcribed and analysed using Braun and Clarke's (2006) inductive thematic analysis. Two themes were identified in relation to the impact social media has on autistic young people's relationships (Socialisation; Communication) and two themes were identified in relation to the perceived barriers and risks to engaging online (Abusive interactions; Talking to strangers). These findings show that social interaction is of particular value to young autistic people, in terms of affording them easier social interactions than there would be in 'real life'. The findings also show that the autistic young people were aware of risks online, and considered ways in which they try to manage this risk. Future research is needed to understand if similar interactions and risk take place across all platforms and whether online communication is successful between matched or mixed autistic and non-autistic groups.
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Affiliation(s)
- Karri Gillespie-Smith
- Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.
| | - Gillian Hendry
- Division of Psychology, School of Education and Social Sciences, University of West of Scotland, Paisley, UK
| | - Nicole Anduuru
- Division of Psychology, School of Education and Social Sciences, University of West of Scotland, Paisley, UK
| | - Tracey Laird
- Division of Psychology, School of Education and Social Sciences, University of West of Scotland, Paisley, UK
| | - Carrie Ballantyne
- Division of Psychology, School of Education and Social Sciences, University of West of Scotland, Paisley, UK
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Chen YL, Schneider M, Patten K. Exploring interpersonal and environmental factors of autistic adolescents' peer engagement in integrated education. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1255-1266. [PMID: 34541934 PMCID: PMC9340126 DOI: 10.1177/13623613211046158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Peer engagement is essential but often challenging for autistic students in integrated education, especially for adolescents. Although peer engagement is bidirectional and context-dependent, research has largely focused on individual characteristics rather than the interpersonal and environmental factors affecting peer engagement. This mixed-methods study examined peer interactions over a school year among 17 adolescents (seven were autistic) in an inclusive school club at a public middle school in the Northeastern United States. The study began with a quantitative phase identifying sessions in which each student was socially engaged with peers more or less often than usual for them. We then qualitatively compared the social interactions and contexts between sessions where each participant experienced high and low peer engagement. Thematic analysis revealed four themes regarding contextual supports and barriers to autistic peer engagement: (1) peer engagement is a participatory process where a student and their peer(s) navigate mutual understanding, shaped by both student and peer social characteristics, openness, and involvement; (2) student-peer synchronicity, such as shared interests or compatibility of social styles, was essential to autistic peer engagement; (3) peer engagement can be supported by activities facilitating joint engagement and exploration of mutual interests; (4) classroom interventions emphasizing strengths can support peer engagement, while normative behavioral standards without peer education on individual differences and diversity can perpetuate peers' negative perceptions of autistic difficulties. The findings have implications for better inclusive practice to support autistic social participation by modifying the peer environments, activities, and classroom interventions.
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Affiliation(s)
| | - Maxwell Schneider
- New York University, USA.,The Kull Initiative for Psychotherapy, USA
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Chen YL, Murthi K, Martin W, Vidiksis R, Riccio A, Patten K. Experiences of Students, Teachers, and Parents Participating in an Inclusive, School-Based Informal Engineering Education Program. J Autism Dev Disord 2021; 52:3574-3585. [PMID: 34410541 PMCID: PMC9296405 DOI: 10.1007/s10803-021-05230-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/24/2022]
Abstract
Many youth on the autism spectrum possess interests and strengths for STEM-related postsecondary pathways, yet there are few research-based programs to support those interests and competencies including complex problem solving and social communication. This qualitative study explored the experiences and perceived outcomes of students, teachers, and parents participating in an inclusive, strength-based, extracurricular engineering design program entitled the IDEAS Maker Club. Twenty-six students, 13 parents, and nine teachers in the program completed interviews and program logs while researchers conducted classroom observations over 2 years. Thematic analysis identified five common themes: (1) positive student experience and engagement, (2) skills acquisition, (3) development of interest in STEM and related careers, (4) social relationships and community, and (5) safe spaces that supported self-determination.
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Affiliation(s)
- Yu-Lun Chen
- Department of Occupational Therapy, New York University, 82 Washington Square East, 6th Floor, New York, NY, USA. .,Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, Pless Hall, 82 Washington Square East, 6th Floor, New York, NY, 10003, USA.
| | - Kavitha Murthi
- Department of Occupational Therapy, New York University, 82 Washington Square East, 6th Floor, New York, NY, USA.,Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, Pless Hall, 82 Washington Square East, 6th Floor, New York, NY, 10003, USA
| | - Wendy Martin
- EDC Center for Children and Technology, 96 Morton Street, 7th Floor, New York, NY, USA
| | - Regan Vidiksis
- EDC Center for Children and Technology, 96 Morton Street, 7th Floor, New York, NY, USA
| | - Ariana Riccio
- EDC Center for Children and Technology, 96 Morton Street, 7th Floor, New York, NY, USA
| | - Kristie Patten
- Department of Occupational Therapy, New York University, 82 Washington Square East, 6th Floor, New York, NY, USA
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43
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Aging on the Autism Spectrum: Self-care Practices and Reported Impact on Well-Being. J Autism Dev Disord 2021; 52:3512-3522. [PMID: 34379240 DOI: 10.1007/s10803-021-05229-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
The population aging on the Autism Spectrum (AS) faces disproportionate physical and mental health comorbidities. This research describes self-care practices, including physical activity (PA), nutrition, and spirituality, and the impact of these practices on the health and well-being of older adults on the AS. Researchers conducted semi-structured interviews (N = 30) with older adults (age 50+ years) on the AS on the following topics: health, employment, relationships, and services/supports. Data were analyzed using Dedoose software and a constant comparative method. Participants described self-reported health benefits of their PA. Participants who engaged with organizations reported receiving instrumental support and fulfillment. Several themes emerged regarding socialization and routines in self-care in older adults on the AS, which may inform interventions.
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Song A, Cola M, Plate S, Petrulla V, Yankowitz L, Pandey J, Schultz RT, Parish-Morris J. Natural language markers of social phenotype in girls with autism. J Child Psychol Psychiatry 2021; 62:949-960. [PMID: 33174202 PMCID: PMC9113519 DOI: 10.1111/jcpp.13348] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Girls with autism spectrum condition (ASC) are chronically underdiagnosed compared to boys, which may be due to poorly understood sex differences in a variety of domains, including social interest and motivation. In this study, we use natural language processing to identify objective markers of social phenotype that are easily obtained from a brief conversation with a nonexpert. METHODS 87 school-aged children and adolescents with ASC (17 girls, 33 boys) or typical development (TD; 15 girls, 22 boys) were matched on age (mean = 11.35 years), IQ estimates (mean = 107), and - for ASC participants - level of social impairment. Participants engaged in an informal 5-min 'get to know you' conversation with a nonexpert conversation partner. To measure attention to social groups, we analyzed first-person plural pronoun variants (e.g., 'we' and 'us') and third-person plural pronoun variants (e.g., 'they' and 'them'). RESULTS Consistent with prior research suggesting greater social motivation in autistic girls, autistic girls talked more about social groups than did ASC boys. Compared to TD girls, autistic girls demonstrated atypically heightened discussion of groups they were not a part of ('they', 'them'), indicating potential awareness of social exclusion. Pronoun use predicted individual differences in the social phenotypes of autistic girls. CONCLUSIONS Relatively heightened but atypical social group focus is evident in autistic girls during spontaneous conversation, which contrasts with patterns observed in autistic boys and TD girls. Quantifying subtle linguistic differences in verbally fluent autistic girls is an important step toward improved identification and support for this understudied sector of the autism spectrum.
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Affiliation(s)
- Amber Song
- Center for Autism Spectrum Disorders, Children’s National Medical Center, Washington, D.C., USA
| | - Meredith Cola
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Samantha Plate
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Victoria Petrulla
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa Yankowitz
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Lei J, Russell A. Understanding the role of self-determination in shaping university experiences for autistic and typically developing students in the United Kingdom. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1262-1278. [PMID: 33535817 PMCID: PMC8264627 DOI: 10.1177/1362361320984897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
LAY ABSTRACT Prior research suggests that autistic students in higher education might struggle with developing autonomy, competence and establish relatedness due to their executive functioning and social communication difficulties. We interviewed 18 autistic and 18 typically developing students to explore how students perceived themselves to be in control of their university experience. Both groups provided anecdotal examples that supported similar perceptions of self-determination in shaping the academic, daily living and socialisation aspects of university life. Autistic students reflected on their cognitive strengths such as attention to detail, persistence and ability to tailor their academic studies towards their interest. Varying degrees of sociability were noted, with some autistic students preferring to focus their self-determination efforts on academic success, while others treasured the novel social experiences including peer support and friendship at university. Compared to greater flexibility endorsed by typically developing students, autistic students perceived establishing a routine at university to be a necessity and were self-determined in maintaining stability amid a sea of change. Recognising strengths and self-determination efforts in autistic students can help stakeholders support their personal development towards independent living and self-sufficiency in adulthood and to successfully transition into, through and out of university.
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Affiliation(s)
- Jiedi Lei
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
- King’s College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London, UK
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
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Winnard R, Roy M, Butler-Coyne H. Motherhood: Female Perspectives and Experiences of Being a Parent with ASC. J Autism Dev Disord 2021; 52:2314-2324. [PMID: 34106393 PMCID: PMC9021069 DOI: 10.1007/s10803-021-05122-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 12/04/2022]
Abstract
Little is known about the emotional pressures and practical management of daily challenges and, intra and interpersonal demands of raising a child as a parent with a diagnosis of Autistic Spectrum Conditions. The present study utilised a qualitative approach to understand perceptions of females diagnosed on the autistic spectrum of ‘being a parent’. Eight semi-structured interviews were analysed using Interpretative Phenomenological Analysis. Benefits and challenges of being a parent were highlighted alongside population-specific skill and characteristics associated with strength and resilience, love, nurture, routine and sensory considerations. Findings identify the need for population-specific specialist parenting support, provide direction for professionals in clinical settings and expand the paucity of research in this area.
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Affiliation(s)
- Rebecca Winnard
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK.,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK
| | - Mark Roy
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK.,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK
| | - Hannah Butler-Coyne
- School of Psychology, University of Central Lancashire, Darwin Building, Preston, PR1 2HE, UK. .,Tier 4 CAMHS Inpatients Services, Lancashire Care NHS Foundation Trust, Piccadilly, Lancaster, LA1 4PW, UK.
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Schmidt MM, Glaser N. Piloting an adaptive skills virtual reality intervention for adults with autism: findings from user-centered formative design and evaluation. JOURNAL OF ENABLING TECHNOLOGIES 2021. [DOI: 10.1108/jet-09-2020-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose
The purpose of this paper is to present evaluation findings from a proof-of-concept virtual reality adaptive skills intervention called Virtuoso, designed for adults with autism spectrum disorders.
Design/methodology/approach
A user-centric usage test was conducted to investigate the acceptability, feasibility, ease-of-use and relevance of Virtuoso to the unique needs of participants, as well as the nature of participants’ user experiences. Findings are presented from the perspectives of expert testers and participant testers with autism.
Findings
This paper offers findings that suggest Virtuoso is feasible and relevant to the unique needs of the target population, and that user experience was largely positive. Anecdotal evidence of skills transfer is also discussed.
Research limitations/implications
The research was conducted in limited settings and with a small number of participants. Multiple VR hardware systems were used, and some experienced instability. This could be accounted for in future research by deploying across multiple settings and with a larger number of participants. Some evidence of cybersickness was observed. Future research must carefully consider the trade-offs between VR-based training and cybersickness for this vulnerable population.
Originality/value
This paper reports on cutting-edge design and development in areas that are under-represented and poorly understood in the literature on virtual reality for individuals with autism.
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Leming MJ, Baron-Cohen S, Suckling J. Single-participant structural similarity matrices lead to greater accuracy in classification of participants than function in autism in MRI. Mol Autism 2021; 12:34. [PMID: 33971956 PMCID: PMC8112019 DOI: 10.1186/s13229-021-00439-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Autism has previously been characterized by both structural and functional differences in brain connectivity. However, while the literature on single-subject derivations of functional connectivity is extensively developed, similar methods of structural connectivity or similarity derivation from T1 MRI are less studied. METHODS We introduce a technique of deriving symmetric similarity matrices from regional histograms of grey matter volumes estimated from T1-weighted MRIs. We then validated the technique by inputting the similarity matrices into a convolutional neural network (CNN) to classify between participants with autism and age-, motion-, and intracranial-volume-matched controls from six different databases (29,288 total connectomes, mean age = 30.72, range 0.42-78.00, including 1555 subjects with autism). We compared this method to similar classifications of the same participants using fMRI connectivity matrices as well as univariate estimates of grey matter volumes. We further applied graph-theoretical metrics on output class activation maps to identify areas of the matrices that the CNN preferentially used to make the classification, focusing particularly on hubs. LIMITATIONS While this study used a large sample size, the majority of data was from a young age group; furthermore, to make a viable machine learning study, we treated autism, a highly heterogeneous condition, as a binary label. Thus, these results are not necessarily generalizable to all subtypes and age groups in autism. RESULTS Our models gave AUROCs of 0.7298 (69.71% accuracy) when classifying by only structural similarity, 0.6964 (67.72% accuracy) when classifying by only functional connectivity, and 0.7037 (66.43% accuracy) when classifying by univariate grey matter volumes. Combining structural similarity and functional connectivity gave an AUROC of 0.7354 (69.40% accuracy). Analysis of classification performance across age revealed the greatest accuracy in adolescents, in which most data were present. Graph analysis of class activation maps revealed no distinguishable network patterns for functional inputs, but did reveal localized differences between groups in bilateral Heschl's gyrus and upper vermis for structural similarity. CONCLUSION This study provides a simple means of feature extraction for inputting large numbers of structural MRIs into machine learning models. Our methods revealed a unique emphasis of the deep learning model on the structure of the bilateral Heschl's gyrus when characterizing autism.
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Affiliation(s)
- Matthew J Leming
- Department of Psychiatry, University of Cambridge, Robinson Way, Cambridge, Cambridgeshire, CB2 0SZ, UK.
- Center for Systems Biology, Massachusetts General Hospital, 149 13th Street, Boston, MA, 02129, USA.
| | - Simon Baron-Cohen
- Department of Psychiatry, University of Cambridge, Robinson Way, Cambridge, Cambridgeshire, CB2 0SZ, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Robinson Way, Cambridge, Cambridgeshire, CB2 0SZ, UK
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How Do Adults with Autism Spectrum Disorder Participate in the Labor Market? A German Multi-center Survey. J Autism Dev Disord 2021; 52:1066-1076. [PMID: 33864556 PMCID: PMC8854283 DOI: 10.1007/s10803-021-05008-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 12/03/2022]
Abstract
International studies show disadvantages for adults with autism spectrum disorder (ASD) in the labor market. Data about their participation in the German labor market are scarce. The aim of this study was to examine the integration of adults with ASD in the German labor market in terms of education, employment and type of occupation by means of a cross-sectional-study, using a postal questionnaire. Findings show above average levels of education for adults with ASD compared to the general population of Germany and simultaneously, below average rates of employment and high rates of financial dependency. That indicates a poor integration of adults with ASD in the German labor market and emphasizes the need for vocational support policies for adults with ASD.
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Hassrick EM, Holmes LG, Sosnowy C, Walton J, Carley K. Benefits and Risks: A Systematic Review of Information and Communication Technology Use by Autistic People. AUTISM IN ADULTHOOD 2021; 3:72-84. [PMID: 36601264 PMCID: PMC8992882 DOI: 10.1089/aut.2020.0048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Communication via the internet is a regular feature of everyday interactions for most people, including autistic people. Researchers have investigated how autistic people use information and communication technology (ICT) since the early 2000s. However, no systematic review has been conducted to summarize findings. Objective This study aims to review existing evidence presented by studies about how autistic people use ICT to communicate and provide a framework for understanding contributions, gaps, and opportunities for this literature. Methods Guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA) statement, we conducted a comprehensive review across five databases, searching for studies investigating how autistic youth and adults use ICT to communicate. Authors reviewed the articles for inclusion and assessed methodological quality. Results Thirty-two studies met the eligibility criteria, including 19 quantitative studies, 12 qualitative studies, and 1 mixed methods study, with data from 3026 autistic youth (n = 9 studies) and adults (n = 23 studies). Ratings suggest that the evidence base is emergent. Underrepresented groups in the sample included autistic women, transgendered autistic people, non-White autistic people, low income autistic people, and minimally speaking and/or autistic adults with co-occurring intellectual disability. Three main themes emerged, including variation in ICT communication use among autistic youth and adults, benefits and drawbacks experienced during ICT communication use, and the engagement of autistic youth and adults in the online autism community. Conclusions Further exploration of the positive social capital that autistic people gain participating in online autism communities would allow for the development of strengths-based interventions. Additional research on how autistic people navigate sexuality and ICTs is needed to identify mechanisms for reducing vulnerability online. Additional scholarship about underrepresented groups is needed to investigate and confirm findings regarding ICT communication use for gender, racial, and socioeconomic minority groups. Lay summary What was the purpose of this study?: People use the internet to communicate (talk and connect) with one another. Some research has found that autistic people may prefer to communicate using the internet instead of in person. Over the past 20 years, there has been research about how autistic people use the internet. To understand what research has discovered so far, we collected published research about how autistic youth and adults use the internet to communicate.What did the researchers do?: We used scientific best practices as described in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to collect research about how autistic people us the internet to communicate. We included research that uses words (qualitative research) and numbers (quantitative research). First, we searched several places that list research studies to find research on autistic people and the internet. Then, we removed research that did not fit what we were looking for (our criteria). Finally, we then read the full articles, collected their most important findings, and looked for patterns.What do these findings add to what is already known?: Thirty-two studies met our criteria, including 19 studies that used closed-ended survey questions that tested relationships between variables, 12 studies that used open-ended interviews and looked for patterns and connections among participants, and 1 mixed methods study. In total, 3026 autistic youth of ages 10-17 years (number of participants = 9 studies) and adults (number of participants = 23 studies) participated in these 32 studies. We rated each of the 32 studies for quality and learned that the evidence base is preliminary, meaning that more rigorous high-quality studies are needed before we can be confident in the findings. We found three main themes: (1) differences in the ways that autistic youth and adults used the internet to communicate, (2) benefits and drawbacks experienced when using the internet to communicate, and (3) the engagement of autistic youth and adults in the online autism community. Some of the benefits of social media for autistic people include more control over how they talk and engage with others online and a greater sense of calm during interactions. However, findings suggest some drawbacks for autistic people, including continued feelings of loneliness and the desire for in-person friendships. Social media provides opportunities for autistic people to find others on the autism spectrum and form a stronger identity as part of the autism community. The study also showed that there is little research about autistic women, autistic transgender people, autistic racial/ethnic minorities, or autistic people from lower socioeconomic status (SES) groups.What are potential weaknesses of this study?: We only included research in scientific articles, and there may be useful information on this topic in books, student research, or online.How will these findings help young adults on the autism spectrum now or in the future?: This study can help identify gaps and opportunities for new research, support the importance of online autistic communities, and suggest possible training opportunities about how to support autistic people when they use the internet for communication.
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Affiliation(s)
| | - Laura Graham Holmes
- The A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
- Silberman School of Social Work at Hunter College, New York, New York, USA
| | - Collette Sosnowy
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jessica Walton
- The A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kathleen Carley
- Institute for Software Research, School of Computer Science, Carnegie Mellon University, Pittsburg, Pennsylvania, USA
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