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de Havenon A, Viscoli C, Kleindorfer D, Sucharew H, Delic A, Becker C, Robinson D, Yaghi S, Li V, Lansberg MG, Cramer SC, Mistry EA, Sarpong DF, Kasner SE, Kernan W, Sheth KN. Disability and Recurrent Stroke Among Participants in Stroke Prevention Trials. JAMA Netw Open 2024; 7:e2423677. [PMID: 39028666 PMCID: PMC11259901 DOI: 10.1001/jamanetworkopen.2024.23677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/24/2024] [Indexed: 07/21/2024] Open
Abstract
Importance Stroke secondary prevention trials have disproportionately enrolled participants with mild or no disability. The impact of this bias remains unclear. Objective To investigate the association between poststroke disability and the rate of recurrent stroke during long-term follow up. Design, Setting, and Participants This cohort study is a post hoc analysis of the Prevention Regimen For Effectively Avoiding Second Strokes (PRoFESS) and Insulin Resistance Intervention After Stroke (IRIS) secondary prevention clinical trial datasets. PRoFESS enrolled patients from 2003 to 2008, and IRIS enrolled patients from 2005 to 2015. Data were analyzed from September 23, 2023, to May 16, 2024. Exposure The exposure was poststroke functional status at study baseline, defined as modified Rankin Scale (mRS; range, 0-5; higher score indicates more disability) score of 0 vs 1 to 2 vs 3 or greater. Main Outcomes and Measures The primary outcome was recurrent stroke. The secondary outcome was major cardiovascular events (MACE), defined as recurrent stroke, myocardial infarction, new or worsening heart failure, or vascular death. Results A total of 20 183 PRoFESS participants (mean [SD] age, 66.1 [8.5] years; 12 931 [64.1%] male) and 3265 IRIS participants (mean [SD] age, 62.7 [10.6] years; 2151 [65.9%] male) were included. The median (IQR) follow-up was 2.4 (1.9-3.0) years in PRoFESS and 4.7 (3.2-5.0) years in IRIS. In PRoFESS, the recurrent stroke rate was 7.2%, among patients with an mRS of 0, 8.7% among patients with an mRS of 1 or 2, and 10.6% among patients with an mRS of 3 or greater (χ22 = 27.1; P < .001); in IRIS the recurrent stroke rate was 6.4% among patients with an mRS of 0, 9.0% among patients with an mRS of 1 or 2, and 11.7% among patients with an mRS of 3 or greater (χ22 = 11.1; P < .001). The MACE rate was 10.1% among patients with an mRS of 0, 12.2% among patients with an mRS of 1 or 2, and 17.2% among patients with an mRS of 3 or greater (χ22 = 103.4; P < .001) in PRoFESS and 10.9% among patients with an mRS of 0, 13.3% among patients with an mRS of 1 or 2, and 15.3% among patients with an mRS of 3 or greater (χ22 = 5.8; P = .06) in IRIS. Compared with patients with an mRS of 0, patients with an mRS of 3 or greater had increased hazard for recurrent stroke in PRoFESS (hazard ratio [HR], 1.63; 95% CI, 1.38-1.92; P < .001) and in IRIS (HR, 1.91; 95% CI, 1.28-2.86; P = .002). There was also increased hazard for MACE in PRoFESS (HR, 1.90; 95% CI, 1.66-2.18; P < .001) and in IRIS (HR, 1.45; 95% CI, 1.03-2.03; P = .03). Conclusions and Relevance This cohort study found that higher baseline poststroke disability was associated with increased rates of recurrent stroke and MACE. Including more patients with greater baseline disability in stroke prevention trials may improve the statistical power and generalizability of these studies.
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Affiliation(s)
- Adam de Havenon
- Department of Neurology, Center for Brain and Mind Health, Yale University School of Medicine, New Haven, Connecticut
| | - Catherine Viscoli
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | - Heidi Sucharew
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Alen Delic
- Department of Neurology, University of Utah, Salt Lake City
| | | | - David Robinson
- Department of Neurology, University of Michigan, Ann Arbor
| | - Shadi Yaghi
- Department of Neurology, Brown University, Providence, Rhode Island
| | - Vivian Li
- Department of Neurology, Center for Brain and Mind Health, Yale University School of Medicine, New Haven, Connecticut
| | | | - Steven C. Cramer
- Department of Neurology, University of California and California Rehabilitation Institute, Los Angeles
| | - Eva A. Mistry
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Daniel F. Sarpong
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Scott E. Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Walter Kernan
- Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Kevin N. Sheth
- Department of Neurology, Center for Brain and Mind Health, Yale University School of Medicine, New Haven, Connecticut
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Hawke LD, Sheikhan NY, Rodak T. Lived experience and family engagement in psychiatry research: A scoping review of reviews. Health Expect 2024; 27:e14057. [PMID: 38678591 PMCID: PMC11056206 DOI: 10.1111/hex.14057] [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] [Received: 12/13/2023] [Revised: 03/14/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND A growing body of research is addressing the process and science of engaging people with lived experience (PWLE) of mental health challenges and other psychiatric conditions, and family members, in research activities. OBJECTIVE This scoping review of reviews synthesizes literature reviews on the engagement of PWLE and family members in research across the field of psychiatry. METHOD Systematic searches were conducted in seven bibliographic databases. Records were independently screened first at the title and abstract level, then at the full-text level. Included were any literature synthesis studies published in English, French, or Spanish in any given year, focusing on the engagement of PWLE and/or family members in research within psychiatry. Twenty records were included. Data were extracted in a spreadsheet and codebook thematic analysis was used across the body of articles to synthesize the findings. RESULTS Aspects of PWLE engagement have been synthesized in 20 review articles reviewing 376 articles across psychiatry as a whole and several subpopulations, including youth mental health, dementia, neurodevelopmental disorders, people who use drugs, and forensic mental health. Information specific to family engagement is lacking. Barriers, facilitators, and positive impacts of PWLE engagement have been widely reported across domains of research, with a considerable degree of consensus across subpopulations. Some negative impacts and reporting challenges have also been identified. DISCUSSION This scoping review of reviews provides an overarching understanding of the current state of the science of PWLE and family engagement across psychiatry research. The findings can inform future research practices enriched with a genuine and effective engagement with PWLE and families. PATIENT OR PUBLIC CONTRIBUTION The authorship team includes members with intersecting lived experience and academic identities. Additional lived experience engagement was not conducted as part of this review.
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Affiliation(s)
- Lisa D. Hawke
- University of TorontoTorontoCanada
- Centre for Addiction and Mental HealthTorontoCanada
| | - Natasha Y. Sheikhan
- University of TorontoTorontoCanada
- Centre for Addiction and Mental HealthTorontoCanada
| | - Terri Rodak
- Centre for Addiction and Mental HealthTorontoCanada
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Davies J, Romualdez AM, Malyan D, Heasman B, Livesey A, Walker A, Pellicano E, Remington A. Autistic Adults' Priorities for Future Autism Employment Research: Perspectives from the United Kingdom. AUTISM IN ADULTHOOD 2024; 6:72-85. [PMID: 38435326 PMCID: PMC10902279 DOI: 10.1089/aut.2022.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background A growing body of research has sought to understand autistic people's research priorities. Several of these studies have identified employment as a key research priority. Yet, there have been a few attempts to identify specific, actionable priorities within this area. Methods Using an online survey, we asked 197 autistic people in the United Kingdom about their priorities for future autism-employment research. Results Participants spoke of their challenges in gaining and sustaining meaningful employment and called for researchers to conduct research that results in direct improvements to employment experiences. Regarding their research priorities, participants indicated a need for research covering all aspects of the employment lifecycle from accessing employment to transitioning out of employment. Importantly, participants also discussed how such research should be conducted: with autistic people as co-researchers and ensuring a diverse range of autistic people are listened to. Conclusion While much existing autism-employment research appears to align with the priorities outlined in this study, seemingly minimal attention has been paid to later stages of the work lifecycle (e.g., progressing into more senior job roles or transitioning out of work). By identifying disparities between autistic people's priorities and the research being conducted, we can support autistic people to drive the research agenda and ensure autism-employment research positively impacts the community it aims to serve.
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Affiliation(s)
- Jade Davies
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Anna Melissa Romualdez
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Danae Malyan
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Brett Heasman
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Adam Livesey
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Amy Walker
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
- Neurodiversity Works, London, United Kingdom
| | - Elizabeth Pellicano
- Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Anna Remington
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
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Fenning RM, Butter EM, Norris M, Chan J, Macklin EA, McKinnon-Bermingham K, Albright C, Stephenson KG, Scherr J, Moffitt J, Hess A, Steinberg-Epstein R, Kuhlthau KA. Optimizing Parent Training to Improve Oral Health Behavior and Outcomes in Underserved Children with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3683-3699. [PMID: 35831693 DOI: 10.1007/s10803-022-05660-6] [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] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families.
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Affiliation(s)
- Rachel M Fenning
- Department of Psychological Science and Claremont Autism Center, Claremont McKenna College, 850 Columbia Avenue, Seaman Hall 235, Claremont, CA, 91711, USA.
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, Fullerton, CA, USA.
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA.
| | - Eric M Butter
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Megan Norris
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - James Chan
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Eric A Macklin
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Kelly McKinnon-Bermingham
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Charles Albright
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kevin G Stephenson
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jessica Scherr
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jacquelyn Moffitt
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, Fullerton, CA, USA
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Amy Hess
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Robin Steinberg-Epstein
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
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Shogren KA. The Right to Science: Centering People With Intellectual Disability in the Process and Outcomes of Science. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:172-177. [PMID: 36996278 DOI: 10.1352/1934-9556-61.2.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
The right to science has been identified in multiple human rights treaties; however, there has not been a clear framework for how governments or research organizations can advance this right particularly ensuring equitable engagement of people with intellectual disability (ID) in the process of scientific research. Although the feasibility and impacts of engaging people with ID in the process of science have been repeatedly demonstrated there remain systemic barriers including ableism, racism, and other systems of oppression that sustain inequities. Researchers in the ID field must take steps to dismantle systemic barriers and advance participatory approaches that advance equity in the process and outcomes of science.
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Affiliation(s)
- Karrie A Shogren
- Karrie A. Shogren, University of Kansas, Kansas University Center on Developmental Disabilities
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Shariq S, Cardoso Pinto AM, Budhathoki SS, Miller M, Cro S. Barriers and facilitators to the recruitment of disabled people to clinical trials: a scoping review. Trials 2023; 24:171. [PMID: 36890505 PMCID: PMC9994780 DOI: 10.1186/s13063-023-07142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/07/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Underrepresentation of disabled groups in clinical trials results in an inadequate evidence base for their clinical care, which drives health inequalities. This study aims to review and map the potential barriers and facilitators to the recruitment of disabled people in clinical trials to identify knowledge gaps and areas for further extensive research. The review addresses the question: 'What are the barriers and facilitators to recruitment of disabled people to clinical trials?'. METHODS The Joanna Briggs Institute (JBI) Scoping review guidelines were followed to complete the current scoping review. MEDLINE and EMBASE databases were searched via Ovid. The literature search was guided by a combination of four key concepts from the research question: (1) disabled populations, (2) patient recruitment, (3) barriers and facilitators, and (4) clinical trials. Papers discussing barriers and facilitators of all types were included. Papers that did not have at least one disabled group as their population were excluded. Data on study characteristics and identified barriers and facilitators were extracted. Identified barriers and facilitators were then synthesised according to common themes. RESULTS The review included 56 eligible papers. The evidence on barriers and facilitators was largely sourced from Short Communications from Researcher Perspectives (N = 22) and Primary Quantitative Research (N = 17). Carer perspectives were rarely represented in articles. The most common disability types for the population of interest in the literature were neurological and psychiatric disabilities. A total of five emergent themes were determined across the barriers and facilitators. These were as follows: risk vs benefit assessment, design and management of recruitment protocol, balancing internal and external validity considerations, consent and ethics, and systemic factors. CONCLUSIONS Both barriers and facilitators were often highly specific to disability type and context. Assumptions should be minimised, and study design should prioritise principles of co-design and be informed by a data-driven assessment of needs for the study population. Person-centred approaches to consent that empower disabled people to exercise their right to choose should be adopted in inclusive practice. Implementing these recommendations stands to improve inclusive practices in clinical trial research, serving to produce a well-rounded and comprehensive evidence base.
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Affiliation(s)
- Sameed Shariq
- School of Public Health, Imperial College London, London, UK
| | | | | | - Marie Miller
- Imperial Clinical Trials Unit, Imperial College London, London, UK
| | - Suzie Cro
- Imperial Clinical Trials Unit, Imperial College London, London, UK
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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den Houting J, Higgins J, Isaacs K, Mahony J, Pellicano E. From ivory tower to inclusion: Stakeholders’ experiences of community engagement in Australian autism research. Front Psychol 2022; 13:876990. [PMID: 36092113 PMCID: PMC9454607 DOI: 10.3389/fpsyg.2022.876990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/27/2022] [Indexed: 01/22/2023] Open
Abstract
Autistic people, and other community stakeholders, are gaining increasing recognition as valuable contributors to autism research, resulting in a growing corpus of participatory autism research. Yet, we know little about the ways in which stakeholders practice and experience community engagement in autism research. In this study, we interviewed 20 stakeholders (academics, autistic people, family members/careers, research students, and service providers) regarding their experiences of community engagement in Australian autism research. Through reflexive thematic analysis of interview data, we generated four themes. First, our participants perceived academia as an “ivory tower,” disconnected from community members’ lives and priorities. Second, our participants identified that different stakeholders tended to hold different roles within their research projects: academics typically retained power and control, while community members’ roles tended toward tokenism. Third, our participants spoke of the need to “bridge the gap” between academia and the community, highlighting communication, accessibility, and planning as key to conducting effective participatory research. Lastly, participants emphasized the changing nature of autism research, describing participatory research as “the way of the future.” Our findings reflect both the progress achieved to date, and the challenges that lie ahead, as the field advances toward genuine co-production of autism research.
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Affiliation(s)
- Jacquiline den Houting
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- *Correspondence: Jacquiline den Houting,
| | - Julianne Higgins
- Sylvia Rodger Academy, Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Developmental Disability Neuropsychiatry (3DN), University of New South Wales, Sydney, NSW, Australia
| | - Kathy Isaacs
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- The Autistic Realm Australia, Inc., Adelaide, SA, Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- Sylvia Rodger Academy, Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
- Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Millington E, Hayashibara E, Arthur T, Husselman TA, Savickaite S, Taylor R. Neurodivergent participatory action research for Virtual Reality (VR). JOURNAL OF ENABLING TECHNOLOGIES 2022. [DOI: 10.1108/jet-05-2022-0037] [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
PurposeThis paper aims to raise awareness of and argue for the use of participatory methods for the research and development of Virtual Reality (VR) applications designed for neurodivergent groups. This includes exploring why it is important to meaningfully include neurodivergent groups and the benefits their inclusion provide.Design/methodology/approachVR is becoming increasingly widespread as a consumer product and interventional tool. It is vital for researchers and developers to embrace best practices in these early stages of using the technology, making certain that neurodivergent people have the best possible outcomes.FindingsThe neurodivergent community is dissatisfied with many of the research directions currently being undertaken. This dissatisfaction arises from conflicting priorities between different stakeholders and the lack of input from the community. Participatory research brings neurodivergent people into the research process, whether as members of the research team or as consultants at key steps. Effective participatory research ensures that the priorities of the neurodivergent community are better incorporated in research, as well as enabling the development of more effective applications for VR.Originality/valueParticipatory methods are unutilised in the development of applications aimed for neurodivergent people. By describing their use and utility in other areas, this article aims to encourage other VR researchers to take neurodivergent people on board.
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Pellicano E, Lawson W, Hall G, Mahony J, Lilley R, Heyworth M, Clapham H, Yudell M. "I Knew She'd Get It, and Get Me": Participants' Perspectives of a Participatory Autism Research Project. AUTISM IN ADULTHOOD 2022; 4:120-129. [PMID: 36605972 PMCID: PMC9645671 DOI: 10.1089/aut.2021.0039] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction Autistic advocates and their supporters have long argued that conventional research practices provide too few opportunities for genuine engagement with autistic people, contributing to social disenfranchisement among autistic people. We recently described one attempt to develop and implement a participatory study in which a team of autistic and nonautistic researchers worked together to gather life histories from late-diagnosed autistic people. In the current study, we sought to understand the impact of this participatory approach on the participants themselves. Methods We spoke to 25 Australian late-diagnosed autistic adults (aged 45-72 years), who had been interviewed by an autistic researcher using an oral history approach. We asked them about their experience of being involved in that project and the research process more broadly. We thematically analyzed participants' interviews. Results Participants responded overwhelmingly positively to the opportunity to tell their life history, considering it illuminating and empowering. While recounting their life history was often described as "exhausting" and "draining," participants also reported feeling "supported all the way" and agreed "it was made easier because I had an autistic researcher interviewing me." One participant went so far as to say that they "probably would have dropped out [of the project] if it was run by people who weren't autistic." Conclusions These findings demonstrate that the benefits of coproduction to researchers and community partners extend to study participants and to the quality of the research itself. Involving autistic partners in the research process, especially in its implementation, can play a crucial role in enhancing autism research.
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Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia.,Address correspondence to: Elizabeth Pellicano, PhD, Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney 2109, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, Australia.,Reframing Autism, Sydney, Australia
| | - Hayley Clapham
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Michael Yudell
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
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Newbutt N, Bradley R. Using immersive virtual reality with autistic pupils: moving towards greater inclusion and co-participation through ethical practices. JOURNAL OF ENABLING TECHNOLOGIES 2022. [DOI: 10.1108/jet-01-2022-0010] [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
PurposeThe potential of head mounted displays based virtual reality (HMD-based VR) for autistic groups has been well documented. However, the deployment and application of this technology, especially in schools, has been extremely limited. One of the main criticisms in this field has been the lack of involvement from practitioners in research on educational approaches for autistic populations and the gap between research and practice in real-life settings.Design/methodology/approachThis conceptual article focuses on our research in a UK-based special needs school that sought to examine the effects and potential use of VR-HMDs, while seeking to establish best practices for safe and ethical application using this technology. This draws upon ethical and participatory research guidance, including British Educational Research Association and Autism Participatory Research.FindingsThe authors make recommendations on planning and implementing a participatory, safe and ethical approach to researching the use of VR-HMDs in special needs schools and engaging with the priorities of autistic children and young people and their teachers.Originality/valueThis conceptual article provides an initial first consideration of ways we can better include autistic people and their views in research that is with and about them. The value in this will mean we are able to better support autistic groups moving ahead using VR HMD-based technologies. Without this paradigm shift and including autistic people (and their stakeholders) the field might continue to build initiatives around medical-based models of disabilities rather that what the community need/want.
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12
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Poulsen R, Brownlow C, Lawson W, Pellicano E. Meaningful research for autistic people? Ask autistics! AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:3-5. [PMID: 35000419 DOI: 10.1177/13623613211064421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Rebecca Poulsen
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,University of Queensland, Australia.,Reframing Autism, Australia
| | - Charlotte Brownlow
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,University of Southern Queensland, Australia
| | - Wenn Lawson
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,Macquarie University, Australia
| | - Elizabeth Pellicano
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,Macquarie University, Australia
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Pickard H, Pellicano E, den Houting J, Crane L. Participatory autism research: Early career and established researchers' views and experiences. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:75-87. [PMID: 34088215 PMCID: PMC8750139 DOI: 10.1177/13623613211019594] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT 'Participatory autism research' refers to ways of involving autistic people and their allies (e.g. family members) in making decisions about research. These decisions can include what research gets done, how it gets done and how research findings are used. While there is more and more interest in participatory autism research, we know little about how researchers at different stages of their careers use this approach. To find out more, we discussed these issues with 25 researchers. Fourteen of these were at an early stage of their careers, and 11 were more senior researchers. We spoke to people in individual interviews or in groups. We then used a technique called thematic analysis to analyse our data, which involved us looking for common topics or 'themes' discussed by our participants. What did we find? Our participants told us that participatory autism research was a flexible approach, meaning that autistic people can be involved in research in many different ways. While people viewed this flexibility in a positive way, it also caused some confusion about what does or does not 'count' as participatory research. Our participants also spoke about how important it was to build relationships with those involved in their research, but they also said it could be difficult to communicate well with diverse groups of people who may not have much experience of research. Finally, our participants said it was hard to do participatory research when there was not much time, funding or support available to researchers. In this article, we discuss these findings, focusing on what needs to change to ensure that autistic people and their allies are meaningfully involved in autism research.
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Affiliation(s)
| | | | - Jacquiline den Houting
- Macquarie University,
Australia
- Cooperative Research Centre for
Living with Autism, Australia
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14
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Cheriyan C, Shevchuk-Hill S, Riccio A, Vincent J, Kapp SK, Cage E, Dwyer P, Kofner B, Attwood H, Gillespie-Lynch K. Exploring the Career Motivations, Strengths, and Challenges of Autistic and Non-autistic University Students: Insights From a Participatory Study. Front Psychol 2021; 12:719827. [PMID: 34744884 PMCID: PMC8568013 DOI: 10.3389/fpsyg.2021.719827] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022] Open
Abstract
Supports for the growing number of autistic university students often focus on helping them succeed in university. However, even educated autistic people experience discrimination and other challenges which can make it very difficult for them to obtain meaningful jobs. Little remains known about how universities can better support their autistic students and alumni in overcoming barriers to meaningful employment. In this participatory study, a team of autistic and non-autistic researchers asked autistic (n = 92) and non-autistic (n = 774) university students about their career aspirations, strengths they believe will help them succeed in their "dream jobs," and obstacles they expect to encounter. Autistic participants' top goal in attending college was to improve their career prospects. However, relatively few autistic students reported learning career-specific skills at university. Autistic students were more likely to seek an academic job and less likely to seek a career in healthcare than non-autistic students. Autistic students highlighted writing skills and detail orientation as strengths that could help them succeed in their dream jobs more often than non-autistic students. However, they were also more likely to expect discrimination, social, and psychological difficulties to stand in the way of their dream jobs. These findings suggest that universities should prioritize experiential learning opportunities to help autistic (and non-autistic) students develop employment-related skills while providing mental health supports. Universities should demonstrate their commitment to supporting diverse learners by seeking out and hiring autistic professionals and by teaching their own staff and employers how to appreciate and support autistic colleagues.
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Affiliation(s)
- Chinnu Cheriyan
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Sergey Shevchuk-Hill
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Ariana Riccio
- The Graduate Center, The City University of New York, New York, NY, United States
| | - Jonathan Vincent
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Steven K. Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Eilidh Cage
- Department of Psychology, University of Stirling, Stirling, United Kingdom
| | - Patrick Dwyer
- Center for Mind and Brain, University of California, Davis, Sacramento, CA, United States
| | - Bella Kofner
- College of Staten Island, The City University of New York, Staten Island, NY, United States
| | - Helen Attwood
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Kristen Gillespie-Lynch
- College of Staten Island, The City University of New York, Staten Island, NY, United States
- The Graduate Center, The City University of New York, New York, NY, United States
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15
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A Systematic Review of Interventions to Improve Healthcare Experiences and Access in Autism. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractAutistic individuals report barriers to accessing and receiving healthcare, and experience increased morbidity and mortality. This systematic review synthesizes 31 research studies evaluating interventions implemented to improve the healthcare experiences and/or access of autistic persons. Interventions were most commonly patient-focused (58.1%), focused on supporting the autistic individual to engage with, tolerate, or anticipate medical procedures, care, or settings. Fewer studies were provider-focused (48.4%) or organization-focused (6.5%). Interventions were typically evaluated using measures of reactions (45.2%) or behavior (48.4%), and outcomes were predominantly positive (80.6%). Further research is imperative and should look to how providers and organizations must change. Future research must be inclusive of the autistic community, must measure what matters, and must offer complete detail on interventions implemented.
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16
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A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractChildren with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.
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Benevides TW, Shore SM, Palmer K, Duncan P, Plank A, Andresen ML, Caplan R, Cook B, Gassner D, Hector BL, Morgan L, Nebeker L, Purkis Y, Rankowski B, Wittig K, Coughlin SS. Listening to the autistic voice: Mental health priorities to guide research and practice in autism from a stakeholder-driven project. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 24:822-833. [PMID: 32429818 PMCID: PMC7787673 DOI: 10.1177/1362361320908410] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
LAY ABSTRACT Autistic adults commonly experience mental health conditions. However, research rarely involves autistic adults in deciding priorities for research on mental healthcare approaches that might work for them. The purpose of this article is to describe a stakeholder-driven project that involved autistic adults in co-leading and designing research about priorities to address mental health needs. Through a large online survey, two large meetings, and three face-to-face focus group discussions involving over 350 stakeholders, we identified five priorities for mental health research desired by autistic adults. These priorities and preferred outcomes should be used to guide research and practice for autistic adults.
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18
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Fletcher-Watson S, Brook K, Hallett S, Murray F, Crompton CJ. Inclusive Practices for Neurodevelopmental Research. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00227-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Purpose of Review
Inclusive research practice is both a moral obligation and a practical imperative. Here we review its relevance to the study of neurodevelopmental diversity in particular, briefly describing a range of inclusive research models and justifying their use. The review itself is inclusively co-authored with three autistic collaborators and community leaders who all have extensive experience of research involvement.
Recent Findings
Drawing on theoretical arguments and specific exemplar projects, we describe six key considerations in the delivery of inclusive research. These are the following: taking the first steps towards inclusive practice; setting expectations; community-specific inclusion measures; inclusion and intersectionality; the role of empowerment; and knowledge exchange for inclusion. Together, these sections provide an illustrated guide to the principles and process of inclusive research.
Summary
Inclusive research practice is both beneficial to and a requirement of excellence in neurodevelopmental research. We call for greater engagement in this participatory research agenda from grant-awarding bodies to facilitate not just inclusive but also emancipatory research.
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Cascio MA, Weiss JA, Racine E. Person-oriented ethics for autism research: Creating best practices through engagement with autism and autistic communities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1676-1690. [DOI: 10.1177/1362361320918763] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Research ethics is an important part of any study. Ethics goes beyond ethics committee approval and consent documents. It addresses broader issues of respect, inclusion, and empowerment in the everyday context of research. This article focuses on everyday aspects of research ethics for studies involving autistic participants. It draws on a review of the literature and a process of ethical deliberation involving a task force of researchers, professionals, autistic self-advocates, and parents. These methods led to the creation of suggestions for researchers. This article describes the community engagement process, briefly presents the task force suggestions, and provides more detailed discussion of select items for illustration. Suggestions are organized around five “person-oriented research ethics” guideposts: (1) individualization (e.g. providing individualized support for participants), (2) acknowledgment of lived world (e.g. acknowledging barriers to care that impact research ethics), (3) empowerment in decision-making (e.g. creating accessible consent processes that address specific communication needs), (4) respect for holistic personhood (e.g. addressing sensory and processing needs and strengths), and (5) focus on researcher–participant relationships (e.g. involving autistic people in ways other than research participants, including but not limited to via participatory research). This project highlights the value of researcher–community partnerships in discussions about research ethics. Lay abstract Research ethics means issues that concern the welfare and wellbeing of people who take part in research. It is important in all scientific studies. Ethics helps people who do research treat people who take part in research fairly and with respect. This article is about day-to-day ethics when autistic people take part in research. We present tips for researchers who want to do this type of study. We used two methods to create these tips. First, we wanted to know what other people said about this topic. We used a literature review to find out. Second, we wanted to know what autistic people, parents, and professionals thought, and had a working group meet to discuss it. The working group provided advice that researchers could consider around day-to-day ethics in research. This article talks about these methods and advice. The advice fits into five big groups: Tailor the research process for the unique needs of each person. Think about the world in which people who take part in research live. Make it easier for people to make their own choices. Value what people who take part in research have to share and consider their needs and strengths. Think about how researchers and people who take part in research work together. This project shows why it is useful for researchers and communities to talk about research ethics together.
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Affiliation(s)
- M Ariel Cascio
- Central Michigan University, USA
- Institut de recherches cliniques de Montréal, Canada
- McGill University, Canada
| | | | - Eric Racine
- Institut de recherches cliniques de Montréal, Canada
- McGill University, Canada
- Université de Montréal, Canada
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20
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Hoekstra F, Mrklas KJ, Khan M, McKay RC, Vis-Dunbar M, Sibley KM, Nguyen T, Graham ID, Gainforth HL. A review of reviews on principles, strategies, outcomes and impacts of research partnerships approaches: a first step in synthesising the research partnership literature. Health Res Policy Syst 2020; 18:51. [PMID: 32450919 PMCID: PMC7249434 DOI: 10.1186/s12961-020-0544-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/21/2020] [Indexed: 01/12/2023] Open
Abstract
Background Conducting research in partnership with stakeholders (e.g. policy-makers, practitioners, organisations, patients) is a promising and popular approach to improving the implementation of research findings in policy and practice. This study aimed to identify the principles, strategies, outcomes and impacts reported in different types of reviews of research partnerships in order to obtain a better understanding of the scope of the research partnership literature. Methods This review of reviews is part of a Coordinated Multicenter Team approach to synthesise the research partnership literature with five conceptually linked literature reviews. The main research question was ‘What principles, strategies, outcomes and impacts are reported in different types of research partnership approaches?’. We included articles describing a literature review of research partnerships using a systematic search strategy. We used an adapted version of the Revised Assessment of Multiple Systematic Reviews tool to assess quality. Nine electronic databases were searched from inception to April 2018. Principles, strategies, outcomes and impacts were extracted from the included reviews and analysed using direct content analysis. Results We included 86 reviews using terms describing several research partnership approaches (e.g. community-based participatory research, participatory research, integrated knowledge translation). After the analyses, we synthesised 17 overarching principles and 11 overarching strategies and grouped them into one of the following subcategories: relationship between partners; co-production of knowledge; meaningful stakeholder engagement; capacity-building, support and resources; communication process; and ethical issues related to the collaborative research activities. Similarly, we synthesised 20 overarching outcomes and impacts on researchers, stakeholders, the community or society, and the research process. Conclusions This review of reviews is the first that presents overarching principles, strategies, outcomes and impacts of research partnerships. This review is unique in scope as we synthesised literature across multiple research areas, involving different stakeholder groups. Our findings can be used as a first step to guide the initiation and maintenance of research partnerships and to create a classification system of the key domains of research partnerships, which may improve reporting consistency in the research partnership literature. Trial registration This study is registered via Open Science Framework: 10.17605/OSF.IO/GVR7Y.
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Affiliation(s)
- F Hoekstra
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - K J Mrklas
- Strategic Clinical Networks™, System Innovation and Programs, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Khan
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - R C McKay
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada.,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - M Vis-Dunbar
- Library, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - K M Sibley
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,George & Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T Nguyen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - I D Graham
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - H L Gainforth
- School of Health & Exercise Sciences, University of British Columbia, Kelowna, Canada. .,International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
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21
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Nicolaidis C, Raymaker DM, McDonald KE, Lund EM, Leotti S, Kapp SK, Katz M, Beers LM, Kripke C, Maslak J, Hunter M, Zhen KY. Creating Accessible Survey Instruments for Use with Autistic Adults and People with Intellectual Disability: Lessons Learned and Recommendations. AUTISM IN ADULTHOOD 2020; 2:61-76. [PMID: 32355908 PMCID: PMC7188318 DOI: 10.1089/aut.2019.0074] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite growing appreciation of the need for research on autism in adulthood, few survey instruments have been validated for use with autistic adults. We conducted an institutional ethnography of two related partnerships that used participatory approaches to conduct research in collaboration with autistic people and people with intellectual disability. In this article, we focus on lessons learned from adapting survey instruments for use in six separate studies. Community partners identified several common problems that made original instruments inaccessible. Examples included: (1) the use of difficult vocabulary, confusing terms, or figures of speech; (2) complex sentence structure, confusing grammar, or incomplete phrases; (3) imprecise response options; (4) variation in item response based on different contexts; (5) anxiety related to not being able to answer with full accuracy; (6) lack of items to fully capture the autism-specific aspects of a construct; and (7) ableist language or concepts. Common adaptations included: (1) adding prefaces to increase precision or explain context; (2) modifying items to simplify sentence structure; (3) substituting difficult vocabulary words, confusing terms, or figures of speech with more straightforward terms; (4) adding hotlinks that define problematic terms or offer examples or clarifications; (5) adding graphics to increase clarity of response options; and (6) adding new items related to autism-specific aspects of the construct. We caution against using instruments developed for other populations unless instruments are carefully tested with autistic adults, and we describe one possible approach to ensure that instruments are accessible to a wide range of autistic participants. LAY SUMMARY Why is this topic important?: To understand what can improve the lives of autistic adults, researchers need to collect survey data directly from autistic adults. However, most survey instruments were made for the general population and may or may not work well for autistic adults.What is the purpose of this article?: To use lessons learned from our experience adapting surveys-in partnership with autistic adults-to create a set of recommendations for how researchers may adapt instruments to be accessible to autistic adults.What did the authors do?: Between 2006 and 2019, the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) and the Partnering with People with Developmental Disabilities to Address Violence Consortium used a participatory research approach to adapt many survey instruments for use in six separate studies. We reviewed records from these partnerships and identified important lessons.What is this recommended adaptation process like?: The adaptation process includes the following: (1) Co-creating collaboration guidelines and providing community partners with necessary background about terminology and processes used in survey research; (2) Collaboratively selecting which constructs to measure; (3) Discussing each construct so that we can have a shared understanding of what it means; (4) Identifying existing instruments for each construct; (5) Selecting among available instruments (or deciding that none are acceptable and that we need to create a new measure); (6) Assessing the necessary adaptations for each instrument; (7) Collaboratively modifying prefaces, items, or response options, as needed; (8) Adding "hotlink" definitions where necessary to clarify or provide examples of terms and constructs; (9) Creating new measures, when needed, in partnership with autistic adults;(10)Considering the appropriateness of creating proxy report versions of each adapted measure; and(11)Assessing the adapted instruments' psychometric properties.What were common concerns about existing instruments?: Partners often said that, if taking a survey that used the original instruments, they would experience confusion, frustration, anxiety, or anger. They repeatedly stated that, faced with such measures, they would offer unreliable answers, leave items blank, or just stop participating in the study. Common concerns included the use of difficult vocabulary, confusing terms, complex sentence structure, convoluted phrasings, figures of speech, or imprecise language. Partners struggled with response options that used vague terms. They also felt anxious if their answer might not be completely accurate or if their responses could vary in different situations. Often the surveys did not completely capture the intended idea. Sometimes, instruments used offensive language or ideas. And in some cases, there just were not any instruments to measure what they thought was important.What were common adaptations?: Common adaptations included: (1) adding prefaces to increase precision or explain context; (2) modifying items to simplify sentence structure; (3) substituting difficult vocabulary words, confusing terms, or figures of speech with more straightforward terms; (4) adding hotlinks that define problematic terms or offer examples or clarifications; (5) adding graphics to increase clarity of response options; and (6) adding new items related to autism-specific aspects of the construct.How will this article help autistic adults now or in the future?: We hope that this article encourages researchers to collaborate with autistic adults to create better survey instruments. That way, when researchers evaluate interventions and services, they can have the right tools to see if they are effective.
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Affiliation(s)
- Christina Nicolaidis
- School of Social Work, Portland State University, Portland, Oregon
- Department of Medicine, Oregon Health & Science University, Portland, Oregon
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
| | - Dora M. Raymaker
- School of Social Work, Portland State University, Portland, Oregon
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
| | - Katherine E. McDonald
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
- Department of Public Health, Syracuse University, Syracuse, New York
| | - Emily M. Lund
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
- Department of Educational Studies in Psychology, Research, Methodology, and Counseling, University of Alabama, Tuscaloosa, Alabama
| | - Sandra Leotti
- School of Social Work, Portland State University, Portland, Oregon
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
- College of Health Sciences, Division of Social Work, University of Wyoming, Laramie, Wyoming
| | - Steven K. Kapp
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Marsha Katz
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
- Rural Institute on Disabilities, University of Montana, Missoula, Montana
| | - Leanne M. Beers
- Partnering with People with Developmental Disabilities to Address Violence Consortium, Missoula, Montana
| | - Clarissa Kripke
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
| | - Joelle Maslak
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
| | - Morrigan Hunter
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
| | - Kelly Y. Zhen
- School of Social Work, Portland State University, Portland, Oregon
- Academic Autism Spectrum Partnership in Research and Education, Portland, Oregon
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Riccio A, Delos Santos J, Kapp SK, Jordan A, DeNigris D, Gillespie-Lynch K. Developing the Multidimensional Visual Scale Assessing Affect, Anxiety, Pride, and Energy Through a Research Partnership with Autistic Scholars. AUTISM IN ADULTHOOD 2020; 2:87-100. [PMID: 36600981 PMCID: PMC8992848 DOI: 10.1089/aut.2019.0067] [Citation(s) in RCA: 2] [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
Autism research studies have traditionally failed to represent the full diversity of the autism spectrum due to the lack of measures available for use with participants who prefer to express themselves visually. A multidimensional measure of emotions, which can include both picture- and text-based prompts, may improve accessibility of emotion rating measures and broaden participation in research and educational evaluations to include those who communicate in diverse ways. Picture-based measures designed to assess participants' emotions may be useful for research concerning autistic identity and service evaluation, two areas where representation of diverse perspectives is needed. Our participatory group of autistic and nonautistic researchers developed a Multidimensional Visual Scale Assessing Affect, Anxiety, Pride, and Energy (AAPE) by adapting and expanding upon an existing emotion rating scale. When testing the AAPE with autistic college students (n = 72), their open-ended responses indicated that the AAPE's dimensions of affect (97.2% correct), anxiety (79.2% correct), and energy (84.7% correct) were well comprehended without text-based labels with potential for improvement in how pride (52.8% correct) was represented. When provided with the labels that each dimension was intended to represent, participants generally agreed that each emotional dimension was well represented. When tested in an informal educational summer camp with autistic children and adolescents (n = 50), the AAPE was well received and revealed insights about the students' emotional responses to different instructional strategies that can guide curricular improvements. The AAPE has utility as a tool to help diverse autistic individuals self-advocate and improve research and services. Lay summary Why was this study done?: There are very few tools that autistic people can use to share how they feel. We wanted to develop a tool to help autistic people express their emotions using pictures. Pictures can help autistic people share how they feel.What was the purpose of this study?: We wanted to make an easy-to-understand tool that autistic people can use to share how they feel.What did the researchers do?: Our research group is participatory, meaning that autistic and nonautistic researchers worked together to make our tool. An autistic artist drew the tool. We called it the AAPE, which stands for the emotions it assesses: Affect, Anxiety, Pride, and Energy. We worked together to see how well the AAPE worked. We used a survey to see if autistic high school and college students understood our first try at the AAPE and we learned how to make the AAPE better from these students. We worked together to make the AAPE better. Then, we did another survey with autistic college students to see if our second try at the AAPE worked better. Then, we asked autistic kids and teenagers to use the AAPE to share how they felt about different ways of teaching.What were the results of the study?: In our final test, we asked 72 autistic college students to tell us what emotions they thought the AAPE was showing. College students thought that affect (97.2%), anxiety (79.2%), and energy (84.7%) showed the emotions we aimed to show with room for improvement in how pride (52.8%) was shown. After we told participants which emotion each scale was showing, they agreed that affect (average score 4.28 of 5) and anxiety (4.29 of 5) showed the emotions best, followed by energy (4.08 of 5) and pride (3.5 of 5) on a scale from 1 to 5 (strongly agree).Students preferred using the AAPE compared with text-based surveys we used in the past. Results showed that the AAPE does a good job at measuring emotions. Edits may still be needed to better show "pride." Work is needed with nonspeaking people to make sure our measure works well for people who communicate in different ways.What are potential weaknesses in the study?: The autistic adolescents and adults we have tested the AAPE with so far have not been very diverse. We did not include participants who communicate without speaking in these first tests of the AAPE. We plan to use the AAPE with more diverse groups in future studies.How will these findings help autistic adults now or in the future?: In a future study, we will use the AAPE to rate pictures that show experiences of being autistic, like feeling outside a social group, having sensory difficulties, and making patterns. We would like to do this because some studies talk about negative experiences of autism, like feeling the need to hide autistic traits, but other studies describe strengths of autism, like strong memories and advanced knowledge in particular subjects. However, these studies do not talk about the emotions that come with these experiences and if these experiences are shared with autistic people who do not use speech to communicate. The AAPE is a tool that might help us understand how diverse autistic people feel about autism.
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Affiliation(s)
- Ariana Riccio
- Department of Psychology, The Graduate Center, The City University of New York (CUNY), New York, New York.,Address correspondence to: Ariana Riccio, PhD, Department of Psychology, The Graduate Center, The City University of New York (CUNY), 365 5 Avenue, New York, NY 10016
| | - Jin Delos Santos
- Department of Psychology, Hunter College, The City University of New York (CUNY), New York, New York
| | | | - Allison Jordan
- Borough of Manhattan Community College and The College of Staten Island, The City University of New York (CUNY), New York, New York
| | - Danielle DeNigris
- School of Psychology and Counseling, Fairleigh Dickinson University, Madison, New Jersey
| | - Kristen Gillespie-Lynch
- Department of Psychology, The Graduate Center and The College of Staten Island, The City University of New York (CUNY), New York, New York
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23
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Lam GYH, Holden E, Fitzpatrick M, Raffaele Mendez L, Berkman K. "Different but connected": Participatory action research using Photovoice to explore well-being in autistic young adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1246-1259. [PMID: 31968999 DOI: 10.1177/1362361319898961] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
LAY ABSTRACT Past research has mainly focused on autistic people's deficits and poor outcomes compared to other groups of people. Little is known about their positive life experiences, and how to support them to achieve a higher quality of life. It is important to include autistic individuals in research so that they can influence how their voices are represented in a meaningful way and how the research results will be useful to them. In this study, a university researcher collaborated with 14 autistic young adults in a post-school transition program to design and run the research, collect and analyze the data, and use the results to create a presentation to the community. Specifically, the participants took photos in daily life and discussed their ideas about what a good life means to them. Results showed that these young adults described themselves as uniquely and different, but they were eager to learn and adapt. They also valued their relationships with their families, friends, and animals around them, as well as the community at large. This research shows that autistic individuals have important perspectives to share and knowledge to contribute when they are given the opportunities to participate in different aspects of research. The findings will be useful in developing services and influencing policies that promote well-being among autistic adults.
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Schwartz AE, Kramer JM, Cohn ES, McDonald KE. "That Felt Like Real Engagement": Fostering and Maintaining Inclusive Research Collaborations With Individuals With Intellectual Disability. QUALITATIVE HEALTH RESEARCH 2020; 30:236-249. [PMID: 31466513 DOI: 10.1177/1049732319869620] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
People with intellectual disability (ID) are increasingly involved in stakeholder-engaged research, such as "inclusive research" (IR). To understand the processes that foster and maintain IR with individuals with ID, we used a narrative interview approach with co-researchers with ID (n = 6) and academic researchers (n = 8). We analyzed the data using grounded theory principles. We then developed a model describing how contextual factors and team-level factors and processes coalesce to foster and maintain IR collaborations. We observed that team members' values and characteristics are foundational to IR and drive a commitment to accessibility. Contextual factors, including funding and partnership duration, influence teams' processes and structures. These processes and structures influence the extent to which co-researchers perceive the IR team to be cofacilitated or academic-facilitated. Co-researcher involvement is partially maintained by perceived personal and societal benefits. Optimizing the relationship between these factors may support involvement of people with ID in stakeholder-engaged research projects.
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Arnold S, Foley KR, Hwang YIJ, Richdale AL, Uljarevic M, Lawson LP, Cai RY, Falkmer T, Falkmer M, Lennox NG, Urbanowicz A, Trollor J. Cohort profile: the Australian Longitudinal Study of Adults with Autism (ALSAA). BMJ Open 2019; 9:e030798. [PMID: 31806608 PMCID: PMC6924702 DOI: 10.1136/bmjopen-2019-030798] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE: There is a significant knowledge gap regarding the lives of adults on the autism spectrum. Some literature suggests significant health and mental health inequalities for autistic adults, yet there is a lack of comprehensive longitudinal studies exploring risk factors. Further, most research does not include the perspective of autistic adults in its conduct or design. Here, we describe the baseline characteristics and inclusive research approach of a nationwide longitudinal study. PARTICIPANTS: The Autism Cooperative Research Centre for Living with Autism's Australian Longitudinal Study of Adults with Autism (ALSAA) is a questionnaire-based longitudinal study of autistic adults (25+ years old) with follow-up at 2-year intervals. Autistic advisors were involved in each stage of research apart from data analysis. Three questionnaires were developed: self-report, informant report (ie, proxy report) and carers (ie, carer experiences and characteristics). FINDINGS TO DATE: An inclusive research protocol was developed and agreed with autistic advisors. Baseline data were collected from 295 autistic adults (M=41.8 years, SD=12.0) including 42 informant responses, 146 comparison participants and 102 carers. The majority of autistic participants (90%) had been diagnosed in adulthood (M=35.3 years, SD=15.1). When compared with controls, autistic adults scored higher on self-report measures of current depression and anxiety. Participant comments informed ongoing data gathering. Participants commented on questionnaire length, difficulty with literal interpretation of forced response items and expressed gratitude for research in this area. FUTURE PLANS: A large comprehensive dataset relating to autistic adults and their carers has been gathered, creating a good platform for longitudinal follow-up repeat surveys and collaborative research. Several outputs are in development, with focus on health service barriers and usage, caregivers, impact of diagnosis in adulthood, further scale validations, longitudinal analyses of loneliness, suicidal ideation, mental illness risk factors and other areas. Baseline data confirm poorer mental health of autistic adults. The ALSAA demonstrates a working approach to inclusive research.
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Affiliation(s)
- Samuel Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Kitty-Rose Foley
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, Bilinga, Queensland, Australia
| | - Ye In Jane Hwang
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Amanda L Richdale
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mirko Uljarevic
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- Stanford Autism Center, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, USA
| | - Lauren P Lawson
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Ru Ying Cai
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Torbjorn Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Marita Falkmer
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
- School of Education and Communication, CHILD Programme, Institution of Disability Research, Jonkoping University, Jonkoping, Sweden
| | - Nick G Lennox
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute - UQ, University of Queensland, South Brisbane, Queensland, Australia
| | - Anna Urbanowicz
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute - UQ, University of Queensland, South Brisbane, Queensland, Australia
- Health, Society & Medicine Research Program, Social and Global Studies Centre, RMIT University, Melbourne, Victoria, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
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Nicolaidis C, Raymaker D, Kapp SK, Baggs A, Ashkenazy E, McDonald K, Weiner M, Maslak J, Hunter M, Joyce A. The AASPIRE practice-based guidelines for the inclusion of autistic adults in research as co-researchers and study participants. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:2007-2019. [PMID: 30939892 PMCID: PMC6776684 DOI: 10.1177/1362361319830523] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As interest in autism in adulthood grows, so does the need for methods to promote the inclusion of autistic adults in research. Our objective was to create practice-based guidelines for the inclusion of autistic adults, both as research team members and as study participants. We conducted an institutional ethnography of three closely related research partnerships that used participatory methods with autistic adults over the years 2006-2018. We used an iterative approach which combined discussions with community and academic partners and artifact review. Guidelines to promote the inclusion of autistic adults as co-researchers focus on being transparent about partnership goals, clearly defining roles and choosing partners, creating processes for effective communication and power-sharing, building and maintaining trust, disseminating findings, encouraging community capacitation, and fairly compensating partners. Guidelines to promote the inclusion of autistic adults as study participants focus on maximizing autonomy and inclusion, creating an accessible consent process, offering multiple modes of participation, adapting survey instruments for use with autistic adults, creating accessible qualitative interview guides, and handling data from proxy reporters. Although these practice-based guidelines may not apply to all research teams, we hope that other researchers can capitalize on these practical lessons when including autistic adults in research.
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Affiliation(s)
- Christina Nicolaidis
- Regional Research Institute, School of Social Work, Portland State University (PSU), Portland, OR, USA
- Department of Medicine, School of Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - Dora Raymaker
- Regional Research Institute, School of Social Work, Portland State University (PSU), Portland, OR, USA
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Steven K Kapp
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
- Sociology, Philosophy and Anthropology, College of Social Sciences and International Studies, University of Exeter, Exeter, UK
| | - Amelia Baggs
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - E Ashkenazy
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Katherine McDonald
- Department of Public Health, Food Studies and Nutrition, Burton Blatt Institute, Syracuse University, Syracuse, NY, USA
| | - Michael Weiner
- Indiana University Center for Health Services and Outcomes Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Joelle Maslak
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Morrigan Hunter
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Andrea Joyce
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
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Nicolaidis C. What Does Inclusion Mean in Research and Scholarship on Autism in Adulthood? AUTISM IN ADULTHOOD 2019; 1:79-81. [PMID: 36601532 PMCID: PMC8992816 DOI: 10.1089/aut.2019.29001.cjn] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Christina Nicolaidis
- Editor-in-Chief, Autism in Adulthood.,School of Social Work, Portland State University, Portland, Oregon.,Department of Medicine, Oregon Health and Science University, Portland, Oregon.,OHSU-PSU School of Public Health, Portland, Oregon
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Moseley RL, Gregory NJ, Smith P, Allison C, Baron-Cohen S. A 'choice', an 'addiction', a way 'out of the lost': exploring self-injury in autistic people without intellectual disability. Mol Autism 2019; 10:18. [PMID: 31007885 PMCID: PMC6458651 DOI: 10.1186/s13229-019-0267-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 03/17/2019] [Indexed: 12/19/2022] Open
Abstract
Background Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients.
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Affiliation(s)
- R. L. Moseley
- Social, Cognitive, Clinical and Affective Neuroscience group, Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset UK
| | - N. J. Gregory
- Social, Cognitive, Clinical and Affective Neuroscience group, Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset UK
| | - P. Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - C. Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - S. Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Legault M, Bourdon JN, Poirier P. Neurocognitive Variety in Neurotypical Environments: The Source of “Deficit” in Autism. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/jbbs.2019.96019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Frazier TW, Dawson G, Murray D, Shih A, Sachs JS, Geiger A. Brief Report: A Survey of Autism Research Priorities Across a Diverse Community of Stakeholders. J Autism Dev Disord 2018; 48:3965-3971. [DOI: 10.1007/s10803-018-3642-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Hotez E, Shane-Simpson C, Obeid R, DeNigris D, Siller M, Costikas C, Pickens J, Massa A, Giannola M, D'Onofrio J, Gillespie-Lynch K. Designing a Summer Transition Program for Incoming and Current College Students on the Autism Spectrum: A Participatory Approach. Front Psychol 2018; 9:46. [PMID: 29487547 PMCID: PMC5816926 DOI: 10.3389/fpsyg.2018.00046] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/11/2018] [Indexed: 01/13/2023] Open
Abstract
Students with Autism Spectrum Disorder (ASD) face unique challenges transitioning from high school to college and receive insufficient support to help them navigate this transition. Through a participatory collaboration with incoming and current autistic college students, we developed, implemented, and evaluated two intensive week-long summer programs to help autistic students transition into and succeed in college. This process included: (1) developing an initial summer transition program curriculum guided by recommendations from autistic college students in our ongoing mentorship program, (2) conducting an initial feasibility assessment of the curriculum [Summer Transition Program 1 (STP1)], (3) revising our initial curriculum, guided by feedback from autistic students, to develop a curriculum manual, and (4) pilot-testing the manualized curriculum through a quasi-experimental pre-test/post-test assessment of a second summer program [Summer Transition Program 2 (STP2)]. In STP2, two autistic college students assumed a leadership role and acted as "mentors" and ten incoming and current autistic college students participated in the program as "mentees." Results from the STP2 pilot-test suggested benefits of participatory transition programming for fostering self-advocacy and social skills among mentees. Autistic and non-autistic mentors (but not mentees) described practicing advanced forms of self-advocacy, specifically leadership, through their mentorship roles. Autistic and non-autistic mentors also described shared (e.g., empathy) and unique (an intuitive understanding of autism vs. an intuitive understanding of social interaction) skills that they contributed to the program. This research provides preliminary support for the feasibility and utility of a participatory approach in which autistic college students are integral to the development and implementation of programming to help less experienced autistic students develop the self-advocacy skills they will need to succeed in college.
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Affiliation(s)
- Emily Hotez
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States.,College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States
| | - Christina Shane-Simpson
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States.,University of Wisconsin-Stout, Menomonie, WI, United States
| | - Rita Obeid
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,Lehman College, City University of New York, New York, NY, United States
| | | | - Michael Siller
- Emory University School of Medicine, Atlanta, GA, United States
| | | | - Jonathan Pickens
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States
| | - Anthony Massa
- College of Staten Island, New York, NY, United States
| | | | | | - Kristen Gillespie-Lynch
- College of Staten Island and the Graduate Center, City University of New York, New York, NY, United States.,College of Staten Island, New York, NY, United States
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Gillespie-Lynch K, Kapp SK, Brooks PJ, Pickens J, Schwartzman B. Whose Expertise Is It? Evidence for Autistic Adults as Critical Autism Experts. Front Psychol 2017; 8:438. [PMID: 28400742 PMCID: PMC5368186 DOI: 10.3389/fpsyg.2017.00438] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 03/09/2017] [Indexed: 11/19/2022] Open
Abstract
Autistic and non-autistic adults’ agreement with scientific knowledge about autism, how they define autism, and their endorsement of stigmatizing conceptions of autism has not previously been examined. Using an online survey, we assessed autism knowledge and stigma among 636 adults with varied relationships to autism, including autistic people and nuclear family members. Autistic participants exhibited more scientifically based knowledge than others. They were more likely to describe autism experientially or as a neutral difference, and more often opposed the medical model. Autistic participants and family members reported lower stigma. Greater endorsement of the importance of normalizing autistic people was associated with heightened stigma. Findings suggest that autistic adults should be considered autism experts and involved as partners in autism research.
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Affiliation(s)
- Kristen Gillespie-Lynch
- Psychology, College of Staten Island and The Graduate Center, City University of New York New York, NY, USA
| | - Steven K Kapp
- College of Social Sciences and International Studies, University of Exeter Exeter, UK
| | - Patricia J Brooks
- Psychology, College of Staten Island and The Graduate Center, City University of New York New York, NY, USA
| | - Jonathan Pickens
- Psychology, College of Staten Island and The Graduate Center, City University of New York New York, NY, USA
| | - Ben Schwartzman
- Educational Psychology, University of California at Los Angeles Los Angeles, CA, USA
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Raymaker DM. Intersections of Critical Systems Thinking and Community Based Participatory Research: A Learning Organization Example with the Autistic Community. SYSTEMIC PRACTICE AND ACTION RESEARCH 2016; 29:405-423. [PMID: 27833398 PMCID: PMC5098939 DOI: 10.1007/s11213-016-9376-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Critical systems thinking (CST) and community based participatory research (CBPR) are distinct approaches to inquiry which share a primary commitment to holism and human emancipation, as well as common grounding in critical theory and emancipatory and pragmatic philosophy. This paper explores their intersections and complements on a historical, philosophical, and theoretical level, and then proposes a hybrid approach achieved by applying CBPR's principles and considerations for operationalizing emancipatory practice to traditional systems thinking frameworks and practices. This hybrid approach is illustrated in practice with examples drawn from of the implementation of the learning organization model in an action research setting with the Autistic community. Our experience of being able to actively attend to, and continuously equalize, power relations within an organizational framework that otherwise has great potential for reinforcing power inequity suggests CBPR's principles and considerations for operationalizing emancipatory practice could be useful in CST settings, and CST's vocabulary, methods, and clarity around systems thinking concepts could be valuable to CBPR practioners.
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Affiliation(s)
- Dora M Raymaker
- Regional Research Institute for Human Services, Portland State University
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McDonald KE, Stack E. You say you want a revolution: An empirical study of community-based participatory research with people with developmental disabilities. Disabil Health J 2016; 9:201-7. [PMID: 26838472 DOI: 10.1016/j.dhjo.2015.12.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/09/2015] [Accepted: 12/19/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Community-based participatory research (CBPR) seeks to improve the responsiveness of science to community priorities and foster positive community change through equitable research collaborations between scientists and community members. CBPR resonates with disability rights principles, and is increasingly being used in disability research, though there are few studies of its use with people with developmental disabilities. OBJECTIVE We conducted a prospective qualitative study to explore the experiences of scientists and community members in a multi-year CBPR project with people with developmental disabilities. METHODS Over the four project years, we conducted periodic individual interviews and focus groups with members of the CBPR project, and used an inductive thematic analysis to identify and develop relational themes. RESULTS We identified factors that contributed to the success of the CBPR project and factors that presented challenges to the CBPR project. We also identified potential individual, project, and societal level impacts of the CBPR project. CONCLUSIONS CBPR with people with developmental disabilities is possible and fruitful, and can serve as an effective model for the full inclusion of people with developmental disabilities in science and society at large.
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Affiliation(s)
- Katherine E McDonald
- Public Health, Food Studies, and Nutrition and the Burton Blatt Institute, Syracuse University, 444 White Hall, Syracuse, NY 13244, USA.
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