Do puzzle pieces and autism puzzle piece logos evoke negative associations?

'Does that mean you will be violent?': A qualitative exploration into Autistic women's experiences of relationships with lecturers at university

LAY ABSTRACT

It is documented that more Autistic woman are becoming university students, but their experiences are not often explored. Eleven Autistic women students made artefacts (such as writing, paintings or poems) and took part in interviews to share their experiences at university. Five participants were undergraduate students and six participants were postgraduate students. The artefacts and words participants shared were looked at closely and some common themes were decided. How lecturers talk to Autistic women students was looked at. Participants said they were lucky if they met helpful lecturers. Also, autism acceptance was explored. Overall, how lecturers treat Autistic women at university is very important. Also, Autistic women students' opinions about making university a more welcoming place need to be listened to.

Advocating for a dementia-inclusive visual communication

INTRODUCTION

This study examines the underlying visual communication strategies found in existing images of dementia in the public domain. By delineating how experiences of dementia are visualized and their consequent social interpretations, we aim to inform and advocate for a dementia-inclusive visual communication, that is, visual depictions that cultivate and represent a dementia-inclusive society.

METHODS

The visuals were analyzed by employing the Visual Discourses of Disability (ViDD) framework that juxtaposes the "perspectivizing-personizing" cline with the "enabling-disabling" continuum. The data studied comprise a total of 432 images sourced from three domains, namely (1) The Star, a Malaysian mainstream English newspaper (2012-2021); (2) Alzheimer's Disease Foundation Malaysia (ADFM) website (2019-2021); and (3) the Ministry of Health Malaysia (2019-2021) website. Findings from the visual analyses were corroborated by four representatives of ADFM in a group interview.

RESULTS

There is a predominance of stigmatized images, constructing dementia as a loss and deficit, thus depicting individuals in distanced suffering. Generic representations of people through stock images, a unique focus on the hands, representations of brain degeneration through abstractions and missing puzzle pieces are also prevalent. Despite these, the interview data confirmed that the perspectivizing aspect may be necessary to educate the public on what dementia entails. While personizing images that depict personhood and actual persons living with dementia are ideal, the use of stock images may be necessary if there is a need to maintain confidentiality and observe sensitivities. Similarly, images with positive emotions are encouraged but disabling ones are equally important to reflect reality and inculcate empathy.

CONCLUSION

When capturing, selecting and publishing images of dementia, organizations should deliberate on different visual elements which evoke empowerment, advocacy, handicapping and othering implications as outlined in the ViDD framework. Any decision should only be made after considering the purposes of publications and implications such images have on the intended audiences.

Learning from the experts: Evaluating a participatory autism and universal design training for university educators

LAY ABSTRACT

Autistic university students have many strengths. They also go through difficulties that professors may not understand. Professors may not understand what college life is like for autistic students. They might judge autistic students. A team of autistic and non-autistic researchers made a training to help professors understand autistic students better. This training also gave professors ideas to help them teach all of their students. Ninety-eight professors did an online survey before the autism training. They shared how they felt about autism and teaching. Before our training, professors who knew more about autism appreciated autism more. Professors who thought people should be equal and women also appreciated autism more. Then, 89 of the professors did our training and another survey after the training. This helped us see what they learned from the training. They did one more survey a month later. This helped us see what they remembered. Our training helped professors understand and value autism. It also helped them understand how they can teach all students better. The professors remembered a lot of what we taught them. This study shows that a training that autistic people helped make can help professors understand their autistic students better.

If you want to develop an effective autism training, ask autistic students to help you

LAY ABSTRACT

Autistic university students are often left out because people do not understand autism. We wanted to help people understand autism. Most autism trainings are not made by autistic people. Autistic people know what it is like to be autistic. So autistic people may be the best teachers when it comes to teaching about autism. Autistic students and non-autistic professors made an autism training. The students made videos for the training. They also helped make questions to see what people learned from the trainings. Professors who are not autistic made a training on their own. Students in New York City tried out the trainings. After they answered questions, they did either the training the autistic students helped make or the training made by only professors. Then, they answered questions again. We learned from the students how to make our trainings better. Then, students from two universities in the United States and one university in Lebanon did our trainings and questions. Both trainings made hidden feelings about autism better. The training autistic students helped make taught students more than the training professors made on their own. The autistic-led training also helped students accept autism more. These studies show that autistic students can make autism research and trainings better. At the end of this article, autistic students share their ideas for how to make autism trainings even better in the future.

Avoiding Ableist Language: Suggestions for Autism Researchers

In this commentary, we describe how language used to communicate about autism within much of autism research can reflect and perpetuate ableist ideologies (i.e., beliefs and practices that discriminate against people with disabilities), whether or not researchers intend to have such effects. Drawing largely from autistic scholarship on this subject, along with research and theory from disability studies and discourse analysis, we define ableism and its realization in linguistic practices, provide a historical overview of ableist language used to describe autism, and review calls from autistic researchers and laypeople to adopt alternative ways of speaking and writing. Finally, we provide several specific avenues to aid autism researchers in reflecting on and adjusting their language choices.

Lay summary

Why is this topic important?: In the past, autism research has mostly been conducted by nonautistic people, and researchers have described autism as something bad that should be fixed. Describing autism in this way has negative effects on how society views and treats autistic people and may even negatively affect how autistic people view themselves. Despite recent positive changes in how researchers write and speak about autism, "ableist" language is still used. Ableist language refers to language that assumes disabled people are inferior to nondisabled people.What is the purpose of this article?: We wrote this article to describe how ableism influences the way autism is often described in research. We also give autism researchers strategies for avoiding ableist language in their future work.What is the perspective of the authors?: We believe that ableism is a "system of discrimination," which means that it influences how people talk about and perceive autism whether or not they are aware of it, and regardless of whether or not they actually believe that autistic people are inferior to nonautistic people. We also believe that language choices are part of what perpetuates this system. Because of this, researchers need to take special care to determine whether their language choices reflect ableism and take steps to use language that is not ableist.What is already known about this topic?: Autistic adults (including researchers and nonresearchers) have been writing and speaking about ableist language for several decades, but nonautistic autism researchers may not be aware of this work. We have compiled this material and summarized it for autism researchers.What do the authors recommend?: We recommend that researchers understand what ableism is, reflect on the language they use in their written and spoken work, and use nonableist language alternatives to describe autism and autistic people. For example, many autistic people find terms such as "special interests" and "special needs" patronizing; these terms could be replaced with "focused interests" and descriptions of autistic people's specific needs. Medicalized/deficit language such as "at risk for autism" should be replaced by more neutral terms such as "increased likelihood of autism." Finally, ways of speaking about autism that are not restricted to particular terms but still contribute to marginalization, such as discussion about the "economic burden of autism," should be replaced with discourses that center the impacts of social arrangements on autistic people.How will these recommendations help autistic people now or in the future?: Language is a powerful means for shaping how people view autism. If researchers take steps to avoid ableist language, researchers, service providers, and society at large may become more accepting and accommodating of autistic people.

Explicit Associations with Autism and Disability

Objectives

Autistic people call for greater acceptance even though the general public has greater awareness of the autism spectrum. This study investigated explicit or conscious attitudes toward the autism spectrum and disability in college students and the general population. We hypothesized that both samples would associate "a person on the autism spectrum" with more negative attributes than other types of people except for "a person with a disability."

Methods

In Phase 1, participants generated 10 word associations for 8 labels: a person on the autism spectrum, a person not on the autism spectrum, a person with a disability, a person without a disability, a college student, a professor, a child, and a parent. In Phase 2, participants rated the 10 most common words for each label (type of person) in Phase 1 on a 7-point Likert scale from extremely negative to extremely positive. Ninety-nine undergraduate students and 106 adults recruited through Amazon Mechanical Turk completed Phase 1. One hundred twenty-two undergraduate students and 101 adults recruited through Amazon Mechanical Turk completed Phase 2.

Results

Only "a person with a disability" in the general population sample was rated as having significant negative associations. However, the associations of "a person with a disability" were rated more negatively than all other labels in both samples, and the associations of "a person on the autism spectrum" were rated as second most negative in the general population sample.

Conclusion

Explicit associations toward disability and autism were somewhat mixed. Adults in the general population tended to have more negative explicit associations with disability, and to a lesser extent autism. These results underscore the need to examine attitudes in samples more representative of the general population. Furthermore, evidence of possible explicit negative associations is concerning and highlights the imperative need to confront ableism.

Lay summary

Why was this study done?: The general public claims to be aware of the autism spectrum and recent research suggests that they have greater knowledge about the autism spectrum than they did in the past. However, as autistic individuals have articulated, autism awareness is not the same as autism acceptance. In order for autistic individuals to be fully included into society, we must move to autism acceptance. One way researchers examine potential discrimination is by studying attitudes.What was the purpose of this study?: This study examines people's explicit attitudes toward the autism spectrum and to disability. Explicit attitudes are attitudes that are conscious and controllable.What did the researchers do?: Two groups of adults participated in the study: a group of college students and a noncollege sample of adults designed to better represent the general population of adults. Participants completed an online study wherein they were asked to list word associations for different types of people including "a person on the autism spectrum" and "a person with a disability." In a second study, participants then rated the most common associations from extremely negative to extremely positive.What were the results of the study?: The results were somewhat mixed. Only the set of associations of "a person with a disability" were rated by participants in the noncollege group as negative. However, the associations of "a person with a disability" were rated more negatively than all other types of people in both groups, and the associations of "a person on the autism spectrum" were rated as second most negative in the noncollege sample.What do these findings add to what was already known?: The majority of research on explicit attitudes toward autism has focused on children, including how interventions may improve attitudes toward autistic children. Therefore, this research provides much needed information on the state of attitudes toward autistic individuals more generally. This research also provides a comparison of attitudes toward autism, disability, and other groups. Furthermore, research assessing attitudes toward autism in adults has largely focused on college students, whereas this research considered both college students and a noncollege sample.What are the potential weaknesses in the study?: These findings may not extend to a more diverse population as both groups had relatively high education levels, were primarily White non-Hispanic and were living in the United States. Furthermore, participants may have generated more positive associations for "a person on the autism spectrum" and "a person with a disability" because they wanted to be viewed in a favorable light. This is known as a social desirability bias.How will these findings help autistic adults now or in the future?: Unfortunately, possible explicit negative associations with the autism spectrum and with disability are concerning as they reflect people's conscious and controllable attitudes. These results highlight a need for action and also support autistic individuals' demand for actions toward autism acceptance.

Development of the AASPIRE Web Accessibility Guidelines for Autistic Web Users

Websites figure predominantly in everyday life. However, many websites remain inaccessible to autistic people, and existing efforts to improve accessibility are in early stages, do not directly include autistic users in their development, or have not been empirically evaluated. The Academic Autism Spectrum Partnership in Research and Education (AASPIRE) used a community-based participatory research approach to create a website to improve health care access for autistic adults. We used the creation of that website as a "living laboratory" to develop the AASPIRE Web Accessibility Guidelines for Autistic Web Users. Our guidelines are grounded in accessibility theory, had autistic end-user involvement at all stages, and were empirically evaluated through a usability study and evaluation surveys. We incorporated what we learned into the design of the website, and compiled the accessibility information into a set of guidelines. The guidelines offer recommendations for increasing the physical, intellectual, and social acceptability of websites for use by autistic adults. In the evaluation of the website by 170 autistic end users, nearly all indicated it was easy to use (97%), easy to understand (95%), important (97%), and useful (96%). Ninety-two percent would recommend it to a friend, and 95% would recommend it to a health care provider. There were no significant associations between usability or understandability and education level, receipt of help using the site, browser type (e.g., IE or Safari), or device type (e.g., PC or tablet). We recommend using the guidelines to improve website accessibility for autistic Internet users.

Lay Summary

AASPIRE Web Accessibility Guideline: This guideline is a summary of the accessibility features we identified and implemented during the course of our study. None of these items were difficult or expensive for us to implement. They did not require special expertise beyond basic web programming and technical communications skills. We recommend that anyone seeking to create accessible websites for autistic users follow the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) Web Accessibility Guideline in addition to broader web and communications standards and principles.Physical accessibility:Provide at least one low-contrast neutral color palette option to accommodate sensitive vision.Provide a selection of color palettes, including one with a dark background and one with a light background, again to accommodate color and contrast sensitivity.Provide a no-style option (i.e., no cascading style sheets (CSS) to accommodate browser customization and users who prefer no stylistic formatting.Provide simple consistent navigation and highly consistent site behavior for increased ease of operation.Avoid textured backgrounds, moving images, decorative elements that do not convey information, and other visual and/or sonic "clutter"; these types of elements may make the site difficult or impossible to comprehend.Provide smaller font sizes in addition to larger ones; large font sizes may make the page appear cluttered and difficult to read.Use a plain accessible sans-serif font (e.g., Arial) for ease of readability.Intellectual accessibility:Use the simplest interface possible for ease of understanding.Use simple concrete icons or images to communicate redundant information with text, and accommodate multiple ways of understanding information.Clearly label site elements with their purpose everywhere on the site, even if it seems redundant, to make navigation and site functionality easier to follow.Provide concrete examples where applicable to accommodate difficulties in understanding abstractions or generalizations.Minimize scrolling so the user does not need to rely on assumptions about content to guess what might be on the page.Show all important features and site navigation (as opposed to within combo box drop-down areas) so the user does not need to rely on assumptions to guess whether the item exists and how to access it. For example, completely visible list boxes or radio buttons can be used instead of combo boxes.Make content as short as possible without sacrificing precision and specificity, to reduce cognitive burden.Social accessibility:Be specific and precise in language use; avoid colloquialisms, idioms, and ambiguity to accommodate difficulties with language pragmatics.Explain the reason behind any nonstandard instructions or unusual information; provide additional pragmatic context to accommodate difficulties with language pragmatics.Provide alternatives to definitive response items on surveys and forms, for example, "do not know," "do not wish to say," or "not applicable," to reduce frustration for not being able to produce an exact answer.Use FAQ formats to organize complex information to enhance clarity as to why the information might be useful to the user and how it connects to their life.Define terms that might have different meanings depending on social context, or which might be jargon related to a specialized field (e.g., "drug interactions" and "health care providers"), to accommodate difficulties with language pragmatics.Be mindful of autistic culture and community preferences, including the language used to describe autism and how community-based symbols and history might influence content and perception of site credibility.