1
|
Blackhurst T, Warmelink L, Roestorf A, Hartley C. The Brunswik Lens Model: a theoretical framework for advancing understanding of deceptive communication in autism. Front Psychol 2024; 15:1388726. [PMID: 39055993 PMCID: PMC11271661 DOI: 10.3389/fpsyg.2024.1388726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Due to differences in social communication and cognitive functioning, autistic adults may have greater difficulty engaging in and detecting deception compared to neurotypical adults. Consequently, autistic adults may experience strained social relationships or face increased risk of victimization. It is therefore crucial that research investigates the psychological mechanisms that are responsible for autistic adults' difficulties in the deception process in order to inform interventions required to reduce risk. However, weaknesses of extant research exploring deception in autism include a heavy focus on children and limited theoretical exploration of underlying psychological mechanisms. To address these weaknesses, this review aims to introduce a system-level theoretical framework to the study of deception in autistic adulthood: The Brunswik Lens Model of Deception. Here, we provide a comprehensive account of how autism may influence all processes involved in deception, including: Choosing to Lie (1), Producing Deception Cues (2), Perceiving Deception Cues (3), and Making the Veracity Decision (4). This review also offers evidence-based, theoretical predictions and testable hypotheses concerning how autistic and neurotypical adults' behavior may differ at each stage in the deception process. The call to organize future research in relation to a joint theoretical perspective will encourage the field to make substantive, theoretically motivated progress toward the development of a comprehensive model of deception in autistic adulthood. Moreover, the utilization of the Brunswik Lens Model of Deception in future autism research may assist in the development of interventions to help protect autistic adults against manipulation and victimization.
Collapse
Affiliation(s)
- Tiegan Blackhurst
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Lara Warmelink
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | | | - Calum Hartley
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| |
Collapse
|
2
|
Emerson LM, Monk R, van der Meer L, Sutherland D, McLay L. Autistic Co-Led Community Priorities for Future Autism Research in Aotearoa New Zealand. AUTISM IN ADULTHOOD 2024; 6:141-151. [PMID: 39139510 PMCID: PMC11317798 DOI: 10.1089/aut.2022.0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Background Previous studies of community priorities for autism research have been limited by low representation of autistic people and thus a bias toward the views of families and professionals. We aimed to determine the first community-led priorities for autism research in Aotearoa New Zealand (NZ). Methods Autistic people were essential partners in the project, from inception and design through to methods and outputs. We gathered the views of the autistic and autism communities (including family, practitioners, and researchers) through focus groups (n = 55) and an online survey (n = 450). Almost 40% of the survey respondents indicated that they were autistic. Results The findings across the focus groups and survey highlighted the importance of research that centralizes the experiences and needs of autistic people, particularly of autistic New Zealanders, including culturally specific research for Māori and Pacific peoples. All five priority topics for autistic adults were also priorities for at least one other group: (1) Health, mental health, and well-being of autistic people (all groups); (2) Services across the life span (autistic adults, health care/disability, and education practitioners); (3) Needs of autistic people in Aotearoa NZ (autistic adults, whānau); (4) Perspectives from autistic people with a diverse range of support needs (autistic adults; education practitioners); (5) Quality of life of autistic people in Aotearoa NZ (autistic adults; health care/disability practitioners). Conclusions We discuss the advantages of autistic involvement in research, and how these community priorities can inform future research and policy in NZ.
Collapse
Affiliation(s)
- Lisa Marie Emerson
- Te Kaupeka Oranga—Faculty of Health, Te Whare Wānanga o Waitaha—University of Canterbury, Ōtautahi—Christchurch, Aotearoa, New Zealand
- Autism Research Collaborative Aotearoa New Zealand, Te Whare Wānanga o Waitaha—University of Canterbury, Aotearoa, New Zealand
| | - Ruth Monk
- Te Kaupeka Oranga—Faculty of Health, Te Whare Wānanga o Waitaha—University of Canterbury, Ōtautahi—Christchurch, Aotearoa, New Zealand
- Autism Research Collaborative Aotearoa New Zealand, Te Whare Wānanga o Waitaha—University of Canterbury, Aotearoa, New Zealand
| | - Larah van der Meer
- Autism, New Zealand
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Dean Sutherland
- School of Psychology, Speech and Hearing, Te Whare Wānanga o Waitaha—University of Canterbury, Ōtautahi—Christchurch, Aotearoa, New Zealand
| | - Laurie McLay
- Te Kaupeka Oranga—Faculty of Health, Te Whare Wānanga o Waitaha—University of Canterbury, Ōtautahi—Christchurch, Aotearoa, New Zealand
- Autism Research Collaborative Aotearoa New Zealand, Te Whare Wānanga o Waitaha—University of Canterbury, Aotearoa, New Zealand
| |
Collapse
|
3
|
Pritchard-Rowe E, de Lemos C, Howard K, Gibson J. Diversity in Autistic Play: Autistic Adults' Experiences. AUTISM IN ADULTHOOD 2024; 6:218-228. [PMID: 39139511 PMCID: PMC11317800 DOI: 10.1089/aut.2023.0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Background Play is important for mental health and well-being. Descriptions of autistic play have typically focused on "deficits" and are based on comparisons to neurotypical "norms". According to the neurodiversity paradigm, it is important that autistic voices are highlighted and that difficulties, differences, and strengths are explored. With this in mind, we designed the present study to focus on the experiences and perspectives of autistic people concerning the topic of autistic play. Methods We conducted a consultation with autistic stakeholders, as well as with parents and teachers of autistic individuals to help us design the study and interview questions. We used semi-structured interviews with 22 autistic adults aged 18-57 years (clinically confirmed diagnosis, n = 21; self-diagnosed, n = 1) who live in the United Kingdom. We analyzed the data using interpretative phenomenological analysis to identify themes. Results We found important commonalities and differences in the ways that socialization in play, imaginary play, and flow (a state involving intense focus on the play) are experienced. Autistic adults discussed the importance of both solitary play and social play, with solitary play having an important recuperative function. They also reported preferences for parallel play and playing with similar autistic people. They also discussed imaginary play experiences, including social role-play and grounded-in-reality play, and the dual nature of flow experiences during play. Conclusions The findings of this study contrast with deficit-focused understandings of autistic play and build on neurodiversity-informed studies. We highlight, for example, the importance of considering the different circumstances under which solitary play or social play are preferred, as well as the importance of taking an individual approach to play. We encourage wider understanding and acceptance of these play preferences and experiences to support autistic people's well-being.
Collapse
Affiliation(s)
- Emma Pritchard-Rowe
- Play & Communication Lab, Play in Education, Development and Learning (PEDAL) Centre, Faculty of Education, University of Cambridge, Cambridge, United Kingdom
| | - Carmen de Lemos
- Play & Communication Lab, Play in Education, Development and Learning (PEDAL) Centre, Faculty of Education, University of Cambridge, Cambridge, United Kingdom
| | - Katie Howard
- School of Education, University of Exeter, Exeter, United Kingdom
| | - Jenny Gibson
- Play & Communication Lab, Play in Education, Development and Learning (PEDAL) Centre, Faculty of Education, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
4
|
Haar T, Brownlow C, Hall G, Heyworth M, Lawson W, Poulsen R, Reinisch T, Pellicano E. 'We have so much to offer': Community members' perspectives on autism research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241248713. [PMID: 38741516 DOI: 10.1177/13623613241248713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
LAY ABSTRACT Autism research is changing. Autistic activists and researchers want Autistic people in the community to have more of a say about what is researched and how. But we haven't asked people in the community what they think. This study used the information obtained from 55 community members, including Autistic people, their families, and professionals working with Autistic people, from an existing study on their priorities for autism research. We re-looked at what was said to see if we could understand community members' views and experiences of autism research. People agreed strongly that research can play a powerful role in shaping good Autistic lives. They also felt that big changes were needed for research to do this. Some of these changes were that researchers should stop thinking about autism narrowly and in a negative way, where Autistic people are seen as the problem. Researchers need to think more about how to improve systems, experiences and how other people respond to Autistic people. They also want the autism community to be more involved in what is researched and how it is researched. The findings from our study here highlight the potential for research to be positive when Autistic people and their families are listened to, approached with understanding, and are respected and valued as individuals in the research process.
Collapse
Affiliation(s)
- Tori Haar
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | - Charlotte Brownlow
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- University of Southern Queensland, Australia
| | - Gabrielle Hall
- Macquarie University, Australia
- ORIMA Research, Australia
| | - Melanie Heyworth
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | - Wenn Lawson
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Rebecca Poulsen
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Reframing Autism, Australia
| | | | - Elizabeth Pellicano
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- University College London, UK
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Ní Ghrálaigh F, Brennan A, Bolshakova N, Foley M, Gallagher L, Lopez LM. Establishing an Irish autism research network. Ir J Psychol Med 2024; 41:157-158. [PMID: 36106582 DOI: 10.1017/ipm.2022.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- F Ní Ghrálaigh
- Department of Biology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - A Brennan
- Department of Biology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - N Bolshakova
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - M Foley
- Trinity PPI Ignite Office, Trinity College Dublin, Dublin, Ireland
| | - L Gallagher
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - L M Lopez
- Department of Biology, Maynooth University, Maynooth, Co. Kildare, Ireland
| |
Collapse
|
7
|
Pellicano E, Adams D, Crane L, Hollingue C, Allen C, Almendinger K, Botha M, Haar T, Kapp SK, Wheeley E. Letter to the Editor: A possible threat to data integrity for online qualitative autism research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:786-792. [PMID: 37212144 DOI: 10.1177/13623613231174543] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
LAY ABSTRACT Doing research online, via Zoom, Teams, or live chat, is becoming more and more common. It can help researchers to reach more people, including from different parts of the world. It can also make the research more accessible for participants, especially those with different communication preferences. However, online research can have its downsides too. We have recently been involved in three studies in which we had in-depth discussions with autistic people and/or parents of autistic children about various topics. It turns out, though, that some of these participants were not genuine. Instead, we believe they were "scammer participants": people posing as autistic people or parents of autistic children, possibly to gain money from doing the research. This is a real problem because we need research data that we can trust. In this letter, we encourage autism researchers to be wary of scammer participants in their own research.
Collapse
|
8
|
Poulsen R, Dwyer P, Gassner D, Heyworth M, Williams ZJ. The INSAR Community Collaborator Request: Using community-academic partnerships to enhance outcomes of participatory autism research. Autism Res 2023; 16:2071-2076. [PMID: 37688487 DOI: 10.1002/aur.3027] [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: 09/18/2022] [Accepted: 08/21/2023] [Indexed: 09/11/2023]
Abstract
Participatory approaches, in which researchers work together with members of the autism community (e.g., autistic people, family members, caregivers, or other stakeholders) to design, conduct, and disseminate research, have become increasingly prominent within the field of autism research over the past decade. Despite growing academic and community interest in conducting participatory studies, stakeholder collaboration remains infrequent in autism research, at least partially due to systemic barriers. To help reduce barriers to engaging in participatory autism research, the International Society for Autism Research (INSAR) Autistic Researchers Committee has launched the INSAR Community Collaborator Request (ICCR; https://www.autism-insar.org/page/iccr), a platform on the INSAR website that allows autism researchers conducting participatory research to seek out stakeholder collaborators from the autism community (including both autistic people and their family members/caregivers, as relevant to a given research project). Interested stakeholders also have the opportunity to subscribe to ICCR posts, allowing them to be alerted of new opportunities for collaboration and potentially increasing their involvement in autism research. Overall, the ICCR provides a venue to connect autism researchers with potential community collaborators, reducing barriers to participatory autism research and increasing the frequency of successful community-academic partnerships within the field. We are hopeful that in the long term, such changes will lead to greater alignment between research outputs and the goals of the greater autism community, and consequently an increase in the overall quality and relevance of autism research.
Collapse
Affiliation(s)
- Rebecca Poulsen
- Macquarie University Hearing, Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
- Reframing Autism, St Leonards, New South Wales, Australia
| | - Patrick Dwyer
- Center for Mind and Brain, University of California Davis, Davis, California, USA
- Department of Psychology, University of California Davis, Davis, California, USA
- MIND Institute, UC Davis Health, Sacramento, California, USA
| | - Dena Gassner
- School of Social Work, Adelphi University, Garden City, New York, USA
- Department of Health Sciences, Towson University, Towson, Maryland, USA
| | - Melanie Heyworth
- Reframing Autism, St Leonards, New South Wales, Australia
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
9
|
Darazsdi Z, Bialka CS. "Oh, you couldn't be autistic": Examining anti-autistic bias and self-esteem in the therapeutic alliance. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2124-2134. [PMID: 36803046 DOI: 10.1177/13623613231154622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
LAY ABSTRACT Many mental health practitioners in the United States are trained to cure or change autistic people. Some of these mental health practitioners may show anti-autistic bias when working with autistic clients. Anti-autistic bias is any kind of bias that degrades, devalues, or others autistic people or autistic traits. Anti-autistic bias is especially problematic when mental health practitioners and clients are engaged in the therapeutic alliance, which is the collaborative relationship between a therapist and client. The therapeutic alliance is one of most important parts of an effective therapeutic relationship. Our interview-based study examined 14 autistic adults' experiences with anti-autistic bias in the therapeutic alliance and the relationship they felt it has on their self-esteem. Results from this research showed that some mental health practitioners expressed hidden and unrealized bias when working with autistic clients, such as making assumptions about what it means to be autistic. Results also showed that some mental health practitioners were intentionally biased and openly harmful to their autistic clients. Both forms of bias negatively affected participant self-esteem. Based on the findings of this study, we offer recommendations to help mental health practitioners and mental health practitioner training programs better serve autistic clients. This study addresses a significant gap in current research on anti-autistic bias in the mental health field and the overall well-being of autistic individuals.
Collapse
|
10
|
Ward JH, Weir E, Allison C, Baron-Cohen S. Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults. Mol Autism 2023; 14:35. [PMID: 37730651 PMCID: PMC10510241 DOI: 10.1186/s13229-023-00565-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The poorer physical health of autistic adults compared to non-autistic adults has been highlighted by several epidemiological studies. However, research has so far been limited to specific geographical areas and has primarily focused on young autistic individuals (aged 35 years and younger). Recent studies indicate a higher rate of mortality in autistic people, as well as poorer quality of self-reported healthcare interactions. This study aims to determine, first, whether autistic people experience greater levels of non-communicable health conditions and second, whether these are explained by differences in demographics (i.e. sex, country of residence, ethnicity, education level), alcohol use, smoking, body mass index (BMI), or family history of medical conditions. METHOD We employed a cross-sectional, convenience-sampling study via an anonymous, online survey of autistic and non-autistic adults (n = 2305, mean age = 41.6, 65.9% female, 49% autistic). The survey asked participants to self-report information about their demographics, autism diagnosis, diet, exercise, sleep, sexual health, substance use, personal medical history, and family medical history (for all first-degree, biological relatives). Binomial logistic regression across four iterative models of increasing complexity was applied to assess rates of physical health conditions. The Benjamini-Hochberg correction was used to account for multiple testing, and only physical health conditions that achieved at least 1% endorsement within the overall sample (n > 22) were included in the analysis to reduce risk of Type I errors. We also used novel network analysis methods to test whether there are increased levels of multimorbidity between autistic and non-autistic people. RESULTS There were significantly elevated rates of non-communicable conditions across all organ systems in autistic people, including gastrointestinal, neurological, endocrine, visual, ear/nose/throat, skin, liver and kidney, and haematological conditions. We confirmed previous findings by showing highly significant differences in rates of neurological and gastrointestinal symptoms (p < 0.0001). In addition, we established in the largest sample to date that Ehler-Danlos Syndrome (EDS) was more likely to occur among autistic females compared to non-autistic females. Finally, we found a higher prevalence of Coeliac's disease among autistic individuals compared to non-autistic individuals after controlling for sex, ethnicity, country of residence, alcohol use, smoking, and BMI, but these results became non-significant after accounting for family history. LIMITATIONS Our study is biased towards females, white individuals, highly educated people, and UK residents, likely due to sampling biases. Our self-report study design may also exclude those who lack access to computers, or those with intellectual disability. Our network analysis is also limited in size. CONCLUSIONS This study provides evidence of widespread, physical health comorbidity that spans nearly all major organ systems in autistic adults compared to non-autistic adults, using both binary logistic regression and network models. Healthcare professionals must be made aware of the range of co-occurring physical health conditions that may be more common among autistic people. However, our findings also point towards potential avenues requiring further exploration, such as the association of autism with both Coeliac's disease and EDS.
Collapse
Affiliation(s)
- John H Ward
- Royal Devon University NHS Foundation Trust, Exeter, Devon, UK
- University of Exeter Medical School, Devon, UK
- University of Oxford, Department of Psychiatry, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Elizabeth Weir
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 8AH, Cambridge, UK.
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 8AH, Cambridge, UK
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18b Trumpington Road, CB2 8AH, Cambridge, UK
| |
Collapse
|
11
|
Ellis R, Williams K, Brown A, Healer E, Grant A. A realist review of health passports for Autistic adults. PLoS One 2023; 18:e0279214. [PMID: 37682898 PMCID: PMC10490970 DOI: 10.1371/journal.pone.0279214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Autism is a normal part of cognitive diversity, resulting in communication and sensory processing differences, which can become disabling in a neurotypical world. Autistic people have an increased likelihood of physical and mental co-occurring conditions and die earlier than neurotypical peers. Inaccessible healthcare may contribute to this. Autism Health Passports (AHPs) are paper-based or digital tools which can be used to describe healthcare accessibility needs; they are recommended in UK clinical guidance. However, questions remained as to the theoretical underpinnings and effectiveness of AHPs. METHODS We undertook a systematic literature search identifying studies focused on AHPs for adults (aged over 16 years) from five databases. Included literature was subjected to realist evaluation. Data were extracted using a standardised form, developed by the research team, which considered research design, study quality for realist review and the Context, Mechanisms and Outcomes (CMOs) associated with each AHP tool. FINDINGS 162 unique records were identified, and 13 items were included in the review. Only one item was considered high quality. Contextual factors focused on the inaccessibility of healthcare to Autistic patients and staff lack of confidence and training in supporting Autistic needs. Interventions were heterogeneous, with most sources reporting few details as to how they had been developed. The most frequently included contents were communication preferences. Mechanisms were often not stated or were inferred by the reviewers and lacked specificity. Outcomes were included in four studies and were primarily focused on AHP uptake, rather than Outcomes which measured impact. CONCLUSION There is insufficient evidence to conclude that AHPs reduce the health inequalities experienced by Autistic people. Using an AHP tool alone in a healthcare Context that does not meet Autistic needs, without the inclusion of the local Autistic community developing the tool, and a wider intervention to reduce known barriers to health inequality, may mean that AHPs do not trigger any Mechanisms, and thus cannot affect Outcomes.
Collapse
Affiliation(s)
- Rebecca Ellis
- Centre for Lactation Infant Feeding and Translation (LIFT), Swansea University, Swansea, United Kingdom
| | - Kathryn Williams
- Autistic UK CIC, Llandudno, Wales, United Kingdom
- School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Amy Brown
- Centre for Lactation Infant Feeding and Translation (LIFT), Swansea University, Swansea, United Kingdom
| | - Eleanor Healer
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
| | - Aimee Grant
- Centre for Lactation Infant Feeding and Translation (LIFT), Swansea University, Swansea, United Kingdom
| |
Collapse
|
12
|
Tan DW. Early-Career Autism Researchers Are Shifting Their Research Directions: Tragedy or Opportunity? AUTISM IN ADULTHOOD 2023; 5:218-224. [PMID: 37663448 PMCID: PMC10468548 DOI: 10.1089/aut.2023.0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Early-career researchers (ECRs) are among the most creative, talented, and energetic researchers, and they play an important role in knowledge production and pushing scientific boundaries. Recent debates have implied that many early-career autism researchers are compelled to shift their areas of focus within autism research as a consequence of their work being scrutinized by the autistic and autism communities. In this Perspective, I draw on my own experience as an early-career autism researcher having recently pivoted my research focus to become more aligned with community priorities. I reflect on whether these putative shifts in research direction are, indeed, a tragedy, as has previously been suggested, or, in fact, an opportunity for autism researchers. I argue that pivoting in research is a demonstration of science adapting to the ever-evolving needs in society and changes in our understanding of neurodiversity, neurodivergence, and research methods. While disagreements between the autistic, autism, and research communities may well feel uncomfortable, these tensions also present an opportunity for us-as non-autistic autism researchers-to reflect and to act toward building trust with the community. I recommend three areas for reflections: the purpose of our research, our position of power, and the epistemic limits of our academic expertise. I end by encouraging ECRs to consider taking actions, however small, to lead the charge in improving practices in autism research.
Collapse
Affiliation(s)
- Diana Weiting Tan
- Macquarie School of Education, Macquarie University, Sydney, Australia
- School of Psychological Science, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| |
Collapse
|
13
|
Pellicano E, Heyworth M. The Foundations of Autistic Flourishing. Curr Psychiatry Rep 2023; 25:419-427. [PMID: 37552401 PMCID: PMC10506917 DOI: 10.1007/s11920-023-01441-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE OF REVIEW All people-including Autistic people-deserve to live flourishing lives. But what does a flourishing life look like for Autistic people? We suggest that the hidden biases, methodological errors, and key assumptions of autism science have obscured answers to this question. Here, we seek to initiate a broader discussion about what the foundations for a good Autistic life might be and how this discussion might be framed. RECENT FINDINGS We identify five ways in which autism science can help us all to secure those foundations, including by (1) giving Autistic well-being prominence in research, (2) amplifying Autistic autonomy, (3) attending better to everyday experiences, (4) acknowledging context, and (5) working in partnership with Autistic people and their families and allies to ensure that they are at the heart of research decision-making. Such an approach would direct the focus of autism research to help shape good Autistic lives.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, 26 Bedford Way, London, WC1H 0DS, UK.
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, Australia.
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, Australia
- Reframing Autism, Warners Bay, NSW, Australia
| |
Collapse
|
14
|
Gillibrand S, Hine P, Conyers R, Gravestock J, Walsh C, McAvoy A, Sanders C. "Take a walk in someone else's shoes": the role of participatory arts for health research development and training. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:40. [PMID: 37291659 DOI: 10.1186/s40900-023-00441-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/26/2023] [Indexed: 06/10/2023]
Abstract
Participatory arts are increasingly recognised as a valuable and accessible mechanism for giving a voice to the experiences of individuals' health and healthcare. In recent years, there has been a move towards embedding participatory arts-based models into public engagement processes. Here, we contribute to the existing literature on the use of participatory arts-based approaches and their role in health research and healthcare practise, focusing on two interlinked approaches, the creation of personas and storytelling. We draw on two recent projects which have utilised these approaches to inform subsequent healthcare research and as a professional training tool to improve patient experience in a healthcare setting. We add to emerging literature to outline the benefits of these approaches in supporting research and training in healthcare settings, with a focus towards the co-produced foundations of these approaches. We demonstrate how such approaches can be utilised to capture different forms of voices, experiences and perspectives to help inform healthcare research and training, rooted in the lived experience of individuals who are directly involved in the creative process of developing personas via storytelling. These approaches challenge the listener to "walk in someone else's shoes", using their own homes and lives as a theatrical set in which to envisage someone else's story, involving the listener in the creative process through (re)imagining the stories and experiences of the characters. Greater use of immersive, co-produced participatory art-based approaches should be used in PPIE to inform research and training in healthcare settings as a means of centring those with lived experience through co-production. Involving those with lived experience, particularly from groups who are traditionally excluded from research, via a process which is based on co-creation and co-production, reorientates the researcher-participant dynamic to fully centre those involved in the research at the heart of the tools used to guide health and healthcare research. In this way, it may also aid in trust and relationship building between institutions and communities in a way which is focused around positive, creative methods to aid health research and healthcare processes. Such approaches may help to break down barriers between academic institutions, healthcare sites and communities.
Collapse
Affiliation(s)
| | | | - Rob Conyers
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Jason Gravestock
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Cole Walsh
- Independent (Public Contributor), Greater Manchester, UK
| | - Aneela McAvoy
- Applied Research Collaboration for Greater Manchester, Manchester, UK
| | - Caroline Sanders
- University of Manchester, Manchester, UK
- Applied Research Collaboration for Greater Manchester, Manchester, UK
| |
Collapse
|
15
|
Cashin A, Kersten M, Howie V, Pracilio A, Morphet J, Griffin K, Trollor JN, Wilson NJ. The Experience of Facilitating Inclusive Research Advisory Groups With Parents and People With Intellectual Disability and/or Autism Spectrum Disorder. ANS Adv Nurs Sci 2023:00012272-990000000-00068. [PMID: 37185206 DOI: 10.1097/ans.0000000000000497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
There is little nursing research about process issues in conducting inclusive project advisory groups of people with autism and/or intellectual disability or those who are parents/carers of this cohort. Through a descriptive qualitative design, this article aims to analyze the processes, challenges, and solutions when facilitating these groups for a nursing project in Australia. Reflexive thematic analysis was utilized to analyze field notes and meeting minutes. Results highlight the need for a defined, robust communication process between researchers and advisory groups, skilled facilitators, and careful planning of when in the life of the project the groups can contribute meaningfully. This project offers a proposed framework for the valuable contribution of lived experiences from research advisory groups.
Collapse
Affiliation(s)
- Andrew Cashin
- Faculty of Health and Human Sciences and Health Clinic, Southern Cross University, Lismore, New South Wales, Australia (Drs Cashin and Howie and Ms Pracilio); School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, New South Wales, Australia (Dr Kersten); Nursing & Midwifery, Monash University, Peninsula Campus, Frankston, Victoria, Australia (Dr Morphet); College of Emergency Nursing Australasia (CENA), Hobart, Tasmania, Australia (Dr Morphet); Australian Primary Health Care Nurses Association, Melbourne, Victoria, Australia (Mr Griffin); Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, UNSW Sydney, New South Wales, Australia (Dr Trollor); and School of Nursing and Midwifery, Western Sydney University, Hawkesbury Campus, Richmond, New South Wales, Australia (Dr Wilson)
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Keating CT, Hickman L, Leung J, Monk R, Montgomery A, Heath H, Sowden S. Autism-related language preferences of English-speaking individuals across the globe: A mixed methods investigation. Autism Res 2023; 16:406-428. [PMID: 36474364 PMCID: PMC10946540 DOI: 10.1002/aur.2864] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
Over the past two decades, there have been increasing discussions around which terms should be used to talk about autism. Whilst these discussions have largely revolved around the suitability of identity-first language and person-first language, more recently this debate has broadened to encompass other autism-related terminology (e.g., 'high-functioning'). To date, academic studies have not investigated the language preferences of autistic individuals outside of the United Kingdom or Australia, nor have they compared levels of endorsement across countries. Hence, the current study adopted a mixed-methods approach, employing both quantitative and qualitative techniques, to explore the linguistic preferences of 654 English-speaking autistic adults across the globe. Despite variation in levels of endorsement between countries, we found that the most popular terms were similar-the terms 'Autism', 'Autistic person', 'Is autistic', 'Neurological/Brain Difference', 'Differences', 'Challenges', 'Difficulties', 'Neurotypical people', and 'Neurotypicals' were consistently favored across countries. Despite relative consensus across groups, both our quantitative and qualitative data demonstrate that there is no universally accepted way to talk about autism. Our thematic analysis revealed the reasons underlying participants' preferences, generating six core themes, and illuminated an important guiding principle-to respect personal preferences. These findings have significant implications for informing practice, research and language policy worldwide.
Collapse
Affiliation(s)
| | - Lydia Hickman
- School of PsychologyUniversity of BirminghamBirminghamUK
| | - Joan Leung
- School of PsychologyUniversity of AucklandAucklandNew Zealand
| | - Ruth Monk
- Autistic member of the Autism New Zealand Community Advisory Group, New Zealand/School of Medical SciencesUniversity of AucklandAucklandNew Zealand
| | - Alicia Montgomery
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | - Hannah Heath
- School of PsychologyUniversity of BirminghamBirminghamUK
| | - Sophie Sowden
- School of PsychologyUniversity of BirminghamBirminghamUK
| |
Collapse
|
17
|
Taffere GR, Abebe HT, Zerihun Z, Mallen C, Price HP, Mulugeta A. Systematic review of community engagement approach in research: describing partnership approaches, challenges and benefits. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-022-01799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
|
18
|
Heselton GA, Rempel GR, Nicholas DB. “Realizing the problem wasn’t necessarily me”: the meaning of childhood adversity and resilience in the lives of autistic adults. Int J Qual Stud Health Well-being 2022; 17:2051237. [PMID: 35297725 PMCID: PMC8933012 DOI: 10.1080/17482631.2022.2051237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Purpose Methods Results Conclusion
Collapse
Affiliation(s)
- Gabrielle A. Heselton
- Faculty of Health Disciplines (FHD), Athabasca University, Athabasca, Alberta, Canada
| | - Gwen R. Rempel
- Faculty of Health Disciplines (FHD), Athabasca University, Athabasca, Alberta, Canada
| | - David B. Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
19
|
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: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [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.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Unsa Fatima
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Reframing Autism, Sydney, New South Wales Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Marc Stears
- UCL Policy Lab, University College London, London, UK
| |
Collapse
|
20
|
Coulter H, Donnelly M, Mallett J, Kernohan WG. Heart Rate Variability Biofeedback to Treat Anxiety in Young People With Autism Spectrum Disorder: Findings From a Home-Based Pilot Study. JMIR Form Res 2022; 6:e37994. [PMID: 36018712 PMCID: PMC9463620 DOI: 10.2196/37994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/04/2022] Open
Abstract
Background People with autism spectrum disorder (ASD) frequently experience high levels of anxiety. Despite this, many clinical settings do not provide specialist ASD mental health services, and demand for professional support frequently outstrips supply. Across many sectors of health, investigators have explored digital health solutions to mitigate demand and extend the reach of professional practice beyond traditional clinical settings. Objective This critical appraisal and pilot feasibility study examines heart rate variability (HRV) biofeedback as an approach to help young people with ASD to manage anxiety symptoms outside of formal settings. The aim is to explore the use of portable biofeedback devices to manage anxiety, while also highlighting the risks and benefits of this approach with this population. Methods We assessed the feasibility of using home-based HRV biofeedback for self-management of anxiety in young people with ASD. We adopted coproduction, involving people with ASD, to facilitate development of the study design. Next, a separate pilot with 20 participants with ASD (n=16, 80% male participants and n=4, 20% female participants, aged 13-24 years; IQ>70) assessed adoption and acceptability of HRV biofeedback devices for home use over a 12-week period. Data were collected from both carers and participants through questionnaires and interviews; participants also provided single-lead electrocardiogram recordings as well as daily reports through smartphone on adoption and use of their device. Results Pre-post participant questionnaires indicated a significant reduction in anxiety in children (t6=2.55; P=.04; Cohen d=0.99) as well as adults (t7=3.95; P=.006; Cohen d=0.54). Participant age was significantly negatively correlated with all HRV variables at baseline, namely high-frequency heart rate variability (HF-HRV: P=.02), the root mean square of successive differences in normal heartbeat contractions (RMSSD: P=.02) and the variability of normal-to-normal interbeat intervals (SDNN: P=.04). At follow-up, only SDNN was significantly negatively correlated with age (P=.05). Levels of ASD symptoms were positively correlated with heart rate both before (P=.04) and after the intervention (P=.01). The majority (311/474, 65.6%) of reports from participants indicated that the devices helped when used. Difficulties with the use of some devices and problems with home testing of HRV were noted. These initial findings are discussed within the context of the strengths and challenges of remotely delivering a biofeedback intervention for people with ASD. Conclusions HRV biofeedback devices have shown promise in this pilot study. There is now a need for larger evaluation of biofeedback to determine which delivery methods achieve the greatest effect for people with ASD. Trial Registration ClinicalTrials.gov NCT04955093; https://clinicaltrials.gov/ct2/show/NCT04955093
Collapse
Affiliation(s)
- Helen Coulter
- South Eastern Health and Social Care Trust, County Down, United Kingdom
| | | | | | | |
Collapse
|
21
|
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] [Key Words] [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.
Collapse
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
| | - 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
| |
Collapse
|
22
|
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.
Collapse
|
23
|
Rødgaard E, Jensen K, Miskowiak KW, Mottron L. Representativeness of autistic samples in studies recruiting through social media. Autism Res 2022; 15:1447-1456. [PMID: 35809003 PMCID: PMC9541916 DOI: 10.1002/aur.2777] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/20/2022] [Indexed: 12/30/2022]
Abstract
Survey-based research with recruitment through online channels is a convenient way to obtain large samples and has recently been increasingly used in autism research. However, sampling from online channels may be associated with a high risk of sampling bias causing findings not to be generalizable to the autism population. Here we examined autism studies that have sampled on social media for markers of sampling bias. Most samples showed one or more indicators of sampling bias, in the form of reversed sex ratio, higher employment rates, higher education level, lower fraction of individuals with intellectual disability, and later age of diagnosis than would be expected when comparing with for example population study results from published research. Findings from many of the included studies are therefore difficult to generalize to the broader autism population. Suggestions for how research strategies may be adapted to address some of the problems are discussed. LAY SUMMARY: Online surveys offer a convenient way to recruit large numbers of participants for autism research. However, the resulting samples may not fully reflect the autism population. Here we investigated the samples of 36 autism studies that recruited participants online and found that the demographic composition tended to deviate from what has been reported about the autism population in previous research. The results may thus not be generalizable to autism in general.
Collapse
Affiliation(s)
| | - Kristian Jensen
- Department of Psychiatry and AddictologyUniversité de MontréalMontrealQuebecCanada
| | - Kamilla Woznica Miskowiak
- Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
- Psychiatric Centre CopenhagenRigshospitaletCopenhagenDenmark
| | - Laurent Mottron
- Department of Psychiatry and AddictologyUniversité de MontréalMontrealQuebecCanada
- Centre de Recherche du CIUSSS‐NIMHôpital Rivière‐des‐PrairiesMontréalQuebecCanada
| |
Collapse
|
24
|
Barugahare J, Kass NE. Managing community engagement in research in Uganda: insights from practices in HIV/AIDS research. BMC Med Ethics 2022; 23:59. [PMID: 35701777 PMCID: PMC9199168 DOI: 10.1186/s12910-022-00797-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022] Open
Abstract
Background Community engagement (CE) in research is valuable for instrumental and intrinsic reasons. Despite existing guidance on how to ensure meaningful CE, much of what it takes to achieve this goal differs across settings. Considering the emerging trend towards mandating CE in many research studies, this study aimed at documenting how CE is conceptualized and implemented, and then providing context-specific guidance on how researchers and research regulators in Uganda could think about and manage CE in research. Methods We conducted qualitative interviews and focus group discussions involving forty-one respondents who were experienced in HIV/AIDS biomedical research involving CE. Thirty-eight of these were directly or indirectly associated with Uganda’s leading research institution in the field of HIV/AIDS. They included Principal Investigators, Community Liaisons Officers, Research Ethics Committee members and Community Advisory Board Members. Three respondents were from Uganda National Council for Science and Technology. Data were collected between August 2019 and August 2020, using audio-taped focus group discussions and key informant interviews, transcribed and analyzed manually to generate themes and subthemes. Results Three major themes emerged: goals or value of CE; the means of CE, and, the evaluation of CE. Goals or value of CE generated four subthemes representing the overarching goals of CE: (1) Promote communities’ agency; (2) Generate and sustain trust; (3) Protect and promote communities’ rights and interests; and, (4) Help studies optimize participation in the form of enrolment and retention of participants. What usually comes under the nomenclatures of methods, strategies, and approaches of CE, such as town-hall meetings, sports events, drama, and the like, should simply be understood as the means of CE, and it is not desirable to hold pre-conceived and fixed ideas about the best means to conduct CE in research since a lot depend on the context. Finally, the study found that despite CE’s critical importance, which suggests the need to track and evaluate it, CE is currently intermittently evaluated, and for inadequate motivations. Conclusions Existing guidance on how to conduct robust CE in research is no substitute for creativity, flexibility, and reflexivity on the part of both researchers and research regulators. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00797-6.
Collapse
Affiliation(s)
- John Barugahare
- Department of Philosophy, Makerere University, Kampala, P. O. Box 7062, Kampala, Uganda.
| | - Nancy E Kass
- Johns Hopkins Berman Institute of Bioethics and Johns Hopkins Bloomberg School of Public Health, 1809 Ashland Avenue, Baltimore, MD, 21205, USA
| |
Collapse
|
25
|
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.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, 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
| |
Collapse
|
26
|
Slade T, Duebel E, Ryan J. "Your double-blind RCT needs feminism": an argument for engaging critical theory in quantitative rehabilitation research. Disabil Rehabil 2022; 45:1563-1571. [PMID: 35507752 DOI: 10.1080/09638288.2022.2068679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Rehabilitation science has, for years, endorsed a connection between quantitative research and the philosophical assumptions of positivism. These assumptions can limit the scope of rehabilitation research, particularly in relation to matters of equity, diversity, and inclusivity. As our field moves toward a greater focus on inclusivity in research design and patient-centred care, it is imperative that we reconsider the theoretical foundations of rehabilitation research and practice. METHODS We provide an analysis of positivism on equity, diversity, and inclusivity within quantitative rehabilitation research, using the Participant Intervention Comparison Outcome (PICO) model to provide structure for the resultant discussion and recommendations. RESULTS Our analysis reveals that there are significant limitations and ethical concerns to engaging in positivism as the primary paradigm for quantitative rehabilitation research. We argue that decoupling of positivism and quantitative research methods may be warranted. CONCLUSIONS Equitable and inclusive rehabilitation research requires the researcher to consider variables which are neglected in the positivist paradigm. We argue that critical theory can equip researchers with a lens to better address injustices within rehabilitation research. We provide a series of recommendations for researchers to engage critical theory at each stage of the PICO model of clinical trials.IMPLICATIONS FOR REHABILITATIONCommon assumptions in quantitative rehabilitation research (i.e., positivism) can limit the utility of research findings to rehabilitation patients.Equitable, diverse, and inclusive participant samples in research better reflect the diversity of real world rehabilitation patients, helping us better serve these populations.Critical theory can help researchers and clinicians identify and avoid interventions that may cause harm to rehabilitation patients.Research and practice that prioritize concepts of "normalcy" (i.e., "normal gait," "normal behaviours") may perpetuate negative concepts of disability and further marginalize the individuals that our interventions aim to serve.
Collapse
Affiliation(s)
- Teri Slade
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Erin Duebel
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Jacalyn Ryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| |
Collapse
|
27
|
Pellicano E, den Houting J. Annual Research Review: Shifting from 'normal science' to neurodiversity in autism science. J Child Psychol Psychiatry 2022; 63:381-396. [PMID: 34730840 PMCID: PMC9298391 DOI: 10.1111/jcpp.13534] [Citation(s) in RCA: 132] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 12/17/2022]
Abstract
Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neurodiversity, where autism is seen as one form of variation within a diversity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm - an overfocus on deficits, an emphasis on the individual as opposed to their broader context and a narrowness of perspective - each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neurodiversity paradigm can potentially help researchers respond to the medical model's limitations. We conclude by considering the implications of a shift towards the neurodiversity paradigm for autism science.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of EducationMacquarie UniversitySydneyNSWAustralia
- Cooperative Research Centre for Living with Autism (Autism CRC)BrisbaneQldAustralia
| | - Jacquiline den Houting
- Macquarie School of EducationMacquarie UniversitySydneyNSWAustralia
- Cooperative Research Centre for Living with Autism (Autism CRC)BrisbaneQldAustralia
| |
Collapse
|
28
|
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.
Collapse
Affiliation(s)
| | | | - Jacquiline den Houting
- Macquarie University,
Australia
- Cooperative Research Centre for
Living with Autism, Australia
| | | |
Collapse
|
29
|
Ashworth M, Crane L, Steward R, Bovis M, Pellicano E. Toward Empathetic Autism Research: Developing an Autism-Specific Research Passport. AUTISM IN ADULTHOOD 2021; 3:280-288. [PMID: 36605365 PMCID: PMC8992899 DOI: 10.1089/aut.2020.0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Autistic adults sometimes report negative experiences of research participation. People have developed passports or toolkits in other areas where community members report dissatisfaction (e.g., health care, criminal justice). We created a Research Passport that autism researchers and autistic adults could use to support the inclusion of autistic adults as research participants. We designed and developed the Research Passport via an iterative design process. First, we gathered ideas for a Research Passport via focus groups with autistic adults without an intellectual disability (ID) (n = 9) and autism researchers (n = 6; one of whom was autistic). We found that the Research Passport (1) was a useful idea, but not a panacea for all issues in autism research, (2) needed to be universal and flexible, and (3) could have a broad remit (e.g., to record scores on commonly used standardized tasks that could, with permission, be shared with different researchers). Next, we conducted a preliminary evaluation of a prototype Research Passport via usability testing in three ongoing research projects. Nine autistic participants without an ID provided feedback on the Research Passport (via a survey), as did three nonautistic researchers (via interviews). We found that the Research Passport (1) promoted positive participant-researcher relationships, (2) provided a structure and framework to support existing practices, and (3) needed to be adapted slightly to facilitate usability and manage expectations. Overall, the Research Passport was useful in promoting empathetic autism research. Further design and development of the Research Passport are warranted. Lay summary Why was this research developed?: Autistic adults taking part in research do not always have good experiences. An autistic member on our team thought that a Research Passport could help improve people's experiences. This idea was inspired by "passports" or "toolkits" that autistic people can use when visiting professionals such as doctors (so the doctor knows about the person and how to support them).What does the Research Passport do?: The Research Passport lets autistic people tell researchers about themselves before taking part in a research study. Autistic people can decide how much, or how little, they tell the researcher. Autistic and/or nonautistic researchers can use the Research Passport to try and make sure that their autistic participants have good experiences when taking part in research.How did the researchers evaluate the Research Passport?: First, nine autistic adults (who did not have an intellectual disability) and six autism researchers took part in group discussions. We asked what they thought about our Research Passport idea and what it should include. We made a Research Passport mock-up based on these discussions. Nine autistic participants who did not have an intellectual disability used the mock-up in one of three university research projects. Autistic participants completed a survey to tell us good and not-so-good things about the Research Passport. Also, we interviewed three researchers about using the Research Passport (asking what they liked and what could have been better).What were the findings?: Autistic adults and researchers involved in designing the Research Passport thought the Research Passport (1) could be useful but could not solve all problems in autism research, (2) needed to be suitable for many different people, and (3) could have many different benefits (e.g., collecting participants' scores on tests that researchers use a lot, so participants do not have to keep doing the same tests each time they take part in a new research study).Autistic adults and researchers used the Research Passport in ongoing studies and told us that it (1) led to good relationships between participants and researchers, (2) helped researchers make sure that the way they did their research was acceptable, and (3) was useful. However, participants need to be told what the Research Passport can/cannot help them with.What were the weaknesses of this project?: This study involved a small group of autistic adults and researchers, and the results may not be the same with autistic adults and researchers who have different needs. Also, participants said the Research Passport was not very easy to complete, and a bit long. We need to change the Research Passport so that a wider range of autistic people (like those with intellectual disability) can use it.What are the next steps?: The Research Passport needs to be professionally designed so it is easier to be used by a wider range of autistic people. A bigger evaluation of the Research Passport could allow us to test it with more participants and in more research studies.How will this work help autistic adults now or in the future?: Using the Research Passport could, with some changes and alongside other supports, improve the experience of autistic adults taking part in research.
Collapse
Affiliation(s)
- Maria Ashworth
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, United Kingdom
| | - Laura Crane
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, United Kingdom
| | - Robyn Steward
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, London, United Kingdom
| | - Melissa Bovis
- Wellcome EPSRC Centre for Medical Engineering, Kings College London, London, United Kingdom
| | | |
Collapse
|
30
|
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.
Collapse
|
31
|
Lei J, Jones L, Brosnan M. Exploring an e-learning community's response to the language and terminology use in autism from two massive open online courses on autism education and technology use. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1349-1367. [PMID: 33567892 PMCID: PMC8264622 DOI: 10.1177/1362361320987963] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
LAY ABSTRACT Within the neurodiversity movement, one recent divergence is in the semantic choice of language when describing autism, as members of the autism and autistic community preferred to use identity-first language (autistic person), whereas professionals were more likely to use person-first language (person with autism). This study explored 803 e-learners' responses from their comments across two massive open online courses on autism education held between 2017 and 2019. Learners agreed that autistic individuals should guide others on which terminology to use when describing autism, and although identity-first language acknowledges autism as part of an individual's identity, it can also conjure up negative stereotypes and be stigmatising. Although family, friends and professionals highlighted that the diagnostic label is a way to facilitate understanding across stakeholder groups and help autistic individuals gain access to support, autistic self-advocates found the process of disclosing autism as a form of disability to conflict with their sense of identity, and broader terms such as 'autism spectrum' failed to capture individual strengths and weaknesses. Semantic language choices may matter less as long as the person's difficulties are clearly acknowledged, with adaptations made to meet their specific needs. Adding to a growing body of literature on terminology use in autism research and practice, we highlight that language used when describing autism should follow the autistic individual's lead, with the primary focus on communicating an individual's strengths and difficulties, to foster a sense of positive autism identity and inclusivity, and enable access to appropriate support.
Collapse
Affiliation(s)
- Jiedi Lei
- University of Bath, UK
- King’s College London, UK
| | | | | |
Collapse
|
32
|
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.
Collapse
|
33
|
Bastable K, Klopper S, Samuels A, Dada S. How Are Stakeholders With Autism Spectrum Disorder Included in the Social Validation of Augmentative and Alternative Communication Research? A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:817-832. [PMID: 33734889 DOI: 10.1044/2020_ajslp-20-00182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Introduction Social validation or the inclusion of stakeholders in the research process is beneficial, as it may decrease bias, increases efficacy, and prevents harm. For direct stakeholders such as individuals with autism spectrum disorder (ASD), social validation has mostly included participants who do not experience significant speech, language, and communication limitations while frequently omitting individuals with ASD who have complex communication needs (CCN). The presence of CCN indicates that augmentative and alternative communication (AAC) strategies are needed for individuals to express themselves. Social validation should not be limited to being participants in an intervention but should include involvement in the research process. This requires an understanding of the current trends, levels, and mechanisms of involvement in AAC research. Purpose This review aimed to identify and describe the inclusion of direct stakeholders with ASD in the social validation of AAC research. Method A scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews) methodology to identify AAC research that included stakeholders with ASD (direct and indirect) for social validation and to evaluate their level of involvement using the Typology of Youth Participation and Empowerment pyramid framework. Results Twenty-four studies were identified. Studies primarily included indirect stakeholders (e.g., caregivers) giving in-depth perspectives, while direct stakeholders were limited to being intervention participants. Conclusions Voices of direct stakeholders with ASD and CCN remain limited or excluded in research. Reasons for the exclusion of individuals with ASD and CCN from research and strategies for future inclusion are raised and discussed.
Collapse
Affiliation(s)
- Kirsty Bastable
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Sandra Klopper
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Alecia Samuels
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Shakila Dada
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| |
Collapse
|
34
|
Wagner L, Frisch M, Turner-Brown L, Andrews S, Edwards A, Moultrie R, Alvarez Rivas A, Wheeler A, Raspa M. Preferences for the research use of electronic health records among young adults with fragile X syndrome or autism spectrum disorder. Disabil Health J 2020; 13:100927. [PMID: 32360031 PMCID: PMC7541430 DOI: 10.1016/j.dhjo.2020.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Health researchers are increasingly using electronic health records (EHRs) to study the health care needs of people with neurodevelopmental disorders (NDDs). However, little is known about the preferences of people with NDDs for sharing EHRs for research. OBJECTIVE To explore preferences for sharing EHRs for research among young adults ages 18-40 who make their own legal decisions and who have autism spectrum disorder (ASD), fragile X syndrome (FXS), or no NDDs. METHODS We conducted a qualitative study with seven focus groups: 2 ASD groups, 3 FXS groups, and 2 no-NDD groups. We asked participants about factors that could affect their willingness to share their EHRs for research: type of organization, type of information, study purpose, duration, contact frequency, return of results, benefits, and risks. We analyzed the qualitative data using directed content analysis. RESULTS Participants with NDDs valued personally relevant and directly beneficial EHR research. Participants with NDDs expressed willingness to share sensitive data if the study was personally relevant. Most participants wanted to receive results, but only participants with FXS indicated it would affect their willingness to participate. Participants were concerned about privacy risks, discrimination, researcher misconduct, and financial conflicts of interest. CONCLUSION This study provides initial evidence suggesting that young adults with NDDs prefer EHR research that is personally relevant, benefits themselves and their communities, and is conducted in the context of trusting, reciprocal participant-researcher relationships. The findings point to the need for researchers to improve the informed consent process and to better engage individuals with NDDs in research.
Collapse
Affiliation(s)
- Laura Wagner
- RTI International, Research Triangle Park, NC, United States.
| | - MaryKate Frisch
- University of North Carolina TEACCH Autism Program, Chapel Hill, NC, United States.
| | - Lauren Turner-Brown
- University of North Carolina TEACCH Autism Program, Chapel Hill, NC, United States.
| | - Sara Andrews
- RTI International, Research Triangle Park, NC, United States.
| | - Anne Edwards
- RTI International, Research Triangle Park, NC, United States.
| | | | - Alexandra Alvarez Rivas
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC, United States.
| | - Anne Wheeler
- RTI International, Research Triangle Park, NC, United States.
| | - Melissa Raspa
- RTI International, Research Triangle Park, NC, United States.
| |
Collapse
|
35
|
Jose C, George-Zwicker P, Tardif L, Bouma A, Pugsley D, Pugsley L, Bélanger M, Gaudet J, Robichaud M. "We are the stakeholders with the most at stake": scientific and autism community co-researchers reflect on their collaborative experience in the CONNECT project. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:58. [PMID: 33005439 PMCID: PMC7520966 DOI: 10.1186/s40900-020-00233-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Little research describes the everyday challenges and needs of autistic adults. In order to fill this data gap, the CONtiNuity of carE and support for autistiC adulTs (CONNECT) project set out to learn about the health and well-being of autistic adults as well as their service and support needs. To do so, CONNECT welcomed autistic adults and caregivers of autistic adults as members of the research team, alongside researchers, policy-makers, service providers and health professionals. Autistic adults were involved in every stage of the research project and participated in team meetings held several times a year as well as in numerous email exchanges. METHODS Two feedback questionnaires were designed for this study: one for the scientific co-researchers and one for the autism community co-researchers (the project's "patient partners"). Although the surveys varied from one another, they probed respondents to provide critical and constructive comments on issues that were central to their engagement in CONNECT. Four scientific co-researchers and four autism community co-researchers filled out the questionnaires. A comparative analysis was carried out on the responses provided to the open- and closed-ended survey questions as well as on complimentary data collected from the team's documents. RESULTS CONNECT was seen as a positive experience for both groups. Highlights included: helping tailor and design research and its relevant materials to better suit the needs of the autistic community; establishing relationships and creating long-lasting friendships with other autistic adults; gaining a better understanding of the research process; and forging new connections with regional, national and international stakeholders. Areas for improvement include: establishing clear roles, responsibilities and expectations from the start; outlining a strategy to address unforeseen changes in project leadership; and creating a platform allowing for the involvement and participation of a more representative sample of adults on the autism spectrum. CONCLUSIONS While not without its challenges, CONNECT demonstrates that a collaborative multi-stakeholder approach engaging autistic adults can be an effective model for conducting research on adult autism. Autistic adults and their caregivers can make the research process more open and accessible and make its outputs more relevant, useful and meaningful to the wider autistic adult community.
Collapse
Affiliation(s)
- Caroline Jose
- Maritime SPOR SUPPORT Unit, Université de Moncton, Moncton, NB Canada
- Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, NB Canada
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, QC Canada
| | - Patricia George-Zwicker
- Autistics Aloud, Halifax, NS Canada
- Patient partner, CONNECT project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, NB Canada
| | - Louise Tardif
- Patient partner, CONNECT project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, NB Canada
| | - Aaron Bouma
- Patient partner, CONNECT project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, NB Canada
| | - Darlene Pugsley
- Patient partner, CONNECT project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, NB Canada
| | - Luke Pugsley
- Patient partner, CONNECT project, Maritime Strategy for Patient Oriented Research Support Unit, Université de Moncton, Moncton, NB Canada
| | - Mathieu Bélanger
- Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, NB Canada
- Department of Family Medicine, Université de Sherbrooke, Sherbrooke, QC Canada
- Vitalité Health Network, Centre hospitalier universitaire Dr Georges-L.-Dumont/Dr. Georges-L.-Dumont University Hospital Centre, Moncton, NB Canada
| | - Jeffrey Gaudet
- Maritime SPOR SUPPORT Unit, Université de Moncton, Moncton, NB Canada
- Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, NB Canada
| | - Marc Robichaud
- Maritime SPOR SUPPORT Unit, Université de Moncton, Moncton, NB Canada
- Research Laboratory on Chronic Disease Prevention, Centre de formation médicale du Nouveau-Brunswick, Moncton, NB Canada
| |
Collapse
|
36
|
Talebizadeh Z, Shah A. The AutGO Initiative: A Conceptual Framework for Developing Genetics-Outcomes Research Hypotheses. Autism Res 2020; 13:1286-1299. [PMID: 32618145 PMCID: PMC7496490 DOI: 10.1002/aur.2331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/23/2020] [Accepted: 04/27/2020] [Indexed: 11/20/2022]
Abstract
The increasing emphasis on translational approaches to complex neuropsychiatric and neurodevelopmental conditions research requires scientists from a broad range of disciplines to build dynamic collaborations when formulating hypotheses and framing study designs. The need to integrate the knowledge and perspectives not only from multiple scientific silos but also from the populations impacted by these conditions presents a significant challenge to researchers, particularly for a heterogeneous condition like autism. As one path toward addressing these challenges, we have previously introduced Autism Genetics Outcomes (AutGO), an initiative to support broad stakeholder partnerships and promote a new integrated concept called GO (i.e., research approaches that draw on both genetics and clinical outcomes perspectives). Herein, we developed a workflow for collecting stakeholders' feedback toward the development of a GO hypothesis. AutGO is an evolving initiative, and here we describe how its three essential components (conceptual framework, applicability, and implementation) have been developed. As a proof‐of‐concept, the AutGO team sought to demonstrate how a GO hypothesis could be developed using a semi‐structured literature review workflow. We also developed a prototype from published reports and formulated a GO hypothesis for autism. Rather than seeking community stakeholder input after a research project is conceptualized and designed, the developed conceptual framework demonstrates the feasibility of formulating scientific hypotheses by engaging stakeholders in retrospective semi‐structured literature reviews. The presented workflow, prototype, and discussed recommendations will bring awareness in the autism research community about the benefits of applying the GO approach in order to promote translational aspects in genetics research. Lay Summary We used a community‐based engagement approach to develop AutGO (Autism Genetics Outcomes), an initiative to establish stakeholder partnerships and to promote research approaches (we refer to as GO) that draw on both genetics and clinical outcomes perspectives. Specifically, we developed a conceptual framework that includes a literature review process for developing GO hypotheses and stakeholder feedback collection protocol. Our work will bring awareness in the autism research community about the benefits of integrating patient perspectives in genetics research. Autism Res 2020, 13: 1286–1299. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC.
Collapse
Affiliation(s)
- Zohreh Talebizadeh
- Children's Mercy Hospital, Kansas City, MO, USA.,University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Ayten Shah
- Children's Mercy Hospital, Kansas City, MO, USA
| | | |
Collapse
|
37
|
Perceived Stigma Among Serbian Parents of Children with Autism Spectrum Disorder and Children with Physical Disabilities: Validation of a New Instrument. J Autism Dev Disord 2020; 51:501-513. [PMID: 32519190 DOI: 10.1007/s10803-020-04559-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Limited research has been done to explore parental perception of stigma. The present study developed the Parental Perceptions of Public Attitudes Scale to examine perceived stigma among Serbian parents of children with autism spectrum disorder (ASD) and children with physical disabilities (PD). The convenience sample consisted of 82 participants. A confirmatory factor analysis was done to validate the scale and a 9-item solution clustered into two factors proved to be the best model. Overall, the parents reported a low-to-moderate level of perceived stigma. Parents of children with ASD reported higher degree of perceived stigma compared to the parents of children with PD. The scale was useful in measuring parental perceived stigma and could be used in other Eastern European countries.
Collapse
|
38
|
Pellicano E, Lawson W, Hall G, Mahony J, Lilley R, Davis C, Arnold S, Trollor J, Yudell M. Documenting the untold histories of late-diagnosed autistic adults: a qualitative study protocol using oral history methodology. BMJ Open 2020; 10:e037968. [PMID: 32474432 PMCID: PMC7264831 DOI: 10.1136/bmjopen-2020-037968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Receiving a diagnosis of autism in adulthood is increasingly common for a subset of individuals who were either misdiagnosed in childhood or missed out on a diagnosis altogether. This qualitative study, coproduced with autistic people, invites late-diagnosed autistic adults to share their life histories to (1) understand better the consequences of living without a diagnosis, (2) elucidate what precipitates an autism diagnosis in mid-to-late adulthood and (3) identify the perceived impact of receiving that diagnosis. METHODS AND ANALYSIS Oral histories have been a successful way to uncover overlooked and marginalised voices. We therefore adopt qualitative, oral history methodology in this study to understand these adults' experiences, especially of living in an era when autism was not well known. We will recruit 24 participants who will (1) have been born before 1975, (2) have received a clinical, autism diagnosis after the age of 35, (3) be English-speaking and (4) have spent most of their childhood and adulthood living in Australia. Participants will take part in four sessions, including the main, qualitative, oral history interview, through a range of possible formats to facilitate inclusion. The interview data will be analysed using reflexive thematic analysis. ETHICS AND DISSEMINATION The protocol has received institutional research ethics approval from Macquarie University's Human Research Ethics Committee (Ref.: 52019556310562). This study will yield understanding of the life experiences of autistic adults, especially middle-aged and older Australians, should inform more effective diagnostic practices and provide insight into the key factors that might promote resilience and enhance quality of life in autistic people. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations and to the autistic and autism communities through accessible reports. The interviews will also be prepared for digital archiving, which will enable ongoing access for future generations and communities.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Catherine Davis
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Samuel Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Yudell
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
39
|
Welch C, Cameron D, Fitch M, Polatajko H. Living in autistic bodies: bloggers discuss movement control and arousal regulation. Disabil Rehabil 2020; 43:3159-3167. [DOI: 10.1080/09638288.2020.1729872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Christie Welch
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deb Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Margaret Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Helene Polatajko
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| |
Collapse
|
40
|
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.
Collapse
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
| |
Collapse
|
41
|
Gowen E, Taylor R, Bleazard T, Greenstein A, Baimbridge P, Poole D. Guidelines for conducting research studies with the autism community. AUTISM POLICY & PRACTICE 2019; 2:29-45. [PMID: 32226635 PMCID: PMC7099931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There has been growing awareness of the concern expressed by autism communities that the majority of research conducted does not reflect the priorities or needs of autistic people and their families. Further, many autistic people report that they feel unable to influence research and desire greater involvement in the research process. Our research generated practical guidelines for researchers to consider when conducting autism research, in order to increase involvement, collaboration and trust between researchers and the autism community. These guidelines are based on the output of focus groups and interview discussions with twenty-two autistic adults and eight parents of autistic children, conducted during a series of workshops carried out as a collaboration between the research network Autism@Manchester and Salfordautism, an autism support group led and run by autistic professionals. The guidelines are organised into four sections: (1) pre-study considerations, (2) recruitment of participants, (3) study visit considerations and (4) post-study considerations. These sections are structured to reflect the research pathway, to allow researchers to understand more easily how to incorporate the recommendations into their research. The recommendations promote effective communication and equal partnerships between the autism and research communities, so that the needs of participants pre-research, during and post- research are taken into account, and so that participants are supported to become involved in research at the level they choose. It is hoped that by implementing transparent and participatory approaches to their work, researchers might be able to reduce some of the dissatisfaction that members of the autism community feel towards research, leading to higher standards in autism research.
Collapse
Affiliation(s)
- Emma Gowen
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
| | | | | | | | - Peter Baimbridge
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
- Salfordautism
| | - Daniel Poole
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
| |
Collapse
|
42
|
Sangill C, Buus N, Hybholt L, Berring LL. Service user's actual involvement in mental health research practices: A scoping review. Int J Ment Health Nurs 2019; 28:798-815. [PMID: 30938019 DOI: 10.1111/inm.12594] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 02/01/2023]
Abstract
Service user involvement in mental health research is on the international political agenda, for example mirrored by an emphasis on user involvement in funding of research. The idea is that service users contribute with their lived experiences of mental distress to the research process and thereby heighten the quality and relevance of the research. The purpose of this scoping review was to identify and evaluate empirical research of how mental health service users actually partake in collaborative research processes and to summarize this research in dialogue with mental health user-researchers. The review included 32 studies. Main findings indicated that actual involvement of service user-researchers in research processes encompassed a complex set of precarious negotiation practices, where academics and service user-researchers were positioned and positioned themselves in alternative ways. The review accounts for how mental health service users were involved in collaborative research processes. The extracted themes concerned: (i) Expectations of research processes, (ii) Contribution to research processes, and (iii) Training and learning from research processes. The study reveals that collaborative research in mental health requires changes to traditional research practices to create and support genuine collaborative partnerships and thereby avoid tokenism and power inequalities.
Collapse
Affiliation(s)
- Carina Sangill
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark
| | - Niels Buus
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,St. Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.,St. Vincent's Private Hospital Sydney, Darlinghurst, New South Wales, Australia.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lisbeth Hybholt
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark
| | - Lene Lauge Berring
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
43
|
Abstract
Abstract
Do autistic people read autistic behavior in the same way as neurotypical observers? We consider evidence that suggests autistic-to-autistic interactions demonstrate enabling norms and question the possibilities for neurotypical researchers to learn from autistic social appraisal.
Collapse
|
44
|
Roestorf A, Bowler D, Deserno M, Howlin P, Klinger L, McConachie H, Parr J, Powell P, Van Heijst B, Geurts H. "Older Adults with ASD: The Consequences of Aging." Insights from a series of special interest group meetings held at the International Society for Autism Research 2016-2017. RESEARCH IN AUTISM SPECTRUM DISORDERS 2019; 63:3-12. [PMID: 31275429 PMCID: PMC6559228 DOI: 10.1016/j.rasd.2018.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/18/2018] [Accepted: 08/25/2018] [Indexed: 05/21/2023]
Abstract
A special interest group (SIG) entitled "Older Adults with ASD: The Consequences of Aging" was held at the International Society for Autism Research (INSAR) annual meetings in 2016 and 2017. The SIG and subsequent meetings brought together, for the first time, international delegates who were members of the autistic community, researchers, practitioners and service providers. Based on aging autism research that is already underway in UK, Europe, Australia and North America, discussions focussed on conceptualising the parameters of aging when referring to autism, and the measures that are appropriate to use with older adults when considering diagnostic assessment, cognitive factors and quality of life in older age. Thus, the aim of this SIG was to progress the research agenda on current and future directions for autism research in the context of aging. A global issue on how to define 'aging' when referring to ASD was at the forefront of discussions. The 'aging' concept can in principle refer to all developmental transitions. However, in this paper we focus on the cognitive and physical changes that take place from mid-life onwards. Accordingly, it was agreed that aging and ASD research should focus on adults over the age of 50 years, given the high rates of co-occurring physical and mental health concerns and increased risk of premature death in some individuals. Moreover, very little is known about the cognitive change, care needs and outcomes of autistic adults beyond this age. Discussions on the topics of diagnostic and cognitive assessments, and of quality of life and well-being were explored through shared knowledge about which measures are currently being used and which background questions should be asked to obtain comprehensive and informative developmental and medical histories. Accordingly, a survey was completed by SIG delegates who were representatives of international research groups across four continents, and who are currently conducting studies with older autistic adults. Considerable overlap was identified across different research groups in measures of both autism and quality of life, which pointed to combining data and shared learnings as the logical next step. Regarding the background questions that were asked, the different research groups covered similar topics but the groups differed in the way these questions were formulated when working with autistic adults across a range of cognitive abilities. It became clear that continued input from individuals on the autism spectrum is important to ensure that questionnaires used in ongoing and future are accessible and understandable for people across the whole autistic spectrum, including those with limited verbal abilities.
Collapse
Affiliation(s)
- A. Roestorf
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - D.M. Bowler
- The Ageing with Autism Project, Autism Research Group, Department of Psychology, City, University of London, United Kingdom
| | - M.K. Deserno
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - P. Howlin
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Brain and Mind Centre, The University of Sydney, Australia
| | - L. Klinger
- University of North Carolina at Chapel Hill, TEACCH Autism Program, Department of Psychiatry, USA
| | - H. McConachie
- Institute of Health and Society, Newcastle University, United Kingdom
| | - J.R. Parr
- Institute of Neuroscience, Newcastle University, United Kingdom
| | - P. Powell
- Georgia Institute of Technology, School of Psychology, Atlanta, GA, USA
| | - B.F.C. Van Heijst
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| | - H.M. Geurts
- Dutch Autism Research Center (d’Arc), Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Doorwerth, The Netherlands
| |
Collapse
|
45
|
Abstract
Many people perceive autism spectrum disorder (ASD) as a childhood disorder, yet ASD is a lifelong condition. Although little is known about the mental and physical health issues of aging individuals with ASD, there are increasing numbers of older adults being diagnosed with ASD. Although there has been a recent "call to action" (to address lack of knowledge and the dearth of services and programs for aging individuals with autism, the authors think it is also important for those who are involved in educational programs related to gerontology and geriatrics settings to be aware of "autism aging." This term conceptualizes the demographics, person and contextual factors, and intellectual awareness of the trends and patterns of ASD as a life course challenge and opportunity for well-being and quality of life. The purposes of this article are to (1) provide a general overview of autism issues and to examine several dimensions of ASD in the context of the emergent and relevant scholarship in the adult and aging domain, (2) propose how to address the "gap" in the literature on autism and aging in terms of a conceptual model and by improving the methodology, and (3) to discuss the implications of these dimensions for educators in gerontology and geriatrics, and for those professionals who work in clinical and health care services. It is the goal of the authors to have this article represent a general introduction to ASD and to be a part of the foundation for educational awareness for educators in gerontology and geriatrics.
Collapse
Affiliation(s)
- Scott D Wright
- a Gerontology Interdisciplinary Program, University of Utah , Salt Lake City , Utah , USA
| | - Cheryl A Wright
- b Family and Consumer Studies Department , University of Utah , Salt Lake City , Utah , USA
| | | | | |
Collapse
|
46
|
Palmer M, San José Cáceres A, Tarver J, Howlin P, Slonims V, Pellicano E, Charman T. Feasibility study of the National Autistic Society EarlyBird parent support programme. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:147-159. [DOI: 10.1177/1362361319851422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The EarlyBird programme is a group-based psychoeducation intervention for parents of young children with autism. Although it is widely used in the United Kingdom, the evidence base for the programme is very limited. Using a mixed method, non-randomised research design, we aimed to test (1) the acceptability of the research procedures (recruitment, retention, suitability of measures), (2) the parental acceptability of EarlyBird (attendance, views of the programme, perceived changes) and (3) the facilitator acceptability of EarlyBird (fidelity, views of the programme, perceived changes). Seventeen families with a 2- to 5-year-old autistic child and 10 EarlyBird facilitators took part. Pre- and post-intervention assessment included measures of the child’s autism characteristics, cognitive ability, adaptive behaviour, emotional and behavioural problems and parent-reported autism knowledge, parenting competence, stress and wellbeing. Semi-structured interviews were completed at post-intervention with parents and facilitators. For those involved in the study, the research procedures were generally acceptable, retention rates were high and the research protocol was administered as planned. Generally, positive views of the intervention were expressed by parents and facilitators. Although the uncontrolled, within-participant design does not allow us to test for efficacy, change in several outcome measures from pre- to post-intervention was in the expected direction. Difficulties were encountered with recruitment (opt-in to the groups was ~56% and opt-in to the research was 63%), and strategies to enhance recruitment need to be built into any future trial. These findings should be used to inform protocols for pragmatic, controlled trials of EarlyBird and other group-based interventions for parents with young autistic children.
Collapse
|
47
|
Hollin G, Pearce W. Autism Scientists' Reflections on the Opportunities and Challenges of Public Engagement: A Qualitative Analysis. J Autism Dev Disord 2019; 49:809-818. [PMID: 30357647 PMCID: PMC6394559 DOI: 10.1007/s10803-018-3783-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article draws upon qualitative interviews in order to examine how UK based research psychologists understand public engagement activities and interactions with autistic advocates. Researchers describe public engagement as difficult and understand these difficulties as stemming from autistic impairments. In particular, it is reported that a heterogeneity of autism impairments means there is little agreement on the form research should take, while socio-communicative impairments make interactions difficult. Conversely, researchers describe autistic individuals as having the capacity to positively influence research. In this paper we discuss the nature of these claims and stress the need for autism-specific modes of engagement to be developed.
Collapse
Affiliation(s)
- Gregory Hollin
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT UK
| | - Warren Pearce
- Present Address: iHuman, Department of Sociological Studies, University of Sheffield, Sheffield, S10 2TU UK
| |
Collapse
|
48
|
Hoy K, Parsons S, Kovshoff H. Inclusive school practices supporting the primary to secondary transition for autistic children: pupil, teacher, and parental perspectives. ADVANCES IN AUTISM 2018. [DOI: 10.1108/aia-05-2018-0016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The primary to secondary school transition can have a significant and long-lasting impact on young people. Autistic children are particularly vulnerable to negative transition experiences; however, there is a lack of research examining effective practices and provision for these pupils. This case study involves a mainstream secondary school in the South of England, which has a dedicated Learning Support base. The purpose of this paper is to collect qualitative data on experiences of the primary to secondary school transition from multiple stakeholders.
Design/methodology/approach
A photovoice activity followed by a semi-structured interview was conducted with five autistic pupils aged 12–16 years; semi-structured interviews were also carried out with six parents and four teachers.
Findings
Five key themes emerged from the data in relation to effective practices: inclusion, child-centred approach, familiarisation, visual supports and communication and consistency.
Research limitations/implications
As a small-scale case study, there are limitations regarding generalisation. However, this research illuminates transition practices that are experienced as effective by autistic children, their families and teachers.
Practical implications
Practical implications related to each of these themes are highlighted. These implications are important in the context of the mandatory responsibilities of schools in England to include the voices of children and young people with special educational needs in decisions about their education.
Originality/value
The findings challenge a rights-based approach to inclusion and illustrate the importance of a needs-based approach which appropriately recognises and understands what autism means for children, their families and the teachers who support them.
Collapse
|
49
|
Fletcher-Watson S, Adams J, Brook K, Charman T, Crane L, Cusack J, Leekam S, Milton D, Parr JR, Pellicano E. Making the future together: Shaping autism research through meaningful participation. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:943-953. [PMID: 30095277 PMCID: PMC6512245 DOI: 10.1177/1362361318786721] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Participatory research methods connect researchers with relevant communities to
achieve shared goals. These methods can deliver results that are relevant to
people’s lives and thus likely to have a positive impact. In the context of a
large and growing body of autism research, with continued poor implementation,
and some evidence of community dissatisfaction, there is a powerful case for
participatory autism research. In order to develop a framework for such
collaborative working, a UK seminar series was organised and co-produced by
autistic and non-autistic people with academic, practitioner and lived
expertise. This article reports on the outcomes from the series, identifying
five topics relevant to building a community of practice in participatory
research: Respect, Authenticity, Assumptions, Infrastructure and Empathy. Each
topic is connected to a specific example from within and beyond research, to
inspire new practices in the field. We call for the development of participatory
research skills among the autism research community and the facilitation of
greater autistic leadership of, and partnership in, research. Such work, if
delivered to a high standard, is likely to lead to better translation into
practice and improved outcomes for autistic people and those who support
them.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Damian Milton
- 8 Participatory Autism Research Collective, UK.,9 University of Kent, UK
| | | | | |
Collapse
|
50
|
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]
|