101
|
Beechey T. On Perspective Taking in Conversation and in Research: A Comment on Bambara et al. (2021). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1597-1599. [PMID: 35263553 DOI: 10.1044/2021_jslhr-21-00606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this letter is to draw attention to recent literature regarding the communication abilities and experiences of Autistic people and the potential for detrimental effects on mental health and service provision resulting from behavior modification programs. I will argue that viewing Autistic communication as characterized by pragmatic language impairment is inconsistent with evidence of effective and positive communication between Autistic people and with the social model of disability. CONCLUSION Proposals for interventions targeting Autistic people should carefully weigh the costs and benefits for Autistic people and should integrate the perspectives of Autistic people.
Collapse
Affiliation(s)
- Timothy Beechey
- Hearing Sciences - Scottish Section, School of Medicine, University of Nottingham, Glasgow, United Kingdom
| |
Collapse
|
102
|
Heyworth M, Chan T, Lawson W. Perspective: Presuming Autistic Communication Competence and Reframing Facilitated Communication. Front Psychol 2022; 13:864991. [PMID: 35360599 PMCID: PMC8960292 DOI: 10.3389/fpsyg.2022.864991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022] Open
Abstract
Debate surrounding the validity of the method of supported typing known as facilitated communication (FC) has been continuous since its inception in the 1990s. Views are polarized on whether FC can be considered an authenticated method for use by people with complex communication needs (CCN) or significant challenges in speech, language, and communication. This perspective article presents an analysis of the research arguing for—and against—the use of FC, combined with the lived experience knowledge of autistic adults who utilize FC, to rehabilitate its current standing as discredited and unevidenced. By considering extant qualitative and quantitative studies, as well as personal accounts of the use of this particular Augmentative and Alternative Communication (AAC) method, the authors argue that the current dismissal of FC is rooted in ableist and outdated approaches. FC research should be reconsidered and reconducted using current best practice autism research approaches, including coproduction and a presumption of autistic communication competence, to assess its validity as a potential AAC method for autistic individuals.
Collapse
Affiliation(s)
- Melanie Heyworth
- Reframing Autism, Sydney, NSW, Australia.,Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Timothy Chan
- Reframing Autism, Sydney, NSW, Australia.,School of Arts and Education, Australian Catholic University, Melbourne, VIC, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia.,Department of Education, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
103
|
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: 115] [Impact Index Per Article: 57.5] [Reference Citation Analysis] [Abstract] [Key Words] [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
|
104
|
Brown HM, Dwyer PSR, Gassner DL, Kapp SK, Ne′eman A, Ryan JG, Waisman TC, Williams ZJ. The Autism Intervention Research Network on Physical Health Autistic Researcher Review Board. Pediatrics 2022; 149:e2020049437F. [PMID: 35363294 PMCID: PMC9069212 DOI: 10.1542/peds.2020-049437f] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 01/29/2023] Open
Affiliation(s)
- Heather M. Brown
- Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
| | - Patrick S. R. Dwyer
- Center for Mind and Brain, University of California Davis, Davis, California
- Department of Psychology, University of California Davis, Davis, California
| | - Dena L. Gassner
- School of Social Work, Adelphi University, Garden City, New York
- Department of Health Sciences, Towson University, Towson, Maryland
| | - Steven K. Kapp
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
| | - Ari Ne′eman
- Harvard University, Cambridge, Massachusetts
| | - Jacalyn G. Ryan
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - TC Waisman
- University of Calgary, Calgary, Alberta, Canada
| | - Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, Tennessee
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, Tennessee
| |
Collapse
|
105
|
Rosenau KA, Hotez E. Promoting Interdisciplinary and Participatory Autism Research. Pediatrics 2022; 149:185638. [PMID: 35363283 DOI: 10.1542/peds.2020-049437p] [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] [Accepted: 11/09/2021] [Indexed: 11/24/2022] Open
|
106
|
Newbutt N, Bradley R. Using immersive virtual reality with autistic pupils: moving towards greater inclusion and co-participation through ethical practices. JOURNAL OF ENABLING TECHNOLOGIES 2022. [DOI: 10.1108/jet-01-2022-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe potential of head mounted displays based virtual reality (HMD-based VR) for autistic groups has been well documented. However, the deployment and application of this technology, especially in schools, has been extremely limited. One of the main criticisms in this field has been the lack of involvement from practitioners in research on educational approaches for autistic populations and the gap between research and practice in real-life settings.Design/methodology/approachThis conceptual article focuses on our research in a UK-based special needs school that sought to examine the effects and potential use of VR-HMDs, while seeking to establish best practices for safe and ethical application using this technology. This draws upon ethical and participatory research guidance, including British Educational Research Association and Autism Participatory Research.FindingsThe authors make recommendations on planning and implementing a participatory, safe and ethical approach to researching the use of VR-HMDs in special needs schools and engaging with the priorities of autistic children and young people and their teachers.Originality/valueThis conceptual article provides an initial first consideration of ways we can better include autistic people and their views in research that is with and about them. The value in this will mean we are able to better support autistic groups moving ahead using VR HMD-based technologies. Without this paradigm shift and including autistic people (and their stakeholders) the field might continue to build initiatives around medical-based models of disabilities rather that what the community need/want.
Collapse
|
107
|
Radulski EM. Conceptualising Autistic Masking, Camouflaging, and Neurotypical Privilege: Towards a Minority Group Model of Neurodiversity. Hum Dev 2022. [DOI: 10.1159/000524122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Autistic masking and camouflaging—concealing Autistic traits to ‘pass’ as non-Autistic—is linked to negative developmental consequences including stress, mental illness, identity loss, and suicidality. Recent psychological literature on masking and camouflaging seeks to urgently address these issues—yet overlooks relevant sociological research. This study uses Sara Ahmed and Frantz Fanon’s work on masking, alongside Judith Butler’s concept of performativity, to formulate distinct sociological definitions for Autistic masking and camouflaging. I offer a qualitative Critical Discourse Analysis of 2018’s #TakeTheMaskOff Neurodiversity Activism campaign, alongside psychology masking/camouflaging literature, to question the social drivers of masking and camouflaging. Autism is widely understood as an ‘Invisible’ Disability. However, I found that the necessity of masking and camouflaging to avoid discrimination renders Autistic people a ‘Visible Neurominority Group’. Proposing a new Minority Group Model of Neurodiversity, I argue that Neurotypical hegemony, invisibility, and majority group privilege are key social drivers of masking and camouflaging.
Collapse
|
108
|
Bauer V, Bouchara T, Bourdot P. Extended Reality Guidelines for Supporting Autism Interventions Based on Stakeholders' Needs. J Autism Dev Disord 2022; 53:2078-2111. [PMID: 35244836 DOI: 10.1007/s10803-022-05447-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 11/24/2022]
Abstract
While Extended Reality (XR) autism research, ranging from Augmented to Virtual Reality, focuses on socio-emotional abilities and autistic children requiring low support, common interventions address the entire spectrum and focus on other abilities, including perceptual abilities. Based on these observations, this paper first addresses common practitioners' interventions, and then suggests XR use cases and guidelines to better support them. To do so, 34 interviews were conducted with stakeholders, mainly including practitioners, and then analyzed. Emerging XR use cases were compared with the findings from two former systematic literature reviews, and emerging design guidelines were compared with the findings from a literature survey that we conducted. Findings suggest that collaborative XR sensory-based and mediation approaches could benefit the entire spectrum.
Collapse
Affiliation(s)
- Valentin Bauer
- Université Paris-Saclay, CNRS, LISN, VENISE Team, Orsay, France.
| | - Tifanie Bouchara
- Université Paris-Saclay, CNRS, LISN, VENISE Team, Orsay, France.,HeSam Universite, CNAM, CEDRIC (EA4626), ILJ Team, Paris, France
| | - Patrick Bourdot
- Université Paris-Saclay, CNRS, LISN, VENISE Team, Orsay, France
| |
Collapse
|
109
|
Turnock A, Langley K, Jones CR. Understanding Stigma in Autism: A Narrative Review and Theoretical Model. AUTISM IN ADULTHOOD 2022; 4:76-91. [PMID: 36605561 PMCID: PMC8992913 DOI: 10.1089/aut.2021.0005] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The experience of stigma by autistic people is relatively understudied, despite contributing to a range of poor outcomes and having an overarching impact on well-being. The current review of the literature synthesizes research to determine what is currently known and presents a theoretical model of autism stigma. Autism stigma is primarily influenced by a public and professional understanding of autism in combination with interpretation of visible autistic traits. Moderating factors include the quality and quantity of contact with autistic people, cultural factors, sex and gender, individual differences, and diagnostic disclosure. Stigma can reduce well-being as well as increase the presence of camouflaging behaviors, which mask autistic traits. Caregivers of autistic people can experience stigma by association, that is, affiliate stigma, which can impact their own well-being. A variety of interventions and approaches to reduce stigma are discussed, including "autism friendly" spaces, positive media representation, educational and psychosocial training for the public and professionals, as well as cultural and systemic shifts that foster inclusivity and recognize neurodiversity.
Collapse
Affiliation(s)
- Alice Turnock
- School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom
| | - Kate Langley
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Catherine R.G. Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom.,Address correspondence to: Catherine R.G. Jones, PhD, School of Psychology, Cardiff University, Park Place, Cardiff CF10 3AT, United Kingdom
| |
Collapse
|
110
|
Quintana DS. Towards better hypothesis tests in oxytocin research: Evaluating the validity of auxiliary assumptions. Psychoneuroendocrinology 2022; 137:105642. [PMID: 34991063 DOI: 10.1016/j.psyneuen.2021.105642] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
Various factors have been attributed to the inconsistent reproducibility of human oxytocin research in the cognitive and behavioral sciences. These factors include small sample sizes, a lack of pre-registered studies, and the absence of overarching theoretical frameworks that can account for oxytocin's effects over a broad range of contexts. While there have been efforts to remedy these issues, there has been very little systematic scrutiny of the role of auxiliary assumptions, which are claims that are not central for testing a hypothesis but nonetheless critical for testing theories. For instance, the hypothesis that oxytocin increases the salience of social cues is predicated on the assumption that intranasally administered oxytocin increases oxytocin levels in the brain. Without robust auxiliary assumptions, it is unclear whether a hypothesis testing failure is due to an incorrect hypothesis or poorly supported auxiliary assumptions. Consequently, poorly supported auxiliary assumptions can be blamed for hypothesis failure, thereby safeguarding theories from falsification. In this article, I will evaluate the body of evidence for key auxiliary assumptions in human behavioral oxytocin research in terms of theory, experimental design, and statistical inference, and highlight assumptions that require stronger evidence. Strong auxiliary assumptions will leave hypotheses vulnerable for falsification, which will improve hypothesis testing and consequently advance our understanding of oxytocin's role in cognition and behavior.
Collapse
Affiliation(s)
- Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway; NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway.
| |
Collapse
|
111
|
Mandy W. Six ideas about how to address the autism mental health crisis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:289-292. [PMID: 35109701 DOI: 10.1177/13623613211067928] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
112
|
Poulsen R, Brownlow C, Lawson W, Pellicano E. Meaningful research for autistic people? Ask autistics! AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:3-5. [PMID: 35000419 DOI: 10.1177/13623613211064421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Rebecca Poulsen
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,University of Queensland, Australia.,Reframing Autism, Australia
| | - Charlotte Brownlow
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,University of Southern Queensland, Australia
| | - Wenn Lawson
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,Macquarie University, Australia
| | - Elizabeth Pellicano
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,Macquarie University, Australia
| |
Collapse
|
113
|
Silver K, Parsons S. Perspectives of autistic adults on the strategies that help or hinder successful conversations. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221101113. [PMID: 36382069 PMCID: PMC9620675 DOI: 10.1177/23969415221101113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background & aims There is increasing recognition of the importance of challenging deficit-focused, medical model approaches to supporting autistic people in daily life, however there is a lack of inclusion of autistic perspectives to inform approaches that may empower autistic people in conversations. Methods This multiple case study used a participatory approach to explore the conversation experiences and exchange in dyads of five autistic and five non-autistic adults over four to 12 months. The study was grounded in the perspectives of autistic people through a series of semi-structured interviews, observations, reflective conversations, and diary records. Results The findings focus on autistic participants' existing knowledge of conversations that they reported could be useful to them, including the communication environment, and type and structure of talk. The study also helped participants to identify and use previously unrecognised metacognitive abilities (what they already knew about conversations) within naturalistic interactive contexts. Conclusions These findings provide novel insights as to how the 'interactional expertise' of non-autistic people could be strengthened to enable the effective contribution of the voices of autistic people in everyday conversations. Implications The identification and use of successful conversation strategies identified by autistic adults gave them a greater sense of empowerment within the conversation based on their accounts of their experiences. Understanding these strategies has valuable implications for staff training, for working with families and for learning by autistic adults.
Collapse
Affiliation(s)
- Kate Silver
- The Autism Community Research Network @Southampton
[ACoRNS] and the Centre for Research in Inclusion, Southampton Education School, University of
Southampton, UK
| | - Sarah Parsons
- The Autism Community Research Network @Southampton
[ACoRNS] and the Centre for Research in Inclusion, Southampton Education School, University of
Southampton, UK
| |
Collapse
|
114
|
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: 24] [Impact Index Per Article: 12.0] [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
|
115
|
Pacione L. Telehealth-delivered caregiver training for autism: Recent innovations. Front Psychiatry 2022; 13:916532. [PMID: 36620655 PMCID: PMC9811175 DOI: 10.3389/fpsyt.2022.916532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
Providing treatment to children with autism is a global health priority, and research demonstrates that caregivers can be trained in techniques to promote their child's social interaction, communication, play, positive behavior and skills. These caregiver-mediated interventions have been shown to promote a number of positive outcomes in children with autism, as well as their caregivers. When provided by telehealth, data indicate that caregiver training is acceptable and feasible, and associated with similar positive outcomes as live face-to-face training. Telehealth innovations, which have accelerated during the COVID-19 era, have demonstrated advantages over in-person delivery of services in terms of cost effectiveness and increased accessibility, however, more research is needed on feasibility, acceptability and effectiveness for different populations in different contexts. This brief review will highlight recent caregiver skills training interventions for autism that have been successfully adapted or designed for telehealth delivery. Telehealth interventions that are scalable, adaptable, caregiver-mediated, open-access, and delivered as part of a stepped care model, have the potential to address the global treatment gap for families of children with autism and other neurodevelopmental disabilities. Considerations relevant to the global scale-up of caregiver-mediated interventions will also be discussed.
Collapse
Affiliation(s)
- Laura Pacione
- Division of Child and Youth Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| |
Collapse
|
116
|
Bowden N, Milne B, Audas R, Clasby B, Dacombe J, Forster W, Kokaua J, Gibb S, Hughes N, MacCormick C, Smiler K, Taylor B, Mirfin-Veitch B. Criminal justice system interactions among young adults with and without autism: A national birth cohort study in New Zealand. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1783-1794. [PMID: 34961358 PMCID: PMC9483704 DOI: 10.1177/13623613211065541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
While sensationalist headlines and highly publicised criminal cases have led many
to believe there is a link between autism and criminal behaviour, extant
literature presents an unresolved debate. We sought to address this issue by
examining the prevalence of criminal justice system interactions among young
adults with and without autism, and by assessing whether offence types differ
between these groups. This was a national birth cohort study using linked health
and criminal justice system data. Cox proportional hazard models were employed
to compare criminal justice system interactions between young adults with and
without autism, controlling for important socio-demographic characteristics.
Data were acquired for 1197 people with autism and 147,879 without autism. Young
adults with autism had significantly lower rates of being proceeded against by
police, charged in court, and convicted in court compared to those without
autism. However, those charged with an offence were significantly more likely to
be charged with serious and violent offences, offences against the person and
against property. Our findings indicate that, although young people with autism
were not over-represented in the criminal justice system, disparities in offence
types and incarceration rates among those charged with an offence suggest the
importance of identification and appropriate response to autism within the
criminal justice system.
Collapse
Affiliation(s)
- Nicholas Bowden
- A Better Start National Science Challenge; University of Auckland, New Zealand.,A Better Start National Science Challenge; University of Otago, New Zealand
| | - Barry Milne
- A Better Start National Science Challenge; University of Auckland, New Zealand
| | - Richard Audas
- A Better Start National Science Challenge; University of Auckland, New Zealand.,A Better Start National Science Challenge; University of Otago, New Zealand
| | | | - Joanne Dacombe
- A Better Start National Science Challenge; University of Otago, New Zealand.,Autism New Zealand, New Zealand
| | | | - Jesse Kokaua
- A Better Start National Science Challenge; University of Auckland, New Zealand.,A Better Start National Science Challenge; University of Otago, Wellington, New Zealand
| | - Sheree Gibb
- A Better Start National Science Challenge; University of Auckland, New Zealand.,A Better Start National Science Challenge; University of Otago, Wellington, New Zealand
| | - Nathan Hughes
- A Better Start National Science Challenge; University of Auckland, New Zealand
| | | | | | - Barry Taylor
- A Better Start National Science Challenge; University of Auckland, New Zealand.,A Better Start National Science Challenge; University of Otago, New Zealand
| | | |
Collapse
|
117
|
Kourti M. A Critical Realist Approach on Autism: Ontological and Epistemological Implications for Knowledge Production in Autism Research. Front Psychol 2021; 12:713423. [PMID: 35002826 PMCID: PMC8732992 DOI: 10.3389/fpsyg.2021.713423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 11/29/2021] [Indexed: 01/28/2023] Open
Abstract
The ontological status of autism has been a subject of considerable debate and philosophical approaches of it have been recent and sparse. On the one hand, from its conception, autism has been historically heavily located in the fields of psychiatry, psychology and neuroscience, which often assume access to an "objective," neutral and infallible reality that is external to the research process and is based on the autistic person's biology and behavioural characteristics, which can be scientifically observed and studied. On the other, proponents of the neurodiversity movement argue against medicalised and pathologising approaches to autism and toward approaches that consider social constructions of autism and relations of power. The Critical Realist philosophy can help reconcile the two positions. Critical Realism conceptualises objectivity as a statement about an object, rather than a neutral and infallible reality. Consequently, Critical Realism suggests that access to reality can only occur through fallible theories. It also suggests that effective theorising goes beyond appearances and phenomena and may even contradict them, which can help challenge dominant behaviourist approaches on autism. I then explore how the tenets of Critical Realism can help strengthen autistic-led theories of autism, the arguments they make, as well as how they support the importance of community autism knowledge. Finally, I present how Critical Realism's approach to knowledge itself as well as the process of knowledge creation can strengthen autistic theorising, autistic participation in autism research and autistic emancipation. In the last part of the article, I explore how the concepts of Critical Realism apply to autistic sociability. I start with the debate between structure and agency, how Critical Realism reconciles this debate and the implications for autistic emancipation and autism research. I then present Critical Realism's process of critique and explanation, how they connect to human emancipation and how they can lead to impactful change in autism research by requiring clear links from research to practice, enhancing practices with strong theoretical underpinnings and thus aiding the aims of emancipatory autism research.
Collapse
Affiliation(s)
- Marianthi Kourti
- Department of Social Work and Social Care, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
118
|
Botha M. Critical realism, community psychology, and the curious case of autism: A philosophy and practice of science with social justice in mind. JOURNAL OF COMMUNITY PSYCHOLOGY 2021. [PMID: 34897720 DOI: 10.1002/jcop.22764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/12/2021] [Accepted: 11/12/2021] [Indexed: 06/14/2023]
Abstract
Community psychology (CP) is a transformative subdiscipline of psychology which aims to address inequality and social injustice and to attend to wellbeing. It has been argued that CP lacks an underpinning philosophy of science. Philosophies of science provide road maps for values, methods, and objectives, thus ultimately framing all research. This study will highlight how traditional philosophies of science such as positivism, interpretivism, and social constructivism fail to support the complexity of CP and often essentialise complex phenomena, such as autism, to the detriment of stakeholders. Critical realism will then be introduced as a promising philosophy of science for CP, which can reinvigorate CPs push for impactful research and social change. The study will highlight how CP provides a platform for appreciating the complexity of autism and for transforming structures of inequality experienced by autistic people, together with autistic people.
Collapse
Affiliation(s)
- Monique Botha
- Division of Psychology, University of Stirling, Stirling, UK
- School of Psychology, University of Surrey, Guildford, UK
| |
Collapse
|
119
|
Abstract
Over the past four decades there have been significant advances in our understanding of autism, yet services for autistic adults continue to lag far behind those for children, and prospects for employment and independent living remain poor. Adult outcomes also vary widely and while cognitive and language abilities are important prognostic indicators, the influence of social, emotional, familial and many other factors remains uncertain. For this special issue marking the 40th anniversary of DSM-III, the present paper describes the changing perspectives of autism in adulthood that have occurred over this period, explores individual and wider environmental factors related to outcome, and suggests ways in which services need to be changed to improve the future for adults living with autism.
Collapse
Affiliation(s)
- Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
| |
Collapse
|
120
|
The Anxiety Caused by Secondary Schools for Autistic Adolescents: In Their Own Words. EDUCATION SCIENCES 2021. [DOI: 10.3390/educsci11110726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Secondary schools are increasingly becoming inclusive of all students whatever their individual needs, but we question whether teachers understand enough about specific needs in order to effectively support all their students. Research indicates that autistic students often struggle with aspects of school (conformity; social communication; sensory challenges; bullying) but very few studies ask autistic adolescents about their experiences. One of the key elements of the school experience for autistic adolescents is the levels of anxiety experienced by many students on a daily basis. This research set out to explore the extent to which autistic students in secondary schools in the UK were able to recognise and reflect on their own anxiety. The eighteen participants in this co-produced qualitative study took part in semi-structured interviews planned by a team of autistic and non-autistic researchers. The themes that emerged from this study, in terms of triggers for anxiety, included other people’s behaviour, fear of the unknown, and sensory sensitivities. A theoretical view of their difficulties concurs with the concept of intolerance of uncertainty. Our data suggest that autistic students continue to experience high levels of anxiety throughout their secondary education, despite supports put in place by some schools. Strategies are highlighted that could be implemented by all schools to promote truly inclusive settings.
Collapse
|
121
|
Garcia JM, Cathey B, Shurack R, Brazendale K, Leahy N, Lee E, Lawrence S. Evaluation of a Nutrition Education and Culinary Program for Adolescents With Autism Spectrum Disorder. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:987-990. [PMID: 34393066 DOI: 10.1016/j.jneb.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/25/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Jeanette M Garcia
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL.
| | - Braden Cathey
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| | - Riley Shurack
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| | - Keith Brazendale
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| | - Nicholas Leahy
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| | - Eunkyung Lee
- Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| | - Shawn Lawrence
- School of Social Work, College of Health Professions and Sciences, University of Central Florida, Orlando, FL
| |
Collapse
|
122
|
Lilley R, Lawson W, Hall G, Mahony J, Clapham H, Heyworth M, Arnold SR, Trollor JN, Yudell M, Pellicano E. 'A way to be me': Autobiographical reflections of autistic adults diagnosed in mid-to-late adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1395-1408. [PMID: 34674564 DOI: 10.1177/13623613211050694] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
LAY ABSTRACT Using oral history methods, we interviewed and recorded 26 autistic adults in Australia about their life history. We wanted to better understand interviewees' self-reflections about their lives. The interviewers were autistic researchers and the interviews were analysed by autistic and non-autistic researchers. All of the adults we interviewed were born before 1975 and formally identified as autistic after age 35 years. This group of people is sometimes referred to as 'late-diagnosed autistic adults'. In general, there is not much research done about autistic adults and even less is known about those diagnosed late in life. In this article, we explore what these adults said about their sense of self and how that changed over time. These autistic adults told us about many negative experiences, including trauma, which had shaped how they think about themselves. For most, autism diagnosis had a very positive impact on their sense of self, allowing them to understand more about their own past and to feel good about their autistic identity. Previously some researchers have said that autistic people have a limited or impaired sense of self. Instead, our results show some autistic people can actually reflect deeply on their lives and their changing sense of self-identity over time.
Collapse
Affiliation(s)
- Rozanna Lilley
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Wenn Lawson
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Gabrielle Hall
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Joanne Mahony
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | | | - Samuel Rc Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,UNSW Sydney, Australia
| | - Julian N Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia.,UNSW Sydney, Australia
| | | | - Elizabeth Pellicano
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| |
Collapse
|
123
|
Lois Mosquera M, Mandy W, Pavlopoulou G, Dimitriou D. Autistic adults' personal experiences of navigating a social world prior to and during Covid-19 lockdown in Spain. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104057. [PMID: 34371305 PMCID: PMC8413264 DOI: 10.1016/j.ridd.2021.104057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/15/2021] [Accepted: 08/01/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The SARS-CoV-2 coronavirus pandemic brought significant movement restrictions and national lockdowns. These drastic changes impacted routines, social life and support networks for the autistic community. AIMS This study investigated the lived experiences of autistic adults with social expectations before and during the first Covid-19 lockdown in Spain. METHODS A qualitative Reflexive Thematic Analysis was applied to 10 Photo Elicitation Interviews using images provided by five autistic adults. Interviews were conducted at two time points, before the pandemic and during the first lockdown. FINDINGS Three themes before the pandemic were identified: (1) everyday interactions, (2) finding sense of belonging, and (3) fractured wellbeing, which revealed the participants' eagerness to fit in socially whilst experiencing rejection, weakening their mental health. During the first Covid-19 lockdown, two master themes were identified: (1) daily, positive experiences, and (2) surfacing failures, which emphasised an increased lived stigma as well as an ineffective autism support network, contributing to a heightened anxiety. CONCLUSIONS The current study provides further support to the recent findings highlighting lack of appropriate mental health support for the autistic communities during the pandemic, across the world. Future research should aim to provide more data on the experiences and needs of autistic communities when sudden societal changes are imposed.
Collapse
Affiliation(s)
- Miguel Lois Mosquera
- Sleep Education and Research Laboratory (SERL), UCL Institute of Education, London, UK.
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Georgia Pavlopoulou
- UCL Institute of Education, Department of Psychology and Human Development, London, UK; Anna Freud National Centre for Children and Families, London, UK
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory (SERL), UCL Institute of Education, London, UK
| |
Collapse
|
124
|
Anderson A, Carr M. Applied Behaviour Analysis for Autism: Evidence, Issues, and Implementation Barriers. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
125
|
Botha M. Academic, Activist, or Advocate? Angry, Entangled, and Emerging: A Critical Reflection on Autism Knowledge Production. Front Psychol 2021; 12:727542. [PMID: 34650484 PMCID: PMC8506216 DOI: 10.3389/fpsyg.2021.727542] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Abstract
There has been a focus on autistic-led and participatory research in autism research, but minimal discussion about whether the field is hospitable to autistic involvement. While the focus on participatory and/or autistic-led research is abundantly welcome, a wider conversation should also happen about how autistic people are treated in the process of knowledge creation. As such, I present a critical reflection on my experiences of academia as an autistic autism researcher. I open by questioning whether I am an academic, an activist, or an advocate before discussing my journey through academia, and my exposure to dehumanizing, objectifying, and violent accounts of autism. I highlight how the construction of objectivity has resulted in a failure to question the validity of these dehumanizing accounts of autism, which are regarded as "scientifically-sound" by virtue of their perceived "objectivity." Furthermore, I discuss how the idea of objectivity is used to side-line autistic expertise in disingenuous ways, especially when this knowledge challenges the status-quo. Despite claiming to be value-free, these dehumanizing accounts of autism embody social and cultural values, with a complete lack of transparency or acknowledgment. I then discuss how these dehumanizing accounts and theories-entangled in values-reverberate into autistic people's lives and come to be ways of constituting us. Following this, I discuss the rationality of the anger autistic people feel when encountering these accounts, and instead of urging people to distance themselves from these emotions, I discuss the value of "leaning-in" as a radical act of dissent in the face of research-based violence. I then make a call to action urging all those who write or speak about autism to engage reflexively with how their values shape their understanding and construction of autistic people. Lastly, I conclude by answering my opening question: I have emerged as an advocate, activist, and academic. For me, belonging to the autistic community, acknowledging our marginalization, and recognizing our suffering within society means that hope for a better and just future has always, and will always underpin my work.
Collapse
Affiliation(s)
- Monique Botha
- Division of Psychology, University of Stirling, Stirling, United Kingdom
| |
Collapse
|
126
|
Chapko D, Rothstein P, Emeh L, Frumiento P, Kennedy D, Mcnicholas D, Orjiekwe I, Overton M, Snead M, Steward R, Sutton J, Bradshaw M, Jeffreys E, Gallia W, Ewans S, Williams M, Grierson M. Supporting Remote Survey Data Analysis by Co-researchers with Learning Disabilities through Inclusive and Creative Practices and Data Science Approaches. DIS. DESIGNING INTERACTIVE SYSTEMS (CONFERENCE) 2021; 2021:1668-1681. [PMID: 34541585 DOI: 10.1145/3461778.3462010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Through a process of robust co-design, we created a bespoke accessible survey platform to explore the role of co-researchers with learning disabilities (LDs) in research design and analysis. A team of co-researchers used this system to create an online survey to challenge public understanding of LDs [3]. Here, we describe and evaluate the process of remotely co-analyzing the survey data across 30 meetings in a research team consisting of academics and non-academics with diverse abilities amid new COVID-19 lockdown challenges. Based on survey data with >1,500 responses, we first co-analyzed demographics using graphs and art & design approaches. Next, co-researchers co-analyzed the output of machine learning-based structural topic modelling (STM) applied to open-ended text responses. We derived an efficient five-steps STM co-analysis process for creative, inclusive, and critical engagement of data by co-researchers. Co-researchers observed that by trying to understand and impact public opinion, their own perspectives also changed.
Collapse
Affiliation(s)
- Dorota Chapko
- Creative Computing Institute, University of the Arts London, London, United Kingdom
| | - Pedro Rothstein
- Creative Computing Institute, University of the Arts London, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mark Williams
- Heart n Soul at the Hub, Heart n Soul, London, United Kingdom
| | - Mick Grierson
- Creative Computing Institute, University of the Arts London, London, United Kingdom
| |
Collapse
|
127
|
Courchesne V, Tesfaye R, Mirenda P, Nicholas D, Mitchell W, Singh I, Zwaigenbaum L, Elsabbagh M. Autism Voices: A novel method to access first-person perspective of autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1123-1136. [PMID: 34482746 PMCID: PMC9340132 DOI: 10.1177/13623613211042128] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
LAY ABSTRACT The perspective of autistic individuals is often left uncaptured, and as a result they are often excluded from making decisions that impact them. Conventional communication can be challenging for many autistic individuals, especially those who are minimally verbal or who have an associated intellectual disability. Currently, a lack of appropriate methods to capture voices across the spectrum is a barrier. In the present study, we developed the Autism Voices protocol using universal design principles to capture the perspectives and experiences of autistic youth with a range of language or intellectual abilities. This protocol was then used with 33 autistic youth aged 11 to 18 years. A scoring rubric was developed to capture the unconventional communication used by the participants and the mitigation strategies used by interviewers to facilitate the interview. Many components of the protocol were found to effectively facilitate communication between the participant and interviewer, including the use of picture cards to support verbal questions/prompts, the fact that participants could respond with their preferred communication methods (writing, texting, pointing), and the fact that interviews were applied flexibly to adapt to each participant. Unconventional communication and mitigation strategies were mostly observed in interviews with minimally verbal individuals, but a fine-grained analysis showed participants were still communicating something through this unconventional communication. Our protocol could help promote the inclusion of more autistic individuals in research and showed that unconventional modes of communication like echolalia provide an understanding that participants' are invested in conversations and certain topics are more meaningful than others.
Collapse
|
128
|
Gillespie-Lynch K, Bisson JB, Saade S, Obeid R, Kofner B, Harrison AJ, Daou N, Tricarico N, Delos Santos J, Pinkava W, Jordan A. If you want to develop an effective autism training, ask autistic students to help you. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1082-1094. [PMID: 34472359 DOI: 10.1177/13623613211041006] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autistic university students are often left out because people do not understand autism. We wanted to help people understand autism. Most autism trainings are not made by autistic people. Autistic people know what it is like to be autistic. So autistic people may be the best teachers when it comes to teaching about autism. Autistic students and non-autistic professors made an autism training. The students made videos for the training. They also helped make questions to see what people learned from the trainings. Professors who are not autistic made a training on their own. Students in New York City tried out the trainings. After they answered questions, they did either the training the autistic students helped make or the training made by only professors. Then, they answered questions again. We learned from the students how to make our trainings better. Then, students from two universities in the United States and one university in Lebanon did our trainings and questions. Both trainings made hidden feelings about autism better. The training autistic students helped make taught students more than the training professors made on their own. The autistic-led training also helped students accept autism more. These studies show that autistic students can make autism research and trainings better. At the end of this article, autistic students share their ideas for how to make autism trainings even better in the future.
Collapse
Affiliation(s)
| | | | | | | | - Bella Kofner
- College of Staten Island, City University of New York, USA
| | | | | | | | | | | | | |
Collapse
|
129
|
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.,Address correspondence to: Laura Crane, PhD, Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, 55-59 Gordon Square, London WC1H 0NU, 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
|
130
|
Dwyer P, Acevedo SM, Brown HM, Grapel J, Jones SC, Nachman BR, Raymaker DM, Williams ZJ. An Expert Roundtable Discussion on Experiences of Autistic Autism Researchers. AUTISM IN ADULTHOOD 2021; 3:209-220. [PMID: 36605367 PMCID: PMC8992911 DOI: 10.1089/aut.2021.29019.rtb] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Patrick Dwyer
- Center for Mind and Brain, University of California at Davis, Davis, California, USA.,Department of Psychology, University of California at Davis, Davis, California, USA.,Address correspondence to: Patrick Dwyer, MA, Center for Mind and Brain, University of California at Davis, 267 Cousteau PI, Davis, CA 95618, USA.
| | - Sara M. Acevedo
- Department of Disability Studies, Miami University, Miami, Ohio, USA
| | - Heather M. Brown
- Department of Educational Psychology, University of Alberta, Alberta, Canada
| | - Jordan Grapel
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Sandra C. Jones
- Department of Engagement, Australian Catholic University, Melbourne, Australia
| | - Brett Ranon Nachman
- Belk Center for Community College Leadership and Research, North Carolina State University, Raleigh, North Carolina, USA
| | - Dora M. Raymaker
- Department of Social Work, Portland State University, Portland, Oregon, USA.,Department of Research and Education, Portland State University, Portland, Oregon, USA
| | - 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
| |
Collapse
|
131
|
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
|
132
|
Walsh C, Lydon S, Geoghegan R, Carey C, Creed M, O'Loughlin L, Walsh E, Byrne D, O'Connor P. Development and preliminary evaluation of a novel physician-report tool for assessing barriers to providing care to autistic patients. BMC Health Serv Res 2021; 21:873. [PMID: 34445991 PMCID: PMC8390217 DOI: 10.1186/s12913-021-06842-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 07/30/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Individuals on the autism spectrum face significant disparities in health and physicians often report difficulties in providing care to autistic patients. In order to improve the quality of care autistic individuals receive, it is important to identify the barriers that physicians experience in providing care so that these may be addressed. This paper reports the initial development and preliminary evaluation of a physician-report 'Barriers to Providing Healthcare' measurement tool. METHOD An established taxonomy of healthcare barriers for autistic individuals informed the initial draft of a 22-item measurement tool. This measurement tool was distributed to physicians working in various healthcare specialties and settings. Exploratory factor analysis (EFA) was conducted to determine the construct validity of the tool; discriminant validity between, and internal consistency of, the resultant factors were assessed. Multiple regressions were used to explore variables potentially associated with barriers endorsed by physicians. RESULTS A total of 203 physicians were included in the analyses. The EFA resulted in a 17-item tool with three distinct factors which explained 37.6% of the variance: 1) Patient-related barriers (Cronbach's α = 0.83; e.g., the patient's reactivity to the healthcare environment); 2) Healthcare provider (HCP)/family-related barriers (Cronbach's α = 0.81; e.g., a lack of providers willing to work with autistic patients); and 3) System-related barriers (Cronbach's α = 0.84; e.g., there is a lack of support for patients and families). Discriminant validity between the factors was adequate (r < .8). The barriers that were most frequently endorsed as occurring 'often' or 'very often' included a lack of support for patients and families (endorsed by 79.9% of physicians); communication difficulties (73.4%); and a lack of coordination between services (69.9%). The regression analyses identified no significant associated variables. CONCLUSION A preliminary version of a novel physician-report tool to assess barriers to providing care to autistic patients has been developed although further validation work is required. The use of this tool will help physicians to identify issues specific to different medical specialities and healthcare settings. This information may help identify the supports physicians require to recognise and implement the required accommodations. Future research which elucidates barriers to healthcare provision for autistic patients is required to support systemic change in healthcare so as to improve care experiences and health outcomes for people on the autism spectrum.
Collapse
Affiliation(s)
- Chloe Walsh
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland.
- School of Medicine, National University of Ireland Galway, Galway, Ireland.
| | - Rosemary Geoghegan
- Discipline of Paediatrics, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Cornelia Carey
- Department of Liaison Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Michael Creed
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland
- Galway University Hospital, Galway, Ireland
| | | | - Ellen Walsh
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland
- Galway University Hospital, Galway, Ireland
| | - Dara Byrne
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Paul O'Connor
- Department of General Practice, School of Medicine, National University of Ireland, Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, University Hospital Galway, Galway, Ireland
| |
Collapse
|
133
|
Keating CT. Participatory Autism Research: How Consultation Benefits Everyone. Front Psychol 2021; 12:713982. [PMID: 34504463 PMCID: PMC8421540 DOI: 10.3389/fpsyg.2021.713982] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/05/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Connor Tom Keating
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
134
|
A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractChildren with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.
Collapse
|
135
|
Fletcher-Watson S, Bölte S, Crompton CJ, Jones D, Lai MC, Mandy W, Pellicano L, Stahmer A, Taylor J, Mandell D. Publishing standards for promoting excellence in autism research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1501-1504. [PMID: 34320849 DOI: 10.1177/13623613211019830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
136
|
Pellicano E, Brett S, den Houting J, Heyworth M, Magiati I, Steward R, Urbanowicz A, Stears M. COVID-19, social isolation and the mental health of autistic people and their families: A qualitative study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:914-927. [PMID: 34362263 DOI: 10.1177/13623613211035936] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT In this study, we show that autistic people and their families have found it very difficult to deal with the lockdowns during the COVID-19 pandemic. Autistic and non-autistic researchers spoke to 144 people, including 44 autistic adults, 84 parents of autistic children and 16 autistic young people (12-18 years old). We asked them about their everyday lives and mental health during lockdown. People told us that they enjoyed having fewer obligations and demands compared to pre-COVID-19 life. They felt that life was quieter and calmer. But people also told us again and again how much they missed meeting people in real life, especially their friends, and their therapists and support workers. People told us that their mental health suffered because they did not have contact with their friends and services. Importantly, many people (including researchers) think that autistic people do not want friends or to be around people. But our results show that is not true. Many autistic people do want friends and to be around other people. Some people's mental health has been damaged by not being able to see people during COVID-19. Autistic people need support in many areas of life so they can keep socialising and seeing their friends even through difficult times, like pandemics.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Jacquiline den Houting
- Macquarie University, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | | | | | | | | |
Collapse
|
137
|
Chapple M, Davis P, Billington J, Myrick JA, Ruddock C, Corcoran R. Overcoming the Double Empathy Problem Within Pairs of Autistic and Non-autistic Adults Through the Contemplation of Serious Literature. Front Psychol 2021; 12:708375. [PMID: 34385964 PMCID: PMC8354525 DOI: 10.3389/fpsyg.2021.708375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Recent research based on the needs of the autistic community has explored the frequent social misunderstandings that arise between autistic and non-autistic people, known as the double empathy problem. Double empathy understandings require both groups to respect neurodiversity by focussing on individuality across groups. This study aimed to explore how literature, through its ability to uncover nuanced emotional response differences between readers, could facilitate double empathy understandings within pairs of autistic and non-autistic adults. A longitudinal, qualitative design was used, with 4 gender-matched pairs. Participants read Of Mice and Men for 1 week, whilst completing a structured, reflective diary. This was followed by 4 one-hour paired reading sessions, where pairs discussed the book and their reflections in depth. Participants were then invited to a final one-on-one interview to discuss their thoughts and experiences of the paired reading sessions. Thematic and literary analysis of the session and interview data revealed four themes (1) The Book as Social Oil; (2) From a World of Difference to a World of Affinity; (3) Emotional Intelligence: From Thinking About to Feeling with; and (4) From Overwhelming to Overcoming. All participants reported having achieved an individualised view of one another to explore their nuanced differences. The non-autistic group reported a more sensitive understanding of what it means to be autistic, while the autistic group overcame concerns about non-autistic people stereotyping autism, and instead reported feeling valued and accommodated by their non-autistic partners.
Collapse
Affiliation(s)
- Melissa Chapple
- Department of Primary Care and Mental Health, School of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Philip Davis
- Centre for Research Into Reading, Literature and Society, University of Liverpool, Liverpool, United Kingdom
| | - Josie Billington
- Centre for Research Into Reading, Literature and Society, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Rhiannon Corcoran
- Department of Primary Care and Mental Health, School of Psychology, University of Liverpool, Liverpool, United Kingdom
- Centre for Research Into Reading, Literature and Society, University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
138
|
Autistic Input in Social Skills Interventions for Young Adults: a Systematic Review of the Literature. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00280-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
139
|
Holt A, Bounekhla K, Welch C, Polatajko H. "Unheard minds, again and again": autistic insider perspectives and theory of mind. Disabil Rehabil 2021; 44:5887-5897. [PMID: 34256672 DOI: 10.1080/09638288.2021.1949052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE The Theory of Mind (ToM) deficit hypothesis is a dominant construct used to explain the social and communication difficulties observed in autistic individuals. This hypothesis was based on an interpretation of autistic individuals' observable behavior, not based on insider accounts. Insider perspectives still remain mostly absent in research on ToM. We aimed to gain an understanding of the relevance and applicability of ToM by examining writings of autistic bloggers. METHODS As part of a series of studies examining insider autistic perspectives, we used a descriptive qualitative approach and conducted a thematic analysis of content scraped from 40 blogs written by autistic authors. RESULTS The blogs offered important perspectives on the applicability of ToM to autistic individuals. The primary themes reflected empirical contradictions to ToM, explicit critiques of ToM, and pointed to ToM as a source of harm. CONCLUSION The insider perspectives call into question the ways clinicians, researchers, and society use ToM to understand autistic individuals and point to the harmful effects of ToM on autistic lived experience. These findings emphasize the importance of attending to autistic people in building a body of knowledge that better reflects autistic experiences and promotes more effective and ethical clinical practices.Implications for RehabilitationOur paper indicates the need for a timely and thorough re-evaluation of the ToM deficit hypothesis of autism.Autistic insider perspectives not only empirically demonstrate and explicitly critique the ToM deficit hypothesis, but reveal the hypothesis as harmful to autistic experience by reinforcing negative stereotypes, prompting acts of discrimination, and perpetuating autistic insider's exclusion from the research concerning them.Given the varied experiences of autistic people and the harmful impacts of the ToM deficit hypothesis, it is safer for clinicians and researchers to presume a presence of ToM and empathy, before they presume a deficit in autistic individuals.Autistic insiders are able, eager, and deserve to be included in the research and practices that concern them.
Collapse
Affiliation(s)
- Abigail Holt
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Khadija Bounekhla
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Christie Welch
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Helene Polatajko
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
140
|
Patterns of Continuity and Change in the Psychosocial Outcomes of Young Autistic People: a Mixed-Methods Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:301-313. [PMID: 31797119 DOI: 10.1007/s10802-019-00602-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Long-term longitudinal studies have consistently demonstrated that the outcomes of autistic individuals are highly variable. Yet, these studies have typically focused on aspects of functioning deemed to be critical by non-autistic researchers, rather than autistic people themselves. Here, we uniquely examined the long-term psychosocial outcomes of a group of young autistic people (n = 27; M age = 17 years; 10 months; 2 female) followed from childhood using a combination of approaches, including (1) the standard, normative approach, which examined changes in diagnostic outcomes, autistic features and adaptive functioning over a 9-year period and (2) a qualitative approach, which involved semi-structured interviews to understand young people's own subjective experiences of their current functioning. On average, there was no significant change in young people's diagnostic outcomes and autistic features over the 9-year period, although there was much variability at the individual level. There was far less variability, however, in young people's everyday functioning, with marked declines over the same period. While these often-substantial everyday challenges aligned well with young people's subjective reports, there was no straightforward one-to-one mapping between self-reported experiences of being autistic and standard measures of severity. These findings call for concerted efforts to understand autistic outcomes through the mixing of quantitative and qualitative reports and for sustained and targeted interventions during adolescence in those areas that matter most to young people themselves.
Collapse
|
141
|
Babb C, Brede J, Jones CRG, Elliott M, Zanker C, Tchanturia K, Serpell L, Mandy W, Fox JRE. 'It's not that they don't want to access the support . . . it's the impact of the autism': The experience of eating disorder services from the perspective of autistic women, parents and healthcare professionals. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1409-1421. [PMID: 33588579 PMCID: PMC8264634 DOI: 10.1177/1362361321991257] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
LAY ABSTRACT This study explores autistic women's experiences of eating disorder services. About 20%-30% of people with anorexia nervosa are also autistic, and current treatments seem not to work as well for them. We interviewed 15 autistic women with experience of anorexia nervosa, 12 parents of autistic women with anorexia nervosa, and 11 healthcare professionals working in eating disorder services. We asked autistic women and parents about their experiences of eating disorder services, and we asked healthcare professionals about their experiences treating autistic women with anorexia nervosa. Participants' views were represented by three overall themes: misunderstanding autism and autistic traits, one treatment does not fit all, and improving accessibility and engagement within services. We found that autistic women face many barriers when in treatment for anorexia nervosa, often because of a lack of autism understanding within eating disorder services. Future research should look at developing anorexia nervosa treatments that can specifically help autistic individuals.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Lucy Serpell
- University College London, UK
- Eating Disorder Service, North East London NHS Foundation Trust, Essex, UK
| | | | | |
Collapse
|
142
|
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: 22] [Impact Index Per Article: 7.3] [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
|
143
|
Fletcher TS, Wiskera ES, Wilbur LH, Garcia NM. The sensory totes programme: sensory-friendly autism program innovations designed to meet COVID-19 challenges. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2021. [DOI: 10.1080/14473828.2021.1943868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tina Sue Fletcher
- School of Occupational Therapy, Texas Woman’s University, Dallas, TX, USA
| | | | | | - Natalie M. Garcia
- School of Occupational Therapy, Texas Woman’s University, Dallas, TX, USA
| |
Collapse
|
144
|
Inclusion and Rigor in Qualitative Autism Research: A Response to Van Schalkwyk and Dewinter (2020). J Autism Dev Disord 2021; 51:1802-1804. [PMID: 32737669 DOI: 10.1007/s10803-020-04634-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
145
|
Stark E, Ali D, Ayre A, Schneider N, Parveen S, Marais K, Holmes N, Pender R. Coproduction with Autistic Adults: Reflections from the Authentistic Research Collective. AUTISM IN ADULTHOOD 2021; 3:195-203. [PMID: 36601467 PMCID: PMC8992895 DOI: 10.1089/aut.2020.0050] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This article explores coproduction in relation to autistic people. We reflect on the coproduction process with autistic adults from the Authentistic Research Collective at University College London. We aimed to support the autistic population's mental health needs by coproducing a document on adapting psychological therapy, and by developing a set of reflective guidelines to guide and encourage future coproduction initiatives between autistic and nonautistic team members. We reflect upon six elements that are of potential importance for future coproduction projects with autistic adults: (1) the meaning of coproduction; (2) ground rules and a traffic light system; (3) environmental adaptations; (4) digital communication tools; (5) encouraging authenticity; and (6) supporting autistic strengths. We conclude by discussing future research avenues into optimizing coproduction with autistic people, and how such research may influence both practice and policy. Lay summary Why is coproduction important?: Coproduction means creating things jointly with others. Ideally, autistic people should be involved in research that is about them so that their thoughts and opinions are included. Coproduction allows this to happen.What is the purpose of this article?: There is little advice for how autistic and nonautistic people can work together to coproduce useful research. This article hopes to encourage discussion by sharing our reflections on how we used coproduction in our project.What did we do?: Our group was made up of autistic and nonautistic people. One of our goals was to gain experience in using coproduction. We created this article containing our reflections-what we found worked well, and what we felt could be done differently in the future.What did we learn?: We learnt the importance of five key areas: (1) group rules, and a "traffic light" system to help group members show how they like to communicate; (2) adapting the environment to suit people's needs; (3) inclusion of digital communication tools; (4) encouraging group members to feel they are authentic (be fully themselves); and (5) supporting autistic strengths. We hope that the discussion of these themes will be helpful for future coproduction projects.
Collapse
Affiliation(s)
- Eloise Stark
- Authentistic Research Collective, University College London, London, United Kingdom.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, United Kingdom.,Address correspondence to: Eloise Stark, MA (Oxon), Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Dorota Ali
- Authentistic Research Collective, University College London, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Annalise Ayre
- Authentistic Research Collective, University College London, London, United Kingdom
| | - Naomi Schneider
- Authentistic Research Collective, University College London, London, United Kingdom
| | - Sophia Parveen
- Authentistic Research Collective, University College London, London, United Kingdom
| | - Keith Marais
- Authentistic Research Collective, University College London, London, United Kingdom
| | - Nick Holmes
- Authentistic Research Collective, University College London, London, United Kingdom
| | - Richard Pender
- Authentistic Research Collective, University College London, London, United Kingdom
| |
Collapse
|
146
|
Searching for What Really Matters: A Thematic Analysis of Quality of Life among Preschool Children on the Autism Spectrum. J Autism Dev Disord 2021; 52:2098-2111. [PMID: 34060000 DOI: 10.1007/s10803-021-05097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Quality of life (QoL) is an essential measure when assessing health interventions. Most early interventions for preschool children on the spectrum evaluate the effects on autism symptoms. However, researchers increasingly believe that good interventions should also improve the QoL of these children. Domains of QoL among preschool children on the autism spectrum have not previously been researched. We interviewed adults on the spectrum to explore early childhood experiences that made their lives satisfying. Our data revealed four major themes: interests, environmental regularity, sensory differences and social interactions. This study provides the first insights on aspects of life important to pre-schoolers on the spectrum. Findings will contribute to developing items for a measure of QoL among this population.
Collapse
|
147
|
Williams GL, Wharton T, Jagoe C. Mutual (Mis)understanding: Reframing Autistic Pragmatic "Impairments" Using Relevance Theory. Front Psychol 2021; 12:616664. [PMID: 33995177 PMCID: PMC8117104 DOI: 10.3389/fpsyg.2021.616664] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/22/2021] [Indexed: 11/30/2022] Open
Abstract
A central diagnostic and anecdotal feature of autism is difficulty with social communication. We take the position that communication is a two-way, intersubjective phenomenon-as described by the double empathy problem-and offer up relevance theory (a cognitive account of utterance interpretation) as a means of explaining such communication difficulties. Based on a set of proposed heuristics for successful and rapid interpretation of intended meaning, relevance theory positions communication as contingent on shared-and, importantly, mutually recognized-"relevance." Given that autistic and non-autistic people may have sometimes markedly different embodied experiences of the world, we argue that what is most salient to each interlocutor may be mismatched. Relevance theory would predict that where this salient information is not (mutually) recognized or adjusted for, mutual understanding may be more effortful to achieve. This paper presents the findings from a small-scale, linguistic ethnographic study of autistic communication featuring eight core autistic participants. Each core autistic participant engaged in three naturalistic conversations around the topic of loneliness with: (1) a familiar, chosen conversation partner; (2) a non-autistic stranger and (3) an autistic stranger. Relevance theory is utilized as a frame for the linguistic analysis of the interactions. Mutual understanding was unexpectedly high across all types of conversation pairings. In conversations involving two autistic participants, flow, rapport and intersubjective attunement were significantly increased and in three instances, autistic interlocutors appeared to experience improvements in their individual communicative competence contrasted with their other conversations. The findings have the potential to guide future thinking about how, in practical terms, communication between autistic and non-autistic people in both personal and public settings might be improved.
Collapse
Affiliation(s)
- Gemma L. Williams
- School of Humanities, University of Brighton, Brighton, United Kingdom
| | - Tim Wharton
- School of Humanities, University of Brighton, Brighton, United Kingdom
| | - Caroline Jagoe
- School of Linguistic, Speech and Communication Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland
| |
Collapse
|
148
|
Brief Report: Investigating the Motivations and Autistic Traits of Video Gamers. J Autism Dev Disord 2021; 52:1403-1407. [PMID: 33886033 DOI: 10.1007/s10803-021-04994-x] [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] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
Video games are commonly of interest in autism, with autistic adolescents playing twice as much as their Typically Developing peers. The aims of this study are to investigate whether motivations to play video games measured using the Gaming Attitudes, Motivations and Experiences Scales and autistic traits using the Autism Spectrum Quotient can predict time spent playing video games. 57 participants were recruited from internet forums and completed an online questionnaire. The preliminary results revealed that only escapism and social motivation predicted time spent playing games. Further investigation revealed interactions between autistic traits and several motivational scales, including escapism, completionism, and customisation. This has consequences for future research into how autistic people use video games to ease their anxieties.
Collapse
|
149
|
Leadbitter K, Buckle KL, Ellis C, Dekker M. Autistic Self-Advocacy and the Neurodiversity Movement: Implications for Autism Early Intervention Research and Practice. Front Psychol 2021; 12:635690. [PMID: 33912110 PMCID: PMC8075160 DOI: 10.3389/fpsyg.2021.635690] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
The growth of autistic self-advocacy and the neurodiversity movement has brought about new ethical, theoretical and ideological debates within autism theory, research and practice. These debates have had genuine impact within some areas of autism research but their influence is less evident within early intervention research. In this paper, we argue that all autism intervention stakeholders need to understand and actively engage with the views of autistic people and with neurodiversity as a concept and movement. In so doing, intervention researchers and practitioners are required to move away from a normative agenda and pay diligence to environmental goodness-of-fit, autistic developmental trajectories, internal drivers and experiences, and autistic prioritized intervention targets. Autism intervention researchers must respond to these debates by reframing effectiveness, developing tools to measure autistic prioritized outcomes, and forming partnerships with autistic people. There is a pressing need for increased reflection and articulation around how intervention practices align with a neurodiversity framework and greater emphasis within intervention programmes on natural developmental processes, coping strategies, autonomy, and well-being.
Collapse
Affiliation(s)
- Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Karen Leneh Buckle
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- The Autscape Organisation, Coventry, United Kingdom
| | - Ceri Ellis
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Martijn Dekker
- The Autscape Organisation, Coventry, United Kingdom
- The European Council of Autistic People, Prague, Czechia
| |
Collapse
|
150
|
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
|