201
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Nicolaidis C, Raymaker D, Kapp SK, Baggs A, Ashkenazy E, McDonald K, Weiner M, Maslak J, Hunter M, Joyce A. The AASPIRE practice-based guidelines for the inclusion of autistic adults in research as co-researchers and study participants. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:2007-2019. [PMID: 30939892 PMCID: PMC6776684 DOI: 10.1177/1362361319830523] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As interest in autism in adulthood grows, so does the need for methods to promote the inclusion of autistic adults in research. Our objective was to create practice-based guidelines for the inclusion of autistic adults, both as research team members and as study participants. We conducted an institutional ethnography of three closely related research partnerships that used participatory methods with autistic adults over the years 2006-2018. We used an iterative approach which combined discussions with community and academic partners and artifact review. Guidelines to promote the inclusion of autistic adults as co-researchers focus on being transparent about partnership goals, clearly defining roles and choosing partners, creating processes for effective communication and power-sharing, building and maintaining trust, disseminating findings, encouraging community capacitation, and fairly compensating partners. Guidelines to promote the inclusion of autistic adults as study participants focus on maximizing autonomy and inclusion, creating an accessible consent process, offering multiple modes of participation, adapting survey instruments for use with autistic adults, creating accessible qualitative interview guides, and handling data from proxy reporters. Although these practice-based guidelines may not apply to all research teams, we hope that other researchers can capitalize on these practical lessons when including autistic adults in research.
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Affiliation(s)
- Christina Nicolaidis
- Regional Research Institute, School of Social Work, Portland State University (PSU), Portland, OR, USA
- Department of Medicine, School of Medicine, Oregon Health & Science University (OHSU), Portland, OR, USA
| | - Dora Raymaker
- Regional Research Institute, School of Social Work, Portland State University (PSU), Portland, OR, USA
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Steven K Kapp
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
- Sociology, Philosophy and Anthropology, College of Social Sciences and International Studies, University of Exeter, Exeter, UK
| | - Amelia Baggs
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - E Ashkenazy
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Katherine McDonald
- Department of Public Health, Food Studies and Nutrition, Burton Blatt Institute, Syracuse University, Syracuse, NY, USA
| | - Michael Weiner
- Indiana University Center for Health Services and Outcomes Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Center for Health Information and Communication, U.S. Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Joelle Maslak
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Morrigan Hunter
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
| | - Andrea Joyce
- Community Council, Academic Autism Spectrum Partnership in Research and Education, Portland, OR, USA
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202
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Foster NC, Bennett SJ, Causer J, Elliott D, Bird G, Hayes SJ. Getting Off to a Shaky Start: Specificity in Planning and Feedforward Control During Sensorimotor Learning in Autism Spectrum Disorder. Autism Res 2019; 13:423-435. [DOI: 10.1002/aur.2214] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Nathan C. Foster
- Cognition, Motion and Neuroscience UnitFondazione Istituto Italiano di Tecnologia Genoa Italy
- Research Institute for Sport and Exercise SciencesLiverpool John Moores University Liverpool UK
| | - Simon J. Bennett
- Research Institute for Sport and Exercise SciencesLiverpool John Moores University Liverpool UK
| | - Joe Causer
- Research Institute for Sport and Exercise SciencesLiverpool John Moores University Liverpool UK
| | - Digby Elliott
- Department of KinesiologyMcMaster University Ontario Canada
| | - Geoffrey Bird
- Department of Experimental PsychologyUniversity of Oxford Oxford UK
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing's College London London UK
| | - Spencer J. Hayes
- Department of Psychology and Human DevelopmentInstitute of Education, University College London UK
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203
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Gowen E, Taylor R, Bleazard T, Greenstein A, Baimbridge P, Poole D. Guidelines for conducting research studies with the autism community. AUTISM POLICY & PRACTICE 2019; 2:29-45. [PMID: 32226635 PMCID: PMC7099931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
There has been growing awareness of the concern expressed by autism communities that the majority of research conducted does not reflect the priorities or needs of autistic people and their families. Further, many autistic people report that they feel unable to influence research and desire greater involvement in the research process. Our research generated practical guidelines for researchers to consider when conducting autism research, in order to increase involvement, collaboration and trust between researchers and the autism community. These guidelines are based on the output of focus groups and interview discussions with twenty-two autistic adults and eight parents of autistic children, conducted during a series of workshops carried out as a collaboration between the research network Autism@Manchester and Salfordautism, an autism support group led and run by autistic professionals. The guidelines are organised into four sections: (1) pre-study considerations, (2) recruitment of participants, (3) study visit considerations and (4) post-study considerations. These sections are structured to reflect the research pathway, to allow researchers to understand more easily how to incorporate the recommendations into their research. The recommendations promote effective communication and equal partnerships between the autism and research communities, so that the needs of participants pre-research, during and post- research are taken into account, and so that participants are supported to become involved in research at the level they choose. It is hoped that by implementing transparent and participatory approaches to their work, researchers might be able to reduce some of the dissatisfaction that members of the autism community feel towards research, leading to higher standards in autism research.
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Affiliation(s)
- Emma Gowen
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
| | | | | | | | - Peter Baimbridge
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
- Salfordautism
| | - Daniel Poole
- Division of Neuroscience and Experimental Psychology, School of biological Sciences, Faculty of Biology, Medicine and Health Sciences, The University of Manchester
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204
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Camm-Crosbie L, Bradley L, Shaw R, Baron-Cohen S, Cassidy S. 'People like me don't get support': Autistic adults' experiences of support and treatment for mental health difficulties, self-injury and suicidality. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1431-1441. [PMID: 30497279 PMCID: PMC6625034 DOI: 10.1177/1362361318816053] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autistic people are at high risk of mental health problems, self-injury and suicidality. However, no studies have explored autistic peoples' experiences of treatment and support for these difficulties. In partnership with a steering group of autistic adults, an online survey was developed to explore these individuals' experiences of treatment and support for mental health problems, self-injury and suicidality for the first time. A total of 200 autistic adults (122 females, 77 males and 1 unreported) aged 18-67 (mean = 38.9 years, standard deviation = 11.5), without co-occurring intellectual disability, completed the online survey. Thematic analysis of open-ended questions resulted in an overarching theme that individually tailored treatment and support was both beneficial and desirable, which consisted of three underlying themes: (1) difficulties in accessing treatment and support; (2) lack of understanding and knowledge of autistic people with co-occurring mental health difficulties and (3) appropriate treatment and support, or lack of, impacted autistic people's well-being and likelihood of seeing suicide as their future. Findings demonstrate an urgent need for autism treatment pathways in mental health services.
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Affiliation(s)
| | | | - Rebecca Shaw
- Coventry and Warwickshire Partnership
NHS Trust, UK
| | - Simon Baron-Cohen
- University of Cambridge, UK
- Cambridgeshire and Peterborough NHS
Foundation Trust, UK
| | - Sarah Cassidy
- Coventry University, UK
- University of Cambridge, UK
- University of Nottingham, UK
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205
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Flygare O, Andersson E, Ringberg H, Hellstadius AC, Edbacken J, Enander J, Dahl M, Aspvall K, Windh I, Russell A, Mataix-Cols D, Rück C. Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:190-199. [PMID: 31187645 DOI: 10.1177/1362361319856974] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obsessive-compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive-compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale-Brown Obsessive-Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale-Brown Obsessive-Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive-compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive-compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive-compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive-compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group.
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Affiliation(s)
- Oskar Flygare
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council and M46, Karolinska University Hospital, Huddinge, Sweden
| | - Erik Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Helene Ringberg
- Stockholm Health Care Services, Stockholm County Council, CAP Research Centre, Stockholm, Sweden
| | | | | | - Jesper Enander
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Matti Dahl
- Stockholm Health Care Services, Stockholm County Council and M46, Karolinska University Hospital, Huddinge, Sweden
| | - Kristina Aspvall
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, CAP Research Centre, Stockholm, Sweden
| | - Indra Windh
- Stockholm Health Care Services, Stockholm County Council and M46, Karolinska University Hospital, Huddinge, Sweden
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, CAP Research Centre, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council and M46, Karolinska University Hospital, Huddinge, Sweden
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206
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Leedham A, Thompson AR, Smith R, Freeth M. 'I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:135-146. [PMID: 31144507 DOI: 10.1177/1362361319853442] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Females often receive autism spectrum condition diagnoses later than males, leaving needs misunderstood. This study aimed to explore the lived experiences of female adults diagnosed with an autism spectrum condition in middle to late adulthood. Eleven autistic females diagnosed over the age of 40 years completed semi-structured interviews, analysed using Interpretative Phenomenological Analysis. Four superordinate themes emerged: A hidden condition (pretending to be normal and fitting in; mental health and mislabelling), The process of acceptance (initial reactions and search for understanding; re-living life through a new lens), The impact of others post-diagnosis (initial reactions; stereotyped assumptions), and A new identity on the autism spectrum (negotiating relationships, connections and community; changing well-being and views of the self; the meaning of diagnosis). Findings highlight several factors not previously identified that affect late diagnosis in females, including widespread limited understandings of others. Diagnosis was experienced by several participants as facilitating transition from being self-critical to self-compassionate, coupled with an increased sense of agency. Participants experienced a change in identity that enabled greater acceptance and understanding of the self. However, this was painful to adjust to at such a late stage.
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Affiliation(s)
- Alexandra Leedham
- University of Sheffield, UK
- Chesterfield Royal Hospital NHS Foundation Trust, UK
| | | | - Richard Smith
- Chesterfield Royal Hospital NHS Foundation Trust, UK
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207
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Howard K, Katsos N, Gibson J. Using interpretative phenomenological analysis in autism research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1871-1876. [PMID: 30672307 DOI: 10.1177/1362361318823902] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Qualitative studies within autism research are gaining prominence, yet there is little evidence about the usefulness of particular qualitative approaches in reflecting the perspectives and experiences of autistic participants. This short report serves to introduce interpretative phenomenological analysis as one among a range of qualitative approaches to autism research. We argue that certain features of interpretative phenomenological analysis, including its commitment to an equality of voice and researcher reflexivity, may help to illuminate the experiences of autistic individuals. The procedures of interpretative phenomenological analysis are presented through the lens of 10 studies into autistic people's experiences, and a case is made for the suitability of this approach within qualitative autism research.
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208
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Vincent J. It's the fear of the unknown: Transition from higher education for young autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1575-1585. [PMID: 30632780 DOI: 10.1177/1362361318822498] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
More young people with a diagnosis of autism are enrolling and successfully completing higher education courses than ever before and this is set to increase; however, while there is a burgeoning body of literature surrounding the transition into this stage of education, there is a paucity of research that investigates the transition as this population exit higher education. This exploratory qualitative study is one of the first to identify the specific experiences of young autistic adults making this transition, drawing on semi-structured interviews with 21 students and recent graduates. Findings indicate that transition out of higher education is challenging on both practical and psychological levels, manifested by feelings of anxiety and loss. However, there is also evidence that the same phenomenon can also be understood as a positive departure with important implications for identity development. Findings are discussed in relation to future research and implications for practice in higher education institutions.
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209
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Lowinger S. Postsecondary Education for Students with ASD: Essential Support Systems. AUTISM IN ADULTHOOD 2019. [DOI: 10.1007/978-3-030-28833-4_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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210
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Au-Yeung SK, Bradley L, Robertson AE, Shaw R, Baron-Cohen S, Cassidy S. Experience of mental health diagnosis and perceived misdiagnosis in autistic, possibly autistic and non-autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1508-1518. [DOI: 10.1177/1362361318818167] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Previous research shows that autistic people have high levels of co-occurring mental health conditions. Yet, a number of case reports have revealed that mental health conditions are often misdiagnosed in autistic individuals. A total of 420 adults who identified as autistic, possibly autistic or non-autistic completed an online survey consisting of questions regarding mental health diagnoses they received, whether they agreed with those diagnoses and if not why. Autistic and possibly autistic participants were more likely to report receiving mental health diagnoses compared to non-autistic participants, but were less likely to agree with those diagnoses. Thematic analysis revealed the participants’ main reasons for disagreement were that (1) they felt their autism characteristics were being confused with mental health conditions by healthcare professionals and (2) they perceived their own mental health difficulties to be resultant of ASC. Participants attributed these to the clinical barriers they experienced, including healthcare professionals’ lack of autism awareness and lack of communication, which in turn prevented them from receiving appropriate support. This study highlights the need for autism awareness training for healthcare professionals and the need to develop tools and interventions to accurately diagnose and effectively treat mental health conditions in autistic individuals.
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Affiliation(s)
| | | | | | - Rebecca Shaw
- Coventry University, UK
- Coventry and Warwickshire Partnership NHS Trust, UK
| | - Simon Baron-Cohen
- University of Cambridge, UK
- Cambridge Lifespan Asperger Syndrome Service (CLASS), UK
| | - Sarah Cassidy
- Coventry University, UK
- University of Cambridge, UK
- University of Nottingham, UK
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211
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Bal VH, Hendren RL, Charman T, Abbeduto L, Kasari C, Klinger LG, Ence W, Glavin T, Lyons G, Rosenberg E. Considerations from the 2017 IMFAR Preconference on Measuring Meaningful Outcomes from School-Age to Adulthood. Autism Res 2018; 11:1446-1454. [DOI: 10.1002/aur.2034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/31/2018] [Accepted: 09/18/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Vanessa H. Bal
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
| | - Robert L. Hendren
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
| | - Tony Charman
- King's College London; Institute of Psychiatry, Psychology & Neuroscience (IoPPN); London UK
| | - Leonard Abbeduto
- MIND Institute and Department of Psychiatry and Behavioral Sciences; University of California; Davis California
| | - Connie Kasari
- Center for Autism Research & Treatment; Graduate School of Education & Information Studies, University of California; Los Angles California
| | - Laura Grofer Klinger
- Department of Psychiatry, TEACCH Autism Program; University of North Carolina; Chapel Hill North Carolina
| | - Whitney Ence
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
| | - Tara Glavin
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
| | - Gregory Lyons
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
| | - Erin Rosenberg
- Weill Institute for Neurosciences Department of Psychiatry; University of California; San Francisco California
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