Do Implicit and Explicit Racial Biases Influence Autism Identification and Stigma? An Implicit Association Test Study

Race and Ethnicity Reporting in Occupational Therapy Research Among Autistic Youth

Historically marginalized racial and ethnic groups are underrepresented in autism research broadly; however, patterns of inclusion in occupational therapy research are unknown.In this secondary data analysis, we examined race and ethnicity reporting across articles included in a systematic review of evidence related to occupational therapy practice with autistic individuals <18 years (2013-2021).Two team members reached >90% interrater coding agreement in race and ethnicity reporting across articles in ADLs/IADLs, education/work, play, sleep, and social participation in clinics, homes/communities, and schools.Intervention outcomes of ADL/IADLs (66.7%) and play (66.7%) had low rates of reporting, while social participation in schools (100%) and education/work (100%) had higher rates of reporting. Sample diversity was greatest among research in schools and most limited in clinic-based settings.Systemic racism that limits individuals' participation in occupational therapy research perpetuates racial and ethnic health inequities among autistic children and adolescents.

Exploring Factors of Diagnostic Timing Among Black Autistic Youth

The goal of the present study was to compare profiles among Black families of autistic youth who were identified Early (≤ 2 years of age), Mid (age 3 or 4), and Delayed (≥ 5 years of age) to better identify the characteristics that contribute to early ASD identification and delayed ASD identification. Black caregivers with autistic youth (N = 101) were divided into Early (N = 34), Mid (N = 39), and Delayed (N = 28) groups and compared on (a) the age at which signs of autism signs were first noticed, (b) wait times, (c) previous misdiagnoses rates, and (d) racial barriers experienced during the diagnostic process. The results revealed differences between the diagnostic profiles. Specifically, (a) Delayed families noticed the first signs of autism significantly later, (b) Early families had significantly smaller wait times between age of noticing signs of autism and age of receiving the diagnosis, (c) the odds of receiving a later or delayed autism diagnosis was nearly three times higher for caregivers who reported receiving a misdiagnosis, and (d) there were no significant differences in racial barriers experienced between Early, Mid, and Delayed families. Challenges in receiving a timely diagnosis remain for some Black autistic youth. To improve early identification for Black autistic youth who are at risk for receiving delayed diagnostic care, further research should examine factors and practices that improve autism knowledge among professionals and caregivers, enhance assessment practices, and integrate culturally responsive practices into assessment and screening procedures.

Black and White Adults' Racial and Gender Stereotypes of Psychopathology Symptoms in Black and White Children

Adults' judgments of children's behaviors play a critical role in assessment and treatment of childhood psychopathology. Judgments of children's psychiatric symptoms are likely influenced by racial biases, but little is known about the specific racial biases adults hold about children's psychiatric symptoms, which could play a critical role in childhood mental health disparities. This study examined one form of such biases, racial stereotypes, to determine if White and Black adults hold implicit and explicit racial stereotypes about common childhood psychopathology symptoms, and if these stereotypes vary by child gender and disorder type. Participants included 82 self-identified Black men, 84 Black woman, 1 Black transgender individual, 1 Black genderfluid individual, 81 White men, and 85 White women. Analyses of implicit stereotypes revealed that White adults associated psychopathology symptoms more strongly with Black children than did Black adults (p < .001). All adults held stronger implicit racial stereotypes for oppositional defiant disorder, anxiety, and depression than for attention-deficit/hyperactivity disorder (p < .001). For explicit stereotypes, White adults generally associated psychopathology symptoms more with Black children than did Black adults but effects varied across child gender and disorder type. As the first study to examine racial and gender stereotypes across common childhood psychopathology symptoms, these findings point to a need for further investigation of the presence and impact of racial biases in the mental healthcare system for Black youth and to identify interventions to mitigate the impacts of racial biases to inform racial equity in mental healthcare in the United States.

Ethnic Group Differences in the Timing of Autism Diagnosis, Intellectual Disability, and Educational Placement of Autistic Children in Singapore

AIM

Given Singapore's distinct multicultural identity, this study examined the hypotheses that there may be ethnic group differences in diagnosis and outcomes in autistic children in Singapore.

METHODS

Retrospective data were obtained from medical records of all children born between 2008 and 2011 who were diagnosed with clinical or confirmed autism. One-way ANOVAs and regression analyses were used to analyze data.

RESULTS

Data from 2577 medical records were extracted. There were more boys (82.5%) and ethnic group distribution was Chinese (67%), Malay (14%), Indian (10%), and Others (10%). Chinese children were more likely to present at a developmental clinic with concerns 3-4 months younger compared to Malay children and those from Other Races (F(3, 2038) = 9.58, p < .001, Cohen's F = 0.12). Chinese children were also more likely to receive an autism diagnosis approximately 3 months younger compared to Malay children. Fewer autistic Chinese children were diagnosed with co-occurring intellectual disability (13.1%) while there were almost twice more Malay children than expected with co-occurring intellectual disability (29.9%) (χ2 (3) = 55.17, p < .001). There are correspondingly more Malay children on the autism spectrum who attend special education schools. Possible confounding variables such as household income level and mother's level of education were identified in some of these findings.

CONCLUSION

Several significant ethnic group differences in autistic children in Singapore exist that warrant more investigation into possible causes and support systems needed, with implications for other ethnically diverse nations.

Contrasting Views of Autism Spectrum Traits in Adults, Especially in Self-Reports vs. Informant-Reports for Women High in Autism Spectrum Traits

There is uncertainty among researchers and clinicians about how to best measure autism spectrum dimensional traits in adults. In a sample of adults with high levels of autism spectrum traits and without intellectual disability (probands, n = 103) and their family members (n = 96), we sought to compare self vs. informant reports of autism spectrum-related traits and possible effects of sex on discrepancies. Using correlational analysis, we found poor agreement between self- and informant-report measures for probands, yet moderate agreement for family members. We found reporting discrepancy was greatest for female probands, often self-reporting more autism-related behaviors. Our findings suggest that autism spectrum traits are often underrecognized by informants, making self-report data important to collect in clinical and research settings.

Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care

PURPOSE

Despite advances in screening and awareness, Black and multiracial families continue to experience challenges when seeking an autism diagnosis for their children.

METHODS

We surveyed 400 Black and multiracial families of young children with autism from an existing research database in the United States about their retrospective diagnostic experiences. We gathered quantitative and qualitative data and engaged in iterative coding to understand timing and content of first concerns, families' experiences of care providers and systems, and the impact of race and culture on accessing care.

RESULTS

Families provided examples of early developmental concern and described provider, systemic, and cultural barriers and facilitators to care. Families also provided insight into the influence of culture and made recommendations on how the medical system could better care for Black and multiracial families of children with autism.

CONCLUSIONS

Results add to a growing body of literature supporting the need for culturally sensitive and accessible care related to developmental monitoring, diagnosis, and follow-up care for Black and multiracial children.

The effect of autism phenotype and diagnosis disclosure on students' desire for social distance from autistic peers

LAY ABSTRACT

Autistic students experience loneliness, rejection from peers, which might negatively affect both their well-being, as well as academic results. Others have studied this topic, however, the existing research does not analyze the desire for social distance from autistic female students in higher education. The goal of this study was to evaluate whether the way autism is expressed and disclosing the autism diagnosis had an effect on students' willingness to interact with autistic male and female students. We also analyzed participants' knowledge about autism, contact with autistic people in the past and its pleasantness in relation to their willingness to interact with autistic students described in the scenarios of the present study. We found that students were less willing to interact with autistic male students compared to autistic female students, as well as with autistic students whose diagnosis was not disclosed compared to autistic students whose diagnosis was disclosed to the raters. In addition, students who reported more pleasant contact with autistic individuals in the past were more willing to socially interact with autistic students if their diagnosis was disclosed. Students with higher knowledge of autism expressed greater willingness to interact with autistic males and autistic students regardless of diagnosis disclosure. Findings suggest that autistic males and individuals who prefer not to disclose their diagnosis are more vulnerable to social exclusion. More subtle expressions of autism need to be researched further.

Barriers to Healthcare for Latinx Autistic Children and Adolescents

PURPOSE

To understand the ways in which autistic Latinx children experience disparities in diagnosis, healthcare, and receipt of specialty services.

METHODS

417 individuals who identified as Latinx caregivers of autistic children who were members of the same integrated healthcare system in Northern California were surveyed. Responses were analyzed using the child's insurance coverage (Government or Commercial) and caregiver's primary language (Spanish or English).

RESULTS

Compared to the commercially-insured, government-insured participants accessed several services at a higher rate and were less likely to cite the high cost of co-pays as a barrier.

CONCLUSION

There were no significant differences in service access by language status, but Spanish speakers were more likely to cite health literacy as a barrier to receiving care.

First things first: An exploration of the effects of psychoeducation for older autistic adults

LAY ABSTRACT

After receiving an autism diagnosis, psychoeducation (i.e. information regarding autism) is a first intervention. We adjusted a psychoeducation program that was originally developed by the Dutch Association for Autism for older adults to enhance its feasibility and efficacy in later life. We expected that participants would report an increase in knowledge and acceptance of the diagnosis and that people close to them would also observe this. Indeed, we found this and participants and those close to them agreed on this. Furthermore, we found some evidence that older autistic adults were better at coping with their autism. We found no positive intervention effects on psychological distress. The feedback of participants and informants about the psychoeducation program was largely positive. In future research, we advise using larger group samples and larger time scales and we also advise to further adjust the program to the needs and requirements of older adults, and to help older autistic adults to construct a new narrative of themselves, and the life they have lived, in the light of the recent autism diagnosis.

Less Negative Implicit Attitudes Toward Autism Spectrum Disorder in University Students: A Comparison with Physical Disabilities

People with autism spectrum disorder (ASD) experience stigmatization rooted in negative attitudes or prejudice toward them due to social awkwardness. However, little is known about implicit attitudes toward ASD, especially differences in attitudes compared to those of more visible conditions; physical disabilities. In this study, we implemented implicit association tests (IATs) to assess implicit attitudes. Sixty-three university students participated in IATs and answered questionnaires that measured explicit attitudes, social desirability, knowledge about-and familiarity with-disorders. The results demonstrated that implicit attitude toward ASD was significantly less negative than toward physical disabilities. Regarding the discrepancy, not socially awkward behavior but appearance of people with ASD can be evaluated as 'in-group' members and lead to less negative attitude compared with physical disabilities.

The many faces of stigma after Acquired Brain Injury: a systematic review

Background Stigma after Acquired Brain Injury (ABI) has been described as a significant obstacle for the recovery of survivors. Despite its theoretical and clinical relevance, studies dedicated to stigma after ABI are just starting to emerge. The goal of this systematic review was to integrate the existing scientific evidence and develop a model of stigma after brain injury that can guide interventions at different levels. Method Three electronic databases were employed. A search strategy was adapted for each database. Articles that explored stigma in adult ABI populations were included. All articles used quantitative, qualitative or mixed method designs and were published in English, Spanish or Portuguese. Results A total of 21 articles were selected. They considered three types of stigma after ABI: (1) self-stigma, (2) stigma-by-association and (3) public stigma. It was also found that information can be processed at implicit and explicit levels across all three forms of stigma. Definitions of each type of stigma used with ABIs are provided as well as related concepts and theoretical frameworks employed. Evidence emerging from different forms of stigma after ABI is summarised. Conclusion Research on stigma after ABI is heterogeneous, and existing studies have explored its impact at individual, family and public levels. A model of stigma after ABI should consider all these levels as well as the interactions that can occur between them. Future studies should explore how to incorporate stigma management as part of neuropsychological rehabilitation programs.

Right amygdala and caudate activation patterns predict implicit attitudes toward people with autism spectrum disorders and physical disabilities, respectively

Attitudes toward people with disabilities tend to be negative, regardless of the visibility of the disorder traits. Individuals with autism spectrum disorder (ASD) experience stigmatization that is rooted in negative attitudes or prejudice toward them because of their social awkwardness. The neural underpinnings of attitudes toward people with disabilities remain unclear. In this study, we focused on implicit attitudes toward people with ASD and physical disabilities, which are more visible than ASD, and investigated whether implicit attitudes were predicted by using neural activity with multivoxel pattern analysis (MVPA) in the prejudice network. Thirty-six, right-handed, Japanese, university students without disabilities participated. Two implicit association tests (IAT) toward people with ASD and physical disabilities revealed negative implicit attitudes. In the MRI scanner, participants performed a one-back task by using the same picture sets of IATs to examine their neural responses toward people with ASD and physical disabilities. According to the MVPA results, activation patterns of the right amygdala and right caudate significantly predicted implicit attitudes toward people with ASD and physical disabilities, respectively. These results suggest that implicit attitudes toward ASD and physical disabilities can be predicted by using neural signals from different regions within the prejudice network.

Sensory Integration Approaches for Children and Youth in Occupational Therapy Practice

This AOTA Position Statement describes the role of occupational therapy practitioners in providing services to children and youth with a variety of sensory processing patterns and sensory integrative dysfunction. It also serves as a resource for policymakers, funding and reimbursement sources, and caregivers.

Do Autistic People's Support Needs and Non-Autistic People's Support for the Neurodiversity Movement Contribute to Heightened Autism Stigma in South Korea vs. the US?

We examined stigma towards vignette characters representing diverse autistic characteristics (social, non-speaking, or repetitive interests or restricted behaviors; RIRB) among 259 South Korean and 240 American participants (age range = 18 ~ 74). Within each domain, participants were randomized to read a vignette depicting low or high support needs. Koreans reported greater stigma towards autistic characteristics and less awareness of and support for the neurodiversity movement than Americans. Autistic characters' support needs and rater characteristics (autism knowledge, neurodiversity endorsement, and contact quantity) predicted stigma in at least one domain, and after accounting for these variables, participants' nationality was suggestively associated only with stigma towards social characteristics and RIRB. Findings highlight the need for culturally adapted-training that provides contact with diverse autistic people.

Autism, thy name is man: Exploring implicit and explicit gender bias in autism perceptions

Males are around three times more likely to possess an autism diagnosis than females. For years this was explained by accounts that considered the male gender more compatible with the autistic phenotype. However, new research suggests that a lack of understanding and recognition of the female autistic phenotype, and a predisposition to associate males with autistic traits, could lead to structural inequalities that hinder the identification of autistic females. To explore how autism and gender are more widely perceived, the present study tested implicit and explicit associations between autism and binary gender using the Implicit Association Test (IAT) and the Autism Quotient (AQ) presented alongside a male or female vignette. A significant association was found on the IAT, identifying an implicit bias towards males and autistic traits. The vignette AQ pairing also revealed some specific items perceived as explicitly male traits, while only reverse-scored items were perceived as female. These findings suggest that current perceptions and even metrics of autism are skewed towards males, which may hinder the identification and understanding of the female autistic phenotype.

Caregiver Perceptions of Social Communication and Interaction: Development and Validation of the SCIPS

Social communication and interaction (SC/I) skill quality may be influenced by cultural values, norms, and expectations. Because difficulties in SC/I is a core criterion for identifying autism and is a frequent construct of interest in autism research, a measure designed to capture cross-cultural differences in the perspectives of SC/I skills is warranted. To address this need we developed and validated the Social Communication and Interaction Perceptions Scale (SCIPS), a caregiver report measure for children ages 6-18 years, that measures both frequency and perceived importance of various SC/I skills. Results from 401 diverse caregiver participants showed that for both domains (i.e., Frequency and Importance) the SCIPS has good reliability (α = 0.88-0.95) and two factors that examine basic and advanced aspects of SC/I skills. Findings support the use of the SCIPS as a measure of caregiver perspectives of SC/I skills in clinical and research contexts.

The importance of disability representation to address implicit bias in the workplace

Introduction

People are disabled by barriers in society, not by their impairment. Barriers can be physical or be caused by people's implicit and explicit attitudes towards people with disabilities.

Methods

We utilise the Implicit Association Test to investigate implicit attitudes towards people with disabilities among Human Resource professionals and people involved in making hiring decisions.

Results

We find no significant differences between people who work for large companies or Small- to Medium-sized Enterprises. Similarly, working in Human Resources (or making recruitment decisions) has no effect on implicit bias. We supply the first evidence linking a person's own health status (measured using EQ-5D-5L) to their implicit bias. We find that a worse health status is associated with lower implicit bias towards people with disabilities. In addition, we find women have lower implicit bias than men.

Discussion

The discussion reflects on the need for greater disability representation within the workplace - especially in making hiring decisions.

Explicit stigma and implicit biases toward autism in South Korea versus the United States

This cross-cultural study examined Koreans’ and Americans’ explicit stigma and implicit biases toward autism to examine potential mechanisms underlying recent evidence for heightened explicit autism stigma in South Korea relative to the United States. This evidence is somewhat at odds with other evidence that individuals living in collectivistic cultures such as South Korea may be more prone to present themselves favorably than those living in relatively individualistic cultures such as the United States. A total 224 American and 536 Korean non-autistic adult participants completed an online survey. Implicit biases were measured using the implicit association test. Koreans reported greater explicit stigma and exhibited more implicit biases toward autism than Americans. Explicit stigma was not correlated with implicit biases in either country. Less autism knowledge and pleasant contact with autistic people predicted greater explicit stigma among both Koreans and Americans. Less frequent contact and heightened assimilation ideology toward ethnic minorities predicted greater stigma only among Koreans. The variance in implicit biases explained by predictors was small, emphasizing the need for follow-up research investigating predictors of implicit biases. Informing Koreans about the shortcomings of assimilationist approaches and fostering an appreciation of the plurality of cultures may reduce stigma toward autistic individuals in South Korea.

Lay abstract

How people report their feelings about autism may be different from how they actually think about autism because some people may not want to reveal their true feelings. People who value the group’s goal tend to present themselves as more socially acceptable than people who value one person’s interests. We studied how people in South Korea and the United States report their feelings about autism and think about autism. Koreans tend to value the group’s goals. Americans tend to prefer one person’s goals. Koreans reported that they wanted more space from autistic people than Americans did. Koreans were more likely to think about autism with negative words (and think more negatively about autism). How Koreans and Americans report their feelings about autism was not related to their thoughts about autism. People who knew about autism and liked meeting with autistic people wanted to get closer to autistic people in South Korea and the US, Koreans who had met autistic people and thought that people who newly came to Korea from abroad should be more like Koreans did not want to get very close to autistic people. This could be because very few foreign people live in South Korea compared to the United States. Teaching Koreans that all cultures have values and should be appreciated will help them like autistic people more.

Black Families' Experiences of Developmental Screening: Review of Well-Child Visits to Inform Enhanced Autism Spectrum Disorder Risk Assessment

OBJECTIVE

Black families face barriers to early diagnosis of autism spectrum disorder (ASD). Most work emphasizes systemic delays to diagnosis rather than how existing screening procedures may affect identification. Our goal was to examine pediatric care visits in which screening was most likely to occur to document behaviors of parents and providers.

METHODS

We examined 18- to 36-month primary care visits in our electronic health record system (n = 99) of thirty-nine 4- and 8-year-old Black children later diagnosed with ASD. We extracted qualitative and quantitative data and engaged in consensus coding. We captured whether formal screening occurred, the content of concerns of parents and providers, and referral patterns for follow-up care or evaluation.

RESULTS

Consistent with existing work, we found differences in parent and provider concerns and discrepancies in referral rates. Parents often endorsed concerns about language, sleeping or eating habits, behavior, or motor skills rather than ASD, but specific mention of ASD as a concern increased over time. Referrals for follow-up care were more likely when providers, not parents alone, expressed concerns about patient development.

CONCLUSION

Pediatric providers cannot place the burden on families to raise autism concerns. Although some level of developmental risk was noted at most visits for children later diagnosed with ASD, referrals were only made when providers were also concerned, and most of these were for speech-language evaluation. Ongoing work is necessary to better understand how existing care systems interact with diverse families to inform the creation of inclusive screening practices that mitigate diagnostic delays.

Autism presentation in female and Black populations: Examining the roles of identity, theory, and systemic inequalities

LAY ABSTRACT

Although the prevalence of autism has been rising in recent years, disparities in diagnosis still remain. Female and Black populations in the United States are diagnosed later, are more likely to have an intellectual disability, and are excluded from research as well as services designed for autistic individuals. Autistic Black girls are effectively invisible in the current scientific literature. Intersectional theory, which looks at a person as a whole, examines models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. This theory may be a useful approach to clinical and research work with autism so that practitioners may be most effective for the whole population of autistic people. The authors recommend research focusing on inclusion of autistic populations with intellectual disability and research studies that include evaluations as part of the procedure. Clinically, the authors recommend a focus on screening all young children for autism and improving provider knowledge in working with diverse autistic populations.

Sensory features in autism: Findings from a large population-based surveillance system

Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population‐based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co‐occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four‐ or eight‐year‐old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006–2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%–74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non‐Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population‐based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co‐occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems.

Cultural differences in social communication and interaction: A gap in autism research

Social communication and interaction deficits are a diagnostic criteria of autism and integral to practitioner and researcher conceptualization. Culture is an influential factor in expectations for, and demonstration of, social communication and interaction skills, but there is limited research published in autism journals on this topic. This paucity of autism research examining cultural factors related to social communication and interaction may contribute to known identification disparities for racial and ethnic populations minoritized by systemic factors and research bias. We call for increased commitment from researchers to recruit racially and ethnically minoritized participants, prioritize investigating cultural expectations and perceptions of social communication and interaction, and evaluate measures related to social communication for cultural and linguistic responsivity. LAY SUMMARY: A diagnosis of autism requires the presence of deficits in social communication and interaction. Examples of these behaviors and skills include holding a back-and-forth conversation, the use of nonverbal communicative behaviors (e.g., gestures), and developing and maintaining social relationships. Culture influences the expectations for, and presentation of, these behaviors. However, research on this topic is lacking. Conducting more research related to culture and social communication could help reduce the disparities in autism identification across racially and ethnically minoritized populations.

Influences of student race/ethnicity and gender on autism special education classification considerations

LAY ABSTRACT

Autism prevalence has continued to rise in recent years. However, females and children from Black, Latinx, and Asian backgrounds are often misidentified or identified less often than White males. These identification disparities make it difficult for children to receive appropriate special education and school intervention services. In this study, school psychologists read a vignette featuring a student with possible autism symptoms. The vignette varied by student race/ethnicity and gender. Afterward, participants rated the likelihood that they would classify the student with autism and their confidence in this rating. Student race/ethnicity and gender influenced both classification likelihood and confidence. These results suggest that school psychologists are influenced by implicit bias and do not fully consider cultural factors in school autism evaluations. This may contribute to identification disparities.

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

LAY ABSTRACT

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

Is autism stigma higher in South Korea than the United States? Examining cultural tightness, intergroup bias, and concerns about heredity as contributors to heightened autism stigma

LAY ABSTRACT

Misunderstandings about autism may be more common in South Korea than the United States. Koreans often have clear ideas about how people should act. Another way of saying this is that Korea has a tight culture. Americans are looser, meaning people are freer to act as they like. Autistic people often do not act as people expect them to. This makes autistic people stand out. Autistic people may stand out more in tight cultures like South Korea. We studied how people in South Korea and the United States feel about autism. We wanted to see why Korean people might reject autistic people more than people in the United States do. American and Korean people did online surveys. Koreans said they did not want to get close to autistic people more than Americans did. People who understood autism and had met and liked autistic people wanted to get closer to autistic people. We were surprised to learn that Americans said having an autistic brother or sister makes it harder to find a romantic partner more than Korean people did. People who believed that autism makes it harder for family members to find love did not want to get very close to autistic people. Koreans said people should act as expected more than Americans did. People who believed that acting as expected was important did not want to get very close to autistic people. Teaching people that there are many ways of being a good person may help them understand and appreciate autistic people.