Language Preferences in the Dutch Autism Community: A Social Psychological Approach

Mental health care use of autistic adults: Identifying longitudinal patterns using sequence analysis

To improve mental health care for autistic adults, a better understanding of their real-world intervention use is required. The aim of this study is to investigate individual differences in the intervention trajectories of autistic adults, by examining longitudinal patterns of therapy, counseling, and medication use. Self-reported intervention use of 445 autistic adults (18-87 years) across at least five consecutive measurements (2015-2021) was collected to identify clusters using sequence analysis and hierarchical clustering. Sensitivity analyses and cross-method validation (group-based multivariate trajectory modeling) were used to verify the obtained clusters. Four out of five obtained clusters had sufficient internal consistency and were replicated. These four clusters had distinct intervention trajectories (least intervention, mostly counseling, mostly medication, mixed use) and differed on several demographic variables. Most notably, the "mixed cluster" contained relatively more females and individuals with self-reported co-occurring psychiatric conditions. Many autistic adults used interventions, although they varied in type and duration of intervention use. This reflects the clinical complexity of tailoring intervention approaches and highlights that accessible and multidisciplinary care is essential to adequately support autistic adults. An important next step is to investigate whether available interventions sufficiently support autistic females and those with co-occurring psychiatric conditions.Lay abstractMany autistic adults experience co-occurring mental health problems, which have a negative effect on their well-being and result in increased use of mental health services. To improve mental healthcare for autistic adults, a better understanding is needed of what type of support they use in real life. Clinical guidelines recommend three kinds of mental health interventions: therapy, counseling, and medication. We investigated the use of these types of interventions in a sample of 445 autistic adults (aged 18-87 years) across a 5-to-7-year period. We found evidence for four different patterns of intervention use, or so-called subgroups: (1) least intervention use, (2) mostly counseling, (3) mostly medication, and (4) mixed intervention use. The group with mixed intervention use consisted of relatively more females and individuals with co-occurring psychiatric conditions, especially compared to the subgroup with the least intervention use. It appeared that many, but not all, autistic individuals used mental health services for an extended period. However, there was considerable variability in the type, combination, and duration of intervention use. This means that determining the optimal support for autistic adults is often a complex task, which requires collaboration of clinical experts and autistic individuals themselves, to make informed decisions.

Adults with Autism Prefer Person-First Language in Dutch: A Cross-Country Study

The correct language to refer to someone with a diagnosis of autism spectrum disorder has received a lot of attention in recent years. Studies in English-speaking countries found a main identity-first language (IFL) preference (e.g. autistic person) opposed to a person-first language preference (PFL) (e.g. person with autism) among adults with autism. However, a recent study conducted in a Dutch-speaking country (the Netherlands) reported a PFL preference (Buijsman et al., 2023). The goal of the current study was to gain insights into language preferences in two Dutch-speaking countries and, in contrast to previous studies, give participants the option to indicate not having a specific language preference. In the current study, we asked 414 Dutch-speaking adults with autism, living either in Belgium or the Netherlands, to fill in an online questionnaire about their language preference. We found that over half of the participants had a PFL preference (54%), followed by having no preference (27%). Only 14% of them had an IFL preference, and 5% proposed another term. Having more years of education was identified as a predictor for having an IFL preference when compared to a PFL preference, while being older predicted having no preference compared to a PFL preference. The majority of Dutch-speaking adults with autism showed a PFL preference, which is in contrast to findings from English-speaking countries, but in accord with a recent study conducted in the Netherlands (Buijsman et al., 2023). Implications of this finding for language use are discussed.

Person-first and identity-first language: A text-mining exploration of how geneticists discuss autism

Introduction: Current discussions surround whether 'person-first language' (PFL) such as 'patient with autism' and 'identity-first language' (IFL) such as 'autistic patient' is most sensitive and appropriate. There is language guidance when talking about disability and race, ethnicity, and ancestry in genetics research, but not around PFL and IFL. We applied natural language processing (NLP) methods to PFL and IFL in published in genetics research, focussing on Autism Spectrum Disorders (ASD). Methods: Of the approximately 38,000 abstracts accepted in European Society of Human Genetics (ESHG) conference between 2001 and 2021, almost 5000 contained autism keywords. NLP analysis of these explored PFL and IFL use over time, in combination with specific nouns, and in combination with each other. Results: 262 instances of PFL and 264 instances of IFL showed similar, common and consistent use over time. Straightforward matches (e.g. 'patient with ASD' or 'ASD patient') accounted for most uses, with subtle differences in the frequently co-occurring nouns. 50 abstracts used both patterns, typically with one example of each. Conclusions: NLP can quantify use, timing and context for PFL and IFL in research articles. Consequently, NLP can support the development of language style guidelines or to evaluate their effectiveness.