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Shaw SC, Carravallah L, Johnson M, O'Sullivan J, Chown N, Neilson S, Doherty M. Barriers to healthcare and a 'triple empathy problem' may lead to adverse outcomes for autistic adults: A qualitative study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1746-1757. [PMID: 37846479 DOI: 10.1177/13623613231205629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
LAY ABSTRACT Autistic people live with more mental and physical health conditions and, on average, die younger than non-autistic people. Despite widespread commitments to tackling these issues, autistic people still report various barriers to accessing healthcare. This article aims to explore the area in depth, from the perspective of autistic people. This research benefits from being led by autistic people, for autistic people - all of the researchers are autistic, and most of us are also medical doctors. Data, in the form of written comments and stories, were collected as part of a large survey. Here, we explored these for common themes and possible deeper meaning within the experiences. People who took part reported a variety of barriers. Here, our article gives voice to their stories, in their own words. Themes included: early barriers; communication mismatch; doubt - in oneself and from doctors; helplessness and fear; and healthcare avoidance and adverse health outcomes. Our findings allowed us to create a model that aimed to understand and explain the reported barriers in the context of the previously known consequences. We also built on wider autism theories to explain our findings in more depth.
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Brady MJ, Jenkins CA, Gamble-Turner JM, Moseley RL, Janse van Rensburg M, Matthews RJ. "A perfect storm": Autistic experiences of menopause and midlife. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1405-1418. [PMID: 38622794 PMCID: PMC11135000 DOI: 10.1177/13623613241244548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
LAY ABSTRACT Previous studies report that menopause can be a very difficult transition for some autistic people. This study focuses on how autistic people experience menopause and what support and information might help them. Autistic Community Research Associates played an important role in the research and co-authored this article. We held four focus groups and eight interviews online with 24 autistic participants who lived in either Canada (n = 13) or the United Kingdom (n = 11). We analysed participant conversations using a method called reflexive thematic analysis. Participants described many intense challenges during menopause. Four themes and eight subthemes were identified across participant groups: (1) Complexity, multiplicity and intensity of symptoms (0 subthemes); (2) Life experience and adversity converging at midlife (three subthemes); (3) The importance of knowledge and connection (two subthemes); and (4) Barriers to support and care (three subthemes). The experiences of our participants may not be the same as other autistic people, and the study could have been more inclusive of diverse autistic groups. However, hearing about the experiences of others may provide reassurance to autistic people who struggle with menopause and let them know they are not alone.
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Cai CQ, White SJ, Chen SHY, Mueller MAE, Scott SK. Autistic adults perceive and experience laughter differently to non-autistic adults. Sci Rep 2024; 14:11590. [PMID: 38773178 PMCID: PMC11109116 DOI: 10.1038/s41598-024-56903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/11/2024] [Indexed: 05/23/2024] Open
Abstract
Human interaction is immersed in laughter; though genuine and posed laughter are acoustically distinct, they are both crucial socio-emotional signals. In this novel study, autistic and non-autistic adults explicitly rated the affective properties of genuine and posed laughter. Additionally, we explored whether their self-reported everyday experiences with laughter differ. Both groups could differentiate between these two types of laughter. However, autistic adults rated posed laughter as more authentic and emotionally arousing than non-autistic adults, perceiving it to be similar to genuine laughter. Autistic adults reported laughing less, deriving less enjoyment from laughter, and experiencing difficulty in understanding the social meaning of other people's laughter compared to non-autistic people. Despite these differences, autistic adults reported using laughter socially as often as non-autistic adults, leveraging it to mediate social contexts. Our findings suggest that autistic adults show subtle differences in their perception of laughter, which may be associated with their struggles in comprehending the social meaning of laughter, as well as their diminished frequency and enjoyment of laughter in everyday scenarios. By combining experimental evidence with first-person experiences, this study suggests that autistic adults likely employ different strategies to understand laughter in everyday contexts, potentially leaving them socially vulnerable in communication.
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Affiliation(s)
- Ceci Q Cai
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AZ, UK
| | - Sarah J White
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AZ, UK
| | - Sinead H Y Chen
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AZ, UK
| | - Marie A E Mueller
- Epidemiology and Applied Clinical Research, Division of Psychiatry, University College London, London, W1T 7BN, UK
| | - Sophie K Scott
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AZ, UK.
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McMaughan DJ, Lewis C, McGehee A, Noreen D, Parker E, Criss MM. Meaningful Social Inclusion and Mental Well-Being Among Autistic Adolescents and Emerging Adults: Protocol for a Community-Based Mixed Methods Study. JMIR Res Protoc 2024; 13:e52658. [PMID: 38483470 PMCID: PMC10979331 DOI: 10.2196/52658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND In the United States, autistic people face high rates of co-occurring mental illnesses and premature death due to self-harm, which are indicators of threats to mental well-being. Social inclusion may enhance mental well-being and resilience among autistic people. According to Simplican and colleague's (2015) model of social inclusion for people with intellectual and developmental disabilities, social inclusion is an interaction between community participation and interpersonal relationships. There is limited research on social inclusion that includes the integration of interpersonal relationships and community participation among autistic people or the impact of social inclusion on the well-being of autistic people. Additionally, little evidence exists regarding how autistic people prefer to be included in the community or form interpersonal relationships. OBJECTIVE The long-term objective of this project is to improve social inclusion factors to support the mental well-being of autistic people. This protocol describes a community-based, mixed methods pilot study to develop a definition of meaningful social inclusion for autistic people and to understand the relationship between meaningful social inclusion and mental well-being among autistic adolescents and emerging adults. METHODS The project uses a community-based, sequential mixed methods design with a formative phase (Phase 1) that informs a survey phase (Phase 2) and concludes with a process evaluation of the community engagement process (Phase 3). During Phase 1, we will recruit 10 community partners (autistic adults and stakeholders) and conduct sharing sessions to cocreate a definition of meaningful social inclusion and a survey of meaningful social inclusion and well-being. During Phase 2, we will recruit 200 participants (100 autistic adolescents and emerging adults and 100 caregivers) to complete the survey. We will examine whether meaningful social inclusion predicts well-being given sociodemographic factors using ordered logistic regression, with well-being categorized as low, medium, and high. During Phase 3, the community partners from Phase 1 will complete a survey on their experiences with the project. RESULTS Ethics approval was obtained for this project in March 2023. We have recruited community partners and started the Phase 1 focus groups as of September 2023. Phase 2 and Phase 3 have not yet started. We expect to complete this study by March 2025. CONCLUSIONS Using a community-based, mixed methods approach, we intended to develop a definition of meaningful social inclusion for autistic people and understand the role meaningful social inclusion plays in the well-being of autistic people. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52658.
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Affiliation(s)
- Darcy Jones McMaughan
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Casey Lewis
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Amy McGehee
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Dani Noreen
- Neurodiversity Unbound, Aurora, CO, United States
| | - Elliot Parker
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
| | - Michael M Criss
- Human Development and Family Science, Oklahoma State University, Stillwater, OK, United States
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O'Loghlen JJ, Lang CP. High Autistic Traits or Low Social Competence? Correlates of Social Camouflaging in Non-Autistic Adults. AUTISM IN ADULTHOOD 2024; 6:60-71. [PMID: 38435328 PMCID: PMC10902277 DOI: 10.1089/aut.2022.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background Autistic traits have been linked with the use of social camouflaging behavior by non-autistic people. In addition, low social competence (i.e., poor social skills) has also been posited as a possible explanation for the use of social camouflaging by non-autistic people. In this study, we investigated the comparative influence of autistic traits and social competence on three components of social camouflaging (compensation, masking, and assimilation) in a sample of non-autistic adults. Methods Using a cross-sectional design, we recruited 284 undergraduate students (28.5% male; 69.7% female; 1.8% not specified) who reported that they had never been diagnosed with autism. Participants completed standardized measures assessing social camouflaging, autistic traits, social competence, and psychological distress via an online questionnaire. Results We found that women reported greater use of social camouflaging, and greater social camouflaging use was associated with worse psychological distress. We also found that both social competence and autistic traits were associated with the use of social camouflaging, with higher autistic traits influencing camouflaging use to a greater degree than low social competence. Compared with the use of compensation- and assimilation-based social camouflaging, masking was the least well explained by the current predictors. Conclusions We conclude that social competence and autistic traits are important factors influencing the use of social camouflaging by non-autistic adults. However, there are other (unknown) factors that contribute to the use of each aspect of camouflaging by non-autistic individuals, and a deeper understanding of the individual motivations for social camouflaging use is still needed. In turn, this may allow for the development of psychosocial interventions to offset the need for social camouflaging and mitigate the negative psychological consequences often associated with its use.
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Affiliation(s)
| | - Cathryne P. Lang
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
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Lei J, Leigh E, Charman T, Russell A, Hollocks MJ. Understanding the relationship between social camouflaging in autism and safety behaviours in social anxiety in autistic and non-autistic adolescents. J Child Psychol Psychiatry 2024; 65:285-297. [PMID: 37632264 DOI: 10.1111/jcpp.13884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Social camouflaging (hereafter camouflaging) in autism includes factors such as masking and compensating for one's neurodevelopmental differences, and to assimilate or 'fit in' with non-autistic peers. Efforts to hide one's authentic self and autism traits (masking) resemble impression management (IM) in safety behaviours identified in Clark and Wells' (1995) cognitive model of social anxiety (SA). This study explores the relationship between camouflaging in autism and safety behaviours in SA among autistic and non-autistic adolescents. METHODS One hundred fifteen adolescents (14-19 years) with (n = 61; 36 female) and without (n = 54; 37 female) a clinical diagnosis of autism matched on age and SA symptom severity were recruited from clinics, schools and online. Adolescents completed online measures including autism traits, SA symptoms, camouflaging behaviours, SA-related safety behaviours and SA-related negative cognitions. Partial and bivariate Pearson's correlations and structural equation modelling were used to understand the relationship between camouflaging, safety behaviours, autism traits and SA in both groups. Exploratory factor analysis assessed item-level factor cross-loadings between camouflaging and safety behaviours. RESULTS Across both groups, masking and IM were significantly associated with SA symptom severity, not autism traits, via SA-related social cognitions. Exploratory factor analysis indicated construct overlap across masking, assimilation, IM and avoidance behaviours and identified factors analogous to self-focused attention, social avoidance and mental rehearsal identified in the Clark and Wells' (1995) model of SA. CONCLUSIONS This is the first study using group-matched design to identify that masking (factor in social camouflaging) and IM both relate to SA in autistic and non-autistic adolescents. Assessment and formulation of construct overlap between masking and IM may inform psychoeducation and adaptation of SA treatment for autistic adolescents.
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Affiliation(s)
- Jiedi Lei
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Trust, London, UK
| | - Eleanor Leigh
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Trust, London, UK
| | - Ailsa Russell
- Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, UK
| | - Matthew J Hollocks
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Trust, London, UK
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Schweizer T, Endres D, Dziobek I, Tebartz van Elst L. Psychosocial therapeutic approaches for high-functioning autistic adults. Front Psychiatry 2024; 14:1265066. [PMID: 38274434 PMCID: PMC10808656 DOI: 10.3389/fpsyt.2023.1265066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Autism spectrum disorder (ASD) is characterized by impaired social interaction and communication skills, repetitive behaviors, restricted interests, and specific sensory processing. Particularly, adults with high-functioning ASD often remain unrecognized, presumably due to their high compensatory skills, but at the cost of high stress, which is often linked to anxiety and depression. This may further explain the significantly high suicide rates and reduced life expectancy among individuals with ASD. Thus, providing support to high-functioning autistic adults in managing core symptoms, as well as co-occurring anxiety and depression, appears essential. To date, only a limited number of evidence-based psychosocial therapeutic options are available, and very few of them have undergone rigorous evaluation in a clinical context. To obtain a comprehensive understanding, a systematic literature search was conducted according to the PRISMA checklist, and only studies demonstrating robust methodological quality were included and discussed in this review article. Although promising initial key factors and methods have been identified, additional evidence-based studies are imperative to ascertain the optimal treatment and evaluate the long-term outcomes for adults with high-functioning ASD.
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Affiliation(s)
- Tina Schweizer
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Isabel Dziobek
- Department of Psychology, Clinical Psychology of Social Interaction, Faculty of Life Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Oshima F, Takahashi T, Tamura M, Guan S, Seto M, Hull L, Mandy W, Tsuchiya K, Shimizu E. The association between social camouflage and mental health among autistic people in Japan and the UK: a cross-cultural study. Mol Autism 2024; 15:1. [PMID: 38178255 PMCID: PMC10768303 DOI: 10.1186/s13229-023-00579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To examine the relationship between social camouflage and mental health in Japanese autistic adults and make an international comparison with a sample from the UK. METHODS This study analysed secondary data of participants with a self-reported diagnosis of autism from Japan (N = 210; 123 men and 87 women) and the UK (N = 305; 181 women, 104, men, and 18 nonbinary). The relationships between the quadratic term of the Camouflaging Autistic Traits Questionnaire and mental health scales, including depression and anxiety, were assessed. RESULTS The UK sample showed linear relationships, whereas the Japanese sample showed significant nonlinear relationships. The quadratic terms of the Camouflaging Autistic Traits Questionnaire slightly explained generalised anxiety (β = .168, p = .007), depression (β = .121, p = .045), and well-being (β = - .127, p = .028). However, they did not explain the association between social anxiety and the Camouflaging Autistic Traits Questionnaire. LIMITATIONS Participants had self-reported diagnoses, and while the autism-spectrum quotient provides a cut-off value for screening, it does not enable confirming diagnoses. Mean scores of the Japanese version of the Camouflaging Autistic Traits Questionnaire were lower as compared to the original CAT-Q, which implies that the social camouflage strategy types used by autistic people in Japan and the UK could differ. The cross-sectional design limits causal inferences. CONCLUSION In the UK, more social camouflage was associated with poorer mental health scores, whereas too little or too much social camouflage was associated with a low mental health score in Japan. The Japanese population is seemingly less aware of and educated on autistic characteristics and considers 'average' behaviour a good thing. This could influence Japanese autistic people's social camouflage use, differing from that of autistic people in the UK. The differences in the relationship between social camouflage and mental health between Japan and the UK could be associated with national-level divergence regarding the culture of autism.
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan.
| | - Toru Takahashi
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masaki Tamura
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Siqing Guan
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
| | - Laura Hull
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Mandy
- Research Department for Clinical, Educational & Health Psychology, University College London, London, UK
| | - Kenji Tsuchiya
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Petty S, Allen S, Pickup H, Woodier B. A Blog-Based Study of Autistic Adults' Experiences of Aloneness and Connection and the Interplay with Well-Being: Corpus-Based and Thematic Analyses. AUTISM IN ADULTHOOD 2023; 5:437-449. [PMID: 38116056 PMCID: PMC10726169 DOI: 10.1089/aut.2022.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Background Autistic adults appear to be more vulnerable to mental ill health, with loneliness being a variable associated with multiple outcomes of poorer well-being. However, a description of meaningful social connection that is suitable for autistic adults is missing from this research, along with a missing understanding of the conditions that contribute to well-being. Methods In this study, autistic adults' experiences of connectedness and aloneness were systematically searched for within data collected from blogs. This contributed a creative method to hear the viewpoint of autistic adults. Corpus-based and thematic analyses explored the descriptions and contexts of relationships. A total of 16 autistic authors contributed views. Results Social connection was desired and was achieved through self-acceptance and rejecting deficit-based views of being autistic, and selectively choosing important relationships. Meaningful social connection changed over time, being more difficult to attain in childhood, and benefiting from self-learning and effortfully applying neuro-normative skills in social communication. Loneliness was only described alongside other causes of unhappiness and was not associated with being autistic. Conclusions The findings offer some explanation for the high estimates of both loneliness and mental ill health for autistic adults. We consider the implications for autistic individuals, clinicians, educators, and researchers. We are also cautious not to imply that these views reflect all autistic people. The findings suggest that improvements are needed in society to share communication differences and relationship expectations for autistic individuals to be accepted and valued.
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Affiliation(s)
- Stephanie Petty
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Shannon Allen
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Hannah Pickup
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Bethannie Woodier
- Department of Psychology, School of Education, Language and Psychology, York St John University, York, United Kingdom
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Levy RS, Fipp-Rosenfield HL, Lee JP, Grauzer JM, Roberts MY. Understanding Internalizing and Externalizing Behaviors in Autistic Toddlers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2908-2921. [PMID: 37748023 PMCID: PMC10721242 DOI: 10.1044/2023_ajslp-23-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/31/2023] [Accepted: 07/30/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The majority of autistic toddlers present with clinically significant levels of internalizing or externalizing behaviors. Despite the prevalence of internalizing and externalizing behaviors in caseloads, the overwhelming majority of speech-language pathologists (SLPs) have not received specialized instruction in how to support children with these behaviors. The purpose of this study was to identify which child and caregiver characteristics are most associated with internalizing and externalizing behaviors in autistic toddlers in order to consider how SLPs may tailor their treatment to better support the individual needs of autistic children. METHOD Participants included 109 mothers and their autistic children between 18 and 48 months of age. This study was a secondary analysis of data from a randomized clinical trial. Participants' baseline data included a variety of child (i.e., expressive language, receptive language, restricted and repetitive behavior [RRB], and nonverbal cognition) and caregiver (i.e., self-efficacy and responsiveness) characteristics. Seemingly unrelated regressions were conducted to determine which characteristics were associated with internalizing and externalizing behaviors in autistic toddlers. RESULTS Higher RRB scores were associated with both higher internalizing and externalizing behavior scores. A lower nonverbal cognition score was also associated with higher internalizing behavior scores but to a lesser extent than RRB. CONCLUSION These findings suggest that SLPs may support internalizing and externalizing behaviors in autistic children by taking RRBs and nonverbal cognition into consideration.
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Affiliation(s)
- Rachel S. Levy
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Hannah L. Fipp-Rosenfield
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jordan P. Lee
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jeffrey M. Grauzer
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Megan Y. Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Zhuang S, Tan DW, Reddrop S, Dean L, Maybery M, Magiati I. Psychosocial factors associated with camouflaging in autistic people and its relationship with mental health and well-being: A mixed methods systematic review. Clin Psychol Rev 2023; 105:102335. [PMID: 37741059 DOI: 10.1016/j.cpr.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 08/20/2023] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
Camouflaging involves hiding one's autistic characteristics in social situations. This mixed methods systematic review synthesized research on psychosocial factors associated with camouflaging and its relationship with mental well-being. Six databases were searched. The 58 included studies (40 qualitative, 13 quantitative, five mixed methods), encompassed 4808 autistic and 1780 non-autistic participants, and predominantly featured White, female, and late-diagnosed autistic adults with likely at least average intellectual and/or verbal abilities. Following a convergent integrated approach, quantitative data were transformed and synthesized with qualitative data for thematic synthesis. We identified three themes on psychosocial correlates of camouflaging: (1) social norms and pressures of a largely non-autistic world, (2) social acceptance and rejection, and (3) self-esteem and identity; and four themes on psychosocial consequences of camouflaging for well-being: (1) a pragmatic way of exerting individual agency and control; (2) overlooked, under-supported, and burnt out; (3) impact on social relationships; and (4) low self-esteem and identity confusion. Camouflaging emerges as primarily a socially motivated response linked to adverse psychosocial outcomes. A whole society approach towards acceptance and support for autistic individuals to express their authentic selves is needed. Future studies examining psychosocial influences on camouflaging should include participants who more broadly represent the autistic population.
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Affiliation(s)
- Sici Zhuang
- School of Psychological Science, The University of Western Australia, Australia.
| | - Diana Weiting Tan
- School of Psychological Science, The University of Western Australia, Australia; Macquarie School of Education, Macquarie University, Australia
| | | | - Lydia Dean
- Autistic Consultant, Western Australia, Australia
| | - Murray Maybery
- School of Psychological Science, The University of Western Australia, Australia
| | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Australia
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Gibson MT, Schmidt-Kassow M, Paulmann S. How neurotypical listeners recognize emotions expressed through vocal cues by speakers with high-functioning autism. PLoS One 2023; 18:e0293233. [PMID: 37874793 PMCID: PMC10597502 DOI: 10.1371/journal.pone.0293233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
We conducted an investigation to explore how neurotypical (NT) listeners perceive the emotional tone of voice in sentences spoken by individuals with high-functioning autism spectrum disorders (ASD) and NT speakers. The investigation included both male and female speakers from both groups. In Study 1, NT listeners were asked to identify the emotional prosody (anger, fear, happiness, surprise or neutral) conveyed by the speakers. Results revealed that emotional expressions produced by male ASD speakers were generally less accurately recognized compared to male NT speakers. In contrast, emotions expressed by female ASD speakers were more accurately categorized compared to female NT speakers, except when expressing fear. This suggests that female ASD speakers may not express emotional prosody in the same way as their male counterparts. In Study 2, a subset of produced materials was rated for valence, voice modulation, and voice control to supplement Study 1 results: Female ASD speakers sounded less negative when expressing fear compared to female NT speakers. Male ASD speakers were perceived as less positive than NT speakers when expressing happiness. Voice modulation also differed between groups, showing a tendency for ASD speakers to follow different display rules for both positive emotions (happiness and surprise) tested. Finally, male ASD speakers were rated to use voice cues less appropriately compared to NT male speakers, an effect less pronounced for female ASD speakers. Together, the results imply that difficulties in social interactions among individuals with high-functioning ASD could be due to non-prototypical voice use of male ASD speakers and emphasize that female individuals do not show the same effects.
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Affiliation(s)
- Mindy T. Gibson
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, United Kingdom
| | - Maren Schmidt-Kassow
- Department of Psychiatry, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Silke Paulmann
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, United Kingdom
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Sunagawa M. How much of my true self can i show? social adaptation in autistic women: a qualitative study. BMC Psychol 2023; 11:144. [PMID: 37138313 PMCID: PMC10155366 DOI: 10.1186/s40359-023-01192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 04/26/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Social adaptation is often aimed at supporting autistic people, yet its specific goals may not include their actual perspectives. That is, the state of adaptation is judged based on the standards and values of non-autistic people. This qualitative study focused on autistic women's perceptions of social adaptation and examined their lived experiences in daily life, as adaptive behaviors have often been reported as a "female autism phenotype." METHODS Semi-structured interviews were conducted face-to-face with ten autistic women aged 28-50 years (M = 36.7; standard SD = 7.66). The analysis was conducted based on the grounded theory approach. RESULTS Two core perceptions were identified: maintaining stable relationships and fulfilling social roles based on past experiences of "maladaptation." The participants sought adaptations within a reasonable range and adjusted their balance with society to maintain stability in their daily lives. CONCLUSION The findings indicated that autistic women's perceptions of adaptation were based on the accumulation of past negative experiences. Further harmful efforts should be prevented. Support for autistic people to make their own choices in life is also important. Moreover, autistic women need a place where they can be themselves and be accepted as they are. This study showed the importance of changing the environment rather than modifying autistic people to adapt to a society.
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Affiliation(s)
- Mebuki Sunagawa
- Department of Psychology, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112- 8610, Japan.
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Wilmot A, Pizzey H, Leitão S, Hasking P, Boyes M. "I struggle at times to see her struggle": Mothers' perspectives on dyslexia-related school struggles and the inter-connected nature of mother and child well-being. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:136-150. [PMID: 36755469 PMCID: PMC10946717 DOI: 10.1002/dys.1733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Parents of children with dyslexia may be at elevated risk for parenting stress and mental health concerns. Our aim was to explore the emotional experience of growing up with dyslexia in Australia from parents' perspectives. In so doing, we also developed an understanding of parents' own mental health and support needs informed by their lived experience. METHODOLOGY Seventeen interviews with mothers of children (9-14 years; 16 with a diagnosis of dyslexia) were analysed using Braun and Clarke's reflexive thematic analysis approach. ANALYSIS Five themes were developed to address our aim: Theme 1: Years in the wilderness: Life before diagnosis; 2: "I struggle at times to see her struggle"; 3. School struggles: Advocating for our children and managing distress; 4. "It's a full-time job" and a "long slog"; 5: Care for the carer: Social support and coping strategies. CONCLUSIONS Our analysis suggests that mothers of children with dyslexia may be at elevated risk for mental health concerns. Specifically, chronic worry and stress, secondary distress, challenges to parenting self-efficacy, and lack of support and understanding (feeling isolated) were highlighted as plausible risk factors. Mothers described coping strategies at the community level (e.g., school connectedness) and at the individual level (e.g., "acceptance") as protective.
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Affiliation(s)
- Adrienne Wilmot
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Hannah Pizzey
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Suze Leitão
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Allied HealthBentleyAustralia
| | - Penelope Hasking
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
| | - Mark Boyes
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
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15
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Milner V, Colvert E, Mandy W, Happé F. A comparison of self-report and discrepancy measures of camouflaging: Exploring sex differences in diagnosed autistic versus high autistic trait young adults. Autism Res 2023; 16:580-590. [PMID: 36490366 PMCID: PMC10946751 DOI: 10.1002/aur.2873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
Abstract
Camouflaging describes masking or compensating for autistic traits and/or related difficulties. Some evidence suggests autistic females camouflage more than autistic males, potentially contributing to delayed or missed diagnosis. Studies predominantly adopt self-report measures of camouflaging, potentially reflecting a person's intent to camouflage without accurately measuring effectiveness (i.e., success in fulfilling the intended effect of minimizing the appearance of autistic traits) of camouflaging. Discrepancy scores between underlying cognitive difficulties (e.g., theory of mind) and observed autistic traits (henceforth camoToM ), or between self-reported autistic traits and observed autistic traits (henceforth camoSRS ), may provide a more accurate measure of camouflaging effectiveness. Three measures of camouflaging administered to autistic males (n = 46) and females (n = 40), and adults with equally high levels of autistic traits but no diagnosis (n = 45 males, n = 43 females) recruited from a large population-based sample were compared. Self-report measures of camouflaging were significantly correlated with camoSRS scores only. Both discrepancy scores were correlated with each other. Adults with high autistic traits, but no diagnosis, had higher discrepancy camouflaging scores than diagnosed adults, but self-reported scores were similar. Diagnosed females scored higher than diagnosed males across all camouflaging measures, but no sex difference occurred in the high trait group. This might indicate that autistic females have higher intentions and greater effectiveness when camouflaging, compared with autistic males. For camoSRS only, high trait males scored significantly higher than diagnosed males; no group difference occurred for females. These results suggest that, despite all participants intending to camouflage to some extent, effective camouflaging as measured by discrepancy scores is higher in undiagnosed high autistic trait individuals. One interpretation is that effective camouflaging reduces the likelihood of autism diagnosis in males and females with high autistic traits.
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Affiliation(s)
- Victoria Milner
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Emma Colvert
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - William Mandy
- Research Department of Clinical, Educational, and Health PsychologyUniversity College LondonLondonUK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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Doran JD, McCrary SG, Morrison BM, Hiruma LS, Chan DV. View of the Work Community and Vocational Rehabilitation Services Among Adults With Autism Spectrum Disorder. REHABILITATION COUNSELING BULLETIN 2023. [DOI: 10.1177/00343552231155217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Many adults diagnosed with autism spectrum disorder (ASD) face challenges in establishing and maintaining employment. These difficulties may be related to ASD symptomology or employer attitudes; however, vocational rehabilitation (VR) can provide employment-related resources. This study sought to understand how adults with ASD view their integration into workplace communities and VR services. Qualitative data were collected from 24 adults with ASD, and analysis identified themes surrounding the importance of workplace contributions, interesting work, and positive workplace relationships contributing to feeling integrated into the workplace community. Responses were also examined for perspectives on the role of VR in supporting workplace integration. Findings indicate the importance of attending to individual employment preferences and the need for long-term VR follow-along services to explore opportunities for employment growth. Implications and future recommendations for research and practice are also discussed.
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Affiliation(s)
- Julie D. Doran
- The University of North Carolina-Chapel Hill, USA
- East Carolina University, Greenville, NC, USA
| | | | | | | | - Dara V. Chan
- The University of North Carolina-Chapel Hill, USA
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17
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Monahan JL, Freedman B, Singh V, Kalb L, Edmondson C. Initial Validation of the Counseling Center Assessment of Psychological Symptoms-62 for the Autistic College Population. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2023. [DOI: 10.1080/07481756.2023.2170246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
| | - Brian Freedman
- University of Delaware Center for Disabilities Studies, Newark, DE, USA
| | - Vini Singh
- Kennedy Krieger Institute, Baltimore, MD, USA
| | - Luke Kalb
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cassidy Edmondson
- University of Delaware Center for Disabilities Studies, Newark, DE, USA
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18
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Abstract
Relative to males, women with autism spectrum disorder (ASD) have neurobiological and clinical presentation differences. Recent research suggests that the male/female ASD prevalence gap is smaller than previously reported. Sex differences in symptom presentation as well as the male bias of ASD account for delayed/missed diagnosis among women. Investigating ASD and providing psychological evaluation referrals for women who are struggling socially and present with complex mental health conditions (e.g., ADHD, depression), even when they do not show typical autistic characteristics, is important. Accurate diagnosis facilitates understanding of challenges, increases access to treatments, and alleviates the burden of ASD.
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Affiliation(s)
- Cesar Ochoa-Lubinoff
- Rush University Medical Center, 1725 West Harrison Street, Suite 710, Chicago, IL 60612, USA.
| | - Bridget A Makol
- Rush University Medical Center, 1653 West Congress Parkway, 12 Kellogg, Chicago, IL 60612, USA
| | - Emily F Dillon
- Rush University Medical Center, 1645 West Jackson Boulevard, Chicago, IL 60612, USA
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19
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Wilmot A, Pizzey H, Leitão S, Hasking P, Boyes M. Growing up with dyslexia: Child and parent perspectives on school struggles, self-esteem, and mental health. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:40-54. [PMID: 36349866 PMCID: PMC10946500 DOI: 10.1002/dys.1729] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/08/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Children with dyslexia, compared with typically reading peers, are at increased risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown. Our aim was to explore the socio-emotional experience of growing up with dyslexia from both child and parent perspectives. In so doing, we aimed to gain a better understanding of self-esteem and mental health in the context of dyslexia. One-to-one semi-structured interviews with 17 children with reading difficulties (aged 9-14 years; 16 with a diagnosis of dyslexia) and their mothers (interviewed separately) were analysed using Braun and Clarke's reflexive thematic analysis approach with a neurodiversity lens. We developed three themes to address the research aim: (1) Different in a good/bad way; (2) Exhausted and overwhelmed; and (3) It takes a community: Family school connections. Children discussed having "worries" and experiencing school-related stress and embarrassment. Mothers perceived children's internalising and externalising behaviour (meltdowns), school refusal, and homework resistance as emotional responses to children's school struggles due to poor "person-environment fit." Our analysis highlights the particular importance of parent support, friendship, and school-connectedness for the wellbeing of children with dyslexia.
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Affiliation(s)
- Adrienne Wilmot
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Hannah Pizzey
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Suze Leitão
- Faculty of Health SciencesSchool of Allied Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Penelope Hasking
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Mark Boyes
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
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21
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Hannon B, Mandy W, Hull L. A comparison of methods for measuring camouflaging in autism. Autism Res 2023; 16:12-29. [PMID: 36424824 PMCID: PMC10099783 DOI: 10.1002/aur.2850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
Abstract
Interest in social camouflaging has led to a multiplicity of measurement methods of uncertain validity. This two-part investigation first used a systematic review ("Study 1") to identify and appraise methods used to quantify camouflaging of autistic traits, using the Consensus-based Standards for the Selection of Health Status Measurement Instruments checklist. A total of 16 distinct measurement tools were identified; all are in the preliminary phases of psychometric evaluation. The systematic review highlighted: (1) the need for parent-report tools which specifically measure camouflaging; and (2) a lack of studies looking at associations between different methods of camouflaging, which limits understanding of their validity. "Study 2" aimed to begin to address these gaps in knowledge. We created a parent-report version of the Camouflaging Autistic Traits Questionnaire (CAT-Q) and evaluated its concurrent validity in autistic young people by examining associations with the self-report CAT-Q and a discrepancy measure. Discriminant validity was investigated by comparing all three methods of measuring camouflaging to a measure of social skills, to test whether they assess a construct distinct from social ability. The self- and parent-report CAT-Q were significantly related (r = 0.47, 95% CI = 0.24-0.65), and were related weakly (r = 0.20, 95% CI = -0.06 to 0.43) and strongly (r = 0.46, 95% CI = 0.23-0.64), respectively, to the discrepancy approach. No measure was associated with social skills. Improving the psychometric properties of these methods, and introducing a novel parent-report measure, may help selection of appropriate methods in future research and integration into clinical practice.
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Affiliation(s)
- Benjamin Hannon
- Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - William Mandy
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Laura Hull
- Department of Clinical, Educational & Health Psychology, University College London, London, UK.,Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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22
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Øverland E, Hauge ÅL, Orm S, Pellicano E, Øie MG, Skogli EW, Andersen PN. Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol. Front Psychiatry 2022; 13:1058601. [PMID: 36506426 PMCID: PMC9732257 DOI: 10.3389/fpsyt.2022.1058601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction This study aims to investigate self-perceived quality of life, daily functioning, and the use of compensatory strategies in emerging adults with autism. Methods and analysis Participants will be recruited from the Lillehammer Neurodevelopmental 10-year follow-up study (LINEUP), with the aim of 15 individual in-depth interviews. Subsequently, two focus groups with clinicians will be invited to reflect on the themes found in the individual interviews. All interviews will be recorded and analyzed using reflexive thematic analysis. Ethics and dissemination The study is approved by the Regional Committee for Medical Research Ethics in South-East Norway. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations. To reach the broader autistic and autism communities, the findings will be shared with the Autism Society at national and local meetings, in their membership magazine, and on their social media channel.
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Affiliation(s)
- Elisabeth Øverland
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Åshild Lappegard Hauge
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Lazerwitz MC, Rowe MA, Trimarchi KJ, Garcia RD, Chu R, Steele MC, Parekh S, Wren-Jarvis J, Bourla I, Mark I, Marco EJ, Mukherjee P. Brief Report: Characterization of Sensory Over-Responsivity in a Broad Neurodevelopmental Concern Cohort Using the Sensory Processing Three Dimensions (SP3D) Assessment. J Autism Dev Disord 2022:10.1007/s10803-022-05747-0. [PMID: 36180667 PMCID: PMC9524317 DOI: 10.1007/s10803-022-05747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 12/01/2022]
Abstract
Sensory Over-Responsivity (SOR) is an increasingly recognized challenge among children with neurodevelopmental concerns (NDC). To investigate, we characterized the incidence of auditory and tactile over-responsivity (AOR, TOR) among 82 children with NDC. We found that 70% of caregivers reported concern for their child's sensory reactions. Direct assessment further revealed that 54% of the NDC population expressed AOR, TOR, or both - which persisted regardless of autism spectrum disorder (ASD) diagnosis. These findings support the high prevalence of SOR as well as its lack of specificity to ASD. Additionally, AOR is revealed to be over twice as prevalent as TOR. These conclusions present several avenues for further exploration, including deeper analysis of the neural mechanisms and genetic contributors to sensory processing challenges.
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Affiliation(s)
- Maia C Lazerwitz
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Cortica Healthcare, San Rafael, CA, USA
| | - Mikaela A Rowe
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | | | | | - Robyn Chu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
- Growing Healthy Children Therapy Services, Rescue, CA, USA
| | | | - Shalin Parekh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jamie Wren-Jarvis
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ioanna Bourla
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Ian Mark
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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Roestorf A, Howlin P, Bowler DM. Ageing and autism: A longitudinal follow-up study of mental health and quality of life in autistic adults. Front Psychol 2022; 13:741213. [PMID: 36081725 PMCID: PMC9447441 DOI: 10.3389/fpsyg.2022.741213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 06/29/2022] [Indexed: 12/27/2022] Open
Abstract
Background Poor mental health is known to adversely affect functional abilities, social isolation, and quality of life (QoL). It is, therefore, crucial to consider the long-term impacts of mental health conditions as autistic adults grow older. Objectives To explore, in a group of community-based autistic adults, the extent of: (i) autistic traits, co-occurring physical and mental health conditions; (ii) age-related differences in those conditions, and changes over time; and (iii) their impact on everyday living and QoL. Method About Sixty-eight autistic adults (aged 19–80 years) participated in the first study (T1); 49 participants from T1 took part in a follow-up at T2 (mean retest interval 2.4 years). Standardised self-report measures of autistic traits, mental health, and QoL were completed at both time points. Results Over two-thirds (71%) of autistic adult participants experienced at least one co-occurring condition, and over a third (37%) met the criteria for three or more co-occurring conditions. Mental and physical health difficulties were related to autistic traits and difficulties in everyday life and were consistent predictors of poor QoL at T1 and T2. Conclusion Mental health difficulties in autism persisted into older age and did not improve over time. These findings have important implications for mental health provision for autistic adults in older age.
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Affiliation(s)
- Amanda Roestorf
- Autism Research Group (ARG), Department of Psychology, City, University of London, London, United Kingdom
- *Correspondence: Amanda Roestorf,
| | - Patricia Howlin
- Department of Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dermot M. Bowler
- Autism Research Group (ARG), Department of Psychology, City, University of London, London, United Kingdom
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25
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Frigaux A, Vacant C, Evrard R. Le devenir autiste au féminin : difficultés diagnostiques et ressources subjectives. Une revue de littérature. EVOLUTION PSYCHIATRIQUE 2022. [DOI: 10.1016/j.evopsy.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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Affiliation(s)
- Danny Dunn
- Department of Psychology and Philosophy, Texas Woman's University, Denton, Texas, USA.,Address correspondence to: Danny Dunn, Department of Psychology and Philosophy, Texas Woman's University, Denton, TX 76204, USA
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27
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Are Extended Reality Interventions Effective in Helping Autistic Children to Enhance Their Social Skills? A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00320-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractAutistic children’s social skills do not always align with those of their neurotypical peers and research suggests that this can negatively impact quality of life. This review aimed to assess the effectiveness of extended reality (XR) interventions in helping autistic children to enhance their social skills. Five electronic databases were systematically searched and seventeen studies were identified. The majority targeted social-emotional reciprocity and were of relatively low quality. There was insufficient evidence to determine whether effects were generalisable, sustained or important to autistic people. Research in this field is in its infancy and evidence of effectiveness should be viewed with caution. Future studies should aim for high-quality, theory-driven research, and involve autistic people to ensure meaningful outcomes.PROSPERO ID: CRD42021229442
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28
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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.
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29
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Harmens M, Sedgewick F, Hobson H. The Quest for Acceptance: A Blog-Based Study of Autistic Women's Experiences and Well-Being During Autism Identification and Diagnosis. AUTISM IN ADULTHOOD 2022; 4:42-51. [PMID: 36605564 PMCID: PMC8992923 DOI: 10.1089/aut.2021.0016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Although studies have found that autism is underdiagnosed in women and that autistic women have poorer well-being outcomes than men, less is known about autistic women's experiences with self-identification or diagnosis or how they feel such experiences affect their mental health. Methods We explored autistic women's experiences of coming to recognize and understand themselves as autistic. We used data collected from blogs written by autistic women about their diagnostic or self-identification experiences. We were particularly interested in well-being, and how this contributed to, was affected by, and interacted with the identification and diagnostic process. We used thematic analysis to explore and document experiences described in blogs from 20 blogsites (representing the views of 23 autistic women). Results Acceptance was a central issue. We developed themes of self-understanding and self-acceptance, being understood and accepted by others (including peers, clinicians, and others in the autism community), and the exhaustion resulting from trying to be accepted and be understood. These issues arose both when going through the diagnostic process, and after receiving a formal diagnosis. Conclusions Diagnosis and identification may have both positive and negative effects on autistic women's well-being, with women often describing difficulties after diagnosis as stemming from facing male stereotypes of autism. We consider the implications of our findings for clinicians, researchers, and those who work with autistic women.
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Affiliation(s)
- Miriam Harmens
- Department of Psychology, University of York, Heslington, York, United Kingdom
| | | | - Hannah Hobson
- Department of Psychology, University of York, Heslington, York, United Kingdom.,Address correspondence to: Hannah Hobson, DPhil, Department of Psychology, University of York, YO10 5DD York, United Kingdom
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Bundy R, Mandy W, Crane L, Belcher H, Bourne L, Brede J, Hull L, Brinkert J, Cook J. The impact of early stages of COVID-19 on the mental health of autistic adults in the United Kingdom: A longitudinal mixed-methods study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1765-1782. [PMID: 35083922 PMCID: PMC9483192 DOI: 10.1177/13623613211065543] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We used mixed methods to learn about the nature and drivers of mental health changes among autistic adults in the United Kingdom during the early stages of the COVID-19 pandemic. In quantitative analyses, we examined the nature and predictors of change in depression, anxiety and stress, prospectively measured in 70 autistic adults at Wave 1 (just before the United Kingdom’s first lockdown) and Wave 2 (10–15 weeks into the United Kingdom’s first lockdown). Retrospective Wave 2 reports of mental health change were also analysed for these 70 participants. For the qualitative analysis, 133 participants (including the 70 from the quantitative analyses) provided reports on their experiences of the pandemic at Wave 2. In quantitative analyses, retrospective reports indicated that participants’ mental health worsened, but prospective data showed a different picture, with overall anxiety and stress scores reducing between Waves 1 and 2. Nevertheless, the mental health impact of the pandemic on autistic adults was variable, with a sizable minority reporting a significant decline in mental health. Qualitative analysis yielded four themes that contributed to mental health changes: (a) adjusting to changes to the social world, (b) living with uncertainty, (c) disruptions to self-regulation, and (d) barriers to fulfilling basic needs.
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31
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Lin XB, Lim CG, Lee TS. Social Deficits or Interactional Differences? Interrogating Perspectives on Social Functioning in Autism. Front Psychiatry 2022; 13:823736. [PMID: 35546922 PMCID: PMC9084456 DOI: 10.3389/fpsyt.2022.823736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Social dysfunction is a key characteristic of autism. Determining and treating autism-related social deficits have been challenging. The medical model views interpersonal difficulties in autism as a localized set of deficits to be managed, whereas the neurodiversity movement calls for the accommodation of differences by the larger community. One common assumption underlying these perspectives is a misalignment in social behaviors between autistic individuals and neurotypicals. This paper reviews and interrogates current perspectives on social functioning in autism to uncover the intricacies of such a notion. Even though extant literature has alluded to a misalignment in social behaviors between autistic and neurotypical individuals, it is uncertain where this disparity lies. Implications for future research and practice are discussed.
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Affiliation(s)
- Xiangting Bernice Lin
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Choon Guan Lim
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University, Singapore, Singapore.,Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Tih-Shih Lee
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,Department of Psychiatry, Singapore General Hospital, Singapore, Singapore
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32
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Kozunova G, Novikov A, Stroganova T, Chernyshev B. Intolerance of Uncertainty and Challenges in Decision-making in Adults with High-Functioning Autism. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2022. [DOI: 10.17759/cpse.2022110402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
<p style="text-align: justify;">Individuals with high-functioning autism have difficulties in decision-making in face of incomplete or ambiguous information, particularly in the context of social interaction. Tasks demanding an immediate response or deviation from the usual behavior make them feel excessive anxiety which restricts their social and professional activity. Attempts to camouflage their conservatism to others are one of the risk factors for comorbid depression. Therefore, they avoid new and non-routine situations, thus restricting their own social activity and professional development. On the other hand, insisting on sameness and clarity may give individuals with autism an advantage in long-lasting monotonous tasks. The aim of this review is to consider these symptoms from the perspective of predictive coding. A range of experimental studies has shown that most of the subjects with autism have difficulty in predicting the outcomes based on the cumulative history of interacting with the environment, as well as updating expectations as new evidence becomes available. These peculiarities of the analysis and pragmatic weighting of information may cause the trait intolerance of uncertainty and novelty avoidance of most people with autism.</p>
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Abstract
Recognition of autism and the associated co-occurring physical and mental health issues has increased over recent years. However, undergraduate and postgraduate curricula take time to adapt and to impact on what is delivered in training so healthcare professionals, including doctors, report little training on these topics. Doctors need to know when someone might be autistic in order to respond to them appropriately. This article sets out the reasons why recognition of autism is important and the positive impacts of recognising and understanding autism on health outcomes, service delivery and patient experience. The negative consequences of not recognising autism or understanding the impact of autistic traits on the person are also explored. A companion article then covers how practice can be made more appropriate for autistic people to improve outcomes.
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Affiliation(s)
- Mary Doherty
- Department of Anaesthesia, Our Lady's Hospital, Navan, Ireland
| | - Clair Haydon
- Department of Adult Autism Services, Cheshire and Wirral Partnership NHS Foundation Trust and Centre for Autism, Neuro-Developmental Disorders and Intellectual Disability (CANDDID), Chester, UK
| | - Ian A Davidson
- Department of Adult Mental Health, Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
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34
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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.
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Affiliation(s)
- Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK.
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35
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Libsack EJ, Keenan EG, Freden CE, Mirmina J, Iskhakov N, Krishnathasan D, Lerner MD. A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder. Clin Child Fam Psychol Rev 2021; 24:783-812. [PMID: 34505231 PMCID: PMC10613328 DOI: 10.1007/s10567-021-00365-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 12/26/2022]
Abstract
While long described in anecdotal accounts of the lived experiences of autistic individuals, the phenomenon of behaving in ways that appear inconsistent with the presence of autism (or passing as non-autistic; PAN) has recently seen a dramatic increase in scrutiny in the published scientific literature. Increased research attention has coincided with a proliferation of methods, definitions, measures, and population assumptions associated with PAN. To date, however, no review has sought to systematically identify and synthesize the literature on PAN. This systematic review reflects the state of the PAN literature as of May 2020. Ninety articles were screened, 66 were identified for evaluation, and 46 met inclusion criteria and were reliably coded for study characteristics and participant characteristics. Results reveal that the PAN literature includes a relatively even mix of qualitative, quantitative, and mixed-method studies, and that a variety of terms are used for PAN (with masking and camouflage being the most frequent). Sample sizes varied widely (from one to 832 participants), with 63.06% of participants being categorized as autistic. Nearly all studies reported methods for confirming autism diagnoses, with community and clinical diagnoses being most common. The majority of studies reported participant gender, with slightly more females included than males on average, but fewer than half of all studies compared PAN across genders. Nearly all studies reported participant age, demonstrating a wide range of 2 to 79 years, with a mean age of 23.85. Conversely, only 23.91% of studies provided participant race or ethnicity data. Nearly all studies formally or informally excluded participants with intellectual disability. Finally, measures of internalizing symptoms, which are often thought to be linked to PAN, were reported in only 17.4% of studies. Implications for gaps in understanding of PAN and future directions for the field are discussed.
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Affiliation(s)
- Erin J Libsack
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA.
| | - Elliot Gavin Keenan
- Department of Human Development and Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Caroline E Freden
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Julianne Mirmina
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | | | | | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA.
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36
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Nenniger G, Hofmann V, Müller CM. Gender Differences in Peer Influence on Autistic Traits in Special Needs Schools-Evidence From Staff Reports. Front Psychol 2021; 12:718726. [PMID: 34803801 PMCID: PMC8599132 DOI: 10.3389/fpsyg.2021.718726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Children and adolescents with an intellectual disability (ID) and autistic traits often attend special needs schools where they are surrounded by peers with diverse characteristics. Given the role that peers can play in social development, we examined whether autistic traits development in students with ID and high levels of such characteristics are influenced by the level of autistic traits among the schoolmates they like most. Furthermore, we investigated the degree to which this peer influence susceptibility depends on students’ gender. A longitudinal design, with data collection points at the beginning and the end of a school year, was used. Staff reported on 330 students with high levels of autistic traits (20.6% girls; age 10.17 years, SD = 3.74) who attended 142 classrooms in 16 Swiss special needs schools. Results showed that students’ future individual level of autistic traits (T2) was not predicted by the autistic traits level of preferred peers (T1), controlling for individual autistic traits at T1, level of general functioning, gender, and age. However, the peer effect was significantly moderated by students’ gender, indicating that girls but not boys were susceptible to peer influence. These findings are discussed in terms of implications for understanding autistic traits development and directions of support for children and adolescents in their peer context.
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Affiliation(s)
- Gina Nenniger
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Verena Hofmann
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
| | - Christoph M Müller
- Department of Special Education, University of Fribourg, Fribourg, Switzerland
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37
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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.
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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
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38
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Peinemann F, Tendal B, Bölte S. Digital serious games for emotional recognition in people with autism spectrum disorder. Hippokratia 2021. [DOI: 10.1002/14651858.cd014673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Frank Peinemann
- Pediatric Oncology and Hematology; Children's Hospital, University of Cologne; Cologne Germany
| | - Britta Tendal
- The Nordic Cochrane Centre; Rigshospitalet; Copenhagen Denmark
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm; Stockholm Sweden
- Child and Adolescent Psychiatry; Stockholm Health Care Services, Region Stockholm; Stockholm Sweden
- Curtin Autism Research Group, Curtin School of Allied Health; Curtin University; Perth Australia
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39
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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.
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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
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40
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Cook J, Hull L, Crane L, Mandy W. Camouflaging in autism: A systematic review. Clin Psychol Rev 2021; 89:102080. [PMID: 34563942 DOI: 10.1016/j.cpr.2021.102080] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/30/2021] [Accepted: 08/24/2021] [Indexed: 01/15/2023]
Abstract
Some autistic people employ strategies and behaviours to cope with the everyday social world, thereby 'camouflaging' their autistic differences and difficulties. This review aimed to systematically appraise and synthesise the current evidence base pertaining to autistic camouflaging. Following a systematic search of eight databases, 29 studies quantifying camouflaging in children and adults with autism diagnoses or high levels of autistic traits were reviewed. The multiple methods used to measure camouflaging broadly fell under two different approaches: internal-external discrepancy or self-report. These approaches appear to relate to two distinct but potentially connected elements of camouflaging: observable behavioural presentations and self-perceived camouflaging efforts. While significant variation was noted across individual study findings, much of the existing literature supported three preliminary findings about the nature of autistic camouflaging: (1) adults with more self-reported autistic traits report greater engagement in camouflaging; (2) sex and gender differences exist in camouflaging; and (3) higher self-reported camouflaging is associated with worse mental health outcomes. However, the research base was limited regarding participant characterisation and representativeness, which suggests that conclusions cannot be applied to the autistic community as a whole. We propose priorities for future research in refining the current understanding of camouflaging and improving measurement methods.
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Affiliation(s)
- Julia Cook
- Research Department of Clinical, Educational, & Health Psychology, University College London, UK.
| | - Laura Hull
- Research Department of Clinical, Educational, & Health Psychology, University College London, UK
| | - Laura Crane
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, UK
| | - William Mandy
- Research Department of Clinical, Educational, & Health Psychology, University College London, UK
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41
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Atherton G, Edisbury E, Piovesan A, Cross L. Autism Through the Ages: A Mixed Methods Approach to Understanding How Age and Age of Diagnosis Affect Quality of Life. J Autism Dev Disord 2021; 52:3639-3654. [PMID: 34482523 PMCID: PMC9296439 DOI: 10.1007/s10803-021-05235-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 12/25/2022]
Abstract
A significant proportion of autistic adults today were not diagnosed until later in life, a group referred to as the ‘lost generation,’ which may affect mental health. In Study 1 we explored quality of life and autistic trait levels in 420 autistic and TD adults, and in Study 2 we explored the experiences of 8 autistic adults diagnosed as adults. We found that autistic adults had lower quality of life outcomes and higher autistic trait levels which related to age of diagnosis, and qualitative findings indicated that while adults were empowered by their new diagnosis, they still require specialized supports. Our findings are discussed, emphasizing future directions and implications for the current care system in place for autistic adults.
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Affiliation(s)
- Gray Atherton
- Department of Psychology, Edge Hill University, St Helens Rd, Liverpool, Ormskirk, L39 4QP, Lancashire, UK.
| | - Emma Edisbury
- Department of Psychology, Edge Hill University, St Helens Rd, Liverpool, Ormskirk, L39 4QP, Lancashire, UK
| | | | - Liam Cross
- Department of Psychology, Edge Hill University, St Helens Rd, Liverpool, Ormskirk, L39 4QP, Lancashire, UK
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42
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Williams EDG, Smith MJ, Sherwood K, Lovelace TS, Bishop L. Brief Report: Initial Evidence of Depressive Symptom Disparities among Black and White Transition Age Autistic Youth. J Autism Dev Disord 2021; 52:3740-3745. [PMID: 34417653 PMCID: PMC8858325 DOI: 10.1007/s10803-021-05242-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Matthew J Smith
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Kari Sherwood
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Temple S Lovelace
- Department of Counseling, Psychology, and Special Education, Duquesne University, Pittsburgh, PA, USA
| | - Lauren Bishop
- Waisman Center, University of Wisconsin, Madison, WI, USA.,Sandra Rosenbaum School of Social Work, University of Wisconsin, Madison, WI, USA
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43
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“We are different, that’s a fact, but they treat us like we’re different-er”: Understandings of autism and adolescent identity development. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-12-2020-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
A key development in early adolescence is the active construction of individual identity; for autistic young people, integrating the idea of “being autistic” forms part of this process. The purpose of this paper is to explore identity development from a contextualist perspective, foregrounding young people’s experiences within mainstream educational settings.
Design/methodology/approach
A longitudinal, qualitative methodology was used: semi-structured interviews were conducted annually with 14 autistic young people, their parents and teachers between school years 6 and 9.
Findings
Young people felt different from their neurotypical peers and their acceptance of their diagnosis changed over time as they managed their developing personal and public identities. In pursuit of being treated “normally,” many camouflaged their differences at school, which sometimes involved opting out of school-based support. Adults described their own understandings of autism and discussed the responses of others in the school environment to autistic differences.
Originality/value
The influence of sociocultural discourses of autism on young people’s identity development is discussed and implications for both school based and post-diagnostic support for young people and their families explored.
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44
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Livingston LA. Substance use, coping, and compensation in autism. Lancet Psychiatry 2021; 8:641-642. [PMID: 34217428 DOI: 10.1016/s2215-0366(21)00205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lucy Anne Livingston
- School of Psychology, Cardiff University, Cardiff CF10 3AT, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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45
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Lai MC, Hull L, Mandy W, Chakrabarti B, Nordahl CW, Lombardo MV, Ameis SH, Szatmari P, Baron-Cohen S, Happé F, Livingston LA. Commentary: 'Camouflaging' in autistic people - reflection on Fombonne (2020). J Child Psychol Psychiatry 2021; 62. [PMID: 33289092 DOI: 10.1111/jcpp.13344] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/29/2020] [Indexed: 11/29/2022]
Abstract
Fombonne's (2020) editorial is a thought-provoking appraisal of the literature on 'camouflaging', whereby some autistic people mask or compensate for their autistic characteristics as an attempt to fit in and to cope with disabilities under neurotypical social norms. Fombonne (2020) highlights three issues of contention: (a) construct validity and measurement of camouflaging; (b) camouflaging as a reason for late autism diagnosis in adolescence/adulthood; and (c) camouflaging as a feature of the 'female autism phenotype'. Here, we argue that (a) establishing construct validity and measurement of different aspects of camouflaging is warranted; (b) subjective experiences are important for the differential diagnosis of autism in adolescence/adulthood; and (c) camouflaging is not necessarily a feature of autism in female individuals - nevertheless, taking into account sex and gender influences in development is crucial to understand behavioural manifestations of autism. Future research and clinical directions should involve clarification of associated constructs and measurements, demography, mechanisms, impact (including harms and benefits) and tailored support.
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Affiliation(s)
- Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Laura Hull
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Bhismadev Chakrabarti
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Centre for Autism, School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK.,India Autism Center, Kolkata, India.,Department of Psychology, Ashoka University, Sonipat, India
| | - Christine Wu Nordahl
- The MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
| | - Michael V Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Stephanie H Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter Szatmari
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lucy Anne Livingston
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
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46
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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]
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47
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Tubío-Fungueiriño M, Cruz S, Sampaio A, Carracedo A, Fernández-Prieto M. Social Camouflaging in Females with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2021; 51:2190-2199. [PMID: 32926304 DOI: 10.1007/s10803-020-04695-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence, and a male-to-female ratio of 4:1. Research has been suggesting that discrepancy in prevalence may be due to the fact that females camouflage their symptoms. In this study, we aimed to systematically review evidence on the camouflage effect in females with ASD. Following the PRISMA guidelines, we reviewed empirical research published from January 2009 to September 2019 on PubMed, Web of Science, PsychInfo and Scopus databases. Thirteen empirical articles were included in this review. Overall, evidence supports that camouflaging seems to be an adaptive mechanism for females with ASD, despite the negative implications of these behaviours in their daily life.
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Affiliation(s)
- María Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Sara Cruz
- Psychology for Positive Development Research Center, Universidade Lusíada - Norte, Porto, Portugal.,Instituto de Neurodesenvolvimento (IND), Porto, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Angel Carracedo
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain.,Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Santiago de Compostela, Spain.,Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Montse Fernández-Prieto
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain. .,Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Santiago de Compostela, Spain. .,Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
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48
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Tubío-Fungueiriño M, Cruz S, Sampaio A, Carracedo A, Fernández-Prieto M. Social Camouflaging in Females with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2021. [PMID: 32926304 DOI: 10.1007/s10803-020-04695-x/tables/1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence, and a male-to-female ratio of 4:1. Research has been suggesting that discrepancy in prevalence may be due to the fact that females camouflage their symptoms. In this study, we aimed to systematically review evidence on the camouflage effect in females with ASD. Following the PRISMA guidelines, we reviewed empirical research published from January 2009 to September 2019 on PubMed, Web of Science, PsychInfo and Scopus databases. Thirteen empirical articles were included in this review. Overall, evidence supports that camouflaging seems to be an adaptive mechanism for females with ASD, despite the negative implications of these behaviours in their daily life.
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Affiliation(s)
- María Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Sara Cruz
- Psychology for Positive Development Research Center, Universidade Lusíada - Norte, Porto, Portugal
- Instituto de Neurodesenvolvimento (IND), Porto, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Angel Carracedo
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Santiago de Compostela, Spain
- Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Montse Fernández-Prieto
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Avda. de Barcelona, s/n, 15782, Santiago de Compostela, Spain.
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Santiago de Compostela, Spain.
- Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
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49
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Higgins JM, Arnold SR, Weise J, Pellicano E, Trollor JN. Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2356-2369. [PMID: 34088219 DOI: 10.1177/13623613211019858] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autistic burnout has been commonly described in social media by autistic people. There is little mention of autistic burnout in the academic literature. Only one recent study has used interviews and reviews of social media descriptions to try to understand autistic burnout. Anecdotally, autistic burnout is a very debilitating condition that reduced people's daily living skills and can lead to suicide attempts. It is suggested that autistic burnout is caused by the stress of masking and living in an unaccommodating neurotypical world. We wanted to create a definition of autistic burnout that could be used by clinicians and the autism community. We used the Grounded Delphi method, which allowed autistic voice to lead the study. Autistic adults who had experienced autistic burnout were considered as experts on the topic, in the co-production of this definition. The definition describes autistic burnout as a condition involving exhaustion, withdrawal, problems with thinking, reduced daily living skills and increases in the manifestation of autistic traits. It is important for future research that there is a specific description of the condition. In practice, it is important for clinicians to be aware that autistic burnout is different from depression. Psychological treatments for depression potentially could make autistic burnout worse. Further awareness of autistic burnout is needed, as well as further research to prove this condition is separate from depression, chronic fatigue and non-autistic burnout.
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Affiliation(s)
- Julianne M Higgins
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Samuel Rc Arnold
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Janelle Weise
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia
| | - Elizabeth Pellicano
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, New South Wales, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW, Sydney, New South Wales, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
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Halsall J, Clarke C, Crane L. "Camouflaging" by adolescent autistic girls who attend both mainstream and specialist resource classes: Perspectives of girls, their mothers and their educators. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2074-2086. [PMID: 33966484 PMCID: PMC8419293 DOI: 10.1177/13623613211012819] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Autistic girls’ heightened social motivation and associated social coping strategies, such as camouflaging, mean they may be less likely to receive appropriate support in mainstream schools. In this research, a multi-informant approach was used to examine the camouflaging strategies used by autistic girls within specialist resource classes attached to mainstream schools (whereby girls transition between resource classes and mainstream classes). Semi-structured interviews were conducted with eight adolescent girls, their parents (eight mothers) and their educators (six teaching assistants/aides and one senior staff member) about the girls’ camouflaging experiences. Using reflexive thematic analysis, four themes were identified: (1) inconsistencies and contradictions in camouflaging, (2) challenges of relationships and ‘finding a tribe’, (3) learning, inclusion and awareness and (4) consequences of camouflaging. These results highlight the challenges that the girls experienced when attempting to hide their autism and fit within both mainstream classes and specialist resource classes. These challenges had significant impacts on the girls’ relationships and learning, as well as consequences for their mental health. The findings highlight the need for increased awareness of how camouflaging presents across the autism spectrum and suggests that individualised, evidence-based support will be essential for enabling autistic girls to flourish in school.
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