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Crowson S, Poole D, Scargill K, Freeth M. Understanding the post-diagnostic support priorities of autistic adults in the United Kingdom: A co-produced modified Delphi study. Autism 2024; 28:854-865. [PMID: 37776060 PMCID: PMC10981182 DOI: 10.1177/13623613231196805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
LAY ABSTRACT Autistic adults in the United Kingdom report that support for themselves and their peers is not suitable for their needs. There has been an increase in adults receiving an autism diagnosis, which many have reported as having a positive impact on their lives. However, the lack of support and understanding after diagnosis, combined with long wait times for an assessment to obtain a diagnosis and to access follow-on support, is having a negative impact on people's lives. This study took place to find out what support autistic people need and want after receiving their diagnosis. It was co-designed with a group of 10 autistic adults which means that the researchers and group members collaboratively designed the research. For the study, 43 autistic adults, diagnosed aged 18 or older, completed three questionnaires. A fourth questionnaire followed that was completed by 139 autistic people who received their diagnosis in adulthood. These questionnaires aimed to help people identify their own priorities when it came to the support they would have liked to receive after being given their autism diagnosis. Participants ranked access to support where they live, training of professionals, support to process the impact of a late diagnosis, use of their preferred mode of contact and a personalised support plan as their top priorities. This demonstrates that local support is highly valued by autistic adults, as are well-trained professionals who offer a range of contact options, support to process a late-in-life autism diagnosis and help to develop and implement support plans.
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Bureau R, Clément C. "Survival classes for a neurotypical world": What French autistic adults want and need after receiving an autism diagnosis. Autism 2024; 28:843-853. [PMID: 37345517 DOI: 10.1177/13623613231183071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
LAY ABSTRACT Adults receiving an autism diagnosis might not react the same depending on their countries or cultures. We also know that autistic people are rarely asked what they think would be best for them following this diagnosis. In this study, we asked 12 French autistic adults about their experiences of receiving an autism diagnosis as well as what they thought might be useful afterwards. Overall, we found that some experiences were similar to experiences related by English or American participants, but some were specific to the French culture, suggesting that such research should expand into new territories and cultures, especially non-European ones. Our participants also had quite a few ideas as to what would be useful for people in the same situation. Some of the suggestions can be put into action by peers and professionals alike, while others are wishes relating to how our participants would like society to behave toward them and people like them, for example. This article allows for a better comprehension of how cultural differences can impact the experience of receiving an autism diagnosis as an adult and provides some insight into what these adults want and desire following such a diagnosis.
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Affiliation(s)
- Raven Bureau
- Université de Strasbourg, France
- Groupement d'Intérêt Scientifique Autisme et TND, France
| | - Céline Clément
- Université de Strasbourg, France
- Groupement d'Intérêt Scientifique Autisme et TND, France
- Strasbourg Translational Research on the Autism Spectrum & Neurodevelopmental Disorders (STRAS&ND), France
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Josyfon E, Spain D, Blackmore C, Murphy D, Oakley B. Alexithymia in Adult Autism Clinic Service-Users: Relationships with Sensory Processing Differences and Mental Health. Healthcare (Basel) 2023; 11:3114. [PMID: 38132004 PMCID: PMC10742835 DOI: 10.3390/healthcare11243114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Mental health difficulties commonly co-occur with autism, especially in autistic people accessing clinic services, impacting substantially on quality-of-life. Alexithymia (difficulty describing/identifying feelings) and sensory processing differences are prevalent traits in autism that have been associated with depression/anxiety in autistic community samples. However, it is important to better understand interrelationships between these traits in clinical populations to improve identification of service-user needs. In this study, 190 autistic adults (65.3% male), seen in a tertiary autism clinic, completed self-report measures of alexithymia (20-item Toronto Alexithymia Scale), sensory processing differences (Adolescent/Adult Sensory Profile) and depression/anxiety (Hospital Anxiety and Depression Scale). Multiple linear regression models and mediation analyses were used to examine associations between alexithymia, sensory processing differences, and depression/anxiety severity. Across the sample, 66.3% of individuals (N = 126) were classified as alexithymic (score ≥ 61). Total alexithymia and difficulty describing/identifying feelings were significantly associated with depression severity (β = 0.30-0.38, highest p < 0.002), and difficulty identifying feelings was significantly associated with anxiety severity (β = 0.36, p < 0.001). Sensory processing differences were also significantly associated with depression severity (β = 0.29, p = 0.002) and anxiety severity across all models (β = 0.34-0.48, highest p < 0.001) Finally, difficulty describing/identifying feelings partially mediated the relationships between sensory processing differences and both depression/anxiety severity. Overall, these results highlight that interventions adapted for and targeting emotional awareness and sensory-related uncertainty may improve mental health outcomes in autistic service-users.
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Affiliation(s)
- Emily Josyfon
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Debbie Spain
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Charlotte Blackmore
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
| | - Declan Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Sackler Institute for Translational Neurodevelopment, King’s College London, De Crespigny Park, London SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust (SLaM), London SE5 8AZ, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, De Crespigny Park, London SE5 8AF, UK
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Bertelli MO, Forte L, Bianco A. Updates in the care of youths with intellectual disability and autism spectrum disorder. Curr Opin Psychiatry 2023; 36:455-460. [PMID: 37781976 DOI: 10.1097/yco.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
PURPOSE OF REVIEW Since the turn of the new millennium, care for people with intellectual disability/intellectual developmental disorders (IDD) and/or autism spectrum disorder (ASD) has drawn increasing attention because of the continuous prevalence increase of these two conditions, the high health vulnerability, especially mental vulnerability, and the crucial role of care provision in the setting of continued deinstitutionalization and the shift to community care. The present review addresses the main issues related to mental healthcare in youth with IDD and/or ASD with a specific focus on adolescence and transition to adulthood. RECENT FINDINGS Despite the existence of specific recommendations, persons with IDD/ASD lack access to quality mental healthcare within communities, receive inadequate diagnosis and intervention, including medication overuse as well as ineffective residential, educational, employment, financial, and social support services. The lack of a unified care system that provides services across all domains and life ages may be the cause of users' perceptions and experiences of inefficiencies. SUMMARY The scientific community seems to converge on that care should be provided in accordance with principles of interdisciplinarity, life-span view, precision, personalization, and participation. Quality of life appears to be an ideal conceptual reference for care planning and outcome evaluation.
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Affiliation(s)
- Marco O Bertelli
- CREA (Research and Clinical Centre), Fondazione San Sebastiano, Misericordia di Firenze
| | - Luciana Forte
- CREA (Research and Clinical Centre), Fondazione San Sebastiano, Misericordia di Firenze
- Department of Neurofarba, University of Florence, Florence, Italy
| | - Annamaria Bianco
- CREA (Research and Clinical Centre), Fondazione San Sebastiano, Misericordia di Firenze
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Curnow E, Utley I, Rutherford M, Johnston L, Maciver D. Diagnostic assessment of autism in adults - current considerations in neurodevelopmentally informed professional learning with reference to ADOS-2. Front Psychiatry 2023; 14:1258204. [PMID: 37867776 PMCID: PMC10585137 DOI: 10.3389/fpsyt.2023.1258204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Services for the assessment and diagnosis of autism in adults have been widely criticized and there is an identified need for further research in this field. There is a call for diagnostic services to become more accessible, person-centered, neurodiversity affirming, and respectful. There is a need for workforce development which will increase capacity for diagnostic assessment and support for adults. ADOS-2 is a gold-standard diagnostic assessment tool for autism recommended in clinical guidelines. However, diagnostic procedures such as the ADOS-2 are rooted in the medical model and do not always sit comfortably alongside the neurodiversity paradigm or preferences of the autistic community. Training and educational materials need to account for the differences between these approaches and support clinicians to provide services which meet the needs of the adults they serve. The National Autism Implementation Team worked alongside ADOS-2 training providers to support clinicians in Scotland, to provide effective and respectful diagnostic assessment. The team engaged with clinicians who had attended ADOS training to identify areas of uncertainty or concern. Training materials were developed to support ADOS assessors to incorporate key principles including "nothing about us without us"; "difference not deficit"; "environment first"; "diagnosis matters," "language and mindsets matter"; and "a neurodevelopmental lens," to support the provision of neurodiversity affirming assessment practice. The National Autism Implementation Team also provided examples of actions which can be undertaken by clinicians to improve the assessment experience for those seeking a diagnosis. Training materials are based on research evidence, clinical experience, and the needs and wishes of autistic people.
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Affiliation(s)
- Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Musselburgh, United Kingdom
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Kutuk MO, Tufan AE, Kilicaslan F, Vural P, Gokcen C, Alsen Guney S, Kutuk B, Ozyurt G, Inal N, Mutluer T, Acikalin EY, Ozer FH, Pamuk EN, Yesilmese SC, Karadag M, Hangul Z, Bilginer C, Sahin N, Bilac O, Kandemir H, Ercan ES, Eseroglu Soylemez T, Acikel SB, Guler Aksu G, Dag P, Toros F, Mutlu C, Kardas O, Kardas B, Kizildag S, Demirci E, Ozmen S, Sevicin L, Karagoz YS, Isik U, Aktepe E, Altun H, Yektas Ç, Polat Tuysuz B, Buber A, Cansiz MA, Ogutlu H, Eray S, Taner HA, Altintas E, Kutuk O. functional outcome in late adolescence/early adulthood of patients with autism spectrum disorder and its relationships with parental burnout and depression: A preliminary multi-center, cross-sectional study. Heliyon 2023; 9:e20766. [PMID: 37867841 PMCID: PMC10589842 DOI: 10.1016/j.heliyon.2023.e20766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
The aim of this study is to determine the functioning of adults with autism spectrum disorders (ASDs) diagnosed in childhood and depression and burnout levels among their parents. A total of 261 adults with ASDs and their parents were recruited for the study. Both parents completed the Beck Depression and Maslach Burnout Inventories and reported the functioning of their adult offspring with ASDs. Only 5.4 % of our sample reported "good" or "very good" outcomes. The most common psychiatric comorbidities were intellectual disabilities and attention-deficit/hyperactivity disorder. Maternal burnout and depression scores were significantly elevated compared to those of fathers. There is an undeniable urgent need for more research to identify the needs of adults and families suffering from ASD. Modifications for those with ASD may have to be made for support in workplaces, achieving driving licenses, using public transportation and attendance at tertiary education.
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Affiliation(s)
- Meryem Ozlem Kutuk
- Department of Child and Adolescent Psychiatry, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University, Faculty of Medicine, Bolu, Turkey
| | - Fethiye Kilicaslan
- Department of Child and Adolescent Psychiatry, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Pınar Vural
- Department of Child and Adolescent Psychiatry, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Cem Gokcen
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey
| | - Sevay Alsen Guney
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Bahtim Kutuk
- Department of Psychology, Ege University, Izmir, Turkey
| | - Gonca Ozyurt
- Department of Child and Adolescent Psychiatry, İzmir Katip Celebi University, Faculty of Medicine, Izmir, Turkey
| | - Neslihan Inal
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koc University Faculty of Medicine, Istanbul, Zip code: 34450, Turkey
| | - Eren Yavuz Acikalin
- Department of Child and Adolescent Psychiatry, Koc University Faculty of Medicine, Istanbul, Zip code: 34450, Turkey
| | - Fadime Hande Ozer
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Zipcode: 27410, Turkey
| | - Esma Nur Pamuk
- Department of Psychology, Cag University, Mersin, Zip code: 33800, Turkey
| | | | - Mehmet Karadag
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Zip code: 27310, Turkey
| | - Zehra Hangul
- Department of Child and Adolescent Psychiatry, Gaziantep University, Faculty of Medicine, Gaziantep, Zip code: 27310, Turkey
| | - Cilem Bilginer
- Department of Child and Adolescent Psychiatry, Karadeniz Technical University, Faculty of Medicine, Trabzon, Zip code: 61080, Turkey
| | - Nilfer Sahin
- Department of Child and Adolescent Psychiatry, Mugla Sitki Kocman University, Faculty of Medicine, Mugla, Zip code: 48000, Turkey
| | - Oznur Bilac
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Zip code: 45030, Turkey
| | - Hasan Kandemir
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Faculty of Medicine, Manisa, Zip code: 45030, Turkey
| | - Eyup Sabri Ercan
- Department of Child and Adolescent Psychiatry, Ege University, Faculty of Medicine, İzmir, Zip code: 35040, Turkey
| | - Tugba Eseroglu Soylemez
- Department of Child and Adolescent Psychiatry, Baskent University, Faculty of Medicine, Istanbul Medical and Research Center, Istanbul, Zip code: 34662, Turkey
| | - Sadettin Burak Acikel
- Department of Child and Adolescent Psychiatry, Konya City Training and Research Hospital, Konya, Zip code: 42090, Turkey
| | - Gulen Guler Aksu
- Department of Child and Adolescent Psychiatry, Mersin University, Faculty of Medicine, Mersin, Zip code: 33343, Turkey
| | - Pelin Dag
- Department of Child and Adolescent Psychiatry, Mersin City Training and Research Hospital, Mersin, Zip code: 33240, Turkey
| | - Fevziye Toros
- Department of Child and Adolescent Psychiatry, Mersin University, Faculty of Medicine, Mersin, Zip code: 33343, Turkey
| | - Caner Mutlu
- Department of Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Zip code: 34494, Turkey
| | - Omer Kardas
- Department of Child and Adolescent Psychiatry, Dicle University, Faculty of Medicine, Diyarbakır, Zip code: 21280, Turkey
| | - Burcu Kardas
- Department of Child and Adolescent Psychiatry, Gazi Yasargil Education and Research Hospital, Diyarbakir, Zip code: 21010, Turkey
| | - Suleyman Kizildag
- Department of Child and Adolescent Psychiatry, Dicle University, Faculty of Medicine, Diyarbakır, Zip code: 21280, Turkey
| | - Esra Demirci
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Sevgi Ozmen
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Leyla Sevicin
- Department of Child and Adolescent Psychiatry, Erciyes University, Faculty of Medicine, Kayseri, Zip code: 38039, Turkey
| | - Yuksel Sumeyra Karagoz
- Department of Child and Adolescent Psychiatry, Training and Research Hospital, Erzurum, Zip code: 25240, Turkey
| | - Umit Isik
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Faculty of Medicine, Isparta, Zip code: 71100, Turkey
| | - Evrim Aktepe
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Faculty of Medicine, Isparta, Zip code: 71100, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University, Faculty of Medicine, Kahramanmaras, Zip code: 46000, Turkey
| | - Çigdem Yektas
- Department of Child and Adolescent Psychiatry, Uskudar University, Istanbul, Zip code: 34662, Turkey
| | - Berna Polat Tuysuz
- Department of Child and Adolescent Psychiatry, Sanliurfa Education and Research Hospital, Sanliurfa, Zip code: 63250, Turkey
| | - Ahmet Buber
- Department of Child and Adolescent Psychiatry, Pamukkale University, Faculty of Medicine, Denizli, Zip code: 20070, Turkey
| | - Mehmet Akif Cansiz
- Department of Child and Adolescent Psychiatry, Yozgat Bozok University, Faculty of Medicine, Yozgat, Zip code: 66100, Turkey
| | - Hakan Ogutlu
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Zip code: 06800, Turkey
| | - Safak Eray
- Department of Child and Adolescent Psychiatry, Uludag University Faculty of Medicine, Bursa, Zip code: 16059, Turkey
| | - Hande Ayraler Taner
- Department of Child and Adolescent Psychiatry, Baskent University, Medical Faculty, Ankara, Zip code: 06490, Turkey
| | - Ebru Altintas
- Department of Psychiatry, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Zip code: 01110, Turkey
| | - Ozgur Kutuk
- Department of Immunology, Baskent University Faculty of Medicine, Adana Dr. Turgut Noyan Medical and Research Center, Adana, Zip code: 01110, Turkey
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Fulceri F, Gila L, Caruso A, Micai M, Romano G, Scattoni ML. Building Bricks of Integrated Care Pathway for Autism Spectrum Disorder: A Systematic Review. Int J Mol Sci 2023; 24:ijms24076222. [PMID: 37047213 PMCID: PMC10094376 DOI: 10.3390/ijms24076222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
An integrated plan within a defined care pathway for the diagnosis, continuative interventions, and periodic redefinition of care of autistic people is essential for better outcomes. Challenges include delivering services across all domains or life stages and effective coordination between health/social care providers and services. Further, in the ‘real world’, service provision varies greatly, and in many settings is significantly weighted towards diagnosis and children’s services rather than treatment and support or adult care. This study aims to identify existing care pathways for Autism Spectrum Disorder (ASD) from referral to care management after diagnosis. The study reviewed the international literature in PubMed and PsycInfo databases and collected information on care for autistic individuals from the Autism Spectrum Disorders in Europe (ASDEU) project partners. The study found that published data mainly focused on specific components of care pathways rather than an integrated and coordinated plan of care and legislative indications. They should be aimed at facilitating access to the services for support and the inclusiveness of autistic individuals. Given the need for care addressing the complex and heterogeneous nature of ASD, effective coordination between different health/social care providers and services is essential. It is also suggested that research priority should be given to the identification of an integrated care pathway ‘model’ centered around case management, individualization, facilitation, support, continuous training and updating, and quality management.
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Wigham S, Ingham B, Le Couteur A, Wilson C, Ensum I, Parr JR. Consensus statements on optimal adult post-autism diagnosis support and services: Delphi process following a UK survey of autistic adults, relatives and clinicians. Autism 2023; 27:344-355. [PMID: 35670069 DOI: 10.1177/13623613221097502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Research has identified types of support helpful to autistic people, for example, physical and mental health interventions, psycho-education, peer support, developing positive identities and affiliation with social groups. However, accessing suitable post-autism diagnosis support and services is extremely difficult. We asked autistic adults, relatives and clinicians about their experiences of receiving and delivering post-autism diagnosis support/services. In Stage 1, 343 autistic adults and 45 relatives completed a survey. They answered questions about their experiences of UK autism post-diagnosis support/services for adults within 12 months after receiving a diagnosis. Thirty-five clinicians completed a similar survey. Just over half of adults and relatives said there was a follow-up appointment or discussion about support after diagnosis. Fewer than 40% received any support/services in 12 months after diagnosis. We used information from the surveys to create 11 statements describing characteristics of appropriate adult post-autism diagnosis support/services. In Stage 2, we asked clinicians for their views on the statements - they agreed with all of them. For example, those adults are offered an additional follow-up meeting after diagnosis and have access to mental and physical health services. We shared results with autistic adults, relatives and clinicians at two events. Some autistic adults, relatives and clinicians were positive about post-autism diagnosis support/services. However, they described many areas for improvement. The study findings can be used to define, develop and improve the types of adult post-diagnosis support services.
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Affiliation(s)
- Sarah Wigham
- Population Health Sciences Institute, Newcastle University, UK
| | - Barry Ingham
- Population Health Sciences Institute, Newcastle University, UK.,Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, UK
| | - Colin Wilson
- Population Health Sciences Institute, Newcastle University, UK
| | - Ian Ensum
- Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Jeremy R Parr
- Population Health Sciences Institute, Newcastle University, UK.,Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. Nat Rev Psychol 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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Hidalgo N, Sjöwall D, Agius H, Byström C, Brar A, Borg J, Hirvikoski T. Psychoeducational group intervention for intellectually able adults with autism and their close relations (Prisma) - an open feasibility study. BMC Psychiatry 2022; 22:556. [PMID: 35986348 PMCID: PMC9389708 DOI: 10.1186/s12888-022-04134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) in adulthood is associated with severe impairments in functioning and poor health, while ASD is also affecting close relations. Accessible first-line interventions addressing the complex clinical needs and care coordination are lacking. METHODS This study investigated the feasibility and preliminary effects of a new psychoeducational intervention (Prisma) developed for intellectually able adults with ASD and their close relations in an outpatient setting. The manualized Prisma intervention consist of four weekly group sessions guided by trained group leaders and providing information about autism, support, and services. Feasibility was examined through treatment completion rate and group-level comparisons between intervention completers and non-completers (Student's t-test, Fisher's exact test, and Pearson's chi-squared test). Perceived treatment credibility was investigated by within-group comparisons of participant's self-ratings from pre-intervention to post-intervention, as well as by group leaders' ratings using an adjusted questionnaire. Treatment satisfaction was examined quantitatively regarding the session evaluations (Student's t-tests), as well as by a qualitative thematic analysis of participants' feedback. Preliminary efficacy was studied using paired t-tests (pre- and post-intervention). RESULTS Completion rate was 77% (n = 71 of the 92 adults with ASD) and 73% (n = 69 of the 94 close relations), respectively. Participants considered Prisma to be an acceptable intervention indicated by increases in treatment credibility and expectations from pre- to post-intervention. The group leaders reported treatment credibility in the same range as the participants. Both autistic adults and their close relations reported good treatment satisfaction for each session, while the qualitative thematic analysis indicated that Prisma could be improved by enhancing active participation. This participant feedback will be used to further improve the intervention for an upcoming RCT. Preliminary analyses of effects showed promising results with an increase in knowledge of ASD and some indications for improvements in relationship quality, mental health, quality of life, acceptance of diagnosis and burden of care. CONCLUSIONS Overall, results indicate that the Prisma is a feasible and acceptable first-line intervention in outpatient services. Randomized controlled trials are needed to further corroborate the evidence base of this novel intervention. TRIAL REGISTRATION Clinicaltrials.org NCT0446097, retrospectively registered July 8th 2020.
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Affiliation(s)
- Nathaniel Hidalgo
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, R5:02, Stockholm, Sweden
- Region Stockholm, Stockholm, Sweden
| | - Douglas Sjöwall
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden
| | - Hanna Agius
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden
| | - Caroline Byström
- Psychiatric Services, Stockholm Health Care Services,, Region Stockholm, Stockholm, Sweden
- Modigo AB, Odengatan 69, 113 22, Stockholm, Sweden
| | - Annika Brar
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jacqueline Borg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, R5:02, Stockholm, Sweden
| | - Tatja Hirvikoski
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden.
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden.
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11
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Murphy S, Flower RL, Jellett R. Women seeking an autism diagnosis in Australia: A qualitative exploration of factors that help and hinder. Autism 2022; 27:808-821. [PMID: 35978525 DOI: 10.1177/13623613221117911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT An autism diagnosis can have a big impact on women and make it possible to access support. This study explored women's experiences of being diagnosed with autism as an adult in Australia, to try to understand what was helpful (facilitators) and unhelpful (barriers) for them during this process. We interviewed 10 autistic women who had been diagnosed in the last 5 years. Framework analysis was used to understand the data. We wanted to understand barriers and facilitators relating to the individual participants, the professionals they saw and the system they went through for their diagnostic assessment. Women reported that being able to recognise they were autistic, being motivated, preparing for the assessment, having social support and unmasking to be themselves were helpful during the diagnostic process. They reported that having a knowledgeable diagnostician who made accommodations for their needs assisted them during the assessment process. When providers dismissed the participants when they first raised the possibility they were autistic, it delayed them in seeking an assessment. At the system level, the women in this study found some aspects of the healthcare system difficult to navigate, particularly costs and long waitlists. Some found the assessment tools used were not well suited to them. The experiences of the women in this study highlight improvements that could be made to accessing an adulthood autism diagnosis in Australia. These include improving provider knowledge of the varied presentation of autism and the development of resources to help autistic women prepare for their diagnostic assessment.
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12
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Reynaud E, Pottelette J, Rabot J, Rolling J, Royant-Parola S, Hartley S, Coutelle R, Schröder CM. Differential effects of COVID-related lockdown on sleep-wake rhythms in adults with autism spectrum disorder compared to the general population. Autism Res 2022; 15:945-956. [PMID: 35234355 PMCID: PMC9073973 DOI: 10.1002/aur.2692] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/25/2022]
Abstract
COVID‐related lockdown led to a radical modification of daily activities and routines which are known to affect sleep. Compared to the general population, participants with autism may be particularly vulnerable to the repercussions of lockdown on sleep, given their intrinsic inflexible adherence to routines and the high overall prevalence of sleep disturbances in this population. The study is a French nation‐wide online survey assessing sleep–wake rhythms and behaviors known to affect sleep (daily screen time, daylight exposure, and physical activity), before and during COVID‐related lockdown. Respondents were 207 adults with autism (56% female) and 1652 adults of the general population (77% female), with a mean age 35.3 years (SD 11.3). Before lockdown, the adults with autism displayed on average later bedtime and waking hours, lower sleep quality, more evening screen time, less exposure to daylight, and less exercise (all p < 0.01). Lockdown affected all studied measures of sleep and related exposures in a similar way in both groups: poorer self‐rated sleep quality as well as a less regular and delayed sleep–wake rhythm, longer screen time in the evening and less exposure to daylight (all p < 0.001). Adults with autism displayed significantly higher levels of sleep and circadian rhythm disturbances and less favorable daily routines known to regulate sleep. While the effect of confinement on sleep and sleep related behaviors was similar in both groups, the results highlight that the pre‐existing shift in circadian rhythms and lifestyles in adults with ASD further deteriorated during lockdown.
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Affiliation(s)
- Eve Reynaud
- UPR3212 - Institute of cellular and intergrative Neurosciences, CNRS UPR3212-Institute of Cellular and Integrative Neurosciences, Strasbourg, France
| | - Julien Pottelette
- UPR3212 - Institute of cellular and intergrative Neurosciences, CNRS UPR3212-Institute of Cellular and Integrative Neurosciences, Strasbourg, France.,Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France.,Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France.,Autism Ressource Centre 67, Strasbourg, France
| | - Juliette Rabot
- UPR3212 - Institute of cellular and intergrative Neurosciences, CNRS UPR3212-Institute of Cellular and Integrative Neurosciences, Strasbourg, France.,Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France.,Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France.,Autism Ressource Centre 67, Strasbourg, France
| | - Julie Rolling
- UPR3212 - Institute of cellular and intergrative Neurosciences, CNRS UPR3212-Institute of Cellular and Integrative Neurosciences, Strasbourg, France.,Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
| | | | - Sarah Hartley
- Réseau Morphée, Paris, France.,Physiologie et Explorations fonctionnelles, APHP Hospital Raymond Poincaré Paris, Garches, France
| | - Romain Coutelle
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France.,Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France.,Autism Ressource Centre 67, Strasbourg, France
| | - Carmen M Schröder
- UPR3212 - Institute of cellular and intergrative Neurosciences, CNRS UPR3212-Institute of Cellular and Integrative Neurosciences, Strasbourg, France.,Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France.,Expert Centre for High-Functioning Autism, Fondation FondaMental, Strasbourg, France
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13
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Wigham S, Ingham B, Le Couteur A, Wilson C, Ensum I, Parr JR. A survey of autistic adults, relatives and clinical teams in the United Kingdom: And Delphi process consensus statements on optimal autism diagnostic assessment for adults. Autism 2022; 26:1959-1972. [PMID: 35168407 PMCID: PMC9597166 DOI: 10.1177/13623613211073020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Accessing adult autism diagnostic pathways can be difficult. This study explored
perspectives of UK autistic adults, relatives and clinicians regarding the
characteristics of optimal adult autism assessment and diagnostic services. In
stage 1, three key stakeholder groups were surveyed about experiences of adult
autism diagnostic services (pre-assessment/assessment): 343 autistic adults, 45
relatives and 35 clinicians completed parallel surveys. Information from stage 1
surveys was used to devise statements for a modified Delphi process in stage 2
seeking consensus among clinicians on optimal diagnostic service
characteristics. Data analyses were non-parametric and descriptive. Over half of
adults were in contact with mental health services prior to autism diagnosis.
Clinicians reported that multidisciplinary diagnostic teams lacked key
professionals. Thirteen statements describing optimal autism diagnostic service
provision were developed. There was consensus from clinicians on 11 statements
relating to clear assessment pathways, updates for people while waiting,
pre-assessment information gathering/provision, co-occurring condition
identification and training/networking. Some autistic adults, relatives and
clinicians were positive about services, all stakeholders identified
improvements were needed. The findings describing optimal service provision are
relevant for UK clinicians, managers and commissioners to improve diagnostic
assessments for autistic adults, and have international relevance for similar
health systems.
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Affiliation(s)
- Sarah Wigham
- Population Health Sciences Institute, Newcastle University, UK
| | - Barry Ingham
- Population Health Sciences Institute, Newcastle University, UK.,Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, UK
| | - Colin Wilson
- Population Health Sciences Institute, Newcastle University, UK
| | - Ian Ensum
- Bristol Autism Spectrum Service, Avon and Wiltshire Mental Health Partnership NHS Trust, UK
| | - Jeremy R Parr
- Population Health Sciences Institute, Newcastle University, UK.,Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
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14
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Micai M, Fulceri F, Salvitti T, Romano G, Poustka L, Diehm R, Iskrov G, Stefanov R, Guillon Q, Rogé B, Staines A, Sweeney MR, Boilson AM, Leósdóttir T, Saemundsen E, Moilanen I, Ebeling H, Yliherva A, Gissler M, Parviainen T, Tani P, Kawa R, Pisula E, Vicente A, Rasga C, Budişteanu M, Dale I, Povey C, Flores N, Jenaro C, Monroy ML, Primo PG, Charman T, Cramer S, Warberg CK, Canal-Bedia R, Posada M, Schendel D, Scattoni ML. Autistic Adult Services Availability, Preferences, and User Experiences: Results From the Autism Spectrum Disorder in the European Union Survey. Front Psychiatry 2022; 13:919234. [PMID: 35757227 PMCID: PMC9226363 DOI: 10.3389/fpsyt.2022.919234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022] Open
Abstract
There is very little knowledge regarding autistic adult services, practices, and delivery. The study objective was to improve understanding of current services and practices for autistic adults and opportunities for improvement as part of the Autism Spectrum Disorder in the European Union (ASDEU) project. Separate survey versions were created for autistic adults, carers of autistic adults, and professionals in adult services. 2,009 persons responded to the survey and 1,085 (54%) of them completed at least one of the services sections: 469 autistic adults (65% female; 55% <35 years old), 441 carers of autistic adults (27% female; 6% <35 years old), 175 professionals in adult services (76% female; 67% in non-medical services). Top choices by autistic adults, carers or professionals for services best suiting their current needs were: residential services: "help in own home" (adults, carers of high independent adults, professionals), "fulltime residential facility" (carers of low independent adults); employment services: "job mentors" (adults, carers of high independent adults, professionals), "Sheltered employment" (carers of low independent adults); education services: "support in regular education setting" (all groups); financial services: financial support in lieu of employment ("Supplementary income for persons unable to have full employment" for adults, "full pension" for carers of low independent adults) or to supplement employment earnings for carers of high independent adults and professionals; social services: "behavior training" (adults) and "life skills training" (carers and professionals). Waiting times for specific services were generally < 1 month or 1-3 months, except for residential services which could be up to 6 months; most professionals were uninformed of waiting times (>50% responded "don't know"). Five of seven residential services features recommended for autistic adults were experienced by <50% of adults. The knowledge of good local services models that work well for autistic adults was generally low across all services areas. The variation in services experiences and perceptions reported by autistic adults, carers, or professionals underscore the need to query all groups for a complete picture of community services availability and needs. The results showed areas for potential improvement in autistic adult services delivery in the EU to achieve recommended standards.
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Affiliation(s)
- Martina Micai
- Istituto Superiore di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Francesca Fulceri
- Istituto Superiore di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Tommaso Salvitti
- Istituto Superiore di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Giovanna Romano
- Directorate General of Health Prevention, Ministry of Health, Rome, Italy
| | - Luise Poustka
- University Medical Center Göttingen, Department of Child and Adolescent Psychiatry and Psychotherapy, Göttingen, Germany
| | - Robert Diehm
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Georgi Iskrov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | | | | | - Anthony Staines
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Mary Rose Sweeney
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Andrew Martin Boilson
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | | | | | - Irma Moilanen
- Clinic of Child Psychiatry, University Hospital of Oulu, Oulu, Finland.,Oulu University Hospital, Medical Faculty, Oulu, Finland
| | - Hanna Ebeling
- Clinic of Child Psychiatry, University Hospital of Oulu, Oulu, Finland.,Oulu University Hospital, Medical Faculty, Oulu, Finland
| | - Anneli Yliherva
- Clinic of Child Psychiatry, University Hospital of Oulu, Oulu, Finland.,Logopedic Child Language Research Center, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Department of Molecular Medicine and Surgery and Region Stockholm, Academic Primary Health Care Centre, Karolinska Institute, Stockholm, Sweden
| | - Tarja Parviainen
- Finnish Association for Autism and Asperger's Syndrome, Helsinki, Finland
| | - Pekka Tani
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Eva Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Astrid Vicente
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Célia Rasga
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Magdalena Budişteanu
- "Victor Babeş" National Institute for Research and Development in Pathology and Biomedical Sciences, Bucharest, Romania
| | - Ian Dale
- National Autistic Society, The Centre for Autism, London, United Kingdom
| | - Carol Povey
- National Autistic Society, The Centre for Autism, London, United Kingdom
| | - Noelia Flores
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos Salamanca, Instituto Universitario de Integración en la Comunidad, University of Salamanca, Salamanca, Spain
| | - Cristina Jenaro
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos Salamanca, Instituto Universitario de Integración en la Comunidad, University of Salamanca, Salamanca, Spain
| | - Maria Luisa Monroy
- Departamento de Psicología Evolutiva y de la Educación, Instituto Universitario de Integración en la Comunidad, University of Salamanca, Salamanca, Spain
| | | | - Tony Charman
- King's College London, Institute of Psychiatry, London, United Kingdom
| | - Susanne Cramer
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ricardo Canal-Bedia
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos Salamanca, Instituto Universitario de Integración en la Comunidad, University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Instituto de Salud Carlos III, Institute of Rare Diseases Research, Madrid, Spain
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Maria Luisa Scattoni
- Istituto Superiore di Sanità, Research Coordination and Support Service, Rome, Italy
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15
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Abstract
Pathways to diagnosis in adulthood are poorly understood. Even less is known about undiagnosed adults who believe they may be autistic. This mixed-methods online survey examined adults' journeys from initial concern to receiving the diagnosis. Quantitative findings showed the diagnostic process to be highly heterogeneous. Qualitative analysis identified desires for explanation and support as motives for seeking diagnosis. Cost and fear of not being taken seriously were major barriers, echoed by qualitative responses that described the process as confusing, expensive and time-consuming. While most participants were satisfied with the diagnosis, their emotional reactions were complex. Findings support the need for thoroughly implementing national guidelines, and for improved knowledge and communication in mainstream clinicians encountering clients with possible autism characteristics.
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Affiliation(s)
- Yunhe Huang
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia.
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Kitty-Rose Foley
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, Sydney, NSW, 2052, Australia
- The Cooperative Research Centre for Living With Autism (Autism CRC), Brisbane, QLD, Australia
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16
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Micai M, Ciaramella A, Salvitti T, Fulceri F, Fatta LM, Poustka L, Diehm R, Iskrov G, Stefanov R, Guillon Q, Rogé B, Staines A, Sweeney MR, Boilson AM, Leósdóttir T, Saemundsen E, Moilanen I, Ebeling H, Yliherva A, Gissler M, Parviainen T, Tani P, Kawa R, Vicente A, Rasga C, Budişteanu M, Dale I, Povey C, Flores N, Jenaro C, Monroy ML, Primo PG, Charman T, Cramer S, Warberg CK, Canal-Bedia R, Posada M, Scattoni ML, Schendel D. Intervention Services for Autistic Adults: An ASDEU Study of Autistic Adults, Carers, and Professionals' Experiences. J Autism Dev Disord 2021; 52:1623-1639. [PMID: 33966137 PMCID: PMC8938388 DOI: 10.1007/s10803-021-05038-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/23/2022]
Abstract
The Autism Spectrum Disorders in the European Union (ASDEU) survey investigated local services’ use experiences of autistic adults, carers and professionals with interventions for autistic adults. The majority of the 697 participants experienced recommended considerations prior to deciding on intervention and during the intervention plan and implementation. Psychosocial interventions were the most commonly experienced interventions, while pharmacological interventions NOT recommended for core autistic symptoms were reported by fairly large proportions of participants. Family interventions were experienced slightly more commonly by carers than adults or professionals. Less than the 26% of autistic adult responders who had experienced challenging behaviors reported receiving an intervention to change them. These results provide insights for improving gaps in service provision of interventions among autistic adults.
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Affiliation(s)
- Martina Micai
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Antonio Ciaramella
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Tommaso Salvitti
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Laura Maria Fatta
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Gottingen, Germany
| | - Robert Diehm
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Georgi Iskrov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Faculty of Public Health, Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Faculty of Public Health, Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Quentin Guillon
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Bernadette Rogé
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Anthony Staines
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Mary Rose Sweeney
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Andrew Martin Boilson
- School of Nursing, Dublin City University, Psychotherapy & Community Health, Dublin, Ireland
| | - Thora Leósdóttir
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Evald Saemundsen
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Irma Moilanen
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Hanna Ebeling
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Anneli Yliherva
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Logopedic Child Language Research Center, University of Oulu, Oulu, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland.,Research Centre for Child Psychiatry, University of Turku, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tarja Parviainen
- Finnish Association for Autism and Asperger's Syndrome, Helsinki, Uusimaa, Finland
| | - Pekka Tani
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Astrid Vicente
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Célia Rasga
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Magdalena Budişteanu
- Development in Pathology and Biomedical Sciences, "Victor Babeş" National Institute for Research, Timisoara, Romania
| | - Ian Dale
- The Centre for Autism, National Autistic Society, London, UK
| | - Carol Povey
- The Centre for Autism, National Autistic Society, London, UK
| | - Noelia Flores
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Cristina Jenaro
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Maria Luisa Monroy
- Departamento de Psicología Evolutiva Y de La Educación, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | | | - Tony Charman
- Institute of Psychiatry, Kings College London, London, UK
| | - Susanne Cramer
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ricardo Canal-Bedia
- Dpto. Personalidad, Evaluación Y Tratamiento Psicológicos, INICO - Instituto Universitario de Integración en La Comunidad University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Institute of Rare Diseases Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore Di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Economics and Business, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
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17
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Evans K, van der Meer L, Eggleston MJF, Taylor LJ, Thabrew H, Waddington H, Whitehouse AJO. A Survey of Autistic Adults from New Zealand on the Autism Diagnostic Process During Adolescence and Adulthood. J Autism Dev Disord 2021; 52:771-781. [PMID: 33788075 DOI: 10.1007/s10803-021-04983-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
The diagnostic experiences of autistic adults in New Zealand have not been investigated and little is known globally about autistic adults' satisfaction with the autism diagnostic process. This study describes the diagnostic experiences of 70 autistic adults living in New Zealand and explores how these experiences are related to satisfaction during three stages of the diagnostic process. The results show that autistic adults were reasonably satisfied with the early query and diagnostic assessment stages, but were dissatisfied with the post-diagnostic support stage, with significant unmet needs. Dissatisfaction during the post-diagnostic support stage was also related to satisfaction during previous stages and poor coordination of supports. Suggestions are made on how to improve the autism diagnostic pathway for autistic adults in New Zealand.
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Affiliation(s)
- Kiah Evans
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, WA, 6872, Australia. .,School of Allied Health, Curtin University, Perth, WA, Australia. .,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Larah van der Meer
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.,Autism New Zealand, Lower Hutt, New Zealand.,School of Education, Victoria University of Wellington, Wellington, New Zealand
| | | | - Lauren J Taylor
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Hiran Thabrew
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Hannah Waddington
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, WA, 6872, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.,School of Psychological Science, University of Western Australia, Perth, WA, Australia
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