Implicit and Explicit Attitudes Toward Autistic Adults

Societal Attitudes Towards Autism (SATA): Validation of the Greek Version in the General Population

This study examined the validity of the Greek version of the Societal Attitudes Towards Autism (SATA) scale in a Greek community sample (n = 633) and explored how the demographic variables of the sample modulate knowledge and attitudes regarding people with Autism Spectrum Disorder (ASD). The principal component analysis confirmed the three-dimension model and explained 40.5% of the variance. All Cronbach's alpha values obtained were over 0.70. SATA's subscales were significantly and positively correlated, indicating good internal reliability. Participants presented moderate knowledge about ASD and mediocre positive attitudes towards people with ASD. Gender, age, and educational level significantly affected SATA total scores. Overall, this Greek version of SATA showed acceptable psychometric properties, indicating that can be a reliable scale for use.

Qualitative Ascriptions of Autistic Behavior by Non-Autistic College Students

In studies that assess perceptions of autistic people by non-autistic people, researchers often ask participants to review vignettes depicting fictional autistic characters. However, few studies have investigated whether non-autistic peers accurately identify these hypothetical individuals as being on the autism spectrum. Accurately ascribing autism as a cause of depicted behaviors likely influences perceptions about autistic peers. In this study, 469 college students (Mage = 18.62; 79.3% female) ascribed cause(s) of an autistic peers' behaviors as depicted in a written vignette. We reviewed and categorized open-ended responses into 16 categories. Non-autistic college students primarily attributed an autistic vignette character's behavior to non-autistic origins. The most commonly ascribed causes of behavior were: attention-deficit/hyperactivity disorder (55.4%), inattention symptoms (20.9%), autism (12.8%), generalized anxiety disorder (11.7%), hyperactivity (11.3%), an unspecified diagnosis (10.7%), an environmental influence (9.6), anxiety or insecurity (8.3%), irritability or anger or annoyance (6.0%), social anxiety disorder (5.3%), and learning disorder (5.1%). Additional ascribed causes include other mental health diagnoses; environmental stressors; and cognitive, emotional, behavioral, biological, or personality characteristics/etiologies. Non-autistic young adults may not always recognize their autistic peers as autistic, which may affect acceptance and inclusion. Future anti-stigma interventions should assess the impact of helping non-autistic peers to accurately identify and better understand behaviors associated with autism. Additionally, autism-focused researchers using vignettes should assess participants' awareness of the character as autistic and interpret their findings with this in mind.

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

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

Negative first impression judgements of autistic children by non-autistic adults

Introduction

Although autism inclusion and acceptance has increased in recent years, autistic people continue to face stigmatization, exclusion, and victimization. Based on brief 10-second videos, non-autistic adults rate autistic adults less favourably than they rate non-autistic adults in terms of traits and behavioural intentions. In the current study, we extended this paradigm to investigate the first impressions of autistic and non-autistic children by non-autistic adult raters and examined the relationship between the rater's own characteristics and bias against autistic children.

Method

Segments of video recorded interviews from 15 autistic and 15 non-autistic children were shown to 346 undergraduate students in audio with video, audio only, video only, transcript, or still image conditions. Participants rated each child on a series of traits and behavioural intentions toward the child, and then completed a series of questionnaires measuring their own social competence, autistic traits, quantity and quality of past experiences with autistic people, and explicit autism stigma.

Results

Overall, autistic children were rated more negatively than non-autistic children, particularly in conditions containing audio. Raters with higher social competence and explicit autism stigma rated autistic children more negatively, whereas raters with more autistic traits and more positive past experiences with autistic people rated autistic children more positively.

Discussion

These rapid negative judgments may contribute to the social exclusion experienced by autistic children. The findings indicate that certain personal characteristics may be related to more stigmatised views of autism and decreased willingness to interact with the autistic person. The implications of the findings are discussed in relation to the social inclusion and well-being of autistic people.

Risks Associated With Undiagnosed ADHD and/or Autism: A Mixed-Method Systematic Review

BACKGROUND

The two most prevalent neurodevelopmental disorders-Attention Deficit Hyperactivity Disorder (ADHD) and Autism (ASD)-(ASD/ADHD) strongly impact individuals' functions. This is worsened when individuals are undiagnosed and risks such as increased imprisonments, depression or drug misuse are often observed. This systematic review synthesizes the risks associated with late/undiagnosed ASD/ADHD.

METHODS

Four databases were searched (Medline, Scopus, PsychInfor, and Embase). Published studies exploring the impact of undiagnosed ASD/ADHD were included. Exclusion criteria included, lack of diagnosis status, studies not solely on ASD or ADHD, gray literature and studies not in English. The findings were summarize through a narrative synthesis.

RESULTS

Seventeen studies were identified, 14 on ADHD and three on ASD. The narrative synthesis identified three main themes: (1) Health, (2) Offending behavior, and (3) Day-to-day impact. The risks highlighted a significant impact on mental wellbeing and social interactions, higher risks of substance abuse, accidents and offending behavior as well as lower levels of income and education.

DISCUSSION

The findings suggest that undiagnosed ASD/ADHD is linked to many risks and negative outcomes affecting individuals, their families, and the wider society. The restricted number of studies on ASD are a limitation to the generalization of these findings Implications for research and practice are discussed, highlighting the importance of screening and acknowledging the possibility of ASD/ADHD in many settings such as psychiatric and forensic.

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

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

Should We Continue to Tell Autistic People that Their Brains are Different?

Autism is often considered to reflect categorically 'different brains'. Neuropsychological research on autism spectrum disorder (ASD) however, has struggled to define this difference, or derive clear-cut boundaries between autism and non-autism. Consequently, restructuring or disbanding the ASD diagnosis is becoming increasingly advocated within research. Nonetheless, autism now exists as a salient social construction, of which 'difference' is a key facet. Clinical and educational professionals must influence this cautiously, as changes to autism's social construction may counterproductively affect the quality of life of autistic people. This paper therefore reviews ASD's value as both neuropsychological and social constructs. Although lacking neuropsychological validity, the autism label may be beneficial for autistic self-identity, reduction of stigma, and administering support. Whilst a shift away from case-control ASD research is warranted, lay notions of 'different brains' may be preserved.

Mortality rate and age of death among Medicare-enrolled autistic older adults

Background

An emerging body of evidence suggests that autistic people are at greater risk for mortality than non-autistic people. Yet, relatively little is known about mortality rates among autistic people during older adulthood (i.e., age 65 or older).

Methods

We examined 5-year mortality among a national US sample of Medicare-enrolled autistic (n=3,308) and non-autistic (n=33,080) adults aged 65 or older.

Results

Autistic older adults had 2.87 times greater rate of mortality (95% CI=2.61-3.07) than non-autistic older adults. Among decedents (39.6% of autistic and 15.1% of non-autistic older adults), the median age of death was 72 years (IQR=69-78) for autistic and 75 years (IQR=70-83) for non-autistic older adults. Among autistic older adults, those with intellectual disability had 1.57 times greater rate of mortality (95% CI=1.41-1.76) than those without, and males had 1.27 times greater rate of mortality (95% CI=1.12-1.43) than females.

Conclusions

Many trends regarding mortality observed in younger samples of autistic people were also observed in our study. However, we found only a three-year difference in median age at death between autistic and non-autistic decedents, which is a much smaller disparity than reported in some other studies. This potentially suggests that when autistic people live to the age of 65, they may live to a more similar age as non-autistic peers.

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

Introduction

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

Methods

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

Results

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

Discussion

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

Resilience and Coping Strategies in Adults with Autism Spectrum Disorder

Individuals with Autism spectrum disorder (ASD) are prone to stress and anxiety affecting their mental health. Although developing coping and resilience are key to cope with stressors of life, limited research exists. We aimed to explore stakeholders' experiences related to the coping and resilience of adults with ASD. We interviewed 22 participants, including 13 adults with ASD, five parents, and four service provides of adults with ASD from various Canadian provinces. Using thematic analysis, three themes emerged including: (a) societal expectations and conformity, (b) adjusting daily routines, and (c) learning overtime. This study highlights the importance of coping and informs the development of services to help enhance resilience among adults with ASD.

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

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

Lay abstract

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

A capabilities approach to understanding and supporting autistic adulthood

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.

Measuring the Wrong Thing the Right Way? Time to Rethink Autism Research Tools

Awareness and understanding of autism are increasing, sometimes in small incremental steps and sometimes through paradigm shifts. Much of this is driven by autistic advocates, whose voices are increasingly recognized as experts in their own lived experiences. The growing presence of autistic people in autism research-as participants, advisors, and (co)researchers-has brought about changes in the quality and relevance of autism research. We are seeing more studies by autistic autism researchers, more studies on issues of importance to autistic people, and more studies utilizing methodologies that resonate with autistic people. However, there remains a reliance on measures that are technically "valid" and "reliable" rather than relevant. As long as this is the case, we will continue to see studies published that "explain autism" in ways that do not reflect autistic experiences. Autism research is still making incremental changes and it is time for a paradigm shift.

The Gatekeepers to Fitness: A Correspondence Study to Examine Disabling Practices Among Fitness Center Personnel

Fitness centers may be an ideal setting for physical activity, yet qualitative findings suggest social-level barriers constrain access for people with disabilities. To further test this, I employed an online message correspondence study to investigate the effect of impairment status on the responsiveness of a national sample of fitness centers to requests for services. Email requests were sent to 800 fitness centers, of which 200 were tailored to each of the four investigative conditions (i.e., control, vision loss, spinal cord injury, or being autistic). The odds of receiving a positive response were 40.5% lower for individuals with vision loss (p = .011) and 33.3% lower for individuals with spinal cord injury (p = .055), as compared with individuals without an impairment. Specifically, the odds of receiving a positive response for personal training were 58.8% lower among individuals with vision loss (p = .003) and 41.1% lower for individuals with spinal cord injury (p = .065).

Greater Social Interest Between Autistic and Non-autistic Conversation Partners Following Autism Acceptance Training for Non-autistic People

Bi-directional differences in social communication and behavior can contribute to poor interactions between autistic and non-autistic (NA) people, which in turn may reduce social opportunities for autistic adults and contribute to poor outcomes. Historically, interventions to improve social interaction in autism have focused on altering the behaviors of autistic people and have ignored the role of NA people. Recent efforts to improve autism understanding among NA adults via training have resulted in more favorable views toward autistic people, yet it remains unknown whether these benefits extend to real-world interactions between autistic and NA people. The current study explores whether a brief autism acceptance training (AAT) program can improve social interactions between autistic and NA adults. Thirty-nine NA males were randomly assigned to complete AAT or a no-training control condition, then participated in a 5-min unstructured conversation with an unfamiliar autistic male (n = 39). Following the conversation, participants rated their perceptions of interaction quality, first impressions of their partner, and their interest in future interactions with their partner. In dyads where the NA individual completed AAT, both the autistic and NA person endorsed greater future interest in hanging out with their partner relative to dyads in which the NA adult did not complete AAT. However, other social interaction outcomes, including ratings of interaction quality and first impressions of autistic partners, largely did not differ between training and no-training conditions, and assessments of the interaction were largely unrelated for autistic and NA partners within dyads. Results also indicated that NA participants, but not autistic participants, demonstrated substantial correspondence between evaluations of their partner and the interaction, suggesting that autistic adults may place less weight on trait judgments when assessing the quality of an interaction. These findings suggest that the brief AAT for NA adults used in this study may increase mutual social interest in real-world interactions between NA and autistic adults, but more systematic changes are likely needed to bridge divides between these individuals. Future work with larger, more diverse samples is recommended to further explore whether interventions targeting NA adults are beneficial for improving autistic experiences within NA social environments.

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

LAY ABSTRACT

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

Juror decision-making in cases of rape involving high functioning Autistic persons

Despite a plethora of research examining juror decision-making within cases of rape, very few studies have attempted to examine how the presence of a developmental disorder within a case can impact jurors' decisions. Research shows that individuals diagnosed with Autism Spectrum Disorder (ASD) are sometimes perceived more negatively (i.e. unempathetic) due to stigmatising beliefs associated with ASD. Thus, the present study sought to examine whether individuals with ASD would be treated differently by jurors in court. Using mock-juror paradigms (N = 204) the present study aimed to explore whether the presence of high-functioning Autism Spectrum Disorder (ASD) amongst either the defendant or claimant influenced juror decisions (guilt verdict, confidence in verdict, and believability towards the defendant and claimant) in cases of rape. The presence of ASD amongst either party failed to have an impact on juror decision-making and final guilt verdicts. However, female participants were more likely to believe the complainant than their male counterparts. Implications of the study and directions for future research are discussed.

Exploring Three Core Psychological Elements When Treating Adolescents on the Autism Spectrum: Self-Awareness, Gender Identity, and Sexuality

For those growing up on the autism spectrum, adolescence is associated with unique challenges. This narrative review explores three core psychological elements for clinicians to consider when treating adolescents on the autism spectrum: self-awareness, gender identity, and sexuality. Developmental tasks of adolescence include adaptation to a maturing mind and body, increased expectations for independence, and the ability to establish satisfying interpersonal relationships. What are welcome opportunities for non-autistic peers can become nearly insurmountable hurdles for autistic teens, which, in turn, could lead to crisis, particularly if skills needed for success in managing these tasks have not yet been acquired.

The Effects of Contact and Labeling on Attitudes Towards Individuals with Autism

Typically developing young adults perceive their peers with autism more negatively than those without autism, but less so when they have experience with individuals with autism. Study 1 examined whether typically developing university students' (n = 70) judgments of their peers would differ as a function of interpersonal contact and being labeled as autistic. Perceptions of peers with autism were consistent with stereotypes about autism and were associated with contact. In Study 2, typically developing university students (n = 130) imagined interacting with a student with manipulations of perseverative behavior and the label of autism. Attitudes towards individuals with autism were more positive following an imagined contact scenario with a peer demonstrating perseverative behavior with a label of autism.