Autism Acceptance Research Articles

Autism in April at public libraries: Shifting from awareness to acceptance

Public libraries in the United States provide programs and services for their communities, including those focused on timely events, holidays, and public awareness campaigns. Formerly known as Autism Awareness Month, April is now recognized as Autism Acceptance Month and has been highlighted through presidential proclamations and campaigns from organizations such as the Centers for Disease Control and Prevention (CDC). This paper explores what services public libraries in the US are providing about autism in the month of April, and what language they use to describe it. Results indicate that while few public libraries hold special events to celebrate autism in April, those that do share potentially valuable information about autism with parents, caregivers, educators, and members of the community at large. Some also provide important opportunities for autistic patrons to gather. However, many event descriptions use language that is not in alignment with autistic individuals’ preferences, and opportunities for autistic patrons of all ages are limited. Results from this study highlight gaps in public library programing, with implications for providing better services around Autism Acceptance Month.

Experiences of and treatment preferences for insomnia in autistic adults: An Interpretative Phenomenological Analysis

Insomnia and insomnia symptoms are frequent experiences of autistic people resulting in pronounced daytime effects and poor quality of life. This study employed an Interpretive Phenomenological Analysis approach to explore lived experiences of autistic adults with insomnia, perspectives on current available interventions and future treatment preferences. Twelve participants (aged 21–48 years old) were interviewed following screening for insomnia, using the Sleep Condition Indicator (scores ranged from 1 to 12; cut off >16). Each interview was analysed individually developing Personal Experiential Themes for each case, which were then mapped across cases based on identified patterns and connections. Results yielded rich personal accounts and identified two Group Experiential Themes: “The Night is Friendlier” and “It Doesn't Really Work for Me”. Participants described experiences with sleeplessness throughout their adult lives and often since childhood. They discussed how the night time offers them a more relaxed and safe space to freely behave as they wish. Advice and interventions were viewed by participants via the prism of underlying social issues, such as autism acceptance and trust, and how these structures can affect participants' experiences with insomnia, help seeking and effectiveness of current interventions. Our results highlight the need for inclusion of autistic people in insomnia research through co-production and co-creation as well as clinical practice and delivery. This is the first study to integrate perspectives and experiences of autistic people towards insomnia and sleep-related advice by health care professionals. Findings are discussed in relation to theoretical and practical implications, as well as directions for future research.

'Does that mean you will be violent?': A qualitative exploration into Autistic women's experiences of relationships with lecturers at university.

It is documented that more Autistic woman are becoming university students, but their experiences are not often explored. Eleven Autistic women students made artefacts (such as writing, paintings or poems) and took part in interviews to share their experiences at university. Five participants were undergraduate students and six participants were postgraduate students. The artefacts and words participants shared were looked at closely and some common themes were decided. How lecturers talk to Autistic women students was looked at. Participants said they were lucky if they met helpful lecturers. Also, autism acceptance was explored. Overall, how lecturers treat Autistic women at university is very important. Also, Autistic women students' opinions about making university a more welcoming place need to be listened to.

What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers.

Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important. This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis. There was no consumer or community involvement in the completion of this project. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs. Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.

Unraveling the Path from Autism Acceptance to Quality of Life in Autistic Transition-Age Youths: A Parallel Mediation Model

Unraveling the Path from Autism Acceptance to Quality of Life in Autistic Transition-Age Youths: A Parallel Mediation Model

Between gaining acceptance and avoiding harm: navigating stigma and its consequences among autistic individuals

This paper examines autistic adults’ narratives and accounts of their experiences. It focuses on exploring how autistic individuals interpret and respond to stigma and negative attitudes surrounding autism. Thematic analysis of qualitative data obtained from interviews and focus groups reveals how autistic persons reconstruct their self-perception and definition of autism in response to stigma and societal attitudes. Further, the analysis reveals the prevalent use of social camouflaging among autistic adults to manage and cope with their stigmatized identities. This research contends that the dual approach that appeared among participants of advocating for autism acceptance while masking and concealing autism, reflects a continuous balancing act between avoiding stigma and its harmful consequences and striving to fit in, gain acceptance, engage in social interaction and relationships. Reframing autism as positive and reporting decreased motivation for camouflaging and increased self-acceptance, demonstrate stigma resistance and the agency and power possessed by autistic people.

Online resources for Autism Acceptance Month.

Online resources for Autism Acceptance Month.

Cross-cultural variation in experiences of acceptance, camouflaging and mental health difficulties in autism: A registered report.

Recent findings suggest that stigma and camouflaging contribute to mental health difficulties for autistic individuals, however, this evidence is largely based on UK samples. While studies have shown cross-cultural differences in levels of autism-related stigma, it is unclear whether camouflaging and mental health difficulties vary across cultures. Hence, the current study had two aims: (1) to determine whether significant relationships between autism acceptance, camouflaging, and mental health difficulties replicate in a cross-cultural sample of autistic adults, and (2) to compare these variables across cultures. To fulfil these aims, 306 autistic adults from eight countries (Australia, Belgium, Canada, Japan, New Zealand, South Africa, the United Kingdom, and the United States) completed a series of online questionnaires. We found that external acceptance and personal acceptance were associated with lower levels of depression but not camouflaging or stress. Higher camouflaging was associated with elevated levels of depression, anxiety, and stress. Significant differences were found across countries in external acceptance, personal acceptance, depression, anxiety, and stress, even after controlling for relevant covariates. Levels of camouflaging also differed across countries however this effect became non-significant after controlling for the covariates. These findings have significant implications, identifying priority regions for anti-stigma interventions, and highlighting countries where greater support for mental health difficulties is needed.

Autistic identity: A systematic review of quantitative research.

Autism can be considered both a personal and social identity. Identifying the factors contributing to positive Autistic identity development is crucial given the potential implications for mental health and wellbeing. In this systematic review, we aimed to synthesize quantitative literature on Autistic identity to identify the (individual and environmental) factors associated with Autistic identity, and to ascertain the relationship between Autistic identity and mental health and wellbeing. A total of 3,617 studies were screened and 20 met our inclusion criteria. Results indicated that people developed a more positive Autistic identity when receiving external autism acceptance and external support. The association between individual factors and Autistic identity were largely nonsignificant or inconclusive, highlighting the need for broad support that meets the needs of a range of Autistic people, rather than specific subgroups. Importantly, positive Autistic identity was associated with improved mental health and wellbeing. Peer support and/or self-directed support resources may be valuable mechanisms for supporting Autistic people to cultivate a positive Autistic identity. The evaluation of such support, including the long-term impacts on identity development, will be a critical avenue for future research.

Strategies for promoting neurodiversity and autism acceptance in higher education.

Strategies for promoting neurodiversity and autism acceptance in higher education.

To mask or not to mask: The role of concealment behavior, stigma experience, and community connectedness in autistic people's mental health

Psychological theory and results from previous empirical studies paradoxically suggest that concealing and revealing one's autism can each result in reduced mental well-being. On one hand, autistic people who reveal their autistic identity experience considerable anti-autism stigma, which can lead to worse mental health outcomes compared to autistic people who conceal their autistic identity. On the other hand, autistic people who conceal their autistic identity are not afforded the benefits of autistic community connectedness, potentially undermining mental health outcomes compared to autistic people who reveal their autistic identity. The present study explores the relationships between autism concealment behaviors, autistic community connectedness, stigma experience, and mental well-being in autistic people. In an analytic sample of 409 autistic people, we found that concealing one's autistic identity was related to worse depressive symptoms, and that this relationship was related to experiencing greater stigma, and not to differences in community connectedness. These findings reinforce the need for combatting stigma against autistic people. Lay Abstract Many autistic people try to hide their autistic traits or appear more in line with typical social norms through changing their behavior, even when it is uncomfortable, which is known as camouflaging. Previous studies have shown that autistic people often attribute mental health difficulties, such as anxiety and depression, to concealing their autism through camouflaging. In part, this might be because concealing one's autism is related the loss of a sense of community with other autistic people, which is a protective factor for autistic people's mental health. However, allowing one's autistic identity to be public by forgoing camouflaging can make autistic people more likely to face judgement, stigmatization, and unfair treatment due to society's negative view of autism, which can also lead to poor mental health. Autistic people may thus be in a double bind between engaging in camouflaging but possibly experiencing related mental health difficulties and camouflaging less but encountering more stigmatization. In this study, we explored what contributes to this seemingly contradictory relationship between autism concealment and depressive symptoms. We collected data from 409 autistic people in an online survey. The results showed that participants who concealed their autism more were more likely to show depressive symptoms. This increase in depression symptoms was explained by experiencing stigma rather than feeling connected to the autistic community. These findings suggest negative effects of camouflaging and stigma on autistic people's mental health and support the call for increased autism acceptance.

Exploring the autism “diagnostic odyssey” in the Greater Accra region of Ghana

Introduction: Despite the increasing global prevalence of autism spectrum disorders (ASD), there is limited information about ASD in Africa. Existing research on ASD in Africa shows that autistic children are diagnosed relatively late or not at all. The purpose of this study was to understand the barriers to an autism diagnosis and to engage key stakeholders to action plan steps to reduce the barriers. Methods: We conducted a participatory, mixed methods study using semi-structured interviews, a survey, photo elicitation, and focus groups with 11 participants (four parents and seven health professionals) in the Greater Accra region of Ghana. Findings: Neuro-paediatricians in our study reported that it takes, on average, two to six visits over two weeks to two years or more to diagnose a child. Our thematic qualitative analysis yielded three overarching themes, with barriers and facilitators for each: 1) Systemic, 2) Community, and 3) Parent/Family factors that influence the diagnostic process. The action plan of our stakeholder focus group prioritizes community education to dispel myths and encourage autism acceptance within the Ghanaian community. Conclusion: Knowledge about the diagnostic odyssey can help facilitate early diagnosis and intervention. Implications for practice This research study confirmed known challenges to the autism diagnostic process. It contributed nuanced insights into the role of culture, the importance of education, and the need for community involvement in improving the diagnostic process, early occupational therapy intervention, and autism acceptance within the community.

Reducing stigma toward autistic peers: a pilot investigation of a virtual autism acceptance program for children.

Inclusive educational practices can be beneficial for autistic children, especially when the general education classroom can better meet the child's academic and socio-emotional needs than a special education classroom. Unfortunately, autistic children may not thrive in general education classrooms if they are perceived negatively, subject to bullying, and are socially isolated and rejected by their typically developing peers. Autism acceptance programs may help address the root cause of these problems, autism stigma. Thus, this study evaluated the effectiveness of a virtual autism acceptance program presented to typically developing, 8-10-year-old children through remote learning technology. The 5-week, stakeholder-approved pilot program included a themed module each week (e.g., facts about autism and reducing stigma, sensory sensitivities, strengths of those with autism) presented through a variety of online educational materials. Pretest, posttest, and maintenance results showed that the program was effective in improving children's knowledge about autism, and children's attitudes and behavioral intentions toward their peers with autism. In addition to reducing autism stigma, study findings suggest that remote learning and virtual tools can be used to implement an efficacious autism acceptance program to children, allowing for greater and more cost-effective outreach to children and schools.

Addressing the autism mental health crisis: the potential of phenomenology in neurodiversity-affirming clinical practices.

The neurodiversity movement has introduced a new era for autism research. Yet, the neurodiversity paradigm and the autism clinic remain largely unconnected. With the present work, we aim to contribute to filling this lacuna by putting forward phenomenology as a foundation for developing neurodiversity-affirming clinical interventions for autism. In the first part of this paper, we highlight that autistic people face a severe mental health crisis. We argue that approaches focused on reducing autistic 'symptoms' are unlikely to solve the problem, as autistic mental health is positively correlated with autism acceptance and perceived quality of support provided, not necessarily with lack of 'symptomatologic severity'. Therefore, the development and dissemination of neurodiversity-affirming clinical interventions is key for addressing the autism mental health crisis. However, therapists and researchers exploring such neurodiversity-affirming practices are faced with two significant challenges. First, they lack concrete methodological principles regarding the incorporation of neurodiversity into clinical work. Second, they need to find ways to acknowledge rightful calls to respect the 'autistic self' within the clinic, while also challenging certain beliefs and behaviors of autistic clients in a manner that is sine qua non for therapy, irrespective of neurotype. In the second part of the paper, we introduce phenomenological psychology as a potential resource for engaging with these challenges in neurodiversity-affirming approaches to psychotherapy. In this vein, we put forward specific directions for adapting cognitive behavioral and interpersonal psychotherapy for autism.

Brief research report: Investigating neurodiversity acceptance in the college classroom: an exploratory study

IntroductionHigher education represents a potential opportunity to address autism stigma and, in turn, prevent the negative health consequences of stigma as autistic college students transition into adulthood. The purpose of the current study was to investigate the general college student body and describe their (1) level of autism acceptance based on the neurodiversity framework utilizing the Autism Attitude Acceptance Scale (AAAS) and (2) self-reported knowledge and interests about neurodiversity.MethodsThe sample (n = 90, M age = 21.86, SD = 1.18) featured undergraduates enrolled in a large, diverse, public university in the U.S. Approximately 32% (n = 29) identified as neurodivergent, with 5 identifying as autistic. Separate groups of students completed the AAAS—administered via Qualtrics—in February and September of 2022. In addition, students were provided the opportunity to ask up to three questions each about neurodiversity. We utilized qualitative thematic coding to extract themes from the neurodiversity questions.ResultsWe derived frequency and descriptive statistics for each item and the two AAAS subscales: (1) the General Acceptance (GA) subscale (Cronbach’s alpha = 0.89) and (2) the Attitudes toward Treating Autistic Behavior (ATAB) subscale (Cronbach’s alpha = 0.77). Responses reflected high general autism acceptance. Responses demonstrated greater variability, however, with respect to attitudes toward treating autistic behaviors. Qualitative findings revealed both a high degree of interest in the neurodiversity movement, as well as high variability in knowledge and familiarity with its tenets.ConclusionThis research can inform higher education’s efforts to address and prevent stigma towards autistic and other neurodivergent students.

"The Beacon on Campus": How an Autism-Specific Community College Support Program Addresses Ableism and Autism Acceptance

Autism-specific college support programs (ASPs) are emerging to create more equitable transitions into higher education for autistic students. Such programming is necessary to guide autistic students' journeys as they navigate academia with greater agency. This case study, drawing on the social justice model of disability, explores how an ASP works to dismantle ableism on a community college campus. Findings suggest how the ASP gained legitimacy, surmounted challenges, and promoted autism acceptance in its quest to disrupt institutional ableism and, consequently, transform its campus into a more welcoming space for autistic students. Student affairs practitioners can draw on findings to eradicate ableist practices and messaging within their campus spaces.

Work-Related Self-Efficacy and Illness Identity in Adults with Autism.

Finding and retaining employment significantly challenges individuals with autism spectrum disorder (ASD). The employment rates of individuals with ASD are described as extremely low, barred by various environmental, occupational, and personal factors. Illness identity is how a person's health condition integrates with their identity and daily life and relates to self-esteem, employment, and quality of life. Adults with ASD may experience challenges developing positive identities within social and work environments, but illness identity has not been studied among this population. This study examines the autism identity of adults with ASD and the relationships to their self-reported work-related self-efficacy and quality of life. Seventeen participants aged 19-47 years diagnosed with ASD completed the Illness Identity Questionnaire, Work-Related Self-Efficacy Scale and World Health Organization Quality of Life Assessment. Participants reported significantly higher autism acceptance feelings. Negative feelings about living with autism were significantly correlated to lower work-related self-efficacy. Higher levels of enrichment feelings were significantly associated with a higher quality of life. These findings highlight the effect of illness identity on the work-related self-efficacy and quality of life among individuals with ASD. Allied health professionals and educators can assist these individuals in raising their awareness of how they perceive their autism, and in promoting its positive perception.

Hey look, I’m (not) on TV: autistic people reflect on autism portrayals in entertainment media

Portrayals of autistic characters in entertainment are becoming increasingly common across a range of media platforms, including movies, television series and novels. No longer is the autistic character a bit part or a minor story arc, we are seeing mainstream television series with autistic characters as protagonists and their autism as the focus of the story. The jury is out as to the educational value of these portrayals, with both positive and negative outcomes being posited. However, to date the ‘jury’ has consisted of non-autistic people commenting on the accuracy and impact of fictional portrayals of autism. This study sought the perceptions of autistic people on the ways they are currently portrayed in entertainment media, finding that the entertainment industry has a lot to learn about accurate, meaningful and respectful portrayal of the autistic experience.

"My whole life has been a process of finding labels that fit": A Thematic Analysis of Autistic LGBTQIA+ Identity and Inclusion in the LGBTQIA+ Community.

Being nonheterosexual and noncisgender appears to be more common among autistic people. This intersection of identities is often stigmatized in research and society. However, we know that community involvement can protect against negative mental health outcomes associated with being a minority; researchers found this effect in separate studies examining participation in the autistic and Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual plus other gender and sexual orientation-based identity (LGBTQIA+) communities. This study examined how autistic LGBTQIA+ individuals navigate their multiple marginalized identities and the LGBTQIA+ community. Twelve autistic LGBTQIA+ people from the United Kingdom took part in semistructured interviews. Questions focused on identity and community. We analyzed the interviews using reflexive thematic analysis. We identified four overarching themes-Identity (Re)Development, Navigating Authenticity, Exclusion from Community Spaces, and Creating Change. Participants viewed accessing a community of similar others as a means of increasing understanding, self-knowledge, and self-acceptance. We identified several barriers to inclusion, including accessibility and gatekeeping. Participants discussed strategies to combat these obstacles, such as the creation of intersectional community spaces and activism and representation as a means of increasing autism understanding. This study suggests that similar to other marginalized groups, autistic LGBTQIA+ individuals are motivated to engage in communities relevant to their identities. However, community spaces for autistic LGBTQIA+ are often inaccessible due to social, sensory, and identity-based barriers. Participants highlighted autism understanding as a barrier to coming out both in community and noncommunity settings. This suggests that improving autism acceptance and understanding is crucial to achieve accessible, intersectional, and inclusive community spaces.

Stigma, Incommensurability, or Both? Pathology-First, Person-First, and Identity-First Language and the Challenges of Discourse in Divided Autism Communities.

Stigma, Incommensurability, or Both? Pathology-First, Person-First, and Identity-First Language and the Challenges of Discourse in Divided Autism Communities.