Autism in adulthood : challenges and management最新文献

{"title":"Development and Initial Validation of the Autism and Neurodiversity Attitudes Scale.","authors":"Rachel A VanDaalen, Frank R Dillon, Carlos E Santos, Cristalis Capielo Rosario","doi":"10.1089/aut.2023.0090","DOIUrl":"10.1089/aut.2023.0090","url":null,"abstract":"<p><strong>Background: </strong>Drawn from aspects of the autistic self-advocacy movement, the neurodiversity movement is a conceptual framework and sociopolitical movement that views neurological differences and disabilities (e.g., autism) as natural human variations that can form a central component of one's identity. This study presents the development and validation of a scale to assess endorsement of neurodiversity beliefs with respect to autism among both autistic and nonautistic adults.</p><p><strong>Methods: </strong>Diverse samples of adults were utilized to conduct exploratory (<i>N</i> = 249) and confirmatory (<i>N</i> = 259) factor analyses, resulting in a 17-item second-order three-factor model that demonstrated adequate evidence of reliability and validity.</p><p><strong>Results: </strong>The three factors consisted of <i>Autism Anti-Stigma</i>, <i>Autism Permanence</i>, and <i>Autism as Difference</i>. Additional analyses of measurement validity revealed that endorsement of the neurodiversity framework is positively correlated with sociopolitical engagement, and that endorsement of the neurodiversity framework is negatively correlated with negative attitudes toward people with disabilities. Self-identified autistic adults endorsed the neurodiversity framework to a greater extent than nonautistic adults.</p><p><strong>Conclusion: </strong>The validity results are congruent with the historical roots of the neurodiversity movement and the attitudes endorsed by many autistic adults. Given the factor structure and reliability results, researchers can use this scale to assess neurodiversity-affirming attitudes as a unitary construct or can use the anti-stigma subscale to assess stigma-related attitudes toward autism. This scale has utility for researchers that seek to understand and promote well-being in autistic adults, as well as research related to potential support systems in the lives of autistic adults. It can also be used to increase self-understanding among autistic individuals and allies, as this scale can be used for both autistic and nonautistic adults.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 1","pages":"39-51"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of PREPARE for Autistic Adults: An Adult Autism Training for Resident Physicians Designed with Autistic Adults and Family Members.","authors":"Brittany N Hand, Daniel Gilmore, Holden DeVassie, Anne Longo, Lisa Juckett, Christopher Hanks, Susan M Havercamp, Daniel Coury","doi":"10.1089/aut.2023.0137","DOIUrl":"10.1089/aut.2023.0137","url":null,"abstract":"<p><p>One barrier to meeting autistic adults' health care needs is the dearth of physicians with autism training. We developed an adult autism training for residents, who are postdoctoral physicians training to become specialists, in internal medicine or family medicine. We used formative evaluation to design the training with autistic adults and family members of autistic adults, who were paid consultants. The training includes six prerecorded presentations, six case studies, and two standardized patient scenarios. We conducted focus groups and interviews with 23 residents and 14 faculty who educate residents. We described the curriculum, reviewed the content in one module, and obtained feedback on maximizing feasibility and scalability. Using semantic-level inductive rapid qualitative analysis we identified three themes and two subthemes. First, \"flexibility is key\" described ways to increase flexibility to accommodate resident and faculty schedules across programs. Second, \"time is the most valuable asset\" described the need to minimize duration and maximize impact. Third, \"buy-in is necessary\" described ways to increase buy-in from residents and residency leadership. Two subthemes, \"we don't talk much about neurodivergence\" and \"this content applies to all patients,\" describe how to increase buy-in by highlighting how this training fills a gap in resident education and can be generalized to multiple populations. Results highlighted ways to modify our training to maximize implementability across different residency programs. Next steps include pilot testing of feasibility, acceptability and effects on resident self-efficacy, attitudes/beliefs, and knowledge. In the long term, we expect this will yield more adult care physicians prepared to meet autistic adults' needs.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 1","pages":"112-120"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating Psychoeducational Care in the Autism Diagnosis Pathway: Experiences, Views, and Recommendations of UK Autistic Adults and Autism Professionals.","authors":"Bryony Beresford, Suzanne Mukherjee","doi":"10.1089/aut.2023.0060","DOIUrl":"10.1089/aut.2023.0060","url":null,"abstract":"<p><strong>Background: </strong>When someone receives a diagnosis they may need support with information and emotional needs. These are called psychoeducational needs. For adults diagnosed with autism, these can include needing to understand and make sense of the diagnosis and finding self-management strategies that work for them. When autistic adults do not receive the psychoeducational support they need their mental health and self-confidence in managing everyday life is affected. However, many diagnostic services do not provide psychoeducational care. In this study, we investigated autistic adults' and autism specialist staff's views on the psychoeducational care that diagnostic services should provide.</p><p><strong>Methods: </strong>We recruited 26 autistic adults and 30 staff working in 8 UK autism services commissioned to provide both diagnostic assessments and post-diagnostic care. The staff sample included five autistic adults employed as \"experts by experience\" to co-deliver psychoeducational support. We used group discussions (or, where required, 1:1 interviews) to explore their views and experiences.</p><p><strong>Results: </strong>Study participants believed psychoeducational needs arose during the assessment process (e.g., possible emotional reactions to diagnosis), and when the diagnosis is divulged (e.g., managing disclosure) as well as during the weeks and months following diagnosis. In this period, study participants agreed that the psychoeducational care offered by diagnostic services should include a debrief appointment, psychoeducation program, and the provision of \"curated\" information. That is, information resources carefully selected by staff and in multiple formats (e.g., text-based, videos). Study participants believed autism professionals and \"experts by experience\" had distinct contributions to make in meeting psychoeducational needs.</p><p><strong>Conclusion: </strong>Findings support the case for diagnostic services to have the resources to address psychoeducational needs across the diagnostic pathway, including the offer of a debrief appointment and group-delivered psychoeducational program (with the option for 1:1 delivery) post-diagnosis. \"Experts by experience\" should be integral to the development and delivery of psychoeducational care.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 1","pages":"13-24"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Positive Psychology and Autism: A Roundtable.","authors":"Patricia Wright, Rachel Moseley, Dan Tomasulo, Hari Srinivasan, Jodie Wilson, Sara Woods, Tayyab Rashid","doi":"10.1089/aut.2024.38246.pw","DOIUrl":"10.1089/aut.2024.38246.pw","url":null,"abstract":"","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"6 4","pages":"389-400"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Member Views on Autism Intervention: Effects of Closeness to Autistic People with Intellectual Disabilities And Nonspeaking Autistic People.","authors":"Lynnette Hersh, Patrick Dwyer, Steven K Kapp, Sergey Shevchuk-Hill, Ava N Gurba, Elizabeth Kilgallon, Ally Pax Arcari Mair, David S Chang, Susan M Rivera, Kristen Gillespie-Lynch","doi":"10.1089/aut.2023.0202","DOIUrl":"10.1089/aut.2023.0202","url":null,"abstract":"<p><strong>Background: </strong>Controversy regarding the neurodiversity movement (NDM), the social and medical models of disability, autism intervention goals, and causal attributions of disability contributes to divides in the autistic and autism communities. The present study investigates the views of autistic and non-autistic autistic and autism community members on these topics. We explored whether these views are shaped by having close relationships to autistic people with intellectual disabilities (ID) and nonspeaking autistic (NSA) people.</p><p><strong>Methods: </strong>A total of 504 autistic and autism community members (278 autistic, 226 non-autistic) completed an online survey about theoretical models and intervention goals. Participants reported whether they had one or more close relationships with NSA people, autistic people with ID, neither, or both.</p><p><strong>Results: </strong>Overall, there was considerable consensus regarding desired intervention goals: normalization goals were generally opposed, while participants generally supported well-being, societal reform, supportive environment, and adaptive skill goals. While autistic participants reported less support for normalization and adaptive skills goals than non-autistic participants, they expressed somewhat more enthusiasm for societal reform and supportive environments than non-autistic people. Autistic people supported the NDM more and the medical model less than non-autistic people. Those close to autistic people with ID gave higher ratings to adaptive skill goals. On average, participants not close to autistic people with ID saw the challenges of those without ID as being slightly more due to environmental/social factors than the challenges of those with ID; there was no such statistical difference among those close to autistic people with ID.</p><p><strong>Conclusion: </strong>Further research investigating community views, with the inclusion of more autistic people with ID and NSA people themselves, is needed, but the results of this study suggest that the broader autistic and autism communities see NDM-consistent intervention goals as appropriate for all autistic people, including NSA people and those with ID. As autism interventions have often pursued unpopular normalization goals, this suggests directions for reform.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"6 3","pages":"253-271"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Call for Papers:</i> Autism and Aging: A Lifespan Approach: Deadline for Manuscript Submission: January 15, 2024.","authors":"Mary Stewart, Anna Day, Hanna Bertilsdotter Rosqvist","doi":"10.1089/aut.2023.29025.cfp","DOIUrl":"https://doi.org/10.1089/aut.2023.29025.cfp","url":null,"abstract":"","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"5 4","pages":"345-346"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138802697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Correction to:</i> Centering the Inner Experience of Autism: Development of the Self-Assessment of Autistic Traits, by Ratto et al. <i>Autism Adulthood</i> 2023;5(1):93-105; doi: 10.1089/aut.2021.0099.","authors":"","doi":"10.1089/aut.2021.0099.correx","DOIUrl":"https://doi.org/10.1089/aut.2021.0099.correx","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1089/aut.2021.0099.].</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"5 3","pages":"344"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468544/pdf/aut.2021.0099.correx.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10147391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Simultaneously Vague and Oddly Specific\": Understanding Autistic People's Experiences of Decision Making and Research Questionnaires.","authors":"Rachael Stacey, Eilidh Cage","doi":"10.1089/aut.2022.0039","DOIUrl":"10.1089/aut.2022.0039","url":null,"abstract":"<p><strong>Background: </strong>Autism researchers often use questionnaires to gather the views and experiences of autistic people. However, questionnaires may not always be designed in accessible ways. In addition, answering questions within a questionnaire involves decision making, which some autistic people have reported finding difficult. Therefore, this exploratory study aimed to enhance our understanding of autistic people's experiences of decision making, and to analyze their feedback on questionnaire measures to further understand decision making within the research context.</p><p><strong>Methods: </strong>One hundred seventeen participants completed an online questionnaire. In the questionnaire, they answered an open question about what affected their ability to make decisions. They then completed four questionnaire measures and after each one provided feedback. We used content analysis to categorize participants' qualitative answers.</p><p><strong>Results: </strong>Participants discussed how their internal state, other people, the quality and quantity of information, pressure on choosing a response, external distractions, and lack of time all affected their decision making. Feedback on the questionnaires highlighted how questions needed context, often questions themselves were unclear and difficult to understand, that there were issues with Likert scales, and how measures could have questionable validity for autistic people.</p><p><strong>Conclusions: </strong>Autism researchers need to consider how they can make their research as accessible as possible for autistic people. Our study highlights how decision making is not a straight-forward process, and researchers have a role in ensuring they give their participants clear and contextualized information. Involving autistic people in the design of research is a potential way of improving the quality of research.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"5 3","pages":"263-274"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Career Autism Researchers Are Shifting Their Research Directions: Tragedy or Opportunity?","authors":"Diana Weiting Tan","doi":"10.1089/aut.2023.0021","DOIUrl":"10.1089/aut.2023.0021","url":null,"abstract":"<p><p>Early-career researchers (ECRs) are among the most creative, talented, and energetic researchers, and they play an important role in knowledge production and pushing scientific boundaries. Recent debates have implied that many early-career autism researchers are compelled to shift their areas of focus within autism research as a consequence of their work being scrutinized by the autistic and autism communities. In this Perspective, I draw on my own experience as an early-career autism researcher having recently pivoted my research focus to become more aligned with community priorities. I reflect on whether these putative shifts in research direction are, indeed, a tragedy, as has previously been suggested, or, in fact, an opportunity for autism researchers. I argue that pivoting in research is a demonstration of science adapting to the ever-evolving needs in society and changes in our understanding of neurodiversity, neurodivergence, and research methods. While disagreements between the autistic, autism, and research communities may well feel uncomfortable, these tensions also present an opportunity for us-as non-autistic autism researchers-to reflect and to act toward building trust with the community. I recommend three areas for reflections: the purpose of our research, our position of power, and the epistemic limits of our academic expertise. I end by encouraging ECRs to consider taking actions, however small, to lead the charge in improving practices in autism research.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"5 3","pages":"218-224"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10143372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lockdown Experiences and Views on Future Research Participation of Autistic Adults in the UK During the First 6 Months of the COVID-19 Pandemic.","authors":"Alba X Realpe, Nicola Mills, Lucy Beasant, Sarah Douglas, Lorcan Kenny, Dheeraj Rai","doi":"10.1089/aut.2022.0027","DOIUrl":"10.1089/aut.2022.0027","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic resulted in large-scale public health restrictions and lockdowns across many countries. There is an increasing literature on the varied impact of such lockdowns in autistic adults. However, there is very little research on how the pandemic and related public health measures may impact the willingness of autistic people in engaging and taking part in research. The aim of this qualitative study was to explore autistic adults' experiences of the COVID-19 lockdown and how the pandemic may affect future research participation.</p><p><strong>Methods: </strong>We conducted in-depth interviews with 31 autistic adults between March and July 2020. Transcripts were analyzed thematically within a critical realism framework.</p><p><strong>Results: </strong>Participants identified positive aspects of lockdown such as enjoying the lack of social pressures and using their well-developed skills for dealing with uncertainty. Autistic people also shared challenges of adjusting to lockdown, for example, rapid change in daily routines. While hopeful about the freedom gained from easing restrictions, participants were concerned about the inconsistent communication and application of rules during the transition out of lockdown. This may have exacerbated already rising mental health issues among autistic people. The participants viewed research participation and engagement with increased relevance during the pandemic and welcomed efforts to conduct research using online methods of communication.</p><p><strong>Conclusion: </strong>The COVID-19 lockdown had a varied effect in the lives and routines of autistic people. However, health care providers and researchers need to be mindful of rising mental health issues in the aftermath of the pandemic, especially for people who were already vulnerable. The response to the pandemic may have offered opportunities for innovation in research processes enabling more autistic people to engage with research and making studies more inclusive.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"5 3","pages":"301-310"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}