Autism in adulthood : challenges and management最新文献

{"title":"Understanding the Impact of Living Situation and Social Satisfaction on Depression and Substance Use in Autistic Young Adults Without Intellectual Disability.","authors":"María E Contreras-Pérez, Xiangyu Tao, Olivia Vezina, Anthony Spirito, Stephen J Sheinkopf, Casey A Cragin, Kristina M Jackson","doi":"10.1177/25739581261474766","DOIUrl":"10.1177/25739581261474766","url":null,"abstract":"<p><strong>Background: </strong>Autistic young adults face elevated risks for depression, and emerging evidence indicates that some engage in substance use. Residential status and social satisfaction may be related to these outcomes, yet little research has examined their interplay in autistic populations.</p><p><strong>Methods: </strong>Baseline data were drawn from 267 autistic young adults ages 18-24 (M=21.56; SD=1.76). Participants were predominantly female (65.63%), non-Hispanic White (75%), and enrolled in school (68.76%). Participants reported their current residential status, mental health, and substance use, and completed measures of social and role functioning, social satisfaction, and demographic characteristics. A unified mediation model tested whether social satisfaction mediated associations between residential status and (1) depression, (2) alcohol use, and (3) cannabis use, adjusting for relevant covariates.</p><p><strong>Results: </strong>Living alone, compared to living with a parental figure, was associated with greater social satisfaction, which in turn predicted fewer depression symptoms. In contrast, living alone or with friends or roommates was directly associated with elevated alcohol and cannabis use but showed no indirect effects through social satisfaction. Social satisfaction predicted lower depression but was not significantly related to alcohol or cannabis use.</p><p><strong>Conclusion: </strong>Residential status and social satisfaction jointly shape emotional and behavioral outcomes among autistic young adults. Independent living may enhance well-being when accompanied by fulfilling social connections, whereas peer cohabitation may increase exposure to substance use. Interventions that support autonomy, foster social engagement, and incorporate harm reduction strategies may be particularly valuable in promoting healthy transitions to adulthood for autistic individuals.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820394","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":"Valid when valued: A community-engaged framework and toolkit to improve identification of autistic people's motor difficulties in research and practice.","authors":"Haylie L Miller, Priscila M Tamplain, Miri Tal-Saban, Stefania Zoia, Anna L Barnett, Sheila E Henderson","doi":"10.1177/25739581261474754","DOIUrl":"10.1177/25739581261474754","url":null,"abstract":"<p><p>Many autistic people experience clinically-significant motor differences that pose lifelong physical health risks including physical inactivity, cardiometabolic disease, falls and injuries, and chronic pain. These differences amplify existing cognitive and social-emotional features of autism and limit daily living skills, which in turn negatively impacts mental health and participation. Yet, professionals often overlook or mischaracterize autistic people's motor difficulties, in part because non-motor factors can affect assessment outcomes. Most standardized motor assessments presume typical communication, sensory processing, regulation, and tolerance of unfamiliar testing environments, leading to construct-irrelevant variance and potential misinterpretation of results. This risk increases when examiners lack autism-specific experience or use rigid administration practices without appropriate adaptation. Adopting a neurodiversity-affirming framework improves validity, equity, and uptake of motor assessment across research, education, and clinical contexts. Here, we present an Adapted Motor Assessment Toolkit for Autism with implementation examples grounded in the Movement Assessment Battery for Children-Third Edition. An interdisciplinary team of clinicians and researchers developed and refined the toolkit in partnership with autistic people and parents of autistic children. The toolkit enables preservation of core task demands and scoring while adapting assessment practices to support accessibility and improve validity of results. Adaptations span five domains: pre-assessment preparation, sensory supports, procedural adaptations, communication supports, and motivation/engagement. The toolkit helps examiners to identify support needs, implementing adaptations, interpreting results, and determining whether normative comparisons remain appropriate. Neurodiversity-affirming assessment practices enable earlier identification of motor differences, inclusion of more diverse participants in research, and tailored intervention and prevention planning to advance physical health equity across the lifespan.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714770","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":"Autistic Experience and Aging: A Neurodiversity-Affirmative Approach.","authors":"Mary E Stewart, Anna Day, Hanna Bertilsdotter Rosqvist","doi":"10.1177/25739581261440760","DOIUrl":"https://doi.org/10.1177/25739581261440760","url":null,"abstract":"","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 2","pages":"145-148"},"PeriodicalIF":0.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347488","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":"Priorities for Research on Autism and Ageing: A Roundtable Discussion.","authors":"Mary E Stewart, Hanna Bertilsdotter Rosqvist, Anna Day, Joseph Long, Aimee Grant, Marion Hersh, Cos Michael, Mary Doherty, Cecilia Ingard, Wenn Lawson","doi":"10.1177/25739581261440762","DOIUrl":"https://doi.org/10.1177/25739581261440762","url":null,"abstract":"","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 2","pages":"149-158"},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018591","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":"Defining Nonsuicidal Self-Injury in Autistic People: A Framework for Assessment Using Key Elements to Aid in Characterization.","authors":"Ligia Antezana, Caitlin M Conner, Jacob Feldman, Lillian L Manna, Amy Ionadi, Derica J Su, Safaa Eldeeb, Holly Gastgeb, Shalini Sivathasan, Jessie B Northrup, Kelly B Beck, Lori N Scott, Carla A Mazefsky","doi":"10.1177/25739581261423792","DOIUrl":"10.1177/25739581261423792","url":null,"abstract":"<p><p>Nonsuicidal self-injury (NSSI) is the intentional destruction of one's own body tissue without suicidal intent and for purposes that are not socially or culturally accepted or practiced (e.g., intentional self-cutting, self-biting). Research on NSSI in autistic people is limited but increasing. NSSI is strongly associated with suicide, and it is an important behavior to better understand given the high rates of NSSI and suicide in autistic people. To date, research focused on autistic people has mostly used self-report questionnaires to assess NSSI, with a more limited application of clinical interviews of NSSI. However, researchers and clinicians may find it challenging to determine whether a behavior is categorized as NSSI in autistic people, especially since autistic people may present with other behaviors that cause self-injury. We set forth key elements in defining NSSI to support better reliability of NSSI assessment across studies. We emphasize that when assessing for NSSI the behavior must meet these key elements: (1) not intended to cause death, (2) the self-injury/harm is intentional, (3) there is immediate physical injury following the behavior, (4) the injury is to the external body, not internal body, (5) the injury is self-imposed and not done by another being, and (6) it is not a part of social or cultural practices. It will be important for future work to develop measures that can accurately assess NSSI in autistic people and advance mechanistic and intervention research related to NSSI.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367341","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":"Formative evaluation 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, J Madison Hyer, Holden DeVassie, Deondray Radford, Lisa Juckett, Christopher Hanks, Susan M Havercamp, Daniel Coury","doi":"10.1177/25739581251376162","DOIUrl":"10.1177/25739581251376162","url":null,"abstract":"<p><p>Efforts are intensifying across the U.S. to better prepare physicians to deliver high-quality, patient-centered care for adults with disabilities like autism. To address this need, we partnered with autistic adults and their families to develop a training program for resident physicians called Promoting Residents' Excellence in Patient-centered cARE (PREPARE) for Autistic Adults. Here, we describe an evaluation of the feasibility, acceptability, and appropriateness of PREPARE for Autistic Adults to inform content and format revisions before efficacy pilot testing. We recruited residents (n=14) at one large academic medical center in the Midwestern U.S. to participate in the eight-week virtual training, which included six pre-recorded lectures, six facilitator-led case studies, and two standardized patient encounters. Participants rated feasibility, acceptability and appropriateness of the training, and participated in qualitative interviews to identify improvement opportunities. We analyzed quantitative data with descriptive statistics and qualitative interviews with an inductive rapid qualitative analysis. Participants' median completion rate was 76.9% of training components. Participants rated feasibility, acceptability, and appropriateness highly. We identified four main qualitative themes: 1) Flexibility facilitates feasibility, 2) High-value experiences increase acceptability, 3) Practicalities affecting participation, and 4) High clinical practice relevance enhances appropriateness. We revised the training based on feedback, including clarifying or adding content, modifying standardized patient encounter logistics, and adding optional components for residency programs to supplement core PREPARE content. These results provide information for continued refinement of the training. Our next steps include pilot testing the efficacy of the revised training at one large academic medical center.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328411","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":"Language Matters in British Newspapers: A Participatory Analysis of the Autism UK Press Corpus.","authors":"Themis Karaminis, Monique Botha, Sophie Longley, Krysia Emily Waldock, Soph Storey, Khiah Strachan, Nick Ransom, Elizabeth Pellicano","doi":"10.1089/aut.2023.0105","DOIUrl":"https://doi.org/10.1089/aut.2023.0105","url":null,"abstract":"<p><strong>Background: </strong>Language around autism plays a crucial role in shaping public attitudes toward autistic people. The use of identity-first versus person-first language and impersonal references to autism can affect how autistic people are perceived. These factors should impact the representation of autistic people in newspapers, where negative and stereotypical representations are often perpetuated.</p><p><strong>Method: </strong>We asked five autistic people to judge the sentiment toward autism and autistic people in 1000 quotes from British newspapers (2011-2020). The coders, who did not know the newspaper title and time of publication, made their judgments based on two dimensions, warmth and competence, from the Stereotype Content Model (SCM). We examined the overall judgments of warmth and competence and considered variations in language context and terminology, such as the use of impersonal references to autism or identity-first and person-first language. We also examined potential differences between broadsheets and tabloids, left- and right-leaning newspapers, and changes over time.</p><p><strong>Results: </strong>The majority of quotes from British newspapers fell under a low warmth and low competence area within SCM. Furthermore, impersonal references to autism tended to be rated lower in warmth and competence than references linking autism to an individual, whereas identity-first language was judged higher in warmth and competence than person-first language. Quotes from broadsheets were assigned similar warmth and slightly higher competence than quotes from tabloids. However, left-leaning and right-leaning papers did not differ regarding warmth and competence, and there were inconsistent changes over time.</p><p><strong>Conclusion: </strong>Our study confirms that the portrayal of autistic people in British newspapers tends to be negative. According to autistic raters, associating autism with a person and using identity-first language are linked to more positive representations. Although we found subtle variations in sentiment related to reporting style, our study shows little progress over time toward more positive portrayals.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"698-711"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108716","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":"Contextual Factors Contributing to Social Participation for LGBTQIA+ Autistic Adults in the United States.","authors":"Elizabeth K Schmidt, Farah Rexha, Mason Williams, Jess Bauza de Garcia, Maya Sicherer, Rachel Hickman","doi":"10.1089/aut.2023.0149","DOIUrl":"https://doi.org/10.1089/aut.2023.0149","url":null,"abstract":"<p><strong>Background: </strong>Separately, autistic and LGBTQIA+ people report experiencing negative social participation outcomes. Specifically, autistic individuals report fewer friendships but a desire for them. LGBTQIA+ individuals report experiences of family rejection, microaggressions from friends, and discrimination. Based on intersectionality theory, we hypothesize that individuals who are both autistic and LGBTQIA+ may have additional challenges with social participation and require unique support. Therefore, in this study, we aim to describe the experiences of social participation and the supports and barriers for autistic LGBTQIA+ adults.</p><p><strong>Methods: </strong>This analysis utilized data from a mixed-method, participatory research study, including qualitative data from 57 LGBTQIA+ autistic adults and quantitative survey data from 107 LGBTQIA+ autistic adults. Qualitative data were collected through virtual semi-structured interviews or focus groups and analyzed using interpretative phenomenological analysis. Analysts used an audit trail and negative case analysis and checked for representativeness of the data across participants to ensure trustworthiness of data. A survey was developed using the findings from the qualitative data and built in Qualtrics for dissemination. Survey data were analyzed using descriptive statistics and merged with qualitative data.</p><p><strong>Results: </strong>Participants discussed relationships with family, friends, and intimate partners-however, primarily focused on friendships. Participants described how they \"found their people\" serendipitously, through shared interests or hobbies, or intentionally online. A subset of participants reported challenges \"finding their people,\" with specific barriers being challenges online and inaccessibility within LGBTQIA+ spaces and events. Participants reported strategies to safely move relationships from online to in-person, such as identifying safe, accessible social activities of shared interest with their friend or intimate partner(s).</p><p><strong>Conclusions: </strong>Autistic LGBTQIA+ adults validate the importance in \"finding their people,\" yet not all autistic LGBTQIA+ adults have successfully developed these relationships. Identified supports and barriers indicate a need for more support to help LGBTQIA+ autistic individuals connect in person, including moving online relationships safely to in-person activities. In addition, these results suggest the need for increasing accessibility of LGBTQIA+ events, such as additional structured activities within the LGBTQIA+ communities and sensory-friendly Pride event options.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"712-723"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108685","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":"What Is Uncertainty? A Grounded Theory of the Role of Uncertainty in Anxiety in Autism.","authors":"Laura Lennuyeux-Comnene, Julia Yates, Sebastian B Gaigg","doi":"10.1089/aut.2022.0085","DOIUrl":"https://doi.org/10.1089/aut.2022.0085","url":null,"abstract":"<p><strong>Background: </strong>Although previous qualitative work has identified the role of intolerance of uncertainty in the development of anxiety in autism, there has been little research on what uncertainty means exactly for autistic people and/or what types of uncertainties may be particularly anxiety provoking.</p><p><strong>Methods: </strong>Fifteen autistic adults (five women) took part in this qualitative interview study in which we probed their understanding and experiences of uncertainty and its links to feelings of anxiety. We applied a grounded theory approach to transcripts of the interviews, broadly following Charmaz's constructivist epistemology, to derive a theory of uncertainty as it is experienced by the autistic people we interviewed.</p><p><strong>Results: </strong>From the interviews, we derived a model of uncertainty, which identified three different levels of uncertainty, ranging from the certainty of the \"known,\" through to the relatively manageable uncertainty of the \"known unknown,\" to the anxiety-provoking \"unknown unknown\" or that which cannot be made known. We propose in this model that anxiety can be understood as resulting from difficulties with avoiding or controlling the latter types of uncertainty through planning or information gathering.</p><p><strong>Conclusion: </strong>Previous researchers had treated uncertainty as a unified construct. However, they may not have explored what uncertainty might mean for autistic people. We have shown in this study that not all uncertainties are experienced equally. We hope that this research will help develop a more nuanced understanding and that it constitutes the first step in disentangling anxiety from intolerance of uncertainty in autism.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"739-751"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108663","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":"Latent Structure of the WHOQOL-BREF: Implications for Measuring Quality of Life Among Autistic Adults.","authors":"Elizabeth A Kaplan-Kahn, Goldie A McQuaid, Nancy Raitano Lee, Gregory L Wallace, Benjamin E Yerys","doi":"10.1089/aut.2023.0101","DOIUrl":"10.1089/aut.2023.0101","url":null,"abstract":"<p><strong>Background: </strong>To accurately measure quality of life among autistic adults, researchers need surveys that are psychometrically validated for autistic populations. Researchers have demonstrated that the short version of the World Health Organization Quality of Life instrument (WHOQOL-BREF) has strong psychometric properties in the general population. Although there has been some research exploring basic psychometric properties (reliability, convergent validity, etc.) of the WHOQOL-BREF in autistic populations, the underlying latent structure of the measure has not been tested in autistic adults. Our goal in the current study was to compare different confirmatory factor analysis (CFA) models to test which one best captured the underlying latent structure of the WHOQOL-BREF data in a sample of autistic adults.</p><p><strong>Methods: </strong>A total of 842 autistic adults between the ages of 18 and 83 years completed the WHOQOL-BREF. Based on participant responses, we compared four <i>a priori</i> CFA models-correlated four-factor, unidimensional, higher-order, and bifactor models-to demonstrate which model structure best captures the underlying latent structure of the measure in this population.</p><p><strong>Results: </strong>Similar to past research, the WHOQOL-BREF showed strong internal reliability in our sample of autistic adults. The bifactor model demonstrated the best fit to the data-demonstrating that the WHOQOL-BREF is best conceptualized as having both domain-specific quality-of-life factors (i.e., the Physical, Psychological, Environmental, and Social domains of the WHOQOL-BREF) and a general quality-of-life factor.</p><p><strong>Conclusion: </strong>Our results provide researchers with psychometric validation of the underlying latent structure of the WHOQOL-BREF in autistic populations. Items on the WHOQOL-BREF capture both domain-specific and general quality of life among autistic adults. Researchers can use the bifactor model to accurately capture multiple dimensions of quality of life in autistic adults, advancing the ways that the WHOQOL-BREF can be used as a measure of quality of life among autistic people.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"763-772"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108695","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}