Autism in adulthood : challenges and management最新文献

{"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}

{"title":"Empathic Disequilibrium as a Predictor of Nonsuicidal Self-Injury in Autistic and Nonautistic People.","authors":"Rachel Moseley, Ido Shalev, Nicola Gregory, Florina Uzefovsky","doi":"10.1089/aut.2023.0134","DOIUrl":"https://doi.org/10.1089/aut.2023.0134","url":null,"abstract":"<p><strong>Background: </strong>Nonsuicidal self-injury (NSSI) affects many autistic individuals, and has been linked to suicidality in this group. It has been closely linked to difficulties with intrapersonal emotion regulation, but a role of interpersonal emotion regulation processes in NSSI has been underexplored. Empathic disequilibrium is a state of imbalance between a person's cognitive empathy (CE) and emotional empathy (EE). We recently found that autistic people exhibit heightened EE relative to CE, consistent with their firsthand reports of hypersensitivity to the emotions of others. Because this kind of empathic imbalance is associated with hyperarousal and emotional reactivity, we hypothesized that it might increase the risk of NSSI, which often occurs as a means of trying to regulate overwhelming or distressing emotions.</p><p><strong>Methods: </strong>We measured CE, EE, emotional reactivity, and NSSI behaviors in 304 autistic and 289 nonautistic participants, and used polynomial regression with response surface analysis to examine empathic disequilibrium as a predictor of emotional reactivity and engagement in NSSI.</p><p><strong>Results: </strong>Replicating previous research, individuals with an autism diagnosis were more likely to show a pattern of EE-dominance (OR = 4.51 [2.66, 7.63], <i>p</i> < 0.001), although they did not differ significantly in overall empathy levels. While empathic disequilibrium was associated with NSSI in autistic and nonautistic people, the nature of these pathways differed between groups. In autistic people, empathic disequilibrium toward EE-dominance was associated with a higher incidence of NSSI through emotional reactivity. In contrast, for nonautistic individuals, the incidence of NSSI was associated with overall empathy and, when accounting for emotional reactivity, with empathic disequilibrium toward CE dominance.</p><p><strong>Conclusions: </strong>While future studies should investigate the direction of relationships with longitudinal designs, these findings highlight different mechanisms for NSSI in autistic and nonautistic people. They corroborate growing evidence that the relative imbalance between empathic abilities may be relevant for meaningful outcomes, such as psychopathology.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"724-738"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108665","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'm Not Trying to Be Difficult When I Can't Do Things\": A Mixed Methods Look at Transitioning from Pediatric to Adult Health Care on the Autism Spectrum.","authors":"Briana P Keller, Laina Heacock, Emily Rothenberg, Jessika C Boles","doi":"10.1089/aut.2023.0093","DOIUrl":"https://doi.org/10.1089/aut.2023.0093","url":null,"abstract":"<p><strong>Background: </strong>Although autistic individuals can require more health care services than the general population, the care they receive is often suboptimal. During young adulthood, autistic patients face additional developmental barriers and achieve poorer medical outcomes as they transition between pediatric and adult health systems. However, little is known about their transition needs, perceptions, and experiences.</p><p><strong>Methods: </strong>This study examined the health care experiences and transition perceptions of 213 autistic young adults aged 18-26 years (mean age 22.72). Both formally diagnosed and self-identified autistic individuals participated in the study. Our research team used mixed methods online survey, including an original health care experience questionnaire, an adapted measure of health care transition readiness, and short-answer questions. We used nonparametric statistical tests to examine relationships between quantitative variables, and qualitative responses were analyzed using an inductive, open-coding approach.</p><p><strong>Results: </strong>Quantitative analyses revealed health care environments to be least accessible for individuals who are female or gender nonconforming, nonspeaking, and/or in their late teenage years. These individuals also showed lower levels of involvement in their own care compared with other subgroups. Conversely, those with a history of regular medication management reported higher levels of readiness for health care transition. Open-ended survey responses clustered around the following five themes: (1) deciding whether to disclose an autism diagnosis, (2) medical staff's current understanding of autism, (3) discrimination, (4) communication challenges, and (5) unique needs.</p><p><strong>Conclusion: </strong>Participants in this study preferred to be actively involved in their health care and required supportive, knowledgeable providers and inclusive environments to accomplish this goal. Noting this, it is important for health care providers to assess individual needs and preferences and design focused supports for autistic patients transitioning from pediatric to adult care.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"773-785"},"PeriodicalIF":0.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108719","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":"Advancing Research on Suicide and Mental Health in Autistic Adults Through a Research Domain Criteria (RDoC)-Inspired Framework.","authors":"Carla A Mazefsky, Caitlin M Conner, Greg J Siegle, Lori N Scott, Lauren M Bylsma, Kelly B Beck, Ligia Antezana, Xin Hu, Annie Cohen, Xenia Borue, Benjamin Handen","doi":"10.1177/25739581251393807","DOIUrl":"10.1177/25739581251393807","url":null,"abstract":"<p><p>Given the dearth of research on adulthood in autism prior to the last decade, we need methods to accelerate progress. One area of interest is mental health, but studies focusing on isolated methods or limited sets of constructs are unlikely to rapidly identify the many contributors to autistic adult mental health outcomes. We argue that adopting a multimethod, dimensional approach will more rapidly speed progress. One framework designed to encourage this approach is the National Institute of Mental Health (NIMH)'s Research Diagnostic Criterion initiative (RDoC). In this paper, we describe the utility of RDoC and considerations for the design of an RDoC-inspired autism study. We demonstrate this via an example focused on suicide because suicide is one serious and well-documented sequelae of poor mental health. This paper begins with a brief overview of the significance of suicide to autism. Then, the paper outlines key aspects of the RDoC, including consideration of the following: dimensional processes, development, different units of analysis (methods), content domains, and environmental influences. We describe the University of Pittsburgh Autism Center of Excellence (Pitt ACE) as project context; it adds an example of how RDoC can work and concepts to consider when designing an RDoC-inspired autism study. Specific methods and constructs are highlighted that may lead to improved understanding of suicide and mental health in autistic adults, and ultimately more tailored interventions and supports.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776388","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":"Proportional Overrepresentation of Gender-Diverse Identities in Two US-Based Autistic Adult Samples from the SPARK Database.","authors":"Lindsay Bungert, Cindy E Li, Annie L Cardinaux, Amanda M O'Brien, Jonathan Cannon, Veronica Shkolnik, John D E Gabrieli, John F Strang, Pawan Sinha","doi":"10.1089/aut.2023.0121","DOIUrl":"https://doi.org/10.1089/aut.2023.0121","url":null,"abstract":"<p><strong>Background: </strong>Previous literature indicates a proportional overrepresentation of both autism and autistic traits within gender-diverse populations (individuals who experience their gender identity as different from their sex assigned at birth). Emerging but limited evidence also suggests a proportional overrepresentation of gender-diverse identities in autism. To our knowledge, this is the first study to report gender diversity prevalence in autistic adults in the United States.</p><p><strong>Methods: </strong>We report the prevalence of gender diversity within two well-characterized samples of autistic adults recruited from SPARK (Simons Foundation Powering Autism Research for Knowledge), the largest online research database of autistic individuals to date. This study includes both an original sample (Dataset 1, <i>n</i> = 205) and a replication sample (Dataset 2, <i>n</i> = 243). In addition, we looked at the co-occurrence of anxiety and/or mood disorders with gender-diverse identities.</p><p><strong>Results: </strong>We found that 16.1% of autistic adults in Dataset 1 and 19.8% of autistic adults in Dataset 2 were gender diverse. This compares with prior findings of 0.5% to 4.5% in the general adult population. Autistic participants who were gender diverse, compared with those who were not, were up to six times more likely to report diagnosed anxiety and/or mood disorder(s). The finding of proportional overrepresentation of gender diversity in autistic individuals is consistent with reports from other countries, and higher than some previous estimates (e.g., 15%).</p><p><strong>Conclusion: </strong>These findings point to the necessity for autism research to take gender identity into account in addition to sex assigned at birth, and to pay particular attention to the mental health challenges that gender-diverse autistic individuals may face. These important steps will lead toward increased understanding of the needs of gender-diverse autistic individuals and ways to improve care.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 6","pages":"685-697"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108650","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":"A Coproduced Exploration of Factors Influential to Quality of Life from the Perspective of Autistic Adults.","authors":"Rebecca Kuzminski, Sven Bölte, Wenn Lawson, Marita Falkmer, Melissa H Black, Sonya Girdler, Ben Milbourn","doi":"10.1089/aut.2023.0091","DOIUrl":"https://doi.org/10.1089/aut.2023.0091","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Autistic adults reportedly experience poorer quality of life (QoL) than their non-autistic peers. However, many tools used to measure their QoL were not developed for autistic adults, but for the general population. It is possible that factors contributing to the QoL of autistic individuals could vary from that of the general population, meaning commonly used tools may inadequately capture the nuances of autistic QoL. It is, therefore, imperative that autistic QoL is comprehensively conceptualized from the perspective of autistic adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used a qualitative semi-structured interview methodology guided by an overarching coproduction approach to capture factors contributing to autistic QoL. A research team, including an autistic researcher and a steering group of five autistic adults, worked together throughout the entire research process. An additional autistic researcher provided consultation about how to authentically coproduce this research. Coproducing this research included the steering group and autistic researcher in developing the methodology, the interview guide, and the thematic analysis and naming of the themes. We interviewed 29 autistic adults aged 18-55 who lived in Australia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Coproduced thematic analysis identified five themes: activities and routines; relationship supports and socialization; mind and body; personal experiences; and environment. Participants described how subthemes within each theme positively and/or negatively impacted their QoL. Examples of subthemes that may represent factors uniquely impacting QoL for autistic adults include understanding their self-identity, sensory experiences, and the impact of societal attitudes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;While some elements identified by autistic adults also appear in non-autistic conceptualizations of QoL, the impact and importance of these factors may vary from non-autistic experiences. We also identified some factors that may uniquely impact QoL for autistic adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Community brief: &lt;/strong&gt;&lt;b&gt;Why is this an important issue?:&lt;/b&gt; Quality of life (QoL) is an important but underresearched outcome for autistic adults. Supports are often provided with the aim of improving QoL, but our understanding of QoL is based on understandings from non-autistic populations. The factors contributing to QoL in autistic adults might be different from non-autistic adults, and assessments used by health professionals to measure QoL may not accurately measure autistic QoL. Understanding the factors that support QoL for autistic adults is important for ensuring accurate assessment and for providing more effective support to enhance QoL for autistic individuals.&lt;b&gt;What was the purpose of this study?:&lt;/b&gt; This study wanted to understand what factors influence autistic adults' QoL. It is the first step toward understanding autistic QoL, which could inform the measurement of autis","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 5","pages":"594-611"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672735","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":"Facial Affect Differences in Autistic and Non-Autistic Adults Across Contexts and Their Relationship to First-Impression Formation.","authors":"Sarah J Foster, Desiree R Jones, Amy E Pinkham, Noah J Sasson","doi":"10.1089/aut.2023.0199","DOIUrl":"https://doi.org/10.1089/aut.2023.0199","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autistic people often receive unfavorable first impressions from non-autistic people, likely because of stigma related to divergent social presentations and expressive behaviors. Although facial expressivity influences first impressions in the general population, no research has examined whether expressivity differences in autism relate to the formation of first impressions by non-autistic people. It is also unclear whether facial expressivity in autism varies depending upon contextual demands and whether this affects first impressions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We video-recorded 21 autistic and 21 non-autistic adults in two contexts, interviewing for their ideal job and discussing a personal interest, and quantified the percentage of video frames displaying positive, neutral, and negative facial affect using iMotions software. We also compared facial affect between the autistic and non-autistic groups within and between contexts. Later, 335 non-autistic undergraduates rated participants using the First Impression Scale to assess whether impressions were modulated by context and showed associations with facial expressivity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings demonstrated that autistic and non-autistic adults differed in overall emotional expressivity, with non-autistic participants displaying more positive affect at a trend-level than autistic participants. Autistic adults also received less favorable first impressions, and these showed some correspondence with their emotional expressivity. For example, their displays of negative affect were moderately to strongly related to worse impressions in the job interview context, a pattern not found to the same degree for non-autistic participants. Impressions of autistic participants also improved more than for non-autistic ones when talking about a personal interest compared with the job interview context, and when their diagnosis was disclosed to observers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Collectively, these findings indicate that autistic people demonstrate divergent facial emotional expressivity that relates to the less favorable impressions they receive from non-autistic observers. Context and diagnostic disclosure also affect how autistic people are perceived.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Community brief: &lt;/strong&gt;&lt;b&gt;Why is this an important issue?:&lt;/b&gt; Autistic people are often stigmatized in professional and personal settings. It is important to understand the factors that relate to stigma in everyday contexts to create more inclusive environments for autistic people.&lt;b&gt;What was the purpose of this study?:&lt;/b&gt; To understand whether autistic differences in how emotions are expressed in the face relate to how autistic people are perceived in personal and professional contexts.&lt;b&gt;What did the researchers do?:&lt;/b&gt; We asked autistic and non-autistic adults to describe a personal interest and sit for a mock job interview. Later, non-autistic people provided their first ","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 5","pages":"581-593"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672749","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've Absolutely Reached Rock Bottom and Have No Energy\": The Lived Experience of Unemployed and Underemployed Autistic Adults.","authors":"Laura J Smethurst, Andrew R Thompson, Megan Freeth","doi":"10.1089/aut.2023.0171","DOIUrl":"https://doi.org/10.1089/aut.2023.0171","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autistic adults are underrepresented in the employment market, and those in work are commonly underemployed. Our study aimed to gain an understanding of autistic adults' experiences of unemployment and underemployment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eight autistic adults who self-identified as currently unemployed or underemployed who were actively seeking to change their employment status participated in semi-structured interviews, analyzed using interpretative phenomenological analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four group experiential themes were identified: &lt;i&gt;feeling paralyzed&lt;/i&gt; (the past weighs heavy; fragile self-confidence); &lt;i&gt;powerlessness&lt;/i&gt; (lack of agency; systemic support failures); &lt;i&gt;negative perceptions&lt;/i&gt; (feeling misunderstood; fear of judgment; pressure to meet societal expectations); and &lt;i&gt;recognizing our needs&lt;/i&gt; (managing mental health difficulties; importance of self-understanding). Participants felt paralyzed by employment experiences, which impacted their confidence to progress with their career aspirations. Autistic people felt misunderstood, judged, and powerless within support systems, which had implications for their mental health. Participants recognized the importance of managing their mental health needs during times of unemployment and underemployment via self-care and seeking psychological support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Putting resource into understanding, acknowledging, and addressing processes within and around employment should be priorities for policy makers if they are serious about improving support to help autistic people find and stay in work.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Community brief: &lt;/strong&gt;&lt;b&gt;Why is this an important issue?:&lt;/b&gt; Autistic people are less likely to have a job than non-autistic people. Autistic people who do have a job are likely to work fewer hours than they want, be in a job that that doesn't fully use their skills or education, or not get paid enough to meet their basic needs.&lt;b&gt;What was the purpose of this study?:&lt;/b&gt; To communicate autistic adults' experiences of unemployment and underemployment to improve understanding of what this is like and what may help.&lt;b&gt;What did the researchers do?:&lt;/b&gt; We developed interview questions in collaboration with two autistic adults. We interviewed eight autistic adults who identified as being unemployed or underemployed who were actively seeking to change their employment status. We asked them about the impact their experiences had on their day-to-day lives. We identified themes from what the interviewees said using interpretative phenomenological analysis (IPA).&lt;b&gt;What were the results?:&lt;/b&gt; Interviewees described feeling paralyzed and stuck at their current employment status because of previous traumatic experiences both within the workplace and around employment processes. They felt misunderstood, judged, and powerless within systems surrounding employment. This impacted their mental health and a","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 5","pages":"638-649"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12670647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672738","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":"\"Listening with Your Heart\": Autism Support Program Faculty Experiences in Teaching Autistic College Students.","authors":"Brett Ranon Nachman","doi":"10.1089/aut.2024.0196","DOIUrl":"https://doi.org/10.1089/aut.2024.0196","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;As more autistic college students enroll in higher education, the need for capable faculty to support their learning experiences rises. Although well intentioned, many educators are not always the most adept in supporting their autistic learners. This descriptive phenomenological reflective lifeworld research seeks to understand the essence of autism-specific college support program faculty experiences in teaching autistic college students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study entailed conducting interviews with four full-time faculty, two staff who teach part-time, and eight other administrators or staff at a community college boasting an autism-specific college support program. Additionally, the author drew on observing a classroom session, program information session, and the campus via a tour, as well as course syllabi, to provide a fuller picture. Dahlberg and colleagues' data analysis methods provided a mechanism for interpreting the information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four themes helped describe the essence of faculty experiences in teaching their autistic learners: unfamiliarity, flexibility, disruption, and optimism. Whereas faculty may, at first, lack familiarity with autism, they draw on that desire for further knowledge to directly learn from their students, creating opportunities for trust building. They also welcome feedback from students and fellow staff alike to engage in flexible teaching techniques. Adaptability and willingness to learn help them navigate difficult course experiences. These experiences ultimately enhance faculty members' confidence to teach autistic learners and translate inclusive teaching measures to their courses writ large.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study unveils the many aspects of faculty members' experiences in interacting with autistic students, particularly within the unique landscape of a college with an autism-specific college support program that highlights neurodiversity. Importantly, this study contributes new knowledge about how faculty draw on their resources, knowledge, and past teaching experiences to shape their iterative approaches to working with autistic students.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Community brief: &lt;/strong&gt;&lt;b&gt;Why is this an important issue?:&lt;/b&gt; Autistic college students are increasingly enrolling in higher education institutions, yet many of the faculty and staff who work with them are unaware of, and unprepared to, support their classroom experiences. This issue contributes to faculty sometimes misunderstanding autistic students and missing opportunities to build more inclusive classrooms.&lt;b&gt;What was the purpose of the study?:&lt;/b&gt; My aim was to find out what faculty experience in working with autistic learners, and how they adapt their teaching approaches.&lt;b&gt;What did the researcher do?:&lt;/b&gt; This study was set in a community college, with an autism-specific college support program that works toward college and career skills for its ","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"7 5","pages":"558-567"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12755849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890612","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}