Autism in adulthood : challenges and management最新文献

{"title":"Patterns of Gaze Behavior During Live Interactions in Adults and Adolescents with Autism or High Autistic Traits: A Systematic Review.","authors":"Lucile Bottein, Antonia F de C Hamilton","doi":"10.1089/aut.2023.0201","DOIUrl":"10.1089/aut.2023.0201","url":null,"abstract":"<p><strong>Background: </strong>Differences in social gaze are part of the diagnostic criteria for autism spectrum condition (ASC), but most studies examining gaze in individuals with autism or high autistic traits use computerized methods that bear little resemblance to authentic conversations. Progress in eye tracking now allows the use of live interaction paradigms. We report a systematic review of this emerging literature.</p><p><strong>Methods: </strong>Using a combination of academic search engines (Google Scholar, OVID, Connected Papers) and backwards citation searches, we identified fourteen studies that explored social gaze in adults and adolescents with autistic traits or an ASC diagnosis, using a live or believed-to-be-live interaction and modern eye-tracking technology.</p><p><strong>Results: </strong>Studies showed mixed results: when gaze is localized to broad regions (face, body, and background), patterns appear similar in all participants. However, when gaze is localized to precise regions (eyes, mouth, and nose) more group differences exist. Specifically, gaze to the eyes seems somewhat consistently reduced in individuals with autism or autistic traits. However, these participants appear to modulate their gaze according to contextual factors, similar to typically developing individuals (e.g., looking less toward the face when speaking than listening).</p><p><strong>Conclusion: </strong>We discuss these results in relation to two dominant theories of autism: low social motivation and aversion to the eyes. The finding that individuals with autism or autistic traits seem to specifically avoid the eyes but show facial orienting and gaze modulation similar to typically developing individuals lends supplemental support to aversive rather than motivational theories of ASC.</p><p><strong>Community brief: </strong><b>Why is this an important issue?:</b> The idea that autistic people make less eye contact than non-autistic people is very common, but it has not often been studied in detail. Most research on the subject has recorded people's gaze when they see photos and videos, not when they see real people during a real interaction. Gaze during a real interaction might be different, because it allows people to send social signals with their eyes. In fact, non-autistic adults often look at their partners' eyes and face less during a real interaction compared with a video. This means researchers should study autistic individuals' eye contact during real interactions, because it may be different compared with looking at photos and videos.<b>What was the purpose of this study?:</b> In this article, the researchers review recent studies that use modern eye-tracking technology to explore eye contact in adults and adolescents with an autism diagnosis or with autistic traits during a real (or believed to be real) conversation.<b>What were the results of the study?:</b> The researchers found that existing studies use many different kinds of methods","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 4","pages":"593-605"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364289","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":"Using State Administrative Data to Examine Aspects of Autistic Adult Life: A Comparative Analysis of Identification, Voting, Marriage, and Parenting.","authors":"Anne V Kirby, Deborah A Bilder, Connor Nicholls, William M McMahon, Amanda V Bakian","doi":"10.1089/aut.2024.0183","DOIUrl":"10.1089/aut.2024.0183","url":null,"abstract":"<p><strong>Background: </strong>Existing outcomes research on autistic adulthood focuses primarily on certain aspects of adult life (e.g., employment) and is limited by methods that are often not representative of whole populations. In the current study, we aimed to use available state administrative data to examine frequencies of receiving state identification, voting, marriage/partnership, and parenting.</p><p><strong>Methods: </strong>In this cross-sectional, population-based study, we accessed Utah state administrative data for 7404 autistic adults born from 1970 to 2002 and matched 1:3 to non-autistic adults (<i>N</i> = 22,213). We identified proportions of documentation of ever achieving each outcome (state identification, voting, marriage/partnership, parenting) and differences by group, sex, race, ethnicity, and co-occurring intellectual disability.</p><p><strong>Results: </strong>Autistic adults were less likely to have state identification (54.9% vs. 97%, <i>p</i> < 0.001) and to vote (39.4% vs. 51.9%, <i>p</i> < 0.001). However, among only those who had state identification, autistic adults were more likely to vote (55.2% vs. 53.1%, <i>p</i> < 0.05). Autistic males were more likely than autistic females to have state identification and equally likely to vote. Autistic females were more likely than males to be married/partnered and to have offspring. We also observed that married/partnered autistic adults were more likely to divorce than married/partnered non-autistic adults (21.0% vs. 6.1%, <i>p</i> < 0.001). When they had offspring, autistic adults had slightly fewer children on average than non-autistic adults (1.69 vs. 2.00, <i>p</i> < 0.001). There were also racial and ethnic group differences among autistic adults across outcomes. In a subset of the data, individuals with co-occurring intellectual disability were less likely than other autistic Utahns to achieve each studied outcome.</p><p><strong>Conclusion: </strong>We found significant differences, indicating that autistic adults are less engaged in multiple aspects of adulthood than their non-autistic peers. Findings point to the need for efforts to better support autistic adult self-determination and to address barriers to achieving the studied outcomes, when desired by autistic individuals.</p><p><strong>Community brief: </strong><b>Why is this an important issue?:</b> Studies on autistic adult outcomes usually focus on certain areas of adulthood, such as employment. There are also very few studies that have looked at adult outcomes for a whole U.S. state population of autistic adults. State-wide administrative data can be a useful resource to use to see if autistic adults have had access to the same opportunities as non-autistic adults.<b>What was the purpose of this study?:</b> The purpose of this study was to use statewide data to look at how many autistic adults have state identification, have voted, have been married or partnered, and have been parents. And we wanted to","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 4","pages":"623-633"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364252","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":"The Architectural Needs and Preferences of Autistic People Versus Gerontological Residential Care Facility Design Practices.","authors":"Elizabeth Ponting","doi":"10.1089/aut.2024.0021","DOIUrl":"10.1089/aut.2024.0021","url":null,"abstract":"<p><strong>Background: </strong>Older autistic people in the United Kingdom are facing a social care crisis. Autistic people are more likely to need social care as they age, but little is known about the architectural needs of autistic people, meaning current residential care facility design makes this form of social care inaccessible to them. Older autistic people often have to rely on fragile informal care or are placed in unsuitable social care situations such as long-stay hospital wards. In contrast, there are established gerontological best practices for designing residential care for older people. This article discusses how the residential architectural needs of autistic people and gerontological residential care design best practices may conflict.</p><p><strong>Methods: </strong>One hundred and five autistic people answered an online questionnaire asking about their architectural needs and preferences. Qualitative results were analyzed using reflective thematic analysis with an inductive approach, and quantitative results were described and tested for statistical significance where appropriate.</p><p><strong>Results: </strong>The research identified three themes where there may be conflict between the architectural needs of autistic people and gerontological residential care design practices: sensory challenges, interactions with others, and day-to-day life. Elements within these themes could make buildings inaccessible to autistic people, cause sensory overload, cause distress, or negatively impact their executive function and ability to complete daily tasks.</p><p><strong>Conclusions: </strong>Certain aspects of residential care design that may positively influence older people's well-being and quality of life may cause autistic people distress and discomfort and inhibit their ability to undertake daily tasks. Some of the elements that may cause this dichotomy are the building location and connectivity, building and spatial size, navigation and wayfinding, open plan flexible spaces or distinct separate spaces, spatial interconnectivity, the extent of the private domain, and social space design. Further research is needed on how to overcome these conflicts.</p><p><strong>Community brief: </strong><b>Why is this an important issue?:</b> Older autistic people are more likely to need social care than older non-autistic people. We don't know much about the best way to design buildings for autistic people. The design of residential care buildings might stop autistic people moving into them. This could stop autistic people accessing social care when they need it.<b>What was the purpose of this study?:</b> We looked at whether the best way to design buildings for autistic people may be different from designing buildings for older people. Understanding those differences may help us design better residential buildings for autistic people.<b>What did the researcher do?:</b> The researcher wrote a questionnaire and asked autistic people to answer it","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 2","pages":"197-210"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347483","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":"The Autistic Parenting Journey: A Systematic Review of Qualitative Evidence and Thematic Meta-Synthesis.","authors":"Maryse Pagnier, Mona Moualla","doi":"10.1089/aut.2024.0176","DOIUrl":"10.1089/aut.2024.0176","url":null,"abstract":"<p><strong>Background: </strong>The emerging literature about parenthood indicates specific differences in autistic individuals' experiences compared with non-autistic ones.</p><p><strong>Methods: </strong>We conducted a systematic search of the literature across PubMed, Embase, Web of Science, and CINAHL Complete to identify articles related to pregnancy, childbirth, and parenthood in autistic individuals. The search was completed on March 5, 2024, and identified 35,581 records. Inclusion criteria included the use of semistructured interviews or focus groups for data collection and interpretative phenomenological analysis or thematic analysis for data analysis as the best methods for exploring our subject.</p><p><strong>Results: </strong>After applying inclusion and exclusion criteria, six articles were included in the systematic review and underwent thematic synthesis. Each study comprised between 7 and 24 autistic participants (all females except three). Their methodological quality was assessed with the Critical Appraisal Skills Programme tool for qualitative studies. We identified three key themes as follows: 1. Parental Challenges and Adaptations; 2. Social Relations and Support; and 3. Identity and Personal Growth. Our analysis identified that autistic individuals face diverse challenges in becoming parents and parenting, including primarily sensory and communication difficulties, which impact their ability to interact with professionals and to manage daily tasks, requiring the implementation of diverse strategies and adaptations to cope. Autistic adults reported a strong emotional connection they build with their children, the need to advocate for them when they are also neurodivergent, and the difficulty in finding formal and informal support fulfilling their specific needs.</p><p><strong>Conclusion: </strong>The educational approach of autistic parents seems influenced by their autism, bringing both strengths and challenges to create, ultimately, a supportive parenting environment. The experience of becoming a parent and raising a child is described as a key step in their personal development. These findings will help autistic parents by promoting a better understanding of their experiences, challenges, and strengths by health care professionals and social workers.</p><p><strong>Community brief: </strong><b>Why is this an important issue?:</b> Many people are diagnosed autistic as adults, and some autistic children want to become parents when they grow up. However, there are few specific supports for autistic parents. Research shows that their experience of parenthood has unique aspects, which can be both strengths and challenges.<b>What was the purpose of this study?:</b> We conducted a comprehensive review of the literature on pregnancy, childbirth, and parenthood in autistic adults. Our goal was to identify, synthesize, and analyze qualitative studies to pinpoint the strengths, challenges, and specific needs of autistic adults in thi","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 4","pages":"571-592"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364297","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":"Are we Missing Character in Strengths-Based Approaches to Coaching and Therapy for Autistic People?","authors":"Jiedi Lei, Alicja Sabina Nocon","doi":"10.1089/aut.2024.0227","DOIUrl":"10.1089/aut.2024.0227","url":null,"abstract":"<p><p>The move toward a social model of disability in autism has generated more interest in \"strengths-based\" approaches in research and practice. Definitions of what constitutes as strengths vary, often conflating skills, talents, or interests that can be harnessed for functional purposes, such as boosting employment outcomes. While such strengths-based approaches have merits, we highlight that the limited focus on skills and talents may not be inclusive of all autistic individuals, and harnessing focused interests for functional outcomes may run the risk of turning everything an autistic individual enjoys into a therapeutic opportunity to reinforce behavior change. We propose that Character Strengths, stemming from Positive Psychology, (1) offer a shared language paradigm when communicating strengths across different stakeholder groups; (2) distinguish between an individual's intrinsic values that motivate them to ac, and extrinsic motivations that may be more akin to social camouflaging and masking; and (3) provide a systematic way to identify and explore strengths profile within every individual. In this perspective piece, we first describe Character Strengths and the research to date in its application with autistic adults. We describe Character Strengths use in autism coaching and share practical interventions aimed at supporting autistic well-being and mental health. Finally, we propose how Character Strengths work may complement mental health treatment through reflecting on one's personhood through strengths use, when woven into routine assessment, treatment formulation and delivery, and potential mechanisms of change.</p><p><strong>Community brief: </strong><b>Why is this topic important?:</b> The focus on strengths-based approaches in autism literature and practice has often been limited to skills, talents, and interests of autistic individuals that support access to employment and education. Such a focus does not capture qualities that speak to an individual's personhood and identity beyond skills and talents, such as \"love\", \"kindness\", and \"humour\" as reported by autistic individuals and their family members. Identifying strengths that reflect individual characteristics and personal values beyond skills and talents might guide an individual's behaviours in a meaningful way that is beneficial to themselves and others.<b>What is the purpose of this article?:</b> We highlight that Character Strengths framework has the unique ability to provide shared language when describing an individual's strengths from different stakeholder perspectives and across contexts (school, employment, personal life). Character Strengths can be harnessed in clinical and coaching work to help autistic individuals develop a better sense of personal identity and good mental well-being.<b>What personal or professional perspectives do the authors bring to this topic?:</b> J.L. is a clinical psychologist and autism researcher, currently completing a clinical resear","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 4","pages":"543-553"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364173","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":"Autism Spectrum-Related Terms Preferred by Polish-Speaking Persons on the Autism Spectrum and Participants Without a Diagnosis of Autism Spectrum Conditions.","authors":"Alicja Niedźwiecka, Ewa Pisula","doi":"10.1089/aut.2024.0162","DOIUrl":"10.1089/aut.2024.0162","url":null,"abstract":"<p><strong>Background: </strong>There is a growing recognition of the need to use community-preferred language to talk about neurodevelopmental conditions. Moreover, the neurodiversity perspective calls for an updated, nonmedicalized terminology reflecting the current approach to neurodevelopment. This study investigated the preferences regarding autism spectrum-related terms in a sample of Polish-speaking participants.</p><p><strong>Methods: </strong>We conducted an online survey involving 3309 respondents: persons with a formal diagnosis of the autism spectrum, self-diagnosed individuals, family members of persons on the autism spectrum, professionals working with persons on the autism spectrum, and other participants. We asked about the terms they found the most adequate to talk about the autism spectrum and persons on the autism spectrum.</p><p><strong>Results: </strong>We found that the term \"autism spectrum\" was most frequently liked in all groups. Having to choose one term, persons with a formal diagnosis of the autism spectrum chose \"autism spectrum\" (51.7%), whereas \"autism spectrum disorder\" was most frequently selected by participants in the other groups. Regarding descriptions of people, persons with a formal diagnosis of the autism spectrum most frequently indicated that they disliked the description \"… is a person with autism spectrum disorder\" and favored the less medicalized expression \"… is on the autism spectrum.\" A preference for the person-first language over the identity-first language was observed in other groups.</p><p><strong>Conclusions: </strong>The term \"(person on the) autism spectrum\" seems the most adequate as it is consistent with the choices of persons on the autism spectrum and the current neurodiversity perspective. Further studies involving non-English-speaking participants are necessary to ensure that the terminology preferred by the local autistic community is respected.</p>","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 3","pages":"518-526"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13254152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254542","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":"Self-Report of Restricted Repetitive Behaviors in Autistic Adults: A Systematic Review.","authors":"Emma Collis, Elizabeth Dark, Ailsa Russell, Mark Brosnan","doi":"10.1089/aut.2023.0111","DOIUrl":"10.1089/aut.2023.0111","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autism research has relatively neglected restricted repetitive behaviors (RRB) and autistic adults compared with the social domain of autism and autistic children. With this review, we aimed to synthesize what is currently known about autistic adult's self-reported RRB, researcher's use of methods, and consideration of masking and gender, and to highlight gaps in our knowledge to inform future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a systematic search of five databases that we last ran in February 2023. We included studies where autistic adults self-reported on one or more subtypes of their repetitive behaviors. We conducted a narrative synthesis to summarize results. We used the Mixed Methods Appraisal Tool to assess the quality of included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our database search identified 35 studies to include for review. The majority of included studies focused on the sensory domain of RRB with other subtypes comparatively neglected. The narrative synthesis identified subject areas of stimuli characteristics, internal reactions, moderators, recovery, self-regulation, and social pressure. We uncovered a narrative where most autistic adults experience hypersensitivity to some sensory stimuli, the unpleasantness of which they then try to avoid, but in doing so may also avoid social situations, contributing to loneliness and increased anxiety surrounding social situations. We identified a cycle of stress where existing stress increased sensory sensitivities leading to more stress and less ability to deal with additional stressors. While the self-regulatory benefits on emotion, cognition, and self-fulfillment of RRB should help with stress, this was prevented by autistic people's awareness of stigma surrounding these behaviors, leading to masking, which is also stressful.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The review highlighted the need for a less categorical and more interrelated approach in researching this domain of autism and a need for more awareness surrounding sensory issues and the benefits of RRB. Future research should also strive to improve study sample representation, particularly regarding gender, race, and IQ.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Community brief: &lt;/strong&gt;&lt;b&gt;Why is this an important topic?:&lt;/b&gt; Historically, research has focused on autistic children and social differences rather than on autistic adults and their repetitive behaviors such as repetitive movements, insisting on sameness, sensory sensitivities, and special or preferred interests. Research has often asked parents and carers about these behaviors rather than asking autistic adults. As such autistic adults' own experiences of their repetitive behaviors are not well known in research.&lt;b&gt;What was the purpose of this review?:&lt;/b&gt; The purpose of this review was to find out: -Which repetitive behaviors have already been studied in self-reporting autistic adults.-How self-reporting autistic adults' repetitive behavio","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 1","pages":"47-67"},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347542","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":"Meta-Synthesis of Autistic Adults' First-Person Perspectives About Mental Health-Related Services.","authors":"Lana Andoni, Abbey Eisenhower, Juliette Gudknecht, Heidi M Levitt","doi":"10.1089/aut.2023.0167","DOIUrl":"10.1089/aut.2023.0167","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autistic adults are at high risk of co-occurring mental health disorders, including depression, anxiety, nonsuicidal self-injury, and suicidality. Existing services are not adequately meeting autistic adults' mental health needs. To better inform evidence-based care, there is a need to synthesize and integrate autistic people's perspectives about the mental health-related services they receive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using the PRISMA method, 40 studies of first-person experiences for autistic adults about mental health-related services met inclusion for this systematic review. Electronic database searches in PsycINFO and PubMed were conducted up to July 2023. Studies needed to be published, qualitative or mixed-methods, and had to include self-report of autistic adults who had experiences with mental health-related services. Original articles were reviewed, coded, and analyzed in line with a modified critical constructivist grounded theory approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twelve studies inquired about participants' experiences and needs with general services, and 28 studies explored participants' experiences with specific services such as specific mental health interventions, support groups, or social-focused interventions. Our analyses of the 40 studies revealed five categories with regard to autistic clients' perspectives on their mental health services: (1) to be more tailored to their individual needs, (2) to provide more accommodations in both format and content, (3) to include more practical support, in addition to emotional support, (4) for providers to have both knowledge of the heterogeneity of autism and humility in their work, and (5) to encourage and embrace a sense of autistic identity and community.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our results offer practical changes that clinicians can make to improve their services and create a better experience for autistic adults. Notably, our analyses highlight that too often the services autistic people receive focus on changing them, rather than on changing or coping with the environment. Diversity in participants was a limitation across our studies (participants were majority White, in a Western-based country, and did not have a co-occurring intellectual disability), and future research should ensure greater diversity in first-person perspectives.&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 adults frequently experience mental health challenges such as depression and anxiety. Unfortunately, autistic adults are not satisfied with their care and report that their experiences with mental health services are not compatible or effective for what they need.&lt;b&gt;What was the purpose of this study?:&lt;/b&gt; To improve the quality of care, it is important to understand what autistic adults want from their mental health services. Our purpose is to provide practical recommendations to mental health clinicians work","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 1","pages":"27-46"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347458","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 and Non-Autistic Experiences of Decreased Sound Tolerance and Their Association with Mental Health and Quality of Life.","authors":"Nichole E Scheerer, Troy Q Boucher, Siamak Arzanpour, Grace Iarocci, Elina Birmingham","doi":"10.1089/aut.2023.0117","DOIUrl":"10.1089/aut.2023.0117","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Decreased sound tolerance (DST) is an increased sensitivity to sound at levels that would not bother most people. DST is highly prevalent in autistic adults; however, the extent to which DST differs across autistic and non-autistic adults is uncertain. This study explores multiple domains of DST symptoms and the severity of DST symptoms, as well as the behavioral reactions and coping strategies adopted to manage DST in both autistic and non-autistic adults. Lastly relationships between DST, autism characteristics, mental health, and quality of life were explored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used online surveys to investigate the characteristics of DST in 77 autistic and 128 non-autistic adults who self-report DST, as well as the relationship between DST and autistic characteristics, mental health, and quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results of this study indicated that clinically relevant misophonia, an aversion to specific sounds, was more prevalent in the sample of autistic adults who self-reported DST. Similarly, clinically relevant hyperacusis, a reduced tolerance to everyday sounds at volumes that would not be distressing to most people, was also more prevalent in the sample of autistic adults who self-reported DST. Across the entire sample, misophonia symptoms were associated with more autistic traits and higher anxiety, whereas hyperacusis symptom severity was associated with more autistic traits, higher anxiety and depression symptoms, and poorer quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Although clinical cases of misophonia and hyperacusis were more prevalent in our sample of autistic adults who self-reported DST, these forms of DST may be related in similar ways to mental health and quality of life of both autistic and non-autistic adults. Future work should focus on differentiating the subtypes of DST to facilitate the development of treatments that specifically target the symptoms of each subtype (i.e., misophonia, and hyperacusis) rather than treating DST as a homogeneous problem.&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; Many autistic adults find sounds to be distressing. However, we are unsure whether these experiences with sound are similar to the experiences of non-autistic adults. We also don't know if the distress caused by sound has similar effects on anxiety, depression, and quality of life for autistic and non-autistic adults. &lt;b&gt;What was the purpose of this study?:&lt;/b&gt; The purpose of this study was to better understand how sounds influence autistic and non-autistic adults who report sounds to be distressing. Specifically we were interested in the types of sounds and general features of sounds that are distressing. We also wanted to know how these adults react to sound and what they try to do to reduce negative reactions to sound. We were interested in how the distress created by sound might be related to autis","PeriodicalId":72338,"journal":{"name":"Autism in adulthood : challenges and management","volume":"8 1","pages":"112-126"},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347486","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}