Pub Date : 2024-07-19DOI: 10.1108/aia-04-2024-0028
Laura Bassette, Maddie Kujawski, Emma Donges
Purpose Previous research found that when exercise partners provided social support to each other, both participants engaged in higher levels of activity (Gellert et al., 2011). These results suggest that there may be benefits to providing inclusive physical activity (PA) programming to individuals with autism; however, little research has explored specific strategies. The purpose of this study is to explore the use of a behavioral intervention consisting of visual social stories and additional intervention components (i.e. prompting, checklists) to teach adolescents/young adults with autism and their workout partners without disabilities to provide social support to one another during partnered PA. Design/methodology/approach A multiple probe across dyads was used to explore the effects of the intervention on social support (i.e. verbal encouragement and feedback). Findings The results indicate the treatment was effective during the intervention phase. When partners and settings changed during generalization, results were maintained in all but one participant. Originality/value Areas for future research and implications for practice to support inclusive PA for autistics are discussed.
目的以前的研究发现，当运动伙伴相互提供社会支持时，双方参与者的活动量都会增加（Gellert 等人，2011 年）。这些结果表明，为自闭症患者提供包容性体育活动（PA）计划可能会有好处；然而，很少有研究对具体策略进行探讨。本研究的目的是探讨如何使用由视觉社交故事和其他干预成分（如提示、核对表）组成的行为干预，教导患有自闭症的青少年和他们的非残疾锻炼伙伴在结伴进行体育锻炼时相互提供社交支持。研究结果表明，该疗法在干预阶段是有效的。原创性/价值讨论了支持自闭症患者包容性 PA 的未来研究领域和实践意义。
{"title":"Teaching social support to promote inclusive physical activity for people with autism","authors":"Laura Bassette, Maddie Kujawski, Emma Donges","doi":"10.1108/aia-04-2024-0028","DOIUrl":"https://doi.org/10.1108/aia-04-2024-0028","url":null,"abstract":"Purpose\u0000Previous research found that when exercise partners provided social support to each other, both participants engaged in higher levels of activity (Gellert et al., 2011). These results suggest that there may be benefits to providing inclusive physical activity (PA) programming to individuals with autism; however, little research has explored specific strategies. The purpose of this study is to explore the use of a behavioral intervention consisting of visual social stories and additional intervention components (i.e. prompting, checklists) to teach adolescents/young adults with autism and their workout partners without disabilities to provide social support to one another during partnered PA.\u0000\u0000Design/methodology/approach\u0000A multiple probe across dyads was used to explore the effects of the intervention on social support (i.e. verbal encouragement and feedback).\u0000\u0000Findings\u0000The results indicate the treatment was effective during the intervention phase. When partners and settings changed during generalization, results were maintained in all but one participant.\u0000\u0000Originality/value\u0000Areas for future research and implications for practice to support inclusive PA for autistics are discussed.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose Navigating the banking world may be overwhelming and intimidating for autistic people due to the generally poor accessibility of banks. Banks around the world are starting to improve the accessibility of their services and products to meet the needs of autistic customers better. However, no empirical research has explored autistic adults’ banking experiences and needs. This study aims to determine what banks can do to make banking more inclusive and accessible for autistic people through understanding the banking experiences of autistic adults living in Australia and identifying the factors that shape these experiences. Design/methodology/approach In total, 57 autistic adults aged 18–67 years (Mage = 33.00, SDage = 11.03) and 29 caregivers of autistic adults aged 32–70 years (Mage = 52.24, SDage = 7.88) completed an online survey about the banking experiences of the autistic adults. In addition, 14 of the 57 autistic adults were interviewed. Findings Almost all autistic participants had a bank account, and online banking was the preferred way of banking for most autistic adults. The factor most often raised by participants that influenced the banking experiences of autistic adults was supportive and helpful bank staff. Other identified factors included autistic adults’ lack of financial and banking knowledge and banks’ poor understanding of autism. The majority of autistic adults felt that banks could become more autism-friendly and provided suggestions. Practical implications Given that most autistic adults are likely to access financial products and services, banks must become more autism-friendly to cater to the diverse needs of autistic customers. Recommendations for how financial institutions can become more inclusive were provided. Originality/value To the best of the authors’ knowledge, this is the first detailed examination of the banking experiences of autistic adults. Practical implications of the research were also provided.
{"title":"Understanding banking experiences of autistic adults: an inquiry into inclusive banking","authors":"Ru Ying Cai, Abigail Love, Kaaren Haas, Emma Gallagher, Vicki Gibbs","doi":"10.1108/aia-08-2023-0052","DOIUrl":"https://doi.org/10.1108/aia-08-2023-0052","url":null,"abstract":"\u0000Purpose\u0000Navigating the banking world may be overwhelming and intimidating for autistic people due to the generally poor accessibility of banks. Banks around the world are starting to improve the accessibility of their services and products to meet the needs of autistic customers better. However, no empirical research has explored autistic adults’ banking experiences and needs. This study aims to determine what banks can do to make banking more inclusive and accessible for autistic people through understanding the banking experiences of autistic adults living in Australia and identifying the factors that shape these experiences.\u0000\u0000\u0000Design/methodology/approach\u0000In total, 57 autistic adults aged 18–67 years (Mage = 33.00, SDage = 11.03) and 29 caregivers of autistic adults aged 32–70 years (Mage = 52.24, SDage = 7.88) completed an online survey about the banking experiences of the autistic adults. In addition, 14 of the 57 autistic adults were interviewed.\u0000\u0000\u0000Findings\u0000Almost all autistic participants had a bank account, and online banking was the preferred way of banking for most autistic adults. The factor most often raised by participants that influenced the banking experiences of autistic adults was supportive and helpful bank staff. Other identified factors included autistic adults’ lack of financial and banking knowledge and banks’ poor understanding of autism. The majority of autistic adults felt that banks could become more autism-friendly and provided suggestions.\u0000\u0000\u0000Practical implications\u0000Given that most autistic adults are likely to access financial products and services, banks must become more autism-friendly to cater to the diverse needs of autistic customers. Recommendations for how financial institutions can become more inclusive were provided.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this is the first detailed examination of the banking experiences of autistic adults. Practical implications of the research were also provided.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability. Design/methodology/approach A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience. Findings Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes. Originality/value This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.
{"title":"Early intervention for children and young people with neurodevelopmental conditions and intellectual disability: “The Getting Help” offer for Northwest England","authors":"Christine Wee, Sujeet Jaydeokar, Chinemerem Ugwuonah, Leanne Armstrong, Mahesh M. Odiyoor","doi":"10.1108/aia-10-2023-0066","DOIUrl":"https://doi.org/10.1108/aia-10-2023-0066","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability.\u0000\u0000\u0000Design/methodology/approach\u0000A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience.\u0000\u0000\u0000Findings\u0000Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes.\u0000\u0000\u0000Originality/value\u0000This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-18DOI: 10.1108/aia-07-2023-0041
Zainab Al-Attar, Rachel Worthington
Purpose Early bio-psycho-social experiences can dramatically impact all aspects of development. Both autism and traumagenic histories can lead to trans-diagnostic behavioural features that can be confused with one another during diagnostic assessment, unless an in-depth differential diagnostic evaluation is conducted that considers the developmental aetiology and underpinning experiences and triggers to trans-diagnostic behaviours. Design/methodology/approach This paper will explore the ways in which biological, cognitive, emotional and social sequelae of early trauma and attachment challenges, can look very similar to a range of neurodevelopmental disorders, including autism. Relevant literature and theory will be considered and synthesised with clinical knowledge of trauma and autism. Findings Recommendations are made for how the overlap between features of autism and trauma can be considered during assessments alongside consideration for interventions to enable people to access the most appropriate support for their needs. Originality/value Many features of the behaviours of individuals who have experienced early childhood trauma and disrupted or maladaptive attachments, may look similar to the behaviours associated with autism and hence diagnostic assessments of autism need to carefully differentiate traumagenic causes, to either dual diagnose (if both are present) or exclude autism, if it is not present. This has for long been recognised in child and adolescent autism specialist services but is less well developed in adult autism specialist services.
{"title":"Trauma or autism? – understanding how the effects of trauma and disrupted attachment can be mistaken for autism","authors":"Zainab Al-Attar, Rachel Worthington","doi":"10.1108/aia-07-2023-0041","DOIUrl":"https://doi.org/10.1108/aia-07-2023-0041","url":null,"abstract":"\u0000Purpose\u0000Early bio-psycho-social experiences can dramatically impact all aspects of development. Both autism and traumagenic histories can lead to trans-diagnostic behavioural features that can be confused with one another during diagnostic assessment, unless an in-depth differential diagnostic evaluation is conducted that considers the developmental aetiology and underpinning experiences and triggers to trans-diagnostic behaviours.\u0000\u0000\u0000Design/methodology/approach\u0000This paper will explore the ways in which biological, cognitive, emotional and social sequelae of early trauma and attachment challenges, can look very similar to a range of neurodevelopmental disorders, including autism. Relevant literature and theory will be considered and synthesised with clinical knowledge of trauma and autism.\u0000\u0000\u0000Findings\u0000Recommendations are made for how the overlap between features of autism and trauma can be considered during assessments alongside consideration for interventions to enable people to access the most appropriate support for their needs.\u0000\u0000\u0000Originality/value\u0000Many features of the behaviours of individuals who have experienced early childhood trauma and disrupted or maladaptive attachments, may look similar to the behaviours associated with autism and hence diagnostic assessments of autism need to carefully differentiate traumagenic causes, to either dual diagnose (if both are present) or exclude autism, if it is not present. This has for long been recognised in child and adolescent autism specialist services but is less well developed in adult autism specialist services.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141334876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-10DOI: 10.1108/aia-05-2023-0025
Zainab Al-Attar, Rachel Worthington
Purpose Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism. Design/methodology/approach The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality. Findings Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life. Practical implications Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life. Originality/value Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.
{"title":"Moral distress and moral injury in the context of autism","authors":"Zainab Al-Attar, Rachel Worthington","doi":"10.1108/aia-05-2023-0025","DOIUrl":"https://doi.org/10.1108/aia-05-2023-0025","url":null,"abstract":"\u0000Purpose\u0000Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism.\u0000\u0000\u0000Design/methodology/approach\u0000The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality.\u0000\u0000\u0000Findings\u0000Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.\u0000\u0000\u0000Practical implications\u0000Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.\u0000\u0000\u0000Originality/value\u0000Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141366607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1108/aia-07-2023-0037
E. Webb, Benedetta Lupattelli Gencarelli, Grace Keaveney, Deborah Morris
Purpose The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework. Design/methodology/approach Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated. Findings Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority. Originality/value To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.
{"title":"Is trauma research neglecting neurodiverse populations? A systematic review and meta-analysis of the prevalence ACEs in adults with autistic traits","authors":"E. Webb, Benedetta Lupattelli Gencarelli, Grace Keaveney, Deborah Morris","doi":"10.1108/aia-07-2023-0037","DOIUrl":"https://doi.org/10.1108/aia-07-2023-0037","url":null,"abstract":"\u0000Purpose\u0000The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework.\u0000\u0000\u0000Design/methodology/approach\u0000Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated.\u0000\u0000\u0000Findings\u0000Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140659320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1108/aia-05-2023-0027
Claire Bates, Rose Matthews
Purpose The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England. Design/methodology/approach Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis. Findings Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support. Practical implications The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality. Originality/value To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.
{"title":"No “cookie cutter rules”: best practice for social care staff in supporting autistic adults with relationships and sexuality","authors":"Claire Bates, Rose Matthews","doi":"10.1108/aia-05-2023-0027","DOIUrl":"https://doi.org/10.1108/aia-05-2023-0027","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England.\u0000\u0000\u0000Design/methodology/approach\u0000Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis.\u0000\u0000\u0000Findings\u0000Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support.\u0000\u0000\u0000Practical implications\u0000The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality.\u0000\u0000\u0000Originality/value\u0000To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140695234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1108/aia-05-2023-0024
Adam Clifford, Deena Camps
Purpose A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot. Design/methodology/approach This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels. Findings The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals. Originality/value This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.
{"title":"A short-term “behavioural support” service for autistic adults without an intellectual disability: a pilot evaluation","authors":"Adam Clifford, Deena Camps","doi":"10.1108/aia-05-2023-0024","DOIUrl":"https://doi.org/10.1108/aia-05-2023-0024","url":null,"abstract":"\u0000Purpose\u0000A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.\u0000\u0000\u0000Design/methodology/approach\u0000This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.\u0000\u0000\u0000Findings\u0000The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.\u0000\u0000\u0000Originality/value\u0000This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140695898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-27DOI: 10.1108/aia-11-2022-0053
Rebecca Day, Luke Simmons, Elizabeth Shade, Jo Jennison, Clare S. Allely, R. A. Mukherjee
Purpose Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism. Design/methodology/approach A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken. Findings Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction. Originality/value This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.
{"title":"Exploring the presence of a sex-specific phenotype of autism spectrum disorder in a random cohort of males and females: a retrospective case note service audit","authors":"Rebecca Day, Luke Simmons, Elizabeth Shade, Jo Jennison, Clare S. Allely, R. A. Mukherjee","doi":"10.1108/aia-11-2022-0053","DOIUrl":"https://doi.org/10.1108/aia-11-2022-0053","url":null,"abstract":"\u0000Purpose\u0000Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism.\u0000\u0000\u0000Design/methodology/approach\u0000A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken.\u0000\u0000\u0000Findings\u0000Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction.\u0000\u0000\u0000Originality/value\u0000This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.\u0000","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Book review of Kids Across the Spectrums: Growing Up Autistic in the Digital Age","authors":"David Chun Yin Li","doi":"10.1108/aia-01-2024-078","DOIUrl":"https://doi.org/10.1108/aia-01-2024-078","url":null,"abstract":"","PeriodicalId":43640,"journal":{"name":"Advances in Autism","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139781523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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