Autism最新文献

Achieving independence in adulthood remains a widely held developmental aspiration. However, prevailing frameworks often equate independence with functional proficiency and physical separation from the family, rarely capturing the lived realities and priorities of autistic individuals and their families. This qualitative study represents the first exploration of how families of autistic adults in mainland China understand, support and engage with the concept of independence. Semi-structured interviews were conducted with 20 parents of autistic adults, including individuals both with and without intellectual disabilities. Through reflexive thematic analysis, four interrelated themes were identified: (1) Doing Independence Versus Being Independent; (2) From Aspirations to Reconceptualisations; (3) Invisible Needs and Misrecognised Competence; and (4) Independence as a Relational Process. These findings challenge reductive definitions of independence as mere task completion or detachment from familial support. Instead, they foreground the emotional, relational and cultural dimensions that shape independence across the lifespan. The study highlights how families actively recalibrate expectations, navigate structural constraints and advocate for contextually attuned support. In doing so, it underscores the need to reconceptualise independence as a dynamic, co-constructed process that honours both the individuality of autistic adults and the ecological contexts within which their lives unfold.Lay AbstractIndependence is often positioned as a hallmark of successful adulthood. This study explored how families in mainland China understand and support independence in autistic adults from the perspective of their parents. We talked with 20 parents of autistic adults, whose children included 11 with and 9 without intellectual disabilities, to learn how they understand and support their children's independence. Parents described independence not simply as living alone or managing daily tasks without help, but as a process that develops gradually over time, shaped by emotions, relationships and cultural values. Some autistic adults demonstrated strong practical skills but still required support with emotional regulation or unexpected situations. Parents also shared how their hopes evolved, with greater focus placed on happiness and well-being rather than traditional adult milestones. Cultural values, such as family ties and mutual support, played a significant role in shaping these perspectives. The study highlights the need for flexible and respectful support systems that honour individual differences and promote meaningful, self-defined forms of independence for autistic adults.

Screening for mental health concerns is essential to identify individuals whose risk would otherwise go unnoticed. Recognizing the need to address growing mental health concerns among autistic college students, we implemented a mental health screening and monitoring protocol within a university program devoted to supporting autistic college students. This article describes the process and service-level feasibility of implementing this program over the course of one academic year at a large public university in the Northeast United States. Anxiety, depression, and suicide risk were measured at four time points. Students with elevated risk of mental health symptoms were connected to mental health supports and received suicide risk assessments. Thirty-two individuals took part in the monitoring process across the academic year. The monitoring process identified 53 instances where monitoring, checking-in, or a risk assessment was indicated. Fourteen risk assessments occurred, and 12 students received at least one mental health referral. Leveraging interdisciplinary collaborations, the mental health monitoring program was able to connect numerous autistic college students facing mental health challenges to clinical resources. Rates of follow-up and referral highlight the significance of monitoring. Attention to the feasible integration of mental health supports into existing academic support programs for autistic students is warranted.Lay abstractAutistic college students often face conditions like depression, anxiety, and suicide risk. Recognizing a need to address these mental health concerns, we created a system to track aspects of mental health to help more quickly identify autistic college students who may need support. This article describes the monitoring process that took place primarily over one academic year. Thirty-two students were asked about their anxiety, depression, and suicide risk four times during the academic year. On 53 occasions, students were monitored or had a check-in with clinicians. Fourteen assessments took place to assess suicide risk, and 12 students were connected to mental health resources. This process involved many individuals working together to be able to help autistic students connect to mental health supports. The process required thoughtful collaboration across many people to make sure that it could be successful, and insights are provided to support other schools in doing something similar. Including this type of monitoring within existing academic programs for autistic students may help to make this easier to do at other universities.

Recognising speech in noise involves focusing on a target speaker while filtering out competing voices and sounds. Acoustic cues, such as vocal characteristics and spatial location, help differentiate between speakers. However, autistic individuals may process these cues differently, making it more challenging for them to perceive speech in such conditions. This study investigated how autistic individuals use acoustic cues to follow a target speaker and whether background music increases processing demands. Thirty-six autistic and 36 non-autistic participants, recruited in the United Kingdom, identified information from a target speaker while ignoring a competing speaker and background music. The competing speaker's gender and location either matched or differed from the target. The autistic group exhibited lower mean accuracy across cue conditions, indicating general challenges in recognising speech in noise. Trial-level analyses revealed that while both groups showed accuracy improvements over time without acoustic cues, the autistic group demonstrated smaller gains, suggesting greater difficulty in tracking the target speaker without distinct acoustic features. Background music did not disproportionately affect autistic participants but had a greater impact on those with stronger local processing tendencies. Using a naturalistic paradigm mimicking real-life scenarios, this study provides insights into speech-in-noise processing in autism, informing strategies to support speech perception in complex environments.Lay abstractThis study examined how autistic and non-autistic adults understand speech when other voices or music were playing in the background. Participants focused on one main speaker while another voice played simultaneously. Sometimes, the second voice differed from the main one in gender or where the sound was coming from. These differences made it easier to tell the voices apart and understand what the main speaker was saying. Both autistic and non-autistic participants did better when these differences were present. But autistic individuals struggled more when the two voices were the same gender and came from the same location. Background music also made it harder to understand speech for everyone, but it especially affected autistic participants who tended to focus more on small details. These findings help us understand how autistic individuals process speech in noisy environments and could lead to better ways to support communication.

There is an increasing need to measure caregiver implementation of strategies from Naturalistic Developmental Behavioral Interventions (NDBIs) as a possible key mediator of outcomes in a child. The NDBI Fidelity (NDBI-Fi) rating scheme is a macro-code to estimate the implementation of core strategies. Yet, there is a need to understand the dependability of this measure to ensure intervention study findings are generalizable to everyday interactions and comparable across studies. We addressed this by evaluating the dependability or consistency of NDBI-Fi scores for 20 caregivers, averaged across observations of two occasions of two routines that were each scored by two raters. Our findings indicated that a single score (i.e. from a single occasion, single routine, and single rater) from the measure has low dependability (g = 0.43). When scores were averaged across two observations each of two routines scored by two raters (i.e. eight scores total), the score was more dependable (g = 0.77). The majority (81.6%) of absolute error variance was attributable to occasions of observation and its interaction with other facets (routine or rater). Therefore, we recommend the NDBI-Fi be applied to more than one observation of more than one routine to strengthen confidence that scores are generalizable to everyday parent-child interactions.Lay abstractOutcomes from caregiver-mediated interventions typically include measuring the caregiver's use of key techniques. The Naturalistic Developmental Behavioral Intervention-Fidelity (NDBI-Fi) tool is a valid measurement strategy for estimating caregiver use. In this study, we sought to understand how to improve data collection from natural observations of caregivers with their children to ensure the scores are representative of how the caregiver and child typically interact. We observed 20 caregiver-child pairs via telehealth in snack and play routines over two different days. Each video was rated using the NDBI-Fi by two observers. We learned that increasing the number of observations may be the best way to improve the dependability of scores from natural caregiver-child observations. This study adds to recent research seeking to understand how to best measure caregiver strategy use. These findings may guide future researchers and clinicians to consider increasing the number of observations used to evaluate caregiver use of intervention techniques in research studies or clinical practice.

While the Bradley et al. paper brought up an interesting question regarding the relationship between autistic identity and eating disorders, there are concerns with the assumptions and design of this study. This article concludes that autistic identity has no connection to potential eating disorder symptom severity. However, the psychometric tool used, the Social Identity Scale, is missing key aspects of autistic identity found in other tools. In addition, the tool used is not validated in autistic adults.Lay AbstractA recent paper by Bradley et al. concluded that there is no relationship between autistic identity and eating disorder symptoms. However, the survey tool used to assess autistic identity of its participants did not include key components needed to arrive at this conclusion. Variations of autistic identity that would need to be considered are manifold. Some of these facets to consider in a survey assessing autistic identity would be whether or not autism is a source of pride, traits are thought to be steadfast or changeable, stigma is felt, and whether they should perform camouflaging behavior. This is important because eating disorder symptoms can be affected by these differences. For example, changeability and autistic pride have been thought to affect eating disorder symptoms. This research can be accomplished through other psychometrically validated surveys such as the Autism Spectrum Identity Scale, which include these features in the survey development. So, the Autism Spectrum Identity Scale or like measure would need to be used before reaching the conclusion of this recent Bradley et al. paper. In addition, the Social Identity Scale used in the Bradley et al. paper has not been validated in an autistic adult sample, which makes it not the ideal survey for the research question as well.

Autistic people are known to demonstrate greater difficulties with cognitive flexibility. These difficulties are associated with a range of poor outcomes, including elevated rates of anxiety and depression. Current intervention approaches fail to account for these specific mechanisms. In this study, we address this by piloting a new intervention which aims to specifically target cognitive inflexibility. The 'Thinking Flexibly' intervention has been co-designed with autistic youth based on previous work, including cognitive remediation therapy. Twenty autistic adolescents were recruited from clinical services and offered the eight-session intervention. Acceptability was assessed through participant drop-out and session completion. Participants (and their parents) also completed questionnaire measures of cognitive inflexibility, anxiety, depression and functional outcomes before and after the intervention. Our results indicated good acceptability with 19/20 participants completing the intervention and session attendance was high, with a single missed session. We found significant increases in flexibility across both parent- and self-report of a moderate effect. Participants reported significant reductions in symptoms of anxiety and depression. We conclude that 'Thinking Flexibly' is acceptable for use with autistic adolescents and shows promise as a standalone or adjunct therapy. Changes on outcome measures are promising and warrant further investigation in a larger trial.Lay abstractAutistic people often have greater difficulties with flexible thinking when compared to those without autism. People with difficulties in this area often appear to be 'stuck' in their style of thinking or in their way of behaving. This can have a negative impact on several areas of life, including on their mental health. In this study, we developed and tested an intervention designed to help autistic individual think flexibly. We showed that the intervention was acceptable (people were able to attend and complete the intervention) and some improvements in cognitive flexibility and mental health symptoms were reported.