Autism最新文献

This study examined how autistic adults conceptualize health and whether their conceptualizations differed substantively from those of their emergency contacts (people who helped with health or healthcare management). We conducted semi-structured interviews with 10 dyads of autistic adults and emergency contacts. A thematic analysis with deductive and inductive codes identified four main themes: (1) health is subjective well-being; (2) healthy is the absence of pain; (3) challenging neurotypical norms; and (4) differences in health definitions were smaller than perceived. Autistic participants and emergency contacts endorsed the first two themes. Only autistic participants discussed the third theme. Despite broad agreement about what "healthy" means, emergency contacts perceived significant differences between their definition of health and that of their autistic counterpart. The data suggest these differences were primarily about health behaviors. We present a model for a Personalized Health Ecosystem, describing important factors for personal conceptualization of health among autistic adults. These findings demonstrate the need for individualized care, for healthcare providers to partner with autistic patients to best support their health, and for education programs for providers who work with this community.Lay AbstractAutistic adults experience worse health and have a higher risk of mortality on average. Many autistic adults say that physicians and other healthcare providers do not understand autism and autistic people's needs. This study wants to understand how autistic adults specifically understand healthy habits as this could inform better care. We interviewed 10 autistic adults and their emergency contacts (family or friends who help them with healthcare decisions) about how they understand health and what they do to be healthy. We compared what the two groups said. Both autistic adults and their emergency contacts said that being healthy could look different for everyone. Beyond physical health, participants talked about mental, financial, and spiritual health. Participants described "healthy" as the absence of pain, though the fact that you can be in pain and healthy was mentioned. Autistic adults and their emergency contacts described health similarly. Autistic adults, however, shared more non-traditional health-promoting behaviors. These findings can help healthcare providers better understand how to work with autistic patients. Physicians should work with autistic patients on how to be healthy, rather than assume that autistic adults do not understand health.

Compared with their non-licensed peers, licensed autistic adults appear to report more positive outcomes in objective measures of quality of life, particularly participation in activities outside of the home. We examined if this is due to individual differences/factors or the ability to independently drive. We conducted a prospective follow-up survey study of 16-21 years old in the United States and compared engagement in activities outside of the home over time by licensing status. Our final sample included 111 young adults; at follow-up, 62% did not have a permit or a license, 18% had obtained a permit, and 20% were licensed. Generally, travel patterns were consistent, except for reported increases in employment. The lack of overall differences across groups over time suggests individual differences in resources, barriers/facilitators to traveling, or general characteristics may underlie objective measures of quality of life rather than the obtainment of a license. Furthermore, regardless of licensure status, most respondents were not traveling everywhere they wanted to go, and nearly 80% were interested in a transportation modality they did not currently use. Thus, there is a continued need to support autistic adults' independent use of various transportation modalities.Lay abstractShort Report: Obtaining a driver's license may not change autistic young adults' engagement in activities outside of the homeAutistic adults who have a driver's license say they participate in activities outside of their home, like employment or socializing, more often than those who do not have a license. It is unclear if this is because these adults can drive or if people who obtain licenses are different in some way than those who do not obtain a license. To examine this, we administered multiple surveys to a group of autistic young adults (16-21 years old) to see if their travel patterns changed after obtaining a license. In total, 111 young adults completed our surveys. Generally, we did not see changes in adults' travel patterns, regardless of if they obtained a license or not. The only change was an increase in employment over time among young adults who never obtained a learner's permit/license and those who obtained a license. Overall, our findings suggest that individual differences may be why some adults are engaged in activities outside of the home more often than others. We also found that most adults in our sample were not traveling everywhere they wanted to go or using all the modes of transportation they were interested in. This suggests more efforts are needed that improve autistic adults' independent mobility across transportation modes (e.g., driving, public transportation).

To date, no studies have investigated whether disparities in hours of applied behavior analysis (ABA) exist in the Medicaid system. We used multilevel modeling to analyze Medicaid billing claims for 1,028 autistic youth under the age of 21 years to examine the extent to which there were disparities in hours of ABA services for Medicaid-enrolled youth based on race/ethnicity and rurality. Although younger children received more hours of ABA, F(1, 964.63) = 118.28, p < .001, there were no statistically significant differences in hours of ABA based on minoritized race/ethnicity status or sex. On average, youth served in rural areas received significantly less hours of ABA per month than those in non-rural areas, F(1, 122.13) = 7.89, p = .006; youth in rural areas received 10.86 less hours per month than those in non-rural areas. Results suggest that publicly funded service systems like Medicaid may reduce ABA service disparities by race/ethnicity. Policymakers should focus on improving service provision for youth in rural areas.Lay AbstractWe used Medicaid billing claims from 1,028 autistic youth to see if there were differences in hours of applied behavior analysis (ABA) services per month for youth from different racial/ethnic groups, different service settings (rural or non-rural), different sexes, and different ages. We found that younger autistic youth received more hours of ABA per month compared to older youth, and and youth served in rural areas received about 11 hours less per month compared to youth in non-rural areas. There were no differences among different race/ethnic groups or sexes. Policymakers should focus on improving service availability for autistic youth served in rural areas.

Non-autistic adults often harbor negative attitudes about autism and show a reluctance to interact with autistic people. For autistic people with multiple marginalized identities, the compounding effects of stigma based on race and disability may worsen peer attitudes. This study investigated first impressions of Black and White autistic adults made by non-autistic observers. Autistic adults (N = 29) stratified by race (15 Black, 14 White) completed a videotaped semi-structured conversation, and non-autistic raters provided their first impressions of each participant. Black autistic people were rated as more likable and trustworthy, and raters endorsed a greater interest in interacting with them, compared to White autistic people. Evidence of intersectional effects of race, gender, and autism was also observed. White autistic men, but not Black autistic men, were evaluated less favorably than non-male autistic participants, with Black autistic men being evaluated more favorably on some items. These results suggest that the intersection of race and autism may, in some cases, counter stereotypes about Blackness and autism, and that holding multiple marginalized identities can modify the characteristics of peer stigma toward autistic adults.Lay abstractMany non-autistic adults have negative feelings about autism and may not want to interact with autistic people. For people who face more than one kind of discrimination, like being part of a racial minority and being disabled, a combination of racism and ableism might make others' opinions even more negative. This study looked at how people's race, gender, and how others judge them are connected when people view videos of Black and White autistic adults. In the first part of the study, 29 autistic adults (15 Black, 14 White) had a conversation with the main researcher, which was recorded on video. In the second part, people who were not autistic watched these videos and shared their thoughts about each person. The results showed that Black autistic people were seen as more likable and trustworthy, and the people watching the videos were more interested in getting to know them compared to White autistic people. The study also found that race, gender, and autism together influenced how people were judged. Black autistic men were often judged similarly to, or better than, non-male participants, while White autistic men were judged less positively than non-male participants. This means that having more than one identity that is discriminated against can change the ways that people view autistic adults, such as allowing Black autistic men to avoid common stereotypes.