Autism

Autism is often thought of as a condition that mainly affects boys in childhood. However, research shows that this view can delay or complicate diagnosis for non-male autistic individuals. For instance, research has demonstrated that autistic females are diagnosed later than males. In this study, we examined when and how autism is diagnosed in gender-diverse individuals (people whose gender identity does not align with the sex they were assigned at birth or who identify outside the male/female binary) compared to cisgender men and women (whose gender aligns with their birth sex). We analyzed data from 2,722 Dutch adults with autism, including 402 gender-diverse participants, mostly diagnosed in adulthood. We looked at the age at which participants were diagnosed and how long it took from first suspecting autism to receiving a formal diagnosis. We also examined whether participants had been diagnosed with another psychiatric condition and whether they perceived that diagnosis to be a misdiagnosis. Our results showed that gender-diverse people and cisgender women tend to be diagnosed later than cisgender men. Gender-diverse individuals and women reported being previously diagnosed with other conditions such as personality disorders, which they later believed were incorrect. These results suggest that gender biases still affect autism diagnosis, especially for gender-diverse people and women. Understanding these challenges is important to improve diagnostic practices and ensure more accurate and timely support for everyone on the autism spectrum.

Many autistic people enjoy spending time with other autistic individuals because they feel more comfortable and better understood in these relationships. While some research has explored autistic adults’ relationships with other autistic people, less is known about their preferences and perceptions within these relationships. To learn more, we surveyed autistic adults in Australia and New Zealand about a range of relationship types they may have with other autistic people (i.e. friendships, romantic relationships, mentoring/support, employment, and volunteering relationships). We then analysed written responses from 142 participants using a reflexive thematic analysis to identify themes within the data set. Participants valued intersubjectivity, mutual understanding, acceptance, and a sense of belonging and described being able to unmask and be authentic in these relationships. However, they also had to consider and balance their relational capacity. While shared neurotype was important, other factors like shared interests, values, and emotional compatibility also influenced relationship satisfaction. Some participants also described challenges or conflicts due to differences in compatibility. These findings highlight that many autistic adults have meaningful relationships with other autistic people, challenging a deficit-based perspective. At the same time, they show that shared neurotype alone does not guarantee compatibility. Instead, the Double Empathy Problem should be understood as a spectrum influenced by factors such as shared life experience and social understanding, reminding us that, like all relationships, those between autistic people are complex and nuanced.

This study explored the attitudes of 871 parents of autistic children and 213 autistic adolescents and adults in Sweden toward genetic research. We aimed to understand whether they think genetic research in autism is positive and beneficial, what they hope the research will achieve, and if they have any concerns. Involving the autism community in Sweden is crucial for the future of genetic research in autism, ensuring it addresses their priorities and concerns. Overall, respondents had a positive view, hoping the findings could lead to better interventions, improved quality of life, enhanced educational opportunities, and stronger support services for autistic individuals and their families. However, many were worried about potential negative consequences, such as increased discrimination and the promotion of eugenics. These findings can guide researchers in designing future studies and highlight the importance of community involvement in research.

We wanted to know if autistic people on Medicaid get therapy or antidepressants after being diagnosed with depression. We also looked at whether people who are also diagnosed with intellectual disability, are female, are children, or are Black or Hispanic are more or less likely to get this care. Earlier studies show that just over half of the people on Medicaid get any treatment after being diagnosed with depression. But no one has looked closely at autistic people on Medicaid. Getting treatment can help reduce depression symptoms and may lower the risk of suicide. In our study, we looked at autistic people on Medicaid who were newly diagnosed with depression. We tracked whether they got therapy or antidepressants over the next 5 months. We grouped people based on how much treatment they got. The largest group (39%) got no treatment. The second group (21%) started treatment but did not continue for all 5 months. The third group (14%) started treatment around the third month and kept going for 2 months. The last group (25%) got treatment for all 5 months. Autistic people who were Black, Hispanic, or had intellectual disability were least likely to get enough treatment. Autistic children and females were most likely to get enough treatment. In short, many autistic people are not getting the care they need for depression. Some may not get enough treatment to feel better. This can make depression last longer and raise the risk of suicide. We need to improve access to care, especially for those who are least likely to get it.

A choir is a powerful metaphor for a successful neurodiverse society, in which achievement stems from blending together voices that are different, rather than from everyone singing the same line in the same way. This study explores a real-life example of this metaphor: a neurodiverse choir composed of 12 adult choristers, 8 autistic adolescents, and 3 professionals specialized in autism. The choir rehearsed for 6 months and then performed a few shows under the direction of a professional choir director. More specifically, we tracked the experience of the 12 adult choristers, using a set of questionnaires before and after their participation in the choir. Consistent with previous qualitative evidence, the results demonstrate a measurable shift in their representation of autism: they understood it better and perceived it more as a neutral difference (from typical development) than a deficit. After participating in this choir, the choristers also felt more able and more inclined to interact with other neurodivergent individuals. These findings lend support to the neurodiversity paradigm, which values autism as a set of natural variations in human neurocognitive functioning. In this view, the social difficulties encountered by autistic individuals can be considered the result of a mutual misunderstanding between autistic and non-autistic people, a problem known as the “double empathy problem.” Our results show that the choristers tended to naturally embrace this view. Thus, this preliminary study provides a promising perspective to address this problem, using choral singing as a natural “double empathy solution.” More generally, this exemplifies the importance of designing inclusive spaces within our societies.

Early and accurate identification of autism helps children and families access helpful supports, yet most screening tools have been developed and tested mainly in English-speaking countries, and we know less about how well they work in Latin America. In this study, we examined how well a Spanish translation of the widely used Social Communication Questionnaire (SCQ) identified autism in a clinic in Quito, Ecuador. Caregivers completed the questionnaire as part of a full clinical evaluation by trained professionals. We found that the SCQ was not very accurate at distinguishing which children did or did not have autism in this setting, meaning it may not be reliable on its own for screening. These results suggest that screening tools should be carefully tested with local communities before widespread use and highlight the need for tools that better reflect the languages, cultures, and experiences of families.

What was the purpose of this study?

The purpose of this study was to understand middle-aged and older autistic adults’ views and experiences of ageing well, their age-related needs, and how services could better support them to age well.

Why is this an important issue?

Very little research explains how autistic people experience ageing. It is important to know more about this to ensure that health and social services know how to best support ageing autistic people to live happier and healthier lives.

What did the researchers do?

We interviewed 17 middle-to-older autistic adults (10 females, 46–72 years) via Zoom or telephone. We typed up participant’s responses and looked for common themes within the data.

What were the results of the study?

Participants felt that links between autism and ageing were poorly understood, and that autistic adults may have a higher risk of certain age-related conditions such as dementia. Participants also felt their autistic characteristics and experiences were changing with age.

This study also revealed that current ageing support is generally felt to be incompatible with autistic adults’ characteristics. This incompatibility was linked to professionals not understanding autistic characteristics, and services being difficult to access. A hub-based model was proposed involving flexible and responsive peer and specialist support options.

How will these findings help autistic adults now or in the future?

This study raises the profile of the needs of ageing autistic adults. We have created a set of recommendations that will contribute to professionals’ understanding of autistic adults’ views on ageing well, their age-related support needs, and how to adapt service provision accordingly.

“Hot” executive function involves the ability to control actions when emotions are involved. For example, a situation when an individual must resist a temptation requires hot executive function. These skills are important for social growth, mental health, and doing well in school. Research shows that autistic children over 3 years of age are less likely to use these skills compared to other children. This study examined whether autistic children under 3 years of age show similar difficulties. We also examined whether autistic children use different strategies than neurotypical children. To find out, we asked both autistic and neurotypical children, ages 2 and 4 years, to complete tasks that required them to delay their responses. The study found that, like older autistic children, younger autistic children also delayed their responses less than neurotypical children. Autistic 2-year-olds waited less for rewards, like food, compared to their neurotypical peers. Similarly, autistic 4-year-olds waited less for both food and other types of rewards, compared to their neurotypical peers. Relative to their neurotypical peers, autistic children also used fewer effective strategies during these tasks. These findings suggest that even very young autistic children have differences in impulse control, which might help in creating better support and interventions for them.

Autistic children can often find participation in physical activity programmes difficult and as a result are often less physical active than to non-autistic children. Many studies have explained why these difficulties exist, such as lack of suitable programmes, uneducated coaches, lack of coach, or physicality difficulties, but there is less information available about practical ways to make programmes more inclusive. This study aimed to create clear, practical recommendations to help community sports clubs and physical activity programmes to better include autistic children. To do this, the Delphi Method was used. This involved a group of ‘experts’ with experience in autism and physical activity to share their views over several rounds of online questionnaires. Twenty-two international experts took part in this study, and over three rounds, they were asked to share suggestions and opinions, answer multiple-choice questions, and rate different ideas. By the end of the process, the experts agreed on 16 key recommendations, which were then used to create the ‘STARTS’ recommendations. This splits the recommendations into six topics: (1) Skill development, (2) Training for coaches/volunteers, (3) Aims for sessions, (4) Resources to improve children’s experiences, (5) Transitioning from autism-specific programmes to mainstream programmes, and (6) Supports to improve inclusion. These recommendations offer practical guidance for clubs and organisations that want to create or adapt community-based physical activity programmes to promote inclusion and help autistic children feel welcomed and supported.

How both cisgender autistic people and trans and gender-diverse autistic people talk about their gender identity development.

Why was this study done?

Not everyone feels they have a gender identity, but everyone goes through a development in which gender identity plays a part. Some people experience a difference between their sex assigned at birth and how they experience their current gender. Here, we refer to this small group as trans and gender-diverse and to those whose gender aligns with their assigned sex as cisgender. An increasing number of studies show that autistic people identify more often as trans and gender-diverse compared to the general population but also autistic cis persons can have questions about gender. However, little research on gender identity in autistic individuals had looked at how their sense of gender developed. So, we wondered how autistic adults experienced their gender and how this changed while growing up.

How was the study conducted?

We interviewed 15 autistic adults between 27 and 52 years old about their gender identity development. In the interviews, we focused on (1) how autistic people described their sense of gender and (2) how their sense of gender changed over time.

What did the study find?

For both cisgender autistic individuals and trans and gender-diverse autistic individuals, gender identity development was a personal journey. We found three key themes: (1) exploring an identity that feels right as an individual; (2) in social situations, finding a balance between personal identity and others’ expectations; and (3) in society, interacting with social views on gender. We also found three themes related to changes over time: (1) people learning by experience; (2) gender identity development takes time and is demanding; and (3) perspectives on gender change over time. However, variety existed in how these themes were expressed and experienced.

Why is this important?

Interviewees shared how autism and identity, including gender identity, intertwined. For some, this was challenging. This shows how adequate information and support on gender and autism, and connections with other autistic people can contribute to a positive gender identity development. Also, a well-timed autism diagnosis and positive views on autism can further support this development.

Autistic adolescents and young adults without intellectual disability are at increased risk of suicidal thoughts and self-harm behaviours, but the factors linked to this risk are still not fully understood. This study examined whether peer victimisation, cognitive emotion regulation, and individual stress reactivity were associated with suicidal thoughts and self-harm in 84 autistic people aged 12 to 32 years. Peer victimisation was related to both suicidal thoughts and self-harm behaviours, suggesting that negative experiences with peers may be an important vulnerability factor. Self-harm also showed a more specific association with emotion regulation. In particular, blaming others was negatively associated with self-harm, especially among participants who reported higher stress reactivity. This suggests that, in some contexts, attributing distress to external causes may have a self-protective function rather than being simply maladaptive. Overall, these findings suggest that suicidal thoughts and self-harm behaviours in autistic people may arise from a combination of social adversity, emotion regulation, and stress-related processes. Clinical assessment and prevention should therefore consider peer victimisation and stress reactivity, as well as the specific function of different emotion regulation strategies.

This study explored how to improve early support services for young children aged 0 to 6 years with autism spectrum disorder in resource-limited areas. We interviewed 47 stakeholders, including policymakers, service managers, healthcare professionals, and parents of autistic children across 11 cities to identify factors that support or limit effective early support services. Key helpful factors were government funding, practical staff training, and parents’ proactive attitudes. Major challenges included low public understanding of autism, unequal resources between regions, too few trained professionals, and difficulties families face accessing care. To address these, we suggest four solutions: increasing funding and community awareness, sharing resources more fairly, training more staff and supporting parents, and using technology and proven therapies. As the first study in China to design solutions with families and professionals, these strategies could help similar communities globally deliver better early autism care.

Our study aimed to understand what earlier studies found when they asked autistic adults for their views on intervention and support for young autistic children. We were interested in the views of autistic adults whether they had taken part in early interventions or not. After searching through online records, we found 19 relevant studies. We evaluated the quality of the studies and then separated qualitative (text-based) and quantitative (number-based) data. In studies with qualitative data, we found five themes. Hear the child’s voice talks about child’s assent, Let the child be a child addresses support being play-based and fun, Celebrate autistic lives focuses on autism acceptance and Understand autistic challenges examines making society more accessible. Damage done outlines the negative experiences of autistic people who took part in early interventions. Studies with quantitative data were very different to each other, so we described their similar aspects. In four quantitative studies, autistic people rated intervention goals based on how good or important the goal is for the child. Autistic people said the best/most important goals focused on safety, child well-being and adult support. The worst/least important goals focused on changing autism characteristics such as stimming and eye contact. A graph was made to show this. We need more research on intervention practices and contexts and more research where we ask diverse autistic people: autistic parents, autistic children, men, people of colour and people with higher support needs. Researchers and practitioners can use these findings to develop and provide support that aligns with autistic people’s priorities.

Wandering occurs when a child leaves a safe space. Children with autism wander more than other children. This can lead to serious injury. We describe wandering in children and adolescents with autism. In total, 258 teens with autism were included in the analysis. Caregivers reported that 45% never wandered, 41% wandered only in early childhood, and 14% wandered at least once in adolescence (including 9% that wandered at both time points). Children with behaviors like hyperactivity were more likely to wander in both early childhood and adolescence. Adolescents who wandered most often left public places (58.3%). To address wandering, caregivers most often added home locks/alarms (30.6%) and least often placed a tracking device (8.3%) on the adolescent. In sum, wandering is less common among adolescents than young children with autism. However, we can still help families with adolescents with autism who wander. One way to help these families is to educate people that behavior problems like hyperactivity are associated with wandering regardless of age. Another way to help these families is to increase ways to address wandering away from the home to keep adolescents with autism safe.

In Oregon and other places across the United States, parents often face long wait times to get their children evaluated for autism. Getting an autism diagnosis before age 3 can help children and their families to get the services and supports they need to thrive. Families might have shorter wait times if pediatric primary care practitioners (PCPs) were trained to do autism assessments. Programs nationwide have been developed and used to train PCPs to conduct autism assessments for these reasons. Twenty-four PCPs in the Portland, Oregon, metropolitan area were trained to conduct autism assessments with young children in 2024. The training asked PCPs to participate in an online autism course; a 2-day, in-person workshop on autism assessment; and eight community learning sessions. We studied this training to understand (a) how practical it was to implement this training, (b) whether PCPs’ self-reported knowledge and confidence about autism assessment changed, and (c) the number and characteristics of children who received autism assessments after the PCPs were trained. We collected data from the PCPs three times, including before training started, after the in-person workshop, and after the community learning sessions. We found that PCPs generally rated their participation and training experience positively. We also found that PCPs’ knowledge and confidence increased. They evaluated 34 children across diverse groups for autism. Similar training programs may help to address shortages of PCPs who are qualified to conduct autism assessments and increase access to early autism evaluation.

As more autistic students are educated in mainstream classrooms, teachers play a crucial role in making inclusion successful. This study explored what shapes teachers’ readiness to teach autistic students in schools in Egypt and Oman. Readiness was considered in two ways: teachers’ Professional Knowledge about how to support autistic students and their emotional and motivational readiness to include them in everyday classroom activities. A total of 436 teachers completed questionnaires about their views on autism inclusion, their Concerns and Attitudes, their sense of teamwork within their schools, and how ready they felt to teach autistic students. The results showed that teachers’ personal beliefs about inclusion were the strongest predictors of readiness. Teachers who reported more positive attitudes and supportive Sentiments toward inclusion also reported higher levels of Professional Knowledge and affective readiness. In contrast, teachers who reported stronger Concerns, such as worries about classroom demands, behavior management, or limited resources, tended to report lower readiness to support autistic students. Background characteristics, such as years of teaching experience, were only weakly related to readiness. The school environment also played an important role. Teachers who believed that staff in their school could work together effectively felt more capable and prepared to include autistic students. However, when Concerns about inclusion were strong, a shared sense of school capability did not necessarily protect teachers’ affective readiness; instead, Concerns became more strongly linked to lower affective readiness. In some cases, when Concerns about inclusion were widely shared but not addressed, they became more strongly linked to lower affective readiness. Differences between the two countries were also observed. Teachers in Oman generally reported higher Professional Knowledge and affective readiness than teachers in Egypt. In addition, the way teachers’ Sentiments and attitudes influenced affective readiness differed across the two contexts, while the effect of Concerns on affective readiness did not significantly differ between Egypt and Oman. Overall, the findings suggest that improving autism inclusion may depend less on teachers’ years of experience and more on strengthening positive beliefs about inclusion, addressing practical Concerns, and fostering supportive collaboration within schools.

This study explored how support through specialist resource centres can help autistic pupils in mainstream secondary schools. Specialist resource centres are supportive spaces within regular schools that offer extra help, trained staff who understand autism, and a calm environment, while also keeping pupils included in the wider school community. Although national policies aim to make schools more inclusive, many autistic pupils still face challenges such as anxiety, social challenges and school absence. This study followed 119 autistic pupils aged 11–14 across seven schools for three years. It compared three groups: pupils in specialist resource centres, autistic pupils in the same schools but not placed in the Centres and autistic pupils in mainstream schools without a Centre. Comparisons were also made with non-autistic pupils from the same schools. The study found that specialist resource centre placement was linked to better academic progress for pupils in this sample and a stronger sense of belonging than other placements. Even so, placement on its own did not lead to clear differences in most areas of well-being, and some results were based on smaller samples, so they should be treated carefully. Specialist resource centre pupils also felt more supported by teachers, and they reported higher levels of happiness and fewer peer problems than non-autistic peers. However, because this information was gathered at one point in time, the findings do not prove that placement caused these differences, though they leave open the possibility that placement may have had an impact. Pupils in specialist resource centre placements appeared to have better attendance than autistic pupils nationally, although attendance was still not as high as whole-school averages. The most important factor linked to positive outcomes was feeling supported by teachers and classmates. These results suggest specialist resource centres may offer the greatest benefits within mainstream schools, when they help pupils build supportive peer and teacher relationships.

Several research studies have suggested that Autistic people are more likely to be diagnosed with personality disorder than people who are not Autistic. We compared rates of personality disorder diagnoses between Autistic people and a comparison group of people not diagnosed Autistic using anonymised data collected by UK primary care practitioners for participants registered at a primary care (general practitioner) practice sometime between 1 January 2000 to 16 January 2019. The comparison group of people in the community who did not have an autism diagnosis were of the same age, sex and registered at the same primary care practice as their matched Autistic participant, with 10 times as many matched participants as Autistic participants. We included 22,112 Autistic adults, of whom 6437 (29.1%) had a diagnosis of intellectual disability. Median age was 20.36 years, and most, 16,881 (76.3%), were men. We included 221,120 comparison adults. New personality disorder diagnoses were more than four times as common for Autistic men and women without an intellectual disability compared to men and women in the comparison group. For Autistic participants with an intellectual disability, the rate was twice as high for Autistic versus comparison men and 8 times higher for Autistic versus comparison women. Between 2000 and 2019, there was an increase in the rate of new personality disorder diagnoses among Autistic people, and in women. The findings highlight the need for further investigation into reasons for this increase.