Autism in Adulthood - 2-4 - December 2020

jeudi 24 décembre 2020

1. Call for Papers : Autism in Adulthood. Autism in Adulthood ;2020 ;2(4):269-269.

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2. “They Don’t Know, Don’t Show, or Don’t Care” : Autism’s White Privilege Problem. Autism in Adulthood ;2020 ;2(4):270-272.

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3. An Expert Discussion on Structural Racism in Autism Research and Practice. Autism in Adulthood ;2020 ;2(4):273-281.

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4. The Critical Lack of Data on Alcohol and Marijuana Use by Adolescents on the Autism Spectrum. Autism in Adulthood ;2020 ;2(4):282-288.

Alcohol is the most commonly used substance among adolescents, and marijuana is the most commonly used illicit drug. Emerging evidence suggests that at least some autistic individuals may be at increased risk of substance use disorder compared with allistic counterparts, potentially to control social anxiety or facilitate social interaction. However, to the best of our knowledge, U.S. population-based estimates of substance use by autistic youth are limited. The aim of this perspective article was to highlight the lack of data sets that collect information about alcohol and marijuana use by autistic youth in the United States. We used a four-step investigation to identify potential data sources that could provide an estimate of the prevalence of alcohol and/or marijuana use in autistic youth, without regard to whether those estimates would be robust. We identified a total of 19 potential U.S. data sources. Of these, only one included information about both autism and alcohol and/or marijuana by youth. There is too little research on substance use by autistic adolescents, and rigorously collected data would benefit the field. Our recommendations include increased federal funding for data collection from autistic youth on substance use, additional questions on nationally representative surveys that assess autism status in multiple ways, and the use of robust measures of substance use that allow for characterization of substance use according to multiple dimensions. As the number of autistic youth identified increases and these youth transition into adulthood, better understanding of their substance use patterns is critical for developing health promotion efforts that appropriately and fully serve the needs of autistic youth.

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5. Critical Reflections on Employment Among Autistic Adults. Autism in Adulthood ;2020 ;2(4):289-295.

Encouraging efforts have emerged in recent years to study and build employment opportunities for adults on the autism spectrum. In this Perspectives piece, we acknowledge this important work while offering critical reflections for consideration as the field of employment in autism advances. We call for five areas of increased focus : (1) nurturing long-term versus short-term employment success ; (2) broadening employment readiness efforts beyond only the individual to the entire community employment ecosystem ; (3) providing professional development that starts with an individual’s strengths, and not with their disability ; (4) building community employment support that can be independent of family support ; and (5) striving for a good life versus just the next job. Overall, we aim to help galvanize the field toward greater consideration of individuals’ quality of life and development, the broader community ecosystem around individuals and their families, and vocational stability over the life course, all on individuals’ own terms.

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6. Autism Research as Validation of Lived Experience. Autism in Adulthood ;2020 ;2(4):296-297.

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7. The Association Between Self-Reported Camouflaging of Autistic Traits and Social Competence in Nonautistic Young Adults. Autism in Adulthood ;2020 ;2(4):298-306.

Background : Autistic individuals often experience difficulties in social settings. Although autistic individuals may not intuitively know the “typical” way to behave in social settings, many autistic individuals have a desire to fit in so they develop techniques to “camouflage” their autistic traits. Although camouflaging may help individuals to navigate social environments, camouflaging has also been shown to produce negative psychological outcomes. This study aims to explore whether this “camouflaging” strategy is associated with poor social competence, an aspect of the autism diagnosis. Methods : In this study, 247 nonautistic adults completed the Multidimensional Social Competence Scale (MSCS) to assess their social competence, and the Camouflaging Autistic Traits Questionnaire (CAT-Q) to assess the extent to which they used strategies to compensate or mask behaviors characteristic of autism in social settings. Results : We found that over and above IQ, gender, and executive functioning scores, social competence (MSCS) scores reliably predicted the extent to which nonautistic individuals camouflaged, accounting for 25% of the variance in CAT-Q scores. Importantly, even when autistic traits were controlled for, social competence was still able to account for additional variance in CAT-Q scores. Conclusion : These results suggest that low social competency in nonautistic adults predicts camouflaging as a strategy in social situations. Given these camouflaging behaviors are being performed in an attempt to comply with an environmental demand to behave in a particular manner, these results also highlight the importance of conceptualizing the social challenges that autistic and nonautistic individuals face in a bidirectional manner, where the onus is not solely on the individual to comply with social conventions but also on society to accommodate diverse behavioral traits.

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8. First-Year Progression and Retention of Autistic Students in Higher Education : A Propensity Score-Weighted Population Study. Autism in Adulthood ;2020 ;2(4):307-316.

Background : Autistic individuals’ enrollment in universities is increasing, but we know little about their study progress over time. Many of them have poor degree completion in comparison to students with other disabilities. However, longitudinal studies on study progression over time of autistic students (AS) in comparison to their peers are absent. It is essential to study AS outcomes during the first year, controlling against the results of students without disabilities. Methods : This preregistered population study examined first-year progression and retention within the same area of study of autistic bachelor students (n = 96 ; age M = 20.0 years, 95% confidence interval [CI] 18.0–21.0) in comparison to students without disabilities (n = 25,001 ; age M = 19.0 years, 95% CI 18.0–20.0), enrolled in the same area of study at a major Dutch university. To control for substantial differences in sample sizes and differences in demographics or prior education, we applied propensity score weighting to balance outcomes. We analyzed progression and retention, examining the average grades, the number of examinations, resits, no shows, the credit accumulation in each period, and the average retention after the first year. Results : Over the course of the first bachelor year, AS received grades similar to students with no disabilities. We found no statistical differences in the number of examinations, resits, and no shows. Credit accumulation was generally similar during the academic year except for one of seven periods, and retention within the same area of study revealed no differences. Conclusions : This study shows that AS have similar success rates compared with students with no disabilities but could benefit from additional support on test-taking. Improved insights can enable universities to develop appropriate and timely support for often-talented students, improve first-year retention, and advance degree completion.

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9. The Expectancies and Motivations for Heavy Episodic Drinking of Alcohol in Autistic Adults. Autism in Adulthood ;2020 ;2(4):317-324.

Background : For autistic adults, the perceived benefits of drinking alcohol to facilitate social interaction may be particularly appealing. Alcohol may be considered “self-medication” for clinical features of autism or may be used to help cope with elevated levels of co-occurring anxiety. Methods : We developed an online survey and 507 autistic adults responded to questions concerning their expectancies and motivations for heavy episodic drinking. The survey also included questions about ways of seeking support, if needed, and barriers to seeking support. Results : Over half of those who had drunk alcohol reported heavy episodic drinking in the past year (6 or more units of alcohol at one time). Heavy episodic drinkers endorsed traditional expectancies (e.g., “Alcohol generally has powerful positive effects on people”) and autism-specific expectancies (e.g., “Alcohol makes verbal communication easier”) to a greater degree than nonheavy episodic drinkers. Autism-specific expectancies, not traditional expectancies, related to frequency of drinking. The strongest motivations for heavy episodic drinking were for social reasons and to enhance positive feelings, rather than for conformity or coping. If support was required for problematic drinking, the internet was the most commonly chosen resource, although 45% of the participants indicated that they would not seek support. Perceived barriers to support included concern that it would take place in an unfamiliar chaotic environment and concern about being misunderstood and judged by a therapist. Conclusions : This study is the first to identify the expectancies and motivations for heavy episodic drinking in autistic adults as well as identifying barriers to seeking support. There may be some autism-specific expectancies related to the nature of autism that impact upon heavy episodic drinking, as well as impacting upon seeking support. The autistic and broader autism communities can benefit from an awareness of these findings, and service providers can adapt support appropriately.

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10. Virtual Reality Air Travel Training Using Apple iPhone X and Google Cardboard : A Feasibility Report with Autistic Adolescents and Adults. Autism in Adulthood ;2020 ;2(4):325-333.

Rapid rises in autism diagnoses are increasing the demand for effective services and straining service providers. When individuals on the autism spectrum turn 18, they are faced with even greater barriers to services, since many services are delivered in school settings. Thus, there is a need for more accessible tools that teach daily life and communication skills to autistic adolescents and young adults. The current project reports findings from a pilot study using virtual reality (VR) to teach air travel skills to autistic young adults. The authors repurposed a virtual airport environment previously used to treat fear of flying for this study. Seven participants on the autism spectrum viewed a 5-minute virtual airport simulation with an overlaid narrative script using an iPhone X® and Google Cardboard® device once per week for 3 weeks. Researchers collected measures of attentiveness, language function, activity comprehension, and clinical observations on how participants interacted with the technology. Analyses revealed improvements in attentiveness, certain language functions such as labeling vocabulary, and activity comprehension in most participants. Clinical observations revealed acceptability of this technology and its capability to serve as an appealing media to deliver interventions. Thus, it is feasible to apply mobile VR trainings with autistic adolescents and young adults. We discuss ways to improve the pedagogical approach of VR-enhanced interventions in light of these findings. In the future, we plan to develop and test more virtual environments that address the needs of young adults on the autism spectrum, such as interview training and independent living skills.

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11. Understanding the Relationships Between Autistic Identity, Disclosure, and Camouflaging. Autism in Adulthood ;2020 ;2(4):334-338.

Background : Camouflaging involves concealing an autistic identity, for example, by adopting nonautistic behaviors in social contexts. We currently know little about the relationship between autistic identity and camouflaging. Furthermore, other variables may mediate the relationship between camouflaging and identity, and this study examined whether disclosure (being openly autistic) might mediate the relationship. We predicted that fewer camouflaging behaviors would be associated with higher autistic identity when an individual is more open about being autistic. Methods : One hundred eighty autistic adults (52% female, 42% male, 5% other gender identities, and 1% preferred not to say) took part in the study. They completed an online survey with measures of camouflaging, autistic identity, and disclosure of autistic status. Results : We found a significant mediation effect such that autistic identity had an indirect negative effect on camouflaging mediated via disclosure. In other words, higher autistic identity linked to more disclosure, which in turn linked to fewer camouflaging behaviors. However, there was evidence for competitive mediation, such that the direct effect (the relationship between identity and camouflaging ignoring disclosure) was significant, with higher autistic identity linking directly to more camouflaging. Conclusions : The initial hypothesis was confirmed, with higher autistic identity linked to less camouflaging via disclosure. This finding indicates that camouflaging can reduce when there is high autistic identification, and someone has openly disclosed that they are autistic to others. However, the direct effect between identity and camouflaging suggests that there may be conflicts for someone who identifies strongly with being autistic but continues to camouflage. Other variables may play a role in the relationship between identity and camouflaging, such as fear of discrimination, self-awareness, timing of diagnosis, age, ethnicity, or gender. The findings indicate the importance of safe nondiscriminatory environments where individuals can disclose and express their autistic identity, which may in turn reduce camouflaging.

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12. Acknowledgment of Our Reviewers. Autism in Adulthood ;2020 ;2(4):339-340.

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13. Correction to : Sleep Quality in Autism from Adolescence to Old Age by Jovevska S, et al. Autism Adulthood 2020 ;2(2):152–162 ; DOI : 10.1089/aut.2019.0034. Autism in Adulthood ;2020 ;2(4):341-341.

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