Barriers to healthcare predict reduced health-related quality of life in autistic adults without intellectual disability / Nicole DAVID ; Pascal Rahlff ; Hannah König ; Sophia Dückert ; Petia Gewohn ; Frank Erik ; Kai VOGELEY ; Daniel SCHOTTLE ; Alexander Konnopka ; Holger Schulz ; Judith Peth in Autism, 29-2 (February 2025)  

Public ISBD [article]  inAutism > 29-2 (February 2025) . - p.476-489 Titre : Barriers to healthcare predict reduced health-related quality of life in autistic adults without intellectual disability : Autism Type de document : Texte imprimé et/ou numérique Auteurs : Nicole DAVID, Auteur ; Pascal Rahlff, Auteur ; Hannah König, Auteur ; Sophia Dückert, Auteur ; Petia Gewohn, Auteur ; Frank Erik, Auteur ; Kai VOGELEY, Auteur ; Daniel SCHOTTLE, Auteur ; Alexander Konnopka, Auteur ; Holger Schulz, Auteur ; Judith Peth, Auteur Article en page(s) : p.476-489 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  health services  quality of life Index. décimale : PER Périodiques Résumé : Autistic adults frequently show increased physical or mental health conditions and impairments in social, occupational, and other life domains. Accordingly, they often report reduced health-related quality of life. Yet, numerous barriers prevent effective healthcare for autistic adults. To date, the impact of healthcare barriers on health-related quality of life in autism has not been investigated. We, thus, sought to investigate the health-related quality of life of autistic adults without intellectual disability in Germany and analyze previously reported and novel predictors of health-related quality of life including healthcare barriers using multiple linear regression. Within a nationwide online survey, 311 autistic adults completed the Short-Form Health Survey and the Barriers to Healthcare Checklist. Demographic, clinical, and healthcare-related predictors were also assessed. Participants showed below-average mental and significantly reduced physical health-related quality of life compared to a German normative sample. Several independent variables differentially predicted mental and physical health-related quality of life. Healthcare barriers resulted as the only predictor, which explained variations in both domains: the more barriers autistic adults experienced, the lower their mental and physical health-related quality of life. Barriers emerged as the strongest predictor for mental health-related quality of life. Our results raise awareness for the barriers autistic adults experience in getting appropriate healthcare and the possible consequences for the individual. Improved healthcare access might contribute to better health-related quality of life in autism. Lay abstract Health-related quality of life reflects a person?s perspective on their well-being in physical, mental, social, work-related, and other aspects of health or life. Autistic adults typically report difficulties in many or all of these domains and, thus, often experience their health-related quality of life being reduced. Nonetheless, they do not obtain the professional support they need and report barriers to accessing or receiving appropriate healthcare. We know little about the impact of barriers to healthcare on health-related quality of life in autistic adults. In the present study, 311 autistic adults without intellectual disability in Germany completed an online survey on their current health-related quality of life and the number of barriers to healthcare they experience. In addition, they were asked about their personal and clinical background as well as about the amount of healthcare and support they recently received. We investigated how this information and, particularly, barriers to healthcare explained variations in individual levels of health-related quality of life. We found that barriers to healthcare, compared to most other variables, were a strong predictor of health-related quality of life: The more barriers autistic adults reported, the lower their experienced psychological and physical well-being. To our knowledge, this is the first paper to examine the relationship between barriers to healthcare and health-related quality of life in autism. Our results suggest that healthcare providers need to become aware of the barriers individuals with autism have in seeking and getting healthcare. Improved access to services might contribute to better health-related quality of life in autistic adults. En ligne : https://dx.doi.org/10.1177/13623613241275406 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=547 [article] Barriers to healthcare predict reduced health-related quality of life in autistic adults without intellectual disability : Autism [Texte imprimé et/ou numérique] / Nicole DAVID, Auteur ; Pascal Rahlff, Auteur ; Hannah König, Auteur ; Sophia Dückert, Auteur ; Petia Gewohn, Auteur ; Frank Erik, Auteur ; Kai VOGELEY, Auteur ; Daniel SCHOTTLE, Auteur ; Alexander Konnopka, Auteur ; Holger Schulz, Auteur ; Judith Peth, Auteur . - p.476-489. Langues : Anglais (eng) in Autism > 29-2 (February 2025) . - p.476-489 Mots-clés : adults  autism spectrum disorders  health services  quality of life Index. décimale : PER Périodiques Résumé : Autistic adults frequently show increased physical or mental health conditions and impairments in social, occupational, and other life domains. Accordingly, they often report reduced health-related quality of life. Yet, numerous barriers prevent effective healthcare for autistic adults. To date, the impact of healthcare barriers on health-related quality of life in autism has not been investigated. We, thus, sought to investigate the health-related quality of life of autistic adults without intellectual disability in Germany and analyze previously reported and novel predictors of health-related quality of life including healthcare barriers using multiple linear regression. Within a nationwide online survey, 311 autistic adults completed the Short-Form Health Survey and the Barriers to Healthcare Checklist. Demographic, clinical, and healthcare-related predictors were also assessed. Participants showed below-average mental and significantly reduced physical health-related quality of life compared to a German normative sample. Several independent variables differentially predicted mental and physical health-related quality of life. Healthcare barriers resulted as the only predictor, which explained variations in both domains: the more barriers autistic adults experienced, the lower their mental and physical health-related quality of life. Barriers emerged as the strongest predictor for mental health-related quality of life. Our results raise awareness for the barriers autistic adults experience in getting appropriate healthcare and the possible consequences for the individual. Improved healthcare access might contribute to better health-related quality of life in autism. Lay abstract Health-related quality of life reflects a person?s perspective on their well-being in physical, mental, social, work-related, and other aspects of health or life. Autistic adults typically report difficulties in many or all of these domains and, thus, often experience their health-related quality of life being reduced. Nonetheless, they do not obtain the professional support they need and report barriers to accessing or receiving appropriate healthcare. We know little about the impact of barriers to healthcare on health-related quality of life in autistic adults. In the present study, 311 autistic adults without intellectual disability in Germany completed an online survey on their current health-related quality of life and the number of barriers to healthcare they experience. In addition, they were asked about their personal and clinical background as well as about the amount of healthcare and support they recently received. We investigated how this information and, particularly, barriers to healthcare explained variations in individual levels of health-related quality of life. We found that barriers to healthcare, compared to most other variables, were a strong predictor of health-related quality of life: The more barriers autistic adults reported, the lower their experienced psychological and physical well-being. To our knowledge, this is the first paper to examine the relationship between barriers to healthcare and health-related quality of life in autism. Our results suggest that healthcare providers need to become aware of the barriers individuals with autism have in seeking and getting healthcare. Improved access to services might contribute to better health-related quality of life in autistic adults. En ligne : https://dx.doi.org/10.1177/13623613241275406 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=547

Brief Report: Altered Horizontal Binding of Single Dots to Coherent Motion in Autism / Nicole DAVID in Journal of Autism and Developmental Disorders, 40-12 (December 2010)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 40-12 (December 2010) . - p.1549-1551 Titre : Brief Report: Altered Horizontal Binding of Single Dots to Coherent Motion in Autism Type de document : Texte imprimé et/ou numérique Auteurs : Nicole DAVID, Auteur ; Michael ROSE, Auteur ; Till R. SCHNEIDER, Auteur ; Kai VOGELEY, Auteur ; Andreas K. ENGEL, Auteur Année de publication : 2010 Article en page(s) : p.1549-1551 Langues : Anglais (eng) Mots-clés : Apparent motion  Bistable perception  Binding  Interhemispheric communication  High-functioning autism Index. décimale : PER Périodiques Résumé : Individuals with autism often show a fragmented way of perceiving their environment, suggesting a disorder of information integration, possibly due to disrupted communication between brain areas. We investigated thirteen individuals with high-functioning autism (HFA) and thirteen healthy controls using the metastable motion quartet, a stimulus consisting of two dots alternately presented at four locations of a hypothetical square, thereby inducing an apparent motion percept. This percept is vertical or horizontal, the latter requiring binding of motion signals across cerebral hemispheres. Decreasing the horizontal distance between dots could facilitate horizontal percepts. We found evidence for altered horizontal binding in HFA: Individuals with HFA needed stronger facilitation to experience horizontal motion. These data are interpreted in light of reduced cross-hemispheric communication. En ligne : http://dx.doi.org/10.1007/s10803-010-1008-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=114 [article] Brief Report: Altered Horizontal Binding of Single Dots to Coherent Motion in Autism [Texte imprimé et/ou numérique] / Nicole DAVID, Auteur ; Michael ROSE, Auteur ; Till R. SCHNEIDER, Auteur ; Kai VOGELEY, Auteur ; Andreas K. ENGEL, Auteur . - 2010 . - p.1549-1551. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 40-12 (December 2010) . - p.1549-1551 Mots-clés : Apparent motion  Bistable perception  Binding  Interhemispheric communication  High-functioning autism Index. décimale : PER Périodiques Résumé : Individuals with autism often show a fragmented way of perceiving their environment, suggesting a disorder of information integration, possibly due to disrupted communication between brain areas. We investigated thirteen individuals with high-functioning autism (HFA) and thirteen healthy controls using the metastable motion quartet, a stimulus consisting of two dots alternately presented at four locations of a hypothetical square, thereby inducing an apparent motion percept. This percept is vertical or horizontal, the latter requiring binding of motion signals across cerebral hemispheres. Decreasing the horizontal distance between dots could facilitate horizontal percepts. We found evidence for altered horizontal binding in HFA: Individuals with HFA needed stronger facilitation to experience horizontal motion. These data are interpreted in light of reduced cross-hemispheric communication. En ligne : http://dx.doi.org/10.1007/s10803-010-1008-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=114

Dissociation Between Key Processes of Social Cognition in Autism: Impaired Mentalizing But Intact Sense of Agency / Nicole DAVID in Journal of Autism and Developmental Disorders, 38-4 (April 2008)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 38-4 (April 2008) . - p.593-605 Titre : Dissociation Between Key Processes of Social Cognition in Autism: Impaired Mentalizing But Intact Sense of Agency Type de document : Texte imprimé et/ou numérique Auteurs : Nicole DAVID, Auteur ; Astrid GAWRONSKI, Auteur ; Natacha S. SANTOS, Auteur ; Wolfgang HUFF, Auteur ; Fritz-Georg LEHNHARDT, Auteur ; Albert NEWEN, Auteur ; Kai VOGELEY, Auteur Année de publication : 2008 Article en page(s) : p.593-605 Langues : Anglais (eng) Mots-clés : Mentalizing Sense-of-agency High-functioning-autism Asperger-syndrome Action-monitoring Self-other-distinction Index. décimale : PER Périodiques Résumé : Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus, we compared high-functioning adults with autism to healthy control subjects using an action monitoring and attribution task. Subjects with autism did not show deficits in this task, yet they showed significant mentalizing deficits. Our findings indicate a dissociation between the sense of agency and ascription of mental states in autism. We propose that social-cognitive deficits in autism may arise on a higher level than that of action monitoring and awareness. En ligne : http://dx.doi.org/10.1007/s10803-007-0425-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=340 [article] Dissociation Between Key Processes of Social Cognition in Autism: Impaired Mentalizing But Intact Sense of Agency [Texte imprimé et/ou numérique] / Nicole DAVID, Auteur ; Astrid GAWRONSKI, Auteur ; Natacha S. SANTOS, Auteur ; Wolfgang HUFF, Auteur ; Fritz-Georg LEHNHARDT, Auteur ; Albert NEWEN, Auteur ; Kai VOGELEY, Auteur . - 2008 . - p.593-605. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 38-4 (April 2008) . - p.593-605 Mots-clés : Mentalizing Sense-of-agency High-functioning-autism Asperger-syndrome Action-monitoring Self-other-distinction Index. décimale : PER Périodiques Résumé : Deficits in social cognition and interaction, such as in mentalizing and imitation behavior, are hallmark features of autism spectrum disorders. Both imitation and mentalizing are at the core of the sense of agency, the awareness that we are the initiators of our own behavior. Little evidence exists regarding the sense of agency in autism. Thus, we compared high-functioning adults with autism to healthy control subjects using an action monitoring and attribution task. Subjects with autism did not show deficits in this task, yet they showed significant mentalizing deficits. Our findings indicate a dissociation between the sense of agency and ascription of mental states in autism. We propose that social-cognitive deficits in autism may arise on a higher level than that of action monitoring and awareness. En ligne : http://dx.doi.org/10.1007/s10803-007-0425-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=340

Impairments in multisensory processing are not universal to the autism spectrum: no evidence for crossmodal priming deficits in Asperger syndrome / Nicole DAVID in Autism Research, 4-5 (October 2011)  

Public ISBD [article]  inAutism Research > 4-5 (October 2011) . - p.383-388 Titre : Impairments in multisensory processing are not universal to the autism spectrum: no evidence for crossmodal priming deficits in Asperger syndrome Type de document : Texte imprimé et/ou numérique Auteurs : Nicole DAVID, Auteur ; Till R. SCHNEIDER, Auteur ; Kai VOGELEY, Auteur ; Andreas K. ENGEL, Auteur Année de publication : 2011 Article en page(s) : p.383-388 Langues : Anglais (eng) Mots-clés : Asperger syndrome  high-functioning autism  multisensory processing  crossmodal priming  local processing Index. décimale : PER Périodiques Résumé : Individuals suffering from autism spectrum disorders (ASD) often show a tendency for detail- or feature-based perception (also referred to as “local processing bias”) instead of more holistic stimulus processing typical for unaffected people. This local processing bias has been demonstrated for the visual and auditory domains and there is evidence that multisensory processing may also be affected in ASD. Most multisensory processing paradigms used social-communicative stimuli, such as human speech or faces, probing the processing of simultaneously occuring sensory signals. Multisensory processing, however, is not limited to simultaneous stimulation. In this study, we investigated whether multisensory processing deficits in ASD persist when semantically complex but nonsocial stimuli are presented in succession. Fifteen adult individuals with Asperger syndrome and 15 control persons participated in a visual-audio priming task, which required the classification of sounds that were either primed by semantically congruent or incongruent preceding pictures of objects. As expected, performance on congruent trials was faster and more accurate compared with incongruent trials (crossmodal priming effect). The Asperger group, however, did not differ significantly from the control group. Our results do not support a general multisensory processing deficit, which is universal to the entire autism spectrum. Autism Res2011,4:383–388. © 2011 International Society for Autism Research, Wiley Periodicals, Inc. En ligne : http://dx.doi.org/10.1002/aur.210 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=145 [article] Impairments in multisensory processing are not universal to the autism spectrum: no evidence for crossmodal priming deficits in Asperger syndrome [Texte imprimé et/ou numérique] / Nicole DAVID, Auteur ; Till R. SCHNEIDER, Auteur ; Kai VOGELEY, Auteur ; Andreas K. ENGEL, Auteur . - 2011 . - p.383-388. Langues : Anglais (eng) in Autism Research > 4-5 (October 2011) . - p.383-388 Mots-clés : Asperger syndrome  high-functioning autism  multisensory processing  crossmodal priming  local processing Index. décimale : PER Périodiques Résumé : Individuals suffering from autism spectrum disorders (ASD) often show a tendency for detail- or feature-based perception (also referred to as “local processing bias”) instead of more holistic stimulus processing typical for unaffected people. This local processing bias has been demonstrated for the visual and auditory domains and there is evidence that multisensory processing may also be affected in ASD. Most multisensory processing paradigms used social-communicative stimuli, such as human speech or faces, probing the processing of simultaneously occuring sensory signals. Multisensory processing, however, is not limited to simultaneous stimulation. In this study, we investigated whether multisensory processing deficits in ASD persist when semantically complex but nonsocial stimuli are presented in succession. Fifteen adult individuals with Asperger syndrome and 15 control persons participated in a visual-audio priming task, which required the classification of sounds that were either primed by semantically congruent or incongruent preceding pictures of objects. As expected, performance on congruent trials was faster and more accurate compared with incongruent trials (crossmodal priming effect). The Asperger group, however, did not differ significantly from the control group. Our results do not support a general multisensory processing deficit, which is universal to the entire autism spectrum. Autism Res2011,4:383–388. © 2011 International Society for Autism Research, Wiley Periodicals, Inc. En ligne : http://dx.doi.org/10.1002/aur.210 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=145

Investigation of Mentalizing and Visuospatial Perspective Taking for Self and Other in Asperger Syndrome / Nicole DAVID in Journal of Autism and Developmental Disorders, 40-3 (March 2010)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 40-3 (March 2010) . - p.290-299 Titre : Investigation of Mentalizing and Visuospatial Perspective Taking for Self and Other in Asperger Syndrome Type de document : Texte imprimé et/ou numérique Auteurs : Nicole DAVID, Auteur ; Natacha S. SANTOS, Auteur ; Fritz-Georg LEHNHARDT, Auteur ; Kai VOGELEY, Auteur ; Carolin AUMANN, Auteur ; Bettina H. BEWERNICK, Auteur Année de publication : 2010 Article en page(s) : p.290-299 Langues : Anglais (eng) Mots-clés : Social-cognition Mentalizing Visuospatial-perspective-taking- Asperger-Syndrome Autism Index. décimale : PER Périodiques Résumé : Mentalizing refers to making inferences about other people’s mental states, whereas visuospatial perspective taking refers to inferring other people’s viewpoints. Both abilities seem vital for social functioning; yet, their exact relationship is unclear. We directly compared mentalizing and visuospatial perspective taking in nineteen adults with Asperger syndrome (AS) and fifteen control participants with the same stimulus material. Stimuli depicted virtual characters surrounded by two different objects. Virtual characters expressed a preference for one of the objects indicated by facial expression, gestures or head/body orientation. Compared to controls, participants with AS showed significantly increased reaction times and decreased accuracy for mentalizing (i.e., when inferring the virtual character’s preference from the character’s nonverbal bodily cues). By contrast, there were no significant group differences in perspective taking (i.e., by mental own-body transformations). These findings demonstrate, first, specific deficits in AS when mental states have to be inferred from nonverbal social cues. Second, visuospatial perspective taking may not necessarily be related to social impairments occurring in autism spectrum disorders. En ligne : http://dx.doi.org/10.1007/s10803-009-0867-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=966 [article] Investigation of Mentalizing and Visuospatial Perspective Taking for Self and Other in Asperger Syndrome [Texte imprimé et/ou numérique] / Nicole DAVID, Auteur ; Natacha S. SANTOS, Auteur ; Fritz-Georg LEHNHARDT, Auteur ; Kai VOGELEY, Auteur ; Carolin AUMANN, Auteur ; Bettina H. BEWERNICK, Auteur . - 2010 . - p.290-299. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 40-3 (March 2010) . - p.290-299 Mots-clés : Social-cognition Mentalizing Visuospatial-perspective-taking- Asperger-Syndrome Autism Index. décimale : PER Périodiques Résumé : Mentalizing refers to making inferences about other people’s mental states, whereas visuospatial perspective taking refers to inferring other people’s viewpoints. Both abilities seem vital for social functioning; yet, their exact relationship is unclear. We directly compared mentalizing and visuospatial perspective taking in nineteen adults with Asperger syndrome (AS) and fifteen control participants with the same stimulus material. Stimuli depicted virtual characters surrounded by two different objects. Virtual characters expressed a preference for one of the objects indicated by facial expression, gestures or head/body orientation. Compared to controls, participants with AS showed significantly increased reaction times and decreased accuracy for mentalizing (i.e., when inferring the virtual character’s preference from the character’s nonverbal bodily cues). By contrast, there were no significant group differences in perspective taking (i.e., by mental own-body transformations). These findings demonstrate, first, specific deficits in AS when mental states have to be inferred from nonverbal social cues. Second, visuospatial perspective taking may not necessarily be related to social impairments occurring in autism spectrum disorders. En ligne : http://dx.doi.org/10.1007/s10803-009-0867-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=966

Mirror me: Imitative responses in adults with autism / Odette SCHUNKE in Autism, 20-2 (February 2016)  

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Quantitative Sensory Testing in adults with Autism Spectrum Disorders / Odette FRÜNDT in Journal of Autism and Developmental Disorders, 47-4 (April 2017)  

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Right Temporoparietal Gray Matter Predicts Accuracy of Social Perception in the Autism Spectrum / Nicole DAVID in Journal of Autism and Developmental Disorders, 44-6 (June 2014)  

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