Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland / Donald MACIVER in Autism, 30-2 (February 2026)  

Public ISBD [article]  inAutism > 30-2 (February 2026) . - p.375-389 Titre : Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland Type de document : texte imprimé Auteurs : Donald MACIVER, Auteur ; Anusua SINGH ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur Article en page(s) : p.375-389 Langues : Anglais (eng) Mots-clés : ADHD  adults  autism  diagnosis  health services  school-age children  sex differences Index. décimale : PER Périodiques Résumé : This study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to-female ratio = 0.79) and adulthood (male-to-female ratio = 0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p < 0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p < 0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5 years; p = 0.002) and diagnosed later (median age: 9.3 vs 11.9 years; p = 0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate increasing balance in sex ratios with age, greater asymmetry in younger age groups, and consistent delays in referral and diagnosis ages for females.Lay abstract This article looks at how males and females are diagnosed with neurodevelopmental differences including autism, attention-deficit/hyperactivity disorder (ADHD) and intellectual disabilities. It studies the case notes of 408 people (adults and children) assessed by 30 different teams during their diagnosis process. The results show overall that more males were diagnosed with neurodevelopmental differences and that males are diagnosed at younger ages compared to females. The increased diagnosis of males compared to females is most common in younger ages, but and as people get older, the number of males and females diagnosed becomes more equal, showing that more women are coming forward for and being diagnosed, for example with autism and ADHD. This research shows that although there are increasing amounts of females diagnosed, that girls and women are still missed when they are young, with more boys gaining a diagnosis as children. It seems there is a pattern of females being diagnosed at later ages (meaning less access to support and self-understanding). The study calls for better diagnostic practices and more research to address these gender differences. En ligne : https://dx.doi.org/10.1177/13623613251383343 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579 [article] Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland [texte imprimé] / Donald MACIVER, Auteur ; Anusua SINGH ROY, Auteur ; Lorna JOHNSTON, Auteur ; Marie BOILSON, Auteur ; Eleanor CURNOW, Auteur ; Victoria JOHNSTONE-COOKE, Auteur ; Marion RUTHERFORD, Auteur . - p.375-389. Langues : Anglais (eng) in Autism > 30-2 (February 2026) . - p.375-389 Mots-clés : ADHD  adults  autism  diagnosis  health services  school-age children  sex differences Index. décimale : PER Périodiques Résumé : This study examined differences in referral and diagnosis based on sex recorded at birth (hereafter, ‘sex’), using case notes from 408 individuals diagnosed by 30 multidisciplinary teams across Scotland. Analyses focused on male-to-female ratios and median ages at referral and diagnosis across attention-deficit/hyperactivity disorder, autism and intellectual disability. The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age. In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to-female ratio = 0.79) and adulthood (male-to-female ratio = 0.94). Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs 19.7 years; p < 0.001) and diagnosed later (median ages: 15.2 vs 20.2 years; p < 0.001), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs 10.5 years; p = 0.002) and diagnosed later (median age: 9.3 vs 11.9 years; p = 0.003). However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate increasing balance in sex ratios with age, greater asymmetry in younger age groups, and consistent delays in referral and diagnosis ages for females.Lay abstract This article looks at how males and females are diagnosed with neurodevelopmental differences including autism, attention-deficit/hyperactivity disorder (ADHD) and intellectual disabilities. It studies the case notes of 408 people (adults and children) assessed by 30 different teams during their diagnosis process. The results show overall that more males were diagnosed with neurodevelopmental differences and that males are diagnosed at younger ages compared to females. The increased diagnosis of males compared to females is most common in younger ages, but and as people get older, the number of males and females diagnosed becomes more equal, showing that more women are coming forward for and being diagnosed, for example with autism and ADHD. This research shows that although there are increasing amounts of females diagnosed, that girls and women are still missed when they are young, with more boys gaining a diagnosis as children. It seems there is a pattern of females being diagnosed at later ages (meaning less access to support and self-understanding). The study calls for better diagnostic practices and more research to address these gender differences. En ligne : https://dx.doi.org/10.1177/13623613251383343 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=579

Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care / Anna GRAY in Autism, 29-12 (December 2025)  

Public ISBD [article]  inAutism > 29-12 (December 2025) . - p.3111-3123 Titre : Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care Type de document : texte imprimé Auteurs : Anna GRAY, Auteur ; Donald MACIVER, Auteur ; Eleanor CURNOW, Auteur ; Lorna JOHNSTON, Auteur ; Marion RUTHERFORD, Auteur Article en page(s) : p.3111-3123 Langues : Anglais (eng) Mots-clés : ADHD  adults  assessment  autism  diagnosis  health services  neurodivergent  pathway  psychoeducational support  qualitative research Index. décimale : PER Périodiques Résumé : There has been limited research to date into contextual factors hindering or supporting the successful implementation of neuro-affirming practice in support for Autistic and otherwise neurodivergent adults. We used a Realist Evaluation approach to explore key contexts affecting neuro-affirming practice. A preliminary programme theory of key aspects of support was developed. Views on current practice were sought through structured interviews with 32 senior professionals in leadership roles within Health and Social Care services in Scotland. This study identified important contexts shaping the implementation of neuro-affirming practice for adults. Results indicate widespread professional support for modifying practice to better accommodate neuro-affirming ideas, and scope to achieve this. However, some contexts, including limited resources, restrictive eligibility criteria and rigid service structures, hinder progress. Growing demand for services was often viewed as a restrictive context, but it also offered a chance to rethink conventional, one-size-fits-all models and adopt neuro-affirming approaches. The study is important in addressing a current gap in research into professional perspectives of the contexts required to develop transdiagnostic, neuro-affirming approaches and pathways for Autistic and neurodivergent adults. The insights from this study may offer transferable practice approaches, applicable across different countries with similar healthcare contexts.Lay abstract Delivery of neuro-affirming adult support pathways for Autistic and other neurodivergent adults by Health and Social Care institutions can be affected by different contexts. However, there is limited research to date into the most supportive contexts for effective neuro-affirming practice. This study aimed to explore the most beneficial contexts for neuro-affirming approaches, and barriers to this. We did this by using existing research to develop a theory about the most helpful approaches to support for Autistic adults, then gathering the views of 32 senior professionals in leadership roles within Health and Social Care services to explore supports and challenges they experience in implementing these approaches. The study identified important contexts for delivery of neuro-affirming practice and how these might be achieved. Some contexts, such as limited resources, restrictive eligibility criteria and inflexible service structures, could limit progress. However, although these were often seen as barriers, they also offered a chance to rethink one-size-fits-all models and adopt neuro-affirming approaches. This study is important in addressing a current gap in research into professional perspectives of the ways neuro-affirming approaches can be developed in practice, to support Autistic and neurodivergent adults. The insights from this study may offer transferable lessons, applicable across different regions and countries. En ligne : https://dx.doi.org/10.1177/13623613251360275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=572 [article] Contextual factors influencing neuro-affirming practice: Identifying what helps or hinders implementation in health and social care [texte imprimé] / Anna GRAY, Auteur ; Donald MACIVER, Auteur ; Eleanor CURNOW, Auteur ; Lorna JOHNSTON, Auteur ; Marion RUTHERFORD, Auteur . - p.3111-3123. Langues : Anglais (eng) in Autism > 29-12 (December 2025) . - p.3111-3123 Mots-clés : ADHD  adults  assessment  autism  diagnosis  health services  neurodivergent  pathway  psychoeducational support  qualitative research Index. décimale : PER Périodiques Résumé : There has been limited research to date into contextual factors hindering or supporting the successful implementation of neuro-affirming practice in support for Autistic and otherwise neurodivergent adults. We used a Realist Evaluation approach to explore key contexts affecting neuro-affirming practice. A preliminary programme theory of key aspects of support was developed. Views on current practice were sought through structured interviews with 32 senior professionals in leadership roles within Health and Social Care services in Scotland. This study identified important contexts shaping the implementation of neuro-affirming practice for adults. Results indicate widespread professional support for modifying practice to better accommodate neuro-affirming ideas, and scope to achieve this. However, some contexts, including limited resources, restrictive eligibility criteria and rigid service structures, hinder progress. Growing demand for services was often viewed as a restrictive context, but it also offered a chance to rethink conventional, one-size-fits-all models and adopt neuro-affirming approaches. The study is important in addressing a current gap in research into professional perspectives of the contexts required to develop transdiagnostic, neuro-affirming approaches and pathways for Autistic and neurodivergent adults. The insights from this study may offer transferable practice approaches, applicable across different countries with similar healthcare contexts.Lay abstract Delivery of neuro-affirming adult support pathways for Autistic and other neurodivergent adults by Health and Social Care institutions can be affected by different contexts. However, there is limited research to date into the most supportive contexts for effective neuro-affirming practice. This study aimed to explore the most beneficial contexts for neuro-affirming approaches, and barriers to this. We did this by using existing research to develop a theory about the most helpful approaches to support for Autistic adults, then gathering the views of 32 senior professionals in leadership roles within Health and Social Care services to explore supports and challenges they experience in implementing these approaches. The study identified important contexts for delivery of neuro-affirming practice and how these might be achieved. Some contexts, such as limited resources, restrictive eligibility criteria and inflexible service structures, could limit progress. However, although these were often seen as barriers, they also offered a chance to rethink one-size-fits-all models and adopt neuro-affirming approaches. This study is important in addressing a current gap in research into professional perspectives of the ways neuro-affirming approaches can be developed in practice, to support Autistic and neurodivergent adults. The insights from this study may offer transferable lessons, applicable across different regions and countries. En ligne : https://dx.doi.org/10.1177/13623613251360275 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=572

Developing Pretend Play in Autistic Children Using the Playboxes Joint Play Approach as Part of Ongoing Practice / Helen MARWICK in Journal of Autism and Developmental Disorders, 52-7 (July 2022)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 52-7 (July 2022) . - p.3050-3060 Titre : Developing Pretend Play in Autistic Children Using the Playboxes Joint Play Approach as Part of Ongoing Practice Type de document : texte imprimé Auteurs : Helen MARWICK, Auteur ; Karena JARVIE, Auteur ; Hilary COWIE, Auteur ; Lorna JOHNSTON, Auteur ; Nicola HAMMOND-EVANS, Auteur ; Rachael COCKAYNE, Auteur Article en page(s) : p.3050-3060 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder  Autistic Disorder/diagnosis/therapy  Child  Humans  Longitudinal Studies  Play and Playthings  Autism  Children  Joint attention  Joint-play support  Ongoing practice  Pretend play Index. décimale : PER Périodiques Résumé : A repeated measures single subject design was used to examine the effectiveness of a joint play approach embedded in professional practice, in supporting pretend play for autistic children. Seven autistic children, aged 5-8 years, with a placement within a specialist educational provision, and who demonstrated restricted play, participated in weekly sessions using the Playboxes approach over a period of 3 months. Pre- and post-approach pretend play abilities were assessed using the Symbolic Play Test and the Test of Pretend Play. Every child gained increased age-equivalent scores on the Test of Pretend Play, ranging from+8 to+30 months. Pretend Play abilities can support developmental outcomes and incorporation of this approach into regular practice could be of value for autistic children. En ligne : http://dx.doi.org/10.1007/s10803-021-05156-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477 [article] Developing Pretend Play in Autistic Children Using the Playboxes Joint Play Approach as Part of Ongoing Practice [texte imprimé] / Helen MARWICK, Auteur ; Karena JARVIE, Auteur ; Hilary COWIE, Auteur ; Lorna JOHNSTON, Auteur ; Nicola HAMMOND-EVANS, Auteur ; Rachael COCKAYNE, Auteur . - p.3050-3060. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 52-7 (July 2022) . - p.3050-3060 Mots-clés : Autism Spectrum Disorder  Autistic Disorder/diagnosis/therapy  Child  Humans  Longitudinal Studies  Play and Playthings  Autism  Children  Joint attention  Joint-play support  Ongoing practice  Pretend play Index. décimale : PER Périodiques Résumé : A repeated measures single subject design was used to examine the effectiveness of a joint play approach embedded in professional practice, in supporting pretend play for autistic children. Seven autistic children, aged 5-8 years, with a placement within a specialist educational provision, and who demonstrated restricted play, participated in weekly sessions using the Playboxes approach over a period of 3 months. Pre- and post-approach pretend play abilities were assessed using the Symbolic Play Test and the Test of Pretend Play. Every child gained increased age-equivalent scores on the Test of Pretend Play, ranging from+8 to+30 months. Pretend Play abilities can support developmental outcomes and incorporation of this approach into regular practice could be of value for autistic children. En ligne : http://dx.doi.org/10.1007/s10803-021-05156-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477

Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018-2022 / Marion RUTHERFORD ; Lorna JOHNSTON ; Anusua Singh ROY in Autism Research, 16-12 (December 2023)  

Public ISBD [article]  inAutism Research > 16-12 (December 2023) . - p.2403-2414 Titre : Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018-2022 Type de document : texte imprimé Auteurs : Marion RUTHERFORD, Auteur ; Lorna JOHNSTON, Auteur ; Anusua Singh ROY, Auteur Article en page(s) : p.2403-2414 Index. décimale : PER Périodiques Résumé : Abstract This study investigated the prevalence of neurodevelopmental needs among children in primary schools in Scotland. Two groups were identified: autistic learners and a larger group of learners who had neurodevelopmental differences. These differences encompassed any need for additional support in various domains, including communication, interaction, emotional regulation, coordination, movement, and cognition. A two-phase process was employed, drawing on data from a cross-sectional study followed by a secondary analysis of a population census. In the first phase, a random sample of 688 children with additional support needs from 22 schools participated. Demographics, support characteristics, and neurodevelopmental needs were identified. Results revealed that 76.89% of children with additional support needs exhibited a need type consistent with a neurodevelopmental difference. In the second phase, data from the Scottish Government Annual Pupil Census, covering all state-provided primary school children between 2018 and 2022, were analyzed. Modeling was conducted using data from the first phase to estimate prevalence of neurodevelopmental differences. Data on autism were directly extracted from the census. Analysis revealed an increase in the prevalence of neurodevelopmental differences and autism. The prevalence of autism rose by 31.98%, with 2.60% of primary school children identified as autistic in 2022. Similarly, the prevalence of neurodevelopmental differences increased by 10.57%, with 16.22% of primary school children exhibiting such differences in 2022. Across 32 localities, regional variations in prevalence were observed. These findings show the substantial number of neurodivergent children within Scottish primary schools and emphasize the need for a neurodevelopmentally informed approach to inclusive education. En ligne : https://doi.org/10.1002/aur.3063 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=518 [article] Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018-2022 [texte imprimé] / Marion RUTHERFORD, Auteur ; Lorna JOHNSTON, Auteur ; Anusua Singh ROY, Auteur . - p.2403-2414. in Autism Research > 16-12 (December 2023) . - p.2403-2414 Index. décimale : PER Périodiques Résumé : Abstract This study investigated the prevalence of neurodevelopmental needs among children in primary schools in Scotland. Two groups were identified: autistic learners and a larger group of learners who had neurodevelopmental differences. These differences encompassed any need for additional support in various domains, including communication, interaction, emotional regulation, coordination, movement, and cognition. A two-phase process was employed, drawing on data from a cross-sectional study followed by a secondary analysis of a population census. In the first phase, a random sample of 688 children with additional support needs from 22 schools participated. Demographics, support characteristics, and neurodevelopmental needs were identified. Results revealed that 76.89% of children with additional support needs exhibited a need type consistent with a neurodevelopmental difference. In the second phase, data from the Scottish Government Annual Pupil Census, covering all state-provided primary school children between 2018 and 2022, were analyzed. Modeling was conducted using data from the first phase to estimate prevalence of neurodevelopmental differences. Data on autism were directly extracted from the census. Analysis revealed an increase in the prevalence of neurodevelopmental differences and autism. The prevalence of autism rose by 31.98%, with 2.60% of primary school children identified as autistic in 2022. Similarly, the prevalence of neurodevelopmental differences increased by 10.57%, with 16.22% of primary school children exhibiting such differences in 2022. Across 32 localities, regional variations in prevalence were observed. These findings show the substantial number of neurodivergent children within Scottish primary schools and emphasize the need for a neurodevelopmentally informed approach to inclusive education. En ligne : https://doi.org/10.1002/aur.3063 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=518

Pupils' views on visual timetables and labels in mainstream primary classrooms / Marion RUTHERFORD in Good Autism Practice - GAP, 21-2 (October 2020)

Public ISBD [article]  inGood Autism Practice - GAP > 21-2 (October 2020) . - p.11-22 Titre : Pupils' views on visual timetables and labels in mainstream primary classrooms Type de document : texte imprimé Auteurs : Marion RUTHERFORD, Auteur ; Brittany LAHOOD-KULLBERG, Auteur ; Julie BAXTER, Auteur ; Lorna JOHNSTON, Auteur ; Katie CEBULA, Auteur Article en page(s) : p.11-22 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : The use of visual timetables and other visual supports such as labelling materials, places and people with words, symbols and/or photos has been advocated by many to enhance communication and understanding, particularly for children with special educational needs. These are used by staff in mainstream and special settings, and parents and carers also often develop these for use at home. A number of studies have been conducted to explore the value of these from the perspective of the adults who implement them but few studies have sought to obtain the children's views. In this paper, the authors who work at Queen Margaret University (MR); within the NHS Lothian Speech and Language Therapy Department (MR); within the Additional Support for Learning Service (JB and LJ) in Edinburgh; and at the University of Edinburgh (BLK and KC) report on a study they conducted to gain the views of 109 pupils with (36) and without additional support needs (73) attending two mainstream primary schools. They conclude that most pupils in both groups found visual supports useful but that they could be more involved in deciding how these were implemented and updated. Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=438 [article] Pupils' views on visual timetables and labels in mainstream primary classrooms [texte imprimé] / Marion RUTHERFORD, Auteur ; Brittany LAHOOD-KULLBERG, Auteur ; Julie BAXTER, Auteur ; Lorna JOHNSTON, Auteur ; Katie CEBULA, Auteur . - p.11-22. Langues : Anglais (eng) in Good Autism Practice - GAP > 21-2 (October 2020) . - p.11-22 Index. décimale : PER Périodiques Résumé : The use of visual timetables and other visual supports such as labelling materials, places and people with words, symbols and/or photos has been advocated by many to enhance communication and understanding, particularly for children with special educational needs. These are used by staff in mainstream and special settings, and parents and carers also often develop these for use at home. A number of studies have been conducted to explore the value of these from the perspective of the adults who implement them but few studies have sought to obtain the children's views. In this paper, the authors who work at Queen Margaret University (MR); within the NHS Lothian Speech and Language Therapy Department (MR); within the Additional Support for Learning Service (JB and LJ) in Edinburgh; and at the University of Edinburgh (BLK and KC) report on a study they conducted to gain the views of 109 pupils with (36) and without additional support needs (73) attending two mainstream primary schools. They conclude that most pupils in both groups found visual supports useful but that they could be more involved in deciding how these were implemented and updated. Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=438

Visual supports at home and in the community for individuals with autism spectrum disorders: A scoping review / Marion RUTHERFORD in Autism, 24-2 (February 2020)  

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Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences / Anusua Singh ROY ; Lorna JOHNSTON ; Marie BOILSON ; Eleanor CURNOW ; Victoria JOHNSTONE-COOKE ; Marion RUTHERFORD in Autism Research, 18-4 (April 2025)  

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