Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology / L. VUILLIER in Molecular Autism, 11 (2020)  

Public ISBD [article]  inMolecular Autism > 11 (2020) . - 63 p. Titre : Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology Type de document : texte imprimé Auteurs : L. VUILLIER, Auteur ; Z. CARTER, Auteur ; A.R. TEIXEIRA, Auteur ; Rachel L. MOSELEY, Auteur Article en page(s) : 63 p. Langues : Anglais (eng) Mots-clés : Alexithymia  Anorexia nervosa  Autism  Autistic traits  Eating disorders Index. décimale : PER Périodiques Résumé : BACKGROUND: Autistic people are disproportionately vulnerable to anorexia nervosa and other eating disorders (ED), and within the general population, autistic traits correlate with ED psychopathology. A putative mechanism which may underpin this heightened risk is alexithymia, a difficulty identifying and describing emotional states which is observed in both autism and ED. In two experiments with independent non-clinical samples, we explored whether alexithymia might mediate the heightened risk of eating psychopathology in individuals high in autistic traits. METHODS: Our first experiment used the PROCESS macro for SPSS to examine relationships between alexithymia (measured by the Toronto Alexithymia Scale (TAS-20)), autistic traits (autism quotient (AQ)), and eating psychopathology (Eating Attitudes Test (EAT-26)) in 121 participants. Our second experiment (n = 300) replicated and furthered this analysis by examining moderating effects of sex and controlling for anxiety and depression as covariates. We also included an additional performance-based measure of alexithymia, the Levels of Emotional Awareness Scale (LEAS). RESULTS: Study 1 suggested that TAS-20 scores mediated the relationship between heightened autistic traits and eating psychopathology. Replication and further scrutiny of this finding, in study 2, revealed that this mediation effect was partial and specific to the female participants in this sample. The mediation effect appeared to be carried by the difficulty identifying feelings subscale of the TAS-20, even when depression and anxiety were controlled for. LEAS scores, however, were not significantly related to autistic traits or eating psychopathology. LIMITATIONS: Cross-sectional data prevents any conclusions around the direction and causality of relationships between alexithymia, autistic traits, and eating psychopathology (alongside depression and anxiety), necessitating longitudinal research. Our non-clinical sample was predominantly Caucasian undergraduate students, so it remains to be seen if these results would extrapolate to clinical and/or autistic samples. Divergence between the TAS-20 and LEAS raises crucial questions regarding the construct validity of these measures. CONCLUSIONS: Our findings with respect to autistic traits suggest that alexithymia could partially explain the prevalence of ED in autistic people and may as such be an important consideration in the pathogenesis and treatment of ED in autistic and non-autistic people alike. Further research with clinical samples is critical to explore these ideas. Differences between men and women, furthermore, emphasize the importance of looking for sex-specific as well as generic risk factors in autistic and non-autistic men and women. En ligne : http://dx.doi.org/10.1186/s13229-020-00364-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433 [article] Alexithymia may explain the relationship between autistic traits and eating disorder psychopathology [texte imprimé] / L. VUILLIER, Auteur ; Z. CARTER, Auteur ; A.R. TEIXEIRA, Auteur ; Rachel L. MOSELEY, Auteur . - 63 p. Langues : Anglais (eng) in Molecular Autism > 11 (2020) . - 63 p. Mots-clés : Alexithymia  Anorexia nervosa  Autism  Autistic traits  Eating disorders Index. décimale : PER Périodiques Résumé : BACKGROUND: Autistic people are disproportionately vulnerable to anorexia nervosa and other eating disorders (ED), and within the general population, autistic traits correlate with ED psychopathology. A putative mechanism which may underpin this heightened risk is alexithymia, a difficulty identifying and describing emotional states which is observed in both autism and ED. In two experiments with independent non-clinical samples, we explored whether alexithymia might mediate the heightened risk of eating psychopathology in individuals high in autistic traits. METHODS: Our first experiment used the PROCESS macro for SPSS to examine relationships between alexithymia (measured by the Toronto Alexithymia Scale (TAS-20)), autistic traits (autism quotient (AQ)), and eating psychopathology (Eating Attitudes Test (EAT-26)) in 121 participants. Our second experiment (n = 300) replicated and furthered this analysis by examining moderating effects of sex and controlling for anxiety and depression as covariates. We also included an additional performance-based measure of alexithymia, the Levels of Emotional Awareness Scale (LEAS). RESULTS: Study 1 suggested that TAS-20 scores mediated the relationship between heightened autistic traits and eating psychopathology. Replication and further scrutiny of this finding, in study 2, revealed that this mediation effect was partial and specific to the female participants in this sample. The mediation effect appeared to be carried by the difficulty identifying feelings subscale of the TAS-20, even when depression and anxiety were controlled for. LEAS scores, however, were not significantly related to autistic traits or eating psychopathology. LIMITATIONS: Cross-sectional data prevents any conclusions around the direction and causality of relationships between alexithymia, autistic traits, and eating psychopathology (alongside depression and anxiety), necessitating longitudinal research. Our non-clinical sample was predominantly Caucasian undergraduate students, so it remains to be seen if these results would extrapolate to clinical and/or autistic samples. Divergence between the TAS-20 and LEAS raises crucial questions regarding the construct validity of these measures. CONCLUSIONS: Our findings with respect to autistic traits suggest that alexithymia could partially explain the prevalence of ED in autistic people and may as such be an important consideration in the pathogenesis and treatment of ED in autistic and non-autistic people alike. Further research with clinical samples is critical to explore these ideas. Differences between men and women, furthermore, emphasize the importance of looking for sex-specific as well as generic risk factors in autistic and non-autistic men and women. En ligne : http://dx.doi.org/10.1186/s13229-020-00364-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433

Brain Routes for Reading in Adults with and without Autism: EMEG Evidence / Rachel L. MOSELEY in Journal of Autism and Developmental Disorders, 44-1 (January 2014)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 44-1 (January 2014) . - p.137-153 Titre : Brain Routes for Reading in Adults with and without Autism: EMEG Evidence Type de document : texte imprimé Auteurs : Rachel L. MOSELEY, Auteur ; Friedemann PULVERMULLER, Auteur ; Bettina MOHR, Auteur ; Michael V. LOMBARDO, Auteur ; Simon BARON-COHEN, Auteur ; Yury SHTYROV, Auteur Article en page(s) : p.137-153 Langues : Anglais (eng) Mots-clés : Reading  Dual-route model  Hyperlexia  Semantics  EEG  MEG Index. décimale : PER Périodiques Résumé : Reading utilises at least two neural pathways. The temporal lexical route visually maps whole words to their lexical entries, whilst the nonlexical route decodes words phonologically via parietal cortex. Readers typically employ the lexical route for familiar words, but poor comprehension plus precocity at mechanically ‘sounding out’ words suggests that differences might exist in autism. Combined MEG/EEG recordings of adults with autistic spectrum conditions (ASC) and controls while reading revealed preferential recruitment of temporal areas in controls and additional parietal recruitment in ASC. Furthermore, a lack of differences between semantic word categories was consistent with previous suggestion that people with ASC may lack a ‘default’ lexical-semantic processing mode. These results are discussed with reference to dual-route models of reading. En ligne : http://dx.doi.org/10.1007/s10803-013-1858-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=220 [article] Brain Routes for Reading in Adults with and without Autism: EMEG Evidence [texte imprimé] / Rachel L. MOSELEY, Auteur ; Friedemann PULVERMULLER, Auteur ; Bettina MOHR, Auteur ; Michael V. LOMBARDO, Auteur ; Simon BARON-COHEN, Auteur ; Yury SHTYROV, Auteur . - p.137-153. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 44-1 (January 2014) . - p.137-153 Mots-clés : Reading  Dual-route model  Hyperlexia  Semantics  EEG  MEG Index. décimale : PER Périodiques Résumé : Reading utilises at least two neural pathways. The temporal lexical route visually maps whole words to their lexical entries, whilst the nonlexical route decodes words phonologically via parietal cortex. Readers typically employ the lexical route for familiar words, but poor comprehension plus precocity at mechanically ‘sounding out’ words suggests that differences might exist in autism. Combined MEG/EEG recordings of adults with autistic spectrum conditions (ASC) and controls while reading revealed preferential recruitment of temporal areas in controls and additional parietal recruitment in ASC. Furthermore, a lack of differences between semantic word categories was consistent with previous suggestion that people with ASC may lack a ‘default’ lexical-semantic processing mode. These results are discussed with reference to dual-route models of reading. En ligne : http://dx.doi.org/10.1007/s10803-013-1858-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=220

A "choice", an "addiction", a way "out of the lost": exploring self-injury in autistic people without intellectual disability / Rachel L. MOSELEY in Molecular Autism, 10 (2019)  

Public ISBD [article]  inMolecular Autism > 10 (2019) . - 18 p. Titre : A "choice", an "addiction", a way "out of the lost": exploring self-injury in autistic people without intellectual disability Type de document : texte imprimé Auteurs : Rachel L. MOSELEY, Auteur ; Nicola J. GREGORY, Auteur ; Paula SMITH, Auteur ; Carrie ALLISON, Auteur ; Simon BARON-COHEN, Auteur Article en page(s) : 18 p. Langues : Anglais (eng) Mots-clés : Alexithymia  Autism  Qualitative  Self-harm  Self-injury  Sensory differences  Suicidality Index. décimale : PER Périodiques Résumé : Background: Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods: One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results: Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions: Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients. En ligne : http://dx.doi.org/10.1186/s13229-019-0267-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=398 [article] A "choice", an "addiction", a way "out of the lost": exploring self-injury in autistic people without intellectual disability [texte imprimé] / Rachel L. MOSELEY, Auteur ; Nicola J. GREGORY, Auteur ; Paula SMITH, Auteur ; Carrie ALLISON, Auteur ; Simon BARON-COHEN, Auteur . - 18 p. Langues : Anglais (eng) in Molecular Autism > 10 (2019) . - 18 p. Mots-clés : Alexithymia  Autism  Qualitative  Self-harm  Self-injury  Sensory differences  Suicidality Index. décimale : PER Périodiques Résumé : Background: Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods: One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results: Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions: Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients. En ligne : http://dx.doi.org/10.1186/s13229-019-0267-3 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=398

Correction to: The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults / Rachel L. MOSELEY in Molecular Autism, 13 (2022)  

Public ISBD [article]  inMolecular Autism > 13 (2022) . - 16 p. Titre : Correction to: The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults Type de document : texte imprimé Auteurs : Rachel L. MOSELEY, Auteur ; Nicola J. GREGORY, Auteur ; Paula SMITH, Auteur ; Carrie ALLISON, Auteur ; Sarah CASSIDY, Auteur ; Simon BARON-COHEN, Auteur Article en page(s) : 16 p. Langues : Anglais (eng) Index. décimale : PER Périodiques En ligne : http://dx.doi.org/10.1186/s13229-022-00496-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477 [article] Correction to: The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults [texte imprimé] / Rachel L. MOSELEY, Auteur ; Nicola J. GREGORY, Auteur ; Paula SMITH, Auteur ; Carrie ALLISON, Auteur ; Sarah CASSIDY, Auteur ; Simon BARON-COHEN, Auteur . - 16 p. Langues : Anglais (eng) in Molecular Autism > 13 (2022) . - 16 p. Index. décimale : PER Périodiques En ligne : http://dx.doi.org/10.1186/s13229-022-00496-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477

‘I did not think they could help me’: Autistic adults’ reasons for not seeking public healthcare when they last experienced suicidality / Tanya L. PROCYSHYN in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2677-2690 Titre : ‘I did not think they could help me’: Autistic adults’ reasons for not seeking public healthcare when they last experienced suicidality Type de document : texte imprimé Auteurs : Tanya L. PROCYSHYN, Auteur ; Rachel L. MOSELEY, Auteur ; Sarah J. MARSDEN, Auteur ; Carrie ALLISON, Auteur ; Tracey PARSONS, Auteur ; Sarah A. CASSIDY, Auteur ; Mirabel K. PELTON, Auteur ; Elizabeth WEIR, Auteur ; Tanatswa CHIKAURA, Auteur ; Holly HODGES, Auteur ; David MOSSE, Auteur ; Ian HALL, Auteur ; Lewis OWENS, Auteur ; Jon CHEYETTE, Auteur ; David CRICHTON, Auteur ; Jacqui RODGERS, Auteur ; Simon BARON-COHEN, Auteur Article en page(s) : p.2677-2690 Langues : Anglais (eng) Mots-clés : autism  mental health  public health  suicide Index. décimale : PER Périodiques Résumé : With autistic people at increased risk of dying by suicide, understanding barriers to help-seeking is crucial for suicide prevention efforts. Using an online survey designed in consultation with autistic people, we examined reasons why autistic adults living in the United Kingdom did not seek help from the National Health Service (NHS) when they last experienced suicidal thoughts or behaviours. Participants who disaffirmed help-seeking from the NHS (n = 754) were able to select from a prepopulated list of 20 reasons why and to enter their own. The three most commonly endorsed reasons were ‘I tried to cope and manage my feelings by myself’, ‘I did not think they could help me’ and ‘The waiting list is too long – no point’. Endorsement of reasons differed significantly with gender identity, age group and degree of lifetime suicidality. Four themes emerged from analysis of free-form responses: NHS is ineffective, NHS as antagonistic, Fear and consequences and Barriers to access. These findings highlight the need to foster more flexible healthcare systems capable of supporting autistic people, and that autistic people view as trustworthy and effective, to enable help-seeking behaviours with the potential to save lives.Lay abstract Autistic people are more likely than non-autistic people to think about, attempt and die by suicide. For people in crisis, public healthcare services are, in theory, a source of help. In reality, many non-autistic people do not seek help from healthcare services. We wanted to understand why autistic people living in the United Kingdom may not seek help from the National Health Service (NHS) when suicidal and if these reasons differed by characteristics like age and gender. This study tried to answer these questions using responses from a survey co-designed with autistic people about various aspects of suicidal experiences. Participants were able to select from a list of 20 reasons and enter their own explanations (free-form responses) why they did not seek NHS support when suicidal. Our findings show that the most common reasons were that people tried to cope and manage by themselves; they did not think the NHS could help; and they thought the waiting list was too long. Reasons for not seeking help differed by age and gender, as well as lifetime history of suicidal thoughts and behaviour. For example, cisgender women and transgender/gender-divergent participants were more likely to say that previous bad experiences with the NHS prevented them from seeking help, and people with experience of suicide attempts were more likely to have been turned away by the NHS in the past. The free-form responses showed that many participants believed the NHS was ineffective, had previously had negative experiences with the NHS, worried about the consequences of help-seeking and experienced barriers that prevented help-seeking. This work highlights the crucial change and work required to make the NHS safe and accessible for autistic people so they can reach out for help when suicidal. En ligne : https://dx.doi.org/10.1177/13623613251370789 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] â€˜I did not think they could help me’: Autistic adults’ reasons for not seeking public healthcare when they last experienced suicidality [texte imprimé] / Tanya L. PROCYSHYN, Auteur ; Rachel L. MOSELEY, Auteur ; Sarah J. MARSDEN, Auteur ; Carrie ALLISON, Auteur ; Tracey PARSONS, Auteur ; Sarah A. CASSIDY, Auteur ; Mirabel K. PELTON, Auteur ; Elizabeth WEIR, Auteur ; Tanatswa CHIKAURA, Auteur ; Holly HODGES, Auteur ; David MOSSE, Auteur ; Ian HALL, Auteur ; Lewis OWENS, Auteur ; Jon CHEYETTE, Auteur ; David CRICHTON, Auteur ; Jacqui RODGERS, Auteur ; Simon BARON-COHEN, Auteur . - p.2677-2690. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2677-2690 Mots-clés : autism  mental health  public health  suicide Index. décimale : PER Périodiques Résumé : With autistic people at increased risk of dying by suicide, understanding barriers to help-seeking is crucial for suicide prevention efforts. Using an online survey designed in consultation with autistic people, we examined reasons why autistic adults living in the United Kingdom did not seek help from the National Health Service (NHS) when they last experienced suicidal thoughts or behaviours. Participants who disaffirmed help-seeking from the NHS (n = 754) were able to select from a prepopulated list of 20 reasons why and to enter their own. The three most commonly endorsed reasons were ‘I tried to cope and manage my feelings by myself’, ‘I did not think they could help me’ and ‘The waiting list is too long – no point’. Endorsement of reasons differed significantly with gender identity, age group and degree of lifetime suicidality. Four themes emerged from analysis of free-form responses: NHS is ineffective, NHS as antagonistic, Fear and consequences and Barriers to access. These findings highlight the need to foster more flexible healthcare systems capable of supporting autistic people, and that autistic people view as trustworthy and effective, to enable help-seeking behaviours with the potential to save lives.Lay abstract Autistic people are more likely than non-autistic people to think about, attempt and die by suicide. For people in crisis, public healthcare services are, in theory, a source of help. In reality, many non-autistic people do not seek help from healthcare services. We wanted to understand why autistic people living in the United Kingdom may not seek help from the National Health Service (NHS) when suicidal and if these reasons differed by characteristics like age and gender. This study tried to answer these questions using responses from a survey co-designed with autistic people about various aspects of suicidal experiences. Participants were able to select from a list of 20 reasons and enter their own explanations (free-form responses) why they did not seek NHS support when suicidal. Our findings show that the most common reasons were that people tried to cope and manage by themselves; they did not think the NHS could help; and they thought the waiting list was too long. Reasons for not seeking help differed by age and gender, as well as lifetime history of suicidal thoughts and behaviour. For example, cisgender women and transgender/gender-divergent participants were more likely to say that previous bad experiences with the NHS prevented them from seeking help, and people with experience of suicide attempts were more likely to have been turned away by the NHS in the past. The free-form responses showed that many participants believed the NHS was ineffective, had previously had negative experiences with the NHS, worried about the consequences of help-seeking and experienced barriers that prevented help-seeking. This work highlights the crucial change and work required to make the NHS safe and accessible for autistic people so they can reach out for help when suicidal. En ligne : https://dx.doi.org/10.1177/13623613251370789 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Levels of Self-representation and Their Sociocognitive Correlates in Late-Diagnosed Autistic Adults / Rachel L. MOSELEY in Journal of Autism and Developmental Disorders, 52-7 (July 2022)  

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Lifetime stressor exposure is related to suicidality in autistic adults: A multinational study / Rachel L. MOSELEY in Autism, 29-5 (May 2025)  

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Links between self-injury and suicidality in autism / Rachel L. MOSELEY in Molecular Autism, 11 (2020)  

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Non-suicidal self-injury and its relation to suicide through acquired capability: investigating this causal mechanism in a mainly late-diagnosed autistic sample / Rachel L. MOSELEY in Molecular Autism, 13 (2022)  

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"A perfect storm": Autistic experiences of menopause and midlife / Miranda J. BRADY in Autism, 28-6 (June 2024)  

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Self-reported sex differences in high-functioning adults with autism: a meta-analysis / Rachel L. MOSELEY in Molecular Autism, 9 (2018)  

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The relevance of the interpersonal theory of suicide for predicting past-year and lifetime suicidality in autistic adults / Rachel L. MOSELEY in Molecular Autism, 13 (2022)  

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'When my autism broke': A qualitative study spotlighting autistic voices on menopause / Rachel L. MOSELEY in Autism, 24-6 (August 2020)  

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