1. Wee C, Jaydeokar S, Ugwuonah C, Armstrong L, Odiyoor M. Early intervention for children and young people with neurodevelopmental conditions and intellectual disability: “The Getting Help” offer for Northwest England. Advances in Autism. 2024; 10(4): 221-35.

Purpose The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability. Design/methodology/approach A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience. Findings Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes. Originality/value This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.

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2. Cardelle-Pérez F, Díaz-Caneja MÁ, Martín-Pérez ÁdL, Andrés-Espallardo S, Ortega-García MD, Horcajo-Marrupe B. Evaluation of a program of social intervention for adolescents with autism spectrum disorders (PROSEAR). Advances in Autism. 2024; 10(4): 236-43.

Purpose The prevalence of autism spectrum disorders (ASD) surpasses 2% in some regions. However, there is a lack of manualized programs targeting the social skills of adolescents with these disorders, particularly in the Spanish language context. This study aims to introduce PROSEAR, an innovative social skills program for adolescents with ASD implemented in a Day Hospital setting. Design/methodology/approach The evaluation used the Strengths and Difficulties Questionnaire (SDQ) and the Social Skills Scale (EHS) as measures, administering pre- and postintervention tests for each patient. Findings SDQ exhibited the most significant improvement in the domain of peer problems. In terms of EHS, it demonstrated beneficial effects across all evaluated domains, with statistically significant improvements observed specifically in the expression of anger or disagreement. Limitations include a small sample size and lack of a randomized control group. Originality/value The outcomes align with existing literature supporting the intervention as positive in clinical practice. Overall, the PROSEAR intervention shows promise for enhancing social skills in adolescents with ASD. Further research is needed to improve therapeutic approaches for this population.

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3. Cai RY, Love A, Haas K, Gallagher E, Gibbs V. Understanding banking experiences of autistic adults: an inquiry into inclusive banking. Advances in Autism. 2024; 10(4): 244-58.

Purpose Navigating the banking world may be overwhelming and intimidating for autistic people due to the generally poor accessibility of banks. Banks around the world are starting to improve the accessibility of their services and products to meet the needs of autistic customers better. However, no empirical research has explored autistic adults’ banking experiences and needs. This study aims to determine what banks can do to make banking more inclusive and accessible for autistic people through understanding the banking experiences of autistic adults living in Australia and identifying the factors that shape these experiences. Design/methodology/approach In total, 57 autistic adults aged 18–67 years (Mage = 33.00, SDage = 11.03) and 29 caregivers of autistic adults aged 32–70 years (Mage = 52.24, SDage = 7.88) completed an online survey about the banking experiences of the autistic adults. In addition, 14 of the 57 autistic adults were interviewed. Findings Almost all autistic participants had a bank account, and online banking was the preferred way of banking for most autistic adults. The factor most often raised by participants that influenced the banking experiences of autistic adults was supportive and helpful bank staff. Other identified factors included autistic adults’ lack of financial and banking knowledge and banks’ poor understanding of autism. The majority of autistic adults felt that banks could become more autism-friendly and provided suggestions. Practical implications Given that most autistic adults are likely to access financial products and services, banks must become more autism-friendly to cater to the diverse needs of autistic customers. Recommendations for how financial institutions can become more inclusive were provided. Originality/value To the best of the authors’ knowledge, this is the first detailed examination of the banking experiences of autistic adults. Practical implications of the research were also provided.

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4. Bassette LA, Kujawski M, Donges E. Teaching social support to promote inclusive physical activity for people with autism. Advances in Autism. 2024; 10(4): 259-72.

Purpose Previous research found that when exercise partners provided social support to each other, both participants engaged in higher levels of activity (Gellert et al., 2011). These results suggest that there may be benefits to providing inclusive physical activity (PA) programming to individuals with autism; however, little research has explored specific strategies. The purpose of this study is to explore the use of a behavioral intervention consisting of visual social stories and additional intervention components (i.e. prompting, checklists) to teach adolescents/young adults with autism and their workout partners without disabilities to provide social support to one another during partnered PA. Design/methodology/approach A multiple probe across dyads was used to explore the effects of the intervention on social support (i.e. verbal encouragement and feedback). Findings The results indicate the treatment was effective during the intervention phase. When partners and settings changed during generalization, results were maintained in all but one participant. Originality/value Areas for future research and implications for practice to support inclusive PA for autistics are discussed.

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5. Giagazoglou P, Kannas T, Dampa A, Iliopoulou S, Alivizatou I, Chalatzoglidis G. The effect of a trampoline exercise program on motor and behavioral characteristics of adolescents with autism spectrum disorder. Advances in Autism. 2024; 10(4): 273-82.

Purpose The aim of this study is to evaluate the impact of a trampoline intervention program on motor and behavioral characteristics of adolescents with autism spectrum disorder (ASD). Design/methodology/approach Twenty-six male students aged 15–18 years with ASD participated in the study. They were equally divided into two groups of 13 students. The intervention group followed an individualized trampoline exercise program that was applied three times a week for 30 min for 12 weeks. Before the intervention program and after the end of this, the motor performance was evaluated through the recording of the total number of jumps. The behavioral characteristics were evaluated with the Behavior Problem Inventory questionnaire. Findings According to the findings, there were statistically significant differences between the intervention group and the control group across all variables. In conclusion, it seems that an intervention program with the use of a trampoline, adapted to the needs and capabilities of adolescents with ASD can improve their motor performance and behavioral characteristics. Originality/value The authors report on the impact of a trampoline exercise program on motor skills and behavioral traits in adolescents diagnosed with ASD. This is significant because our research focused on investigating the effects of a structured trampoline exercise program both on motor skills and behavioral characteristics. The findings contribute to the growing body of evidence supporting targeted exercise programs as effective interventions for addressing motor and behavioral challenges in adolescents with ASD. The authors believe the research aligns closely with the aims and scope of research in developmental disabilities, and the authors hope that it will make a meaningful impact on the field of autism research and intervention.

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6. Hernández O, Durán LR, Fresno A, Chamorro MF. Camouflage in autism: a bibliometric perspective. Advances in Autism. 2024; 10(4): 283-98.

Purpose In response to the challenges posed by the social environment, numerous individuals with autism use coping strategies, engaging in a phenomenon known as “camouflaging” to mask their distinctive traits. Despite the growing attention directed toward this area of study, to date, there are no bibliometric studies delineating the evolution of this research theme. This study aims to analyze scientific research on camouflage and the autistic spectrum published in Web of Science (WoS). Design/methodology/approach Articles on camouflage and autism were retrieved from the WoS. The advanced search interface used was “Title, Abstract, Keywords (autistic OR asperger syndrome OR Autism OR ASD AND camouflage OR camouflaging AND Masking).” The analysis and visualization of the selected records and their data were carried out using MS Excel (v16.0) and Biblioshiny (v2.0, R package). Findings Following the selection process, a total of 70 articles were included. Notably, the UK emerged as the leading contributor in terms of the number of published articles. Prominent authors in this domain included William Mandy, Laura Hull and Meng-Chuan Lai, who exhibited the highest number of published articles and citations. The Journal of Autism and Developmental Disorders stood out as the most prolific journal. Predominant research themes encompassed camouflage (and its synonyms, masking or compensation), gender differences and mental health. Originality/value This study contributes to existing knowledge on this topic, as well as identifying new areas of research related to autism and camouflage. Moreover, it serves as a valuable resource for health-care professionals, including physicians and clinical psychologists, who may seek to augment their understanding and proficiency in the field.

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7. Suzuki K, Oi Y, Mitsuhashi S, Hirata S, Goto T. Relationship between teacher ideals and attitudes toward peers with autism spectrum disorder among teacher college students. Advances in Autism. 2024; 10(4): 299-313.

Purpose This study aims to examine the relationship between teacher ideals and attitudes toward peers with autism spectrum disorder (ASD) among teacher college students, and the effect of knowledge of ASD identification on this relationship. Design/methodology/approach This study used a quantitative approach and included 341 teacher college students. A vignette was used to assess social and professional attitudes toward peers with ASD. The participants were divided into identification and nonidentification groups based on how accurately they identified the peer depicted in the vignette as having ASD. A teacher ideals questionnaire consisting of two subscales indicating different ideal teachers − a dedicated/engaging teacher (e.g. a teacher who can work with enthusiasm) and a skillful teacher (e.g. a teacher who is knowledgeable) − was developed and administered to evaluate the participants’ teacher ideals and self-perceptions of a teacher. Findings In the nonidentification group, ideals of a skillful teacher were significantly correlated with social attitudes toward peers with ASD. The identification group exhibited no significant correlations between ideals and social attitudes. Furthermore, the self-perceptions of being a dedicated/engaging teacher was significantly correlated with professional attitudes toward peers with ASD in the identification group. Originality/value To the best of the authors’ knowledge, this study is the first to examine the relationship between teacher ideals and attitudes toward peers with ASD. Teacher ideals were related to negative social attitudes toward peers with ASD. While knowledge of ASD identification weakens this relationship, it may drive the relationship between self-perceptions of a teacher and professional attitudes toward peers with ASD. Therefore, ASD education is important for reducing the stigma toward ASD in teacher education.

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8. Cruz Puerto M, Sandín Vázquez M. Understanding heterogeneity within autism spectrum disorder: a scoping review. Advances in Autism. 2024; 10(4): 314-22.

Purpose In this study, the research question posed was: What are the defining characteristics, limitations, and potential opportunities in the research on heterogeneity within ASD? Design/methodology/approach This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology to address the research question: “What are the defining characteristics, limitations, and potential opportunities in the research on heterogeneity within ASD?” A comprehensive literature search was conducted across databases including MEDLINE/PubMed, SciVerse Scopus and Springer Link, with keywords such as autism, autism spectrum disorder (ASD), heterogeneity and neurodevelopment. Inclusion criteria covered original research, reviews and protocols published since 1990, while irrelevant or out-of-date works were excluded. Thematic analysis was applied to collected data to identify common patterns, trends and key characteristics, leading to a narrative synthesis. Ethical review board approval was not required due to the nature of the review. Findings The scoping review underscored the multifaceted nature of ASD, emphasizing its clinical, methodological and investigational complexities. ASD’s diverse behavioral, social and biological characteristics challenged its classification as a uniform entity. To address this, the review examined strategies like stricter clinical criteria, categorization into functional subgroups, and larger, diverse sample sizes. Moreover, it highlighted the transformative role of Big Data and machine learning in advancing the comprehension of ASD’s manifold manifestations. This research contributed valuable insights and innovative approaches for addressing the intrinsic heterogeneity of ASD, reshaping the understanding of this complex condition. Research limitations/implications One limitation of this scoping review is that it primarily relied on existing literature and did not involve primary data collection. While the review synthesized and analyzed a substantial body of research, the absence of original data collection may limit the depth of insights into specific aspects of ASD heterogeneity. Future research could benefit from incorporating primary data collection methods, such as surveys or interviews with individuals with ASD and their families, to gain more nuanced perspectives on the condition’s heterogeneity. Practical implications The reliance on existing literature in this scoping review highlights the need for further empirical studies exploring ASD’s heterogeneity. Researchers should consider conducting primary data collection to capture real-world experiences and variations within the ASD population. This approach could provide more comprehensive and context-specific insights, ultimately informing the development of tailored interventions and support strategies for individuals with ASD and their families. Originality/value This paper offers a fresh perspective on understanding ASD by examining its clinical, methodological and investigational implications in light of its inherent heterogeneity. Rather than viewing ASD as a uniform condition, this study explores strategies such as stricter clinical criteria, subcategorization based on functionality and diverse sample sizes to address its complexity. In addition, this study highlights the innovative use of Big Data and machine learning to gain deeper insights into ASD’s diverse manifestations. This approach contributes new insights and promising directions for future research, challenging the conventional understanding of ASD as a singular entity.

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9. Dachez J, Seksek S, Ete N, Bianciotto M, Toubhans M-P, Rachedi Nasri Z, Bureau R, Garnier P. Experiences of autistic people in supported employment in France: a participatory research project. Advances in Autism. 2024; 10(4): 323-39.

Purpose The employment rate of autistic people is low, and they are often employed in low-paying jobs or in jobs involving tasks that fall short of their skills and competence. To address this situation, the individual placement and support method (IPS) offers promising perspectives for personalized and long-term support measures. This evidence-based method has produced positive results in several countries. IPS has been used in France only since 2016. This paper aims to examine the experience of autistic people in France who have benefitted from supported employment measures. Design/methodology/approach Nineteen autistic adults in France took part in semistructured interviews. Interview questions focused on work and measures to support employment. The authors analysed the interviews using reflexive thematic analysis, within the paradigm of critical realism. The authors adopted a participatory approach; the project was led by an autistic researcher and autistic individuals were included at all stages. Findings This study identified six primary themes and three subthemes across the data: (1) The uphill battle to obtain adjustments in the workplace; (2) insufficient knowledge of autism; (2.1) explaining again and again: the educative burden; (3) the challenge of making oneself heard; (3.1) when the entourage steps in; (4) support measures as material assistance and reassurance; (4.1) between benevolence and condescension; (5) organizational factors that affect the quality of support; and (6) personal and professional life are closely intertwined. Originality/value This research provides a better understanding of how autistic people experience supported employment in France and highlights ways to improve it. Job coaches play a crucial role in offering practical help and reassurance, and their efforts to nurture an active personal life are perceived positively. However, supported employment also carries the risk of limiting autistic individuals’ capacity for action and causing several difficulties if job coaches are not well-informed about autism, do not reflect on their own attitudes, do not assist in obtaining necessary accommodations and if there are organizational problems leading to a lack of resources.

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10. Yanga R, Underwood L, Schoeps A, Waldie KE, Morton SMB, Peterson ER. Retrospective analysis of the challenges and highlights of parenting two-year-old children who were subsequently recognised as autistic. Advances in Autism. 2024; 10(4): 340-55.

Purpose This study retrospectively investigates the parenting experiences of mothers of two-year-old children who expressed concerns that their child may have autism up to when they were 4.5 years old. This study aims to identify early parenting challenges and joys and explore whether certain challenges are associated with a subsequent autism diagnosis. Design/methodology/approach Using a longitudinal design, this study draws from a cohort of 6,853 children, focusing on 103 mothers who reported concerns that their child may have autism when they were between 2 and 4.5 years old, compared to a demographically matched control group. It also tracks whether children initially flagged for autism concerns at 2 to 4.5 years had received a formal diagnosis by age eight. Findings Mothers of autistic children were more likely to mention early challenges with their child’s psychosocial development and family cohesion. However, the nature of the challenges discussed within these categories were similar across the two groups, suggesting that these two challenges, while important, are not definitive indicators of autism on their own. Many mothers highlighted their love and joy in watching their child develop. By age eight, 56% of the children who were flagged with autism concerns at aged 4.5 had an autism diagnosis, underscoring the importance of early concerns. Originality/value This novel research leverages a large, diverse longitudinal cohort to retrospectively explore mothers’ views on raising two-year-old children who were subsequently recognised as being autistic. It uniquely balances the exploration of parenting challenges with the highlights, offering a more holistic view of parenting a child who may later be diagnosed with autism, and considers the link between early parental concerns and challenges and subsequent autism diagnosis.

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11. Odiyoor M, Potts L, Shatananda S, Oyedokun A, Jaydeokar S, Shahzad S. Autism diagnostic aid (ADA) tool for use in adults with intellectual disability: development, face and content validation. Advances in Autism. 2024; 10(4): 356-66.

Purpose Individuals with intellectual disability have an increased predisposition to other co-morbid physical health conditions, mental illness and neurodevelopmental conditions including autism spectrum condition. There are challenges in diagnosing autism in adults with intellectual disability, and these are often attributes to the complexities in symptoms. The purpose of this paper is to describe the development of the autism diagnostic aid (ADA) tool and face and content validation of its properties. Design/methodology/approach The ADA tool was developed following a detailed scoping exercise which included literature reviews, observations and discussion with wider multi-disciplinary team members. A face and content validation after consultation with eight experts who are trained and routinely perform assessments for autism spectrum disorders. The experts also have expertise in working with individuals with intellectual disability. Findings The experts agreed that the ADA tool is appropriate to the targeted construct and assessment objectives as a diagnostic aid in the assessment of autism in adults with intellectual disability. They also determined that the content of ADA tool was valid for its use as a diagnostic aid in the diagnosis of adults with intellectual disability. Research limitations/implications The ADA tool was considered a valid tool from the expert’s perspective. It was identified to have a good face and content validity. To the best of the authors’ knowledge, the ADA is first of its kind tool, developed specifically to aid clinicians with autism assessments in adults with intellectual disability. Practical implications This tool could potentially help with timely assessment and help with providing appropriate intervention but would require further exploration. Originality/value To the best of the authors’ knowledge, this is the first of its kind tool for the assessment of autism in adults with intellectual disability.

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12. Collins J, Metcalfe D. Mental health, wellbeing and coping strategies of autistic adults during isolation. Advances in Autism. 2024; 10(4): 367-81.

Purpose The negative effects of loneliness and isolation on mental health and wellbeing on the neurotypical population are well documented. The purpose of this qualitative study was to explore the effects of isolation on the mental health and wellbeing of autistic adults who were separated from friends and family for an extended period. Design/methodology/approach Semi-structured interviews were conducted shortly after the lifting of the third UK lockdown of the Covid-19 pandemic with a sample of 7 people (mean age, 35) formally diagnosed with autism spectrum disorder. Findings The study explored effects stemming from the absence of social interaction. Thematic analysis led to the creation of three themes: The first, “Context affects perception of isolation: I’m going to continue on with my life as much as I possibly can” shows a negative impact on wellbeing, perceived through the filter of larger issues resulting from lockdown and the necessity of isolation. The second, “Being alone can be comfortable: Lockdown has been good for me” discusses the mental health benefits of isolation and participants feeling of being “primed” for that isolation. The third, “Challenges from isolation: ‘Changing routine’” explores the changes people made while isolated, with a focus on coping strategies and communication. Originality/value Findings reveal the importance of supporting autistic adults to maintain social contact during and after isolation and contradict research suggesting autistic people are not motivated to seek social interaction.

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13. Mankinen S, Ferreira JM, Mykkänen A. Peer support amongst autistic children: an examination of the communication structure in small-group discussions. Advances in Autism. 2024; 10(4): 382-400.

Purpose Over the past decade, many studies have investigated peer support between neurotypical and neurodivergent children. Less is known about how autistic children support each other in educational contexts, especially in basic education, where child-adult interactions are still predominant. This study aims to investigate whether and how autistic children supported each other in small-group discussions in the first years of basic education. This paper focused on unraveling the communication structures of these supportive events, aiming to understand further how autistic children make sense of social interactions and intersubjective processes that require peer support. Design/methodology/approach Building on conversation analysis methods, this paper analyzed the transcripts of the small-group discussions, identifying and analyzing the construction of support in children’s dialogues. Nine Finnish children (7–10 years old) attending mainstream school in Finland under intensified support in part-time special classrooms participated in this study. The study adopted a specific method called Idea Diary to frame the small-group discussions. The teacher guided the conversations, providing a dynamic structure for children’s interactions, but students were encouraged to interact among themselves. This paper recorded 11 sessions within the six-month implementation of the Idea Diary, totaling 240 min of data. Findings Results show that the children recognized situations where other children needed support in interactions and intervened in ways that promoted the continuation of the conversation and the clarification of ideas. Autistic children were sensitive to peers’ unspoken needs, capable of identifying subtle nuances of conversation dynamics and able to express support through comments and questions during the small-group discussions. Originality/value This study provides insights into the understudied phenomenon of peer support among autistic children in small-group discussions. It contributes to the growing corpus of research dedicated to exploring and revealing social competencies among autistic people. It discusses implications for developing educational practices that foster social interactions respecting the quality of autistic interactions and the interests of autistic students.

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