Advances in Autism – 7-3 – Gender and Diversity
1. Chester V. Guest editorial. Advances in Autism;2021;7(3):193.
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2. Driver B, Chester V. The presentation, recognition and diagnosis of autism in women and girls. Advances in Autism;2021;7(3):194-207.
Purpose Autistic women and girls have received comparatively less attention within clinical practice and research. Research suggests women tend to be diagnosed later than men, and are more likely to experience misdiagnosis. Design/methodology/approach This paper aims to report a narrative literature review that examines research on the presentation, recognition, and diagnosis of autistic women and girls. Findings Findings suggest that autistic females present differently to males and highlight low recognition of the female presentation of autism among the general public, in social spheres, educational, clinical and forensic settings. This lack of recognition appears to affect the likelihood of females being referred for diagnosis, the reliability of diagnostic assessments and subsequent access to support. Originality/value Recommendations for clinical practice focus on initiatives to increase awareness of the female presentation of autism, improving the diagnostic process for females, increasing female representation within autism training and for future research to support these goals.
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3. Sedgewick F, Leppanen J, Tchanturia K. Gender differences in mental health prevalence in autism. Advances in Autism;2021;7(3):208-224.
Purpose Mental health conditions are known to be more common amongst autistic than non-autistic people. To date, there is little work exploring gender differences in mental health amongst autistic people and no work including non-binary/trans people. This paper aims to address this gap. Design/methodology/approach This was a large-scale online study, with 948 participants between 18 and 81 years old. Participants self-reported autism, anxiety, depression and eating disorder status. Analyses were run examining gender differences in the rates of these conditions in each group. Findings Autistic people are more likely to have anxiety and depression than non-autistic people of all genders. Autistic women and non-binary people experienced mental health issues at higher rates than men and at similar rates to each other. Autistic people were twice as likely as non-autistic people to have all eating disorders. Further, gendered patterns of eating disorders seen in the non-autistic population are also present in the autistic population. Research limitations/implications There are inherent issues with self-report of diagnoses online, but this study showed that using screening questionnaires is effective. Originality/value This is the first paper to look at gender differences in common mental health issues amongst autistic and non-autistic adults. It highlights that there are significant gendered patterns in the prevalence of mental health issues in both the autistic and non-autistic population and that these have an impact for how treatment should be approached to be effective.
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4. Gemegah E, Hartas D, Totsika V. Public attitudes to people with ASD: contact, knowledge and ethnicity. Advances in Autism;2021;7(3):225-240.
Purpose The increase in autism prevalence and presentation in the media suggests a rise in public awareness. This paper aims to explore what factors (contact, knowledge and ethnicity) may be associated to positive attitudes towards individuals with autism spectrum disorder (ASD). Design/methodology/approach An online survey examined contact with and knowledge of ASD among Black, Asian and White ethnic groups to predict public attitudes to people with ASD. Findings In multiple regression models, the results suggested that the level of contact predicts positive attitudes towards autism when demographic factors were accounted. The level of knowledge about autism were significantly associated to attitudes, but not consistently when demographic factors were accounted. However, differences in knowledge and attitudes to people with ASD were identified amongst Black, Asian and White ethnic groups. Research limitations/implications These findings have implications for policy and public health and education campaigns, including ensuring contact and knowledge of autism among the public. Originality/value These findings have implications for policy and public health and education campaigns, including ensuring contact and knowledge of autism among the public. Additionally, further effort is required to target public knowledge and attitudes to autism, particularly among ethnic groups. Institutional support tailored to encourage structured and unstructured contact across public domains such as education, health, social and care practices could effectively reduce prejudice between the public and people with ASD over time.
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5. Tromans S, Chester V, Gemegah E, Roberts K, Morgan Z, Yao GL, Brugha T. Autism identification across ethnic groups: a narrative review. Advances in Autism;2021;7(3):241-255.
Purpose The purpose of the paper is to review autism identification across different ethnic groups. Diagnosis of autism may be missed or delayed in certain ethnic groups, leading to such groups being underserved relative to their needs. This can result in members of such groups being effectively denied essential avenues of support that can substantially improve the quality of life of autistic persons as well as those whom care for them. Design/methodology/approach A literature search for articles reporting autism identification across ethnic groups was undertaken. Data are compared, with a special focus on possible explanations for any inter-group variation. Findings Autism identification appears to be generally lower in minority ethnic groups relative to the majority population. Individuals presenting with autism from minority groups appear to have more severe forms of the condition. Originality/value There are a multitude of potential explanations for inter-ethnicity variation in autism identification, including health care-related factors, broader environmental influences, cultural factors and possible biological differences. Implications for clinical practice and public health include a need to look at means of ensuring equitable access to relevant autism diagnostic and support services across ethnic groups. Further work is required to better understand the belief systems that operate within specific ethnic groups, how this may potentially impact upon autism identification and measures to address the concerns of such groups.
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6. Henley R. Being diagnosed with autism in adulthood: a personal case study. Advances in Autism;2021;7(3):256-261.
Purpose This paper aims to report the personal experiences of an adult male diagnosed with autism at the age of 48 years. Design/methodology/approach A personal case study methodology was used to illustrate the journey to autism diagnosis, the experience of diagnosis and post-diagnosis support. Findings This case study illustrates how stress and mental health difficulties can precede autism diagnosis in adults. The personal experiences detailed highlight how an adult autism diagnosis can bring about positive change, prompting increased self-knowledge and coping skills, improved relationships and. Furthermore, it highlights how a supportive employer can make reasonable adjustments in the workplace to improve productivity of an autistic employee. Research limitations/implications This case study has implications for various practice issues, including post-diagnosis counselling and access to support for autistic adults nationally. Originality/value This paper provides an original case study highlighting the personal experiences of an adult diagnosed with autism.
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7. Tromans S, Chester V. Commentary on “being diagnosed with autism in adulthood: a personal case study”. Advances in Autism;2021;7(3):262-265.
Purpose The purpose of this paper is to provide a commentary on “being diagnosed with autism in adulthood: a personal case study”. Design/methodology/approach A commentary on an individual’s personal experiences of being referred to autism assessment services and subsequently receiving a diagnosis of autism in adulthood. Findings Many individuals are not diagnosed with autism until their adult life, and as a result, miss the benefits of timely introduction of sources of support, such as during their schooling. Receiving an autism diagnosis can come as a relief and promote self-understanding, but availability of high-quality post-diagnostic support services and accommodating employers are both highly important. Originality/value A commentary on an original viewpoint is published in this special edition on gender and diversity.
