1. Feidner MJ. Burning Bridges and Building New Ones: A Story of Autistic Burnout in the Workplace. Autism in Adulthood;2024;6(2):117-118.

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2. Roux AM, Voltaire S, Steinberg H, Williams E-D, Anderson KA, Hutson TM, Shea LL. More Than Just a Variable: The Need to Explicitly Focus on Black Youth Within Autism Transitions Research. Autism in Adulthood;2024;6(2):119-127.

Little evidence is available to provide context for understanding the experiences of parents and youth from historically marginalized groups as they age into adulthood, especially in regard to the transition experiences of Black autistic transition-age youth and their family members. This commentary builds upon recent publications that inform intersectional understandings of Black autistic experiences in America, and outlines research recommendations to better address the specific needs of Black autistic transition-age youth. Given the noted deficits in transition research and the transition process in regard to the experiences of Black autistic youth, we provide recommendations for improving autism transition research. We propose changes that are necessary to achieve equitable research processes, which could inform the design of targeted interventions to improve transition experiences for Black autistic youth.

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3. Bottini SB, Morton HE, Buchanan KA, Gould K. Moving from Disorder to Difference: A Systematic Review of Recent Language Use in Autism Research. Autism in Adulthood;2024;6(2):128-140.

Background: The neurodiversity paradigm positions autism as a neurological difference that is disabling in the societal context, shifting away from the traditional medical view of a disorder. Several recent publications recommend use of alternative neuro-affirming language (ANL) instead of traditional medical language (TML) with the aim to increase acceptance of autistic people and reduce prejudice. Examining language use within recent autism literature, including by journal and study characteristics, may offer insight into the influence of these recommendations and current disability discourse. Methods: A systematic review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines in autism research from 2021 (n = 2322 articles; 394 journals). Articles were coded according to topic, participants, and use of self-report. Journals were coded by topic, geographic region, and language guidelines. Terminology use was extracted using QDA Miner software. Results: Many articles primarily used TML with a smaller subset primarily using ANL. There was a positive correlation between ANL use and publication date. More ANL was associated with articles on topics of autistic traits, diversity, equity, and inclusion (DEI), or lifespan and that included autistic adults or autistic self-report. More ANL was also found in journals from Australasia or Europe or those that had identify-first language (IFL) guidelines. Less ANL (more TML) was associated with articles on biology/causes or treatment and that included autistic or non-autistic parents, autistic youth, siblings, or other clinical groups, and were published in medical journals. Conclusion: TML continues to largely dominate language choices in autism research, with an emerging shift toward ANL in recent literature. Increased ANL may be facilitated by journal and article language recommendations. Neuro-affirming language was also more likely in articles on topics prioritized by the autistic community, that included autistic adults, and may also be driven by cultural differences. Researchers and practitioners should consider the potential for their language use to impact individual and societal views of autistic people.

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4. Emerson LM, Monk R, van der Meer L, Sutherland D, McLay L. Autistic Co-Led Community Priorities for Future Autism Research in Aotearoa New Zealand. Autism in Adulthood;2024;6(2):141-151.

Background: Previous studies of community priorities for autism research have been limited by low representation of autistic people and thus a bias toward the views of families and professionals. We aimed to determine the first community-led priorities for autism research in Aotearoa New Zealand (NZ). Methods: Autistic people were essential partners in the project, from inception and design through to methods and outputs. We gathered the views of the autistic and autism communities (including family, practitioners, and researchers) through focus groups (n = 55) and an online survey (n = 450). Almost 40% of the survey respondents indicated that they were autistic. Results: The findings across the focus groups and survey highlighted the importance of research that centralizes the experiences and needs of autistic people, particularly of autistic New Zealanders, including culturally specific research for Māori and Pacific peoples. All five priority topics for autistic adults were also priorities for at least one other group: (1) Health, mental health, and well-being of autistic people (all groups); (2) Services across the life span (autistic adults, health care/disability, and education practitioners); (3) Needs of autistic people in Aotearoa NZ (autistic adults, whānau); (4) Perspectives from autistic people with a diverse range of support needs (autistic adults; education practitioners); (5) Quality of life of autistic people in Aotearoa NZ (autistic adults; health care/disability practitioners). Conclusions: We discuss the advantages of autistic involvement in research, and how these community priorities can inform future research and policy in NZ.

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5. Steinberg H, Garfield T, Roux A, Shea L, Shattuck P. Same Transition, Different Perspectives: Comparing Dyadic Interviews with Autistic Young Adults and Parents. Autism in Adulthood;2024;6(2):152-161.

Introduction: The transition to young adulthood can be a turbulent life stage, and this is often magnified for autistic youth. Young adults frequently profess different goals and values than their parents. While there is some indication in autism research about how parents, and to a lesser extent, autistic young adults, feel about this transition, little research leverages dyadic interviews with both populations or has used this method with Black and/or low-income families. Method: We conducted four sets of dyadic interviews with autistic young adults and their parents who live together. Results: We identified three key themes that both groups found important to the transition: independence, structured transition, and interpersonal relationships. However, we found that how the groups conceptualized these themes were divergent and revealed differences in goals and values. Parents were more oriented toward long-term normative views of fulfillment, whereas young adults spoke about what was meaningful to them currently. Conclusion: This work has implications for changes to how autism research will conceptualize the transition to young adulthood and how we can create better social opportunities for this population. Community brief Why is this an important issue? Autistic adults are at risk for difficulties getting work and education, which can lead to them feeling alienated or unfulfilled. Most research on autistic people becoming adults is based on White people with more cultural and financial resources and does not ask autistic people themselves or their families with them. Research is needed to improve transition outcomes for these underresearched and underserved groups. What was the purpose of this study? This study explored how autistic youth and their parents thought about and experienced the transition to adulthood out of an urban, low-resourced school district. What did the researchers do? Researchers interviewed four parents and four autistic youth. Three families were Black, and one family was White and from a low-income household. All autistic youth had received special education services, needed support to transition to adulthood, and had finished high school 1 to 6 years before the study. The young adults lived with their mothers and received support from them for daily tasks. We interviewed the parents and then the youth. In some cases, youths joined parents’ interviews or parents joined youths’ interviews to provide help with remembering information or giving answers. What were the results of the study? Researchers identified three themes. First, parents and youth thought about independence differently. Parents focused more on work and financial independence. Youth focused more on social aspects of work and having independence in daily activities such as shopping. The second theme was that youth and parents approached ongoing structured supports differently. Youth reported positive experiences with a range of services but did not discuss the need for ongoing supports like their parents did. Third, youth emphasized the importance of social relationships and opportunities to connect with peers through shared interests. What do these findings add to what was already known? We learned that standard questions about transition may not reflect how autistic youth and their parents think about becoming an adult. Interviewing families coming out of a predominantly Black and low-income urban school district helped us to understand how these groups experience and think about the transition to adulthood, even though they did not use these identities as a logic for how they thought about young adulthood. This suggests that parent and youth perspectives differ in groups that are not usually well represented in research studies related to transition for autistic youth. What are potential weaknesses in the study? This study only included a small number of youth and parents. These results do not represent all Black autistic youth or low-income autistic youth coming from urban school districts. Families who are less connected o services may have been less likely to hear about or take part in the study. How will these findings help autistic adults now or in the future? These findings could inform the development of better interviewing approaches and research to address the needs of diverse autistic youth entering adulthood. This work could improve transition support. Parents, youth, support providers, and researchers may think about adulthood differently. Improved support could help build mutual understanding and coordination around youths’ and their families’ goals.

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6. Clegg A, Wood J, Hobson H, Sedgewick F. The Experiences of Autistic People When Facemask Wearing and Interacting with Masked Individuals. Autism in Adulthood;2024;6(2):162-176.

Background: The World Health Organization recommended that individuals use a facemask to prevent the ongoing spread of COVID-19. Many governments implemented this recommendation into law. However, the increased usage of facemasks may have had particular impacts on the autistic population, due to differences in emotion processing, sensory issues, and anxiety about regularly changing rules. This research aimed to investigate the lived experiences of autistic people when wearing facemasks and their experiences interacting with others wearing facemasks. Methods: First, the research team conducted a content analysis of social media posts (n = 124) created by autistic individuals. Based on this, we developed a novel questionnaire and distributed it so that autistic adults could share their facemask experiences (n = 49). Results: Seven main themes were identified from the social media analyses: general attitudes toward masks, sensory issues, “wear-a-mask” message, rules and expectations, sunflower lanyards, social problems and benefits, and mask exemption. Secondary questionnaire responses highlighted that the experience of facemasks was mixed. Many individuals experienced sensory issues. Yet, for some individuals, there were benefits: they did not have to monitor their facial expressions to camouflage their autistic responses. Participants reported differing opinions on the topic of mask exemption, and the sunflower lanyard as a symbol of mask exemption. Data did not suggest anxiety around rule changes but did suggest feelings of anger at others who were perceived not to be following the rules. Conclusions: These findings highlight the mixed experiences of autistic people with facemasks and suggest lessons for future events in which there are rapid changes to public health messaging.

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7. Andrews HE, Hedley D, Bury SM. The Relationship Between Autistic Traits and Quality of Life: Investigation of Indirect Effects Through Self-Determination. Autism in Adulthood;2024;6(2):177-191.

Background: Self-determination, described broadly as experiencing causal agency, is positively associated with quality of life (QoL) and increases through satisfaction of three basic psychological needs: autonomy (feeling able to make choices free from pressure), competence (perceived self-efficacy), and relatedness (social connection). Both unsupportive environments and challenges with social interaction can interfere with satisfaction of psychological needs. Social challenges are a key trait for autism diagnosis, and unsupportive environments are also known to adversely affect QoL for autistic people. Autistic people report, on average, lower self-determination than non-autistic people. Therefore, it is hypothesized that higher levels of autistic traits may reduce opportunities to develop self-determination, affecting QoL. Methods: We tested a parallel indirect effects model where we hypothesized that the relationships between autistic traits and four domains of QoL (psychological, social, physical, and environmental) would be indirectly influenced through self-determination (represented through satisfaction of the basic psychological needs for autonomy, competence, and relatedness). This study drew participants from the general population (N = 262; MAGE = 37.6, standard deviation = 11.92; 1.9% reported an autism diagnosis and 2.7% identified as autistic without a diagnosis). Participants completed an online survey. Results: Higher levels of autistic traits were associated with lower levels of self-determination and lower levels of QoL, and there was a significant indirect effect between autistic traits and QoL via self-determination. More specifically, we found a significant indirect effect between autistic traits and all QoL domains via competence; between autistic traits and the environmental, social, and psychological QoL domains via relatedness; and between autistic traits and the physical and environmental QoL domains through autonomy. Conclusions: Our results suggest that supporting satisfaction of the needs for autonomy, competence, and relatedness may represent an important element in designing effective programs to support the development of self-determination in people with higher levels of autistic traits (potentially including autistic individuals) and also to support these people to improve their QoL.

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8. Friedman S, Noble R, Archer S, Gibson J, Hughes C. “It Helps Make the Fuzzy Go Away”: Autistic Adults’ Perspectives on Nature’s Relationship with Well-being Through the Life Course. Autism in Adulthood;2024;6(2):192-204.

Background: While previous work highlights the links between nature and various positive well-being-related outcomes, the experiences of autistic people in nature have received limited empirical research. Our study aimed at gathering autistic adults’ perspectives on the relationship between nature and well-being in both childhood and adulthood. Methods: We used an online survey to capture the views of 127 autistic adults across the United Kingdom. Using reflexive thematic analysis, we analyzed responses to three questions focused on nature experiences in childhood and adulthood and how the participants felt that nature was (or was not) related to well-being. Guided by self-determination theory, we used both inductive and deductive analysis. Results: We developed three main themes to reflect the nature experiences of autistic adults: choosing to escape into nature, supporting relatedness through connecting in (and to) nature, and nature doesn’t judge, but other people do. Compared with many other contexts, nature provides a non-judgmental space through which (in both childhood and adulthood) many, but not all, autistic individuals can meet individual needs and experience autonomy, relatedness, and competence. Conclusion: This analysis of how autistic adults in the United Kingdom utilize nature to support well-being has implications for how nature can be used in social prescribing as well as in ensuring that existing outdoor spaces, organizations, and activities are supportive of autistic people.

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9. Szechy KA, Turk PD, O’Donnell LA. Autism and Employment Challenges: The Double Empathy Problem and Perceptions of an Autistic Employee in the Workplace. Autism in Adulthood;2024;6(2):205-217.

Background: High unemployment rates are found among autistic adults. Difficulties with social functioning in non-autistic workplaces can be significant barriers to employment success. Autistic social functioning challenges in non-autistic spaces have traditionally been attributed to assumed impairments in Theory of Mind (ToM). Alternatively, the Double Empathy Problem (DEP) posits that autistic social challenges arise not from assumed impairments within the autistic person but instead from mutual misunderstandings in the autistic/non-autistic social interaction. The purpose of this study was to compare the ToM impairments explanation of autistic social functioning with the DEP, within the context of autistic employee social functioning in a non-autistic workplace. Methods: This study compared autistic and non-autistic participants’ ability to accurately interpret the behaviors of an autistic employee at work. A sample of 254 participants (173 non-autistic and 81 autistic) read a vignette about a hypothetical autistic employee having difficulty coping in the workplace. Participants answered open-ended questions regarding their interpretation of the employee’s behavior and emotional state. Results: A significantly greater proportion of autistic participants (50.7%) accurately interpreted the behavior of the employee compared with non-autistic participants (31.2%) (χ2 = 8.65, p = 0.003). Autistic participants with the highest behavior interpretation scores had significantly higher mean self-reported autism traits scores (M = 26.8) compared with autistic participants who scored lowest on behavior interpretation (M = 19.3, p < 0.001). The opposite relationship was found for non-autistic participants. Conclusions: Results from this study contribute to evidence supporting the DEP, shifting the paradigm of autistic social functioning away from a deficit model and toward addressing mutual misunderstandings in the autistic/non-autistic social interaction. The pattern of findings between neurotype groups by behavior interpretation abilities on an autism traits measure points to mutual misunderstandings as a clash of neurologically different social cultures. Addressing the DEP in the workplace would contribute to removing barriers to successful employment for autistic adults.

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10. Pritchard-Rowe E, de Lemos C, Howard K, Gibson J. Diversity in Autistic Play: Autistic Adults’ Experiences. Autism in Adulthood;2024;6(2):218-228.

Background: Play is important for mental health and well-being. Descriptions of autistic play have typically focused on “deficits” and are based on comparisons to neurotypical “norms”. According to the neurodiversity paradigm, it is important that autistic voices are highlighted and that difficulties, differences, and strengths are explored. With this in mind, we designed the present study to focus on the experiences and perspectives of autistic people concerning the topic of autistic play. Methods: We conducted a consultation with autistic stakeholders, as well as with parents and teachers of autistic individuals to help us design the study and interview questions. We used semi-structured interviews with 22 autistic adults aged 18–57 years (clinically confirmed diagnosis, n = 21; self-diagnosed, n = 1) who live in the United Kingdom. We analyzed the data using interpretative phenomenological analysis to identify themes. Results: We found important commonalities and differences in the ways that socialization in play, imaginary play, and flow (a state involving intense focus on the play) are experienced. Autistic adults discussed the importance of both solitary play and social play, with solitary play having an important recuperative function. They also reported preferences for parallel play and playing with similar autistic people. They also discussed imaginary play experiences, including social role-play and grounded-in-reality play, and the dual nature of flow experiences during play. Conclusions: The findings of this study contrast with deficit-focused understandings of autistic play and build on neurodiversity-informed studies. We highlight, for example, the importance of considering the different circumstances under which solitary play or social play are preferred, as well as the importance of taking an individual approach to play. We encourage wider understanding and acceptance of these play preferences and experiences to support autistic people’s well-being.

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11. Evans JA, Krumrei-Mancuso EJ, Rouse SV. What You Are Hiding Could Be Hurting You: Autistic Masking in Relation to Mental Health, Interpersonal Trauma, Authenticity, and Self-Esteem. Autism in Adulthood;2024;6(2):229-240.

Background: Autistic masking refers to some autistic individuals’ tendency to hide, suppress, or camouflage their autistic traits, autistic identity, or autism diagnosis. Autistic masking also may include unconscious or conscious attempts to mimic the behavioral, cognitive, or sensory styles of nonautistic neurotypical people and to suppress natural forms of autistic behavior, cognition, and reactions to sensory experiences. Since autistic people are a stigmatized minority in many neurotypical dominated societies, passing as nonautistic through autistic masking may be an attempt to avoid autism stigma and a reaction to previous interpersonal trauma. Increased autistic masking behaviors are associated with reports of increased depression, anxiety, burnout, and exhaustion in autistic people, and thus, exploring the roots and impact of autistic masking is an important mental health topic. Methods: This study investigated the relationships between autistic masking and depression, anxiety, gender identity, sexual orientation, interpersonal trauma, self-esteem, authenticity, and autistic community involvement. Participants were autistic adults (n = 342) recruited through autistic social media groups. Results: This study found that higher self-reported autistic masking behaviors were associated with higher reports of past interpersonal trauma, greater anxiety and depression symptoms, lower self-esteem, lower authenticity, and lower participation within the autistic community. Autistic masking was not associated with gender identity or sexual orientation. Conclusions: The results of this study highlight the relationship between autistic masking and past interpersonal trauma, finding that autistic masking behavior is associated with mental health, self-esteem, and authenticity risks for autistic adults. We call into question the teaching of autistic masking strategies in therapies and education programs for autistic people based on the negative associations with autistic masking presented in this study and other research in this field.

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12. Pfeiffer B, Song W, Davidson A, Salzer M, Feeley C, Shea L. Transportation Use and Barriers for Employed and Unemployed Autistic Adults. Autism in Adulthood;2024;6(2):241-246.

Background: Autistic adults are significantly unemployed or underemployed even compared with other disability groups. Employment is a social determinant that, when satisfied, closely influences health-related quality of life. For autistic adults, environmental barriers to transportation can impact the ability to get to employment resulting in limited employment opportunities. This study provides a closer examination of the association between transportation use and employment status. Objective: To examine the use of different types of transportation and barriers to public transit by employed and unemployed autistic adults. Method: The data were from a large statewide study conducted between May 2017 and June 2018 using the Pennsylvania Autism Needs Assessment (PANA), in which information about employment and transportation use was obtained from autistic adults who were residents of Pennsylvania. The study sample included 1120 autistic adults (Mage = 28.03 years, standard deviation = 9.84; 70% men; 82% non-Hispanic White). Results: Participants who were employed were more likely to drive themselves than those who were unemployed (45% vs. 21%, p < 0.001), while they were less likely to take rides from others (62% vs. 75%, p < 0.001) or use service transportation (11% vs. 18%, p = 0.001). For barriers to public transit, the results identified that employed participants reported fewer barriers to public transportation than unemployed participants with a small effect size (1.98 vs. 2.54, d = 0.22). Conclusion: Employed autistic adults exercise more transportation independence. Unemployed autistic adults report more barriers to participation and lower ability to independently use public transportation. Future transportation and employment studies are necessary.

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13. Frizell CA. Re: “‘I’ve Spent My Whole Life Striving to Be Normal’: Internalized Stigma and Perceived Impact of Diagnosis in Autistic Adults” by Huang et al.: Late Diagnosis Illuminated—Perspectives on Autism Resilience and Complexity. Autism in Adulthood;2024;6(2):247-248.

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