1. Ratto AB. Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for Autism in Adulthood. Autism in Adulthood. 2024; 6(3): 249-.

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2. Barclay-Morton JL. Out of Trauma/Out of Time. Autism in Adulthood. 2024; 6(3): 250-2.

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3. Hersh L, Dwyer P, Kapp SK, Shevchuk-Hill S, Gurba AN, Kilgallon E, Mair APA, Chang DS, Rivera SM, Gillespie-Lynch K. Community Member Views on Autism Intervention: Effects of Closeness to Autistic People with Intellectual Disabilities And Nonspeaking Autistic People. Autism in Adulthood. 2024; 6(3): 253-71.

Background: Controversy regarding the neurodiversity movement (NDM), the social and medical models of disability, autism intervention goals, and causal attributions of disability contributes to divides in the autistic and autism communities. The present study investigates the views of autistic and non-autistic autistic and autism community members on these topics. We explored whether these views are shaped by having close relationships to autistic people with intellectual disabilities (ID) and nonspeaking autistic (NSA) people. Methods: A total of 504 autistic and autism community members (278 autistic, 226 non-autistic) completed an online survey about theoretical models and intervention goals. Participants reported whether they had one or more close relationships with NSA people, autistic people with ID, neither, or both. Results: Overall, there was considerable consensus regarding desired intervention goals: normalization goals were generally opposed, while participants generally supported well-being, societal reform, supportive environment, and adaptive skill goals. While autistic participants reported less support for normalization and adaptive skills goals than non-autistic participants, they expressed somewhat more enthusiasm for societal reform and supportive environments than non-autistic people. Autistic people supported the NDM more and the medical model less than non-autistic people. Those close to autistic people with ID gave higher ratings to adaptive skill goals. On average, participants not close to autistic people with ID saw the challenges of those without ID as being slightly more due to environmental/social factors than the challenges of those with ID; there was no such statistical difference among those close to autistic people with ID. Conclusion: Further research investigating community views, with the inclusion of more autistic people with ID and NSA people themselves, is needed, but the results of this study suggest that the broader autistic and autism communities see NDM-consistent intervention goals as appropriate for all autistic people, including NSA people and those with ID. As autism interventions have often pursued unpopular normalization goals, this suggests directions for reform.

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4. Graham J, Rodgers J, Cassidy S. Why Are Autistic People More Likely to Experience Suicidal Thoughts? Applying the Integrated Motivational–Volitional Model with Autistic Adults. Autism in Adulthood. 2023; 6(3): 272-83.

Background: Autistic people are at considerably greater risk of suicidality than non-autistic people, and the reasons behind this are not fully understood. Current suicide theories may be useful to help further our understanding of the mechanisms behind autistic suicidality. We aimed to test the key predictors of suicidal ideation?defeat and entrapment?as described in the integrated motivational?volitional (IMV) model of suicide behavior, in an autistic group. We also looked to extend the IMV model by including autism-related constructs of camouflaging and intolerance of uncertainty (IU). Methods: We recruited 374 autistic adults from the community (female 42.5%; 18?63 years of age), who completed a cross-sectional online survey between August 2020 and January 2021. We collected data on lifetime suicidality, depression symptoms, defeat, entrapment, camouflaging, and IU. Results: We found that entrapment significantly mediated the relationship between defeat and suicidal ideation. Camouflaging and IU were not found to moderate this pathway but were found to be significantly associated with suicidal ideation. Conclusions: We found that entrapment mediates the relationship between defeat and suicidality in autistic adults. This is consistent with the predictions in the motivational phase of the IMV model of suicidal behavior, suggesting that this model is useful for understanding autistic suicidality. We did not find evidence that camouflaging and IU act as moderators within the mediated model. Nevertheless, there is some evidence that camouflaging and IU are worthwhile constructs to be aware of for future work researching autistic suicidality.

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5. Quadt L, Williams G, Mulcahy J, Larsson DEO, Silva M, Arnold AJ, Critchley HD, Garfinkel SN. “I’m Trying to Reach Out, I’m Trying to Find My People”: A Mixed-Methods Investigation of the Link Between Sensory Differences, Loneliness, and Mental Health in Autistic and Nonautistic Adults. Autism in Adulthood. 2023; 6(3): 284-99.

Background: Rates of loneliness are substantially higher among autistic compared with nonautistic individuals. This observation refutes the persistent stereotype that autistic individuals are not motivated to seek meaningful social relationships. More plausibly, social environments systematically exclude people with higher levels of sensory differences, impeding on opportunities for autistic individuals to form meaningful relationships. In this study, we sought to quantify the level of distress associated with loneliness (Study A) and provide complementary qualitative insight into experiences of loneliness in relationship to sensory differences in autistic adults (Study B). Methods: In Study A, N?=?209 participants completed a range of self-report questionnaires. In Study B, nine autistic adults took part in 10-minute unstructured dyadic conversations around the topic of loneliness. We derived a qualitative understanding of autistic individuals’ experience of loneliness, enriched by inductive and deductive analyses. Results: In Study A, the autistic group showed significantly higher levels of loneliness, loneliness distress, anxiety, depression, and sensory reactivity. We found significant positive correlations between variables, but no group differences in differential relationships. The effect of sensory reactivity on anxiety and depression was mediated by levels of loneliness in both groups. In Study B, autistic participants described the pain of feeling lonely and socially disconnected, while simultaneously experiencing a need for restorative solitude after social overstimulation. Discussion: Our results indicate that sensory differences are related with higher loneliness and associated poor mental health in both autistic and nonautistic adults. This effect was exacerbated in autistic adults due to higher levels of sensory reactivity. First-hand reports from autistic adults on intense loneliness and the obstructive role of sensory environments refute stereotypes about a lack of social motivation in autistic adults. We conclude that to enable meaningful and inclusive social interaction, a societal effort is needed to create spaces that consider the sensory needs of all neurotypes.

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6. Glackin A, Pearson A, Davis R. “You Are the Expert of Your Own Experience”: A Thematic Analysis of Experiences of Autism and Gender Diversity in Adulthood. Autism in Adulthood. 2023; 6(3): 300-11.

Background: Autistic people are more likely to report gender dysphoric traits, and transgender and gender-expansive individuals frequently report higher scores on self-report measures of autistic traits. Despite the clear association between autism and gender diversity, there is a dearth of qualitative research exploring the lived experiences of autistic adults. Methods: This study contributes to the evidence base by exploring the strengths and challenges of the intersectional experiences of autism and gender diversity in adulthood. Twelve transgender/gender-expansive autistic people participated in an online semi-structured interview or an open-ended survey, and reflexive thematic analysis was used to analyze the data. Results: Three main themes were identified: (1) Navigating a gender journey, (2) The impact of social context on self, and (3) Provision of health care. Conclusion: The findings highlight the importance of acknowledging the unique experiences of being both an autistic and transgender/gender-expansive person to further understand the intersection between autism and gender diversity.

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7. Al Ansari M, Edwards C, Gibbs V. “Living Independently Means Everything to Me”: The Voice of Australian Autistic Adults. Autism in Adulthood. 2023; 6(3): 312-20.

Background: Despite the desire of many autistic adults to live independently, recent studies suggest that only about one in six autistic adults do. This includes living alone, with a partner, or with friends. This is a rate that is lower than adults with other disabilities. Existing studies from other countries have explored the potential barriers to independent living, with very few exploring the actual experiences of autistic adults. To the best of our knowledge, there have been no published studies exploring the firsthand moving out experiences of autistic adults globally and none that have explored their independent living experiences in Australia. Methods: Autistic adults with independent living experience in Australia were invited to partake in an interview to understand their moving out and independent living experiences. Interviews were held virtually, audio recorded, and transcribed. Transcriptions were coded in NVivo and thematically analyzed. Results: A total of 11 autistic adults were interviewed (aged 21?50 years). Three key themes were derived from the interviews. Autistic adults perceived independent living as important to have their own space with added autonomy and control (Theme 1). However, autistic adults shared that the moving out process and independent living comes with many challenges, and currently supports are limited (Theme 2). Nine of the 11 participants were diagnosed as adults, and they shared the importance of diagnosis and how an earlier diagnosis may have influenced their choice of accommodation and living arrangements (Theme 3). Conclusions: Findings from this study reiterate the importance of independent living to autistic adults and shed light on the challenges of transitioning to independent living. It further adds to the growing literature about the importance of early diagnosis on later life choices. Better pathways toward adult diagnosis and the provision of supports for the moving out process would be useful to ease transition to independent living for autistic adults.

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8. Kimber L, Verrier D, Connolly S. Autistic People’s Experience of Empathy and the Autistic Empathy Deficit Narrative. Autism in Adulthood. 2023; 6(3): 321-30.

Background: There is a dominant discourse, both in clinical texts and throughout the academic literature, that autistic people lack empathy; however, over the past decade, both clinicians and academics have increasingly rejected deficit-based descriptions of autism in favor of more nuanced explanations of the experience of autistic individuals in a social world. Methods: This study asked 76 autistic individuals about their own experience of empathy and the oft-cited empathy deficit. Data were thematically analyzed and revealed a wide array of empathic self-concepts among respondents. Results: Notably, there was a high proportion of hyper-empathic experiences. Many respondents reported their empathic responses to be overwhelming, or even distressing. These different experiences of empathy contrast with societal expectations of empathy, which often result in additional labor for autistic people as they navigate the non-autistic centered world. Conclusion: Although the academic literature is, in some areas, slowly moving away from a deficit perspective, more broadly there is still a negative impact from misconceptions around autistic people and empathy. Further work needs to be done to not only explore this misconception at a societal (rather than academic) level, but also better bridge the gap around the changing ideas of empathy and real-world understanding of autistic empathy.

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9. Tomas V, Kingsnorth S, Anagnostou E, Kirsh B, Lindsay S. “I Wish This Tool Was Available to Me Sooner”: Piloting a Workplace Autism Disclosure Decision-Aid Tool for Autistic Youth and Young Adults. Autism in Adulthood. 2023; 6(3): 331-44.

Background: For autistic youth and young adults, deciding whether to disclose their autism at work may be complex since they are newly entering the workforce and are at an impressionable developmental period. Decision-aid tools can help someone make a choice regarding a topic/situation. We developed a workplace autism disclosure decision-aid tool called DISCLOSURE (Do I Start the Conversation and Let On, Speak Up, and REveal?) to support autistic youth and young adults navigate disclosure decision-making. In this study, we aimed to assess the DISCLOSURE tool’s (1) impact on decision-making and self-determination capabilities and (2) usability, feasibility, and acceptability. Methods: This was a single-arm pre?post pilot study. The DISCLOSURE tool comprises three interactive PDF documents and videos. Thirty participants (mean age of 23.5 years) completed online surveys before and after interacting with the DISCLOSURE tool. We used descriptive statistics for usability, feasibility, and acceptability. We calculated the Wilcoxon signed rank and paired t-tests to determine pre?post changes in decision-making and self-determination capabilities (Decisional Conflict Scale?Low Literacy Version [DCS-LL]; adapted Arc’s Self-Determination Scale). We analyzed open-ended data using conventional (inductive) content analysis. Results: There were significant decreases in DCS-LL total and subscale scores (p?

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10. McQuaid GA, Sadowski LY, Lee NR, Wallace GL. An Examination of Perceived Stress and Emotion Regulation Challenges as Mediators of Associations Between Camouflaging and Internalizing Symptomatology. Autism in Adulthood. 2023; 6(3): 345-61.

Background: Camouflaging involves the masking of autism traits, potentially creating an outer impression of ?non-autisticness.? Although associations of camouflaging with anxiety and depression in autistic adults are widely reported, factors that mediate these associations are unclear. We examined two potential mediators of the association between camouflaging and anxiety/depression: perceived stress and emotion regulation (ER) challenges. Methods: Seven hundred eighty-seven autistic adults (18.2?78.2 years) recruited through Simons Powering Autism Research (SPARK) Research Match completed questionnaires, including the Camouflaging Autistic Traits Questionnaire (CAT-Q), and measures of autistic traits, depressive and anxious symptomatology, perceived stress, and ER challenges. Four moderated mediation models were tested. In all models the independent variable was CAT-Q total score, and the moderator variable was sex designated at birth. The dependent variable was depressive or anxious symptomatology, and the mediator variable was perceived stress or ER challenges. Results: We found that more camouflaging, increased ER challenges, and higher levels of perceived stress were associated with greater depressive and anxious symptomatology. We also found that perceived stress and ER challenges significantly mediated the associations between camouflaging and both depression and anxiety. In the model with perceived stress and anxiety, sex moderated the mediation, with females showing a stronger mediation. There was no significant moderation in any of the other models. Conclusion: We contextualize the findings within the broader literature on camouflaging as a response to stigma and other facets of minority stress. We discuss how the results of this study support the idea that the day-to-day stress of living in a neurotypical world, the cognitively demanding nature of camouflaging, and the constraints that camouflaging place on autistic people’s behaviors in social contexts (e.g., contributing to suppressing ER strategies such as stimming), create a cycle that contributes to elevated rates of anxiety and depression in autistic people.

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11. Rapaport H, Clapham H, Adams J, Lawson W, Porayska-Pomsta K, Pellicano E. “In a State of Flow”: A Qualitative Examination of Autistic Adults’ Phenomenological Experiences of Task Immersion. Autism in Adulthood. 2023; 6(3): 362-73.

Background: There is considerable conceptual overlap between Autistic hyperfocus and flow, yet these phenomena have seldom been associated in the literature. Moreover, no studies have provided an in-depth empirical investigation of Autistic people’s flow-like or hyperfocus experiences. In this study, we sought to address this gap by investigating Autistic people’s phenomenological experiences of task immersion, and how their experiences relate to existing conceptualizations of flow, hyperfocus, and monotropism. Methods: To address this aim, we drew on data from a broader qualitative study, designed in partnership with Autistic community members, to understand Autistic people’s experiences of Autistic inertia. For that broader study, Autistic and non-Autistic researchers conducted semi-structured interviews with 24 Autistic adults about their everyday experiences of starting and stopping tasks. During these interviews, participants repeatedly discussed their experiences of task immersion and the benefits and challenges associated with it. We analyzed these responses specifically, using reflexive thematic analysis, adopting a combination of deductive and inductive approaches within an essentialist framework. Results: Our participants’ accounts closely matched conceptual understandings of flow, Autistic hyperfocus, and monotropism. Specifically, the analysis revealed the all-encompassing nature of task immersion experiences, and how it could be difficult to ?find the balance? between the joy and other aspects of everyday life. Despite the drawbacks, participants were glad to be immersed because they felt they could be themselves, with no pretences. Conclusions: These results are important for reframing task immersion as a state of great potential value to Autistic people’s lives, but one that may require additional support if it is to play its role in enabling Autistic people to flourish.

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12. Andrzejewski T, Gomez Batista S, Abu-Ramadan T, Breitenfeldt KE, Tassone AU, Winch A, Rozek DC, McDonnell CG. Examining Rates of Traumatic Events and Posttraumatic Stress Disorder Symptoms Among Autistic Adults. Autism in Adulthood. 2023; 6(3): 374-87.

Background: Autistic adults experience high rates of traumatic events and posttraumatic stress disorder (PTSD) symptoms. However, less is known about how autistic adults experience (i.e., by directly experiencing, witnessing, and/or learning about) distinct types of traumatic events (e.g., social, nonsocial traumas). Little research has considered whether the four-factor structure of PTSD symptom domains (e.g., avoidance, intrusions, hypervigilance, negative mood/cognition) can be applied for autistic adults. Lastly, understanding how demographic factors (e.g., gender, race/ethnicity) relate to rates of traumatic events and symptoms among autistic adults is critical for understanding disparities relating to PTSD. Therefore, the current study aims to examine self-reported traumatic events and PTSD symptoms, and identify associations with demographic factors, among autistic adults. Methods: Participants included 276 autistic adults and a nationally representative sample of 361 nonautistic adults who completed online measures, including the Life Events Checklist for DSM-5, Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Autism-Spectrum Quotient-Short, and Patient Health Questionnaire-4. Analyses focused on evaluating group differences in traumatic events and symptoms and considered associations with demographic factors. Results: Autistic adults reported significantly higher rates of directly experiencing, witnessing, and learning about traumatic events than nonautistic adults, including more interpersonal events (e.g., physical assault, sexual assault) and fewer transportation accidents than nonautistic adults. Autistic adults also reported significantly higher levels of all PTSD symptom clusters than nonautistic adults. A confirmatory factor analysis and follow-up invariance analyses of the PCL-5 revealed that the four-factor Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5) PTSD symptom subscale structure was equivalent across groups of autistic and nonautistic adults. Conclusion: Autistic adults experienced more traumatic events and PTSD symptoms overall, particularly more interpersonal traumas and hyperarousal and negative mood/cognition symptoms than nonautistic adults. Future research should examine outcomes of trauma exposure, identify protective factors, and examine efficacy of trauma-focused treatments for autistic individuals, in partnership with autistic adults.

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