1. Woods SEON. Why We Need More Autistic Health Care Professionals and How to Support Them. Autism in Adulthood;2026;8(1):5-13.

Many autistic characteristics (especially attention to detail, social nonconformity, monotropism, and knowledge of autism) set autistic health care professionals apart as especially well-suited for their fields. Increasing the number of autistic health care professionals will benefit their clients, colleagues, and health care fields as a whole. Autistic health care professionals face many challenges, including being misunderstood and discouraged from participating in their fields. Despite the challenges, many health care professionals are thriving. Autistic connections and solidarity are an important part of helping autistic health care professionals overcome obstacles and succeed. Suggestions for making health care more accommodating of autistic people are offered. Recommendations are also provided for autistic health care professionals looking to find community and meet others in the same position.Community Brief Why is this topic important?Autistic people have many characteristics that are well-suited to health care. It can be difficult for autistic health care professionals to become health care professionals, and once they do, their autistic characteristics are sometimes misunderstood instead of appreciated. Autistic health care professionals have many traits that set them apart as being especially good at what they do, but others in their fields may not always be aware of that. The autistic community, and people in general, benefit from autistic health care professionals.What is the purpose of this article?The purpose of this article is to draw attention to the various ways that autistic characteristics are beneficial in health care and discuss some of the obstacles that health care professionals face. The main point is that although it may be difficult to be an autistic health care professional, we (as a society) need more of them.What personal or professional perspectives do the authors bring to this topic?The author is a clinical psychologist working in private practice and in an academic medical center. The majority of her time is focused on autism assessment and consultation, and she spends long periods of time listening to the stories of autistic professionals as they explore their identities and collaborate to find recommendations that will make their work experiences go more smoothly. She also consults with health care providers on better serving autistic clients in different health care settings. The author is also influenced by autistic colleagues and mentors with whom she regularly consults and collaborates. The author combines the knowledge gained from listening to clients’ stories, working with autistic people, learning from autistic people, and reading formal research on autistic experiences.What is already known about this topic?There are some individual accounts of autistic people thriving as well as experiencing difficulties in health care, and there is some research on groups of people within the same profession (e.g., doctors, psychologists, medical students), but this article combines this information to show the overall trends across health care professions. There have been some previous articles on autistic strengths among doctors, researchers, and psychologists separately. This article summarizes the overall findings of autistic strengths in specific areas across health care professions.What does the author recommend?The author recommends that autistic health care professionals work together to support each other and change their professions for the better by finding community and joining groups for autistic health care professionals. The author also offers recommendations for workplaces and individual health care workers to be more accommodating of autistic professionals.How will these recommendations help autistic adults now or in the future?Improving conditions for autistic health care professionals will make it more likely that they can thrive and less likely that they will burn out or change careers. Increasing the number of autistic health care professionals will also make it easie to be an autistic health care professional, which will open up more career opportunities. Helping autistic health care professionals find community will reduce the likelihood that they will burn out or drop out. It will also support them in making changes in their professions. Autistic adults in general are also well-served by autistic health care professionals. Even if autistic adults are not served directly by autistic health care professionals, their presence will help change their fields for the better, which will improve health care for autistic people.

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2. Chow C, Cooper K. What Are the Lived Experiences of Strengths in Autistic Individuals? A Systematic Review and Thematic Synthesis. Autism in Adulthood;2026;8(1):14-26.

Background: Research about strengths in autistic individuals has often been based on informant perspectives. These may not align with the subjective experiences and perspectives of autistic people themselves. This study therefore aimed to center the perspectives of autistic people through a qualitative synthesis investigating the lived experiences of strengths in autistic individuals.Methods: A systematic search identified 26 qualitative articles that met the inclusion criteria, out of articles that used qualitative methods to understand autistic participants’ perspectives on strengths in autism.Results: A thematic synthesis approach generated four themes as follows: wired differently, focused interests enrich life, embracing an autism identity, and context-dependent strengths. The review findings showed that autistic individuals value abilities and attributes that they can use to help them thrive in their daily lives, for example, by enhancing their performance at work, enjoyment during an activity, or helping others. Participants had differing views about whether their strengths were attributable to their autism. Autistic strengths extended beyond abilities to pride in having an autism identity and self-knowledge. Participants recognized that their ability to express themselves or their strengths often depended on the context.Conclusion: Recommendations include supporting autistic individuals to openly explore their interests and experiences and to recognize for themselves the characteristics and skills they value, for example, how to draw upon focused interests to develop relaxation strategies.Community Brief Why is this an important issue?Autism research has often focused on the difficulties faced by autistic people rather than on their strengths. Also, research has often asked parents or professionals their opinions rather than asking autistic people themselves.What was the purpose of this study?We wanted to understand how autistic people experience and talk about their own strengths. Strengths are the things we are good at.What did the researchers do?This type of research is called a systematic review and meta-synthesis. We searched online databases to find all the published research articles in this area. We looked for studies that asked autistic people how they experience their own strengths. We collected the findings from the studies and identified themes across them. The themes tell us what autistic people think about their strengths.What were the results of the study?We found 26 published articles that could be included in our review. We generated four themes. Autistic people described different thinking abilities and traits that they linked to autism: some brought enjoyment while others were useful life skills. Focused interests were described as enriching life through bringing well-being, knowledge and skills, and opportunities for social connection. Autistic participants described that having an autistic identity could be a strength, for example, through reflecting on their past or taking pride in their differences. Strengths changed over time and depended on the context of the time or situation.What do these findings add to what was already known?This adds to our knowledge by providing an integrated and robust summary of all the published literature in the area. Our findings show that autistic people experience some of their autistic traits as strengths, including thinking skills and focused interests.What are potential weaknesses in the study?Not many of the included articles set out to explore strengths, so we did not always have a large amount of data to analyze from each study. We are just focusing on one aspect of the autistic experience: some people may not experience autistic strengths, either through not associating their experiences with autism or because they experience mostly challenges associated with autism.How will these findings help autistic adults now or in the future?The findings show that autistic people identify strengths and benefits to being autistic. It could help to share these findings with newly diagnosed autistic people or those who are struggling with understanding autism and what it means for them personally. It might help autistic people who have mostly identified challenges associated with being autistic to identify some of their strengths.

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3. Andoni L, Eisenhower A, Gudknecht J, Levitt HM. Meta-Synthesis of Autistic Adults’ First-Person Perspectives About Mental Health-Related Services. Autism in Adulthood;2026;8(1):27-46.

Background: Autistic adults are at high risk of co-occurring mental health disorders, including depression, anxiety, nonsuicidal self-injury, and suicidality. Existing services are not adequately meeting autistic adults’ mental health needs. To better inform evidence-based care, there is a need to synthesize and integrate autistic people’s perspectives about the mental health-related services they receive.Methods: Using the PRISMA method, 40 studies of first-person experiences for autistic adults about mental health-related services met inclusion for this systematic review. Electronic database searches in PsycINFO and PubMed were conducted up to July 2023. Studies needed to be published, qualitative or mixed-methods, and had to include self-report of autistic adults who had experiences with mental health-related services. Original articles were reviewed, coded, and analyzed in line with a modified critical constructivist grounded theory approach.Results: Twelve studies inquired about participants’ experiences and needs with general services, and 28 studies explored participants’ experiences with specific services such as specific mental health interventions, support groups, or social-focused interventions. Our analyses of the 40 studies revealed five categories with regard to autistic clients’ perspectives on their mental health services: (1) to be more tailored to their individual needs, (2) to provide more accommodations in both format and content, (3) to include more practical support, in addition to emotional support, (4) for providers to have both knowledge of the heterogeneity of autism and humility in their work, and (5) to encourage and embrace a sense of autistic identity and community.Conclusion: Our results offer practical changes that clinicians can make to improve their services and create a better experience for autistic adults. Notably, our analyses highlight that too often the services autistic people receive focus on changing them, rather than on changing or coping with the environment. Diversity in participants was a limitation across our studies (participants were majority White, in a Western-based country, and did not have a co-occurring intellectual disability), and future research should ensure greater diversity in first-person perspectives.Community Brief Why is this an important issue?Autistic adults frequently experience mental health challenges such as depression and anxiety. Unfortunately, autistic adults are not satisfied with their care and report that their experiences with mental health services are not compatible or effective for what they need.What was the purpose of this study?To improve the quality of care, it is important to understand what autistic adults want from their mental health services. Our purpose is to provide practical recommendations to mental health clinicians working with autistic adults.What did the researchers do?We conducted a systematic review of 40 studies that gathered firsthand experiences of autistic individuals about mental health-related services. The studies included autistic first-person perspectives on general mental health service needs, as well as perspectives on specific mental health-related services such as counseling or psychiatric services, support groups, or psychotherapy groups.What were the results of the study?From our analysis, we identified several categories to answer the question: what do autistic adults want from their mental health-related services? 1.Mainstream mental health services should be made available to autistic clients as autistic clients often do not qualify for such services. Clinicians should tailor services to autistic client’s skill set, needs, and age, and not based on stereotypes of autism.2.Clinicians should offer accommodations to address the unique needs for autistic clients, including the following: Sensory needs: make changes in the environment such as lights, sounds, or offer telehealth options.Time expectations: offer longer duration of sessions or greater number of sessions given the difficulty of getting used to a new clinician.Communication needs: offer options to accommodate different communication styles such as using written or visual information or slowing down when speaking.3.Autistic clients may need pragmatic support such as filling out a form, figuring out job benefits, or problem-solving house situations. Clinicians should be flexible in supporting their client’s practical needs or referring to services that are tailored toward practical support.4.Clinicians should know about autism and have the humility to honor the autistic client’s lived experiences. Clinicians should understand the heterogeneity of autism.5.Clinicians should use a strength-based approach within the neurodiversity paradigm and not a medical-based approach to help clients explore and understand their autistic identity. Autistic peer support groups and groups that are led by a neurodivergent clinician are often better at embodying that approach.What do these findings add to what was already known?An important finding is that autistic adults want services that focus on exploring their identities and managing the stressors of living with a disability in an ableist society, instead of changing the adult’s characteristics.What are potential weaknesses in the study?The population sample included in the study was not very diverse. Participants were majority White, in a Western-based country, and did not have a co-occurring intellectual disability.How will these findings help autistic adults now or in the future?Our results offer practical recommendations for clinicians so that autistic adults can have a more helpful and affirming service experience.

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4. Collis E, Dark E, Russell A, Brosnan M. Self-Report of Restricted Repetitive Behaviors in Autistic Adults: A Systematic Review. Autism in Adulthood;2026;8(1):47-67.

Background: Autism research has relatively neglected restricted repetitive behaviors (RRB) and autistic adults compared with the social domain of autism and autistic children. With this review, we aimed to synthesize what is currently known about autistic adult’s self-reported RRB, researcher’s use of methods, and consideration of masking and gender, and to highlight gaps in our knowledge to inform future research.Methods: We conducted a systematic search of five databases that we last ran in February 2023. We included studies where autistic adults self-reported on one or more subtypes of their repetitive behaviors. We conducted a narrative synthesis to summarize results. We used the Mixed Methods Appraisal Tool to assess the quality of included studies.Results: Our database search identified 35 studies to include for review. The majority of included studies focused on the sensory domain of RRB with other subtypes comparatively neglected. The narrative synthesis identified subject areas of stimuli characteristics, internal reactions, moderators, recovery, self-regulation, and social pressure. We uncovered a narrative where most autistic adults experience hypersensitivity to some sensory stimuli, the unpleasantness of which they then try to avoid, but in doing so may also avoid social situations, contributing to loneliness and increased anxiety surrounding social situations. We identified a cycle of stress where existing stress increased sensory sensitivities leading to more stress and less ability to deal with additional stressors. While the self-regulatory benefits on emotion, cognition, and self-fulfillment of RRB should help with stress, this was prevented by autistic people’s awareness of stigma surrounding these behaviors, leading to masking, which is also stressful.Conclusion: The review highlighted the need for a less categorical and more interrelated approach in researching this domain of autism and a need for more awareness surrounding sensory issues and the benefits of RRB. Future research should also strive to improve study sample representation, particularly regarding gender, race, and IQ.Community Brief Why is this an important topic?Historically, research has focused on autistic children and social differences rather than on autistic adults and their repetitive behaviors such as repetitive movements, insisting on sameness, sensory sensitivities, and special or preferred interests. Research has often asked parents and carers about these behaviors rather than asking autistic adults. As such autistic adults’ own experiences of their repetitive behaviors are not well known in research.What was the purpose of this review?The purpose of this review was to find out: -Which repetitive behaviors have already been studied in self-reporting autistic adults.-How self-reporting autistic adults’ repetitive behaviors have been studied.-What the findings of those studies were and to summarize them.-If masking (the “hiding” of autistic behaviors) and gender differences have been considered in these studies.What did the researchers do?We conducted a systematic review looking at papers where autistic adults self-reported/participated in studies exploring one or more repetitive behaviors. A systematic review searches and summarizes all existing research on a topic to answer specific questions and make clear what we already know about a topic and what still needs to be researched. Our search ran until February 2023 and found 35 papers.What were the results of the review?We found that sensory sensitivities are researched more than other repetitive behaviors, followed by special interests. We also found that autistic adults’ repetitive behaviors are self-fulfilling and help them manage their emotions and attention. This helps them to cope with things that might cause stress, such as sensory sensitivities. Autistic people said that they had strong internal reactions to sensory stimuli, especially those such as loud or high-pitched noises, bright lights, scratchy textures, and strong smells. This was made worse where multiple of these things were present; multiple stimuli overlapped, they couldn’t control the sensory stimuli, were already stressed, and because of past or present negative reactions of others. Repetitive behaviors are often viewed negatively or stigmatized by others, and so many autistic adults mask or hide these behaviors. This may cause problems for autistic people—although very little research has looked into this. Gender differences were also not considered often. There was no gender difference in the amount or intensity of repetitive behaviors; females seemed to have increased sensitivity to taste and smell and had different special interests to males.What are the next steps?Future research should consider repetitive behaviors as a whole and how they relate to one another. Researchers should recruit participants to better represent autistic adults of all backgrounds, particularly regarding gender, race, and IQ, as current findings are fairly limited to white autistic adults of average or above average intelligence within the gender binary.What are the potential weaknesses of the review?The review looks at self-reporting autistic people; this means that the review does not look at autistic people who cannot self-report, and so the findings may not apply to them. It is also possible that we missed potentially relevant studies in our search, although every effort was made to avoid doing so. Some studies had to be excluded because results were reported in a way that did not separate the experiences of autistic adults from other groups such as children or adults with attention-deficit hyperactivity disorder (ADHD) who were not autistic. This increases the review’s relevancy to autistic adults but means that some potentially relevant findings were not reported.How will these findings help autistic adults now or in the future?The findings in this review help to highlight the areas of restricted repetitive behavior (RRB) research that are lacking, particularly regarding insistence on sameness behaviors and repetitive movements. This will hopefully prompt more research in these areas and increase understanding of these misunderstood behaviors. The findings also highlighted the experience of sensory sensitivities and the benefits of other forms of RRB, which challenges the stigma surrounding these behaviors and increases awareness.

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5. Beck KB, MacKenzie KT, Kumar T, Breitenfeldt KE, Chang JC, Conner CM, Mandell DL, White SW, Mazefsky CA. “The World’s Really Not Set Up for the Neurodivergent Person”: Understanding Emotion Dysregulation from the Perspective of Autistic Adults. Autism in Adulthood;2026;8(1):68-78.

Background: Emotion dysregulation is associated with mental health challenges and suicidality in autistic adults. Little is known about how emotion dysregulation manifests in adulthood and whether current services adequately support their needs. We explored autistic adults’ experiences of emotion dysregulation and identified key contributors to emotion dysregulation to inform future service development.Methods: We performed qualitative semi-structured interviews with autistic adults, in which they shared emotion dysregulation stories. Three researchers developed the codebook using a consensus approach, coded interviews, and completed thematic analyses. Autistic adults were part of our study team and involved at every step.Results: Fifteen autistic adults participated in the interviews. Emotion dysregulation was described in the context of a pervasive lack of control in various settings, most often experienced in health care settings. Limited awareness of internal states (i.e., emotions, sensory) until it was too late was a prominent theme. Many participants described emotion dysregulation as indistinguishable from sensory overload. Interpersonal conflict, largely social rejection because of being misunderstood by a neurotypical person, contributed to difficulty regulating emotions and low perception of self-worth. Participants described feeling powerless in health care settings and workplaces, where they experienced disproportionate and inappropriate responses to their emotion dysregulation, including involuntary sedation, termination of care, and job loss. Most participants described a lack of safety and supports for adaptively coping with emotion dysregulation, leading to tension between the personal costs of masking and the societal consequences of not masking.Conclusions: Autistic adults attributed their emotion dysregulation to a lack of control across all contexts. It is important for autistic adults to develop emotion regulation skills, but more work is needed to understand and remediate the impact of social marginalization on autistic adults, as this directly contributed to instances of dysregulation.Community Brief Why is this an important issue?Problems with emotion dysregulation are associated with mental health challenges and suicidality in autistic adults. Yet, scientists lack the understanding of what emotion dysregulation looks like in the lives of autistic adults. We have not yet asked autistic adults what causes emotion dysregulation from their perspective.What was the purpose of this study?The purpose of this study was to hear autistic adult perspectives of their experiences of emotion dysregulation. We hoped to learn identify unique factors impacting autistic people in adulthood that may require new and different supports than those developed for autistic children.What did the researchers do?We conducted interviews with 15 autistic adults. We asked them to share stories of recent instances of emotion dysregulation. We asked the participants to share what caused the dysregulation, what they did when dysregulated, and to describe consequences of the emotion dysregulation. We looked for common themes in their answers. What were the results of the study?Participants told us that their emotion dysregulation often resulted from not having control over aspects of their life in multiple ways. We learned that sensory sensitivities contributed to emotion dysregulation, and it was difficult to recognize emotions. Every participant told a story about becoming emotionally dysregulated after being misunderstood by a neurotypical person, such as a family member, friend, or coworker. Many also described how neurotypical people responded to their dysregulation by threatening serious consequences. Autistic adults also told stories about feeling powerless in health care settings and workplaces. They felt unsafe in these settings and experienced unjust responses to their emotion dysregulation, such as involuntary sedation, removal of care, and loss of their job. Many participants coped with the lack of safety by mas ing, and they reflected on the personal costs of masking. They shared unmet needs for better emotion dysregulation support, including access to safe places and people, connection with other autistic people, self-acceptance, and broader societal acceptance of autistic people.What do these findings add to what was already known?This study is the first to study autistic adults’ own perception of their emotion dysregulation and the key role of that feeling marginalized has on emotion dysregulation. Our findings suggest that emotion dysregulation in autistic adults can be triggered by environmental stressors that are out of their control. The consequences of emotion dysregulation can be severe across social, employment, and health care settings.What are potential weaknesses in the study?The sample did not include autistic people with severe intellectual disability or those who relied on forms of communication other than speech.How will these findings help autistic adults now or in the future?Our findings suggest the need for autism researchers and clinicians to support autistic adults beyond individual mental health treatments. It is important to focus on promoting wider acceptance of autism in society. We also need to focus on ensuring the emotional safety of autistic people in health care and employment settings.

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6. Neville F, Sedgewick F, McClean S, White J, Bray I. Reacting, Retreating, Regulating, and Reconnecting: How Autistic Adults in the United Kingdom Use Time Alone for Well-Being. Autism in Adulthood;2026;8(1):79-89.

Background: Firsthand accounts by autistic people describe a need for regular time alone. However, there is little in the literature that explores (1) why time alone is desired, (2) how that time is spent, or (3) where that time is spent. This article describes a neurodiversity-informed, qualitative study that demonstrates the importance and purpose of “alone-time” for autistic adults.Methods: We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their “alone-time” and the benefits experienced from this time. We conducted the interviews online, some using a video link, and some using a synchronously accessed text-based document, according to the participants’ preferences.Results: We used Reflexive Thematic Analysis with the interview data to generate four qualitative themes as follows: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others.Conclusions: These themes highlight a need for balancing social activities and spaces with time and space alone and the benefits of creating or protecting spaces, which encourage recovery from overwhelm.Community Brief Why is this an important issue?Autistic people often talk and write about how they need regular time alone for their well-being, but there is very little in the academic literature on the importance of “alone-time” or what “alone-time” might look like.What was the purpose of this study?We wanted to explore why autistic people might want time alone, how autistic people like to spend time alone, and where autistic people like to spend time alone.What did the researchers do?We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their alone-time and what they felt the benefits of alone-time were. Then we analyzed what was said in the interviews using Reflexive Thematic Analysis.What were the results of the study?Four themes help describe what the autistic adults talked about: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others. These themes highlight how social and sensory environments can be overwhelming, how finding quiet spaces and/or engaging with intense interests can be helpful, and how socializing can be made less overwhelming.What do these findings add to what was already known?This study is the first to explore why autistic people might choose to spend time away from social spaces, how they choose to spend this time, and where they choose to spend this time. The findings support previous research on sensory and social overwhelm and on well-being strategies that autistic people use to support their own well-being.What are potential weaknesses in the study?All the participants lived in the United Kingdom, had access to the internet, and were able to give informed consent, and most of the participants were White and female. We do not know if the findings are true for autistic people who are not represented by this sample (e.g., people who are further marginalized by not living independently).How will these findings help autistic adults now or in the future?This study shows the importance for autistic adults in balancing social activities and spending time in social spaces, with alone-time. It also shows the benefits of finding/creating and protecting spaces that are not overwhelming for autistic adults. These findings may help autistic adults explain their need for alone-time, which is useful information for people who support, live with, and work alongside autistic adults.

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7. Bang P, Igelström K. Relationships Between Autistic Trait Dimensions and Speech Understanding, Affective Sound Intolerance, and Self-Reported Hearing Difficulties. Autism in Adulthood;2026;8(1):90-101.

Background: Decreased sound tolerance (DST) is a disabling transdiagnostic phenomenon with high clinical relevance in autism. Neurodevelopmental DST is often studied as part of a general multisensory construct that includes both hyper- and hyposensitivity. Therefore, knowledge about the potential relevance of individual differences in the auditory modality is lacking. The purpose of the study was to begin to differentiate between commonly pooled auditory functions, by incorporating psychometric tools from the field of audiology.Methods: In a pilot sample (N = 520 adults, 23% autistic), we used Bayesian correlations to quantify the contribution of individual auditory items from the Glasgow Sensory Questionnaire to the degree of social, communicative, and rigid autistic traits measured with the Broad Autism Phenotype Questionnaire (BAPQ) subscales. Then, we recruited an independent sample (N = 175 adults, 18% autistic) to measure, more specifically, (1) emotional reactions to sounds (affective DST), (2) speech understanding difficulties, and (3) nonsocial auditory processing (spatial perception and stream segregation), using self-report questionnaires. We used multiple regression to test for associations with the autistic trait domains.Results: We found that all autistic traits measured by the BAPQ (social, communicative, and rigid) linearly predicted affective DST, and these associations remained when autistic participants were excluded. Difficulties with speech perception, as well as spatial perception and auditory stream segregation, were most strongly predicted by communication differences.Conclusion: The robust relationship between autistic traits and emotional sound reactivity suggests that affective DST falls on a spectrum just like autism. This argues against strict dichotomization and encourages the use of continuous measures. The results support a dominant role for emotional and stress systems in autism-related DST and may suggest that detailed audiological tests are clinically useful, in particular, in the context of pragmatic language difficulties.Community Brief Why is this an important issue?Differences in sensory perception go hand in hand with an autistic neurotype. Many individuals find everyday noises intolerable or difficult to understand, but there is little knowledge of how these experiences vary among individuals.What was the purpose of this study?To understand which aspects of auditory processing are related to autistic characteristics, using assessment tools from the audiology field.What did the researchers do?They studied 175 adults with different levels of autistic-like social function, communication style, and rigid thinking (18% with an autism diagnosis). They used clinical questionnaires to measure emotional reactions to sounds, speech understanding, auditory space perception, and the ability to distinguish overlapping sounds.What were the results of the study?All autistic characteristics were linked to strong emotional reactions to sounds. Those with an autistic communication style also reported difficulties with speech perception, auditory space perception, and separating overlapping sounds.What do these findings add to what was already known?The results highlight a role of emotional and stress responses in autistic sound sensitivity. In addition, they point to the existence of broader auditory difficulties in adults with an autistic communication style.What are potential weaknesses in the study?It did not include laboratory measurements of auditory function.How will these findings help autistic adults now or in the future?This study helps by breaking down specific hearing challenges in autism, such as trouble understanding speech or reacting strongly to everyday sounds, rather than looking at sensory issues as a whole. This can lead to better support and solutions for these specific difficulties.

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8. Wijekoon S, Robison J, Welch C, Westphal A, Loftin R, Perry B, Rombos V, Picciolini C, Bosyj C, Senman L, Jachyra P, Baron-Cohen S, Penner M. Neurodivergence and the Rabbit Hole of Extremism: Uncovering Lived Experience. Autism in Adulthood;2026;8(1):102-111.

Background: There have been sporadic and disturbing media accounts of autistic people engaging with extreme ideologies, with comparatively little systematic exploration of this suggested association. Existing research has failed to consider the contextual factors that could influence these rare occurrences of engagement with extreme ideologies. This study explores how autistic individuals involved in extreme ideologies describe personal and contextual factors affecting their participation.Methods: Twelve individuals from Canada and the United States who were either diagnosed or self-identified as autistic and have engaged with extreme ideologies participated in semistructured interviews. The research approach and analysis of the data were informed by interpretative phenomenological analysis. Our interdisciplinary team met regularly to collectively examine initial assumptions and interpretations, while maintaining a central focus on the perspectives of the participants.Results: We identified the following three key themes: (1) early wounds, (2) missed formative opportunities, and (3) finding a fit for neurodivergence. Traumatic experiences, disenfranchisement, learned hatred from an insular upbringing, and systemic failings in health and social service systems contributed to participants’ decisions to engage with extreme ideologies. Hate groups, in turn, filled the voids by providing acceptance, purpose, structure, sense of community, and by accommodating participants’ neurodivergent needs.Conclusion: Autism alone did not explain participants’ engagement with extreme ideologies. Trauma and disenfranchisement related to being neurodivergent were common factors that made hate groups more appealing. Proactive interventions to prevent engagement in extreme ideologies must champion inclusive environments that recognize autistic individuals’ skills and address underlying factors that contribute to their disenfranchisement.Community Brief What was the purpose of this study?The media has reported on high-profile cases of autistic people with extreme beliefs who acted in violent ways. There is a lack of research on this topic and researchers have not directly spoken with autistic people who have been involved with these extreme beliefs. Our goal was to understand why some autistic people engaged with hateful beliefs, asking them about both autism and their life circumstances.What did the researchers do?We interviewed 12 people who identified as autistic to understand why they became involved in extreme beliefs. We conducted the interviews by phone or using Zoom Health. We read the interview text, identified important statements, and then identified the ideas linking these statements.What were the results of the study?Most of the people in our study were young to middle-aged men with White/European background from Canada and the United States. Only a few had a formal autism diagnosis.Participants faced many challenges, including being neglected by parents, experiencing trauma, and not feeling like they belong. Many of them were not given opportunities to freely express themselves or have positive interactions with people from different backgrounds. Everyone lacked the opportunity to build a positive view of themselves and the world around them.Participants described some autistic and neurodivergent traits, such as having a focused interest in one topic, having difficulty understanding and connecting with others, preferring clear rules and a set routine, and having difficulty controlling emotions, were not accepted elsewhere but were accepted in groups with extreme beliefs.What do these findings add to what was known?Hate groups provided autistic people a supportive environment where their strengths were highlighted, their individuality was celebrated, and their challenges were accommodated. This level of support contrasted with what autistic people had previously experienced in society.What are potential weaknesses?One limitation of our study was that we included people who identify as autistic, but we did not verify the r diagnosis through formal testing. Our sample is a small group of autistic people who had engaged with hateful beliefs; our findings do not apply to all autistic people and should not be interpreted that all autistic people are more likely to have extreme or hateful beliefs.How will these findings help autistic adults now or in the future?Engagement with extreme groups or beliefs is only one possible negative outcome from the lack of inclusion and acceptance of autistic people, but is an important one. We should create supportive environments that welcome and appreciate autistic peoples’ skills and interests to allow them to feel valued and connected to their community. Families, teachers, and professionals should prioritize accurate and timely diagnosis and provide supports that are tailored to their needs. These steps can help autistic people build meaningful relationships and prevent them from turning to extremist groups to meet their needs.

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9. Scheerer NE, Boucher TQ, Arzanpour S, Iarocci G, Birmingham E. Autistic and Non-Autistic Experiences of Decreased Sound Tolerance and Their Association with Mental Health and Quality of Life. Autism in Adulthood;2026;8(1):112-126.

Background: Decreased sound tolerance (DST) is an increased sensitivity to sound at levels that would not bother most people. DST is highly prevalent in autistic adults; however, the extent to which DST differs across autistic and non-autistic adults is uncertain. This study explores multiple domains of DST symptoms and the severity of DST symptoms, as well as the behavioral reactions and coping strategies adopted to manage DST in both autistic and non-autistic adults. Lastly relationships between DST, autism characteristics, mental health, and quality of life were explored.Methods: This study used online surveys to investigate the characteristics of DST in 77 autistic and 128 non-autistic adults who self-report DST, as well as the relationship between DST and autistic characteristics, mental health, and quality of life.Results: The results of this study indicated that clinically relevant misophonia, an aversion to specific sounds, was more prevalent in the sample of autistic adults who self-reported DST. Similarly, clinically relevant hyperacusis, a reduced tolerance to everyday sounds at volumes that would not be distressing to most people, was also more prevalent in the sample of autistic adults who self-reported DST. Across the entire sample, misophonia symptoms were associated with more autistic traits and higher anxiety, whereas hyperacusis symptom severity was associated with more autistic traits, higher anxiety and depression symptoms, and poorer quality of life.Conclusion: Although clinical cases of misophonia and hyperacusis were more prevalent in our sample of autistic adults who self-reported DST, these forms of DST may be related in similar ways to mental health and quality of life of both autistic and non-autistic adults. Future work should focus on differentiating the subtypes of DST to facilitate the development of treatments that specifically target the symptoms of each subtype (i.e., misophonia, and hyperacusis) rather than treating DST as a homogeneous problem.Community Brief Why is this an important issue?Many autistic adults find sounds to be distressing. However, we are unsure whether these experiences with sound are similar to the experiences of non-autistic adults. We also don’t know if the distress caused by sound has similar effects on anxiety, depression, and quality of life for autistic and non-autistic adults. What was the purpose of this study?The purpose of this study was to better understand how sounds influence autistic and non-autistic adults who report sounds to be distressing. Specifically we were interested in the types of sounds and general features of sounds that are distressing. We also wanted to know how these adults react to sound and what they try to do to reduce negative reactions to sound. We were interested in how the distress created by sound might be related to autism characteristics, anxiety, depression, and quality of life. What did the researchers do?We had 77 autistic and 94 non-autistic adults who self-reported a decreased tolerance to sound fill out questionnaires online. These questionnaires asked about experiences with sound, autistic characteristics, anxiety, depression, and quality of life. What were the results of the study?The results indicated that misophonia, a dislike of specific trigger sounds, was worse in autistic adults. Hyperacusis, or suffering caused by everyday sounds at a loudness that does not bother most people, was also worse in autistic adults. Misophonia symptoms were related to anxiety in both autistic and non-autistic adults. Hyperacusis symptoms were related to autism characteristics, anxiety, and depression, and a lower quality of life in both autistic and non-autistic adults. What do these findings add to what was already known?These findings tell us that the kinds of sounds that are troublesome and the reactions adults have to sound are qualitatively similar for autistic and non-autistic adults, with autistic adults having more severe symptoms. These findings also tell us that decreased sound tolerance may affect mental health and quality of life. However, as we looked at associations between different variables, we cannot say that decreased sound tolerance is causing poor mental health and reduced quality of life; rather these findings just reveal that they are related.What are potential weaknesses in the study?Our data were collected online, so we could not make sure that our autistic participants had official diagnoses. Online collection also made us unable to test participants’ hearing. Most of our sample was female. We are unsure if this is because more females find sound distressing, or more females are willing to complete online surveys. Lastly, because participants were describing their trouble with sound, we were not objectively measuring reactions to sound; it is possible that the observed findings might be the result of how people chose to describe their experiences. The instruments used to measure hyperacusis and misophonia have not been validated on autistic samples. Future work using measures validated on autistic samples could reveal different patterns of results.How will these findings help autistic adults now or in the future? These findings explain the types and features of sounds that cause the most trouble for autistic people. These findings also suggest that sound may have a big effect on the mental health and quality of life of autistic people. As such, these findings provide important information that can be used to help people to create more sensory-friendly environments that will be of great benefit to autistic people with sound sensitivities.

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10. French B, Cassidy S. “Going Through Life on Hard Mode”—The Experience of Late Diagnosis of Autism and/or ADHD: A Qualitative Study. Autism in Adulthood;2026;8(1):127-136.

Background: In the United Kingdom, more than 2.5 million adults with undiagnosed neurodevelopmental conditions, such as autism and attention-deficit/hyperactivity disorder (ADHD), can face difficulties accessing diagnosis and support. Our qualitative study explores people’s experiences of receiving a diagnosis in adulthood and its impact on their lives.Methods: We conducted semi-structured interviews with seven health care professionals and 13 late-diagnosed adults (5 autistic, 5 with ADHD, and 3 with dual diagnoses) using reflexive thematic analysis.Results: We developed five themes from the analysis representing the journey and factors influencing participants’ experiences of receiving a late diagnosis: (1) the key role of relationships and mental well-being; (2) the wider impact on well-being and lifelong mental health; (3) understanding—the answer to postdiagnosis changes; (4) the flip side of diagnosis—the burden of a label; and (5) are you ready—the importance of timing.Conclusion: Our study demonstrates the multiple impacts a lack of diagnosis has and the many benefits experienced from receiving one. Although a lack of diagnosis can at times have some negative effects, the importance of understanding and the wider impacts on relationships and mental well-being are discussed. Primarily, the emerging concept of being ready and the importance of the right timing highlight an important nuance in the diagnosis journey.Community Brief Why is this an important issue?In the United Kingdom, more than 2.5 million adults with undiagnosed neurodevelopmental conditions such as autism and ADHD often struggle to access diagnosis and support.What was the purpose of this study?This study aimed to explore the experiences of adults receiving a diagnosis of autism or ADHD later in life and how the lack of diagnosis affected them.What did the researchers do?The research involved interviews with 7 health care professionals and 13 late-diagnosed adults (5 with autism, 5 with ADHD, and 3 with both conditions). We conducted these interviews over Teams and included representations from different countries, conditions, and genders to ensure we represented a wide range of experiences.What were the results of the study?Through the analysis, the following five themes were developed from the analysis representing the journey and factors influencing the experiences of receiving a late diagnosis: (1) the key role of relationships and mental well-being; (2) the wider impact on well-being and lifelong mental health; (3) understanding—the answer to postdiagnosis changes; (4) the flip side of diagnosis—the burden of a label; and (5) are you ready—the importance of timing.First, the study highlights the crucial role of relationships and mental well-being in this process. Understanding emerges as an important factor for individuals in navigating postdiagnosis changes. However, the study also sheds light on the flip side of diagnosis—the burden of carrying a label. Finally, the importance of timing was also another significant theme. The study suggests that being ready for the diagnosis and the right timing play a crucial role in the overall journey. This study emphasizes the nuanced impact of the lack of diagnosis and the various benefits that come with receiving one. Although there are instances of negative impacts and despite the challenges, the study emphasizes the positive impacts of diagnosis, emphasizing the need for a comprehensive understanding of the individual’s experiences and the broader context of relationships and mental health.What do these findings add to what was already known?This study adds a more comprehensive view of adults’ experiences, which have not been widely explored in research so far, in terms of the impacts, both negatives and positives, of growing up with autism or ADHD and not knowing.What are potential weaknesses in the study?The study would have benefited from having the voice of close friends or family members too as they might have been able to reflect in a different way on any changes the di gnosis brought.How will these findings help autistic adults now or in the future?These findings reinforce the benefits that can come with early diagnosis, through understanding, finding a community, and better mental health. The study also highlights the potential drawbacks of this and can help autistic adults, as well as health care professionals, understand the process of diagnosis and its potential impact (negative or positive). It can help autistic adults prepare themselves for the diagnosis process by further understanding what it might mean and how it would impact them, giving them more information.

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