1. Kirby A, McDonald K. Call for Special Issue Papers : Autism in Adulthood : The State of the Science. Autism in Adulthood ;2020 (2020/06/01) ;2(2):101-101.

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2. Nicolaidis C. Call for Papers : Autism in Adulthood. Autism in Adulthood ;2020 (2020/06/01) ;2(2):102-102.

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3. den Houting J. Stepping Out of Isolation : Autistic People and COVID-19. Autism in Adulthood ;2020 (2020/06/01) ;2(2):103-105.

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4. Cassidy SA, Nicolaidis C, Davies B, Rosa SDR, Eisenman D, Onaiwu MG, Kapp SK, Kripke CC, Rodgers J, Waisman TC. An Expert Discussion on Autism in the COVID-19 Pandemic. Autism in Adulthood ;2020 (2020/06/01) ;2(2):106-117.

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5. Kripke-Ludwig R. Believe in Me : Insights of a Nonspeaking College-Bound Autistic. Autism in Adulthood ;2020 (2020/06/01) ;2(2):118-120.

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6. Crompton CJ, Michael C, Dawson M, Fletcher-Watson S. Residential Care for Older Autistic Adults : Insights from Three Multiexpert Summits. Autism in Adulthood ;2020 (2020/06/01) ;2(2):121-127.

As autistic people get older, they may suffer increasingly with poor health and as a result may transition to residential care. Very little is known about the support needs of older autistic adults in general, or their specific needs within residential care services. As such, it is impossible to determine whether existing residential services are meeting the needs of older autistic adults. A first step to resolving this issue is to determine what are the priority topics for research and practice in this area. A multidisciplinary expert group was formed, and three meetings were held in 2018. Group members included older autistic adults, the immediate family members of older autistic adults (siblings and children), service providers, clinicians, and researchers based in the United Kingdom. Their aim was to progress the research and practice agenda in residential care for older autistic adults by identifying priority topics for research and recommendations for practice and policy. Ten key topics were identified, including supporting transitions to residential care, training for staff, and supporting physical health. This article summarizes the discussions around these topics and highlights areas for future research and practice development. Lay Summary Why is this topic important ? We know very little about the support needs of older autistic adults, or their specific needs if they have to enter residential care. We do not know whether existing residential services are providing autism-appropriate support. What is the purpose of this article ? To identify priority topics for future research and practice development relating to older autistic adults in residential care. What did the researchers do ? We formed an expert group, including older autistic people, family members, service providers, clinicians, and researchers, to discuss how residential care is run now and what research and recommendations are needed to adjust residential care to meet autistic needs. What did the expert group recommend ? We identified 10 topics, where important adjustments for the needs of autistic older people may need to be made in existing residential care. These are as follows : managing transitions into residential care ; autism training for residential care staff ; recognizing and respecting autistic differences and understanding autistic well-being ; supporting physical health ; the sensory environment and sensory processing ; design principles ; creating community and belonging ; autonomy and choice ; advocacy ; and evaluating care quality. We hope that identifying these 10 priority topics will act as a starting point for researchers to pursue these important questions. What are potential weaknesses in these recommendations ? Although we included representatives from many areas of the autism community, we were not able to directly include any autistic people currently living in residential care, although we hope that through this work their experiences will be centered in future research. In addition, we did not include the direct perspectives of autistic adults with high support needs (e.g., intellectual disability and communication difficulties) although these perspectives were conveyed by proxy representatives such as siblings and specialist service providers. How will these recommendations help autistic adults now or in the future ? We believe these insights can guide further research with residential care service providers, determining how to provide for the increasing number of older autistic people living in residential care homes. The well-being of these residents must be equivalent to the standard for their nonautistic peer group.

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7. Lebenhagen C. Including Speaking and Nonspeaking Autistic Voice in Research. Autism in Adulthood ;2019 (2020/06/01) ;2(2):128-131.

Autistic individuals frequently report that their experiences are minimized or reinterpreted by well-meaning nonautistic parents, researchers, educators, and allies. Although the inclusion of autistic voice is improving, obstacles persist, particularly in research with individuals who might be described as non- or minimally speaking. In this perspective piece, I present three arguments : (1) ableist assumptions and practices that equate speaking voice with rational voice have led to the exclusion of autistic voice in research ; (2) technologies such as augmentative and alternative communication, including computers and tablets, can be both emancipatory and oppressive ; and (3) researchers who commit to the practice of ethical listening improve opportunities for non- or minimally speaking autistic individuals to participate in research. Lay summary 1.?Why is the inclusion of non- and minimally speaking voice in research important ? Although the inclusion of autistic voice in research is improving, non- and minimally speaking autistic voice is often left out. Autistic self-advocates challenge researchers to make sure that they consider the authentic experiences and diverse perspectives of non- and minimally speaking autistic individuals. Non- and minimally speaking individuals also remind nonautistic researchers that there are ways to participate in research besides with spoken words. This can broaden their own thinking and benefit their research. It also helps make sure that research topics and experiences are positive and meaningful to autistic individuals. 2.?How can augmentative and alternative communication be both emancipatory and oppressive ? There are many reported benefits to using augmentative and alternative communication (AAC), including improved opportunities for non- or minimally speaking autistic individuals to communicate their thoughts and experiences to researchers. However, since the framework of AAC is built on an ableist assumption that verbal speech is better than other forms of communication, non- or minimally speaking autistic individuals may feel that their natural language is less valued. 3.?How can ethical listening be used to support the inclusion of autistic voice in research ? Ethical listening happens when a person pays attention to all of the ways someone is communicating, including both speaking and nonspeaking forms of language. For example, they pay attention to a person’s gestures and nonspeech sounds. Ethical listening improves the inclusion of autistic voice in research because it values nonspoken forms of communication and demonstrates to autistic people that they and their perspectives are important.

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8. Raymaker DM, Teo AR, Steckler NA, Lentz B, Scharer M, Delos Santos A, Kapp SK, Hunter M, Joyce A, Nicolaidis C. “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew” : Defining Autistic Burnout. Autism in Adulthood ;2020 (2020/06/01) ;2(2):132-143.

Background : Although autistic adults often discuss experiencing ?autistic burnout ? and attribute serious negative outcomes to it, the concept is almost completely absent from the academic and clinical literature. Methods : We used a community-based participatory research approach to conduct a thematic analysis of 19 interviews and 19 public Internet sources to understand and characterize autistic burnout. Interview participants were autistic adults who identified as having been professionally diagnosed with an autism spectrum condition. We conducted a thematic analysis, using a hybrid inductive ?deductive approach, at semantic and latent levels, through a critical paradigm. We addressed trustworthiness through multiple coders, peer debriefing, and examination of contradictions. Results : Autistic adults described the primary characteristics of autistic burnout as chronic exhaustion, loss of skills, and reduced tolerance to stimulus. They described burnout as happening because of life stressors that added to the cumulative load they experienced, and barriers to support that created an inability to obtain relief from the load. These pressures caused expectations to outweigh abilities resulting in autistic burnout. Autistic adults described negative impacts on their health, capacity for independent living, and quality of life, including suicidal behavior. They also discussed a lack of empathy from neurotypical people and described acceptance and social support, time off/reduced expectations, and doing things in an autistic way/unmasking as associated in their experiences with recovery from autistic burnout. Conclusions : Autistic burnout appears to be a phenomenon distinct from occupational burnout or clinical depression. Better understanding autistic burnout could lead to ways to recognize, relieve, or prevent it, including highlighting the potential dangers of teaching autistic people to mask or camouflage their autistic traits, and including burnout education in suicide prevention programs. These findings highlight the need to reduce discrimination and stigma related to autism and disability. Lay summary Why was this study done ? Autistic burnout is talked about a lot by autistic people but has not been formally addressed by researchers. It is an important issue for the autistic community because it is described as leading to distress ; loss of work, school, health, and quality of life ; and even suicidal behavior. What was the purpose of this study ? This study aimed to characterize autistic burnout, understand what it is like, what people think causes it, and what helps people recover from or prevent it. It is a first step in starting to understand autistic burnout well enough to address it. What did the researchers do ? Our research group ?the Academic Autism Spectrum Partnership in Research and Education ?used a community-based participatory research approach with the autistic community in all stages of the study. We analyzed 9 interviews from our study on employment, 10 interviews about autistic burnout, and 19 public Internet sources (five in-depth). We recruited in the United States by publicizing on social media, by word of mouth, and through community connections. When analyzing interviews, we took what people said at face value and in deeper social context, and looked for strong themes across data. What were the results of the study ? The primary characteristics of autistic burnout were chronic exhaustion, loss of skills, and reduced tolerance to stimulus. Participants described burnout as happening because of life stressors that added to the cumulative load they experienced, and barriers to support that created an inability to obtain relief from the load. These pressures caused expectations to outweigh abilities resulting in autistic burnout. From this we created a definition : Autistic burnout is a syndrome conceptualized as resulting from chronic life stress and a mismatch of expectations and abilities without adequate supports. It is characterized by pervasive, long-term (typically 3+ months) exhaustion, loss of f nction, and reduced tolerance to stimulus. Participants described negative impacts on their lives, including health, capacity for independent living, and quality of life, including suicidal behavior. They also discussed a lack of empathy from neurotypical people. People had ideas for recovering from autistic burnout including acceptance and social support, time off/reduced expectations, and doing things in an autistic way/unmasking. How do these findings add to what was already known ? We now have data that autistic burnout refers to a clear set of characteristics, and is different from workplace burnout and clinical depression. We have the start of a model for why autistic burnout might happen. We know that people have been able to recover from autistic burnout and have some insights into how. What are the potential weaknesses in the study ? This was a small exploratory study with a convenience sample. Although we were able to bring in some diversity by using three data sources, future work would benefit from interviewing a wider range of participants, especially those who are not white, have higher support needs, and have either very high or very low educational attainment. More research is needed to understand how to measure, prevent, and treat autistic burnout. How will these findings help autistic adults now or in the future ? These findings validate the experience of autistic adults. Understanding autistic burnout could lead to ways to help relieve it or prevent it. The findings may help therapists and other practitioners recognize autistic burnout, and the potential dangers of teaching autistic people to mask autistic traits. Suicide prevention programs should consider the potential role of burnout. These findings highlight the need to reduce discrimination and stigma around autism and disability.

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9. Dickter CL, Burk JA, Zeman JL, Taylor SC. Implicit and Explicit Attitudes Toward Autistic Adults. Autism in Adulthood ;2020 (2020/06/01) ;2(2):144-151.

Background : Research examining attitudes toward autistic adults has relied on explicit self-report measures, which may be susceptible to socially desirable responding. Because implicit attitudes predict behavioral rejection, understanding both implicit and explicit attitudes toward autistic adults is important. Furthermore, previous research has almost exclusively examined attitudes toward autistic children and has not investigated attitudes toward autistic adults who may also experience prejudice from their peers. Methods : We created an implicit association test (IAT) to examine implicit attitudes toward autistic adults. In Study 1, we examined 94 neurotypical adults’ (mean [M]age ?= ?31.37 years) implicit attitudes and explicit attitudes toward autistic adults as well as autistic behaviors. In Study 2 (n ?= ?137 ; Mage ?= ?33.43 years), we assessed the same variables using an IAT with descriptive rather than stereotypical words. Results : Participants from both studies demonstrated negative implicit attitudes but positive explicit attitudes toward autistic adults. In Study 2, analyses examining self-reported traits related to autism revealed that more autistic behaviors were associated with less implicit bias. Conclusions : These findings may help explain why autistic adults report discrimination from their peers. The results suggest that there may be benefits in modifying interventions that reduce implicit bias toward other marginalized groups for use with implicit bias against autistic adults. Lay summary Why was this study done ? The goal of this study was to understand how neurotypical adults in the United States feel and think about autistic adults. Negative attitudes can lead to discrimination against autistic adults or to harmful interactions between autistic and neurotypical adults. Although research has previously examined the attitudes that neurotypical adults have toward autistic adults, most of this work has directly asked people about their attitudes, assessing their explicit, or conscious, attitudes. Neurotypical adults, however, may not be able or willing to admit that they have negative attitudes toward autistic adults. Therefore, it is important to evaluate implicit attitudes, which are underlying attitudes at the unconscious level of awareness. What was the purpose of this study ? This study investigated the implicit and explicit attitudes that neurotypical adults in the general U.S. population have about autistic adults. Assessing both kinds of attitudes is important because each type of attitude predicts different sorts of behaviors toward and judgments of individuals. What did the researchers do ? We conducted this study online using a crowdsourcing method of data collection (Amazon’s Mechanical Turk) that gave us access to adults throughout the United States. We developed and administered a reaction-time task to examine implicit attitudes toward autistic adults. In this task, participants rapidly categorized words associated with autism and words not associated with autism as being ?good ? or ?bad.? We assessed explicit attitudes with questions about people’s knowledge of autism and their liking for autistic adults. Study 1 measured 94 neurotypical adults’ (average age ?= ?31.37 years) implicit and explicit attitudes toward autistic adults ; Study 2 measured 137 neurotypical adults’ (average age ?= ?33.43 years) implicit and explicit attitudes. Whereas Study 1’s implicit task used words associated with stereotypes about autistic adults (e.g., extraverted, independent), Study 2 used nonstereotypical words associated with autism (e.g., autistic, spectrum). What were the results of the studies ? Participants in both studies reported positive explicit attitudes but negative implicit attitudes toward autistic adults. In one study, we also found that neurotypical adults with more autistic traits themselves had more positive implicit attitudes toward autistic adults. What do these findings add to what was already known ? Although previous research examined neurotypical adults’ explicit attitudes toward autistic adults the current study demonstrated that neurotypical adults hold negative implicit attitudes toward autistic adults. These findings may help explain why autistic adults experience discrimination from neurotypical adults. Furthermore, our findings suggest that having more autistic traits can lead to a better understanding of the behaviors associated with autism. What are the potential weaknesses in the study ? Limitations of the study were that we collected the data online rather than in person and we only included neurotypical adults as participants. How will these findings help autistic adults now or in the future ? These results shed light on underlying reasons for the potential negative judgments and discrimination that autistic adults face from neurotypical adults. These findings should encourage policy makers to design and implement training programs to reduce neurotypical adults’ negative attitudes toward autistic adults.

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10. Jovevska S, Richdale AL, Lawson LP, Uljarević M, Arnold SRC, Trollor JN. Sleep Quality in Autism from Adolescence to Old Age. Autism in Adulthood ;2020 (2020/06/01) ;2(2):152-162.

Background : Sleep problems are common in autism from early childhood. Although research suggests that poor sleep continues at least into early middle age, the pattern of sleep problems has rarely been characterized beyond childhood. The aim of this study was to examine sleep quality from adolescence to old age in autistic individuals as compared with age-matched non-autistic comparison groups from the general population. Methods : Participants ranged from 15 to 80 years ; there were 297 participants in the autistic group (mean [M]age ?= ?34.36 years, standard deviation [SD] ?= ?15.24), and the comparison group had 233 participants (Mage ?= ?33.01 years, SD ?= ?15.53). Sleep quality, sleep onset latency (SoL), total night sleep, and sleep efficiency as measured by Pittsburgh Sleep Quality Index were compared between groups and across age groups (15 ?19, 20 ?39, 40 ?59, 60+ years). Five predictors of sleep quality (autistic traits, mental health condition, medication, employment, and sex) were also examined. Results : Overall, problematic sleep was more common for the autistic participants (63.7%) than the comparison group (46.4%), and autistic participants had poorer sleep quality and longer SoL (all p ?
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