Autism in Adulthood – 4-4 – December 2022 : Autism and Intersectionality

Revues de sommaires

1. Lopez K. Intersectionality on the Horizon: Exploring Autism in Adulthood from a Unique Vantage Point. Autism in Adulthood. 2022; 4(4): 255-7.

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2. Lopez K, Nicolaidis C, Garcia A, Waisman TC, Cascio MA, Feng B. An Expert Roundtable Discussion on Intersectionality and Autism in Adulthood. Autism in Adulthood. 2022; 4(4): 258-64.

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3. Burks-Abbott G. A Theory of Mine: My Perspective on Perspective-Taking. Autism in Adulthood. 2022; 4(4): 265-7.

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4. Abubakare O. An Unexpected Autistic. Autism in Adulthood. 2022; 4(4): 268-70.

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5. Malone KM, Pearson JN, Palazzo KN, Manns LD, Rivera AQ, Mason Martin DL. The Scholarly Neglect of Black Autistic Adults in Autism Research. Autism in Adulthood. 2022; 4(4): 271-80.

Black autistic individuals, regardless of age, have not been centered in autism research. Instead, they often exist on the margins?on the periphery of autism research. In fact, Black autistic adults are largely absent from the literature. Most participants in autism research are majority-white autistic individuals and families. In this conceptual article, we use intersectionality and Dis/ability Studies and Critical Race Theory theories to contextualize Black autistic adults’ experiences. Second, we argue that systemic disparities and methodological concerns are two contributors to the scholarly neglect of Black autistic adults in autism research. Third, we provide guidelines to support researchers in moving from neglect to inclusive research with Black autistic adults. Community brief Why is this topic important? The experiences of Black autistic adults are not well represented in research. The lack of cultural responsiveness in autism research ignores the nuanced experiences of Black autistic adults, which limits the ability to understand their experiences and effectively meet their needs. What is the purpose of this article? The purpose of this article is to highlight the void in autism research concerning Black autistic adults. This article is a call to action for research that is inclusive of Black autistic adults. Specifically, we (1) use intersectionality and Dis/ability Studies and Critical Race Theory theories to contextualize Black autistic adults’ experiences, (2) describe the systemic disparities (e.g., health care) that contribute to the scholarly neglect of Black autistic adults, and (3) provide guidelines to support researchers in moving from neglect to inclusive research with Black autistic adults. What personal or professional perspectives do the authors bring to this topic? The first author identifies as a white, non-binary, doctoral student in Applied Developmental Science and Special Education. The second author identifies as a Black, cisgender female, Assistant Professor of Special Education. The third author identifies as a white, non-binary, autistic autism researcher. The fourth author identifies as a Black, cisgender male, doctoral student in Educational Equity. The fifth author identifies as a black, cisgender female, doctoral student in Educational Equity. The sixth author identifies as a Black, cisgender female, dual-licensed special education teacher, and doctoral student in Educational Equity. Although none of the authors embody the lived experience of being both Black and autistic, our research team is committed to supporting and advocating for Black autistic individuals through our ongoing professional development and dedication to strength-based, and identity-centered research. What is already known about this topic? Although we know about disparities in Black autistic children, little research has focused on the experiences of Black autistic adults. Most of what we know about autistic adults is based on the experiences of white participants. What do the authors recommend? First, we recommend that researchers work to understand how their own perspectives, values, and experiences shape their research (e.g., cultural reciprocity). Second, we recommend that researchers intentionally include the perspectives and experiences of Black autistic adults. This can include collaborating on research with Black autistic scholars and highlighting autistic and Black autistic led research. Finally, we advocate for systemic changes in institutions of higher education (e.g., reduce barriers to admission) and in communities (e.g., culturally responsive supports) to better address the inequities that impact the representation of Black autistic adults in autism research. How will these recommendations help autistic adults now or in the future? These recommendations will prepare researchers with strategies to effectively build partnerships with Black autistic adults in ways that honor their knowledge and contributions to the field. As a result, Black autistic adults will have more representation in autis research, both as participants and as leading scholars in the field. We hope that more inclusive representation of Black autistic adults will lead to more culturally responsive approaches in adult autism research.

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6. Mallipeddi NV, VanDaalen RA. Intersectionality Within Critical Autism Studies: A Narrative Review. Autism in Adulthood. 2021; 4(4): 281-9.

The aim of this narrative review was to examine intersectionality within critical autism studies. A growing body of evidence has demonstrated the importance of intersectional frameworks in highlighting the diverse experiences of marginalized communities. Many disability studies researchers investigated intersectionality to elucidate the impact of race, gender, sexuality, class, and other constructs on disability identification. Within critical autism studies, a field that emerged to challenge the deficit-laden, pathologizing autism discourses favored by the medical community, intersectionality has started to become an integral component of the literature. This review highlights intersectional frameworks utilized to explore autism in both academic and nonacademic contexts, to provide a foundation for future study. Upon analysis, we found overarching themes regarding the explicit, implicit, and descriptive approaches to intersectionality, racial and gender biases within critical autism studies, and the multidisciplinary nature of intersectionality and critical autism studies. We finish the review with recommendations for how to more fully address the experiences of all autistic people?particularly of racial, gender, and sexual minority individuals?in future study. Our recommendations include utilizing intersectionality as an analytical lens for describing previously overlooked phenomena and questioning central tenets of methodology and processes, including developing research questions, analyzing data, and writing results. Community briefs Why is this topic important? Intersectionality means that many different social influences make up a person’s experiences. Examples of these social influences are gender and sexism, ethnicity and racism, and disability and ableism. This topic is important because different autistic people may have different experiences depending on these other social factors. Studying intersectionality helps us to understand these differences and better serve those autistic communities that may be ignored. What is the purpose of this article? We looked at how authors of published studies and community projects have thought about intersectionality in autistic communities. What personal or professional perspectives do the researchers bring to this topic? Both authors have invisible disabilities. We have both done research on disability and social influences, and we have worked with people in disability communities, including autistic communities. We have also noticed how our gender, race, and sexual orientation have affected how we experience our disabilities. What results did the researchers find? We found three main ways that authors talked about intersectionality. (1) Sometimes authors directly talk about intersectionality. This means that some authors use the idea of intersectionality to help them think of a research question or to help them understand their data. In these cases, authors use the word ?intersectionality? in their articles. (2) Sometimes authors talk about intersectionality, but not directly. This means that some authors do not use the word ?intersectionality? to talk about their research, but they still use similar ideas. For example, sometimes authors looked at what it is like to be an autistic woman. This topic is intersectional because it talks about two different social influences (autism and gender). However, the authors did not directly write that it was intersectional. (3) Finally, sometimes authors do not talk about intersectionality, but their study can be used as a starting point for talking about intersectionality later. For example, sometimes authors look at differences in whether people are diagnosed with autism, based on their race. Research such as this can be helpful because other researchers can use it to make studies to learn about why differences between autistic groups happen. What do the researchers recommend? We recommend that researchers in many fields and people working with autistic communities think about how intersectionality and social influences affect autistic people. They can do this when thinking of research questions, understanding their data, and writing about their results. We also recommend that researchers think more about racial, gender, and sexual minority group experiences within the autistic community. This is important because sometimes researchers or stakeholders have forgotten about certain groups of autistic people. How will these recommendations help autistic adults now or in the future? Thinking about intersectionality can help people understand autistic people’s different experiences, especially in terms of how these experiences are affected by social influences. We hope that our article leads to research that makes life better for all autistic people and fits better for autistic people who have been ignored or forgotten about in some research or advocacy projects.

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7. Ames JL, Morgan EH, Onaiwu MG, Qian Y, Massolo ML, Croen LA. Racial/Ethnic Differences in Psychiatric and Medical Diagnoses Among Autistic Adults. Autism in Adulthood. 2022; 4(4): 290-305.

Background: Racial/ethnic disparities in access to diagnostic services are pervasive for autistic children. However, a few studies have examined racial/ethnic health disparities among autistic adults, who commonly experience higher rates of health conditions than non-autistic adults. We aimed at examining the intersection of autism and race/ethnicity in association with psychiatric and medical diagnoses. Methods: The study population included adult members of Kaiser Permanente Northern California enrolled from 2008 to 2012. We ascertained 1507 adults who had an autism diagnosis documented in their electronic medical records. We sampled a matched control group of adults without an autism diagnosis (N?=?15,070) at a 10:1 ratio. Our sample was 46% White, 17% Hispanic, 16% Asian, 7% Black, and 14% other race/ethnicity. We compared health diagnoses (a) between autistic and non-autistic adults within strata of race/ethnicity and (b) across race/ethnicity within strata of autistic and non-autistic adults. Lastly, we examined the interaction between autism and race/ethnicity on both multiplicative and additive scales. Results: Autistic adults were more likely to be diagnosed with most medical and psychiatric conditions compared with their non-autistic counterparts of the same race/ethnicity. Among autistic adults, Black, Hispanic, and Asian adults were less likely to be diagnosed with psychiatric conditions and Black and Hispanic autistic adults were more likely to be diagnosed with obesity than their White counterparts. In interaction models, we found that adults who were Black and autistic were disproportionately less likely to be diagnosed with psychiatric conditions and autoimmune disease and more likely to be diagnosed with hypertension than expected. Conclusion: Health vulnerabilities may be compounded at the intersection of autism and race/ethnicity. Future research should continue to apply an intersectional lens toward understanding and addressing these disparities. Our findings likely underestimate the health disparities that exist in uninsured autistic adults and those living in other parts of the United States. Community brief Why is this an important issue? Very few studies have looked at how the combination of a person’s autistic and racial/ethnic identities affects their health in adulthood. Dual experiences of ableism and structural racism may have a larger negative effect on the health of autistic people of color than either one experience alone. It is important to identify potential health disparities so that they can be addressed. What is the purpose of this study? We wanted to understand whether autistic adults of color were more likely to be diagnosed with medical and psychiatric conditions than non-autistic and/or White peers. What did the researchers do? We studied a diverse group of 1507 autistic adults and 15,070 non-autistic adults who all received health care from the same large, health plan in California. We examined electronic health records to determine whether diagnoses of health conditions differed by autism status and race/ethnicity. We then looked at whether autistic people of color were disproportionately diagnosed with these conditions compared with other groups. What were the results of the study? Within every racial/ethnic group, autistic adults were more likely than non-autistic adults to be diagnosed with most medical and psychiatric conditions. Among the autistic group, Black, Hispanic, and Asian adults were less likely to be diagnosed with psychiatric conditions compared with White adults. We saw similar differences in psychiatric diagnoses by race/ethnicity among non-autistic adults. Further, the diagnostic patterns among adults who were autistic and Black suggested that this group may experience unique difficulties receiving mental health and autoimmune diagnoses. They also may be at a higher risk of hypertension. What do these findings add to what was already known? Previous studies have found racial/ethnic disparities in both mental health and access to health care among autisti children. This study suggests that racial/ethnic disparities, especially in mental health care, may also exist among autistic adults. What are potential weaknesses in the study? As a broad social label, race/ethnicity does not tell us much about people’s lived experiences. Future studies should replace race/ethnicity with more useful measures of our social environment, including economic opportunity and experiences of structural racism. In addition, health records may imperfectly represent the actual occurrence of health conditions. For example, we cannot tell from this study whether autistic people of color actually experience fewer psychiatric problems, are less likely to visit the doctor, or are more likely to have their problems missed by doctors. Lastly, because our findings are from an insured population, we have likely underestimated the health disparities that exist among autistic adults who do not have consistent insurance coverage or health care access. How will these findings help autistic adults now or in the future? We hope this study highlights the need for greater attention to the unique health risks at the intersection of autism and race/ethnicity in adults. Through more research and advocacy, we can increase awareness and understanding of these potential health disparities. This will lead to changes that promote more equal access to health care and greater well-being among autistic people of color.

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8. Davis A, Solomon M, Belcher H. Examination of Race and Autism Intersectionality Among African American/Black Young Adults. Autism in Adulthood. 2022; 4(4): 306-14.

Background: African American/Black (AA/B) young adults with diagnoses of autism spectrum disorders rarely are studied in a way that acknowledges both their racial identity and their autism diagnosis. Little is known about intersectional oppression in the lives of these young adults. Early adulthood is a time when a young people of color may come to terms with a society that may not treat them fairly and equally due to their race. Autistic AA/B young adults may be even more vulnerable to stress and psychological disempowerment due to the added impact of negative experiences of being Black and having an autism diagnosis. Methods: Thirty-two autistic and 30 non-autistic AA/B young adults took part in an online survey examining risk factors of everyday discrimination, perceived stress and potential protective factors of psychological empowerment, and Black identity. Differences in score measures for the autistic and non-autistic samples were examined along with the predictors of perceived stress assessed. Frequencies of intersectional discrimination experiences were also examined. Results: Autistic AA/B participants reported significantly less everyday discriminatory experiences than non-autistic AA/B participants, whereas perceived stress was not significantly different between the two groups. The majority of non-autistic AA/B participants endorsed race as their prime source of experiences of discrimination, whereas autistic AA/B participants also cited being autistic as a major contributor to reports of discrimination. Although the autistic group had significantly lower reports of self-determination, they reported higher on the Black identity, private regard scale, pertaining to feelings about group membership, which can be considered a protective factor. There is heterogeneity in reasons for discriminatory experiences for autistic AA/B young adults whereby some of the participants (12%?30%) endorsed race + disability as dual reasons for experiencing regular discrimination. Conclusions: Mental health clinicians and other direct service providers working with autistic AA/B young adults should understand that intersecting identities of race and disability may be at play when they are working with these individuals, and that treatment should consider these factors. Community brief Why is this an important issue? The experiences of autistic African American/Black adults need more attention. There is not much research looking at intersecting identities of race and disability. What was the purpose of this study? The purpose of this study was to examine race + disability intersectionality in discrimination experiences and to examine how risk factors and protective factors vary between autistic and non-autistic African American/Black young adults. What did the researchers do? The researchers conducted an online study comparing the experiences of autistic and non-autistic young adults who identified as African American/Black. Thirty-two autistic and 30 non-autistic African American/Black young adults took part in the study looking at experiences of discrimination, stress, Black identity, and self-determination. What were the results of the study? Autistic African American/Black participants reported fewer everyday discriminatory experiences than non-autistic African American/Black participants, but perceived stress was not different between the two groups. Most of the non-autistic African American/Black participants listed race as their prime source of discrimination experiences, whereas autistic African American/Black participants also cited being autistic as a major contributor to reports of discrimination. Reasons for discriminatory experiences for autistic African American/Black young adults are varied, with up to 30% relating to experiences of discrimination being dual issues of race and disability. What do these findings add to what was already known? There is a lot of research on the experiences of African African/Black people facing social adversities due to race. This study adds to what is known by shedding light on iscrimination experiences of autistic African American/Black young adults. The findings show the need for both societal change and trauma-informed practices with autistic individuals who are negatively impacted by a society that views them through a racialized lens. What are potential weaknesses in the study? This study is not reflective of all autistic African American/Black people. Individuals who took part in the study may have self-selected due to interest in the topic. In addition, gender was not taken into account for this study. How will these findings help autistic adults now or in the future? Knowing more about autistic African American/Black young adults’ experiences can help inform advocacy to reduce discrimination and interventions to promote resiliency. The results of this study also highlight the importance of studying intersectionality in disability research. More research is needed about the experiences of autistic African American/Black young adults.

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9. Cohen SR, Joseph K, Levinson S, Blacher J, Eisenhower A. “My Autism Is My Own”: Autistic Identity and Intersectionality in the School Context. Autism in Adulthood. 2022; 4(4): 315-27.

Background: School is an important context for identity development across childhood and adolescence. These formative experiences impact adulthood. Minimal research has examined first-person autistic perspectives of how school experiences shape autistic identity as well as other intersecting identities. In this study, we examined the school messages that autistic individuals received and how individuals engaged with these external messages to formulate their identities. Methods: Ten U.S.-based autistic adolescents and adults ages 15?35 participated in qualitative interviews about their elementary through secondary school experiences, interactions with teachers and peers, and how these shaped their identities. Two interviewees also engaged in three follow-up interviews each for member checking and further data gathering. Using a critical constructivist approach informed by grounded theory, we coded interviews inductively. We ensured the trustworthiness of data through peer debriefing, reflexive journaling, memoing, and member checking. Results: In the school context, autistic students received stigmatizing messages from teachers and peers regarding their autism. These messages varied in relation to students’ other identities, including race and gender. Participants felt that, following autism disclosure, teachers viewed them narrowly through an autism lens. Participants actively resisted these negative messages from teachers and peers by reclaiming their autistic identity. They reframed and redefined their autistic identity, embraced their autism-related strengths, and actively made choices about how, when, and to whom to disclose their autism. Decisions around autism disclosure intersected with decisions to emphasize other identities such as race or mental health, especially when these identities were more visible or more acceptable to others. Conclusions: The school context conveyed powerful, stigmatizing messages around autism. In response, autistic students actively reclaimed and shaped their identities to prioritize a positive, empowered sense of self. Findings show a need for educators to model positive perceptions of autism, build an inclusive school community, and advocate for autistic representation in schools to facilitate autism-affirming messages. Community brief What was the purpose of this study? This study examined how autistic adolescents’ and adults’ school experiences affected their identities including autism, race, gender, and sexuality. We explored how teachers’ and peers’ messages impacted autistic students’ views of themselves and how participants’ experiences with autism differed by race, gender, mental health, and other identities. What did the researchers do? We interviewed 10 autistic adolescents and adults ages 15?35 in the United States and conducted 3 follow-up interviews with 2 participants. Participants had diverse identities across gender, race, and sexuality. Participants answered questions about their autistic identity, their school experiences, and interactions with teachers and peers. We read and analyzed interviews to look for common themes. What were the results of the study? Participants reported receiving negative messages about autism from teachers and peers in school. Participants felt that teachers often treated them differently than other students, seeing only their autism and not seeing other aspects of their identity. Autistic students’ gender and race seemed to also affect how their teachers and peers treated them. For example, autistic women and people of color often described negative experiences related to their teachers’ biases about gender or race. At the same time, autistic participants resisted these negative ideas. They held positive views and saw autism as bringing strengths, such as helping them learn. Participants believed that autistic identity looks different for each person and they were careful in deciding when to tell someone that they were autistic. They emphasized their autistic identity less than other identities that were more visible (e.g., race) o more acceptable to others (e.g., mental health problems). What do these findings add to what was already known? Participants were vocal in rejecting negative messages from teachers and peers. They formed their own positive opinions about autism. Most past research does not look at autistic people’s other identities, such as race and gender, but we did: we found that autistic students with other stigmatized identities, such as girls and people of color, reported especially negative treatment in school. What are potential weaknesses in the study? With a small sample, we could not find patterns by gender or race. We did not always ask every participant about how their other identities, such as sexuality, race, or gender, were related to their autistic identity. If we had done so, we may have heard more details from some participants. We also did not have any participants with high communication support needs, and so, we could not include their experiences. As the researchers are all nonautistic, we may have interpreted people’s responses differently from autistic people’s experiences. How will these findings help autistic adults now or in the future? Teacher and peer messages can negatively affect how autistic youth view themselves and their autistic identity. Teachers should be trained to affirm and support autistic students. Findings also showed that autistic students and their peers learn negative ideas about autism early. To address these biases, we need to educate all students about autism.

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10. Digard BG, Davis R, Stanfield A, Sorace A, Fletcher-Watson S. “The Languages That You Know Draw the Boundary of Your World”: A Thematic Analysis of the Experiences of Autistic Bilingual Adults Living in the United Kingdom. Autism in Adulthood. 2022; 4(4): 328-39.

Background: Although being bilingual (knowing two or more languages) is becoming a more common experience globally, little is known about the combined experience of bilingualism and autism. Research currently available focuses on quantifying language and cognitive development, and the only two qualitative accounts of first-hand experiences are from either bilingual children or highly multilingual adults (with four languages or more), which may not represent the wider autistic bilingual population. All other accounts focus on parents or practitioners. This qualitative study reports the experiences of autistic bi- and multilingual adults, focusing on barriers and enablers to language learning and the reported benefits of bilingualism. Methods: Thirty-nine U.K.-based autistic bilingual adults (41% female, mean age?=?33.2 years, range?=?16?61) with knowledge of two to seven languages (mean?=?3.6, standard deviation?=?1.4) completed an online Demographic and Language Questionnaire, including three open-ended questions about the interplay between autism and bilingualism. A thematic analysis was conducted on the responses to these open-ended questions. Results: Participants perceived many opportunities and benefits brought by bilingualism, in terms of relationships, hobbies, mobility, employment, education, and cultural insight. Respondents reported social communication as being a major benefit of being bilingual, and discussed how bilingualism had broadened their mindset, while identifying factors that had enabled or challenged their language learning journey. Conclusions: This study builds upon the few reports available to highlight the experiences that are shared by autistic bilingual people regardless of the number of languages they know. It is the first study to report the perspectives of U.K.-based autistic bilingual adults who, in most cases, grew up in a bilingual environment. Accounts of the factors that can facilitate or hinder language learning will inform the development of strategies to better support autistic people. These findings have implications for bilingual families and practitioners supporting autistic bilingual people. Community brief Why is this an important issue? At least half the world’s population is bilingual or lives in a bilingual environment. However, the experiences of autistic bilingual people are rarely represented or acknowledged. So far, research in this field has concentrated primarily on parent perspectives and on the effects of bilingualism for autistic children’s skills. Only one study to date has focused on understanding the experiences of autistic bilingual adults themselves, but this research focused on multilinguals with four or more languages. It is essential to represent the whole autistic bi- or multilingual community, including those with two or three languages. What was the purpose of this study? The study explored the experiences of autistic bilingual people, focusing on the perceived benefits of bilingualism; the shared experiences of autism, bilingualism, especially regarding identity; and the elements that make language learning easier or more difficult. What did the researchers do? Thirty-nine autistic bilingual adults completed an online questionnaire. The questionnaire included quantitative questions about the participants’ language profile, and open-ended questions about their experiences of being autistic and bilingual. The answers were analyzed and summarized using a method called thematic analysis. What were the results of the study? Participants reported that being bilingual had shaped their ability to communicate socially; it had helped them to understand the perspectives of others, and better express themselves. Participants also identified many additional opportunities and benefits of bilingualism in terms of relationships, hobbies, mobility, employment, education, and cultural insight. They discussed how bilingualism had influenced their self-understanding in terms of increased awareness of their own skills, and it had contributed to a broadened mindset. Par icipants also listed several difficulties in becoming bilingual that they considered linked to being autistic. Participants highlighted several elements that had made their language learning easier or harder, including the learning environment, opportunities for practice, or specific language competencies. What do these findings add to what was already known? Previous studies describing the experiences of autistic bilingual people only represented people with four or more languages, and most of these studies only involved one or two people. This study is more representative of the wider autistic bilingual population. It shows that autistic people benefit from bilingualism in their daily life, even when they know ?only? two languages. It highlights that being bilingual is a part of autistic bilingual people’s identity. It reports that different autistic people need different learning strategies to best learn additional languages. What are potential weaknesses in the study? Participants answered our pre-set questions online, and our questions had very few prompts. As a result, it is possible that many topics were not mentioned. Future research should build upon the topics presented here to describe them more specifically. How will these findings help autistic adults now or in the future? There are still many barriers to equal access to additional language learning for autistic people. This study shows how valuable autistic people find bilingualism, and it supports autistic people’s advocacy movement for equal rights and opportunities.

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11. Doyle N, McDowall A, Waseem U. Intersectional Stigma for Autistic People at Work: A Compound Adverse Impact Effect on Labor Force Participation and Experiences of Belonging. Autism in Adulthood. 2022; 4(4): 340-56.

Background: Little research addresses the experiences of autistic people at work, yet employment prospects remain bleak. The extant literature takes a largely remedial perspective and does not focus on harnessing this population’s considerable talents. In global organizational practice, several programs purposefully target autistic people for their abilities. However, preliminary evidence suggests that such programs are inadvertently attracting mainly White males, to the exclusion of other demographics. Therefore, stigma surrounding autism at work remains, creating potential compound adverse impacts by marginalizing identities, including gender, race, ethnicity, sexuality, and socioeconomic status. We explored the intersection of autism with other marginalizing identities in the context of work. The research focused on labor force participation for autistic people and, for those in employment, perceptions of exclusion and inclusion. We compared the aforementioned variables by gender identity, racial identity, sexuality, socioeconomic background, and geographic origin. Methods: We undertook a global cross-sectional survey, advertised through various social media platforms and promoted directly to relevant organizations. The survey included a range of validated measures as well as demographic information. We analyzed the data with frequencies, cross tabulations, chi-square tests, and non-parametric, group-wise comparisons. Results: We found preliminary evidence of reduced rates of employment participation by race and geographic location. Females and non-binary people had lower perceptions of inclusion and belonging at work. The perception of accommodation provision had a strong association with inclusion and belonging; more so than incidental provision of flexibility in environment and scheduling not framed as a specific accommodation. Conclusions: The findings highlight the relational aspects of accommodation and a more universal inclusion perspective. We urge practitioners and researchers to monitor employment participation and levels of inclusion/exclusion using intersectional demographic identification. We appeal for cross-cultural collaboration with academic institutions outside the anglosphere to improve our knowledge of global programs and their impact. Community brief Why is this an important issue? Employment data show that autistic people find it harder to get and keep work. This study focuses on understanding whether multiple identities and people’s background make a difference. What is the purpose of this study? We asked a group of Autistic people about gender and race, as well as being gay lesbian, bisexual, transgender or queer (LGBTQ). We asked where people live, their education, parents’ education and whether they had any diagnoses in addition to autism. We predicted that these things would have a negative effect on autistic employment rates. We thought they would also affect how autistic people felt at work. What we did? An online survey was completed by 576 autistic people. We analyzed whether their identities and backgrounds made it more or less likely that they were in work. We then asked the 387 employed people within this group about their experiences at work. We compared their experiences by identity and background to see whether these made a positive or negative difference. What we found? We found that White Autistic people living in western countries such as the United States and Europe were more likely to have jobs. They were also more likely to have jobs specifically designed for Autistic people. We found that women, non-binary, and transgender autistic people felt less included at work. We also found that feeling that someone cares is more important than any adjustments to work scheduling such as flexible working to support people. What do these findings add to what was already known? It is already known that autistic people are less likely to be in work than non-autistic people. This study shows that these overall numbers are masking important differences arising from gender, race, and et nicity. What are the potential weaknesses in the study? The survey was taken at one point in time, which does not explain how these differences happened. Most people who completed the study were highly educated. We did not have enough people from the non-western countries or communities of color. Therefore, the sample is not large or diverse enough to draw firm conclusions. How will the study help Autistic people now or in the future? We hope that the study inspires people to think about different identities and additional stigma for autism at work programs. We have provided a sample of baseline data from all over the world that shows a difference by location. Even though this is just a trend, it might spark more research looking at the crossover between autism, identities, and backgrounds. It provides a starting point to help researchers who want to do longer studies that test interventions to improve autistic participation and experiences in work.

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