'Who Am I?': An Exploratory Study of the Relationships Between Identity, Acculturation and Mental Health in Autistic Adolescents

Autistic adolescents are at increased risk of mental health difficulties. One potential factor contributing to this is identity development, although this hypothesis has been little explored. These adolescents also have to consider how autism forms their identity, a process called acculturation. This exploratory study examined the relationships between identity, acculturation and mental health in autistic adolescents. Twenty-four participants completed measures investigating identity, acculturation and mental health. Findings suggested mental health was not related to personal identity. Mental health scores did not differ between acculturation groups, however those aligned to non-autistic culture tended to generate more positive self-statements than those aligned to neither culture. These findings suggest autistic adolescents should be encouraged to explore autistic culture and supported in constructing their identity

Dropping out and moving on: A qualitative study of autistic people's experiences of university

Autistic people are at high risk of dropping out of university, but little research has examined this issue. Fourteen participants participated in semi-structured interviews examining their experiences at university and the reasons they had dropped out. Thematic analysis identified patterns in participants’ responses. Themes were categorised as systemic issues, challenges within university or life after dropping out. Systemic issues centred around accessing diagnosis, autism understanding, mental health and outsider status. Challenges at university included culture shock, becoming disengaged, lack of proactive support and perceived inevitability of dropping out. Finally, life after dropping out was characterised by processing of trauma and shame, and realisation of doing ‘what’s right for you’. Together, these themes suggest that many improvements could be made at universities, such as more proactive support, and creating more accessible environments. Societal-level change is also needed to improve educational opportunities for autistic people

The experiences of peer relationships amongst autistic adolescents:A systematic review of the qualitative evidence

Background Peer relationships can be especially difficult for autistic adolescents, given their marked social communication difficulties. The purpose of this systematic review is to synthesise reported qualitative findings on how autistic adolescents experience peer relationships, including the rewards and challenges, from their perspective. The review includes the perspectives of others (e.g. parents, support workers), from included papers where these were reported in addition to the adolescent viewpoint. Method PRISMA guidelines and the Joanna Briggs Institute meta-aggregative approach to qualitative synthesis informed this review process. Articles included were published in the last ten years, specific to autistic adolescents between the ages of 10 and 19. Of the 75 articles meeting eligibility for full-text review, ten matched the final inclusion criteria. Results Findings relating to four main themes emerged from the qualitative synthesis: understanding friendship, having and wanting friends, challenges of peer relationships and overcoming challenges. Fourteen sub-topics are described in detail, for example, that autistic adolescents do have and want friends, though this is often not easily achieved, leading to feelings of loneliness. Findings also revealed experiences of peer rejection and victimisation, and specific factors that might make building positive peer relationships difficult, such as group settings. Conclusions Autistic adolescents face a number of difficulties with understanding social rules and conventions, which seem to make peer relationships difficult. However, due to many autistic adolescents having a desire for friendship, some have developed ways of overcoming these challenges. This review highlights that additional support is needed to support the development of autistic adolescents’ social skills and awareness; further research is needed to establish how this could be done most effectively

Reputation Management in Children on the Autism Spectrum

Being able to manage reputation is an important social skill, but it is unclear whether autistic children can manage reputation. This study investigated whether 33 autistic children matched to 33 typical children could implicitly or explicitly manage reputation. Further, we examined whether cognitive processes—theory of mind, social motivation, inhibitory control and reciprocity—contribute to reputation management. Results showed that neither group implicitly managed reputation, and there was no group difference in explicit reputation management. Results suggested different mechanisms contribute to reputation management in these groups—social motivation in typical children and reciprocity in autistic children. Explicit reputation management is achievable for autistic children, and there are individual differences in its relationship to underlying cognitive processes

Mechanisms of social influence : reputation management in typical and autistic individuals

Other people greatly influence behaviour – a phenomenon known as social influence. One reason people change their behaviour when others are present is to manage their reputation. Individuals with autism have social and communicative difficulties, which may result in difficulties in reputation management. This thesis aimed to examine reputation management in autistic individuals, the development of reputation management, and the cognitive mechanisms underpinning reputation management. In Chapter Two, autistic adults managed their reputation in a donation task when it was explicitly clear that they should manage it. Despite this ability, the autistic adults demonstrated a reduced propensity for reputation management, which results suggested was due to low expectations of reciprocity. In Chapters Three and Four, reputation management and potential mechanisms – theory of mind, social motivation, reciprocity, and inhibitory control – were examined in typical children aged 6 to 14. Two forms of reputation management were tested: an automatic or implicit form and a deliberate or explicit form. Implicit reputation management appeared in adolescence, while explicit reputation management occurred at 8-years-old. Theory of mind and social motivation underpinned explicit reputation management. In Chapters Five and Six, autistic children did not implicitly manage their reputation, although some were able to do so explicitly. Autistic children who were fairer and more sensitive to reciprocity were more likely to explicitly manage reputation. None of the suggested mechanisms underpinned implicit reputation management in either typical or autistic children. Finally, semi-structured interviews were conducted with autistic adolescents and school staff (Chapter Seven). Thematic analysis showed that autistic adolescents were concerned about their reputation; however, many preferred to stay true to themselves rather than appear “cool”. Overall, this thesis noted autistic individuals do have the ability to manage reputation, yet there was variation in this ability, due to a number of factors. These results suggest autistic individuals are not completely immune to social influence

Expectations of the university to post-graduation transition of students with mental health conditions

The number and percentage of students with mental health conditions (MHC) attending university is increasing. Students with MHC can be well supported during their time at university, but receive less support with the transition from university to post-graduation. This time is characterised by great change and can be accompanied by mixed feelings. This paper presents preliminary data on the transition expectations and perceptions of 35 students with MHC. High levels of fear and low levels of preparedness regarding the transition were reported. Only 55-60% of students had accessed transition-related or careers-related support, but those who had found it productive. Students suggested that more condition-specific support, and support in the form of workshops, lectures and 1:1 meetings would be beneficial. This knowledge can be used to better support students with MHC with the university to post-graduation transition

Burnt Out and Dropping Out: A Comparison of the Experiences of Autistic and Non-autistic Students During the COVID-19 Pandemic

Autistic students are more likely to drop out of university, while facing both challenges and opportunities within university environments. This study compared the experiences of autistic and non-autistic current United Kingdom students, in terms of thoughts about dropping out, burnout, mental health and coping, during the COVID-19 pandemic. Burnout was of particular interest as this is a relatively unexamined phenomenon for autistic students. Seventy autistic and 315 non-autistic students, completed a mixed methods questionnaire with standardized measures of burnout (personal and academic), mental health (depression, stress, and anxiety), and coping styles (adaptive and maladaptive). We also included qualitative questions about dropping out and COVID-19 experiences. We found autistic participants experienced higher rates of burnout and mental health symptoms and were more likely to have thought about dropping out. Reasons given for thinking about dropping out, for both groups, focused on poor mental well-being, doubts about university, and academic challenges. For autistic participants, further analyses did not identify specific predictors of thinking about dropping out, but for non-autistic participants, this was predicted by maladaptive coping styles and academic burnout. Academic and personal burnout predicted one another for autistic students, and age, maladaptive coping, autistic characteristics, stress, and anxiety additionally predicted burnout for non-autistic students. Similarities in experiences during the pandemic were noted, with both groups experiencing negative social implications, difficulties adjusting to emergency online learning, and poorer psychological well-being. Moving forward from COVID-19, universities must find ways to enhance both academic and social support, to enable equal opportunity within Higher Education for autistic students

Expectations of the university to post-graduation transition of students with mental health conditions

The number and percentage of students with mental health conditions (MHC) attending university is increasing. Students with MHC can be well supported during their time at university, but receive less support with the transition from university to post-graduation. This time is characterised by great change and can be accompanied by mixed feelings. This paper presents preliminary data on the transition expectations and perceptions of 35 students with MHC. High levels of fear and low levels of preparedness regarding the transition were reported. Only 55-60% of students had accessed transition-related or careers-related support, but those who had found it productive. Students suggested that more condition-specific support, and support in the form of workshops, lectures and 1:1 meetings would be beneficial. This knowledge can be used to better support students with MHC with the university to post-graduation transition

"Simultaneously vague and oddly specific": Understanding autistic people's experiences of decision-making and research questionnaires

Background: Autism researchers often use questionnaires to gather the views and experiences of autistic people. However, questionnaires may not always be designed in accessible ways. Additionally, answering questions within a questionnaire involves decision-making, which some autistic people have reported finding difficult. Therefore, this exploratory study aimed to enhance our understanding of autistic people’s experiences of decision-making, and to analyse their feedback on questionnaire measures to further understand decision-making within the research context. Methods: One hundred and seventeen participants completed an online questionnaire. In the questionnaire they answered an open question about what affected their ability to make decisions. They then completed four questionnaire measures and after each one provided feedback. We used content analysis to categorise participants’ qualitative answers. Results: Participants discussed how their internal state, other people, the quality and quantity of information, pressure on choosing a response, external distractions and lack of time all affected their decision-making. Feedback on the questionnaires highlighted how questions needed context, often questions themselves were unclear and difficult to understand, that there were issues with Likert scales, and how measures could have questionable validity for autistic people. Conclusions: Autism researchers need to consider how they can make their research as accessible as possible for autistic people. Our study highlights how decision-making is not a straight-forward process, and researchers have a role in ensuring they give their participants clear and contextualised information. Involving autistic people in the design of research is a potential way of improving the quality of research.Output Status: Forthcomin

"Autism Research is in Crisis": A mixed method study of researcher's constructions of autistic people and autism research

While not all autism research is ableism, autism researchers can be ableist, including by talking about autistic people in sub-human terms (dehumanisation), treating autistic people like objects (objectification), and making othering statements which set autistic people apart from non-autistic people, and below in status (stigmatization). This mixed-method study aimed to investigate how autism researchers construct autistic people and autism research, and to investigate whether including autistic people more in research relates to lower ableism in narratives about autistic people. We used a survey with autism researchers (N =195) asking five open-ended questions about autism and autism research, as well as demographics, career length, contact with autistic people (familial and non-familial) and degree to which researchers involve autistic people in their research. We used content analysis to categorize narratives used by autism researchers and cues for ableism (dehumanization, objectification, and stigmatization). We then used binary-logistic regression to identify whether narrative or higher inclusion of autistic people predicted fewer ableist cues, controlling for career length and connections to autistic people. Using medicalised narratives of autism predicted higher odds of ableist cues compared to employing social model or neutral embodiment narratives. Greater inclusion of autistic people in research predicted significantly lower odds of ableist cues, while controlling for other contact with autistic people and career length. Next, we used reflexive thematic analysis to analyse researcher’s perceptions of autistic people and autism research. Narratives reflected core ideological disagreements of the field, such as whether researchers consider autism to be an intrinsic barrier to a good life, and whether researchers prioritise research which tackles “autism” versus barriers to societal inclusion for autistic people. Instrumentality (a form of objectification) was key to whether researchers considered a person to have social value with emphasis revolving around intellectual ability and independence. Lastly, language seemed to act as a tool of normalisation of violence. Researchers relied on an amorphous idea of “autism” when talking about prevention or eradication, potentially because it sounds more palatable than talking about preventing “autistic people”, despite autism only existing within the context of autistic people