Everyday executive function issues from the perspectives of autistic adolescents and their parents: Theoretical and empirical implications

There is a long tradition of research into autistic people’s executive function skills. Yet, despite decades of research on EF in autism, the existing literature remains contradictory and ‘confusing’, with a large – and unresolved – discrepancy between small-to-moderate effect sizes demonstrated on laboratory-based EF tasks and large effect sizes on questionnaire-based everyday EF measures. We sought to understand this mismatch between ‘lab and life’ by inviting 12 autistic adolescents (12–19 years) and their mothers (n = 7) to convey their views and perspectives about their own, or their child’s, EF skills as they transition to adulthood. We followed Braun and Clarke’s method for reflexive thematic analysis using an inductive approach. Participants told us that their EF skills were highly variable, acutely dependent on the context in which they were deployed and potentially related to differences in the way that they process information more broadly. Participants’ reports provided rare insights into their and their children’s executive control – insights that do not straightforwardly map onto traditional theoretical models of EF. Future work on EF needs to take seriously the perspectives and subjectivity of autistic people themselves, including by triangulating quantitative, objective assessments with qualitative, subjective reports in complementary (controlled, uncontrolled) settings

Career progression for autistic people: A scoping review

Many autistic people are unemployed. Of those who are employed, many are in roles that do not reflect their skills, qualifications and/or capabilities, and little is known about how autistic people progress throughout their careers. This study aimed to review and synthesise the existing evidence about career progression for autistic people. In total, 33 studies met the criteria for inclusion, though no study directly aimed to explore the topic. Our findings suggest that underemployment is common within the autistic population. Indirectly, we identified several potential barriers and facilitators of career progression for autistic people. Possible barriers included personal (e.g. gaps in education and employment history), relational (e.g. disclosing an autism diagnosis) and organisational factors (e.g. inadequate employment support). Adequate employment support was the most frequently discussed facilitator. Future research should seek to identify the most successful employment supports for autistic people over the long term to ensure that all autistic people are able to live – and work – in ways that are meaningful to them

Evaluating the Impact of an Online Autism Training on Changing Employers’ Autism Knowledge and Commitment to Inclusion in the Workplace

Employers’ knowledge about autism can be a key barrier to autistic people obtaining employment. The current study evaluated the efficacy of an online autism training program, Understanding Autism in the Workplace, in changing employers’ autism knowledge and commitment to inclusion in the workplace. Employers (N = 129) from 22 organizations in the UK completed the training with an autistic (n = 45) or non-autistic (n = 84) trainer and completed surveys measuring (1) autism knowledge and (2) commitment to inclusion in the workplace (CIW), before and after the training. Results showed that at a group level, autism knowledge and CIW improved from before training to after training for all participants, for both the autistic and non-autistic trainer. This latter result may be attributable to the training being co-designed by autistic people. At an individual level, however, only a minority of participants (both with an autistic and non-autistic trainer) showed a significant increase in autism knowledge (10.1%) and CIW (5.8%), suggesting autism training was more effective for some participants than others. Autism training should not be the sole initiative to address barriers to employment for autistic people but should be part of a broader package of support for employers

Evaluating measures to assess loneliness in autistic adults

Several measures have been developed to assess loneliness in the general population. Here, we examined if, and how accurately, widely-used measures capture the experience of loneliness in autistic adults. A total of 203 autistic participants from the UK completed an online survey, which included two widely-used loneliness questionnaires: the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and the Social and Emotional Loneliness Scale for Adults (SELSA). Participants completed the measures and provided their views on how well they captured their experiences of loneliness. A direct measure, asking participants how often they felt lonely, was also completed. Results demonstrated that scores on the UCLA and SELSA questionnaires positively correlated with the direct measure of loneliness, suggesting that these tools accurately index autistic experiences of loneliness. However, qualitative responses suggested that participants found both scales difficult to complete. Using reflexive thematic analysis, we identified three themes that encapsulated participants’ views: (1) failing to distinguish between the characteristics/experiences of loneliness and being autistic, (2) loneliness is not a static trait and (3) inappropriate wording. Given that our sample of autistic participants tended to prefer the UCLA scale to the SELSA, we provide initial recommendations around how the UCLA scale could be adapted for autistic adults

Evaluating a New Supported Employment Internship Programme for Autistic Young Adults Without Intellectual Disability

Supported employment initiatives have been shown to increase employment rates for autistic people who want to enter the workforce. Despite the success of supported employment initiatives in increasing employment rates, little is known about the first-hand experiences and views of those involved. In the current study, we examined the experiences and views of autistic young adults without intellectual disability (ID; ‘interns’), employers and parents regarding a previously unevaluated paid internship scheme that offers tailored support for interns and employers before, during, and after the internship, the Employ Autism network. In total, 51 participants (19 interns, 22 employers, ten parents), across eight internships, engaged in semi-structured interviews. Reflexive thematic analysis was used to identify three themes, shared across participant groups: (1) the internship was “an invaluable experience”, (2) the internship helped break down autism-specific barriers to employment, and (3) stakeholder groups had some unmet expectations. Drawing on this multi-informant qualitative evaluation of a novel supported employment scheme, we derive recommendations of best practice for supported employment initiatives for autistic young adults without ID

Lightening the Load: Perceptual Load Impairs Visual Detection in Typical Adults but Not in Autism

Autism spectrum disorder (ASD) research portrays a mixed picture of attentional abilities with demonstrations of enhancements (e.g., superior visual search) and deficits (e.g., higher distractibility). Here we test a potential resolution derived from the Load Theory of Attention (e.g., Lavie, 2005). In Load Theory, distractor processing depends on the perceptual load of the task and as such can only be eliminated under high load that engages full capacity. We hypothesize that ASD involves enhanced perceptual capacity, leading to the superior performance and increased distractor processing previously reported. Using a signal-detection paradigm, we test this directly and demonstrate that, under higher levels of load, perceptual sensitivity was reduced in typical adults but not in adults with ASD. These findings confirm our hypothesis and offer a promising solution to the previous discrepancies by suggesting that increased distractor processing in ASD results not from a filtering deficit but from enhanced perceptual capacity

“It seems like a luxury to be able to offer that”: Factors influencing the implementation of annual health checks for autistic people in England

Autistic people in England face worse health outcomes than non-autistic people. Autismspecific annual health checks have been proposed as one solution to this issue. This study identified strategies to incentivise primary care providers to offer autism-specific annual health checks, using a behavioural science approach. In phase one, we conducted interviews and focus groups with autistic people (n=10) and primary care providers (n=11). In phase two, we conducted a national survey of primary care providers (n=196). Qualitative data were analysed using a framework method and the Theoretical Domains Framework. Quantitative data were analysed descriptively, and comparisons between sub-groups of survey respondents were made using Mann-Whitney U and Kruskal-Wallis tests. The most salient Theoretical Domain was environmental context and resources. Participants identified lack of time and staff as key barriers to implementation. Delegating tasks to non-GPs and automating processes were seen as key facilitators. Autism-specific knowledge was another relevant domain; education produced and delivered by autistic people was posited to increase health check uptake and quality. Overall, participants were enthusiastic about autism-specific annual health checks but were concerned about the practical aspects of implementation. We identified specific barriers and facilitators that can be addressed prior to policy adoption to maximise chances of success

Disclosing an autism diagnosis improves ratings of candidate performance in employment interviews

Employment interviews can be challenging for autistic people. In addition to standard interview procedures often being inaccessible, features associated with autism (including atypical emotional expression, eye-contact, and gestures) may lead to negative first impressions. Research using vignettes and ‘thin slices’ of communication indicate that perceptions of an autistic individual can be improved when their autism diagnosis is disclosed. Here, we examined the impact of diagnostic disclosure on judgements of autistic adults undergoing an entire mock employment interview. A total of 119 participants (known as ‘raters’) watched a video of an autistic candidate’s mock employment interview, after which they provided overall impressions of the candidate on factors such as confidence, motivation, and knowledgeability. Raters were either (1) unaware of the interviewee’s diagnosis, (2) aware of their diagnosis, or (3) aware of their diagnosis and provided with information about autism. Results indicate that diagnostic disclosure improved perceptions of autistic candidates across all dimensions compared to when raters were unaware of their diagnosis. The provision of additional information about the diagnosis did not further improve ratings. The findings have important implications for employers and autistic people, who should consider the potential impact of diagnostic disclosure prior to interviewing for a role

Teachers’ Views on Preparation for Employment of Young Autistic People

Background. Contemporary literature indicates that there is significant support and assistance provided by schools for young autistic people, which has had a positive impact on the accessibility of jobs. Nevertheless, the employment rate of autistic people is unacceptably low in the UK. The current study investigated teachers’ views on the preparation for employment of young autistic people in the UK. Methods. Interviews were conducted with individuals from the educational field and thematic analysis was used to explore the teachers’ views regarding the factors that have an impact on the preparation for employment of young autistic people. Results. Four main themes emerged from the analysis. These themes included awareness, funding and government support, action plans and motivation. Conclusion. These results have critical implications for the educational field and future research, which are discussed in the paper

“I did what I could to earn some money and be of use”: A qualitative exploration of autistic people’s journeys to career success and fulfilment

Employment contributes to wellbeing, yet many autistic people who want to work face barriers to meaningful employment. Much research focuses solely on employment rates, rather than taking a more holistic view of professional trajectories and occupational experiences. We conducted semi-structured interviews with 18 autistic adults to explore their experiences of, and perspectives on, career success. Our participants highlighted the overarching importance of finding fulfilment in one's career. Using reflexive thematic analysis, we identified five additional key themes: (1) volatile career journeys, (2) the need for continuing career support, (3) the impact (positive or negative) of social interactions, (4) the important role of organisations, and (5) the catastrophic impact of poor experiences. Our findings highlight the importance of tailored, lifelong employment support and inclusive workplaces in enabling autistic people to thrive at work. Enabling autistic career fulfilment requires moving beyond entry-level hiring to foster sustainable, fulfilling employment for all autistic people