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Autistic individuals are at increased risk of trauma exposure and post-traumatic stress disorder (PTSD). Diagnostic overshadowing, however, often results in PTSD symptoms being mislabelled as autistic traits. This study aims to develop professional consensus on the identification and assessment of co-occurring PTSD in autistic adults.

An online modified Delphi design was used to gather professionals’ perspectives on key aspects of the identification and assessment of PTSD in autistic adults. Data were gathered qualitatively in Round 1 and then synthesised using content analysis into a list of statements that were rated in Round 2. Statements reaching 60–79% consensus and additional suggestions were sent out for rating in Round 3. Consensus for the final statement list was set at 80% agreement.

Overall, 108 statements reached consensus. These form the basis of professional-informed recommendations to facilitate the identification and assessment of PTSD symptoms in autistic adults.

The final Delphi statements provide a framework to assist with the assessment and recognition of traumatic stress reactions in autistic adults presenting to mental health, diagnostic or social services.

To the best of the authors’ knowledge, this is the first study to explore the presentation and identification of PTSD in autistic adults (with and without intellectual disability), using a bottom-up approach informed by professional consensus.

The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework.

Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated.

Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority.

To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.

Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism.

A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken.

Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction.

This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.

The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England.

Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis.

Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support.

The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality.

To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

Although increased social time is associated with healthier lifestyles, autistic people often present in therapy with social time difficulties. Given the growing interest in digital interventions and their applicability for autistic individuals, a social time app could be beneficial to support autistic people to manage social time, but there is limited research in this field, especially that which involves people with lived experience. The purpose of this study was to use co-production to conduct consultations with expert clinicians about the relationship between autism and social time, and the future development of a smartphone app to monitor and support social time in autistic people.

A qualitative methodology investigated clinicians’ views on the relationship between autism and social time and potential development of a social time app. Clinicians (N = 8) participated in semi-structured interviews facilitated by a researcher with lived experience of autism.

Participants were psychologists and psychotherapists from a specialist autism service. Thematic analysis identified factors associated with social time, such as differences with neurotypical populations, need for balance with non-social time and gender differences. According to participants, advantages of social time were connecting with people and forming relationships, whereas challenges were limited social skills, anxiety and anger and frustration. Suggested features of an app were a user-friendly design, psychoeducational components and prompts and reminders. Potential advantages of the app were support outside of therapy, support in therapy and monitoring emotional responses, whereas challenges were task completion and personalising content.

Findings reinforce the importance of a balance between social and non-social time for autistic people, which could be monitored and supported using a social time app. Clinicians could incorporate use of this app within psychological therapies to support emotional regulation and general functioning.

The aim of the study is to conduct a thematic review of assessment tools and types of activities in the application of robotics to autistic students during the period 1996–2021 using Web of Science and Scopus. The sample consisted of 119 documents.

Nowadays, emerging technologies have become increasingly prevalent across various fields of knowledge. In this regard, robotics is being increasingly applied in the educational environment. The characteristics of this tool are the ones that best suit the needs of autistic students.

Results reveal that 16.80% of the studies used automatic measurement systems, whilst 15.96% of the studies used user observation and recording techniques. As for the tasks, 37.80% were focussed on imitation tasks. Amongst the practical implications is the need to include tasks that could be developed collaboratively in the regular classroom.

With this research, it is intended to disseminate in the scientific community what are the characteristics that should have the interaction activities between a robot and autistic students. In addition, the type of tool needed to evaluate the improvements in the interaction is proposed.

With a historic lack of attention to synthesis methods such as systematic review and meta-analysis and a lack of randomised controlled trials, the evidence base for behavioural interventions for children and adults who are autistic or are diagnosed with developmental disabilities is patchy. The Sharland Foundation Developmental Disabilities Applied Behavioural Research and Impact Network (SF-DDARIN), a network of like-minded researchers and practitioners across the UK, aims to address this. The purpose of this paper is to describe the network’s work and provide the context for the remaining articles in the special issue that exemplify network projects.

In this case study paper, the authors describe how the SF-DDARIN works and is resourced, detailing the process used to maximise research opportunities by facilitating network members working together. The authors outline the progressive research steps that the SF-DDARIN has identified are needed to develop and improve the evidence base for behavioural interventions systematically and, with examples, describe how the network delivers these steps.

Since its establishment in 2016, the SF-DDARIN network members have collectively worked on more than 53 projects involving over 50 researchers, had over 120 special schools contribute to projects and have recruited over 500 participants. This has been achieved through funding from the Sharland Foundation, primarily to cover the staffing costs of a small support team and internship partnerships with external organisations. Some projects have attracted external funding.

SF-DDARIN may provide an innovative, effective and resource-efficient model for other groups seeking to develop and extend their evidence base in developmental disability research.

This paper aims to outline the process of developing a new co-produced virtual group support programme called Positive Family Connections (PFC) aimed at family carers of children with a learning disability, or who are autistic, aged between 8 and 13 years.

Development process: family carers were recruited to develop PFC prior to a feasibility randomised controlled trial being conducted (not reported in this paper). The programme was positively oriented and family systems-focused. PFC was developed by family carers, along with the research team, and designed to be delivered by family carer facilitators. The development process included several meetings to design the format and content of the programme. An initial pilot was then delivered and further amendments made to the programme in response to the pilot participants’ feedback.

The programme: the co-produced PFC programme involved attending six weekly sessions on Zoom; each 2-h session focused on different themes (e.g. communication and activities).

Reflections on the co-production process: key ingredients of co-production included ensuring clarity on roles, positive communication and understanding of the family carers’ situation and utilising the varied skills family carers can bring to research and practise.

This is the first family systems-focused programme that the authors know of, that has been co-produced with family carers and solely delivered virtually by trained family carer facilitators from the outset.

Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.