Non-autistic individuals often hold negative attitudes and behavioral intentions toward autistic people. However, existing research is limited by relatively weak theoretical integration and a lack of systematic investigation into the antecedents of implicit attitudes toward autism. Drawing on the value-attitude-behavior model, social identity theory, and attribution theory, this study examines the associations between personal values, autism-related knowledge, and attributions and implicit and explicit attitudes toward autism. Eighty-five non-autistic Japanese university students participated in the study. Bayesian multiple regression analyses treating explicit attitudes as the outcome variable provided strong evidence of a negative association with implicit benevolence values and a positive association with explicit conformity. In the implicit model, higher implicit security values were associated with more negative implicit attitudes toward autism, whereas greater agreement with autism-related knowledge buffered against such negative implicit attitudes. In the Bayesian logistic regression model predicting volunteer intention, explicit stimulation and explicit achievement were positively and negatively associated with volunteer intention, respectively. Findings highlight the importance of personal values in predicting autism stigma, as well as the role of neurodiversity-informed knowledge. Lay Abstract Many non-autistic people hold negative attitudes toward autistic individuals, which can contribute to the social exclusion of autistic individuals. However, little is known about what shapes these attitudes. In this study, we examined how personal values, autism-related knowledge, and attributional judgments about autism are related to both explicit (controlled) and implicit (automatic) attitudes toward autistic people. We found that those who placed a strong emphasis on security were more likely to show negative implicit attitudes toward autism. In contrast, people who agreed with accurate, neurodiversity-informed knowledge about autism exhibited less negative implicit attitudes toward autism. For explicit attitudes, prioritizing the welfare of close others (benevolence) was associated with lower autism acceptance, whereas valuing universalism and conformity was associated with higher autism acceptance. In addition, individuals who valued excitement, novelty, and challenge in life were more willing to volunteer, whereas those who placed greater importance on personal success according to social standards were less willing to do so. Our findings emphasize the importance of personal values in predicting non-autistic individuals’ attitudes and behavior toward autistic individuals, as well as the role of neurodiversity-informed knowledge in this regard.
Autism is over-represented in eating disorder (ED) populations, including binge-type presentations. However, research has focused predominantly on Autism in restrictive EDs, particularly anorexia nervosa. Furthermore, studies examining Autism in binge-type presentations have largely centred on patient perspectives, while clinician accounts remain underexplored. Clinician perspectives shape recognition, formulation and treatment adaptation in routine care. This study therefore explored clinicians’ perspectives on working with Autistic patients with binge-type EDs. Individual semi-structured interviews were conducted with 16 multidisciplinary ED clinicians and analysed using reflexive thematic analysis through a neuro-affirming lens. Five themes were developed: (a) Recognition shaped by expectation ; (b) Entrenchment to engagement ; (c) Escalating, unseen distress ; (d) Sensory needs without support ; and (e) Precarious adaptation . Autism appeared under-recognised in binge-type EDs and frequently co-occurred with Attention-Deficit/Hyperactivity Disorder (ADHD), complicating identification and formulation. Emotional overwhelm and sensory seeking may represent particularly salient maintaining mechanisms in this group. Findings highlight the need for improved clinician training, integrated Autism-ADHD assessment, and Autism-informed adaptations to ED treatment models. Lay Abstract Autism is more common in people with eating disorders than in the general population, yet most research has focused on anorexia nervosa. Less is known about autism in binge-type eating disorders, like bulimia nervosa or binge eating disorder, and existing studies have mainly explored patient perspectives. This study explored clinicians’ experiences of working with Autistic patients with binge-type eating disorders. Sixteen clinicians were interviewed. Data were analysed using reflexive thematic analysis to identify common patterns and themes. Clinicians described that Autism is often unrecognised in binge-type disorders, partly because services have traditionally focused on restrictive presentations. Autism also frequently co-occurred with ADHD, complicating identification. Clinicians reported high emotional distress, which could be difficult to interpret, and highlighted sensory needs, such as sensory seeking, as influencing eating behaviours. Finally, clinicians described challenges in adapting standard treatments to better support Autistic patients. These findings suggest that Autism may be under-recognised in binge-type eating disorders, with emotional and sensory factors playing important maintaining roles. Improved clinician training, routine screening for Autism and ADHD, and clearer guidance on treatment adaptation could help enhance care for Autistic individuals with eating disorders.
Several tools assess community attitudes toward autism, but they stop short of measuring meaningful inclusion. This study aimed to develop and validate the Meaningful Autistic Inclusion Attitudes (MAIA) scale with input from autistic self-advocates and to examine whether attitudes toward meaningful inclusion differed by state of residence, personal contact with autism, and demographic variables. A total of 772 participants across four U.S. states (Arizona, Florida, Missouri, and Oklahoma) completed the 25-item MAIA and a published scale measuring general attitudes toward neurodiversity (Neurodiversity Attitudes Questionnaire [NDAQ]; 28 items). Using exploratory structural equation modeling, we identified four factors of the MAIA (Capabilities, Interpersonal, Impact, and Building Inclusive Communities) with acceptable-to-good internal consistency and convergent validity with NDAQ scales. Personal contact with autistic people and people with other psychiatric conditions positively predicted two of the four factors (Capabilities and Impact), whereas some types of personal contact negatively predicted the Interpersonal factor. Participants from Arizona reported more positive attitudes toward interpersonal inclusion than participants from the other three states. Differential relationships between demographic variables and the four factors were also observed. If replicated, findings suggest several modifiable factors that could increase effectiveness of initiatives aimed at improving autism inclusion. Lay Abstract This study describes the development of the Meaningful Autistic Inclusion Attitudes (MAIA) scale, a survey measure to assess community attitudes toward meaningful community inclusion of people with autism. We define meaningful inclusion as inclusion efforts that move beyond acceptance to include an appreciation of the value autistic people can bring to their communities and the belief that investing in inclusion is worthwhile. Prior to this study, existing surveys designed to measure attitudes toward autism focused on negative attitudes (i.e., stigma) and neutral attitudes (i.e., acceptance) and did not include items meant to assess respondents’ beliefs about meaningful inclusion. We recruited 772 participants across four U.S. States (Arizona, Florida, Missouri, and Oklahoma) to complete the MAIA. We found that MAIA survey items measure attitudes toward four different areas related to meaningful inclusion: (a) Capabilities of autistic people; (b) Interpersonal inclusion; (c) Impacts of inclusion; and (d) Building inclusive communities. We then compared participant scores in each of these areas to understand whether attitudes toward meaningful inclusion differed by participant state of residence, personal contact with autism, and demographic variables (age, sex, race/ethnicity, education, and income). We found that participants residing in Arizona had more positive attitudes toward interpersonal inclusion than participants in the other three states. Participants who reported any personal contact with autism had more positive attitudes toward the capabilities of autistic people and the impacts of inclusion. In contrast, participants who had friends, relatives, or acquaintances with autism reported less positive attitudes toward interpersonal inclusion than participants who had no personal contact with autism. Finally, we observed differential relationships between demographic variables and the four factors. Together, findings suggest that the MAIA is a promising tool for measuring nuanced differences in attitudes toward meaningful inclusion.
Autistic individuals are more likely to be sexual minorities (e.g., gay, lesbian, bisexual, asexual). While several theories have been posited to explain this overlap, the voices of autistic sexual minorities are missing from this conversation. Moreover, there is limited qualitative research exploring the intersection between their dual identities. The co-creation of research by autistic sexual minorities is, therefore, an ethical imperative. This research used semi-structured interviews, facilitated by the shared lived experience of the lead researcher. Fourteen autistic sexual minorities were asked why they think they're more likely to be sexual minorities and how they experience the intersection between their two identities. Reflexive thematic analysis identified four themes: (a) my identities are interconnected, for better or worse, (b) resisting the influence of social norms on sexual orientation, (c) the intersection between autism and a-spec (asexual and aromantic) identities and (d) being autistic within the LGBTQIA+ community. These findings validate intersectionality as a framework for understanding autistic sexual minority identities and suggest that an indifference to social norms is key to autistic sexual minority identities. Recommendations are provided to facilitate inclusive, LGBTQIA+ spaces and develop educational resources to help autistic sexual minorities navigate attraction, intimacy and consent.Lay Abstract Autistic people are more likely to be sexual minorities (e.g., gay, lesbian, bisexual, asexual). Several theories have attempted to explain why this is; however, the actual voices of autistic sexual minorities are missing from this conversation. In addition, there is very little research exploring how their two identities intertwine. As such, a researcher who is part of this community interviewed 14 autistic sexual minority adults to find out why they think they're more likely to be sexual minorities and how their autistic and sexual minority identities influence one another. Through analysing these conversations, four main themes were identified: (a) my identities are interconnected, for better or worse, (b) resisting the influence of social norms on sexual orientation, (c) the intersection between autism and a-spec (asexual and aromantic) identities and (d) being autistic within the LGBTQIA+ community. These findings suggest that autistic and sexual minority identities combine to produce a unique lived experience. Participants suggested that they may be more likely to be a sexual minority because they don't care about following typical social norms. Recommendations are given to create more inclusive LGBTQIA+ spaces and develop educational tools to help autistic people navigate the complexities of attraction, intimacy and consent.
With the growing inclusion of autistic children in general education settings, the need for effective use of evidence-based practices (EBPs) in schools has become increasingly important. Leadership behaviors by principals and administrators that support educators' use of EBPs with autistic children play a crucial role in promoting and sustaining these practices. This study aims to understand implementation leadership in schools quantitatively and qualitatively. In this mixed-methods study, participants included 161 general education teachers, 138 special education teachers, and 62 paraeducators (N = 361). Participants completed the School Implementation Leadership Scale (SILS), which assesses the degree to which their school leader is knowledgeable, supportive, proactive, perseverant, communicative, centered on the school's vision/mission, and available. Eighty-two participants were randomly selected for an interview to discuss their high or low EBP implementation. Quantitative analysis via aggregated mean scores on the SILS subscales (Total M = 2.4) shows educators rate their school's leadership qualities in the moderate range. Qualitative analysis provides insights into the educators' expressed needs and desires when it comes to support from their leadership. The results highlight the importance of strong leadership to improve the implementation of EBPs for autistic children in general education settings. Authors discuss implications and recommendations to support educators' EBP use.Lay Abstract As more autistic children are included in general education classrooms, it is increasingly important for schools to use research-supported strategies known as evidence-based practices (EBPs). School leaders, such as principals and administrators, play a crucial role in helping teachers implement these practices consistently and effectively. This study aims to understand the perspectives of 361 educators, including 161 general education teachers, 138 special education teachers, and 62 paraeducators, regarding the support they receive from school leadership in using EBPs with autistic children. Participants completed a survey called the School Implementation Leadership Scale, which included questions about various leadership qualities, such as being knowledgeable, supportive, proactive, perseverant, communicative, aligned with the school's vision and mission, and available to support the use of EBPs. On average, educators rated their school leadership as moderately supportive. To further explore educators' experiences, selected participants were also invited to participate in interviews. These interviews provided deeper insights into what educators find most helpful from school administrators when implementing EBPs for autistic children. The results emphasize the importance of strong, supportive leadership in building a positive and inclusive school environment and helping educators use EBPs. The authors offer practical recommendations to help school administrators better support their staff in using EBPs.
