Autistic women experience the perinatal cycle with specific sensory challenges that remain insufficiently documented, particularly among those with diverse support levels. This qualitative study investigated sensory processing experiences of autistic women during pregnancy and labour, and how environmental and attitudinal factors articulate with sensory overload. Thirty-four autistic Brazilian women with Support Levels 1 and 2 ( Diagnostic and Statistical Manual of Mental Disorders [5th ed., text rev.]) participated in four Hermeneutic-Dialectic Circle (HDC) cycles through semi-structured interviews in multiple formats. Iterative hermeneutic-dialectic analysis, supported by NVivo, identified four themes: (1) Pregnancy as a sensory amplifier; (2) The birth environment as the epicentre of sensory overload; (3) Communication barriers and professional invalidation; and (4) Sensory experiences in early motherhood. Pregnancy amplified pre-existing sensitivities, particularly olfactory and proprioceptive. The hospital environment emerged as the epicentre of overload, with touch as the most aversive stimulus. Peritraumatic dissociation was reported by 19 participants (56%). The deliberate inclusion of women with intellectual disability and complex communication needs revealed that saturation observed in earlier cycles was artifactual, a finding with methodological implications for qualitative autism research. Lay Abstract Autistic women often face challenges during pregnancy, childbirth and the postpartum period related to how they process sensory information such as sounds, lights, touch and smells. Very little research has explored how these differences affect the experience of becoming a mother, and even less has included autistic women with higher support needs or complex communication needs. This study explored the sensory experiences of 34 autistic women in Brazil through in-depth interviews, deliberately including women with Support Levels 1 and 2, some of whom used augmentative and alternative communication. The interviews were conducted in multiple formats (video call, in-person and text messaging) to ensure accessibility. We found that pregnancy amplified pre-existing sensory sensitivities. Smells, temperature changes and foetal movement were experienced with an intensity far beyond what is typically reported, sometimes causing shutdowns and crises. The hospital birth environment was a major source of sensory overload, with touch being the most distressing stimulus: 31 of 34 women reported aversive experiences related to being touched during labour. Even comfort techniques widely recommended for pain relief, such as massage, were described as unbearable. Communication barriers intensified suffering throughout the perinatal cycle: women reported that health care professionals frequently dismissed their sensory experiences as exaggeration or anxiety, which made it harder to access appropriate care. More than half the participants (19 of 34) reported memory gaps and dissociation during labour, suggesting that childbirth can be a traumatic event for autistic women when care is not adapted to their sensory needs. When health care teams made accommodations (reducing lighting, minimising unnecessary touch, maintaining continuity of care, providing predictability), women reported substantially better experiences. A key methodological finding was that the apparent saturation of themes observed when only women with Support Level 1 were interviewed proved artifactual: including women with higher support needs revealed new and important experiences that would otherwise have been missed. These findings highlight the need for sensory-informed, neurodiversity-affirming perinatal care and for research that deliberately includes autistic women with diverse support levels and communication profiles.
This piece examines the data and preliminary geographical patterns yielded from a question on autism included in the Census of Northern Ireland in 2021. There are two objectives here: (a) to present summary statistics, indicators of spatial clustering, and assess the correlation of autism with other census-based socioeconomic indicators, and (b) to assess the opportunities and limitations offered by this dataset in light of international work on the spatial distribution of autism. This exercise reveals evidence of spatial clustering and patterning, particularly within urban areas (the City of Belfast especially), and strong differences between urban Belfast and the Rest of Northern Ireland. Explorations of socioeconomic correlates of autism show an association between autism and family structure, education and labour market status. Lay Abstract A Geography of Autism? Preliminary Findings From the Northern Ireland Census, 2021 There is a lot of research coming out about Autism and neurodiversity. Part of that research includes studies using maps and other tools from geography. These maps allow us to look at where Autism rates might be high or low, and to see if there are any patterns. Do places with high or low rates of Autism cluster together? Are places with high Autism rates closer to places where people or families who suspect neurodivergence might go to get an assessment? Once we know this, we can then start to look at other features of places, like the percentage of people unemployed, living in poverty, lone parent families or levels of education. This lets us figure out whether certain features are correlated with Autism. Are areas with higher percentages of lone parent families more likely to also have high Autism rates? This is important because past studies might have looked at environmental influences in Autism such as whether an area was near a busy motorway or a source of environmental contamination. I am interested in what a region like Northern Ireland can tell us about why certain areas might have higher rates of Autism. This will let us figure out more about how detection works, where services might be needed and how information on neurodivergence might spread within certain types of community more so than others.
The gut microbiota plays a significant role in autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD), though findings vary substantially across studies. Using gut microbiome data from a genome-wide association study of 5,959 participants and summary statistics from 46,351 ASD and 55,374 ADHD cases, we conducted bidirectional Mendelian randomization (MR) analyses with inverse variance weighting as the primary method. Reverse MR analysis assessed potential reverse causality. We annotated single nucleotide polymorphisms (SNPs) with SNP-nexus to identify associated genes, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to characterize their functional roles. Seventeen gut microbial taxa showed causal associations with ASD risk, while 27 were linked to ADHD. Reverse MR analysis revealed associations between aSD and species Desulfovibrio piger as well as species Bacillus U , but no reverse causality was detected for ADHD. Biological annotation identified five novel conserved genes in host-microbiome interactions shared by ASD and ADHD, with CNTN4 emerging as a common candidate gene. These findings support a potential causal relationship between gut microbiota and ASD/ADHD risk while uncovering novel conserved genes implicated in host–microbiome interactions for both disorders. Lay Abstract Distinct gut microbiota profiles were observed in individuals with ADHD and ASD. Seventeen microbial species showed significant associations with ASD, while 27 were linked to ADHD. CNTN4 emerged as a potential candidate gene shared across both neurodevelopmental conditions and host–microbiome interactions.
Living arrangements play essential roles in the lives of adults with autism and neurodevelopmental disabilities (NDDs). Many individuals with NDDs face challenges transitioning from the family home to long-term independent or supported living arrangements, but few studies have examined the ages at which residential transitions may occur within NDD adulthood, nor how residential transition ages differ by co-occurring intellectual disability (ID) status. This study examined predictors of residential status and residential transition ages among 134 American adults (52% with ID) diagnosed with NDDs, primarily autism, in childhood. Kaplan–Meier survival analyses revealed 37% of participants with ID moved from the family home by their mid-30s (predominantly to supported living), compared to 69% without ID (predominantly to independent living). Cox models indicated higher family income and irritability (behavioral difficulties) predicted earlier-aged transitions among participants with ID; these effects were stronger at younger ages. For participants without ID, greater autistic behaviors predicted later-aged transitions; these effects strengthened with age. Findings point to potential “windows of opportunity” to transition to independent or supported living between ages 18 and 22, though these windows may differ by adult symptom and family income profiles. Needs for early-aged, equitable access to residential planning services are discussed. Lay Abstract Housing is a major part of daily life. This study investigated the ages at which adults with autism or neurodevelopmental disabilities (NDDs) leave the family home to move into longer-term supported or independent living settings, and how those pathways differ for those with and without co-occurring intellectual disability (ID). Among 134 American adults diagnosed with NDDs (mostly autism) in childhood, 37% of participants with co-occurring ID had moved by roughly their mid-30s (predominantly to supported living, for example, group homes), compared to 69% of those without ID (predominantly to independent living). Different factors were linked to moving at different ages. Among people with ID, those with higher family income and those with more irritability (behavioral challenges) were more likely to move out earlier, especially around ages 18 to 22. Among people without ID, those with greater autistic behaviors tended to move later in adulthood; this pattern became stronger with age. These findings suggest neurodivergent adults with different support needs follow unique pathways to moving out of the family home, and that both individual traits, such as irritability and autistic behaviors, and family financial assets may shape these pathways in complex ways. However, for both adults with and without ID, there may be key “windows of opportunity” for moving out in early adulthood (around ages 18–22). These results highlight the need for more numerous and flexible supported housing models, and for equitable and earlier-aged access to supports (such as functional skills supports) that help adults with NDDs both with and without ID to make transitions to supported and independent living if and when they desire them.
Emerging evidence suggests that Parkinson’s Disease (PD)-related conditions (i.e., parkinsonism) co-occur more commonly with autism than in the general population. However, prior prevalence-based studies did not account for the influence of antipsychotic usage, which is linked to secondary parkinsonism as a possible side effect, or co-occurring intellectual disability (ID). In addition, no study of incidence rates of parkinsonism among older autistic adults has been completed to date. Prevalence and incidence were examined among 56,970,786 45+ year old persons across four groups (autism only, ID only, autism + ID, and control sample) utilizing U.S.-based, individually linked Medicaid and Medicare health care claims data from 2017 to 2019. Compared with the control sample (1.57%), highly elevated prevalence of co-occurring PD-related diagnoses was found across groups (autism only: 3.83%; ID only: 4.32%; autism + ID: 4.86%). This elevation in prevalence persisted after the exclusion of individuals prescribed antipsychotic medications. Whether examining broader or narrower (excluding secondary) parkinsonism, the age-standardized incidence or risk of newly documented co-occurring parkinsonism was highest in those with autism + ID, followed by those with autism only and those with ID only, all of which far outpaced control sample findings. Overall, elevated co-occurrence of autism and parkinsonism has significant scientific, clinical, and service-system implications. Lay Abstract Some studies find that people with autism are more likely to have co-occurring parkinsonism, or the core motor features linked to Parkinson’s Disease, like tremors and slowed movements. However, previous prevalence (number of cases at any one point in time) studies usually did not account for the influence of antipsychotic usage, which is relatively high in autism and can be associated with parkinsonism symptoms. Prior studies also rarely examined the influence of intellectual disability (ID) on the co-occurrence of parkinsonism and autism. Finally, no study of incidence rates (i.e., newly emerging cases over time) of parkinsonism among older autistic adults has been completed to date. Prevalence and incidence of parkinsonism were examined among 56,970,786 45+ year old persons across four groups (autism only, ID only, autism + ID, and control sample) utilizing U.S.-based, individually-linked Medicaid and Medicare health care claims data from 2017 to 2019. Relative to the control sample (1.57%), highly elevated prevalence of co-occurring PD-related diagnoses was found across groups (autism only: 3.83%; ID only: 4.32%; autism + ID: 4.86%), even after the exclusion of individuals prescribed antipsychotic medications. Whether examining broader or narrower (excluding secondary) parkinsonism, the age-standardized incidence or risk of newly documented co-occurring parkinsonism was highest in those with autism + ID, followed by those with autism only and those with ID only, all of which far outpaced control sample findings. Overall, elevated co-occurrence of autism and parkinsonism has significant scientific, clinical, and service system implications.
