INSAR poster: Contextual References as a Mechanism to Support Time-Based Prospective Memory in Autistic Adults
Background:
In everyday life, we often need to ‘remember-to-remember’ to do activities in the future (prospective memory). Some of these tasks need to be carried out at a specific time (time-based prospective memory). Because prospective memory tasks are usually carried out during unrelated everyday activities (ongoing tasks), this kind of ‘memory skill’ is very demanding on our mental resources. For example, successful time-based prospective memory depends on self-monitoring the time while also remembering what needs to be done and when to do it. Research has found that giving people an idea of the context in which a future task will occur, can improve prospective memory accuracy in the general population. Although there is very little research on this topic in autism research, the findings tend to suggest that autistic people commonly experience general difficulties with prospective memory, and particularly have difficulties carrying out plans for future time-based prospective memory activities.
Aims:
The research looked at how context cues might support autistic people to carry out every day time-based prospective memory tasks. The researchers predicted that context cues would improve time-based prospective memory accuracy to a greater extent for autistic people, compared to receiving no context information or receiving incorrect information.
Method:
The study included 62 participants, who were 38 autistic adults and 24 non-autistic adults. Participants were matched on age, gender and general intellectual ability (IQ). All participants first completed a No Context task and then completed a second task with different context information. The ongoing task was to sort words and pictures as either ‘foods’ or ‘non-foods’. Participants also had to keep track of time during the task, by checking an on-screen timer. For the time-based prospective memory task, participants had to remember to press a button when the clock showed 3-minutes. In the Correct Context and False Context conditions, participants were given information on when the target time would happen. The Correct Context cue should help participants to make more accurate prospective memory responses, but the False Context cue would likely show less accurate responses.
Results:
The researchers are still completing their analysis of the data. Their provisional findings suggest that targeted contextual information could help to reduce time-based prospective memory difficulties for autistic adults. They also observed that autistic adults were more vigilant in time monitoring – they checked the clock more often than non-autistic participants. Further analysis is being done to understand if autistic people use time monitoring combined with contextual information as strategies to support prospective memory. These early insights could offer new ways to potentially improving prospective memory and, in this way, support autistic people to live more autonomously in everyday life.
Check out the poster here:
INSAR panel: Global Insights on Understanding and Reducing Autism Stigma
At INSAR, Dr Botha and Dr Cage co-chaired a panel on autism stigma, which brought together cutting-edge and novel research exploring autism stigma from the perspectives of non-autistic and autistic researchers, using a range of methods, in different settings, from multiple geographic regions. Stigma involves the discrediting of an identity or a negative perception of differentness. Research shows that autism is a stigmatised identity, with non-autistic people holding negative biases against autistic people. Furthermore, stigma can be a life-limiting experience for autistic people: exposure to stigmatising events and attitudes relates to worse mental health outcomes and higher psychological distress for autistic people both in cross-sectional and longitudinal studies. Therefore, understanding stigma is an important topic within research, in order to reduce and prevent stigma.
The panel consisted of four talks, which covered the following topics: Dr So Yoon Kim and colleagues from Duksung Women’s University (Seoul, South Korea), Yonsei University (Seoul, South Korea), and Department of Psychology, City University New York (United States), presented their work on “A Cross-Cultural Comparison of Stigma Toward Autism in the US and South Korea”. Their study was a cross-cultural comparison of autism stigma in South Korea, a relatively collectivistic and ethnically homogeneous country, and in the US, a relatively multicultural and individualistic country. Overall, 296 American and 494 Korean participants completed online surveys. The researchers found that Koreans reported higher autism stigma than Americans. Heightened vertical individualism, less accurate autism knowledge, less pleasant and frequent previous contact with autistic people, and higher cultural tightness predicted greater stigma.
Dr Eilidh Cage presented work with Taylor Doyle, a former Stirling MSc student, on “Investigating the Implicit and Explicit Attitudes of Primary School Educators in Scotland Towards Autism”. This study aimed to investigate Scottish educator’s explicit (i.e. conscious) and implicit (i.e. unconscious) attitudes towards autistic children, and to understand the relationships between educator’s attitudes, knowledge and experience. Seventy primary school educators working in Scotland took part, completing measures of attitudes and knowledge about autism. Overall, participants held positive attitudes towards autistic children in both explicit and implicit attitude measures, although 24% showed negative implicit attitudes. Younger educators with less experience had more positive attitudes, perhaps reflecting societal changes in perceptions and greater exposure to autistic experiences in recent years. Enhanced knowledge also predicted more positive attitudes.
Dr Monique Botha and colleagues from the University of Surrey and UCL presented their work entitled ‘“It’s Being a Part of a Grand Tradition, a Grand Counter-Culture”: A Qualitative Investigation of Autistic Community Connectedness, Stigma, and Identity.’ This interview study with 20 autistic people looked at autistic people’s experiences of the autistic community, and noted how stigma and discrimination seemed to push autistic people towards autistic community connectedness (ACC), whereas an internalisation of that stigma seemed to push people away. Three domains (belongingness, social, and political connectedness) appear to inform the broad construct of ACC. This community level togetherness may provide a form of social resource to help protect against stigma and discrimination, and work to further the political causes of the autistic community.
Finally, Desi Jones and colleagues from the University of Texas at Dallas presented their research on “Effects of Autism Acceptance Training on Explicit and Implicit Biases Towards Autism”. This study aimed to determine whether training to improve autism knowledge and familiarity in non-autistic adults is associated with more favourable attitudes about autism. A total of 238 non-autistic adults were randomly assigned to one of three conditions: 1) autism acceptance training, 2) mental health training, or 3) a control condition. They found that a brief video training about autism was associated with more accurate autism knowledge and more favourable attitudes towards autism compared to the general mental health training video and a control condition. However, the benefits of training were restricted to explicitly held attitudes, with negative implicit beliefs about autism present across training groups.
The panel was followed by a reflection on the four talks by Dr Jac Den Houting (Macquarie University, Australia) and a question and answer session with attendees. The discussion covered topics such as intersectional stigma (what happens when someone has multiple minority identities?), internalised stigma (how can we prevent the internalisation of all the stigma autistic people are exposed to?), and the role of society and in particular autism researchers in perpetuating autism stigma. Although we are making progress, there is clearly still a long way to go.
If you have any questions about this panel, please contact Dr Eilidh Cage and Dr Monique Botha (eilidh.cage@stir.ac.uk & m.d.botha@stir.ac.uk).
INSAR poster: A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People
Background:
Recognition, diagnosis and high-quality support for mental and physical health relies on the knowledge, attitudes and confidence of healthcare professionals. However, there is variability among healthcare professionals in different contexts, professions and cultures. While several studies have examined healthcare professionals’ experience of working with autistic people, no systematic review has compiled this evidence. Therefore, the present study aimed to bring together the current evidence base on healthcare professionals’ knowledge, self-efficacy (confidence) and attitudes towards working with autistic people.
Methods:
The review of the literature was conducted following systematic review guidelines in November 2019. Studies had to look at the topic of knowledge, confidence or attitudes towards autism in healthcare professionals (e.g. doctors, nurses, medical students etc.), used quantitative methods and were published in English from 1994 to present.
Results:
Overall, thirty-five studies were identified, spanning over many countries and occupations. The methodologies of all studies were rated as moderately good and the number of participants totalled 8,398. Of these studies, findings were inconsistent regarding the impact of characteristics such as gender, age or experience on knowledge, attitudes or self-efficacy. Six of the thirty-five studies looked at self-efficacy and found moderate confidence reported overall. It was determined that specialities (e.g., paediatrics) had better knowledge than general healthcare providers. However, of the 27 studies that investigated autism knowledge, knowledge ranged widely between poor and fair. Furthermore, two studies found attitudes of discomfort in working with autistic people moreover, and two studies linked beliefs around curses and enemies causing autism as well as poor parenting. These findings show clear room for improvement among healthcare professionals to ensure improved knowledge, self-efficacy and attitudes towards working with autistic people.
This research has recently been accepted as a paper – watch this space!
In the meantime, check out the poster here:
INSAR poster: Longitudinal Investigation of the Impact of Minority Stress and Autistic Community Connectedness on Mental Health in the Autistic Community
Background:
The minority stress model (MSM) suggests that marginalised minorities are exposed to excess stress resulting in health inequalities and is useful for understanding the high rate of mental illness in the autistic community. Similarly, intra-community connectedness (being connected to other autistic people) has been shown to weaken the impact of perceived stigma on both depression and suicidality. No previous research has investigated the utility of the MSM for understanding mental health and autistic community connectedness for autistic people over time. Thus, the present study aimed to answer whether exposure to exposure to minority stress is associated with worse mental health and wellbeing, and whether higher connectedness with the autistic community is associated with better mental health over time in the autistic population.
Methods:
Overall, 99 autistic participants took park in the longitudinal study, in which participants completed a survey on two occasions, nine months apart. The survey measured: demographics, general stress, minority stress, autistic community connectedness, wellbeing and psychological distress.
Results:
The results found that higher exposure to minority stress reported at time one was associated with significantly worse mental health at follow-up. Conversely, higher ‘outness’ (being ‘out’ as autistic) at time one predicted significantly better wellbeing at the second time point. Furthermore, higher rates of autistic community connectedness at time one was associated with significantly higher emotional, social and psychological wellbeing at time two, as well as significantly lower psychological distress. This research demonstrates the continued utility of the MSM and community connectedness for understanding wellbeing in the autistic community.
Check out the poster here:
INSAR poster: Seeing in the Mind’s Eye. A Study of Aphantasia in Relation to Episodic Memory and Future Thinking in Autistic Adults
Background:
Many autistic people experience difficulties in recalling personally experienced past events (episodic memory). These memory difficulties also extend to thinking about the future (episodic future thinking) and remembering to carry out tasks in the future (prospective memory). These processes require the use of mental visualisation of oneself in past or future. Visualisation skills reflect a spectrum of individual differences, from little to no mental visualisation (Aphantasia) to high clarity vivid mental imagery (Hyperphantasia). In the general population, approximately 2% of people experience Aphantasia.
Aims:
The research investigated whether autistic people experience higher rates of Aphantasia compared to non-autistic people, and how visualisation skills might relate to episodic memory and future thinking.
Methods:
193 participants took part in this study, of which 98 were autistic diagnosed or self-identifying autistic adults and 93 were non-autistic adults. Participants completed the research online, answering a series of questionnaires about autistic traits, visualisation, episodic memory, and episodic future thinking.
Results:
The results of the study that showed a higher rate of Aphantasia in autistic adults (5.6%) compared to non-autistic adults in this study (1%) and previous research (2%). In the autistic group, mentalizing difficulties related to autistic traits were associated with less visualisation of mental images (greater levels of Aphantasia). However, visualisation difficulties, but not mentalizing difficulties, were specifically related fewer future thinking events. This was not the case for episodic memory in autistic adults. However, compared to non-autistic adults, the autistic adults in the present study made more errors, overall, and generated fewer episodic memories and future thinking events. The findings of the study offer promising insights to the pattern of cognitive variability in autistic adults. These insights could be potentially useful to inform future targeted support for every day remembering.
Check out the poster here:
INSAR poster: Identity After an Autism Diagnosis: Gender, Self-Esteem and Wellbeing
Background:
Autism diagnosis is common in adulthood, particularly for females, and is often noted to be emotionally impactful, with a lack of post-diagnostic support. Personal identity consists of characteristics that define an individual and differentiate them from others. Autistic personal identity is an individual’s sense of whether autism is part of who they are, as opposed to autistic social identity which involves identifying with other autistic people. The present study hypothesised that more positive personal autistic identity would relate to higher self-esteem and wellbeing, and that earlier diagnosis and longer time passed since diagnosis would relate to more positive personal autistic identity.
Method:
The study distributed an online survey which was completed by 151 autistic adults, which measured: autistic characteristics, self-esteem, mental wellbeing and personal autistic identity. Lastly, participants were asked how receiving an autism diagnosis affected how they felt about themselves using an open qualitative question.
Results:
The results showed that greater pride in autistic identity was linked with higher self-esteem and that greater feelings of dissatisfaction with autistic identity related to reports of lower wellbeing. In addition, as the number of years since diagnosis increased, dissatisfaction with autistic identity decreased. In response to the qualitative question, most commonly participants noted there to be an emotional adjustment and adaptation process that over time led to improved satisfaction in autistic personal identity. However, it was noted that there was a lack of external support. Therefore, the study highlighted a clear need for high-quality information and support post-diagnosis.
This study is available as a preprint here: https://psyarxiv.com/4ns83/
Check out the poster here: