Autism, Neurodivergence, Support Needs and Inclusion — What’s New in December and January
In this research roundup, Ann Memmott brings together recent papers from December and January exploring Autism and other Neurodivergent conditions, with a particular focus on support needs, inclusion, and ethics in research and practice. The studies span education, healthcare, social work, mental health, relationships, and the built environment, highlighting where systems continue to fall short — and where better understanding, inclusive design, and genuinely Neurodivergent-informed approaches are urgently needed.
High support needs, Autism and research
Donald and team consider how researchers need to work ethically and inclusively with Autistic people who have current high support needs:
The autistic spectrum includes a vast diversity of people..Within this diversity, however, there is a group of autistic people who are persistently and profoundly disabled. These people often (though not always) have a concurrent intellectual disability, limited speech/language even with assisted and augmentative communication (AAC) supports, and require intensive help with the activities required for daily living…
1. We need more sharing of evidence about how best to conduct research in settings that cater specifically for this population….
2. We need more relevant frameworks and guidance to underpin research in this area (e.g. informed ethics committees, protocols for monitoring assent).
3. We need better support for researchers undertaking this type of research. This includes suitable training (e.g. in de-escalation and safeguarding), and supervision that focuses on emotional support as well as research practice...
Donald, S., Sutherland, H. E. A., & Fletcher-Watson, S. (2025). Doing research in services for autistic people with complex support needs: Challenges and considerations based on UK experiences. Autism. Advance online publication. https://doi.org/10.1177/13623613251390277
Dyscalculia and its impact
Staller and team asked 18 university students who have a diagnosis of dyscalculia—in other words, severe difficulties working with numbers and maths generally.
We don’t know enough about this relatively common Neurodivergence yet. It is likely to be between 3% and 7% of the population.
Mathematical skills are essential in our modern world and difficulties with math can significantly impact a person's life, from their education to their daily activities. Yet, little is known about the specific challenges that adults with a mathematical learning difficulty like dyscalculia face... We spoke with 18 university students to learn about their struggles. Our conversations revealed three key areas of difficulty:
First, all participants reported fundamental problems with numbers and basic calculations.
These issues were not just limited to academics; they also caused significant daily struggles with common tasks like managing money and understanding time.
These challenges, in turn, had a profound emotional impact. The students described feeling shame and anxiety about math, and often went to great lengths to avoid situations involving numbers.
Our findings show that dyscalculia can significantly impact an adult's life, affecting their studies, personal life, and emotional well-being. By shedding light on the experiences of these students, we hope to start a broader conversation about dyscalculia and create a more inclusive understanding of neurodevelopmental differences. By exploring the experiences of adults with dyscalculia, our work highlights the need for greater understanding, recognition, and support for this often-overlooked group.
Staller, L., Moeller, K., Weiss, E. M., & Dresen, V. (2026). Neurodivergent conditions critically limit societal participation—The case of dyscalculia in adults. Neurodiversity, 3. https://doi.org/10.1177/27546330251406911 (Original work published 2025)
Accessibility for Autistic pupils in schools. Are we changing the buildings?
Adams and team reviewed past research on this topic. They found that it…
…suggests an association between increased or specific noises and reductions in student learning and/or well-being, and a link between specific visual elements (lighting, distractions) and reductions in learning outcomes.
Few studies reported upon physical space, smell, or temperature of the school environments, highlighting these as avenues for future research.
This study has implications for modification to education environments.Lots to do, therefore. We have tens of thousands of Autistic children potentially unable to learn in their school buildings, and that research is desperately needed.
Adams, D., Dargue, N., Malone, S., Carroll, A., & Simpson, K. (2025). Are sensory aspects of the built school environment associated with learning or well-being outcomes for autistic students? A systematic review. International Journal of Inclusive Education. Advance online publication. https://doi.org/10.1080/13603116.2025.2589290
Inclusive design
What about sensory factors in buildings generally, for those with developmental disabilities? If we improve these, do all building users benefit? Generally, yes.
Gaines and team asked over 600 people about buildings and sensory processing/coping in those spaces. Their participants included Autistic adults and people with a learning disability, education specialists, and other related staff. They used (1) a focus group, (2) interviews, (3) observations, and (4) surveys.
Auditory and tactile sound triggers were found to be the most problematic sensory responses…. Unexpected sounds, background noise, and noise from mechanical systems were among the most problematic, while incorporating music and nature sounds were found to alleviate sound triggers. Tactile sensitivity in the environment was increased or reduced based on textures and materials, available personal space, and temperature.
Conclusion: The research also showed that all users of a space benefited from the integration of inclusive design principles. This information is communicated in an easy-to-understand format that might benefit design professionals, educators, administrators, parents, and the general public.
Gaines, K., Bourne, A., Pearson, M., & Wang, H. (2025). A sensory approach to design: Inclusive principles. Journal of Autism and Developmental Disorders. Advance online publication. https://doi.org/10.1007/s10803-025-07156-5
Social work and Neurodiversity
A new paper out by Flynn on social work and its understanding of Neurodiversity.
The idea of neurodiversity and the neurodiversity movement have become of increased relevance to social work in ways that extend well beyond social science research and academe… In this article, the specific focus has been on neurodiversity inclusion. In looking to the future, propositions have been set out for how social workers can be more informed when seeking equality and respect for the whole neurological spectrum. Restitching the frayed interface between social work and macro-level social justice work (McGregor, 2022) is just one way to build a profession more celebratory of the differences we each have and the richness this difference ultimately brings.
Flynn, S. (2025). Neurodiversity, social work, and social justice: Key issues and overlaps. International Journal of Disability and Social Justice, 5(3), 290–309. https://doi.org/10.13169/intljofdissocjus.5.3.0002
Post Traumatic Stress (PTSD) in Autistic and non-Autistic adults
More important and useful work on the subject of post traumatic stress for Autistic people. Prosser and team asked 242 people, 94 of them Autistic, about their potentially traumatic experiences in life and their symptoms of trauma afterwards, if any:
…We found that autistic people experienced more types of traumatic events directly (it happened to them)… Interestingly, both groups reported events like bullying or the death of a loved one as traumatic, but these events would not meet the official diagnostic criteria for post-traumatic stress disorder. As expected, autistic people reported worse post-traumatic stress disorder symptoms than non-autistic people and were more likely to meet the cut-off for post-traumatic stress disorder diagnosis. Autistic people also reported more negative thoughts about the trauma, especially feeling unsafe, disconnected, ashamed, or that the trauma was their fault... Our findings suggest that therapies focusing on these negative thoughts could be helpful for autistic people with post-traumatic stress disorder…. It is also important that mental health services offer support for post-traumatic stress disorder even when events do not meet the current diagnostic criteria, as this might prevent autistic and non-autistic people who need support with post-traumatic stress disorder getting help.
I would argue that what we also need to do is to challenge why on earth we do not include clearly traumatic events in the diagnostic criteria for trauma. Time for a rethink, surely.
Prosser, R., Rumball, F., King, D., & Steel, C. (2025). Post-traumatic stress disorder in autistic and non-autistic adults: The impact of appraisals on reactions to traumatic events. Autism. Advance online publication. https://doi.org/10.1177/13623613251403405
Autistic adults and view on social touch
Li and team asked 31 Autistic adults and 43 non-Autistic adults to explain their views on people touching them, on areas of their body. Was this different for e.g. partner, friend, family, acquaintances? Much to reflect on, given the common past experiences of Autistic people.
Autistic people find certain types of touch, particularly light or unexpected touch, uncomfortable or overwhelming... We found that the autistic group engaged in social touch just as often as the non-autistic group… autistic adults, on average, still reported enjoying social touch less overall and experiencing more touch-related challenges in romantic relationships. They also placed less importance on touch for bonding. Moreover, the autistic group rated touch as less appropriate, less pleasant, or less intimate than the non-autistic group in professional (like physiotherapy) or friendly (like a dance class) situations. While social interaction difficulties influence how both groups experience touch, other factors seem to play a stronger role for the autistic group, such as how predictable the touch is, whether they experience sensory challenges, and how socially confident they feel or how anxious about touch they are. Rather than assuming autistic people dislike touch, it is important to recognise that they may have different preferences, and that certain situations make touch feel more comfortable and enjoyable. Respecting these preferences can help make social touch more positive and meaningful, potentially improving relationship quality with autistic people.
Li, M. T. W., Mello, M., MacLennan, K., & Lee Masson, H. (2026). Autistic adults prefer social touch less but engage just as much: The impact of social context, relationship type, sensory responsivity, and psychological factors. Autism. Advance online publication. https://doi.org/10.1177/13623613251403906
Gender and sexually diverse Autistic adults and romantic relationships
Ciric and team ask, ‘How do gender and sexually diverse Autistic adults experience and perceive romantic relationships?’
16 gender and/or sexual minority Autistic adults took part in semi-structured interviews... Four main themes were identified from the interview data: (1) ‘It’s Quite Difficult to Put Autistic Relationships Into a Box’, (2) Challenging Social Norms, (3) The Perks and Perils of Online Dating and (4) Understanding and Neurotype. Overall, participants described their relationships as individual, inherently valuable, and shaped by unique preferences, mutual understanding, and explicit communication. They also emphasized…
- the fluidity between friendships and romantic partnerships,
- the importance of mutual understanding
- the inherent value of rejecting prescriptive social norms in favour of individualized romantic relationship dynamics.
Ciric, T., White, L. C., Allison-Duncan, C., Maloney, E., & Gillespie-Smith, K. (2026). ‘It’s quite difficult to put Autistic relationships in a box’: A qualitative exploration of romantic relationships in gender and sexually diverse Autistic adults. Autism. Advance online publication. https://doi.org/10.1177/13623613251407765
The links between Autism, tics, and Tourette syndrome?
Liang and team look at Functional Tic-like Behaviour (FTLB) diagnoses for 63 children. It has been believed that the young people may ‘catch’ tic-like behaviour from watching others do it and can be trained not to do it. But are such research teams missing something here?
In the FTLB sample, 69.8% were diagnosed with autism and 37% had Tourette syndrome, both much higher than in the general population… those with autism had higher rates of co-occurring attention-deficit/hyperactivity (ADHD, 61%) and specific learning [difficulties] (27%)…. There is a high prevalence of autism in patients with FTLB. Those with FTLB and autism may be more likely to have ADHD and specific learning [difficulties] compared with those with FTLB alone. Better clinical screening for autism is essential in patients with FTLB...
The team make good mention of the huge stress on Autistic individuals, especially if they have a variety of other co-occurring diagnoses and are e.g. working through the daunting years of Covid-19 lockdowns and consequences. The team does not appear to mention or consider Autistic stimming—the repeated movements or sounds which are a natural part of Autistic self-regulation. I wonder if what they are considering to be ‘tics’, which teams believe can be ‘caught’ from watching other Autistic people, e.g. social media influencers, may be e.g. Autistic teenage girls realising what a brilliant and needed coping strategy stimming is, after years of masking their autism?
As this is not considered in the paper, clearly extra research is very much needed, including good thought as to how to work with Autistic specialists as co-partners, so that potentially important factors are not missed in future papers.
Liang, H., Wu, C., Duncan, M., Simpson, L., Smith, A., Harrold, K., Pearman, Z., Warren, A., Shavel-Jessop, S., Murphy, T., Heyman, I., Evans, S., & Catanzano, M. (2026). Autism in children and young people with functional tic-like behaviours: A retrospective cross-sectional study. Archives of Disease in Childhood. Advance online publication. https://doi.org/10.1136/archdischild-2024-328445
Racial disparities in depression and mental health service use among Black Autistic adults compared to White Autistic adults
Williams and team included 93 Black Autistic individuals in their study of depression diagnoses and symptoms. Of concern, they noted how many had high levels of depression but no lifetime diagnosis of depression, so may be excluded from the right support and services for their distress:
…Black autistic adults without a lifetime depression diagnosis report experiencing comparable levels of current depressive symptoms as those with a lifetime depression diagnosis, which for both groups fall near clinical cutoffs.
Findings underscore the need for more nuanced mental health services that address the complex needs of Autistic adults, particularly Black individuals who remain underrepresented in autism research. The similarly high anxiety and depression symptom levels across Black Autistic adults with and without a lifetime depression diagnosis suggest that those with depression and who have access to mental health services may not find that such services fully address ongoing distress. The elevated rates of co-occurring mental health conditions among those with a history of depression point to the importance of integrated, intersectional approaches to care that consider both racial identity and Neurodivergence.
Williams, E. G., Sivathasan, S., Anthony, N., Eack, S. M., & Mazefsky, C. A. (2026). Racial disparities in depression and mental health service use among Black and White autistic adults. Scientific Reports. Advance online publication. https://doi.org/10.1038/s41598-025-34696-8
What do physiotherapists know about Autism?
Autistic people often experience higher rates of co-occurring health conditions, many of which will be commonly encountered by physiotherapists. Despite this, the healthcare needs of Autistic people often go unmet due to multiple barriers in accessing services. Additionally, research indicates that health professionals may often lack training and confidence in working with Autistic patients. Physiotherapists and Autistic people—what do they know? What can we do about this?
This team asked over 600 physiotherapists working in the UK and Ireland. The answer was, “Not a lot” (paraphrased).
The majority had never had training.
The majority also rated themselves as only ‘slightly confident’ in knowing anything about how to work with Autistic people in their practice.
Generally, confidence in knowing how to adapt sensory factors was low or moderate at best.
That's a concern. Autistic people are as likely as anyone else to need physiotherapy—possibly more so, given the higher co-occurrence of e.g. hypermobility and/or dyspraxia. Autistic people may also become physiotherapists or may wish to work in other roles in physiotherapy practices. It's 1 in 30 of the population, of every age and background. If no-one knows anything about Autism, how safe are they to disclose the diagnosis?
If you are a physiotherapist or recommending that Autistic people access one, please check that you're knowledgeable on the subject. Get really good modern training from Autistic-led teams who can advise on ongoing situations.
O’Donald, F., & Wroth, C. (2025). Physiotherapists’ confidence and training in autism: A UK and Irish survey. Physiotherapy, 126. https://www.physiotherapyjournal.com/article/S0031-9406(25)00261-5/abstract
Are we getting better at finding Neurodivergent girls and women? Yes, it seems.
Maciver and team looked at the case notes for over 400 Neurodivergent people in Scotland. This included male-to-female ratios, average (median) ages at referral, and the diagnoses of e.g. ADHD, Autism, and learning disability. It is often assumed that Autism is nearly all males, and often only a token number of Autistic females are added to studies. Is this assumption about gender true, though?
The lifespan male-to-female ratio across all diagnoses was 1.31, varying by category and age.
In autism, the male-to-female ratio was 2.21 for children under 10 years, but there were more females in adolescence (male-to-female ratio = 0.79) and adulthood (male-to-female ratio = 0.94).
Across the lifespan, combining all diagnoses, females were referred later (median ages: 14.4 vs. 19.7 years) and diagnosed later (median ages: 15.2 vs. 20.2 years), indicating a 5-year delay. Among autistic children and adolescents, females were referred later (median age: 7.5 vs. 10.5 years) and diagnosed later (median age: 9.3 vs. 11.9 years).
However, no significant differences were found in age of referral or diagnosis for autistic adults. Overall, the results indicate increasing balance in sex ratios with age, greater asymmetry in younger age groups, and consistent delays in referral and diagnosis ages for females.It would appear that we are indeed getting better at finding the Autistic women and girls, but we’re missing most of them from early diagnosis. This is an important study because those delayed diagnoses represent many years of lost support, lost opportunity for self-discovery, and lost chances to connect with Neurodivergent peers in positive and useful ways.
Maciver, D., Singh Roy, A., Johnston, L., Boilson, M., Curnow, E., Johnstone-Cooke, V., & Rutherford, M. (2025). Are we getting better at identifying and diagnosing neurodivergent girls and women? Insights into sex ratios and age of diagnosis from clinical population data in Scotland. Autism. Advance online publication. https://doi.org/10.1177/13623613251383343
