Autism, ADHD, Lived Experience and Inclusion—What’s New in November
In this month’s research roundup, Ann Memmott brings together new work exploring Autism, ADHD, first‑person perspectives and inclusion. Ann reflects on sensory and communication challenges, access barriers in schools and healthcare, the ethics of interventions and how Neurodivergent people articulate their own experiences.
Autistic hearing in noisy places
Silva and team have done some valuable research on why Autistic people struggle with hearing in some places. Very relevant to many of our mental health wards, where people are expected to participate in social groups or access therapies in noisy environments. Autistic patients and staff may be at a substantial disadvantage.
Autistic individuals often have very different sensory experiences compared with non-Autistic individuals. … This may be hearing where particular sounds are coming from, or understanding what is being said, particularly in noisy situations… we asked Autistic and non-Autistic adults to fill out a short survey that measures one’s hearing experiences in daily life. We found that Autistic individuals report more difficulty across several types of hearing, and most prominently regarding speech hearing, when compared with non-Autistic individuals. This finding highlights that reports of auditory processing difficulties when there is no hearing loss are not niche experiences, but rather reflect a common experience in Autistic adults. … This study, therefore, emphasises the need for more research and awareness regarding auditory perception and hearing in Autistic adults.
Silva, E. S., Drijvers, L., & Trujillo, J. P. (2025). Exploring auditory perception experiences in daily situations in Autistic adults. Autism, 0(0). https://doi.org/10.1177/13623613251391492
ADHD: The lived experiences of children and young people
Ling and Diamond ask 12 children and young people about their experiences of ADHD.
Attention-Deficit Hyperactivity Disorder (ADHD) is… common [but] there have been few studies investigating first-hand accounts of the lived experiences of children with ADHD. This study addresses that gap with qualitative data from open-ended interviews with 12 children ages 8 to 14 years about the positive and negative aspects of their ADHD. … [There is a difference between the] generally negative perception of ADHD by society and the medical profession (a psychiatric disorder that needs to be cured) and the more nuanced perceptions of children who themselves have ADHD, where they express positive as well as negative aspects. Positive aspects reported included having more energy, the ability to hyper-focus, and being more creative and more fun because of their ADHD... The children perceived that some aspects of their ADHD are not advantageous. Implications are discussed with reference to rethinking how we understand ADHD, treatment practices for ADHD, and how to involve children with ADHD in future research.
Ling, D. S., & Diamond, A. (2025). A qualitative study of the lived experience of children with ADHD. https://www.preprints.org/manuscript/202511.0032
Using robots as pretend friends, offering hugs programmed by strangers. Safety considerations?
A team designed a huge furry robot that can hug people. They pair up Autistic people, most of them men, and one person gets the robot to hug the other person.
Apparently, this will help the Autistic people build good friendships.
My concerns include that there seems to be no consideration of what it might teach people about appropriateness of who gets to hug them. There is also apparently no consideration of the potential for past trauma and no differentiation between experiences of men and women in this, as they didn't put in enough women to test this meaningfully.
Also worth considering, what does it say about what they may think about Autistic people? That they should accept robots as proxy ‘friends’ and it's fine for a robot to hug them if someone else programs it to do so?
We live in a world where AI and robotics have moved far, far beyond clumsy single-action hug-machines covered in fur and I would like to see teams thinking far more carefully about safeguarding, and indeed any other form of safety.
Suhardita, K., Dharmayanti, P. A., Dewa Ayu Eka Purba Dharma Tari, I., Saputra, R., Arizona, A., Datuti, S., Ulfah, Badriyah, R. D. U., Soejanto, L. T., Ramadhani, E., & Padillah, R. (2025). Enhancing peer connection in Autism: Evaluating the impact of robot-mediated role-play hug interventions. Asian Journal of Psychiatry, 115, 104772. https://doi.org/10.1016/j.ajp.2025.104772
Physical activity for Autistic people – is it worth it?
Some teams are keen for Autistic people to do more physical activity, and there’s no doubt that there can be good outcomes for wellbeing, for some. Yet few teams have asked Autistic people for their views on what’s good, and what’s a barrier.
Physical activity (PA) has been suggested as a key modifier for many health concerns amongst Autistic adults, yet engagement remains low compared to non-Autistic peers. Numerous barriers, including lack of motivation, have been suggested as rationale for this reduced engagement. However, first-hand experiences of Autistic adults remain elusive within the literature. A qualitative descriptive methodology utilised the social media platform Twitter/X to explore how Autistic adults experience PA. A total of 30 questions were administered over six asynchronous discussions, and 125 tweeted responses were collected from 10 Autistic individuals. Three main themes emerged from the collected data: support from others is important; it needs to be measurable; and it’s just not worth it. Participants demonstrated detailed understanding of the benefits of being physically active; however, engaging in PA proved difficult due to inaccessible environments, sensory overload, and inappropriate support from individuals outside family or close friends.
Colombo-Dougovito, A. M., McNamara, S. W. T., & Kupferstein, H. (2025). “Not everybody enjoys physical activity”: A qualitative social media study of the barriers experienced by Autistic adults. International Journal of Disability and Social Justice, 5(2), 177–199. https://doi.org/10.13169/intljofdissocjus.5.2.0003
Are psychiatric emergency admissions services coping well with patients with both an Autism and Emerging Unstable Personality/Borderline Personality diagnosis (EUPD/BPD)? New research from Canada
Lee and team make some good recommendations for what should happen when a patient has an emergency mental health admission with a diagnosis of both Autism and EUPD/BPD. Whilst this is Canadian information, there have been related concerns raised in the UK over some mixups over the correct diagnosis for distressed Autistic younger women. (See the Tamilson paper, linked below, for some more background on this). Some have been misidentified with EUPD, later better explained by an Autism diagnosis. A pathway to healing needs to reflect Autistic needs, in most cases:
Autism and borderline personality disorder (BPD) are each associated with increased psychiatric emergency department (PsyED) use, yet the service impact of coexisting Autism-BPD remains unclear. We conducted a retrospective chart review of 1027 PsyED visits by 345 Autistic adults (2018-2020) at an urban Canadian psychiatric hospital to compare service patterns between those with and without a BPD diagnosis... BPD was documented in 33.5% of visits and in 11.0% of unique Autistic individuals, more often in birth-assigned females. Among all Autistic individuals’ PsyED visits, an Autism diagnosis was documented in 60.2% of their text-based charts. Furthermore, Autism was documented less frequently when BPD was recorded, suggesting possible diagnostic overshadowing. … Findings underscore the need for sex-sensitive, Autism-aware assessments and trauma-informed care in PsyED settings, and caution against diagnostic overshadowing that influences clinical decision-making. … Integrated Autism-BPD care pathways, with specialised outpatient supports, sensory-friendly adaptations, and structured referrals, may improve care and reduce PsyED visits.
Lee, C. J., Man, L. L. Y., Morra, A., Pace-Tonna, C., Castelino, C., Courchesne, V., Frayne, M., Luk, V., Baharikhoob, P., Jachyra, P., Zaheer, J., Ameis, S. H., Lin, H. Y., Sawyer, A., Lunsky, Y., & Lai, M. C. (2025). Psychiatric emergency visits of Autistic adults with or without documented Borderline Personality Disorder. Autism Research. https://doi.org/10.1002/aur.70148
Tamilson, B., Eccles, J. A., & Shaw, S. C. (2025). The experiences of Autistic adults who were previously diagnosed with borderline or emotionally unstable personality disorder: A phenomenological study. Autism, 29(2), 504–517. https://doi.org/10.1177/13623613241276073
Autistic experiences of school
Exley and team looked at past research to try to get a better understanding of the main difficulties experienced by Autistic pupils in schools. Their findings underline the importance of peer education, reasonable adjustments, adaptive teaching and staff training, meeting the needs of the Autistic pupil.
… Autistic students experience significantly higher rates of mental health difficulties compared with their Neurotypical peers and are vastly overrepresented in permanent exclusions. … Fourteen studies were critically appraised … [and the team found] four analytical themes: ‘feeling unsupported and misunderstood by peers’, ‘experiencing sensory overload in the school environment’, ‘feeling inappropriately supported with academic work’, and ‘feeling misjudged and undervalued by teaching staff’.
Exley, M., & Morgan, G. (2025). The challenges of mainstream secondary school: A synthesis of qualitative views from Autistic students. Review Journal of Autism and Developmental Disorders, 1–17. https://doi.org/10.1007/s40489-025-00527-9
Navigating racism, stigma and Autism services
Sterman and team take a look at this vital topic:
Research and clinical practice that addresses the needs of Autistic children often de-centres minoritised voices, despite the existing inequities that prevent their access to services and community participation. … Fifty-six studies were included in this scoping review, with a total of 1454 participants across the included studies. Findings illuminated that families had difficulty learning about and understanding Autism, gaining access to services that met their cultural and language needs, and experienced disability-based stigma and racism.
Families thrived when they were provided opportunities to learn about Autism and available resources, could advocate for their child and others, access services from providers they trusted, and have their Autistic child celebrated within their community.
To reduce inequities, there is a need for service providers to conduct culturally attuned paediatric clinical practice that centres the priorities of Autistic children and their families from racially and ethnically minoritised backgrounds. This paediatric practice needs to be Neurodiversity-positive, culturally affirming, and financially, geographically, physically, socially, and culturally accessible.
Sterman, J., Wagland, Z., Scott-Cole, L., Spassiani, N., & Njelesani, J. (2025). Navigating racism, stigma, and Autism services: A scoping review of the lived experiences of racially and ethnically minoritised families. PLOS Mental Health, 2(11), e0000481. https://doi.org/10.1371/journal.pmen.0000481
Using dogs to enforce normality on Autistic children?
Decades of experience in this field, including working directly with therapy dog charities who are assisting Autistic individuals, reveals that there is often a fantastic benefit to sharing life with animals. Clearly, this has to work well for the family and the individual concerned, of course. But we see a number of places who perhaps misunderstand the benefits, and imagine that the purpose of the dog is to enforce non-Autistic behaviour.
Shanley and team take a look at past research into dogs as an “Animal Assisted Intervention” (AAI), and discover that they are indeed often used to promote e.g. expected eye contact and spoken language. Unfortunately, the team do not consider the research into the known adverse effects of enforced normalisation on Autistic children, and they do not consider whether any of the children were asked or whether any Autistic people were involved in the design and running of the studies.
Assistance animals can do a fantastic job as e.g. ‘sighted guides’ in blindingly bright and busy environments, or e.g. as a source of reassurance and companionship. It is in my professional experience not wise for the dog or the child to focus on using the assistance animal as tools of stressful normalisation (‘masking’). (See recent paper by Scheeren, Crane and team, below re masking.)
Shanley, A. A., Egan, J., & Larkin, F. (2025). A systematic review of canine-assisted therapy and its effect on social behaviours in Autistic children. https://cora.ucc.ie/items/c50d4728-1d83-4035-9b06-87d8e23ec388
Scheeren, A. M., Nieuwenhuis, S., Crane, L., Roke, Y., & Begeer, S. (2025). Masking, social context and perceived stress in Autistic adults: An ecological momentary assessment study. Autism. https://doi.org/10.1177/13623613251353358
Improving hospital environments for some Neurodivergent children and young people (Autism and ADHD)
More potentially useful information about building hospitals and wards that are fit for purpose. This, from Albuquerque and team.
This study investigates Neurodiversity in hospital environments, focusing on the specific needs of Neurodivergent children, particularly those with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). An integrative literature review examines the influence of these conditions on the hospital experience and identifies inclusive design strategies to address them. Case studies of pediatric hospital projects are presented to demonstrate the practical application of such strategies. The findings propose recommendations for responsive design in paediatric healthcare, emphasising environmental clarity, predictability, and user control to improve the experience of Neurodivergent patients and their families. The study underscores the need for continuous evaluation and adaptation of these guidelines across diverse contexts, fostering design approaches that enhance effectiveness, empathy and inclusivity in paediatric care.
Albuquerque, C. F. H. (2025). Hospital architecture responsive to Neurodiversity. https://www.researchgate.net/profile/Ciro-Albuquerque/publication/397608559_Hospital_Architecture_Responsive_to_Neurodiversity/links/69173bec8c69163d566a395c/Hospital-Architecture-Responsive-to-Neurodiversity.pdf
Museum and art galleries – experiences of Autistic adults
Dantas and team have produced some useful research on the ways that Autistic adults use museums and art galleries. Unfortunately, building access is a significant barrier for many, and something that museum teams need to consider when designing or curating spaces and exhibits.
Visiting galleries and museums can be good for human wellbeing, but we do not know if that works in the same way for Autistic people specifically. … we asked 45 Autistic and 44 non-Autistic adults to complete an online survey … some participants wrote that they used their focused interests to help their wellbeing and mental health. Autistic people reported focused interests more frequently than non-Autistic people, but the content and purpose of their interests were similar. Both groups talked about good experiences in visiting museums/galleries and exploring their focused interests there, but Autistic people specifically complained about environments that were not accessible. Our findings show that being able to explore focused interests in galleries and museums can lead to positive feelings, while barriers in the environment and accessibility issues can stop Autistic people from enjoying their visits and exploring their interests.
Dantas, S., & Fletcher, A. (2025). Focused interests, motivation, and museum/gallery attendance–A mixed-methods survey exploring Autistic adults’ experiences and wellbeing outcomes. Neurodiversity, 3, 27546330251394513. https://doi.org/10.1177/27546330251394513
Applied Behaviour Analysis and mental health
Applied Behaviour Analysis, the basis of Positive Behaviour Support, is commonly used on Autistic people in mental health and school settings. The Autistic communities and research teams have raised significant concerns about the appropriateness of ABA and the lack of ABA team investigations into potential harms from the approaches, but there has been a request for further evidence before change is considered. The new research paper by Aguirre Mtanous and team looked at possible links between ABA being used, and severe mental health situations. Their work raises concerns and asks for further research to be done.
… We divided Autistic youth into groups based on how much ABA they received, so we could see if different amounts of ABA had different associations with mental health. There were 17,120 Autistic youth in the group that did not receive ABA, and 17,120 Autistic youth in the group that did receive ABA. In this sample, ABA therapy was associated with a greater use of acute mental health services; Autistic youth in the ABA group had an overall risk that was 30% higher for mental health hospitalisations; and a 32% greater frequency of mental health hospitalisations. These results suggest that there may be a relationship between mental health hospitalisations and getting ABA. However, more work is needed to fully understand the impact of ABA therapy on mental health outcomes.
Aguirre Mtanous, N. G., Koenig, J., Nikahd, M., Effertz, S. E., Silinonte, S., Hyer, J. M., Hand, B. N., & Bishop, L. (2025). Mental health outcomes associated with applied behavior analysis in a US national sample of privately insured Autistic youth. Autism, 0(0). https://doi.org/10.1177/13623613251390604
