Autism, ADHD, Neurodiversity Language and Accessibility Research—What’s New in October
In this month’s research roundup, Ann Memmott explores new studies on Autism, ADHD, neurodiversity language and accessibility. Highlights include adolescent emotion regulation, terminologies, educational and healthcare support and ethical debate in Neurodivergent lives.
ADHD in female students age 10-20 – What are their experiences?
It’s good to see this research by Sach and team. Based in Australia, the paper has a huge amount of detail on existing research on ADHD in girls and young women and explores the opinions of a selection of female students age 10-19. We don’t know enough about this subject yet, so this is well worth reading.
The current study provided insight into the experiences of female students diagnosed with ADHD in the Australian school context. The findings of this study highlighted the complex and challenging experiences faced by female students, these encompassed: experiences of poor teacher understanding of ADHD, biases and stigma, and a desire to be better understood by teachers and peers; factors contributing to the provision and accessibility of effective support, as well as factors involved with promoting agency and self-advocacy and the role of neurodiversity in social experiences. The findings highlighted the need for improved teacher education surrounding ADHD and the need for improved school-based ADHD psychoeducation. Further research is needed to extend our understanding of the factors contributing to under-detection of ADHD in female young people, as well as how the efficacy and accessibility of school-based support can be improved for female students with ADHD.
Sach, L. M., & Porter, M. A. (2025). “That’s not what ADHD is”: Australian Schooling Experiences of Female Students with ADHD: An Interpretative Phenomenological Analysis. J Edu Psyc Res, 7(2), 01-20. https://www.researchgate.net/profile/Lucas-Sach/publication/396692655_That's_not_what_ADHD_is_Australian_Schooling_Experiences_of_Female_Students_with_ADHD_An_Interpretative_Phenomenological_Analysis_Research_Article_Sach_L_M_and_Porter_M_A_Corresponding_Author/links/68f5a041ffdca73694b90b2b/Thats-not-what-ADHD-is-Australian-Schooling-Experiences-of-Female-Students-with-ADHD-An-Interpretative-Phenomenological-Analysis-Research-Article-Sach-L-M-and-Porter-M-A-Corresponding-Author.pdf
Board gaming for Autistic people
Cross and team surveyed over 1600 board game players, finding that there were far more Autistic people than some might expect. Further questioning of some participants showed they loved the predictability of parts of it, the escapism of some games, and the chance to communicate in useful Autistic-friendlier ways with their peers.
This analysis uncovered themes around how board games are challenging but encouraged growth and how they were an alternative vehicle for forging social relationships. Through this paper, we discuss how and why board games may be a popular hobby amongst the Autistic population, and its potential utility for improving Autistic wellbeing.
Cross, L., Belshaw, F., Piovesan, A. et al (2025). Game Changer: Exploring the Role of Board Games in the Lives of Autistic People. J Autism Dev Disord 55, 3478–3497. https://doi.org/10.1007/s10803-024-06408-0
An online survey of UK-based Neurodivergent adults’ views of neurodiversity-related terminology
It was good to be a part of this important work, looking at the descriptions Neurodivergent people prefer for e.g. Autism, ADHD, dyspraxia, dyslexia and Tourette syndrome. A really big sample of people responded, and there’s lots to reflect on in this. The full version should be out within Neurodiversity Journal shortly.
Neurodivergent people report being stigmatised including by language. The language preferences of Neurodivergent adults have been largely restricted to studies focused on single forms of neurodivergence, primarily Autism.
We undertook an online survey with 901 Neurodivergent adults from the UK, focused on their use of and thoughts about terminology related to Neurodivergence, including terms such as “neurodiversity” and “Neurodivergence”…. Those providing services to Neurodivergent people should generally use neurodiversity terminology correctly, but could also mirror the individual’s language choices when communicating one-to-one.Grant, A., Leigh, J., Botha, M., Macdonald, S. J., Williams, K., Williams, G., ... & Pearson, A. (2025). “A lovely safe umbrella to describe yourself with” or “meaningless”: an online survey of UK-based Neurodivergent adults’ views of neurodiversity-related terminology.
https://durham-repository.worktribe.com/output/4652426/a-lovely-safe-umbrella-to-describe-yourself-with-or-meaningless-an-online-survey-of-uk-based-neurodivergent-adults-views-of-neurodiversity-related-terminology
Autistic empathy
Zhang takes a deep look at what we mean by ‘empathy’, in a world that generally doesn’t empathise with Autistic people, or understand Autistic forms of empathy. With good discussion of the pioneering work of Dr Damian Milton, Zhang also examines a wide range of other modern research that provides very strong challenge to the ‘deficit myths’.
Whilst Autistic individuals may indeed face challenges in…[empathy], they are often unfairly held solely accountable…recent research suggests that such difficulties… often arise from mismatches in communicative expectations and interpretive frameworks. For instance, studies by [teams led by Crompton, Heaman & Gillespie, & Morrison] indicate that Autistic to Autistic communication tends to be more fluent, emotionally attuned, and marked by stronger relational connection than interactions between Autistic and non-Autistic individuals…
Zhang J. (2025). Navigating Autistic empathy: phenomenological perspectives and debates. Med Health Care Philos. doi: 10.1007/s11019-025-10303-5. Epub ahead of print. PMID: 41108341. https://pubmed.ncbi.nlm.nih.gov/41108341/
Emotion regulation in Autism and ADHD – Neurodivergence adolescents’ perspectives
Pavlopoulou and team ask young people to talk about their experiences of emotional expression in times of great stress, and what really helps. We need much more of this kind of research, grounded in people’s lived experiences and deep curiosity about how to make a difference to their lives. Well worth reading.
Accounts of emotional dysregulation in Autism and ADHD are typically based on external adult observations anchored in neurotypical notions of appropriate emotional responses. These often fail to account for Neurodivergent people's efforts to regulate in the context of the upsetting experiences they face, and to explore how Neurodivergent young people manage emotional burden or find effective strategies to reduce distress and increase resilience. We interviewed 57 adolescents (11-15 years; 19 females) with diagnoses of ADHD (n=24), Autism (n=21) or both (n=12), about their experience of upsetting events… Three themes were found: (1) What helps prevent experiences from becoming upsetting, (2) Managing emotional responses during periods of upset and (3) Leveraging own strengths. Participants highlighted the importance of consistent, Neurodivergent-affirming environments, flexible supports, and being genuinely accepted. Autonomy in choosing self-regulation strategies, co-regulation and expressing distress without stigma were key to emotional wellbeing.
These findings underscore the value of stable, trusting relationships and the need for predictable routines. Results offer actionable insights for educators, caregivers, and professionals aiming to foster inclusive, emotionally supportive environments for Neurodivergent youth.”
Pavlopoulou, G., Chandler, S., Lukito, S., Kakoulidou, M., Matejko, M., Jackson, I., Balwani, B., Boyens, T., Poulton, D., Harvey-Nguyen, L., Glen, Z., Wilson, A., Ly, E., Macauley, E., Hurry, J., Baker, S., Sonuga-Barke, E. J. S., & RE-STAR Team. (2025). Situating emotion regulation in Autism and ADHD through Neurodivergent adolescents' perspectives. Scientific reports, 15(1), 37464. https://doi.org/10.1038/s41598-025-21208-x
Autistic people and eyecare
Edwards and team asked a large sample of eye care professionals (Opticians, Ophthalmologists, etc) about their Autism knowledge & confidence, using the AASPIRE self-efficacy scale and other measures.
Participants reported moderately high levels of self-efficacy, Autism knowledge and positive disability attitudes, yet only 14% perceived they had received formal Autism-specific training. Frequent clinical contact with Autistic individuals was the strongest predictor of higher self-efficacy (p < 0.001). Qualitative analysis identified common challenges (e.g., sensory sensitivities, time constraints and communication barriers) and practical strategies (e.g., flexible testing, sensory accommodations and clear communication). Participants expressed a strong desire for further training and system-level supports to provide more accessible, person-centred care.
The challenge, perhaps, is that we have found almost no Autistic adults as yet (see, e.g. the NHS data on this at https://www.england.nhs.uk/long-read/Autistic-peoples-healthcare-information-strategy-for-england/#number-of-people-with-autism-known-to-gps ), so many of the eye care professionals will be entirely unaware of who their Autistic patients are. Other patients may of course not wish to say that they are Autistic, due to concerns about how this information will be received. An important paper highlighting the need for really good, modern training for eye care professionals.
Edwards, C., Love, A. M., Cai, R. Y., Constable, P. A., Love, D. C., Parmar, K., ... & Gibbs, V. (2025). Autism in eye care: A mixed‐methods study of professional knowledge, confidence and clinical experience. Ophthalmic and Physiological Optics. https://onlinelibrary.wiley.com/doi/abs/10.1111/opo.70029
Restraints used on Autistic people and people with a learning disability e.g. those needing an operation?
Physical restraints are often used on Autistic people and people with a learning disability, in some settings. In discussing this, we’ll look at an example paper by Ito and team, who examined how a particular hospital team in another country approached distressed Autistic individuals in need of surgery.
Published in a formal Anaesthesia Journal, the narrative is very much around alleged danger from the Autistic individuals, and I’d like to reflect on some of the statements within it. The team describes Autistic individuals as challenging, and report that they struggle to understand what’s needed of them, so are showing ‘reduced co-operation’.
In addition, apparently, they show ‘maladaptive behaviours’ such as ‘hypersensitivity’. In my view, finding something painful is not a maladaptive behaviour.
The paper details the restraints used to force the patient to have the procedure, if they did not, or could not, co-operate. A photograph of a young man in restraints illustrates this, with a note that the parents consented to the use of the image. One must assume that the individual did not consent to either the procedure, or use of the image. What ethical problems does this highlight?
The paper states that 40% of Autistic patients in their care ‘required’ restraint. Did they? That question is an important one to reflect on. The paper linked below, by Perers and team, discusses, “…an incidence of post-traumatic stress disorder after seclusion or restraint varying from 25 to 47%”. This is in addition to risks of physical injury to the person or indeed the staff, and the potential to further damage trust and chances of future successes in healthcare. Replacing one harm with significant risk of another long-lasting harm is arguably not a step forward in care.
Whilst mindful of the considerable ethical and practical challenges involved for, e.g. emergency situations, it is of concern that any cohort of individuals is fairly routinely restrained, in any setting across the globe. A reduction of restraints to zero is a better aim, with every patient treated with dignity and enabled to understand what is needed, with good pre-visits and transitions, and opportunity for trust-building with team members. Clearly, in an absolute crisis, teams have to do the best they can, but there should be good and careful consideration to the potential for lasting trauma, injury etc from any restraints used, a very thorough debriefing, and good access to any therapies needed for the person to recover from their ordeal & any injuries sustained during it.
Seek out good training on removing the need for restraints in your everyday practices. Ask care teams about the restraints they use, how often and why they use them, and what training they are getting so that they move away from the need to do so.
Ito, H., Tsuji, T. & Sobue, K. (2025). Clinical and demographic characteristics of patients with Autism spectrum disorder receiving general anesthesia with or without physical restraint: a single-center retrospective study. J Anesth. https://doi.org/10.1007/s00540-025-03592-w
Perers, C., Bäckström, B., Johansson, B. A., & Rask, O. (2022). Methods and strategies for reducing seclusion and restraint in child and adolescent psychiatric inpatient care. Psychiatric quarterly, 93(1), 107-136. https://link.springer.com/article/10.1007/s11126-021-09887-x
Getting Autism research right
Good to see this from LaPoint, Bottema-Beutel, Fletcher-Watson and the rest of the team, taking a deep look at the state of Autism research. Stark findings, strong recommendations, and important for everyone to reflect on, when they are reading research papers.
Large number of research papers which show risk of biased reporting.
Only 1 in every 10 research papers checked for adverse effects of interventions or treatments.
Widespread undisclosed conflicts of interest in research papers, e.g. teams not reporting that they are earning a living from the thing they are researching (thus may be more likely to find it ‘works’).
Plenty of good recommendations for how the industry can sort itself out. Research needs to be fit for purpose, and one cannot over-stress how vital it is that we have an ethical and robust system for Autism, as we do for other fields. It is of concern when any of us are making recommendation for best practice, only to later find that the research was highly flawed. Improved systems are better for everyone.
LaPoint, S., Klein, C. B., Sandbank, M., Bottema‐Beutel, K., Fletcher‐Watson, S., Divan, G., ... & Green, J. (2025). Maximizing the Quality and Reporting Standards of Autism Intervention Science. Autism Research. https://onlinelibrary.wiley.com/doi/10.1002/aur.70126
The severity of eating disorders, for Autistic people, is related to masking
Carpita and team examine whether there’s a link between how severe an eating disorder is, and how much the person is having to camouflage/mask being Autistic.
Our findings reinforce the notion that social camouflaging, often used as a coping strategy, is associated with the presence and severity of eating disorder symptoms. Overall, the study underscores the complex interplay between Autistic traits and disordered eating, highlighting the importance of further research into this connection.
Exploring this, in therapeutic settings, may be a way forward for some individuals with an eating disorder. How much are they having to disguise being their true Autistic selves? What strain is it putting on them? Does that strain make it more likely that they don’t cope well with the sensory and social overload of meals? More research is needed, but it’s an important early finding and worth reflecting on, for teams in ED units.
Carpita, B., Nardi, B., Pini, S., Parri, F., Perrone, P., Pronestì, C., Giovannoni, F., Russomanno, G., Bonelli, C., Massimetti, G., Cremone, I. M., Fiorillo, A., & Dell'Osso, L. (2025). Social camouflaging of Autistic traits is associated with more severe symptoms among subjects with feeding and eating disorders. Eating and weight disorders: EWD, 30(1), 81. https://doi.org/10.1007/s40519-025-01785-6
What do Autistic people think about? A reflection on poor wording in questionnaires
Forby and team examine what people think about, when given five minutes to just sit, doing nothing. They tried to link the findings to how highly the people had scored on the Autism screening.
Neurotypicals [not-Autistic] minds wander between 20% and 50% of their waking hours, during which they engage in mental tasks such as problem-solving, planning, mulling current concerns, and self-reflection… To investigate the effects of Autistic traits on MW, we asked 92 participants to sit in a quiet room for five minutes with their eyes closed.
Very unfortunately, the test they used had very unclear wording, about whether they thought about, ‘… putting themselves in someone’s shoes’. The likely-to-be-Autistic people scored lower in that section, and the team declared that this may mean they didn’t understand other people’s experiences, thus had lower Theory of Mind. No, arguably it didn’t mean this. Any Autistic person who thinks more literally may have taken the ‘shoes’ question literally. ‘Did I think about other people’s shoes, and putting my feet in them? No.’
Another reminder to be cautious in interpreting test results based on questionnaires and tick-box lists. Are we sure that Autistic people have interpreted the questions in the way we meant? Always ensure that Autistic specialists review findings, so that such potential errors are spotted.
Forby, L., Porto, G. G., & Kingstone, A. (2025). Mind wandering during five minutes of rest: Autistic traits, visual thought, and thinking about others. Acta psychologica, 261, 105746. Advance online publication. https://doi.org/10.1016/j.actpsy.2025.105746
The importance of the right message, for charities and organisations
What messages do the big Autism charities rely on, and do those messages help Autistic people make progress, in society?
Abnett and team looked at the language and imagery used in the Trustees’ Annual Reports and Accounts of 11 large English and Welsh Autism charities.
Representation within these reports emphasises adversities associated with Autism, and the language chosen to portray Autistic people largely describes Autism as an impairment. In contrast, charities represent themselves as the solution to the ‘problem’ of Autistic people, and thus deserving of increased resources and funding. Government is largely depicted as ineffective and deficient. We argue that these Autism charities are thereby upholding – rather than challenging – the disabling barriers in society experienced by Autistic people. For Autistic charities to better represent Autistic people and improve wider societal understanding of Autism, there is a need for more positive portrayals that challenge the ‘charity saviour’ trope in charity communications.
Whilst focusing on Autism charities in particular, there are good reflections and recommendations for all organisations who use marketing and PR strategies in their work supporting marginalised communities and individuals. Until organisations are confident in showing positive portrayals, they may be keeping people trapped in a repeating cycle of difficulties.
Abnett, H., Williams, K., Holloway, W., & Grant, A. (2025). Expert organisations with "challenging" and "complex" service users: Representation in English and Welsh Autism charity reports and accounts. PloS one, 20(10), e0335132. https://doi.org/10.1371/journal.pone.0335132
