Purpose: Autistic adults reportedly experience poorer quality of life (QoL) than their non-autistic peers. However, many tools used to measure their QoL were not developed for autistic adults, but for the general population. It is possible that factors contributing to the QoL of autistic individuals could vary from that of the general population, meaning commonly used tools may inadequately capture the nuances of autistic QoL. It is, therefore, imperative that autistic QoL is comprehensively conceptualized from the perspective of autistic adults.Methods: We used a qualitative semi-structured interview methodology guided by an overarching coproduction approach to capture factors contributing to autistic QoL. A research team, including an autistic researcher and a steering group of five autistic adults, worked together throughout the entire research process. An additional autistic researcher provided consultation about how to authentically coproduce this research. Coproducing this research included the steering group and autistic researcher in developing the methodology, the interview guide, and the thematic analysis and naming of the themes. We interviewed 29 autistic adults aged 18-55 who lived in Australia.Results: Coproduced thematic analysis identified five themes: activities and routines; relationship supports and socialization; mind and body; personal experiences; and environment. Participants described how subthemes within each theme positively and/or negatively impacted their QoL. Examples of subthemes that may represent factors uniquely impacting QoL for autistic adults include understanding their self-identity, sensory experiences, and the impact of societal attitudes.Conclusion: While some elements identified by autistic adults also appear in non-autistic conceptualizations of QoL, the impact and importance of these factors may vary from non-autistic experiences. We also identified some factors that may uniquely impact QoL for autistic adults. Community Brief Why is this an important issue? Quality of life (QoL) is an important but underresearched outcome for autistic adults. Supports are often provided with the aim of improving QoL, but our understanding of QoL is based on understandings from non-autistic populations. The factors contributing to QoL in autistic adults might be different from non-autistic adults, and assessments used by health professionals to measure QoL may not accurately measure autistic QoL. Understanding the factors that support QoL for autistic adults is important for ensuring accurate assessment and for providing more effective support to enhance QoL for autistic individuals. What was the purpose of this study? This study wanted to understand what factors influence autistic adults' QoL. It is the first step toward understanding autistic QoL, which could inform the measurement of autistic QoL. What did the researchers do? The research involved in this study used a participatory approach, working with a steering group that included five autistic adults. An autistic researcher is also part of the research team, and a second autistic researcher provided advice about how to authentically coproduce the study. The steering group and research team developed an interview guide about QoL. We used it in interviews with 29 autistic adults aged 18-55 years. The research team and steering group analyzed the interviews to represent the perspectives of the participants. The research team and steering group developed the themes together. What were the results of the study? We identified five themes summarizing the factors that influence autistic QoL: activities and routines; relationships supports and socialization; mind and body; personal experiences; and environment. Participants described how subthemes within each theme positively and negatively impacted their QoL. Some subthemes include understanding their self-identity, sensory experiences, socialization, relationships, health, and the impact of societal attitudes. How do these findings add to what is already known? This research provides an in-depth understanding of the factors that influence autistic adults' QoL. Until now, there has been a limited understanding of these factors. What are the potential weaknesses of the study? The participants in this study were generally highly educated, and most were diagnosed in adulthood. Only one participant reported having an intellectual disability, and all participants communicated verbally. This could mean that the results do not represent all factors important to the QoL of those with an intellectual disability or who use other forms of communication. How will these findings help autistic people now and in the future? These findings highlight the factors that health professionals should consider when working with autistic adults to enhance their QoL. These results can also inform the development of better assessments to measure autistic QoL.

A systematic review and meta-analysis were utilised to explore the methodological quality, program fidelity, and efficacy of social skills group programs (SSGPs) aiming to support autistic adolescents in navigating their everyday social worlds. The study evaluated the methodological quality and theoretical fidelity of studies, with a random effect meta-analysis conducted to summarise the overall efficacy of SSGP and its effect on social communication and interaction, behavioural/emotional challenges, adaptive functioning, and autism characteristics. Although findings from the 18 identified studies indicated an adjusted medium overall effect with these programs successfully supporting autistic adolescents’ socialisation needs (g = 0. 60, p < 0.001), most studies demonstrated medium to low program fidelity despite their good methodological quality. Given the significant heterogeneity of SSGPs and variations in the design and measurement frameworks of efficacy studies, understanding the generalisability of the findings of this research is unclear.

Autistic individuals experience poor vocational outcomes internationally. Transition planning and interventions during adolescence may assist in improving outcomes in adulthood. Strength-based technology clubs show promise in improving outcomes for autistic adolescents by developing skills specific to the Information and Communication Technology industry, and fostering positive traits, such as self-determination. Although strength-based technology clubs have been examined with autistic adolescents, to date, no framework has been proposed to underpin their design and delivery. In this conceptual analysis, we propose a practical framework for delivering strength-based technology clubs for autistic adolescents. The framework builds on work from a previous systematic review of qualitative research and a realist evaluation study of technology clubs for autistic adolescents, combined with theoretical understandings from three health models. The new framework comprised the components of interests, value, autonomy, and requirements, forming the acronym IVAR. Interests refer to strategies drawing on adolescents' areas of interest. Value represents a culture of valuing autistic adolescents as individuals for their unique strengths and skills. Autonomy refers to providing opportunities for adolescents to make decisions, and Requirements refers to aspects of the social and physical environment. Practical recommendations of the framework are discussed, including design and delivery of future strength-based technology clubs, facilitator training, and design activities. The proposed IVAR framework may be useful in guiding the development of strength-based technology clubs. Future research is needed to validate the feasibility and efficacy of the IVAR framework in underpinning the delivery of strength-based technology clubs to autistic adolescents.

Community brief

Why is this topic important?

The shift from adolescence to adulthood can be challenging for young people on the autism spectrum, and opportunities for employment may be limited. Modern approaches to improving employment outcomes for autistic youth highlight the importance of adopting a strength-based framework, such as matching the strengths and interests of autistic young people to future career pathways. The strengths of many autistic individuals are considered beneficial for employment in the Information and Communication Technology (ICT) sector. Strength-based technology clubs provide opportunities for autistic young people to develop their technological and social skills, meet role models working in the ICT industry, and help them to find work experience.

What was the purpose of this article?

The purpose of this article was to develop a new framework for delivering strength-based technology clubs to autistic adolescents. The development of this framework was guided by the authors' earlier work in this area.

What do the authors conclude?

The authors proposed a new framework for delivering strength-based technology clubs to autistic adolescents. The framework contains four components, creating the acronym IVAR: Interests, Value, Autonomy, and Requirements. The component, Interests, refers to strategies that draw on adolescents' areas of interest, such as changing activities to include adolescents' focused interests. Value represented a culture of valuing autistic adolescents as individuals for their unique strengths and skills. Autonomy refers to providing opportunities for adolescents to make decisions during the program, and Requirements refers to the design of the social and physical environment.

What do the authors recommend for future research on this topic?

The authors recommend that future research should focus on exploring how practical and appropriate the IVAR framework is in supporting the delivery of strength-based technology clubs for autistic adolescents. The four IVAR components are potentially applicable to other areas of community focus to guide strength-based approaches more generally within autism research.

How will this analysis help autistic adults now and in the future?

This analysis and discussion will provide researchers, autistic individuals, and the community with practical examples of how service providers can apply IVAR to design and deliver strength-based technology programs for autistic adolescents.

Background

Picture My Participation (PMP) is a valid instrument for measuring participation of children with disabilities, but it has not yet been evaluated for its content validity for children with autism spectrum disorders (ASD) in mainland China.

Aim

To explore the content validity of the simplified Chinese version of PMP (PMP-C; Simplified) for children with ASD and typically developing (TD) children in mainland China.MethodsA sample of children with ASD (n = 63) and TD children (n = 63) recruited through purposive sampling were interviewed using the PMP-C (Simplified), which contains 20 items of everyday activities. Children rated attendance and involvement on all activities and selected three most important activities.

Results

Children with ASD selected 19 of 20 activities as the most important activity while TD children selected 17 activities. Children with ASD used all scale points for rating attendance and involvement on all activities. TD children used all scale points for rating attendance and involvement in 10 and 12 of 20 activities, respectively.

Conclusion

The contents of 20 activities of PMP-C (Simplified) were relevant for all children and especially for children with ASD for assessing participation in community, school and home activities.

Strengths-based approaches leveraging the strengths and interests of autistic students are increasingly recognised as important to meeting their school-related needs. A scoping review exploring elements contributing to strengths-based approaches for autistic students in schools was undertaken. Eighteen articles were identified, with results conceptualised according to the Bioecological Model of Development. One personal (strengths and interests), six microsystem (specialised instructions, curriculum integration, curriculum differentiation, common interests with peers, reciprocal roles and adult involvement), three mesosystem (matching resources and activities, real-life learning experiences and benefiting all students), and three exosystem (cost-effective and timesaving, collaboration with colleagues and parents and teachers' attitude and knowledge) elements were identified. Findings highlight the interrelatedness of the elements contributing to strengths-based approaches for autistic students, which can be used to aid in the development of more inclusive school environments.

Strength-based technology clubs are thought to help autistic adolescents transition to adulthood by developing positive traits, enhancing technical skills, and creating supportive networks. A newly developed strength-based technology club was delivered to 25 autistic adolescents, with the feasibility tested via qualitative and quantitative methods. Autistic adolescents, their parents, and club facilitators participated in separate focus groups, with audio data transcribed and thematically analyzed. Quantitative data was collected via adolescent and parent-reported pretest-posttest measures following the 15-week program. Autistic adolescents were highly satisfied with the club (acceptability), the technology club satisfied an unmet need (demand), with the program demonstrating the potential to be integrated into the current therapy system in Australia (integration). Feasibility areas that could be improved in delivering future clubs are discussed.

Strength-based programs that incorporate technology have gained increasing popularity as an approach to improve outcomes for individuals with autism spectrum disorder (ASD). Despite this, the core elements of strength-based technology programs remain poorly described. This study aimed to identify the core elements of strength-based technology programs for youth with ASD through a systematic review of the literature. Electronic databases were searched for qualitative studies delivering strength-based technology-driven interventions to youth on the spectrum. Ten of the 874 studies identified met the criteria. Qualitative analysis revealed three core elements of strength-based technology programs for this population: mutual respect, demonstrating skills, and interests. The findings underpin the design of future strength-based technology programs for youth with ASD.

This study captured the experiences of 35 autistic adolescents and their parents after completing a 16-session variant of social skills group training KONTAKT® (ACTRN12617001117303). Semi-structured interviews explored participants' and relatives' perceptions of KONTAKT® and associated social outcomes. Adolescents were classified as either high (HR, n = 23) or low (LR, n = 12) responders based on the primary outcome effects during the previous trial. Thematic analysis revealed that both HR and LR participants their parents were satisfied with KONTAKT®, noting consistent patterns of improvement in adolescents' social understanding, communication, relationships, and empowerment, although positive reports were more frequent among HR than LR groups. This study enhances the understanding of the impact of SSGT, which is key in improving their content, principles, and administration.

While there is a large body of evidence drawn from randomised controlled trials supporting the efficacy of SSGT in autistic adolescents, the control arms of these studies are almost exclusively treated either as usual or waitlist. Addressing this limitation, 90 verbal autistic adolescents (70% male) aged 12-17 years (M = 13.77, SD = 1.6) with IQ > 70 participated in this pragmatic two-armed randomised controlled trial design study evaluating the efficacy of sixteen 90-min sessions of SSGT KONTAKT (R) (n = 46) in comparison to a manualised interactive group cooking programme (n = 44) of equal dosage controlling for the potentially confounding effects of exposure to a social group context. The primary outcome was the adolescents' progress towards achieving their personally meaningful social goals at follow-up. Secondary outcomes were changes in autistic traits, quality of life, facial emotion recognition skills, social anxiety, and loneliness. Assessments were conducted at baseline, post intervention and 12-week follow-up. The interaction between time point and group allocation was investigated through a random-effects regression model (linear mixed model) to examine changes in the dependent outcomes. While intention-to-treat analysis (N = 90) demonstrated that both SSGT (ES = 1.36, p < .001) and active control (ES = 1.10, p < .001) groups made progress towards their personally meaningful social goals at follow-up, KONTAKT (R) participants demonstrated greater progress in social goal attainment than their peers in the active control group (ES = 0.35, p = .04). Findings suggest that KONTAKT (R) is efficacious in supporting autistic adolescents to achieve their personally meaningful social goals compared to other prosocial group activities.

Background: Limited studies exist exploring employers’ capacity in hiring and supporting employees on the autism spectrum, and even fewer have considered interventions targeting employers’ skills and knowledge in enhancing employment opportunities. In response to this need, the Integrated Employment Success Tool (IESTTM) was developed and its effectiveness established in a randomized controlled trial (RCT). Furthermore, a process evaluation was conducted to determine the usability and implementation of the IESTTM.

Aims/objectives: The process evaluation was conducted to determine employers’ perceived usability, implementation, and perceived barriers and facilitators in using the IESTTM.

Material and methods: Employers (N = 29) provided their feedback via an online questionnaire. Of these, 11 participants were interviewed, further exploring their experiences. Data were analysed via descriptive statistics and thematic analysis.

Results: While employers’ frequency and usage of the IESTTM varied across workplaces, it was predominantly used to increase employers’ knowledge of autism and implement workplace strategies. A major barrier was the paper-based format of the intervention, with more than 60% of employers indicating the need for an online version.

Conclusions and significance: The process evaluation was a critical step in understanding why the IESTTM was effective, and how it could be further optimized for prospective employers.