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Research on Community Integration in Autism Spectrum Disorder: Lessons from Research on Psychosis
For many individuals with an autism spectrum disorder (ASD) community integration is an important challenge in their adult lives (Howlin & Moss, 2012). Difficulties in community integration such as finding a paid job are also commonly found among individuals with a psychotic disorder. By comparing the literature on community integration of these two groups, we aimed to pinpoint gaps in our existing knowledge on community integration of individuals with ASD.
Objectives:
The study’s objectives were to answer the following research questions:
1) What are the potential gaps in the literature when it concerns community integration of adolescents and young adults with ASD?
2) How do the research foci in psychosis research compare to research foci in ASD research?
3) What can we - researchers in the ASD field - learn from research on community integration of individuals with a psychotic disorder?
Methods:
We systematically reviewed the literature on community integration of individuals with ASD or a psychotic disorder (publication period: 1990-2014). Following a literature search, abstract screening and full paper screening, we selected 76 eligible papers on community integration of individuals with ASD and 110 papers on individuals with a psychotic disorder. Papers were reliably categorized according to the following domains: housing, employment, education, social contacts, leisure, stigma, subjective quality of life, multiple domains, or other. To enable a direct comparison between the foci of interest in the research fields of ASD and psychosis, we compared the relative number (proportion) of publications in each domain.
Results:
There are clear disparities in research foci and gaps in the fields of ASD and psychosis. First of all, half (50%) of all selected publications on ASD address the social networks of adolescents and young adults with ASD or interventions to improve their social skills. However, only 5% of all selected psychosis papers address the social domain. Secondly, comparatively little research attention is devoted to (prevention of) stigma of ASD (7% of all selected ASD papers) compared to stigma of psychosis (30% of all selected psychosis papers). Thirdly, relatively few papers on ASD address multiple domains of community integration (18%) compared to papers on psychosis (35%). Finally, more papers were found on employment of individuals with a psychotic disorder (15%) compared to ASD (11%).
Conclusions:
As anticipated, there is a stronger research focus on community integration of individuals with a psychotic disorder compared to individuals with ASD. Studies in the psychosis field have demonstrated a preference for social distance toward people with a psychotic disorder, varying effectiveness of different anti-stigma programs, and success of employment rehabilitation methods such as Supported Employment. Based on these findings we recommend future research on community integration of individuals with ASD, stigma of ASD and the effectiveness of anti-stigma programs and employment interventions. The outcomes of this systematic review demonstrate a need for more practical research focused on the daily lives of adolescents and adults with ASD.