Toward Social Acceptance of Autism: Listening to Autistic People

Background:  In the first study to compare knowledge and stigma toward autism among autistic adults, family members, and the public, we found that autistic adults exhibited significantly more knowledge of autism than the public, especially in terms of strengths (Gillespie-Lynch, Kapp et al., 2015). Autistic adults reported the least autism stigma and defined autism in the least medical terms; stigma was inversely related with knowledge. Findings challenge the clinical notion that autistic people lack perspective on autism, and suggest the need for more nuanced inquiry into possible inaccuracy and harm arising from the medical emphasis on changing autistic people rather than their environments.

Objectives:  

1)  Examine associations between normalization-related attitudes and autism knowledge/stigma in an online sample of autistic adults, nuclear family members, and the public.

2) Evaluate critiques of scientific knowledge about autism (an autism training and associated measures) by survey participants.

3) Compare in-person discussions of the training by autistic high school and college students to findings from the online sample.

Methods:  An online survey of autistic adults (N = 309), nuclear relatives of autistic people (N = 188), and the public (N = 139) assessed autism knowledge, autism stigma, and related attitudes (Gillespie-Lynch et al., 2015). Participants could provide open-ended elaborations to responses. We qualitatively coded open-ended elaborations to the item from each category of questions about autism (e.g., importance of a cure/cause/normalcy, stigma, and knowledge) that yielded the highest effect size when comparing across groups. Sixteen autistic high school and college students discussed the training as part of a summer program. Their perspectives will be coded and compared to the online sample. Only p<= .001 are reported as significant.

Results:  

Greater endorsement of the importance of normalizing autistic individuals, curing autism, and finding the cause of autism were associated with more stigma across groups. Greater endorsement of normalizing/curing autism was associated with less knowledge across groups (the association between cure and knowledge was a trend for the public; p=.006).

Recognition that autistic people have empathy was associated with the largest group difference for knowledge items. In elaborations, autistic adults exhibited a trend toward reporting an excess of empathy relative to family members (p< .008).

The stigma item yielding the largest effect size difference assessed willingness to marry an autistic person. Autistic participants more often elaborated that they would prefer an autistic romantic partner than family and the public, although the latter was a trend (p=.002).

The largest effect size difference in normalization-related attitudes reflected autistic adults endorsing the least interest in curing autism. In their elaborations, they most opposed the medical model and the view that autism is a disease.

Conclusions:  Society may stigmatize autistic people and disadvantage their development by overlooking their perspectives and overpathologizing differences. Disinterest in normalizing autistic individuals had the most consistent relationship with knowledge of and lack of stigma toward autism. Findings question whether losing an autism diagnosis constitutes an “optimal outcome”. Individuals’ manifestations of autism may decline despite persistent adaptive impairments as they seek acceptance in an often unaccepting society.