Meaghan Weldele, Author at Autism Research Institute https://autism.org/author/mweldele/ Advancing Autism Research and Education Tue, 18 Nov 2025 15:10:30 +0000 en-US hourly 1 https://wordpress.org/?v=6.9.4 Language and Communication Issues in Autism: Let’s Talk About Talking https://autism.org/language-and-communication-issues-in-autism-lets-talk-about-talking/ Mon, 27 Oct 2025 13:15:48 +0000 https://autism.org/?p=25204 Handouts are available HERE You can take the knowledge quiz HERE Difficulties with language and communication are one of the defining features of autism. We’ll investigate language peculiarities and development in autism from the perspective of different sensory perceptual processes and cognitive styles; then we can see

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Handouts are available HERE

You can take the knowledge quiz HERE

Difficulties with language and communication are one of the defining features of autism. We’ll investigate language peculiarities and development in autism from the perspective of different sensory perceptual processes and cognitive styles; then we can see that autistic (including non-verbal) people do communicate (though sometimes their attempts to transmit information are unnoticed by their non-autistic communicative partners); they do not lack communicative intent but rather often use unconventional means of communication.

To communicate successfully, we have to speak the same language. Teaching autistic children ‘our’ language is not good enough; we have to learn ‘their’ language(s) and communication systems as well.

This is a joint webinar with the World Autism Organization.

About the speaker:

Prof. Olga Bogdashina, Ph.D. (linguistics), MSc (Psychology), MA (Teaching methods) MA Ed (Autism), Honorary Professor, Honorary Doctor, KSPU, Co-founder of the International Autism Institute, and Programme Leader (Autism courses), Visiting Professor in Autism Studies, author of 9 books that reflect her specific interests in autism research: sensory perceptual issues in autism; language and communication in autism; autism and spirituality.

Having founded the first day centre for autistic children in Gorlovka,  Ukraine over 30 years ago, she has ‘lived and breathed autism’ since then. However, before 1988 – she knew absolutely nothing about autism or just how much it would mean to her and change her life.

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Aging and Autism: Exploring the Challenges of Autistic Seniors https://autism.org/aging-and-autism-un-think-tank/ Tue, 23 Sep 2025 20:48:19 +0000 https://autism.org/?p=24881 UN Think Tank Playlist on YouTube Recorded October 3, 2025 United Nations, New York City In partnership with the Nancy Lurie Marks Family Foundation, the Autism Research Institute sponsored the 2025 United Nations Think Tank on Aging and Autism.  Think

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Recorded October 3, 2025

United Nations, New York City

In partnership with the Nancy Lurie Marks Family Foundation, the Autism Research Institute sponsored the 2025 United Nations Think Tank on Aging and Autism. 

Think Tank Format

Moderators invited key experts to give brief overviews of topics related to aging and autism, followed by a focused exploratory roundtable discussion.

Panelists and audience members included autistic individuals, clinicians, researchers, and representatives of UN member states.

The Think Tank was moderated by Fakhri Shafai (AIDE Canada) & Vanessa Bal (Rutgers University).

Meeting Agenda

Time Presentation
10:00-10:15am Welcome remarks by the sponsors: Stephen M. Edelson, (Autism Research Institute, USA), H.E. Natasha Meli (Permanent Representative of Malta to the UN), and Elizabeth Zwick (NLM Foundation, USA).
10:15-10:30am Dena Gassner, Drexel University and Chan Li, University of Malta – Navigating  healthcare systems and reducing administrative burdens and bureaucratic barriers
10:30-10:45am Karen Turner, Massachusetts General Hospital and David Nicholas, University of Calgary – Needs and capacity in long-term care and acute medical settings, including hospital admissions
10:45-11:05am Robert L. Hendren, Professor of Psychiatry Emeritus, UCSF; Autism Research Institute; Oak Hill School Board and Research and Margaret Bauman, Boston University School of Medicine – (a) Impact of medications on autistic individuals during aging; and (b) Physical and mental health challenges associated with aging
11:05-11:20am Melissa Levin, Dana-Farber Cancer Institute and Mary Doherty, University College Dublin School of Medicine – Cancer treatment considerations in older autistic adults
11:20-11:40am Abha Chauhan, Ph.D., NYS Institute for Basic Research in Developmental Disabilities – (a) Biological underpinnings of aging in autism; and (b) Age-related neurological conditions, such as Dementia.
11:40-11:55am Christopher Palmer, Commission for the Rights of Persons with Disability, Malta) – Preparing autistic adults to effectively communicate with healthcare providers during medical visits
11:55-12:10pm Kimberly Armstrong, University of British Columbia, Simon Fraser University and Spectrum Works (Canada) and Wenn Lawson, (Curtin University, West Australia) – Benefits of late autism diagnosis and self-recognition in older adults
12:10-12:25pm Alistair de Gaetano, Autism Advisory Council (Malta) – Financial vulnerability, precarity and support for exercising legal capacity
12:25-12:40pm Laura Graham Holmes, Hunter College (CUNY) – Learning from other sectors (e.g., the LGBTQ community) about addressing systemic issues
12:40-12:55pm Fakhri Shafai, Chief Science Officer at AIDE Canada – Loneliness and social isolation
12:55-1:00 pm Stephen M. Edelson, , Autism Research Institute – Closing remarks

10:00-10:15am – Welcome remarks by the sponsors: Stephen M. Edelson, (Autism Research Institute, USA), H.E. Natasha Meli (Permanent Representative of Malta to the UN), and Elizabeth Zwick (NLM Foundation, USA).

10:15-10:30am – Dena Gassner, Drexel University and Chan Li, University of Malta – Navigating healthcare systems and reducing administrative burdens and bureaucratic barriers

10:30-10:45am – Karen Turner, Massachusetts General Hospital and David Nicholas, University of Calgary – Needs and capacity in long-term care and acute medical settings, including hospital admissions

10:45-11:05amRobert L. Hendren, Professor of Psychiatry Emeritus, UCSF; Autism Research Institute; Oak Hill School Board and Research and Margaret Bauman, Boston University School of Medicine – (a) Impact of medications on autistic individuals during aging; and (b) Physical and mental health challenges associated with aging

11:05-11:20am – Melissa Levin, Dana-Farber Cancer Institute and Mary Doherty, University College Dublin School of Medicine – Cancer treatment considerations in older autistic adults

11:20-11:40amAbha Chauhan, Ph.D., NYS Institute for Basic Research in Developmental Disabilities – (a) Biological underpinnings of aging in autism; and (b) Age-related neurological conditions, such as Dementia.

11:40-11:55Christopher Palmer, Commission for the Rights of Persons with Disability, Malta) – Preparing autistic adults to effectively communicate with healthcare providers during medical visits

11:55-12:10pmKimberly Armstrong, Spectrum Works (Canada) and Wenn Lawson, (Curtin University, West Australia) – Benefits of late autism diagnosis and self-recognition in older adults

12:10-12:25pmAlistair de Gaetano, Autism Advisory Council (Malta) – Financial vulnerability, precarity and support for exercising legal capacity

12:25 to 12:40pmLaura Graham Holmes, Hunter College (CUNY) – Learning from other sectors (e.g., the LGBTQ community) about addressing systemic issues

12:40-12:55pmFakhri Shafai, Chief Science Officer at AIDE Canada – Loneliness and social isolation

12:55-1:00pmStephen M. Edelson, , Autism Research Institute – Closing remarks

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Social Stories, AI, and Autism https://autism.org/social-stories-ai-and-autism/ Thu, 29 May 2025 20:04:46 +0000 https://autism.org/?p=23273 When you're able to make a tool to improve accessibility for one person or group, so many others benefit as well. All of this work is meant to be collaborative [...] and that has been such a beautiful thing in this community. -- Dr. Mojdeh Mostafavi (Webinar: Healthcare Equity and Access Concerns in

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When you’re able to make a tool to improve accessibility for one person or group, so many others benefit as well. All of this work is meant to be collaborative […] and that has been such a beautiful thing in this community.

— Dr. Mojdeh Mostafavi (Webinar: Healthcare Equity and Access Concerns in Autism)

Physician assistant helping a young girl with her mother sitting by.

What are social stories?

Carol Gray developed social stories as they are known today with the aim of addressing “shared social challenges and [fostering] mutual understanding.” Social stories are personalized narratives used to help navigate social situations and learn new skills. They describe a personally relevant topic (e.g., context, skill, achievement, or concept) in a meaningful and safe way for the audience. Social stories simplify goals, tasks, events, and behaviors into easily learned and generalized steps. By combining supportive visual and written cues, they facilitate understanding around lived experiences and, as such, serve as a versatile tool for promoting healthcare equity and access.

It’s important to note that social stories benefit the entire care network. For the audience, they offer predictability and clarity in navigating complex situations and for providers they offer a tool to build understanding and reduce anxiety. Social stories champion collaboration and compassion, allowing a deeper sense of community understanding and more effective supports. Families and practitioners often use social stories to help:

  • Prepare for unfamiliar events or situations
  • Explain social scenarios and the expected behaviors
  • Teach routines
  • Navigate life changes and task transitions
  • Divide target skills and behaviors into easy, manageable steps

Social story structure

Compelling social stories employ descriptive, perspective, instructive/coaching, and affirmative sentences written in the first or third person. For example, “Sara went to the store” or “I feel happy with my friends.” Never “You go to the store.” By avoiding the second person (“you”), the stories maintain a supportive “coaching” tone that guides instead of directs. Effective social stories also include a visual representation of the event or situation. They can be symbols, photos, or any other depiction that fits the person’s needs and interests. Most social stories include more descriptive than instructive phrases. For example: 

Descriptive: I go to eat dinner with my family in a restaurant. Sometimes, I get upset in restaurants because they are crowded and noisy.

Instructive/Coaching: When I feel upset in the restaurant, I can put on my headphones and listen to something. 

Affirmative: Staying calm and relaxed in the restaurant is good for my family and me.

Including the intended audience in social story creation ensures the final product is personal, meaningful, and valuable. It’s critical to review and revise the stories as they are used to ensure they remain practical and applicable to a person’s life. 

Free social stories and templates for common experiences like making friends and washing hands are available online from organizations like Autism Speaks, Social Workers Toolbox, Watson Institute, Autism Little Learners, and many more. However, finding social stories that are personalized to one’s needs and skills can be difficult, and creating social stories at home can be very time-consuming. 

Creating Social Stories with AI

Many AI tools can help you create your own social stories. Generative AI platforms like ChatGPT, Gemini, Copilot, and Claude (to name a few) can create structured, personalized story text and images when given the right prompt. AI prompts should focus on a specific response outcome with clear expectations for the best results. The primary objective is to guide the generative AI toward a desired response with minimal ambiguity. Prompts should give context and precise details about the story’s function and audience. Social story outlines should answer the following questions:

  • Who: The story is about Jimmy
  • What: We explain what an EEG is
  • When: This information is about health exams
  • Where: We talk specifically about the doctor’s office and EEG procedures
  • Why: We explain why we need to take this test and what it means for their health
  • How: We explain how the machines work, what data they collect, and how it will help the doctors know what to do. We also clarify that the experience will probably be uncomfortable and review plans to mitigate discomfort

Example Prompt 1 – Task Transitions 

Entered into Gemini

Create a structured social story about transitioning between activities. Only use first and third person (“I” and “we” – do not use “you”). Ensure that most sentences are descriptive and supportive, with a few directive phrases to demonstrate expected behaviors. The story is for my 7-year-old son and should explain that sometimes we have to stop something fun and switch to something new and that it’s okay to feel unsure or wish we had more time. Include strategies like using a visual schedule, setting a timer, or having a phrase to say during transitions. Reinforce that transitions happen every day, and using these strategies can make them easier. The setting is Saturday morning at home, and the tone should be encouraging.

It is Saturday morning, and we have been having a wonderful time playing with LEGOs. Building towers and spaceships is so much fun! Sometimes, even when I am enjoying an activity a lot, it is time for us to stop and do something different. This change from one activity to another is called a transition.

When it is time for a transition, like when we need to put away the LEGOs and get ready to go to the park, I might feel a little sad that playtime is ending. It is okay for me to feel this way. It’s natural to wish we had more time to keep doing something we love.

To help make transitions smoother, we have some helpful strategies we can use. One strategy is our visual schedule. This shows us pictures of what we will be doing throughout the morning. Looking at the schedule helps me know what to expect next, even when it’s time to stop playing LEGOs. I can see that after LEGO time, it will be park time, which is also fun!

Another strategy we can use is a timer. We can set the timer for five more minutes of LEGO building. When the timer makes its sound, it tells us that LEGO time is almost over, and park time will begin soon. Knowing when the transition is coming helps me get ready for the change. When the timer rings, it is time for us to start putting the LEGOs away.

We also have a special phrase we can say when it’s time to transition. We can say, “LEGOs away, park today!” Saying this phrase helps me understand that one activity is ending, and another fun activity is beginning.

Transitions happen many times each day. We transition from sleeping to waking up, from eating breakfast to playing, and from playing to reading books. Everyone experiences transitions, even grown-ups!

Using our strategies, like checking the visual schedule, using the timer, and saying our special phrase, can make these transitions feel easier. It’s like having a plan that helps us move from one part of our day to the next.

It is okay if transitions sometimes feel a little challenging. We can always use our strategies, and with practice, they will become easier and easier. I am learning how to handle transitions well, and we are working on this together. Soon, we will be having lots of fun at the park!

Example Prompt 2 – Doctor’s Visit

Entered into Copilot

Create a structured social story about visiting the doctor’s office for a check-up. Only use first and third person (“I” and “we” – do not use “you”). Ensure that most sentences are descriptive and supportive, with a few directive phrases to demonstrate expected behaviors. The story is for my 7-year-old patient and should explain what to expect when visiting, including the bright medical rooms, loud machinery, regular medical check-up procedures, and the importance of telling the doctor how they feel. Reinforce that everyone goes to the doctor, and using personalized strategies to make it easier for them is great! The setting is a pediatric doctor’s office, and the tone should be supportive and encouraging.

Going to the Doctor: A Social Story

Today is a check-up day at the doctor’s office. Everyone goes to the doctor, even parents, teachers, and friends. It helps keep us strong and healthy.

When I walk into the office, the waiting room might have colorful chairs and toys. Sometimes other kids and families are waiting too. We all wait patiently until it is our turn.

When it’s time for my check-up, we go into a bright medical room. The walls might have fun pictures, and there are special tools the doctor uses to help check how I’m growing. Some of the machines may beep or make loud sounds. That’s okay—these tools help the doctor do their job.

The doctor or nurse might ask questions. It is important to tell them how I feel. If something hurts or feels different, I can say so. Talking to the doctor helps them know how to help me feel my best.

During the check-up, the doctor may listen to my heartbeat, check my height, and look inside my ears. Sometimes, I might need a small test, like a shot or a blood pressure check. If something makes me nervous, I can use a strategy that helps me feel calm. Some kids take deep breaths, hold a parent’s hand, or bring a favorite toy.

After the check-up, we talk about how to stay healthy. The doctor might share helpful tips, like drinking water, eating good foods, or getting plenty of rest. Then, it is time to go home, knowing that my body is being taken care of.

Going to the doctor is an important part of staying healthy. Everyone does it, and I can use my own special ways to make it a good experience!

Example Prompt 3 – Restaurant Outing

Entered into Claude

Create a structured social story about eating dinner in a restaurant. Only use first and third person (“I” and “we” – do not use “you”). Ensure that most sentences are descriptive and supportive, with a few directive phrases to demonstrate expected behaviors. The story is for my 7-year-old son and should explain what to expect, including how to sit at a table and order from the waiter and what the environment may look like with loud noises, crowded rooms, and many food options. Include calming and regulation strategies, such as taking deep breaths, bringing headphones for noise, letting a parent know how they feel, and asking for help with decisions. Reinforce that everyone has different ways of making restaurant experiences easier and that using the best strategies is okay and important. The setting is an Italian restaurant, and the tone should be supportive.

Going to an Italian Restaurant – A Social Story

Getting Ready to Go

I am going to eat dinner at an Italian restaurant with my family. Italian restaurants serve foods like pizza, pasta, and breadsticks. Sometimes these restaurants can be busy places with many people talking and eating together.

Before we leave home, I can think about what might help me feel comfortable at the restaurant. Some people bring special headphones to make loud sounds quieter. Some people bring a small toy or book to help them wait. I can ask my parent what I might want to bring with me.

Arriving at the Restaurant

When we arrive at the restaurant, there might be other families waiting to be seated. The restaurant might smell like garlic, cheese, and tomato sauce. These are normal smells at Italian restaurants.

We will wait for someone called a host or hostess to show us to our table. Sometimes we need to wait a few minutes. While we wait, I can stay close to my family and look around at the restaurant decorations.

Sitting at Our Table

The host will take us to our table. Italian restaurants often have dim lighting and may play music. Sometimes the music and talking from other tables can sound loud. This is normal in restaurants.

I will sit in my chair and put my napkin on my lap. My feet can touch the floor or rest on the chair. I can sit in the way that feels most comfortable for me.

If the restaurant feels too loud, I can put on my headphones or ask to sit in a quieter spot. I can tell my parent how I’m feeling by using words like “loud,” “crowded,” or “okay.”

Looking at the Menu

Our waiter will bring us menus. Italian restaurant menus often have many choices. There might be different types of pasta, pizza, chicken, and other foods. Sometimes there are pictures to help me see what the food looks like.

I can take my time looking at the menu. If I feel overwhelmed by too many choices, I can ask my parent to help me find two or three options that sound good. Then I can choose from those.

Some Italian restaurants have kids’ menus with simpler choices. This can make deciding easier.

Ordering Our Food

When the waiter comes to our table, they will ask what we would like to eat and drink. The waiter is there to help us and wants us to enjoy our meal.

I can tell the waiter what I would like, or my parent can help me order. It’s okay to ask questions about the food, like “Does this have cheese?” or “Is this spicy?”

If I need more time to decide, I can say “I need a few more minutes, please.” Taking time to make a good choice is perfectly fine.

Waiting for Our Food

After we order, we will wait for our food to be cooked. Sometimes this takes 15-20 minutes. While we wait, I can talk with my family, color if I brought something, or look around the restaurant.

If waiting feels hard, I can take slow, deep breaths. I can breathe in slowly through my nose and out through my mouth. This helps my body feel calmer.

When Our Food Arrives

The waiter will bring our food to the table. Italian food is often served on big plates and might look different than I expected. This is normal.

I can try my food slowly. If something doesn’t taste the way I thought it would, that’s okay. I can eat what I like and let my parent know if I need something different.

Most Italian restaurants serve bread or breadsticks while we eat. I can enjoy these if I want to.

During Our Meal

While we eat, the restaurant might stay busy with people coming and going. I might hear dishes clinking, people talking, and kitchen sounds. These are all normal restaurant sounds.

If I start to feel overwhelmed by the noise or activity, I can use my strategies. I can put on headphones, take deep breaths, or tell my parent that I need a quiet moment.

Every person has different ways of feeling comfortable in busy places. Using the strategies that work best for me is important and okay.

Finishing Our Meal

When we are done eating, our waiter will ask if we want dessert or if we need anything else. I can choose to have dessert or say “No thank you.”

My parent will pay for our meal while I stay seated at the table. Sometimes this takes a few minutes.

Leaving the Restaurant

When it’s time to go, we will walk out together. I might feel proud that I tried a new experience and used my helpful strategies.

Going to restaurants takes practice, and each time can feel a little easier. I did a great job trying new things and taking care of myself during our restaurant visit.

Remember

  • Every person has different needs in busy places like restaurants
  • Using headphones, taking deep breaths, and asking for help are all good strategies
  • It’s okay to take time making decisions about food
  • Telling my parent how I feel helps them support me
  • Restaurants can be loud and busy, and that’s normal
  • I can feel proud of myself for trying new experiences

AI safety and editing

Each generative AI platform provides its output type, as demonstrated by the different response structures from Gemini, Copilot, and Claude above. Most do not have guidelines for protecting sensitive data, so it is essential to avoid using real names or real medical histories and other private details. Use general descriptions when you engage with generative AI tools and personalize the story afterward.  The creators and audience should revise AI social story texts to add personal details and ensure they are relatable and compelling. Generative AI provides a fantastic place to start but is not a one-step solution. Some generative AI tools also create images, though photos and symbols from a person’s real life may be easier to relate with. You can make simple social story images with free tools like Storyboard That.

AI tools specific to storyboard creation are also available for free. Because these tools were built to create social stories, prompt inputs can focus less on output structure, lending more to story details and quick turnarounds. Required inputs vary across platforms, but they each provide a solid base for at-home or in-office social story creation:

Autism, AI, and social stories

Social stories offer a wonderful and adaptable way to support people with autism and those who care for them. These highly modifiable stories can help prepare for new experiences or gently guide learning new skills and behaviors one manageable step at a time. It’s heartening to see how artificial intelligence is now helping to create social stories, making this valuable tool even more readily available to the wider autism community. Families and practitioners consistently note how impactful social stories are and the wealth of knowledge they foster when shared.

Learn more about the importance and impact of social stories from Dr. Mojdeh Mostafavi as she describes how her team at Mass General created a free endoscopy social story and recommendations for GI specialists working with autistic patients.

Minute 38:00 – 50:00 (48:00 QR code to further resources)

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Autism Transition Resources https://autism.org/autism-transition-resources/ Thu, 27 Mar 2025 23:06:56 +0000 https://autism.org/?p=21986 Life transitions can be incredibly challenging for people with autism as they signal a lack of predictability and change in routine and often entail new sensory, social, and healthcare experiences. Providing support during these challenging phases is critical to the long-term well-being of autistic people. Contemporary research asserts the need for capacity-building around

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Life transitions can be incredibly challenging for people with autism as they signal a lack of predictability and change in routine and often entail new sensory, social, and healthcare experiences. Providing support during these challenging phases is critical to the long-term well-being of autistic people. Contemporary research asserts the need for capacity-building around transition support implementation at the family, community/program, and policy levels. Further research emphasizes approaches that build awareness of strengths and challenges through communication skills most suited to each person. Self-advocacy and appropriate sexual education are also critically important in ensuring the best possible transition experiences.

Learn from expert researchers and educators how best to prepare for and support transitional phases for people with autism using the ARI articles and webinars listed below.

Additional resources from ARI and AIDE Canada are also provided.

Articles on Transitions & Autism

Mother and father helping daughter unpack car for college

Transition to College

The ability to be more confident and prepared for life in a college setting is an invaluable part of transitioning into higher education. This transition can make or break how students feel about life after college and set the stage for their academic future… Discovering how to balance all aspects of college life while developing the necessary skills to live independently can be challenging for any student. This transition is even more complicated when difficulties in executive functioning and social skills come into play.

Read Article

The Arts & Transition: Making It Possible

Written by Elaine Hall, aka Coach E, who is known by many through the Emmy award winning HBO documentary AUTISM: The Musical. She is an author, educator, international keynote speaker, inclusion activist, and mother to an awesome nonverbal son who types to communicate.

“… One of my very first students, a nine-year-old boy named Daniel, came to The Miracle Project after being kicked out of every other traditional acting class he had ever tried. In his first few days with us, he hid behind his mother’s back and couldn’t even enter the room. Today, he is a leader among his peers, winning dance contests in school and taking on lead roles in theatrical productions. Last summer, Daniel attended a transition to adulthood boarding school 3,000 miles from home. Although his shyness returned, instead of hiding, he used the skills he had learned from his seven years at The Miracle Project and boldly gathered his peers together, leading them to brainstorm, write, and then perform an original play…”

Read Article

Webinars on Transitioning & Autism

Examining the Transition to Adulthood in Autism: Challenges and Opportunities in the Aim of Thriving

David B. Nicholas, Ph.D., examines the transition to adulthood and its implications for autistic individuals. He presents the ecosystem mentality and discusses recent findings supporting a holistic and future-oriented integrated care system. The speaker details potential areas of capacity building within post-secondary education and employment and highlights the need for cross-sector collaboration and lifelong care. Nicholas summarizes the presentation, underscoring changes in contemporary discourse, and considers future avenues of research before the Q&A session.

View Summary

Transition to Adulthood

Stephen Shore, Ed.D., recounts his experiences with autism and discusses the support systems that helped him transition to adulthood and independence. He describes the ability-based approach and uses anecdotal stories to portray its potential for assisting with transitions and overall quality of life. Shore presents suggestions to help individuals find what and how to disclose and underscores the importance of finding strengths by looking at personal interests. The speaker notes difficulties in sexual experiences and education for youth with autism and reiterates the importance of self-advocacy, especially during and after the pandemic. He closes with a question-and-answer session.

View Summary

Transitions from Pediatric to Adult Medical Care

Julie Corder, CNP, and Carrie Cuomo, DNP, CPNP, with the Cleveland Clinic Learning Hospital, discuss the critical stages of transition from pediatric to adult healthcare for individuals with complex medical needs. They define health care transitions (HCT), outline core elements for a successful HCT, and provide various resources. The presenters consider potential timelines and goals for different stages of HCT and discuss what turning 18 means in the US. Cuomo and Corder underscore the role that telehealth can play in HCT and share a video resource with explanations and social stories. Throughout the presentation, the speakers emphasize that it is never too late or too early to begin preparing for HCT and that transition plans are individual and different. They close with a question and answer session where they discuss insurance, COVID anxiety, social workers, and more.

View Summary

Help ARI improve the quality of life of autistic individuals

  • Various words written on a white background with different shades of green shapes

Self-Regulation Strategies for Self-Injury

March 25th, 2025|Adults on the Spectrum, Anxiety, Assessment, depression, Meltdowns, News, Self Care, Self Injury, Self-Injury, Webinar|

Emily Ferguson, Ph.D., discusses self-regulation strategies for self-injurious behaviors (SIB). She outlines recent research on the frequency and distribution of different SIBs across a large sample, underscoring the importance of assessing individual behavior

  • Support gesture. Woman comforting woman patient at group rehub meeting.

Wellbeing Wins: Integrating Positive Psychology into the Autism Community

January 2nd, 2025|Adults on the Spectrum, Anxiety, Anxiety, Back to School, depression, Executive Function, Health, Neurological, News, Self Care, Sleep Issues, Social Skills, Webinar|

Patricia Wright, PhD, MPH, and Katie Curran, MAAP, introduce Proof Positive - The Autism Well-being Alliance. The speakers describe positive psychology, its impact on well-being, and why it matters for autistic

  • Person made of colorful data in the virtual reality

Gender Discomfort and Autism

June 16th, 2023|News|

"I think society has an expectation where you have to be male or female, or you can be somewhere in between [...]. But they don't get that, actually, there are many genders

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Research Update Webinar Series https://autism.org/research-update-webinar-series/ Tue, 25 Mar 2025 00:43:41 +0000 https://autism.org/?p=22038 As part of ARI’s work to advance autism science and education, we offer free bi-monthly expert-led webinars on topics related to autism. Presenters discuss emerging trends and research findings on the underlying biology of autism and effective care strategies. Information presented in ARI webinars is evidence-based, making our video library a trustworthy

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As part of ARI’s work to advance autism science and education, we offer free bi-monthly expert-led webinars on topics related to autism. Presenters discuss emerging trends and research findings on the underlying biology of autism and effective care strategies. Information presented in ARI webinars is evidence-based, making our video library a trustworthy resource for the autism community. Webinar playbacks are free on our website and YouTube Channel, with more than 1.35 million views.

ARI’s recurring Research Update webinar series offer uniquely up-to-date insights on critical topics in autism. These series cover ongoing investigations and their implications for research and care, providing families and practitioners with crucial information in a timely manner. Within the ever-changing landscape of autism science, these webinar series also offer a transparent look at how our understanding of autism continues to evolve. Research topics recently updated include systemic inflammation, sleep, challenging behaviors, trauma, and gastrointestinal issues. 

Research Update Series

Sleep

Research Updates: Bringing Sleep and Autism into Community Settings (2025)

Beth Mallow, MD, shares current research updates on sleep and autism. She highlights the multifactorial nature of sleep patterns and how they affect daily functioning and core autism traits like emotion regulation. The speaker provides helpful sleep questionnaires and tips for minimizing sleep resistance and night waking. Mallow outlines preliminary work from ongoing sleep education trials for parents and therapists and emphasizes the efficacy of behavior-based interventions. She provides contact information for potential study participants and notes the lack of research surrounding common medications before the Q&A. 

Autism and Sleep – Research Updates (2024) -Presented by Dara S. Manoach, Ph.D.

Food and Sleep (2022) – Presented by Vicki Kobliner, RDN, CD-N

Sleep Issues and ASD (2018) – Presented by Dr. Beth Mallow

Systemic Inflammation & PANS/PANDAS

Research Updates: At the Crossroads of Infection, Inflammation, and Mental Health (2024)

Jennifer Frankovich, MD, MS, dives into the intersection of infection, inflammation, and mental health. She discusses the increase in recognition of this critical overlap over the last decade, highlighting how systemic inflammatory conditions have the highest rate of co-occurring psychiatric disorders. The speaker outlines ten inflammatory diseases that frequently co-occur with mental health conditions, including spondyloarthritis, psoriasis/psoriatic arthritis, Behçet’s Syndrome, Sjögren’s disease, Scleroderma, CNS Vasculitis, Sydenhams’ Chorea, and Lupus. Frankovich underscores the connection of Streptococcal infections to many of these inflammatory conditions, noting their similarities to PANS and challenges with diagnosis. She provides thanks and acknowledgments before the Q&A.

This is a follow-up to our June 12, 2024 webinar featuring Dr. Jennifer Frankovich, Ayan Mondal, Ph.D., and Noor A. Hussein, Ph.D.

View Summary

Research Update: Blood-brain barrier dysfunction in Pediatric Acute Neuropsychiatric Syndrome (PANS) and Regulation (2024) – Presented by Dr. Jennifer Frankovich, Ayan Mondal, Ph.D., and Noor A. Hussein, Ph.D

Systemic Inflammatory & Autoimmune Diseases—PANS (2022) – Presented by Jennifer Frankovich, MD MS

PANS/PANDAS – Research Updates (2020) – Presented by Susan Swedo, M.D.

Challenging Behavior

Self-Regulation Strategies for Self-Injury

Emily Ferguson, Ph.D., discusses self-regulation strategies for self-injurious behaviors (SIB). She outlines recent research on the frequency and distribution of different SIBs across a large sample, underscoring the importance of assessing individual behavior severity instead of an overall SIB score. The presenter considers the role of emotion regulation in SIB interventions. Ferguson considers emotion recognition, coping strategies, and prevention methods and provides free online resources for parents and clinicians.

(Not recorded) Strategies for Addressing Challenging Behaviors and Implementing Coping Skills in Parenting (2025) – Presented by Emily Ferguson, Ph.D.

Autism and Pica (2023) – Presented by Dean Alexander, Ph.D.

Understanding and Treating Challenging Behaviors Parts 1 & 2 (2022) – Presented by Paul Shattock & Lauren Moskowitz, Ph.D.

Assessing and Treating Challenging Behavior in Individuals with Autism (2015) – Presented by Lauren Moskowitz, Ph.D.

Trauma

Autism and Trauma: Research Updates (2025)

Dr. Connor Kerns delivers research updates on the intersection of trauma and autism. She describes the relationship between childhood adversities, trauma, and mental health and highlights the need for trauma measurements that are specific to the autism community. The presenter considers the complexities of diagnosing PTSD in autism and details the development of the Childhood Adversity & Social Stress Questionnaire (CASS-Q). Kern’s ongoing work aims to describe the adversities of autistic youth and compare the CASS-Q PR symptom subscale to the DSM-5 PTSD descriptors. She discusses preliminary results revealing high validity and summarizes limitations and implications before the Q&A.

The Intersection of Race and Disability (2025) – Presented by Dr. Amber Davis

Autism and Trauma (2024) – Presented by Dr. Connor Kerns

Gastrointestinal Issues

Autism and Gastrointestinal Comorbidities (2025)

Mojdeh Mostafavi, MD, describes gastrointestinal conditions commonly seen in individuals with autism, including gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), Eosinophilic GI disease (EGID), avoidant/restrictive food intake disorder (ARFID), disorders of the gut-brain interaction (DGBI), and constipation. She outlines recent research on the prevalence of these conditions in people with autism, emphasizing the complexities of symptom presentation, drivers, and care. The speaker provides a free social story for endoscopies and considers the relationship between pain expression and GI conditions. Mostafavi considers the difficulties of transitioning from pediatric to adult healthcare in autism. She summarizes the presentation before the Q&A. 

View Summary

Research Updates: GI Symptoms & Behavior (2024) – Presented by Dr. Bradley Ferguson, Ph.D.

The Gut, Autism, and Mental Health (2024) – Presented by Dr. Calliope Holingue, MPH, Ph.D.

Gastrointestinal Symptoms in Autistic Patients (2023) – Presented by Frederico Balzola, MD

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Understanding Autism – Free Online Apps https://autism.org/understanding-autism-free-online-apps/ Mon, 17 Mar 2025 22:14:10 +0000 https://autism.org/?p=21714 The Understanding and Treating Autism book series, from Jessica Kingsley Publishers, provides a cutting-edge resource for parents, professionals, and academics seeking further insight into the co-occurrence of  sleep disturbances, anxiety, and self-injurious behavior with autism. Each book explores contemporary research and is written by experts in the autism field, edited by ARI’s chief science

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The Understanding and Treating Autism book series, from Jessica Kingsley Publishers, provides a cutting-edge resource for parents, professionals, and academics seeking further insight into the co-occurrence of  sleep disturbances, anxiety, and self-injurious behavior with autism. Each book explores contemporary research and is written by experts in the autism field, edited by ARI’s chief science officer, Stephen M. Edelson, and past ARI Board member, Jane B. Johnson.

Based on this book series, ARI developed online apps for parents and practitioners. Our free questionnaires help identify potential care strategies for issues commonly associated with sleep disturbances and self-injurious behaviors related to autism.

How to use

Questions are set up on a Likert-type scale: “Yes”, “Sometimes”, “No”, “Don’t know/Not applicable”. Selecting “Yes” will evoke the same results as “Sometimes” just as selecting “No” will pull the same results as “Don’t know/Not applicable”.

Questions are divided into sections based on aspects of the given co-occurring conditions or behaviors. You must read and agree to the disclaimer notice in order for results to be processed.

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Peer Support in Autism https://autism.org/peer-support-in-autism/ Fri, 14 Mar 2025 16:12:28 +0000 https://autism.org/?p=21718 Though institutionalization is not as prevalent as it was in the 20th century, people with autism and other developmental or physical disabilities are still frequently separated from allistic (non-autistic) groups and spaces. As such, a large part of the physical world and many critical social experiences are not available to autistic people.

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Though institutionalization is not as prevalent as it was in the 20th century, people with autism and other developmental or physical disabilities are still frequently separated from allistic (non-autistic) groups and spaces. As such, a large part of the physical world and many critical social experiences are not available to autistic people. The resulting social ostracization and lack of self-determination significantly impact mental health and long-term well-being. Peer-mediated support strategies offer a framework for social group integration based on mutual respect, understanding, and care. Many school and work-based programs show increases in mental health, social skills, and work/academic performance for both mentees and mentors across time and location. Further, research suggests that simply completing a task with someone can impact how we view them in reference to ourselves (“us” or “them”), highlighting the potential impact that peer-mediated frameworks may have on broader society.
Five peers with their arms around each other facing away from the viewer.

A brief history of peer support

Peer mentorship, though not referred to as such, has been used as a framework for enhancing classroom learning and student social experiences for many years. Throughout research literature, peer-based methods include cooperative learning, inclusive/inclusion classrooms, peer arrangements, and peer-mediated supports. Modern peer support programs are based on cooperative learning techniques, first published in the early 1990s. Most programs involve an allistic (non-autistic) peer who provides social and/or academic support to students with autism or other disabilities (Brock et al., 2017). Cooperative and inclusion learning studies show decreases in disruptive behavior and increases in reading skills, academic engagement, and peer interaction (Koegel et al., 1995; Kamps et al., 1994; Dugan et al., 1995; McCurdy & Cole, 2013). Many studies also show that mentees and mentors acquire targeted academic and social skills and build on and apply them across situations and groups (Hunt et al., 1994; Christensen et al., 2004; Carter et al., 2005). 

Modern peer support programs are highly modifiable and can be woven into various care strategies and goals across ages, locations, and activities (Brock & Huber, 2017). Simpson and Bui recently implemented a peer-based reading buddy strategy to increase social interaction among autistic children (2024). Another study using partner-focused conversation skills revealed increased pragmatic language efficiency for autistic youth, and all students (both autistic and allistic) reported that the program was beneficial (Bambara et al., 2021). Further, peer-based interventions implemented in a three-year adventure therapy program and group for individuals experiencing gender discomfort/dysphoria saw increased social skills and comfort and positive psychological results with potential for long-term impact (Karoff et al., 2017; Brandsma et al., 2022).

Instances of peer support in autism

School-based peer support

Systematic reviews of peer-intervention programs show improvements in social interactions, academic engagement, and quality of friendships in autistic high school students and their allistic peers (Carter et al., 2016; Asmus et al., 2016). Research also suggests that communication skills gained via peer support relationships can be generalized to other settings (Belchic & Harris, 2008). In a recent study on student and teacher perspectives of peer support programs, respondents said that the programs help autistic youth to better understand their identity as students, peers, and learners. Students felt more empowered to set and achieve goals for their future, and teachers observed increased self-confidence and assertiveness in their pupils (Kiblen et al., 2024). 

Peer-based support programs are highly effective methods of care and development support for autistic children and youth. Successful peer support techniques present a framework for creating and maintaining an atmosphere of mutual respect, acceptance, and support, which naturally reinforces mental health, social development, and quality of life for all involved (Carter et al., 2010; Sun et al., 2020; Sandstrom et al., 2014; Mazurek, 2013; Cooper et al., 2023).

University-based support

Increasing numbers of people with autism and other disabilities are attending higher education, and many universities have employed peer-support programs to assist these students. Mentorship programs for autistic adults entering universities have seen positive outcomes in social skills, academic success, and sense of belonging (Duerksen et al., 2021; Siew et al., 2017).

Although results are generally positive, researchers assert that the field of university peer support in autism is still in its infancy (Duerksen et al., 2021). Peer-based strategies serve as a fantastic blueprint for further acceptance and integration of people with disabilities who would likely have been institutionalized for their differences just two decades ago. Support for these programs stems from an increased understanding of autism in the wider community.

Learn more about transitioning to adulthood with autism in our free webinars Transition to Adulthood, presented by Dr. Stephen Shore

and

Examining the Transition to Adulthood in Autism: Challenges and Opportunities in the Aim of Thriving, presented by David B. Nicholas, Ph.D.

Peer support in adulthood

Until relatively recently, autism was understood strictly as a childhood condition. Although today we know that autism is experienced across the lifetime, there remains a significant lack of research and care for autistic adults and older adults. Beyond university settings, few peer-based strategies for adults on the spectrum exist, but those that do suggest similar outcomes to classroom-based peer supports. 

Work and professional arrangements

In a qualitative study on post-diagnostic support, autistic adults highlighted a mismatch in support needed and provided. They underscore the need for community connection and flexible, personalized strategies and suggest peer-support programs as a potential avenue of success (Crompton et al., 2022). Stakeholders (participants, parents, peer mentors, and employers) from a peer-based work preparation program in Canada reported decreased concern over job qualification and attainment following the program (Nichols et al., 2019). Another recent study assessed a peer-mediated intervention in a work-based learning setting for transition-age autistic students. Results showed increased social, vocational, and independent interaction skills for all three students (Athamana & Chushing, 2019).

In recent years, large IT companies have started actively seeking autistic individuals for employment because they know that some people with autism can contribute to the company at levels that nobody else can. They have also realized that those with these specific abilities often have challenges, social or otherwise, that must be supported for their employees to be successful. Today, companies like Microsoft, SAP (Systems Applications and Products in Data Processing), Apple, Google, and others offer peer-based programs specifically for autistic people.

While initial findings show promise, peer support programs remain a severely undeveloped pathway for generating employment opportunities for autistic adults. Studies show that employers must gain a greater understanding of the heterogeneity of autism and commit to inclusive/flexible environments and hiring processes for workplace peer support to function (Nichols et al., 2019; Bury et al., 2020). In the United Kingdom, The National Health Service (NHS) recently implemented The Autism Peer Support Worker Capability Framework, which develops paid roles for autistic people to support others with autism based on their lived experiences. The program also provides peer support for caregivers, highlighting the importance of connecting to individuals with similar lived experiences. Supportive evidence for applying peer support in the workplace is robust and asserts that all participants (mentees, mentors, employers) require education and training around work experiences and accommodations. Outside of the tech industry, there remains a need for acceptance and appreciation of autistic people and the talents they bring to an organization. It is high time we begin addressing the issue of employment in autism more intently, and peer support modalities seem a good place to start (Shea et al., 2024; Nichols et al., 2019; Bury et al., 2020). 

Peer support in older adulthood

Self-reports from autistic adults show that autism does not negatively affect aging, but a lack of understanding and proper care greatly hinder quality of life (QoL) (Hwang et al., 2017). In the allistic population, peer support has yielded positive results for social, emotional, and mental well-being for low-income older adults and those living alone or in assisted living facilities (Geffen et al., 2019; Kim, 2012; Tomasino et al., 2017). No studies on peer support for autistic older adults have been published. However, peer support initiatives for mental health and early-onset dementia show positive changes in QoL (Chapin et al., 2013; Sullivan et al., 2022). Given the co-occurrence of mental health difficulties and dementia in autism, these findings suggest that modification of peer support for older autistic adults is not only possible but urgently necessary.

Parental perspectives

Megan O’Connor and Steve Gauin emphasize their joy in seeing Nick gain his independence through the Options Program at Bishop Hendricken High School. The peer arrangements gradually minimize parental interaction and ensure participating students collaborate with multiple mentors every day. His parents feel that they can trust Nick is cared for and supported at the school, allowing them more time to focus on work and home life. 

“It’s really touching and inspiring to see him to go to school for an event, see him walk down the hall and every person, every student, every teacher, is saying, Hi, giving them a high five. You know, it’s priceless.”

— Steven Gaurin, Parent, Scientist, Advocate (Interview Sept 2024)

A 2023 study on parental perspectives of the effect of peer support on their children’s mental health found that 33% of the 985 parent participants definitely favored peer support, especially Latinx parents. These findings bolster the sentiments of discussed lived experiences and also present peer support as an innovative approach to mental health disparities (Sekhar et al., 2023).

Intervention participation

Most peer support initiatives do not require parental involvement as they are applied in classroom or therapy settings (Falkmer et al., 2015). However, in the Program for the Education and Enrichment of Relational Skills (PEERS), parents/caretakers attend a class where they learn how to assist adolescents in making and keeping friends. Simultaneously, children attend a class using didactic lessons, role-play demonstrations, and socialization activities to learn and practice social skills. Thus, PEERS programs offer support at the family level, ensuring personal empowerment and social skills continue to evolve (Mandelberg et al., 2013). Parent/caregiver participants report improvements in family chaos and self-advocacy with potential long-term impact following PEERS training (Karst et al., 2015; Tripathi et al., 2022). 

It is clear that parent involvement in peer support strategies directly impacts intervention success. However, participation also requires significant adaption from parents, who often manage the needs of more than one child on top of their own (Tripathi et al., 2022; Estes et al., 2017). A 2017 study found that caregiver burden had a negative relationship with quality of life and that social support mediated that negative relationship (Marsack & Samuel, 2017). Further investigation shows that both received and perceived social support are significantly related to parental stress, suggesting that perceived social support may be an underutilized aspect of care (Robinson & Wess, 2020). 

Learn more about the UCLA PEERS program in The Science of Making Friends for Autistic Youth: Lessons from the UCLA PEERS Program, presented by Dr. Elizabeth Laugeson.

Support for siblings of autistic children

Siblings play an essential role in shaping one another’s development trajectories and so are a critical aspect of lifelong support for many autistic individuals. In many cases, having siblings is a protective factor as both younger and older siblings have been associated with stronger socialization, communication, and daily living skills in many people with autism (Kryzak et al., 2014; Ben-Itzchack et al., 2019; Brewton et al., 2012; Daughrity, 2018). It is essential to understand that siblings of autistic individuals (SibASD) have their own needs and experiences, which are inherently impacted by care routines for their autistic siblings (Kryzak et al., 2014; Ferraioli et al., 2012). A recent scoping review found that SibASD experience lower psychological well-being, less perceived social support, increased aggressiveness, and higher levels of anxiety and stress compared to siblings of allistic individuals (Quatrosi et al., 2022). 

Research suggests that including SibASD in behavioral interventions benefits both children and is associated with skill generalization in autistic siblings (Ferraioli et al., 2012; Lu et al., 2021). In many cases, siblings provide a built-in communication partner, living skills role model, and social companion who can help teach them how to live happy and healthy lives (Rosen et al., 2023). In most sibling peer support strategies, SibASDs implement care techniques via play and other interactions after specific training (Bass& Mulick, 2007; Lut et al., 2021). For example, one community care program encompassed a SibASD support group, care skills training, and inclusive recreation time. Results showed decreases in stress, anxiety, and depression, as well as increases in social networks for allistic siblings, growth in reciprocal interactions, and overall program acceptance from parents (Kryzak et al., 2014). 

Sibling peer support programs assessed to date show positive social validity of program appropriateness, acceptance, and satisfaction (Kryzak et al., 2014; Lu et al., 2021). Researchers assert the need to observe and document the nature and extent of siblings’ shared activities, how individual adjustments affect relationship qualities over time, and the importance of context for promoting positive interactions. For example, researchers have found that sibling interactions are more reciprocal during recreation and hierarchical during care administration and that rewarding behaviors may be more effective in the presence of parents/adult caregivers (McHale et al., 2015).

Parent and caregiver peer supports

Parents of autistic children often experience increased stressors due to a lack of support and demands of caregiving. Recently, parent-peer support has emerged as a critical aspect of autism care, especially for families in low-resource settings (Lee et al., 2023; Sartore et al., 2021). Parents have reported that peer-to-peer supports catalyze learning, encouragement, support, and more balanced friendships for themselves and their autistic children (Shilling et al., 2014; Bray et al., 2017; Daughrity, 2018). Current research underscores the value of learning and discussing with people who have shared similar experiences and the direct impact that such relationships can have on anxiety and stress associated with caregiving (McCabe, 2008; Sharma et al., 2022; Catalano et al., 2018). For example, Parents Taking Action is a peer-led educational and community-based program for parents/caregivers of autistic children that has seen auspicious results (Dababnha et al., 2021). The program has been successfully adapted for Black parents, Chinese immigrant parents, Latinx parents, and Diné (Navajo) parents of young children with autism/intellectual disabilities in cities across the U.S. (Magaña et al., 2017; 2021; Lindly et al., 2023). Participants and researchers attribute the success of these programs to collaborative creation and the subsequent adaptability of the initiatives (Magaña et al., 2021; Dababnah et al., 2021). 

Many parent support programs have also been adapted for online use, significantly increasing accessibility. Internet-based peer support initiatives in the allistic population reveal promising results for parental support, information sharing, and community building (Niela-Vilén et al., 2014). Hermaszewska and Sin recently published potential strategies for content and implementation of an online peer-led intervention for parents of autistic children. Parent focus groups underscored the need for multicomponent online strategies that combine psychoeducation with peer support and access to healthcare professionals (2021). This combination balances expert and parental advice and ensures program malleability to individual needs, which is critical for program success (Clifford & Minnes, 2013; Sin et al., 2018; Hemdi & Daley, 2017; Catalano et al., 2018; Hermaszewska et al., 2021).

Learn about self-care strategies in our free webinar, Parents and Caregivers: The Importance of Self-Care, presented by Amanda Tami, LPC, BCBA.

Mechanisms of success

Peer support initiatives are highly modifiable to individual and location, allowing for a variety of implementation strategies. Successful peer mentorship programs are created in collaboration with those involved, ensuring some degree of universal design. They also feature social interactions that are simultaneously fun and educational, fostering individual expression and group cohesion.

Universal Design 

Effective peer arrangements generally include education and support for academic/work success and social skills/comfort built into some degree of Universal Design for Learning (UDL). The Universal Design Handbook lists the principles of UDL as Equitable Use, Flexibility in Use, Simple and Intuitive Use, Perceptible Information, Tolerance for Error, Low Physical Effort, and Size and Space for Approach and Use. These principles should be applied to architecture, products, and software (Preiser & Smith, 2011). Dr. Shore describes UDL tactics he uses in university settings, like presenting information in multiple mediums (e.g., visual, auditory, tactile) and giving students more autonomy in coursework and planning (Grogan, 2015). Similarly, a college assistance program at California State University, Fullerton, has made its peer-support program available online, significantly increasing accessibility to services (Cote et al., 2020; Cresswell et al., 2019).

The benefits of UDL are not reserved for neurodiverse and disabled people. In most cases, when UDL is employed, an environment, curriculum, or intervention becomes more accessible and accommodating for everyone. Many neurotypical people also have preferences and needs that they may try to hide or not call attention to. So, using UDL as a basis for an intervention or activity promotes the success and well-being of all people (Atherton Interview, 2024; American University of Washington, 2023).

“This is just good design in general… as we start to focus more on accessibility, we can also realize that that’s not just benefiting people who are neurodivergent or have physical differences. It’s just better for everyone. And if we start with neurodiversity and work our way backwards, then we’re just creating a better version of whatever we are trying to do.”

— Dr. Gray Atherton, Researcher and Lecturer, University of Plymouth (Interview, Sept 2024)

Participatory methodologies

Social support models, or frameworks that utilize socialization for well-being and acceptance, have emerged as critical aspects of successful peer arrangements along with peer-mediated communication (Kapp, 2018; Chan et al., 2009; Chapin et al., 2018). Specifically, friendship groups, augmentative and alternative communication (AAC), and interest-driven play are associated with positive communication outcomes (Chapin et al., 2018). A recent co-designed online peer support program saw autistic young adults gain practical skills and social connections while empowering communication and collaboration (Davies et al., 2024). Autism-specific peer supports are generally well-received by autistic young adults. However, participants and researchers assert the need for careful design, training, and awareness efforts around the rights, needs, and preferences of each autistic person (Crompton et al., 2022; Magaña et al., 2021; Dababnah et al., 2021). 

As with any intervention method or measurement tool, peer-support strategies for autistic people must be developed based on input from the autism community. Community participation is paramount to creating effective care strategies, and over the last few decades, participatory research and tool development has become the standard. Excluding the voices and perspectives of target audiences breeds discontent and maintains a feeling of “othering” where connection and acceptance should be the norm.

Learn more about the importance of participatory research and care tactic creation with our free webinar, Autism Research: Nothing About Me Without Me, presented by Dr. Wenn Lawson.

Contemporary research asserts the need for peer support programs created by and for autistic individuals. However, this is not always possible, and in order to facilitate wider cultural acceptance and prejudice reduction, allistic and autistic groups must continue to share space and interact (Cross & Atherton, 2024 Interview; Valderrama et al., 2022). While empathizing with other social groups can be difficult, allistic mentors tend to have a close personal connection to autism either through a family member or through their work/study in special education, psychology, or therapy. (Cote et al., 2020; Shore interview, 2024; Duerksen et al., 2021). Mentors are self-motivated to participate and often recognize the gap in cultural understanding and acceptance of their autistic peers. For example, at Bishop Hendricken High School, Adelphi University, and CSU Fullerton, many student mentors participate in the programs year after year, citing increases in their social interactions, academic success, and feelings of belonging as reasons for participation (Carter et al., 2011; Huber & Carter, 2019; Biggs et al., 2017). 

“[The mentors] are self motivated to take part in this program… driven by their own personal values and desire to help… [One of my son’s mentors] is going to become a special educator and the other young man decided he’s going to volunteer tutor throughout his college experience… and f you ask the school, they say that the peer mentor program is what really drives the school being this inclusive environment where everyone belongs.”

— Megan O’Connor, Parent, Educator, Advocate (Interview, Sept 2024)

In instances where autistic-led peer support is not possible, allistic mentors must be trained to minimize gaps in empathy and safety risks. Many school, family, and work-based peer-support models described in this article include mentor training specific to their environments (Kryzak et al., 2014; Dababnha et al., 2021; Nichols et al., 2019; LaPoint et al., 2024). Similarly, Linda Jones, founder of Families United in Newtown, has created a training program for student mentors. FUN training videos cover safety, how to mentor, the basics of autism, communication, and what it means to volunteer. After the training, students complete a quiz focused on safety and thinking from the other person’s point of view. 

“What’s really essential is for them to be able to think about how others experience the world, [take on] another perspective, and that really takes a lot of practice… you know [your partner] might not talk, but they probably understand what you’re saying…”

— Linda Jones, LMFT, MS, RD, Parent, Clinician, FUN Founder and President (Interview, Sept 2024) 

[Linda Jones discusses mentor trainings and the importance of trust and understanding.]

Shared tasks and gamification

Shared experiences, be it games, chores, spiritual activities, or something else, provide a central focus and structure for social interactions, which can alleviate anxiety around how one presents oneself in social situations. For example, Steve Gauin, father of Nick, who participates in the Options Program at Bishop Hendricken High School, says that social interactions centered around spirituality have helped Nick connect with school staff and build his self-confidence as he manages specific tasks related to spiritual services. 

“The fact that it is a Catholic institution means there are masses, there are certain ceremonies around that theme. And Nick has gotten so much out of all that. I, myself identify as agnostic. But, you know, I approached Nick going to this school with an open mind and I think it has been a real benefit to him socially. [It’s helped] in relating to the faculty who have really gotten to know him. And also confidence wise…That’s not to say that you need to have [a religious aspect], I don’t think you do. But I wanted to point that out.”

— Steven Gaurin, Parent, Scientist, Advocate (Interview, Sept 2024)

Contemporary autism literature specifically highlights gaming as an avenue of social support. For example, Dr. Gray Atherton and Dr. Liam Cross have found that autistic people and traits are overrepresented amongst board gamers and that the most common reason that autistic people game is for socialization. Their work shows that board games create a structured outlet for building social relationships. Study participants noted that having eyes on the board instead of on each other lowers anxiety, allowing conversations to flow more easily without the stress of small talk and open-ended conversations (Cross et al., 2023; 2024; Cross & Atherton Interview, 2024). Board games are also relatively affordable, making them an accessible way of providing a naturalistic, collaborative environment that allows players to practice social skills like cooperation and social deduction (Atherton et al., 2024).

Learn more about gaming and social connections in our free webinar How Games Foster Social Connection, presented by Dr. Gray Atherton.

Read Doctors’ Atherton and Cross’s 2025 publication, Metaphors and myths: using the board game Dixit to understand the autistic lived experiencepublished in Discover Psychology.

Humans are an inherently social species, so shared activities like games and hobbies come naturally and are used to create and maintain connections. In many ways, shared activities can break down societal roles, allowing participants to interact on the same level, no matter their social standings or capabilities. Gamification is steadily gaining use in employment recruitment and work training for autistic and allistic people and FUN founder Linda Jones has always included crafts and board games (sometimes life-sized!) in their monthly community activities (Tan et al., 2022; Willis et al., 2021; Zlotnik et al., 2023). 

Interpersonal coordination – The driving force

Social interactions and friendships are critical aspects of childhood development closely linked to academic/work success and emotional well-being across populations (Carter et al., 2010; Sun et al., 2020). Unfortunately, people with physical and intellectual differences are often restricted in their social opportunities and, therefore, are at increased risk for loneliness and associated mental health difficulties (Tought et al., 2017). As outlined throughout this piece, peer-based interventions improve social interactions, academic engagement, and friendship quality across ages and locations. Skills gained via such care strategies are generalizable to other settings and participants frequently report stronger feelings of self and increased confidence and assertiveness (Kiblen et al., 2024; Belchic & Harris, 2008; Carter et al., 2016; Asmus et al., 2016; Crompton et al., 2022; Duerksen et al., 2021; Siew et al., 2017; Nichols et al., 2019). 

“Once they hit middle school they’re not as included as you would hope… in eighth grade, when they started to socially isolate him, he acted out for the first time ever. So we knew he needed social engagement even though he has tremendous challenges with expressive language… [Now] he’s extremely happy being in a school that allows him access everywhere. He wants to be treated like everybody else.” 

— Megan O’Connor, Parent, Educator, Advocate (Virtual Interview, Sept 2024)

Learn about synchrony, interpersonal coordination and much more at Neuroplay Lab, the research page for Doctors Gray Atherton and Liam Cross.

The human urge to divide others into “us” and “them” is particularly detrimental to minority groups who experience prejudice, social exclusion, and reduced access to equal opportunities. Pro-social outcomes of interpersonal coordination are only seen among co-actors and not among observers. This means that experiences of interdependent identity, connection, and acceptance only extend to people who directly interact with one another (Atherton & Cross, 2020; Cross et al., 2018; 2020b). Therefore, those excluded from social interactions have fewer opportunities for creating meaningful connections and an increased likelihood of depression and anxiety. Compared to allistic youth, children with autism are lonelier, have fewer friends, and have poorer friendship quality (Bauminger & Kasari, 2003; Calder et al., 2012; Patrina et al., 2014). In autistic adults, loneliness is associated with depression, anxiety, and decreased life satisfaction and self-esteem. On the contrary, greater quantity and quality of friendships generally correlate with decreased loneliness and higher self-satisfaction, which is associated with lower social anxiety and higher psychological well-being (Mazurek, 2013; Cooper et al., 2023). 

“If you ask Nick what is his favorite thing about Bishope Hendricken, and it’s been like this consistently since he started, he’ll say it’s his friends.”

— Megan O’Connor, Parent, Educator, Advocate (Interview, Sept 2024)

Opportunities for interpersonal coordination across allistic and autistic groups are challenging to create, especially given the historically siloed approach of education systems, where “different” students were removed from wider classroom settings and, therefore, cut off from group-level social interactions. Such tendencies deprive all students, autistic or otherwise, of invaluable opportunities for creating interdependent identities and fostering self-acceptance. Pro-social outcomes of IC have been recorded up to 24 hours after completing a coordinated task. This means that group-based identity and empathy extend beyond laboratory settings, similar to how skills acquired during mentorship can be used and improved across situations and groups (Cross et al., 2020b; Hunt et al., 1994; Christensen et al., 2004; Carter et al., 2005). Contemporary research on IC and peer support strategies provides a roadmap for breaking down prejudice by fostering pro-social coordination in school and group settings (Cross et al., 2020a; Brock & Huber, 2017).

Barriers to support

In education settings, barriers to support for autistic students often center around stigmatization and prejudices held by teachers and staff (Stephenson et al., 2020; Taylor, 2005; Myers et al., 2011). Therefore, school instructors and personnel must receive appropriate training to accommodate and support autistic students, primarily via peer support (Koegel et al., 2012). In higher education, studies show a need for professional development around support accessibility and stigmatization of autistic students, specifically around the capability of autistic individuals to offer support to their peers (Davis et al., 2021; Valderrama et al., 2022; Bertilsdotter Rosqvist, 2019; Shea et al., 2024). Researchers assert that transitional support for autistic students requires training among teachers and school districts/universities, professional development opportunities that resist the deficit view of autism, and a strengths-based approach to addressing stigmatization (LaPoint et al., 2024). Barriers to the adoption of gamification in educational settings include misunderstandings around the benefits of play in learning, lack of resources, students’ apathy, subject fit, and classroom dynamics, where students quickly become over-competitive (Sánchez-Mena & Martí-Parreño, 2017; Yaşar et al., 2020; Zoom Interview, September 2024). 

One of the biggest barriers is actually kind of adult courage. Teachers and people in charge of curriculum seeing games as fun and not having any real kind of educational or social value. That’s one of the biggest barriers we’ve come across – convincing teachers that it’s not just messing around with a game, that the kids are actually practicing important skills they wouldn’t be motivated to learn otherwise. 

— Dr. Liam Cross, Researcher and Lecturer at University of Plymouth (Interview, Sept 2024)

[Dr. Liam Cross and Dr. Gray Atherton discuss social barriers to gamifying interventions and classroom activities.]

Time and infrastructure present two critical barriers to peer support initiatives at all education levels. Grade and high school administrators, as well as university professors and mentors, are very busy, making it difficult to ensure that the needs of program participants are always being met (Shore, Zoom interview, 2024). Enacting the kind of systemic changes needed requires time for upskilling and some groups to administer or incentives to participate in necessary training. 

As peer-support strategies in the workplace are severely underutilized, there is no data on specific barriers to such care. However, researchers assert the need for coordinated and systematic approaches to employment support that utilize peer-led initiatives and accommodating spaces for autistic adults (Harmuth et al., 2018). Similarly, peer support for older autistic adults remains an untapped avenue of care. However, peer support and training strategies are already being implemented by and for hospital staff to assist in worker well-being and knowledge transfer. Results are generally positive and may present a blueprint for creating similar peer initiatives to help educate health professionals caring for autistic individuals (Davison et al., 2006; Lim et al., 2020; Olsson, 2020).

Other critical barriers to support include financial pressures, geographic location, and service flexibility. It is vital to consider families in under-served areas where schools and other infrastructure lack funding to implement peer support strategies (Dababnah et al., 2021; Wallace-Watkin et al., 2022). It is also important to highlight the disparity in access to autism-specific services associated with demographic characteristics like age, assigned gender, race, and income. Therefore, successful peer support models must be adapted for cultural and socioeconomic effects and consider different avenues of access for individuals across resource settings (Hermaszewska et al., 2021). Just as the stigma surrounding autism must dissolve, policymakers and community leaders must also take specific action to ensure peer support and other critical care is accessible and practical for autistic people across populations and backgrounds (Adams & Young, 2020; Anderson et al., 2018; Lai et al., 2020).

I think it’s money – because you have to have money to do these programs. You also have to have money for the people that you want to help with it. you know, they don’t have enough aids, they don’t have enough people. They’ve been under-staffed for the last few years in our schools.

— Linda Jones, LMFT, MS, RD, Parent, Clinician, FUN Founder and President (Interview, Sept 2024) 

Learn more about care gaps across social groups in our free webinar, The Intersection of Race and Disability, presented by Dr. Amber Davis.

A peer-supported future

Contemporary research strongly asserts that peer-mediated support is an effective avenue of intervention for autistic people. Social, emotional, and academic/work outcomes are overwhelmingly positive, and parents report feelings of empowerment and reduced stress. Peer support modalities are highly modifiable across ages and settings, making them a valuable option for individualized autism treatment plans and goals. Outside of education settings, adult peer support is being applied in workplaces, hospitals, therapy programs, and more. Peer support methods provide a framework for destigmatization around autism, especially about autistic people’s capability to mentor other people with autism. In most cases, allistic mentors have a personal connection to autism and go on to become therapists and practitioners or remain otherwise involved in the autism community. It is critical to note that involving soon-to-be psychologists, therapists, and other practitioners in this work can instill empathy and a deeper understanding of the autistic experience and care needs even before they enter the workforce, potentially minimizing the research-practice gap.

“Yeah, I share that optimism and that hopefulness as well. Programs like this are leading us more towards a society where not only are people with different abilities or disabilities accepted, but better understood and and given more opportunities for taking part in society. And you know that that’s really where Nick is headed. He already has everybody at his favorite restaurant wrapped around his finger. They love him. They let him come back in the kitchen to make a pizza the other night, and we took it home… He used to make pretend pizzas in ABA. Now he’s making real pizzas”

— Steven Gaurin, Parent, Scientist, Advocate (Interview, Sept 2024)

Structured interactions between autistic and allistic people provide space to develop respectful, empathetic relationships where mentors and mentees learn from each other. In cases where peer support models are successfully implemented, mentors and mentees report increased socialization and self-confidence, and the general environment also benefits. For example, at Bishop Hendricken High School, parents and teachers feel a different social structure compared to other schools where students are routinely separated instead of thoughtfully integrated. Such instances serve as a microcosm of what our wider society might look like if individual differences were celebrated, understood, and accounted for instead of minimized, disregarded, or prejudged. 

“I think everybody just needs to take a step back and if they can think about what it’s like to be in someone that has a disability shoes, that they can then do something different with what they do to help other people.”

— Linda Jones, LMFT, MS, RD, Parent, Clinician, FUN Founder and President (Interview, Sept 2024) 

[Linda Jones discusses the importance of exposure and interacting across allistic and autistic groups.]

Peer support methodologies should be the norm. Research across disciplines asserts the importance of thoughtful integration from childhood to older adulthood. Isolation and mental health are critical issues across all populations, and friendships and social interactions are consistently cited as important supports for well-being and mental health. Lifetime care for autistic people depends on increasing accessibility, reducing stigma, and enhancing peer and professional understanding to promote accessible autism-friendly spaces (Lai et al., 2020; Mandell & Salzer, 2007; Wallace-Watkin et al., 2022). Peer support modalities should include aspects of universal design and must be created according to the needs and preferences of autistic people. Interpersonal coordination (IC), or participation in shared tasks or games, is also critical to successful peer mentorships. IC plays an integral role in expanding personal identities and deconstructing perceptions of in-groups and out-groups. The social benefits of IC are restricted to those who participate in a shared activity, underscoring the importance of creating opportunities for interaction across social groups. 

“We talk about inclusion, but you actually have to do it. I feel very fortunate that we found this program, but it should really be a demand… we should demand this model, because it works… this is best practice. This is what students need…”

— Megan O’Connor, Parent, Educator, Advocate (Interview, Sept 2024)

[Megan O’Connor discusses peer-support strategies as the norm and the importance of demanding interventions that are proven to be effective.]

Infrastructure and financial limitations prevent many organizations from implementing peer support strategies. However, as technology and digital spaces have evolved over the last few decades, so too have intervention capabilities. Cell phones and social media provide ample opportunity for peer connections, and some peer support initiatives have been successfully adapted for virtual use. Contemporary research also shows that imagined IC can foster rapport and dilute social prejudices and has been associated with increased empathy and decreased negative attitudes toward minority groups (Crossey et al., 2021; Crisp & Turner, 2009; Cross et al., 2020a; Atherton & Cross, 2020; Atherton et al., 2019; Gali et al., 2023; 2024). Such findings provide hope and opportunity for creating imagined IC and online peer connections where physical peer interactions may not be feasible (Sandstrom et al., 2014). 

Peer support modalities provide a blueprint for developing a more accepting society that celebrates differences. It is important to remember that less than a generation ago, children with autism were commonly institutionalized and wholly cut off from society. While we have made great strides in the last few decades, much work remains to be done. Many peer support and mentorship programs have been birthed and carried on by fierce parent advocates, just as ARI was founded by parent advocate Dr. Bernard Rimland. As parents of children with autism, they understand the impact of social ostracization on mental health and the critical need for friendships and community. As peer mentorship continues to gain traction in education, workplace, and care settings, the skills that set autistic and other neurodiverse people apart from allistic groups will be supported. As we honor more of the spectrum of human experiences and support inclusive spaces and organizations, our capacity as a human species will also continue to expand.

“I get a lot of hope and excitement from the ever increasing knowledge that the general population is gaining about autism and neurodivergence in general, and greater acceptance and appreciation of people who are different. Instead of trying to make people who are different poor imitations of typical individuals, the focus is on using the strategies that we know to help autistic or otherwise neurodivergent individuals be the best person they can be with their characteristics.”

— Stephen M. Shore, EdD, Autistic Professor, Adelphi University, Peer Support Creator, Internationally Renowned Author and Presenter (Interview, Sept 2024)

Resources and information

Programs and resources mentioned in text:

Free webinars from ARI:

Further information

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