Examination of professional biases about autism: How can we do better?

Abstract

Objective: This paper lends a critical eye to six common assumptions/biases about autism that may influence neuropsychologists in their clinical work. These biases are based on research as well as the historical roots of the study of autism. Our goal is to encourage curiosity and reflection on these biases in order to improve neuropsychological service delivery for people on the autism spectrum. Methods: We argue that psychologists should strive to understand the function of behaviours observed with autism in order to offer helpful supports. We explore the assertions that autism is not a dichotomous or linear construct and that the use of high and low functioning descriptors are not useful nor appreciated by the autism community. We discuss the widely held beliefs that individuals on the autism spectrum lack theory of mind, empathy and social motivation. Importantly, people on the autism spectrum are telling us that the dialogue about them around theory of mind and empathy is a human rights issue. Finally, we discuss the role of standardized testing. Conclusions: Through an exploration of research literature, the writings of scholars and advocates on the autism spectrum, and personal, clinical and research experience we encourage our profession to take a leadership role in examining biases and changing the clinical and research landscape so that it better reflects respectful discourse for individuals on the autism spectrum. This is critical to reduce the stigma that continues to be associated with autism and has a negative affect on mental health and quality of life.

Keywords:

• Autism
• theory of mind
• empathy
• professional biases
• social motivation
• assessment

Recommended reading

Below a list of diverse readings is provided, which includes voices of people on the autism spectrum, caregivers, and professionals in the field. Best practices are to listen to and consider the perspectives of individuals from diverse groups when in a provider role. It is important that we also do this when working with individuals with disabilities and/or neurodiverse presentations. We hope this collection of readings will allow professionals to deepen their knowledge of autism and ability to connect with and understand clients on the autism spectrum and their support teams.

Online resources

Autism Community Training British Columbia – actcommunity.ca

Nason, B. Facebook.com/­autismdiscussionpage

Neuroclastic.com

EllenNotbohm.com

Thinkingautismguide.comhttps://autisticadvocacy.org https://www.aane.org

Books

Des Roches Rosa, S., Byde Meyers, J., Ditz, L., Willingham, E., & Greenberg, C. (2011). The thinking person’s guide to autism: What you really need to know about autism from autistics, parents and professionals. Deadwood City Publishing.

Greenspan, S. I., & Wieder, S. (2006). Engaging autism: Using the floortime approach to help children relate, communicate, and think (1st Da Capo Press ed.). Da Capo Lifelong Books.

Nason, B. (2014a). The autism discussion page: On the core challenges of autism. Jessica Kingsley Publishers.

Nason, B. (2014b). The autism discussion page: On anxiety, behavior, school, and parenting strategies. Jessica Kingsley Publishers.

Notbohm, E. (2012). Ten things every child with autism wishes you knew (Updated and expanded ed.). Future Horizons.

Prizant, B. M., & Fields-Meyer, T. (2015). Uniquely human: A different way of seeing autism. Simon & Schuster.

Silberman, S. (2015). Neurotribes: The legacy of autism and the future of neurodiversity. Avery, an imprint of Penguin Random House.

Disclosure statement

This work was not funded and neither author has a conflict of interest to declare.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1 Clinical psychologists may be engaged in providing family therapy, individual psychotherapy or group therapy to individuals with autism. As well, they may be engaged as clinical supervisors for those doing direct intervention work.

2 Heterogeneity is very important to consider for females who may present quite differently. This topic is complex and important, but is too hefty to adequately address in this commentary. For more information the reader is referred to Mandy et al. (2012). Sex differences in autism spectrum disorder: Evidence from a large sample of children and adolescents. Journal of Autism and Developmental Disorders, 42(7), 1304–1313. This may also apply for non-binary individuals and future work is needed in this area.

3 This term is originally attributed to Bruno Bettleheim, however Shea (2013) stated that it is actually from a 1949 paper by Leo Kanner.

4 Autistic-led is a term that comes from the disability rights movement which calls for “nothing about us without us.”