PTOTSLPOtherAutism : the international journal of research and practice2025

Barriers to healthcare predict reduced health-related quality of life in autistic adults without intellectual disability.

Nicole David, Pascal Rahlff, Hannah König and 8 others

PMID 39262134

WHAT IT FOUND

Autistic adults in Germany reported significantly lower health-related quality of life than the general population.

The number of barriers they experienced in accessing healthcare was the strongest predictor of poor mental quality of life and a key predictor of poor physical quality of life.

Key findings

01Barriers to healthcare were the strongest independent predictor of reduced mental health-related quality of life.

02Barriers to healthcare also significantly predicted reduced physical health-related quality of life, alongside somatic comorbidities.

03Mental health-related quality of life was far below average (more than 1.5 standard deviations below the norm) in this sample.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study was cross-sectional, so it cannot prove that barriers to healthcare cause lower quality of life; it only shows an association. The sample consisted of adults without intellectual disability who had sufficient language skills to complete an online survey, so findings do not apply to autistic adults with intellectual disability or those with limited communication skills. There was no matched control group; HRQOL scores were compared to general population norms, which may not account for other confounding variables.

Declared interests

The authors declared no potential conflicts of interest. The study was funded by the Innovation Fund of the German Federal Joint Committee of Health Insurance Companies (G-BA). The funding body had no role in the design, data collection, analysis, or writing of the manuscript.

The easy way to misread this

Do not assume that reducing healthcare barriers will automatically improve quality of life. This is an observational study showing a correlation, not a randomized trial proving that removing these barriers causes the improvement.

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