How can we make therapy better for autistic adults? Autistic adults' ratings of helpfulness of adaptations to therapy.
Jessica Paynter, Kristyn Sommer, Amanda Cook
PMID 39840840WHAT IT FOUND
Autistic adults rated no therapy adaptation as helpful for everyone.
The most valued changes were neurodiversity-affirming practices, clear information beforehand, and sensory adjustments. Shorter sessions, telephone therapy, and involving family were rated least helpful. Ask each client what they need.
Key findings
01Psychologist high level knowledge about autism, online booking options, and a neurodiversity-affirming approach were rated most helpful, with 86.92% to 96.15% of participants rating them as helpful.
02Shorter sessions, telephone therapy, group therapy with other autistic people, and involving family or partners were rated below neutral on average.
03No single adaptation was rated as helpful by all participants, indicating substantial individual differences in preference.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was predominantly female (85.4%) and highly educated, with 63.1% holding a bachelor's or postgraduate degree, which may not represent autistic men or those with lower literacy or education levels. Participants were recruited via social media and clinics, creating a self-selected sample of people who had already accessed therapy and could read/write English online. The rating scale was developed for this specific study and lacks established external validation or comparison to other standardised measures. The study measured perceived helpfulness of adaptations in general, not their impact on actual therapy outcomes or symptom reduction. Definitions of 'neurodiversity-affirming' varied, and the study did not explore participants' own understanding or general knowledge of autism, which may have influenced ratings.
Declared interests
The authors declared no potential conflicts of interest. The research was funded by internal grants from the School of Applied Psychology at Griffith University and a Postdoctoral Fellowship Grant from Griffith University.
The easy way to misread this
Do not interpret the group averages as a universal checklist. Since no adaptation was rated as helpful by all participants, and individual differences were substantial, applying the highest-rated adaptations to every autistic client without asking them first may still result in unhelpful care.