‘Living in a world that’s not about us’: The impact of everyday life on the health and wellbeing of autistic women and gender diverse people
Rachel Grove,
Hayley Clapham,
Tess Moodie
et al.
Abstract:Background: Autistic women and gender diverse people have specific needs related to their physical and mental health. They also experience more barriers to accessing services. While there are autobiographical accounts of the ‘invisible’ challenges that autistic women and gender diverse people face day-to-day, there has been limited research that explores how these experiences impact health and wellbeing. Objectives: This study aimed to understand the everyday experiences of autistic women and gender diverse pe… Show more
“…Efforts to bridge this social “mismatch” have also been associated with “autistic burnout”, a particular form of chronic stress associated with increased anxiety, depression, and suicidality, especially in autistic adulthood [ 44 , 45 ]. Chronic stress due to nonacceptance of neurodivergence may also be exacerbated by additional intersectionalities, such as being an autistic female or having gender expansive identities [ 46 ].…”
Section: Resultsmentioning
confidence: 99%
“…Efforts to bridge this social "mismatch" have also been associated with "autistic burnout", a particular form of chronic stress associated with increased anxiety, depression, and suicidality, especially in autistic adulthood [44,45]. Chronic stress due to nonacceptance of neurodivergence may also be exacerbated by additional intersectionalities, such as being an autistic female or having gender expansive identities [46]. As underlying nervous system dysregulation is implicated in the development and maintenance of chronic pain [24], the assessment of these social stressors was critical to integrate into the conceptualization and treatment of pain in autistic youth.…”
Section: Affirmation Of Autistic/neurodivergent Identitiesmentioning
Though there is growing awareness of the overrepresentation of autistic patients in chronic pain clinics, potential adaptations for the assessment and treatment of chronic pain in this population have not yet been established. To address this gap, a retrospective review of electronic medical records and discussions by an interdisciplinary pain treatment team were summarized to inform potential biopsychosocial factors affecting the presentation, assessment, and treatment of chronic pain in autistic youth. Our sample included a record review of 95 patients receiving treatment in an interdisciplinary outpatient pediatric pain clinic. Results indicated that 9% (n = 9) of the patients presented to the clinic with a prior diagnosis of autism, but an additional 21% (n = 20) were identified as likely meeting criteria for autism based on the clinical assessment of the developmental history, behaviors observed during the clinical encounter(s), and expert clinical judgment, suggesting that the prevalence rate of autism may be closer to 30% in our outpatient pediatric pain clinic. Over half (52%) of the autistic youth presented to the clinic with widespread pain, 60% identified as female, and 6% identified as gender expansive or transgender. Qualitative insights revealed that most of the autistic patients had co-occurring sensory-processing challenges and difficulty in describing their pain, emotions, and somatic experiences and exhibited cognitive inflexibility and social challenges. We summarize our team’s clinical reflections on how autism-relevant biopsychosocial vulnerability factors may contribute to the experience of pain in autistic youth and propose treatment targets and adaptations for the assessment and treatment of pain in this population. Finally, we recommend the need for interventions focused on sensorimotor integration, especially for autistic youth, and describe how pain clinics may be particularly helpful for identifying and supporting autistic females, for whom the potential role of autism in pain experiences had not been considered until receiving treatment in our clinic.
“…Efforts to bridge this social “mismatch” have also been associated with “autistic burnout”, a particular form of chronic stress associated with increased anxiety, depression, and suicidality, especially in autistic adulthood [ 44 , 45 ]. Chronic stress due to nonacceptance of neurodivergence may also be exacerbated by additional intersectionalities, such as being an autistic female or having gender expansive identities [ 46 ].…”
Section: Resultsmentioning
confidence: 99%
“…Efforts to bridge this social "mismatch" have also been associated with "autistic burnout", a particular form of chronic stress associated with increased anxiety, depression, and suicidality, especially in autistic adulthood [44,45]. Chronic stress due to nonacceptance of neurodivergence may also be exacerbated by additional intersectionalities, such as being an autistic female or having gender expansive identities [46]. As underlying nervous system dysregulation is implicated in the development and maintenance of chronic pain [24], the assessment of these social stressors was critical to integrate into the conceptualization and treatment of pain in autistic youth.…”
Section: Affirmation Of Autistic/neurodivergent Identitiesmentioning
Though there is growing awareness of the overrepresentation of autistic patients in chronic pain clinics, potential adaptations for the assessment and treatment of chronic pain in this population have not yet been established. To address this gap, a retrospective review of electronic medical records and discussions by an interdisciplinary pain treatment team were summarized to inform potential biopsychosocial factors affecting the presentation, assessment, and treatment of chronic pain in autistic youth. Our sample included a record review of 95 patients receiving treatment in an interdisciplinary outpatient pediatric pain clinic. Results indicated that 9% (n = 9) of the patients presented to the clinic with a prior diagnosis of autism, but an additional 21% (n = 20) were identified as likely meeting criteria for autism based on the clinical assessment of the developmental history, behaviors observed during the clinical encounter(s), and expert clinical judgment, suggesting that the prevalence rate of autism may be closer to 30% in our outpatient pediatric pain clinic. Over half (52%) of the autistic youth presented to the clinic with widespread pain, 60% identified as female, and 6% identified as gender expansive or transgender. Qualitative insights revealed that most of the autistic patients had co-occurring sensory-processing challenges and difficulty in describing their pain, emotions, and somatic experiences and exhibited cognitive inflexibility and social challenges. We summarize our team’s clinical reflections on how autism-relevant biopsychosocial vulnerability factors may contribute to the experience of pain in autistic youth and propose treatment targets and adaptations for the assessment and treatment of pain in this population. Finally, we recommend the need for interventions focused on sensorimotor integration, especially for autistic youth, and describe how pain clinics may be particularly helpful for identifying and supporting autistic females, for whom the potential role of autism in pain experiences had not been considered until receiving treatment in our clinic.
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