Neurodiversity in Practice: a Conceptual Model of Autistic Strengths and Potential Mechanisms of Change to Support Positive Mental Health and Wellbeing in Autistic Children and Adolescents

Abstract

Objectives Neurodiversity affirming frameworks are a paradigm shift from a deficit-focused approach to autism to recognizing autism as a heterogeneous constellation of differences in abilities and strengths. This article completed a literature review and data synthesis to (1) identify autistic strengths used in the design of psychosocial interventions, (2) propose mechanisms of change that explain strength-based psychosocial intervention effects on mental health and wellbeing outcomes, and (3) integrate findings in a conceptual model for testing in future research studies. Methods A search for articles was completed in June 2023 and resulted in 24 articles that met the inclusion criteria. The Distillation and Matching Model methods were used to code articles and subsequent conceptual groupings generated categorical domains included in the conceptual model. Results Autistic strengths identified in the design of psychosocial interventions were grouped into four domains: (1) perceptual, (2) reasoning, (3) expertise, and (4) character strengths. Mechanisms of change were grouped into four domains: (1) affective, (2) behavioral, (3) cognitive, and (4) physiological. The resulting conceptual model presents autistic strengths that can be leveraged in psychosocial interventions and potential mechanisms of change that explain intervention effects on mental health and wellbeing. Conclusions Growing focus on the translation of positive psychology has resulted in strength-based psychosocial intervention programs. However, intervention strategies have not leveraged the diverse array of autistic strengths identified by autistic individuals, their families, and their communities. Furthermore, research is needed to determine mechanistic paths by which strength-based interventions achieve positive effects on mental health outcomes in autistic children and adolescents.

Psychosocial interventions for autistic children and adolescents delivered by non-specialists in low- and middle-income countries: a scoping review

“…Implementation science is urgently needed to identify mechanisms of change that result in positive effects. Mechanisms of change include affective, behavioral, cognitive, and physiological mediating variables ( Cherewick and Matergia, 2023 ). Identification of implementation barriers and facilitators would provide evidence needed to understand the implementation factors required to achieve effects in diverse contexts.…”

Nurturing the Positive Mental Health of Autistic Children, Adolescents and Adults alongside That of Their Family Care-Givers: A Review of Reviews

“…Various psychosocial interventions have used this thinking to reduce mental health disorders and to promote mental wellbeing, but their use within autism has been limited. A review of 24 studies that used this approach informed the development of a conceptual model for creating strength-based interventions [34]. Four categories of strengths were identified among people with autism: perceptual (e.g., attention to detail, memory); reasoning (e.g., logical reasoning; problem solving); expertise (e.g., special interests; indepth knowledge); character strengths (e.g., honesty; creativity).…”

A brief neuro-affirming resource to support school absences for autistic learners: development and program description

“…Neuro-affirming practice aims to foster acceptance and selfcomprehension, as well as amplifying the voices, experiences, and needs of neurodivergent individuals (Roche et al, 2021;Wood et al, 2022). While the transition to neuro-affirming practices is gaining momentum, there is little comprehensive and accessible guidance on supporting autistic individuals who experience dysregulation or anxiety in school, and there remains a need to reassess the ways in which pedagogy and school environments are conceptualized and understood through a neuro-affirming lens (Cherewick and Matergia, 2023).…”