In this Perspective, we summarize the evidence to date around the use of the Camouflaging Autistic Traits Questionnaire (CAT-Q) as a tool in research and clinical settings, and offer suggestions for its future use. We highlight that the CAT-Q is a useful measure of camouflaging/masking for research purposes, although questions remain regarding sociocultural variation in camouflaging experiences, and its specificity regarding autistic camouflaging compared with impression management more generally. With respect to clinical practice, we note that very little research has examined the use of the CAT-Q in clinical settings to date, and we encourage clinicians to be mindful of this limited evidence base and to refrain from using CAT-Q scores in diagnostic decision-making or as an intervention monitoring/outcome tool.

Background: Autistic adults experience disproportionately low employment rates, shaped by systemic and structural barriers that extend beyond individual skills. Although research on autism and employment has grown, it remains fragmented across disciplines and undersynthesized. Addressing these gaps requires not only stronger empirical evidence but also reflection on how knowledge in this field is organized and shared. Methods: We analyzed 1279 publications on autism and employment (1982–2025) indexed in Scopus. Document co-citation analysis was conducted in CiteSpace, supported by citation burst detection, dual-map overlays, examination of journal productivity, and international collaboration. Results: The analysis revealed three broad stages of development: individual-focused intervention, sociocontextual framing, and organizational inclusion. Thematic clusters showed a shift from behavioral and skill-based interventions to neurodiversity-informed approaches, emphasizing discrimination, the double empathy problem, and inclusive employment practices. However, research remains fragmented, dominated by Western perspectives, and limited in autistic-led contributions. Conclusions: This scientometric review shows that autism and employment research have shifted from individual-focused interventions toward more systemic and neurodiversity-informed approaches, yet remain fragmented across disciplines and heavily concentrated in Western contexts. To address these gaps, future research should prioritize organizational-level inquiry (e.g., workplace norms, human resource practices, and evaluation systems), strengthen integration between psychology, organizational studies, and policy research, and expand participatory, autistic-led designs that are attentive to global and cultural diversity.

Background: Autistic adults frequently have negative workplace experiences, as well as challenges with their psychological health, yet few studies have examined the linkages among aspects of employment and mental health in this group. To address this gap, we drew from the Job Demands-Resources model to investigate which aspects of employment were associated with psychological health outcomes in autistic adults. Methods: Participants were autistic adults ( n = 109; 18–43 years old) employed in community settings, who completed online surveys and interviews about aspects of employment (perceived workplace climate, part-time vs. full-time employment, and occupational contact with others) and psychological health (depressive symptoms, psychological quality of life [PQOL]). Results: Perceived workplace climate was the only aspect of employment significantly associated with psychological health; adults who reported more positive workplace climates had higher PQOL. Workplace climate was more strongly associated with PQOL among adults in this sample who were older (vs. younger) and had lower (vs. higher) daily living skills. Conclusion: These findings highlight the importance of safe and supportive workplace climates for autistic adults, especially for those who have more challenges with daily living skills and are further into adulthood. Importantly, results may not generalize to those from racial or ethnically diverse backgrounds, nor to autistic adults who are minimally verbal or would otherwise be unable to self-report.

Background: Autistic adults are at high risk of co-occurring mental health disorders, including depression, anxiety, nonsuicidal self-injury, and suicidality. Existing services are not adequately meeting autistic adults’ mental health needs. To better inform evidence-based care, there is a need to synthesize and integrate autistic people’s perspectives about the mental health-related services they receive. Methods: Using the PRISMA method, 40 studies of first-person experiences for autistic adults about mental health-related services met inclusion for this systematic review. Electronic database searches in PsycINFO and PubMed were conducted up to July 2023. Studies needed to be published, qualitative or mixed-methods, and had to include self-report of autistic adults who had experiences with mental health-related services. Original articles were reviewed, coded, and analyzed in line with a modified critical constructivist grounded theory approach. Results: Twelve studies inquired about participants’ experiences and needs with general services, and 28 studies explored participants’ experiences with specific services such as specific mental health interventions, support groups, or social-focused interventions. Our analyses of the 40 studies revealed five categories with regard to autistic clients’ perspectives on their mental health services: (1) to be more tailored to their individual needs, (2) to provide more accommodations in both format and content, (3) to include more practical support, in addition to emotional support, (4) for providers to have both knowledge of the heterogeneity of autism and humility in their work, and (5) to encourage and embrace a sense of autistic identity and community. Conclusion: Our results offer practical changes that clinicians can make to improve their services and create a better experience for autistic adults. Notably, our analyses highlight that too often the services autistic people receive focus on changing them, rather than on changing or coping with the environment. Diversity in participants was a limitation across our studies (participants were majority White, in a Western-based country, and did not have a co-occurring intellectual disability), and future research should ensure greater diversity in first-person perspectives.

Background: Firsthand accounts by autistic people describe a need for regular time alone. However, there is little in the literature that explores (1) why time alone is desired, (2) how that time is spent, or (3) where that time is spent. This article describes a neurodiversity-informed, qualitative study that demonstrates the importance and purpose of “alone-time” for autistic adults. Methods: We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their “alone-time” and the benefits experienced from this time. We conducted the interviews online, some using a video link, and some using a synchronously accessed text-based document, according to the participants’ preferences. Results: We used Reflexive Thematic Analysis with the interview data to generate four qualitative themes as follows: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others. Conclusions: These themes highlight a need for balancing social activities and spaces with time and space alone and the benefits of creating or protecting spaces, which encourage recovery from overwhelm.

Introduction: Research exploring the contextual factors influencing the rare instances of autistic people engaging with extreme ideologies is limited. This article explores factors that affected autistic people who engaged with extreme ideologies, from the perspectives of close contacts and clinicians. Methods: This article presents findings from interviews with two participant groups: family and friends, and clinicians. We recruited participants through a gatekeeper, professional networks, and social media. We used reflexive thematic analysis to analyze the data. Results: Participants included seven family members and one friend in the first group and five clinicians in the second. Across both groups, we identified four themes: (1) experiences of social vulnerability; (2) autistic and neurodivergent characteristics in the context of risk; (3) negotiating a complex identity; and (4) a slippery rabbit hole. Social vulnerabilities including lack of secure attachments in childhood and social rejection led to a sense of persecution. System-level marginalization compounded the sense of exclusion. A negative autistic self-image was an important factor. Inflexible thinking, differences in social cognition, hyperfixation, and need for structure and routine were identified as neurodivergent features that could find a fit within the ideologies and practices of extremist groups. However, participants emphasized that autism itself did not fully account for this engagement. With limited engagement in prosocial real-world activities and ample idle time, internet algorithms exacerbated exposure to extreme ideologies, which offered provocative explanations for these autistic peoples’ struggles. Conclusions: Timely diagnosis, qualified and continuous support structures, neuroinclusive societies, and digital literacy are all key components to preventing autistic people from this harmful engagement.

Efforts are intensifying across the U.S. to better prepare physicians to deliver high-quality, patient-centered care for adults with disabilities like autism. To address this need, we partnered with autistic adults and their families to develop a training program for resident physicians called Promoting Residents' Excellence in Patient-centered cARE (PREPARE) for Autistic Adults. Here, we describe an evaluation of the feasibility, acceptability, and appropriateness of PREPARE for Autistic Adults to inform content and format revisions before efficacy pilot testing. We recruited residents (n=14) at one large academic medical center in the Midwestern U.S. to participate in the eight-week virtual training, which included six pre-recorded lectures, six facilitator-led case studies, and two standardized patient encounters. Participants rated feasibility, acceptability and appropriateness of the training, and participated in qualitative interviews to identify improvement opportunities. We analyzed quantitative data with descriptive statistics and qualitative interviews with an inductive rapid qualitative analysis. Participants' median completion rate was 76.9% of training components. Participants rated feasibility, acceptability, and appropriateness highly. We identified four main qualitative themes: 1) Flexibility facilitates feasibility, 2) High-value experiences increase acceptability, 3) Practicalities affecting participation, and 4) High clinical practice relevance enhances appropriateness. We revised the training based on feedback, including clarifying or adding content, modifying standardized patient encounter logistics, and adding optional components for residency programs to supplement core PREPARE content. These results provide information for continued refinement of the training. Our next steps include pilot testing the efficacy of the revised training at one large academic medical center.

Language around autism plays a crucial role in shaping public attitudes toward autistic people. The use of identity-first versus person-first language and impersonal references to autism can affect how autistic people are perceived. These factors should impact the representation of autistic people in newspapers, where negative and stereotypical representations are often perpetuated. We asked five autistic people to judge the sentiment toward autism and autistic people in 1000 quotes from British newspapers (2011-2020). The coders, who did not know the newspaper title and time of publication, made their judgments based on two dimensions, warmth and competence, from the Stereotype Content Model (SCM). We examined the overall judgments of warmth and competence and considered variations in language context and terminology, such as the use of impersonal references to autism or identity-first and person-first language. We also examined potential differences between broadsheets and tabloids, left- and right-leaning newspapers, and changes over time. The majority of quotes from British newspapers fell under a low warmth and low competence area within SCM. Furthermore, impersonal references to autism tended to be rated lower in warmth and competence than references linking autism to an individual, whereas identity-first language was judged higher in warmth and competence than person-first language. Quotes from broadsheets were assigned similar warmth and slightly higher competence than quotes from tabloids. However, left-leaning and right-leaning papers did not differ regarding warmth and competence, and there were inconsistent changes over time. Our study confirms that the portrayal of autistic people in British newspapers tends to be negative. According to autistic raters, associating autism with a person and using identity-first language are linked to more positive representations. Although we found subtle variations in sentiment related to reporting style, our study shows little progress over time toward more positive portrayals.

Research suggests that autistic youth and young adults often experience barriers to sustained employment. Although there is an existing body of literature on the barriers and facilitators to employment, little of this literature focuses solely on the perspectives of autistic youth and young adults. To better support autistic youth and young adults at work, we aimed to determine which workplace supports and accommodations these individuals classify as key supports based on their lived experiences. We conducted semi-structured qualitative interviews with 12 autistic youth and young adults (ages 17-29 years old) about their workplace experiences and perspectives. We conducted interviews virtually and used a grounded theory approach to analyze and organize the transcribed interview data into themes. Six themes of workplace supports emerged from the data. The resulting themes were as follows: (1) hands-on training methods with opportunities for practice, (2) employer-provided accommodations, (3) social support, (4) job-fit, (5) external supports, and (6) inclusive workplace culture and self-advocacy. Employer-provided accommodations included written and direct instruction, flexible scheduling, and supports for sensory needs and social-communication. Social support included support from managers, coworkers, and through proximity to others. Job-interest match, workload, level of social interaction, and a sense of routine all contributed to job-fit. The six identified themes provide a guide for the ways in which employers could better support autistic youth and young adults at work. Notably, many of the identified themes were cost-effective, easy to implement, and may benefit autistic and nonautistic employees alike. Practical implications for employers and vocational support practitioners are also discussed.