By Prof Tony Attwood and Dr Michelle Garnett
At some stage in early childhood, an autistic child begins to recognise that they are different from most of their peers in terms of understanding social conventions, reading facial expressions and gestures, preferred activities, coping with change and sensory sensitivity. Unfortunately, self-perception to being different to others can lead to a negative sense of self. During the teenage years, a time of physiological, cognitive, and friendship changes, an autistic adolescent may continue to have difficulty determining why they face difficulties at school that their peers do not. This can lead to deep and solitary introspection about oneself and a yearning to connect to a peer group that understands them and shares the same challenges in daily life.
An autistic teenager’s sense of self-identity, self-confidence and self-worth is often based on peer rejection and criticism, not compliments and acceptance, as illustrated in these two quotes from autistic teenagers:
I was afraid to be myself because I thought I wasn’t good enough.
I was teased unmercifully because other people just didn’t understand my way of thinking.
Factors contributing to a positive autistic sense of self are crucial, given the potential implications for mental health and well-being and the concealment of autistic characteristics leading to camouflaging or masking the authentic self (Botha & Frost, 2020).
External autism acceptance and support
A recent systematic review of quantitative research on autistic identity has confirmed that a more positive autistic identity occurs when receiving external autism acceptance and external support (Davies et al., 2023). The review confirmed a positive association between autistic identity and learning about autism from autistic advocates, social media, online blogs and autistic people, not parents and professionals. This can also lead to an increased recognition of the benefits of autism (Nguyen et al., 2020).
Connection to others
Peer and self-directed support resources may be valuable for encouraging a positive autistic sense of self. Defining oneself as a group member improves well-being when the group is seen positively, or one experiences a sense of collective self-esteem (Ferenc et al., 2023). Engagement with online autistic communities, where autistic people can speak to each other about their experiences, as well as blogs and autobiographies by autism advocates, can result in a more positive sense of self (Bury et al., 2022).
A study by Crompton et al. (2020) explored the experiences of autistic adults spending time with autistic and non-autistic family and friends. With non-autistic family and friends, the autistic participants in the study described the amount of energy and effort in resonating with non-autistic communication styles, reading facial expressions and unspoken social rules and anxiety preceding a social occasion. This created emotional exhaustion, as illustrated in the following quote from the study:
I get anxious because I have to behave well, to behave neurotypically, to do the right thing.
There was also concern that non-autistic family members and friends often did not consider aspects of autism when organising and during social events.
In contrast, interactions with autistic family members and friends were associated with feelings of comfort and ease and appreciating similar communication styles. There is less need to mask or camouflage due to acceptance of the characteristics of autism and ways of interaction.
There is no pressure to talk. If there are silences, it is not awkward, shared understanding that silence is nice.
There was a sense of belonging, connection, and being the authentic self.
Emerging evaluations of peer support programmes for autistic people have confirmed the benefits of developing a positive sense of self. For example, Crane et al. (2021) evaluated a 10-week autistic-led post-diagnostic support programme for autistic adults. Qualitative findings from the study indicated that the programme provided attendees with a sense of belonging and, significantly, a more positive outlook on being autistic. The participants also found ‘unity in diversity’ and highlighted the benefits of being part of a diverse group with varied experiences,
Over several decades, we have designed and evaluated a range of group Cognitive Behaviour Therapy (CBT) programmes for autistic adolescents and adults to reduce anxiety and depression. We had assumed that the success of these groups was primarily due to CBT. However, we now recognise that there would have been a positive effect in all group participants being autistic. This would have facilitated a sense of connection, which would have contributed to reducing anxiety and depression and encouraging a positive sense of self.
Where to from here?
Our online course Developing a Positive Self-Identity covers each topic discussed in this blog in greater depth and describes strategies for autistic individuals, parents and professionals to develop a positive sense of autistic self. The Event was designed for autistic adolescents and adults, parents and health and educational professionals.
References
APA (2023) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision American Psychiatric Association.
Attwood and Garnett (2016). Exploring Depression and Beating the Blues London, Jessica Kingsley Publishers.
Botha and Frost (2020). Society and Mental Health 10,
Bury et al. (2022) Journal of Autism and Developmental Disorders 52.
Cage et al. (2018) Journal of Autism and Developmental Disorders 48.
Cooper et al. (2017) European Journal of Social Psychology 47
Corden et al (2021) Frontiers in Psychology 12.
Crane et al. (2021) Journal of Autism and Developmental Disorders 51
Crompton et al. (2020) Autism 24,
Davies et al. (2023). Autistic identity: A systematic review of quantitative research. Manuscript submitted for publication. https://doi.org/10.31219/osf.io/74k6m
Ferenc et al. (2023). Autism 27.
Jackson (2002) Standing Down Falling Up: Asperger’s syndrome from the inside out. Bristol: Lucky Duck Publishing.
Lai et al. (2019). The Lancet Psychiatry 6
Lee and Hobson (1998). Journal of Child Psychology and Psychiatry 39.,
Maitland et al (2021) Autism 25
Nguyen et al (2020) Frontiers in Psychology 11.
Ommensen, B. (2023) PhD Thesis, University of Queensland.
Perry et al. (2022). Journal of Autism and Developmental Disorders 52.
Williams (1992) Nobody Nowhere: The remarkable autobiography of an autistic girl. London: Doubleday.
