Reporting by people with autism: A new evidence-based supportive model for information gathering in applied interview contexts

Autism spectrum disorder (ASD) is diagnosed in around 1% of the population and presents a number of challenges to the day-to-day lives of these individuals as well as their families and support services. This project will provide an evidence base and guide improvements to existing methods used by professional groups to support those with ASD. This will take place in three important information-gathering contexts in which they are currently at a disadvantage. First, only around half of young adults with ASD have worked for pay outside the home - the lowest rate among disability groups. Performance in occupational interviews is a crucial determinant of employment prospects, yet the social, cognitive and communication difficulties of ASD mean they are often unable to perform to the best of their abilities in interviews. Second, people with ASD are more likely to have certain social and health-related issues and co-occurring conditions, and may therefore be more likely to visit health and social care professionals. However, difficulties with introspection and social communication are likely to make relaying relevant information difficult, unless their specific difficulties are appropriately supported. Finally, although individuals with ASD are over-represented in the Criminal Justice System (CJS) as both witnesses (victims) and suspects, current police interviewing models are ineffective in supporting them to provide 'best evidence'.

For people with ASD and their families, research on societal issues and improving the lives of ASD individuals is vital. Yet research of this nature is currently lacking. Most services including health and social care, employment and the justice system are developed to cater for "neurotypical" people, or adapted for those with broad intellectual disability. However little consideration or support is in place for the social and cognitive difficulties that are specific to ASD. If individuals with ASD are to receive appropriate and fair access to services and justice, their difficulties must be better understood and accommodated. This begins with their reporting of relevant information to authorities and services. People with ASD show impairments in socio-cognitive domains, including a lack of insight into their own and others' intentions, as well as 'executive functions' (a set of capacities involving cognitive control, regulation, planning and flexibility). As a result, they experience problems in open-ended social situations where the desired response or type of information required from them needs to be inferred. The proposed project will compare how individuals with and without ASD perform on varying social and open-ended tasks. It builds on my existing work to test 1) how the shifting social contexts and increased task complexity inherent in information-gathering interactions in employment, healthcare and CJS contexts might heighten ASD impairments, and 2) how these can be ameliorated with appropriate support. Furthermore, people with ASD can also have areas of strength, and the research aims to determine how these strengths can be utilised to develop interviewing formats that support their difficulties whilst capitalising on their strengths.

This research will directly inform best practice in HR, health and social care and the CJS, improving access to services and justice for people with ASD. It will also advance theory by providing new insight into how the social and cognitive difficulties (and strengths) of ASD impact upon real life social interactions. Findings will have implications for national organisations, including the Department of Health, Department for Business Innovation and Skills, Home Office, as well as more local groups, for example, potential employers, police interviewers and health and social care professionals. An extensive program of dissemination to both academic and non-academic stakeholders is planned to maximise the research impact with a broad range of key users.

AUTISM COMMUNITY AND SUPPORT ORGANISATIONS: Societal issues and improving the lives of those with ASD have been identified as areas that people with ASD and their families believe should be key priorities for research (Pellicano et al., 2013). Employment, health and social care, and justice are fundamental human rights, yet the difficulties experienced by people with ASD disadvantage them under current protocols. To ensure that these human rights are met, their difficulties must be better understood and accommodated. By producing guidance for interviewing people with ASD in these contexts, this work will directly impact upon the ASD community by improving access to services and justice, enhancing their capacity for independence and achieving their potential.

EMPLOYERS, LOCAL AUTHORITIES AND EMPLOYMENT SERVICES: Equal opportunities in the workplace are increasingly a priority for employers. Despite many years of special education services, 85% of people with ASD do not work full time (Knapp et al., 2009) - the lowest rate among disability groups. Many people with ASD have areas of strength that other individuals do not, but their talents are often missed. This represents a missed opportunity for society at large and for people with ASD. Performance in occupational interviews is a crucial determinant to employment prospects, and the development of an evidence-based specialised ASD employment interview protocol will help job seekers with ASD to highlight their strengths, improving their opportunities for obtaining work.

HEALTH AND SOCIAL CARE PROVIDERS: People with ASD are more likely to have various medical (Mannion & Leader, 2013), social and mental health issues (Buck et al., 2014) and are more likely to visit health and social care professionals (Cidav et al., 2013). However, they may be disadvantaged in these contexts (e.g., in putting across a truthful but prudent account when trying to obtain benefits or social housing, or relaying relevant personal episodic information to a doctor). The proposed research aims to reduce this disadvantage by developing support for people with ASD to communicate their health and social care needs in consultations, which may improve their access to appropriate support, care and treatment.

CRIMINAL JUSTICE SYSTEM (CJS) PROFESSIONALS: People with ASD may be more likely to be questioned as a victim/witness or suspect. In a survey of 450 UK Police Officers I found a strong need among police for the development of an interviewing model to support ASD cognitive and communication difficulties (Maras et al., in prep). The proposed research will provide criminal investigators with an evidence-based tool enabling people with ASD to give their best evidence, increasing access to justice and professionalism of the CJS, potentially improving conviction rates while reducing miscarriages of justice.

PUBLIC SERVICES AND POLICY: The 2014/15 review of the Adult Autism Strategy (Department of Health, 2014) identified challenges that people with ASD and their families wished to be prioritised for action. These included reasonable adjustments within services, better support for their needs in the CJS, and the opportunity to achieve their aspirations in obtaining employment. The research will provide psychologically-guided, good practice interview methods that support adults with ASD in all of these areas, and may impact policy on interviewing guidance across several government departments (e.g., Home Office, MoJ, Dept. for Business Innovation and Skills, Dept. of Health).

SOCIETY: Autism is estimated to cost the UK economy at least £32billion a year in areas such as medical care and productivity loses (Knapp et al., 2009). There is a societal and financial case for the proposed research, which will potentially contribute to reducing costs for the taxpayer associated with ineffectual health and social care, untapped potential in employment, and ineffectively pursuing investigations in the CJS.