New directions for UK autism research

Lead Research Organisation: University College London
Department Name: Psychology and Human Development

Abstract

Scientists believe they are making great strides towards understanding autism. This is partly because there has been a dramatic expansion of autism research in the past decade in the UK and abroad (Dawson, 2013). The most comprehensive review of UK autism research ever undertaken recently found that almost £21 million was invested in autism research between 2007 and 2011 by UK government and non-government organisations, spread across 106 different projects (Pellicano et al., 2013). The Economic and Social Research Council made more funding awards than any other organization, while the Medical Research Council awarded more money for autism research than any other funder.

These developments are to be hugely welcomed. With 1 in every 100 UK people on the autism spectrum, it is vital that we develop our understanding of autism. Greater knowledge of the nature of the condition and its potential impact is clearly of significant social import. The same comprehensive review has also shown, however, that autistics, parents, clinicians and service providers are concerned that the research profile in the UK has largely prioritised basic science, especially biological science, potentially at the expense of other fundamental, but more applied areas, of research, including public services for autistic people, evidence-based treatments for autism and its related symptoms and the social and ethical challenges posed by some of the more recent scientific advances.

This proposed seminar series will bring together some of the world's most celebrated autism scientists with leading experts and practitioners drawn from these other fields in an effort to develop a new research agenda in each area of concern. They will seek to build new networks of inter-disciplinary researchers capable of pursuing this new agenda in the decades to come.

The seminars will be participatory in nature and begin by posing key provocations or questions that should both stimulate immediate discussion and assist scholars in developing more detailed research questions for the future, in collaboration with community members.

The seminars on public services would begin with questions including: What are the socioeconomic, ethnic and gender disparities in access to services? How can we improve post-diagnostic support for parents of children with autism and autistic adults? What are the best ways to get autistic adults into work and keep them there?

The seminars on evidence-based treatments, interventions and educations would begin with: What do we mean by 'evidence' when referring to autism interventions? How do we measure the effectiveness of education programmes in schools who follow 'eclectic' programmes? What 'outcome measures' should we use in interventions and who gets to make these decisions?

The seminars on autism and society would begin with: Should we be aiming for "inclusion" of autistic people in society and, if so, how do we achieve it? What place should the autism community have in shaping the research agenda? How do we know if, when and how we should intervene with autistic children, young people and adults? How should we best promote awareness (and acceptance) of autism?

Planned Impact

This seminar series originates from a sense that although UK autism research is world-leading, it has not as yet realised its "translational" potential. In other words, major scientific discoveries have not been translated into recommendations for new services or treatments nor have they been properly and fully examined for their social and ethical implications. Moreover, autistic people and their family members have rarely been actively engaged in the research process - in deciding what the priorities are, how an issue is researched, who undertakes the research and so on - and many people report feeling disenfranchised as a result. These seminars aim to help put all of this right. Enhancing the impact of British autism research, is thus, at the very heart of their purpose.

That effort to enhance impact will be shaped in two ways,

First, those representing the main advocacy organisations and funders (e.g., National Autistic Society, Ambitious about Autism, Research Autism, Autistica, Autism Education Trust, Scottish Autism, Autism Cymru), and members of the autism community, including autistic young people (where appropriate) and adults, family members, and individuals from the policy and practice sectors (those focused on children and adults) will be intimately involved in each stage of the proposed seminars. Representatives of many of these bodies have already been consulted on the proposal and have discussed the ideas directly with the applicants. Should the bid be successful, they will be invited to participate in the seminars and will bring their conclusions directly to their membership. We believe this will stimulate significant and long-lasting interest in the seminars and their subjects.

Second, we will also use the established and extensive networks and resources of the applicants, including the London Centre for Research in Autism and Education (CRAE), to disseminate the results of the seminar discussions and provoke wider discussion and further future research, both academic and non-academic. We will use social media (Twitter, Facebook) to publicise events and to promote a dialogue with those unable to attend (e.g., via 'live tweeting'). Parts of the seminars will be filmed and podcasts posted on the CRAE YouTube channel for wider dissemination.

Publications

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Fletcher-Watson S (2019) Making the future together: Shaping autism research through meaningful participation. in Autism : the international journal of research and practice

 
Description Despite widespread public interest in autism, autistic people and their families living in the UK have rarely been actively engaged in the research process. They have not been given the opportunity to decide research priorities, shape how an issue is researched, or help draw out practical lessons from research. Many have reported feeling disenfranchised as a result (Pellicano et al., 2014).

The Shaping Autism Research seminar series sought to bring together (non-autistic) researchers and funders, and autistic people, their family members, and those who support them to work out ways of turning this around. We sought to encourage a dialogue between research and autism communities and build and maintain partnerships that were mutually supportive and mutually beneficial - one key way to ensuring greater community engagement in research. To this end, we held 6 seminars across England, Scotland and Wales with over 200 delegates that were highly participatory and interactive in nature and, critically, were inclusive. Indeed, autistic people represented one third to half of attendees.

Three key findings emanated from our seminars:

1. Seminar delegates reported that the lived experiences of autistic people - their experiential expertise - is rarely apparent in the context of autism research. They also highlighted several barriers to participatory autism research, including tokenistic involvement or 'tick-box exercises' in which people's input does not influence the outcome; power inequalities between (non-autistic) researchers and community members; a 'deficit' (can't do) view of autism, including potentially harmful assumptions about what autistic people are capable; a lack of inclusive structures to support participatory autism research and a lack of shared understanding or 'mutual incomprehension' between autistic and non-autistic people.
2. The discussions across the seminars gave rise to three core principles of participatory autism research: Trust (that researchers must be honest and committed in their interactions), Mutual Respect (that autistic people and their allies need to feel respected - and for their views to be valued - by researchers) and Listening and Learning (that researchers, both autistic and non-autistic, need to listen to and learn from the community's expertise and experience).
3. Seminar delegates also identified two keys ways to promote participatory autism research. The first is through building supportive environments, which are necessary to build a culture where autistic people and their allies can take on active, meaningful roles in research. These include: changing the language we use to describe autism; modifying or identifying physical spaces to enable autistic participation; and adapting the structures and bureaucracy of academia to facilitate autistic involvement and leadership in research. The second is through addressing challenging questions, which encompasses those issues which are not addressed by current roadmaps for participatory research, including how to capture the 'voices' of autistic people who have additional intellectual disabilities and/or do not speak; and how to respond to disagreements within and between groups.

In sum, the seminars enabled a diversity of perspectives to be shared, enabled institutional assumptions to be challenged, and articulated a vision for mutual and equal engagement.
Exploitation Route As part of the research seminars, we produced a series of outcomes, including (1) supporting collaborative partnerships between autistic people (including researchers) and non-autistic researchers; (2) a website, Shaping Autism Research (www.shapingautismresearch.co.uk), which contains all of the details on the seminars (e.g., seminar presentations, seminar themes, a template programme for 'autism friendly' events), and a Twitter feed (@ShapeARUK), which has 1,441 followers (June 2017); (3) a manuscript for publication in an academic journal authored by autistic and non-autistic researchers (Fletcher-Watson et al., in preparation), (4) a 'starter pack' for participatory autism research, designed in collaboration with autistic scholars and allies, which outlines overall the principles of 'Trust', 'Listening and Learning' and 'Mutual Respect' identified from the seminars. This latter outcome was created with early career researchers in mind (although is applicable to anyone entering/interested in autism research) and is freely available from the Shaping Autism Research website. It was a key resource for Liz Pellicano's webinar as part of the International Society for Autism Research (INSAR) Summer Institute 2017, which is available to all INSAR members, and for a more recent British Academy funded workshop for early career researchers on participatory autism research (led by Dr Laura Crane, UCL Institute of Education).

It is hoped that the foundations laid throughout the Shaping Autism Research seminar series should lead to a greater, co-created knowledge base for the better integration of community perspectives in research.
Sectors Communities and Social Services/Policy,Education,Healthcare

URL http://www.shapingautismresearch.co.uk
 
Description The findings from the first five ESRC-funded seminars in the Shaping Autism Research series were used to draft publicly-available guidance on researcher-community engagement practices (see http://www.shapingautismresearch.co.uk for details). At the end of this grant, we produced a set of outputs that can be used by autism researchers, particularly early-career researchers, to help them involve the autistic and autism communities (autistic adults, parents of autistic children, practitioners) in the research that ultimately affects them. All of these outputs are hosted on the Shaping Autism Research website: http://www.shapingautismresearch.co.uk. The Starter Pack for Participatory Autism Research describes how researchers can begin to genuinely involve autistic people in their research - in such a way that it promotes trusting relationships, is built on mutual respect, and involves listening to, and learning from, one another - that is, being empathetic researchers. The Pack also provides some practical ideas about how autistic people and their allies can work together in research. All of the content was inspired by discussions and debates held in Edinburgh, Newcastle, Cardiff and London as part of the ESRC-funded Shaping Autism Research seminar series, and was co-created with autistic and non-autistic scholars and artists. We have also since had a paper reporting on the outcomes from the series, identifying five topics relevant to building a community of practice in participatory research: Respect, Authenticity, Assumptions, Infrastructure and Empathy (Fletcher-Watson et al., 2018). It has already been cited 548 times (as of March 2023), an Altmetric score of 280 and is in the top 10 most read papers in the journal (impact factor = 6.41). It also highlights the Starter Pack describes above.
Sector Communities and Social Services/Policy,Education,Healthcare
Impact Types Cultural,Societal

 
Description An Expert for the National Autism Project
Geographic Reach National 
Policy Influence Type Citation in other policy documents
 
Description Mentioned in House of Commons
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
Impact Many practitioners, researchers, community members - and now policymakers - know that the funding portfolio for autism research is unduly biased towards biomedical research and that we need more research on the issues that are of more immediate, practical concern to autistic people and their families. During the debate on World Autism Awareness Week in April 2016, Jon Cruddas, Member of Parliament for Dagenham and Rainham, emphasised the importance of identifying effective services for autistic people and their families, mentioning research conducted by the Centre for Research in Autism and Education from our 'Future Made Together Project' and Shaping Autism Research projects.
URL https://hansard.parliament.uk/Commons/2016-04-28/debates/16042848000001/WorldAutismAwarenessWeek
 
Description Westminster Autism Commission
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
URL https://westminsterautismcommission.wordpress.com
 
Description ARC Future Fellowship
Amount $978,000 (AUD)
Funding ID FT190100077 
Organisation Australian Research Council 
Sector Public
Country Australia
Start 04/2020 
End 03/2024
 
Description Autism Cooperative Research Centre Strategic Funding
Amount $251,000 (AUD)
Funding ID 0.11RS 
Organisation Autism Cooperative Research Centre 
Sector Charity/Non Profit
Country Australia
Start 07/2018 
End 06/2020
 
Description Participatory autism research in the CRC and beyond 
Organisation Autism Cooperative Research Centre
Country Australia 
Sector Charity/Non Profit 
PI Contribution This project involves mixed methodologies to evaluate the participatory research currently being conducted within the Autism CRC and to create an evaluation framework for use in future CRC projects and other autism research internationally. It employs a Postdoctoral Research Fellow for 2 years, funded by the Autism CRC, to: (1) conduct a review of the nature and extent of community involvement in Autism CRC projects to date and gain people's perspectives of such involvement, both the potential benefits and challenges, situated within the context of the Autism CRC's journey of engaging end-user organisations and inclusive research practices, including its initiatives directed to the promotion of co-production (Study 1 - year 1); (2) develop an evaluation framework for participatory autism research and (pilot) test the efficacy of that framework in 1-2 Autism CRC funded projects (Study 2 - year 2) (3) review and revise (as necessary) the co-production mechanisms of the Autism CRC (e.g., the Inclusive Research Practice Guides and Checklists) in light of the findings from aims 1 and 2; and (4) contribute to other work on social and ethical issues that are of significant concern to the Autistic and autism communities (Studies 3-4; years 1 and 2). The long-term aim of this research is to enhance the uptake and quality of inclusive research practices within the Autism CRC and autism research internationally.
Collaborator Contribution The Autism CRC are providing funding for the Postdoctoral Research Fellow and associated project travel costs and consumables to enable the implementation of this project. They will also provide access to researchers funded through the Autism CRC, marketing and media expertise, and potential collaborations with existing researchers.
Impact Project just started so no outputs as yet.
Start Year 2018
 
Description Autism Practice Seminar I 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact The goal of the first ESRC-funded Shaping Autism Research seminar, held at Edinburgh University on June 10th and 11th 2015, was for researchers to come together with the autism community, including autistic adults, parents of children with autism and practitioners in health, education, social services and the third sector, to identify challenges and solutions to creating, evaluating and disseminating evidence-based supports for children and adolescents.

During Day One of the Edinburgh seminar, two sets of small group discussions were convened, compiled from seminar delegates from a range of backgrounds. The main issues raised by the discussion on 'What's the problem?' are summarised here: http://www.shapingautismresearch.co.uk/post/131418915380/whats-the-problem-outcomes-from-small-group

Speakers' slides from the event can be found here: http://www.shapingautismresearch.co.uk/post/121671104750/autism-practice-slides. And a full transcript of the Twitter activity from the 2-day seminar can be found here: https://storify.com/autresearchuk/autism-and-practice-seminar
Year(s) Of Engagement Activity 2015
URL http://www.shapingautismresearch.co.uk/tagged/autismpractice
 
Description Autism and Practice seminar II 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact The final seminar in our ESRC-funded Shaping Autism Research seminar series was held at University College London on March 3rd 2017. The overall goal of the seminar series has been to effect a culture change in the way researchers engage with members of the autistic community and their allies: "shaping autism research". The purpose of this final seminar was to produce a range of materials that will contribute to this cultural shift and can be carried forward by workshop attendees and everyone else who has been associated with the seminar series so far.

We hope that a cultural shift in the research community will also influence similar cultural shifts in related communities (e.g. among service providers and practitioners) and will result in better translation of research into practice by virtue of the research having been informed by community priorities in the first place.

The seminar outputs are still being produced. They will be available on the Shaping Autism Research website in the coming months: http://www.shapingautismresearch.co.uk
Year(s) Of Engagement Activity 2017
URL http://www.shapingautismresearch.co.uk/tagged/wellbeing
 
Description Autism and Society seminar I 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact there has been a substantial increase in research activity on autism during the past decade. But little of this research has concentrated on the everyday needs of autistic people and even less has been shaped directly by autistic people and their families; read more here. Involving community members in research - from the very inception of an idea to research design to implementation and interpretation of findings - is one vital means of ensuring that more of the research that gets done has a direct and sustained impact on those who need it most. The goal of the fourth ESRC-funded Shaping Autism Research seminar, held at University College London on July 18th and 19th 2016, was for researchers to come together with the autism community, including autistic adults, parents of children with autism and practitioners to:
1. Examine the different ways to conducting participatory research, drawing from such work both inside and outside the field of autism,
2. Discuss the opportunities and challenges to involving the autistic community in research, and
3. Determine ways to overcome any such challenges.
Short talks, panel discussions and creative activities ensured plenty of opportunities for discussion among the attendees. The main themes that emerged from the seminar are catalogued on the Shaping Autism Research website: http://www.shapingautismresearch.co.uk/tagged/participation
Year(s) Of Engagement Activity 2016
URL http://www.shapingautismresearch.co.uk/tagged/participation
 
Description Autism and Society seminar II 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact The 5th seminar in our ESRC Shaping Autism Research series was on Autistic Wellbeing, held at University College London on March 1st and 2nd 2017. This particular seminar focused on working towards a shared definition of autistic wellbeing and determining how best to measure autistic wellbeing in our research and embed this understanding in our practice. Half of the seminar attendees were autistic and half were from the broader autism community (researchers, including early-career researchers, practitioners and charitable organisations). As in all of our seminars, there were short talks, panel discussions and creative activities to enable as much discussion as possible between attendees. All of the emerging themes will be documented on the Shaping Autism Research website: http://www.shapingautismresearch.co.uk/tagged/wellbeing
Year(s) Of Engagement Activity 2017
URL http://www.shapingautismresearch.co.uk/tagged/wellbeing
 
Description INSAR Summer Institute 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This web-based keynote presentation was invited by the International Society for Autism Research, and was co-presented by autistic activist and campaigner, Ari Ne'eman. During the presentation, we considered the kind of autism research that gets done and who gets to make decisions about research; we proposed a new, more ethically-informed way of doing autism science, namely participatory autism research; we suggested ways to form genuine partnerships with the Autistic and autism communities, including community-based participatory research. Participants asked questions throughout the webinar and our presentation generated much discussion both online (hour-long Q&A) and offline.
Year(s) Of Engagement Activity 2017
URL http://www.autism-insar.org/general/custom.asp?page=Pellicano_Neeman
 
Description Public Services Seminar I 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The second seminar in the ESRC-funded series on Shaping Autism Research took place in Newcastle on 9th and 10th November 2015. As the majority of autism research in the UK focuses heavily on "basic science" - neural and cognitive systems, genetics and other risk factors (Pellicano et al., 2014), the goal of this second seminar was to address research that targets the immediate circumstances in which autistic people find themselves in daily life, on services, interventions and education. The first Public Services seminar focused on discussing the development of more effective Health and Social Care services in partnership with the autism community.

Here is just one outcome of this 2-day seminar: http://www.shapingautismresearch.co.uk/post/134340220890/good-news-about-outcomes-from-the-series-so-far
Year(s) Of Engagement Activity 2015
URL http://www.shapingautismresearch.co.uk/tagged/publicservices
 
Description Public Services Seminar II 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The third ESRC-funded seminar in the Shaping Autism Research series took place at Cardiff University on 4th and 5th February 2016. While the Newcastle seminar focused on public services for older individuals, the focus for the Cardiff seminar was on younger adults and children, highlighting the importance of involving the views of autistic people and their families in decisions that affect their lives and the need for integration and partnership working in research and services. There was a special focus on services in Wales, with the possibility of informing the final version of the Welsh Government's Strategic Action Plan.
Year(s) Of Engagement Activity 2016
URL http://www.shapingautismresearch.co.uk/tagged/publicservices
 
Description Researcher Code of Practice 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact One of the intended outputs of the ESRC-funded Shaping Autism Research seminar series is guidance on researcher-community engagement. To this end, we have produced a draft document intended to provide guidance to established researchers on mimimum standards in community engagement. It was derived from discussions at the initial seminars and was shared on the Shaping Autism Research website. Comments and feedbacks were invited from interested parties. As each seminar in the series takes place, and the information and discussions are captured, this document will be updated and new drafts will be posted on the site.
Year(s) Of Engagement Activity 2016
URL http://www.shapingautismresearch.co.uk/post/137151331575/researcher-code-of-practice