“I Have a Different Perspective as I Am Working Through This”

Abstract

Purpose: Whereas the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) characterizes autism as a neurological disorder typified by impairment in social communication and restricted interests/repetitive behaviors (American Psychiatric Association, 2013), the neurodiversity paradigm focuses on autism as a form of neurological diversity that may be central to a person's identity. The purpose of this study was to pilot the Autism Understanding Tool for Introspection and Evaluation (AUTIE) as a means to encourage and examine speech–language pathologists' (SLPs) reflections on autism. Methods: We utilized purposeful maximum variation sampling to recruit nine SLPs (one being a graduate student) and administered a “think aloud” procedure with video conferencing to elicit their reflections while taking the AUTIE. Participant reflections were analyzed using three sequential phases of inductive thematic analysis. Results: The analysis of 270 self-reflective comments led to eight key themes that were each associated with comments from four or more of the nine participating SLPs: (a) acknowledgment of divergent perspectives, (b) specification of environmental barriers, (c) importance of autistic identity, (d) questioning the concept of normality, (e) resolving tensions through person-centered care, (f) integrating multiple forms of expertise, (g) parallels with other marginalized identities, and (h) changes in views over time. We contextualized the themes by embedding examples within analytic narratives from two autistic SLP participants Conclusion: Results supported use of the AUTIE as a tool to elicit meaningful reflection about the divergent and evolving views of autism. Implications focused on the need to address this complex landscape both within our individualized clinical practice and our professional field at large.