Adapting communication with autistic service users: Co-produced adaptations for medical services, employers, and the third sector

Abstract

Autistic people have a greater need to access services (e.g., health and social care, welfare, justice, etc.), yet face significant disadvantages when doing so, often due to poor two-way communication between service providers and service users. This study aimed to co-develop practical, evidence-based adaptations to facilitate communication between service providers and autistic people. Based on a review of current research evidence, an initial list of adaptations was developed, across four categories: (1) adapting the environment to reduce sensory stressors, (2) facilitating diagnosis disclosure, (3) adapting direct communication, and (4) modifying visual or written information. Second, we co-delivered (with autistic people) a workshop for service providers, tailoring these adaptations to their sectors. Finally, a large survey sample of autistic people and the autism community evaluated these adaptations and added their own suggestions. Workshop attendees’ autism knowledge and confidence in communicating with autistic people significantly improved post-workshop, and they went on to implement the evidence-based adaptations. The autism community endorsed the adaptations and suggested some additional adaptations that they would like. Findings demonstrate that providing evidence-based adaptations in a workshop co-delivered with autistic people improves service provider autism knowledge and confidence in communicating with autistic people, and encourages them to offer adaptations. Lay abstract What is already known about the topic? Autistic people need access to a range of services, including health and social care, welfare, and access to justice. However, research with autistic people and their supporters has identified several barriers when trying to access these services, including a lack of autism understanding, reluctance to make accommodations, and difficulties with communication. What this paper adds? Research has shown several ways in which communication can be adapted. The current study aimed to apply these research findings to real-world practice by working with service providers, autistic people, and the autism community to create a suite of practical adaptations. We developed an initial list of adaptations, under the categories: (1) adapting the environment to reduce sensory stressors, (2) facilitating autism diagnosis disclosure (where desired), (3) adapting communication, and (4) adapting visual/written information. With autistic people, we then co-delivered a workshop for service providers, tailoring these adaptations to each sector. Service providers who attended the workshop felt more confident working and communicating with autistic people, demonstrated improved autism knowledge, and implemented several adaptations in their services. We also surveyed the autism community, who agreed that the adaptations were helpful, and also suggested additional adaptations they would like to see offered by service providers. Implications for practice, research, or policy The findings demonstrate that adaptations autistic people find helpful can be tailored to specific services. This will help autistic people and their supporters to access crucial services, and will enable service providers to offer an effective service to autistic people.