Dr. Gray Atherton discusses the critical role of age and age of diagnosis in shaping the quality of life for autistic individuals. She provides a brief history of autism understanding and considers how changes in diagnostic criteria and cultural stigmas have affected the “lost generation.” The speaker details two studies that emphasize the importance of early intervention and how best to support people who receive a late diagnosis. Atherton explains that diagnosis directly affects quality of life, making detection and diagnosis critical for adults. She notes that further research must incorporate lived experiences and underscores the need for investment in care across the lifespan. 

Take the knowledge quiz for this presentation HERE

In this webinar: 

2:30 – Autism prevalence estimates
5:00 – Diagnosis differences by gender
8:30 – Autism through the ages
10:30 – DSM description evolution
13:15 – Special education and the Salamanca Statement
17:10 – Changes in autism assessments
18:20 – The lost generation
21:00 – Study: Age of Diagnosis, Autistic Traits, and Quality of Life
23:25 – Results
27:00 – Quality of life and aging
31:00 – Study recap
31:30 – Study: Lived experiences of late diagnosed adults
33:20 – Themes and results
34:25 – Participant quotes
39:00 – How to disclose
41:20 – Overview of study results
44:35 – Future directions
47:22 – References and contact information
47:30 – Q &A

Introduction

Atherton states that autism is a lifelong condition and highlights that less than 1% of research funding goes to lifespan issues in autism. She discusses differences in prevalence rates by country and gender (3:20) as well as environmental and heritability drivers (6:30). The speaker provides a brief history of autism understanding through the ages, highlighting significant milestones and epidemiological studies from 1943 to today (8:30). She details changes in autism prevalence from 4.5 in 10,000 children in 1966 to 1 in 54 children in 2013 (11:30). Atherton attributes the rise in prevalence to improved diagnostic practice and increased awareness and educational inclusion (12:25). 

The “lost generation” refers to autistic individuals who received an autism diagnosis in adulthood and therefore lost the time and support afforded to those who receive an early diagnosis (18:20). Atherton outlines two recent studies investigating why these individuals are being missed and how it affects their quality of life: 

Study One: Age of Diagnosis, Autistic Traits, and Quality of Life

The first study focused on understanding the impact of age of diagnosis on quality of life and autistic traits. Atherton and her colleagues examined a sample of individuals diagnosed with autism later in life by assessing responses to five autism diagnosis and symptom questionnaires (21:00). Findings revealed that about two-thirds of females were diagnosed over 18. In contrast, the majority of men were diagnosed under 18. Despite being diagnosed later in life, females reported high levels of autistic symptoms (24:45). There was a significant association between late diagnosis in adulthood and lower quality of life. These individuals reported higher levels of autistic traits, including social anxiety, loneliness, and lower satisfaction with life. In contrast, earlier diagnosis was associated with better quality of life outcomes (29:15).

Study Two: Qualitative Interviews with Late Diagnosed Adults

The second study involved qualitative interviews with adults who received an autism diagnosis later in life (31:30). Atherton highlights the importance of exploring their lived experiences to gain insights into the challenges and benefits of late diagnosis. Themes found during interviews included barriers to diagnosis, negative sentiments to non-diagnosis, benefits of diagnosis, and the pros and cons of receiving a diagnosis (33:20). The speaker quotes study participants for each theme, demonstrating the intersectionality of late diagnosis and quality of life. Overall, participants overwhelmingly expressed positive sentiments about receiving a diagnosis in adulthood. One person described it as a signpost that provided answers and guidance on how to approach life differently and feel proud of one’s identity (37:29). Diagnosis brought relief, clarity, access to appropriate support, and personal advocacy. However, participants also expressed some barriers to diagnosis, such as parental perceptions and societal misconceptions about autism (39:20).

Implications of Late Diagnosis

Atherton asserts that these findings underscore the significance of early diagnosis in autism (41:25). She highlights diagnostic disparities between men and women and considers potential drivers. The speaker emphasizes that receiving a late diagnosis matters and assures viewers that, although a late diagnosis may be complex and confusing, the identity and understanding that come with it can have a significant positive impact on personal acceptance (43:15). Early detection enables timely interventions, tailored educational approaches, and access to support services, all of which contribute to better outcomes for autistic individuals.

Future Directions

The presenter highlights the need to recognize autism in females and change stereotypes of autism as a male condition. We must also reduce stigmas, continue care into adulthood, and support the “lost generation” as they realize their diagnoses. She asserts the need for increased research into cultural differences, societal perceptions, and access to diagnosis and support (45:00). The speaker also discusses the significance of studying the experiences of individuals from diverse backgrounds, including women, people of color, parents of children with autism, and employment experiences of autistic people.  

Gray Atherton, Ph.D., discusses pet ownership as it relates to autistic individuals. She gives context for the importance of this topic, details the theories underpinning her research, and outlines her recent mixed-method studies. The speaker describes differences in the directness of animal communication compared to human social cues and underscores the positive relationship between pet ownership and mental health for autistic people. Atherton describes themes in her qualitative research, noting potential barriers and breakthroughs. The presenter provides ideas and solutions for future research and application directions and introduces the research team before opening the question and answer session.

Learn more about our speaker, Gray Atherton, Ph.D. HERE

Take the knowledge quiz HERE

In this webinar

0:59 – Agenda
1:55 – Introduction and context
3:31 – Theory behind animal connections and autism
5:15 – Eye gazing serotonin feedback loops
7:02 – Visual cues in animal interactions
8:58 – Mixed methods approach and study outlines
10:39 – Study: Autistic vs. non-autistic pet ownership survey
15:11 – Equal animal attachment across groups
17:15 – Pet attachment and mental health in autism
17:34 – Study: Real-life applications for pet contact
18:40 – Themes from research
19:25 – Sensory benefits
20:31 – Companionship
21:08 – Judgment
22:56 – Social lubricant
24:37 – Barriers
26:33 – Responsibility as a breakthrough
27:43 – Challenges
29:00 – Ideas, solutions, and future directions
30:54 – Volunteerism
32:09 – Mentoring
33:25 – Ways to start
36:25 – Presentation summary
37:26 – Research team
38:06 – Q & A

Summary 

Research shows that autistic people prefer interactions with animals over humans and that 80% of autistic children have participated in pet therapy. This, the speaker asserts, gives context as to why pet contact in relation to autism is an important topic (1:55). The Biophilia Theory, as described in Atherton’s recent publication (3:31), asserts that humans innately love nature and seek connection with other forms of life (4:45). Most of human history, she continues, has been lived in a direct relationship with nature which allowed humans and domesticated animals to evolve in stride and foster a connection of love and affection (6:15). For example, studies have revealed that when humans and dogs exchange eye gazes both participants experience an increase in serotonin, creating a serotonin feedback loop. Therefore, humans have a profound physiological and biological connection with domesticated animals. (There is an emphasis on domestic animals as such feedback loops do not occur in gaze exchanges with wolves)  (5:15). 

Atherton explains that, although autistic individuals often avoid human eye contact, eyes are one of three focal points they consider when interacting with animals (7:02). The speaker implies this trend could be because animals give much more direct social cues than humans – as there are no contradictory social signals to puzzle together (i.e., contradicting words and facial expressions), animal behavior is more straightforward to interpret (8:03). The presenter details another recent study and the mixed method approach they used to discover outcomes and themes of pet ownership among autistic individuals (8:58): 

Experiment 1: Researchers surveyed 700 adults, half of whom were autistic, on lifetime pet ownership, pet attachment, and mental health (10:39). Contrary to previous research, Atherton and her team found that autistic people are less likely to own pets as children and adults. They also found pet ownership corresponded with better life satisfaction (12:20). Atherton asks viewers not to distance this finding from its context, reminding them that the ability to own a pet likely corresponds with having a steady job and home, which innately increase life satisfaction. Pet attachment, she continues, is related to better mental health in autistic individuals (17:15). The study also found that autistic people use relationships with pets to compensate for social avoidance experienced as a result of social difficulties (16:15). Importantly, both groups exhibited equal attachment to pets, and the type of pet did not change the relationship quality (15:11). The presenter asserts that this fundamentally dismantles the assumed stereotype that autistic people lack emotional complexity and connection compared to the non-autistic population. 

Experiment 2: Researchers interviewed autistic participants about pet experiences to understand what real-life applications exist for pet contact (17:34). Atherton lists themes found in the research (18:40) and details several benefits of having pets. Sensory benefits, for example, include the touch of fur and scales, weight of an animal on one’s lap, and the bidirectional calming interaction of petting an animal (19:25). Animals also offer a type of social presence that allows individuals not to be alone, but does not apply pressure to perform or conform (20:31). Further, the speaker shares, pets can offer a solution to masking because there is no judgment as animals accept care and love in whatever form it’s given, which boosts owner confidence and self-esteem (21:08). Pets can also act as a social lubricant, opening connections between family members and the community (22:56). Barriers discovered in the study included economic standing and a personal fear or anxiety that, as an autistic person, one cannot be responsible for taking care of another being (24:37). However, she continues, the responsibility of pet ownership seems to spur a breakthrough in self-confidence and independence as it provides motivation to care for someone else and, therefore, a reason to get up, put the video game down, and ensure employment and housing (26:33). 

The presenter reviews the challenges found in these studies (27:43) and provides ideas and solutions for future directions (29:00). For example, if pet ownership is unavailable, volunteerism can allow for animal contact and simultaneously create a connection with a community and job experience (30:54). Atherton suggests ways to start preparing for pet ownership (33:25), including fostering, starting with smaller pets, getting advice from a mentor (32:09), and more. The speaker summarizes the presentation (36:25) before opening the question and answer session (38:06), where she discusses equine therapy (39:04), mental health indicators (41:20), benefits to early childhood development (46:11), hoarding (48:50), the effects of pet ownership on aggressive behavior (55:15), and more. 

Moira Peña, BScOT, MOT, OT, Reg. (Ont.), answers questions about sensory strategies for home. This recorded live question and answer session was a follow-up to our two-part series on brain and sensory processing differences and sensory strategies for home.  

Handouts for this webinar are online HERE
Learn more about our speaker, Moira Peña, BScOT, MOT, OT, Reg. (Ont.), HERE
Take the knowledge quiz for this webinar HERE

Please note: This previously recorded Q & A session is not intended to diagnose or treat any medical conditions and should not replace a personal consultation, as appropriate, with a qualified healthcare professional.

In this webinar: 

1:38 – Sensory processing in autism
3:15 – Explaining sensory differences to family members
8:00 – Sensory diets and self-regulation
11:06 – Sensory schedules and ARFID
14:10 – No age limit for sensory tools
18:25 – Vocalization stereotype
24:15 – Aggression, SIB and context
26:06 – Environmental contexts
30:00 – Vocal stimming is enjoyable
38:50 – Behavioral changes, time, and data
41:58 – Visual stimming advice and options for sensory diets
48:00 – Neurodiversity acceptance in Latin America
51:30 – Weighted blankets
53:25 – Masking behaviors across a lifetime
56:55 – Difficult conversations with friends
1:00:13 – Sensory kits
1:01:44 – Psychomotor practices and non-pharmacological interventions
1:06:25 – Breaking down context
1:13:17 – What causes sensory issues in autism
1:15:00 – Adult diagnosis

Peña discusses the frequency of sensory processing differences in individuals with autism (1:38). She emphasizes the need to ask autistic people about their lived experiences to understand how we can assist them best (2:00) and provides ideas for explaining sensory processing differences to family members (3:15). Peña reminds listeners that sensory strategies are not about “fixing a person” (33:57) and underscores the importance of creating safe, non-stressful sensory environments that are conducive to an individual’s needs (8:00).  

The speaker details how personalized sensory diets can remediate interconnected symptoms and provides sensory support suggestions for Avoidant Resistant Food Intake Disorder (ARFID) (11:06). Peña notes that there is no age limit for sensory tools as they are modes of self-regulation and often help individuals complete daily activities (14:10). She discusses vocalization stereotypy and stresses that controlling a behavior is not the goal (18:25). The presenter urges listeners to move away from the idea of “high and low functioning” and to focus instead on what an individual’s needs are (25:00). Throughout the Q&A, she re-emphasizes the necessity of understanding individuals within their current sensory environments and identifying triggers and solutions for disruptive behaviors (31:00). 

Peña notes the value of speech-language pathologists and other specialists in diagnosis and treatment planning (27:40). She encourages viewers to be curious about treatments and sensory strategies (29:00), noting that we need to “embrace individual differences and expect complexity” (30:24). Peña encourages active data collection and assessment when making decisions about behavioral supports that work or don’t work, noting that even failed ideas are productive (38:50). She provides ideas for creating sensory environments conducive to multiple sensory profiles (37:00; 54:45) and discusses masking in individuals with autism (53:25). 

The presenter reviews visual stimming and states that stopping stim behaviors causes huge amounts of distress. She encourages individuals to intentionally integrate stimming into daily schedules and look for triggers in different environments (42:58). Peña touches on neurodiversity acceptance and understanding in Latin America (48:42) and provides support ideas for young children forced to sit for five hours or more (50:40). She outlines weighted blankets and their use in anxiety. However, she cautions listeners against using these with individuals with motor differences (e.g., epilepsy) (51:30). 

Peña gives advice on navigating conversations about sensory development and perception (56:55), highlighting the importance of positive assumptions and noting that people will act when they are ready (59:10). She describes sensory kits (1:00:13) and discusses psychomotor practices and other non-pharmacological interventions for self-regulation (1:01:44). The speaker suggests discovering what individuals enjoy about certain activities and how to make those behaviors more socially accepted or create scheduled times for them at home (1:06:25 – 1:10:56). 

Peña directs listeners to Part 1 of this series for information on neurobiological causes of sensory difficulties (1:13:17). Throughout the presentation, she reminds viewers that diagnosis and sensory strategy creation take time and can be difficult. She emphasizes that every step forward is a victory that should be celebrated (36:40).

Resources mentioned during the session include:

On Vocal Stimming:

• Stimming and Autism: Parents’ Guide to Snorting
• LOMAH  Disability Podcast: Vocal and Verbal Stimming
• Sensory Processing Differences Toolkit – Aide Canada

On our current understanding of the neurobiology of autism:

• ▪Ameis, Stephanie H., et al. “A diffusion tensor imaging study in children with ADHD, autism spectrum disorder, OCD, and matched controls: distinct and non-distinct white matter disruption and dimensional brain-behavior relationships.” American Journal of Psychiatry 173.12 (2016): 1213-1222.
• Aide Canada interview with Dr. Evdokia Anagnostou 

Vicki Kobliner, MS RDN, CD-N, discusses steps for optimizing preconception health through good nutrition and healthy environments. She discusses the US healthcare systems and statistics and asserts that, although the numbers can be scary, taking preventive action is often simple. The speaker outlines steps for personal health risk assessment and self-advocacy with family and healthcare providers. Kobliner discusses aspects of a nutritious diet and best practices for protein and produce consumption. She considers environmental exposure to chemicals and pesticides and provides alternatives for household products and foods. The presenter highlights the need to “keep it simple” and summarizes the healthy baby road map before the Q & A. 

In this webinar: 

1:10 – Introduction and disclaimer
2:16 – Healthy Baby Roadmap and presentation goals
4:04 – US health statistics
7:00 – Study – Folate deficiencies and risk of autism
8:08 – Study – Maternal diet and fetal microbiome
8:45 – Placental microbiome
9:22 – Study – Toxins and chemical and umbilical blood
10:45 – Study – Body burden of chemical exposure
11:35 – State of women’s health care in the US
13:22 – Assessment and action steps for a healthy baby road map
16:40 – Health history and clues to look for
20:00 – Medications and supplements
21:50 – Study – Acid-suppressive drugs and childhood asthma
22:37 – Gut health during pregnancy
23:59 – MTHFR gene (Methylenetetrahydrofolate reductase)
25:35 – Genotypes for CT variant of MTHFR
26:38 – Testing
27:30 – What matters for nutrition
28:10 – Proteins, produce, and fats
32:11 – Dirty Dozen and Clean Fifteen
32:58 – Water
33:34 – Priority preconception nutrients
34:26 – Omega 3s, Vitamin D, and Choline
38:07 – Inflammatory triggers
38:41 – Study – Maternal inflammation and chronic illness risk
39:29 – Pitch the parabens, toxic bedding, and kitchen storage
42:11 – Cleaning supplies and air filters
43:40 – Reducing stress
44:37 – Steps for advocacy
45:40 – How to keep it simple
46:23 – Q & A

Background and introduction

Kobliner defines the healthy baby road map (2:16) with reference to preconception planning for chronic illness risk reduction (1:10). She explains that 38% of children in the US have one or more chronic illnesses and that more than one in five kids have a mental, emotional, developmental, or behavioral problem (4:04). The presenter outlines studies investigating folate deficiencies and risk of autism (7:00), maternal diets and infant gut microbiota (8:08), and the levels of toxins and chemicals present in umbilical cord blood after birth (9:22). Kobliner discusses body burden and explains the different effects of chemical exposure on a mother (150 – 200 pounds) and a fetus (one pound) (10:45). The presenter details how women are treated within current US medical systems (11:35) and asserts that “women need facts so they can be empowered to make the choices that align with their pregnancy goals” (13:00). This knowledge, she continues, must be acquired via personal research (13:22) and discussions with family and health care providers (16:05).

Assessing and planning for risks

Health history information, like genetics, supplements, and family and personal medical history, is vital for understanding what risks to consider (16:40). The speaker discusses critical factors and clues in medical histories (17:50) and suggests investigating the sources and intake amount of essential vitamins and nutrients in one’s diet (20:00). Kobliner discusses birth control and vitamin B (21:40) and summarizes the first study that significantly associated acid-suppressive drugs and the risk of childhood asthma (21:50). The speaker demonstrates how changes to gut microbiota during pregnancy often lead to increased lactic acid and have been linked to an elevated risk of gestational diabetes, autoimmune diseases, and preterm pregnancy (22:37). 

The MTHFR gene (Methylenetetrahydrofolate reductase) is integral to the body’s ability to process folate, which is necessary for producing DNA and modifying proteins (basis of fetal development) (23:59). Kobliner details the difference between active folate and folic acid (synthetic), noting that children may inherit folate mutations (24:45). She outlines potential genotype mapping for the MTHFR CT variants and underscores that such mutations do not indicate disease but mean that the body needs support for normal folate processing (25:35). To investigate potential risks further, the speaker advises asking one’s doctor to test levels of various vitamins and thyroid panels and conduct a comprehensive digestive stool analysis before conception (26:38). 

What matters for nutrition

Kobliner dives into aspects of a quality diet (27:30) and discusses differences in protein sourced conventionally, organically, and pasture-fed (28:10), noting that truly grass-fed animals are the most nourishing. She considers pesticides in produce and stresses their correlation with developmental disabilities (30:06). The Environmental Working Group’s annual Dirty Dozen and Clean Fifteen is a good reference for understanding which produce is safe to purchase conventionally and which is not, based on known pesticide levels (32:11). Kobliner provides sources and ideas for buying affordable pasture-fed protein and clean produce. The speaker gives examples of inflammatory and anti-inflammatory fats and highlights the need to consume the correct type (not avoiding fats) and add lacto-fermented foods to one’s diet (31:18). She also suggests using a good water filter as water generally lacks minerals and contains chlorine, fluoride, pesticides, antibiotics, and BPA which seeps from plastic bottles as well (32:58). 

The speaker lists priority preconception nutrients (33:34), underscoring Omega 3s as “hands down the most important thing to do to support preconception and periconception health” (34:26). Kobliner explains that up to 60% of the US population is vitamin D deficient as the recommended levels, between 30 and 70, are insufficient to support optimal health and should be between 50 and 75 (35:30). Choline, she continues, is under-appreciated for its effect on neurological health and is often chronically deficient in women (37:06). The presenter reminds viewers that such deficiencies are generally an easy fix as long as one is aware of one’s risks and needs. 

Lifestyle and body burdens

Maternal inflammation has been linked to autism, asthma, obesity, tics/OCD, gestational and childhood diabetes (38:41). Kobliner notes that common inflammatory triggers include sugar, processed foods, and stress (38:07). To reduce bodily stress and burden, it is vital to account for toxins present in one’s environment and lifestyle (38:52). The speaker advises viewers to “pitch the parabens” as they can disrupt hormones and interfere with fertility and reproductive health and increase cancer risk (39:29). She lists bedding and furniture labels that indicate they are free of toxins associated with neurobehavior, reproductive health, and cancer (40:29). The speaker suggests using steel or glass containers, parchment paper, and silicone bags for kitchen storage, instead of plastics (and soft plastics) which are known endocrine disruptors with links to cancer, diabetes, and fertility issues (41:30). Household cleaning supplies are high in chemicals and toxins, but most can be replaced with a mix of vinegar, lemon juice, baking soda, and water (42:11). Kobliner suggests indoor plants and filters for cleaner air (42:55) and highlights reducing stress as a necessity that should be done however and whenever one can (43:40). 

Advocacy and moving forward

Kobliner lays out four steps to successful self-advocacy in conversations with family and healthcare providers (44:37): 

1. Do your research
2. Ask a lot of questions
3. Use a decision tree
   1. H: Healthiest option for me and my baby
   2. B: Best choice and possible alternatives
   3. R: Risk involved in my choice
4. Show evidence

The speaker gives examples for each step and reminds viewers to keep it simple. She suggests starting with the “low-hanging fruit” (easiest thing to accomplish) and asserts that progress will grow from there, one day at a time. Kobliner reviews the health baby road map before opening the Q & A.