I’m Fine with Autistic People,but Other Folks Feel Uncomfortable: Exploring the Gap Between Reported Community Attitudes and Autistic Lived Experience

Abstract

Background:

Studies of community attitudes toward autism often report predominantly positive or neutral attitudes toward autistic people. However, studies of the experiences of autistic people and their families consistently report high levels of stigma, discrimination, and exclusion from society.

Methods:

Our autistic-led study utilized the “third person” method to assess subconscious attitudes toward autism, by asking participants how they and hypothetical “others” would feel about interacting with autistic people in a range of scenarios. We conducted an online survey using a probability-based panel representative of the Australian population with 1626 non-autistic adults who reported not having close contact with an autistic person.

Results:

The majority of the participants agreed that there is a need to find better ways to support autistic people and that autistic people should be able to access disability services, although this varied by service type. There were overt differences in participants’ reports of how they would feel about meeting an autistic person and how “other people” would feel in the same situation, with other people consistently described as considerably more likely to feel uncomfortable or very uncomfortable. Participants also reported a lower level of comfort, for both themselves and others, with engaging and interacting with autistic adults compared with autistic children. These findings provide a bridge between studies with and by non-autistic people that report positive attitudes and studies with and by autistic people that report experiences of exclusion, discrimination, and stigmatization. The significant literature on, and lived experience of, autistic children and their families would suggest that there is a considerable element of social desirability bias in responses to surveys of attitudes toward autism and that in reality our communities are populated with these “other” people.

Conclusion:

Future research into community attitudes should utilize measures such as these that address social desirability bias and explore deeply held beliefs and attitudes that may not be expressed in response to direct questions. Future policy and advocacy interventions should focus on acceptance and appreciation of autistic adults. These are the attitudes we need to change if we are going to build a society that is truly inclusive.

Community Brief

Why is this an important issue?

Research shows that the reported attitudes of non-autistic people toward autism don’t match autistic people’s lived experiences within the community. While most people in the community say they like autistic people, many autistic individuals feel left out and unfairly treated in schools, at work, and when getting help.

What was the purpose of this study?

We aimed to explore how non-autistic people feel about interacting with autistic people by asking them about their feelings and what they think “others” feel.

What did the researchers do?

Our autistic-led research team surveyed 1626 non-autistic adults from a panel representing the Australian population. We asked them how they feel about spending time with autistic children and adults in different situations, and having family members who are autistic. We also asked them how they thought other people would feel about meeting and interacting with autistic children and adults, and having autistic people in their family, in the same situations.

What were the results and conclusions of the study?

Most people agreed that we need to find better ways to support autistic people, and said that they would like to know more about how to support autistic people. Across all of the situations we asked about, people were much more likely to say that they would feel comfortable meeting and interacting with autistic people than “other people” would. They said that they, and other people, would feel more comfortable in situations that involved autistic children than those that involved autistic adults.

What is new or controversial about these findings?

These findings help us understand the disconnect between how non-autistic people say they feel about interacting with autistic people and how autistic people experience these interactions. While studies with non-autistic people report positive feelings, autistic people often feel excluded and badly treated in the community. Our study suggests people may not always be honest about, or might not understand, their true feelings toward autistic people. The findings also show that it is important to distinguish between autistic children and autistic adults—both in research and in interventions to improve social inclusion—as community attitudes toward autistic adults are much less positive.

What are potential weaknesses in the study?

The study participants were Australian adults, so the findings may not generalize to other populations.

How will these findings help autistic adults now or in the future?

These findings will encourage future research into community attitudes toward autistic adults. They show the importance of using measures that explore deeply held beliefs that may not be expressed in response to direct questions. They also have the potential to inform policy and raise awareness of the need for educational and advocacy campaigns to focus on acceptance and appreciation of autistic adults. These are the attitudes we need to change if we are going to build a society that is truly inclusive.

Introduction

An interesting anomaly evident in both the academic literature and the lived experience of autistic people is the apparent divergence between autistic people’s experiences of stigma and discrimination, and non-autistic people’s reports of positive attitudes toward autistic people. Studies of community attitudes toward autism, while they are not numerous, often report predominantly positive or neutral attitudes.^1–4 Conversely, studies of the experiences of autistic people and their families consistently report high levels of stigma, discrimination, and exclusion from society.^5–8

This discrepancy can be, in part, explained by methodological issues with the measurement of attitudes toward autism, with current instruments setting a relatively low benchmark for a person to be considered to have a positive attitude toward autistic people. For example, it is possible to receive a “positive attitude” score on the Societal Attitudes Towards Autism (SATA) scale while reporting that you would not be comfortable sitting next to an autistic person and are a little bit afraid of them; see the recent perspective piece in this journal for more details and worked examples.⁹ Similarly, being found to be less stigmatized than another group does not mean that the discriminatory attitudes are not significant. For example, the survey of 1000 French adults found that 6% said they would not agree to live with an autistic family member (compared with 11% for a family with bipolar disorder and 24% for a family member with schizophrenia), and 6% said they would refuse to work with an autistic person (compared with 12% and 30%, respectively).²

More nuanced studies have found that while people self-report positive attitudes toward autism, they may concurrently hold dehumanizing beliefs about autistic people.¹⁰ However, even when the questions used relate to simple factual statements of likely responses to interactions with autistic people—and the questions are written by autistic people themselves—the results seem inconsistent with reality. For example, in our 2017 study, including 2032 non-autistic people,¹¹ slightly more than one in 10 reported that they would be concerned if an autistic person was appointed as their colleague or an autistic adult moved in next door (although two in 10 would be concerned if an autistic person was appointed as their boss or a close relative married an autistic person). However, of the 1297 autistic people and their parents/carers in the same study, more than half reported experiencing negative reactions when out in the community, including people staring at them, tutting or shaking their heads, and actively avoiding them.

Autistic people are mostly children, aren’t they?

While it is increasingly recognized that autism is a lifelong condition, that we do not grow out of or cure autism, many people still associate autism with children. This is likely due to the greater visibility of autistic children, in the community and in the media, with autistic adults less visible because they avoid community spaces or mask while in public.^12,13 The proportion of people in our 2017 study who reported that they would be concerned about an autistic child entering their life was lower for an autistic child (compared with an adult) moving in next door, being their child’s classmate, or befriending their child.¹¹

What I feel vs. what I think I feel …

It is likely that there is an element of social desirability bias inherent in these reported attitudes.¹⁴ For example, a study into an employer’s reactions to hypothetical job candidates found that those higher on social desirability, measured using the 13-item Short Form Marlow-Crown Social Desirability Scale,¹⁵ were more likely to rate hypothetical autistic candidates positively.¹⁶

Recent research has demonstrated that there is a significant difference between non-autistic adults’ explicit and implicit attitudes toward autism¹⁷; that is, attitudes outside a person’s conscious awareness that predict subtle forms of bias and discrimination. Using two different forms of the Implicit Association Test, the authors found that participants demonstrated negative implicit attitudes but positive explicit attitudes toward autistic adults. Similar effects have been found in children, with school-aged children demonstrating negative mplicit and explicit attitudes toward autistic peers, with improvement over time in explicit but not implicit attitudes.¹⁸

It’s not me, it’s other people …

The tendency for people to view themselves more favorably than others is known as the “better-than-average effect” (BTAE).¹⁹ This phenomenon has been well-documented in research²⁰ and is thought to be related to the theory of self-enhancement, which suggests that people tend to have overly positive views of themselves, leading to biased and inaccurate self-evaluations.²¹ The BTAE is also linked to social desirability bias, which is the tendency for individuals to downplay undesirable attitudes and behaviors and to overreport more desirable ones.²² The BTAE is typically stronger for traits that are personally and culturally significant, and for abstract qualities that cannot be easily verified (as was the case in this study).²⁰

There are several methodological approaches that can be used to address the BTAE and implicit attitudes, as well as unconscious bias and social desirability, in responding to questions about interpersonal attitudes. The “third person” method is an approach that asks participants to report on their perceptions of the views of “others” as well as themselves. This projective technique²³ allows participants to project their feelings, motivations, and/or attitudes to bypass their own defenses and reduce the influence of social desirability bias.²⁴ Previous studies using this indirect method have found that individuals rated themselves as having more desirable personality traits and less undesirable personality traits compared with others (see Zell²⁰ for review). This approach is particularly useful when studying attitudes and behaviors that are strongly influenced by social norms, such as parents’ reasons for providing their children with (un)healthy food²⁵ or alcohol.²⁴ Thus, it appears an appropriate approach to studying the complex issues of acceptance of autistic people and attitudes toward autism.

The current study

The aim of the present study was to explore community attitudes toward autistic people, using a methodology designed to elicit attitudes that sit beneath those they articulate when asked explicitly how they feel and react. Furthermore, we examined whether demographic factors (i.e., age, gender, education level) and level of autism knowledge further influenced attitudes as evidenced in prior research.^3,26

Some of our questions were exploratory in nature, and aimed to provide an overview of the sample’s perceived knowledge of and interest in supporting autistic people. These focused on people’s general perceptions of their understanding of, and interest in, how to support autistic people. We also sought to separately explore attitudes toward engagement with autistic children and autistic adults, rather than “autistic people” per se, given the findings of our previous research, and the prevalent stereotype of autism as a “childhood” condition.

Our previous research, and lived experience, demonstrates a significant disparity between reported attitudes toward autism and the discrimination shown toward autistic people. The BTAE posits that people will perceive and report their own attitudes as more positive than those of others, and the literature on third person effects suggests that reports of “others” attitudes are often a better indication of own implicit attitudes. Thus, we hypothesized that: H1:

Non-autistic adults will be more likely to report that others, compared with themselves, will experience negative emotions when meeting autistic people.

H2:

Non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic children in their community and their family.

H3:

Non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic adults in their community and their family.

It has been suggested that negative attitudes toward autistic people are a function of lack of autism knowledge, and that increasing knowledge could thus eliminate discrimination against autistic people. However, previous research has shown that negative attitudes and stereotypes persist among those with exposure to, and knowledge of, autistic people;^27,28 and that increasing knowledge reduces explicit but not implicit biases.²⁹ On balance, we expected that those with higher knowledge of autism would have, or at least express, more positive attitudes. Thus, we hypothesized that: H4:

Those with high autism knowledge scores will report more positive attitudes toward autistic children and adults than those with low knowledge scores.^a

Methods

Participants

The study participants were Australians aged 18 years and older who are members of the Life in Australia Panel; a probability-based survey panel, randomly recruited via landline and mobile telephone numbers, that is generalizable to the Australian adult population.³⁰

The majority of the participants were online panel members (96.2%), with a smaller portion of offline members who completed the survey by phone (3.8%). We collected data between December 6 and December 21, 2021.

A total of 1983 people completed the survey. We excluded those who identified as autistic or having a close family member (i.e., a child, a partner, a sibling, or parent) who was autistic from the analysis as the aim of the study was to explore general community attitudes toward autism. Thus, we included 1626 completed participant responses in this analysis. Participants were non-autistic individuals who did not report having close contact with an autistic person (see Supplementary Table S1 in Supplementary Data S2). More than half of the participants (56.2%) identify as female, the majority were born in Australia (69.5%), and live in a metropolitan area (69.9%). Demographic details of the sample are provided in Table 1. The study was approved by the Australian Catholic University’s Human Research Ethics Committee (2020-53H).

Table 1.

Participant Demographics

	n	%
Gender
Male	703	43.2
Female	914	56.2
Other	9	0.6
Age
18–24	96	5.9
25–34	196	12.1
35–44	207	12.7
45–54	250	15.4
55–64	316	19.4
65–74	355	21.8
75+	206	12.7
Australian State/Territory
NSW	592	36.4
VIC	443	27.2
QLD	284	17.5
SA	105	6.5
WA	131	8.1
TAS	27	1.7
NT	24	1.5
ACT	20	1.2
Location
Metro	1136	69.9
Regional	490	30.1
Country of Birth
Australia	1130	69.5
Other	496	30.5
Highest Level of Education
Postgraduate degree level	281	17.3
Graduate diploma/certificate level	154	9.5
Bachelor’s degree level	380	23.4
Advanced diploma and diploma level	184	11.3
Certificate III and IV level	187	11.5
Secondary education—Year 12	198	12.2
Secondary education—Years 10 and 11	148	9.1
Secondary education—Years 9 and below	29	1.8
Other/unstated	65	4.0
Employment status
Employed	851	52.3
Unemployed	43	2.6
Retired/pension	574	35.3
Student	46	2.8
Home duties	65	4.0
Other	47	2.9

Questionnaire design

In preparation for the survey, the research team established an “Expert Autism Panel” to provide feedback about the survey questions from a previous wave to make improvements and additions for the current study. Based on issues identified in the 2017 study,¹¹ the key areas of interest included the nature of contact/interaction (such as proximal vs. distal and concrete vs. abstract) and age of the autistic person (adult vs. child). The Panel consisted of autistic people and parents/carers of autistic people, was led by an autistic autism researcher (the first author), and was administered by an autistic autism advocate (Shadia Hancock). The research team undertook an extensive and iterative process of reviewing and revising the questionnaire in collaboration with the Panel. This process included a series of meetings (face-to-face and online), document reviews, and email discussions to ensure the final questions that were developed for the study reflected the issues of importance to the autism community, and that the wording of the questions was clear, appropriate, and respectful.

Materials and procedure

To measure the general awareness and attitudes toward autistic people, we asked participants their level of agreement with two statements: “I personally have a good understanding of how to support autistic people” and “I would like to know more about how to support autistic people.” Both had a 5-point response scale, from strongly agree to strongly disagree, with an additional don’t know/prefer not to say option. We also asked them for a binary (yes/no) response to the question, “Do you think we need to find better ways to support autistic people?”

To measure attitudes toward meeting autistic people, we asked participants two questions, one about themselves (“When you think about meeting an autistic person you have never met before, how do you feel? Would you be…?”) and one about other people they know (“Thinking about people you know, when meeting an autistic person they have never met before, how do you think they would feel? Would they be…?”). We then presented them with 13 response options (nervous, scared, comfortable, uncomfortable, curious but unsure how to approach, sad/sympathetic, disgusted, happy, excited, relieved, confused, indifferent, don’t know/not sure) and asked them to select all that apply.

To measure attitudes toward autistic adults in the community and family, we asked participants to what extent they would personally feel comfortable or uncomfortable in each of six scenarios, presented in random order to control for order effects. The response options were a 5-point scale from “very comfortable” to “very uncomfortable” (with the addition of a don’t know/prefer not to say option). We then asked to what extent they thought other people in the community would feel comfortable or uncomfortable in each of the same six scenarios.

To measure attitudes toward autistic children in the community and family, we asked participants to what extent they would personally feel comfortable or uncomfortable in each of six scenarios relating to autistic children, with the same response options. Again, we repeated this in relation to perceptions of the feelings of other people in the community.

To measure autism knowledge, we asked participants a series of 18 questions (yes/no responses) developed by the research team in consultation with the Panel. While there are existing knowledge scales that have been validated, the Panel was strongly of the view that these instruments reflect an outdated understanding of autism. The 18-item scale is included as Supplementary Appendix.

Data analysis

We used descriptive statistics to summarize survey data, and report the summary statistics as frequencies and percentages for all categorical variables. We calculated percentages by dividing the frequency by the total number of valid responses for each question. To test the association between variables with only two responses (i.e., yes/no), we performed chi-square tests (excluding participants who responded that they were unsure or those who did not respond). We compared observed frequencies in each category to expected frequencies based on the null hypothesis of no association between the variables. Interpretation focused on identifying categories with observed counts that were higher or lower than expected. To determine differences in responses for variables that used a Likert scale, we used the nonparametric Kruskal–Wallis test and post hoc Dunn test. We were unable to use the parametric equivalent (i.e., analysis of variance) as our data did not meet the assumptions required. We analyzed responses by participant age (18–24, 25–34, 35–44, 45–54, 55–64, and 65 years or older), gender, education level, and autism knowledge. We assessed participants’ knowledge of autism through their responses to a series of statements (refer to Supplementary Appendix) where they indicated whether each statement was true or false and used a median split on their total knowledge score to classify respondents as having “high” or “low” autism knowledge. To reduce the likelihood of type I error, we applied the Bonferroni correction and set statistical significance at a threshold of p < 0.001. All analyses were performed using IBM SPSS Statistics 27.

Results

Attitudes toward autism: Exploratory questions

The exploratory questions identified that these non-autistic people overwhelming believed that they, and society more generally, need to improve their capacity to support autistic people. The majority of the participants (90.7%) agreed that there is a need to find better ways to support autistic people.

Over two-thirds (69%) reported that they want to know more about how to support autistic people, while approximately one-quarter (28.9%) believed they understand how to support autistic people.

The Kruskal–Wallis test identified significant gender differences in perceived understanding of how to support others (χ²[1, n = 1507] = 12.029, p < 0.001), with females more likely than males to agree they have a good understanding. In addition, significant differences were observed in the desire to learn more about supporting autistic individuals, based on both age (χ²[6, n = 1542] = 27.749, p < 0.001) and gender (χ²[1, n = 1542] = 32.895, p < 0.001). Post hoc Dunn’s test revealed that females and participants aged 18–44 were significantly more likely to express a desire to learn more compared with males and individuals aged 55 and older (all p < 0.001).

Participants with higher autism knowledge scores were significantly more likely to agree that they personally had a good understanding of how to support autistic people (χ²[1, n = 1516] = 50.985, p < 0.001). Interestingly, those with higher autism knowledge scores were also significantly more likely to express a desire to learn more about supporting autistic people (χ²[1, n = 1551] = 15.438, p < 0.001).

Experimental questions: Hypothesis testing

Attitudes toward autism: Meeting and interacting with autistic people

We hypothesized that non-autistic adults will be more likely to report that others, compared with themselves, will experience negative emotions when meeting autistic people. When asked how they themselves would feel when meeting an autistic person they hadn’t met before, participants were most likely to report that they would feel “curious but unsure how to approach the person” or “comfortable” (see Supplementary Table S2 in Supplementary Data S2). Participants aged 65 and older were less likely to report that they would feel “nervous” (χ²[6, n = 1626] = 37.871, p < 0.001) or “indifferent” (χ²[6, n = 1626] = 63.038, p < 0.001) and more likely to report that they would feel “comfortable” (χ²[6, n = 1626] = 44.182, p < 0.001), while those aged 75 and older were more likely to report that they would feel “sad/sympathetic” (χ²[6, n = 1626] = 34.346, p < 0.001) or “confused” (χ²[6, n = 1626] = 27.328, p < 0.001). Participants aged 18–24 years were more likely to feel “curious but unsure how to approach the person” (χ²[6, n = 1626] = 24.200, p < 0.001) and “excited” (χ²[6, n = 1626] = 41.646, p < 0.001). Those with higher autism knowledge scores were more likely to report that they would feel “comfortable” (χ²[1] = 17.827, p < 0.001).

When asked how they thought others would feel in the same situation, they most commonly anticipated that people would likely feel “uncomfortable,” “curious but unsure,” or “nervous” (see Supplementary Table S2 in Supplementary Data S2). Participants were significantly more likely to report that others would experience negative reactions (e.g., uncomfortable, nervous, confused, scared) than they themselves would. This pattern of findings was observed regardless of participants’ autism knowledge levels (see Table 2). For example, participants were more likely to report that they, compared with others, would feel “comfortable” and that others, compared with themselves, would feel “uncomfortable.”

Table 2.

Proportion of People Reporting That They/Others Would Feel (Positive and Negative) Emotions When Meeting an Autistic Person They Hadn’t Met Before

Item	High knowledge (n = 857)			Low knowledge (n = 769)
Item	Self (n)	Other (n)	Statistic (if significant)	Self (n)	Other (n)	Statistic (if significant)
Nervous	113	318	χ²(1) = 130.261, p < 0.001	126	198	χ²(2) = 20.270, p < 0.001
Scared	11	126	χ²(1) = 104.919, p < 0.001	18	76	χ²(2) = 38.117, p < 0.001
Comfortable	335	101	χ²(1) = 168.432, p < 0.001	224	81	χ²(2) = 83.631, p < 0.001
Uncomfortable	92	399	χ²(1) = 269.017, p < 0.001	102	253	χ²(2) = 83.502, p < 0.001
Curious but unsure how to approach	428	398	—	376	243	χ²(2) = 47.825, p < 0.001
Sad/sympathetic	130	161	—	118	111	—
Disgusted	0	13	χ²(1) = 13.099, p < 0.001	3	10	—
Happy	66	40	—	47	21	χ²(2) = 10.401, p < 0.001
Excited	32	28	—	15	20	—
Relieved	10	13	—	8	17	—
Confused	20	164	χ²(1) = 126.249, p < 0.001	40	91	χ²(2) = 21.704, p < 0.001
Indifferent	154	143	—	101	98	—

While both high and low knowledge groups exhibited similar patterns, a notable distinction arose in the high knowledge group, where participants were more likely to identify others as feeling “disgust.”

Attitudes toward autism: Autistic children and adults in the community

We hypothesized that non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic children in their community. The overwhelming majority reported that they would feel “comfortable” or “very comfortable” if a family who had an autistic child moved in next door (69.5%), their child had an autistic classmate (70.9%), their child became good friends with an autistic child (77.4%), or their child’s new best friend was autistic (74.4%). However, participants felt that others would be considerably less likely to feel “comfortable” or “very comfortable” in the same situations (28.3%, 26.7%, 27.5%, and 25.9% respectively; see Table 3). Supplementary Figure S1 in Supplementary Data S1 shows visually the stark differences in the frequency of participants’ reports that they, compared with others, would feel “uncomfortable” or “very uncomfortable” in each of these scenarios.

Table 3.

Reported “Self” and “Other” Feelings Regarding Autistic People in the Family and Community

Item	Self		Other
Item	Frequency	Percentage	Frequency	Percentage
Community
An autistic adult moved in next door
Refused	4	0.2%	12	0.7%
Don’t know	55	3.4%	404	24.8%
Very comfortable	472	29.0%	84	5.2%
Comfortable	646	39.7%	391	24.0%
Neither comfortable nor uncomfortable	411	25.3%	434	26.7%
Uncomfortable	29	1.8%	270	16.6%
Very uncomfortable	9	0.6%	31	1.9%
Autistic adult was appointed as a boss
Refused	7	0.4%	13	0.8%
Don’t know	175	10.8%	452	27.8%
Very comfortable	250	15.4%	58	3.6%
Comfortable	504	31.0%	196	12.1%
Neither comfortable nor uncomfortable	502	30.9%	291	17.9%
Uncomfortable	153	9.4%	490	30.1%
Very uncomfortable	35	2.2%	126	7.7%
Autistic adult was appointed as a colleague
Refused	6	0.4%	12	0.7%
Don’t know	94	5.8%	436	26.8%
Very comfortable	330	20.3%	65	4.0%
Comfortable	653	40.2%	320	19.7%
Neither comfortable nor uncomfortable	470	28.9%	357	22.0%
Uncomfortable	61	3.8%	388	23.9%
Very uncomfortable	12	0.7%	48	3.0%
A family who had an autistic child moved in next door
Refused	4	0.2%	9	0.6%
Don’t know	58	3.6%	406	25.0%
Very comfortable	466	28.7%	80	4.9%
Comfortable	664	40.8%	380	23.4%
Neither comfortable nor uncomfortable	396	24.4%	473	29.1%
Uncomfortable	28	1.7%	252	15.5%
Very uncomfortable	10	0.6%	26	1.6%
An autistic child was in class with a child from your own family
Refused	6	0.4%	8	0.5%
Don’t know	61	3.8%	412	25.3%
Very comfortable	460	28.3%	72	4.4%
Comfortable	693	42.6%	363	22.3%
Neither comfortable nor uncomfortable	358	22.0%	419	25.8%
Uncomfortable	40	2.5%	322	19.8%
Very uncomfortable	8	0.5%	30	1.8%
A child from your own family became good friends with an autistic child
Refused	5	0.3%	11	0.7%
Don’t know	57	3.5%	425	26.1%
Very comfortable	511	31.4%	74	4.6%
Comfortable	747	45.9%	373	22.9%
Neither comfortable nor uncomfortable	274	16.9%	411	25.3%
Uncomfortable	29	1.8%	300	18.5%
Very uncomfortable	3	0.2%	32	2.0%
Your child’s new best friend was autistic
Refused	7	0.4%	8	0.5%
Don’t know	64	3.9%	438	26.9%
Very comfortable	477	29.3%	71	4.4%
Comfortable	733	45.1%	349	21.5%
Neither comfortable nor uncomfortable	291	17.9%	370	22.8%
Uncomfortable	45	2.8%	349	21.5%
Very uncomfortable	9	0.6%	41	2.5%
Family
A close relative married an autistic person
Refused	8	0.5%	13	0.8%
Don’t know	89	5.5%	439	27.0%
Very comfortable	398	24.5%	73	4.5%
Comfortable	585	36.0%	298	18.3%
Neither comfortable nor uncomfortable	456	28.0%	373	22.9%
Uncomfortable	78	4.8%	382	23.5%
Very uncomfortable	12	0.7%	48	3.0%
Partner was diagnosed as autistic
Refused	16	1.0%	14	0.9%
Don’t know	183	11.3%	454	27.9%
Very comfortable	310	19.1%	68	4.2%
Comfortable	531	32.7%	286	17.6%
Neither comfortable nor uncomfortable	366	22.5%	311	19.1%
Uncomfortable	174	10.7%	409	25.2%
Very uncomfortable	46	2.8%	84	5.2%
Child of close family member was diagnosed as autistic
Refused	9	0.6%	12	0.7%
Don’t know	93	5.7%	425	26.1%
Very comfortable	318	19.6%	53	3.3%
Comfortable	595	36.6%	277	17.0%
Neither comfortable nor uncomfortable	425	26.1%	404	24.8%
Uncomfortable	159	9.8%	419	25.8%
Very uncomfortable	27	1.7%	36	2.2%
Close family member (such as an uncle or cousin) was diagnosed as autistic
Refused	5	0.3%	13	0.8%
Don’t know	94	5.8%	422	26.0%
Very comfortable	375	23.1%	79	4.9%
Comfortable	580	35.7%	345	21.2%
Neither comfortable nor uncomfortable	450	27.7%	392	24.1%
Uncomfortable	103	6.3%	335	20.6%
Very uncomfortable	19	1.2%	40	2.5%
Your child was diagnosed as autistic
Refused	22	1.4%	13	0.8%
Don’t know	227	14.0%	443	27.2%
Very comfortable	207	12.7%	45	2.8%
Comfortable	401	24.7%	231	14.2%
Neither comfortable nor uncomfortable	337	20.7%	270	16.6%
Uncomfortable	303	18.6%	461	28.4%
Very uncomfortable	129	7.9%	163	10.0%

> more comfortable; = equally comfortable; ≤ equally or less comfortable.

This difference was significant across all scenarios and irrespective of the level of autism knowledge (see Table 4). Participants reported that others would feel less comfortable interacting with, or having their child interact with, autistic children than they would, in scenarios such as having an autistic child move in next door, to their own child becoming best friends with an autistic child. There were no significant differences in responses due to respondent gender, age, or educational level.

Table 4.

Proportion of People Responding “Comfortable” or “Very Comfortable” to Each Scenario

Item	High knowledge (n = 857)			Low knowledge (n = 769)
Item	Self	Other	Kruskal–Wallis test statistic	Self	Other	Kruskal–Wallis test statistic
Community
Family with autistic child moved in next door	80.5	32.9	χ²(1) = 312.305, p < 0.001	57.2	23.1	χ²(1) = 114.446, p < 0.001
An autistic child was in class with child	81.4	30.9	χ²(1) = 365.553, p < 0.001	59.2	22.1	χ²(1) = 147.357, p < 0.001
Child became good friends with an autistic child	86.6	31.4	χ²(1) = 433.727, p < 0.001	67.1	23.1	χ²(1) = 190.156, p < 0.001
Child became best friends with an autistic child	84.0	28.8	χ²(1) = 432.699, p < 0.001	63.7	22.5	χ²(1) = 171.180, p < 0.001
Autistic adult moved in next door	80.6	33.6	χ²(1) = 295.770, p < 0.001	55.5	24.3	χ²(1) = 106.982, p < 0.001
Autistic adult appointed as a boss	58.8	18.0	χ²(1) = 361.334, p < 0.001	32.5	13.0	χ²(1) = 109.340, p < 0.001
Autistic adult appointed as a colleague	73.2	27.7	χ²(1) = 319.625, p < 0.001	46.3	19.2	χ²(1) = 113.524, p < 0.001
Family
Close relative married an autistic person	72.8	26.7	χ²(1) = 324.411, p < 0.001	46.7	18.5	χ²(1) = 114.058, p < 0.001
Partner diagnosed as autistic	61.4	25.0	χ²(1) = 215.637, p < 0.001	41.0	18.2	χ²(1) = 69.957, p < 0.001
Close family member diagnosed as autistic	70.9	30.8	χ²(1) = 226.978, p < 0.001	45.1	20.8	χ²(1) = 64.392, p < 0.001
Child of close family member diagnosed autistic	67.4	23.6	χ²(1) = 277.782, p < 0.001	43.6	16.6	χ²(1) = 86.530, p < 0.001
Your child was diagnosed autistic	44.2	18.2	χ²(1) = 138.333, p < 0.001	29.8	15.6	χ²(1) = 25.575, p < 0.001

We hypothesized that those with high autism knowledge scores would report more positive attitudes toward autistic children and adults than those with low knowledge scores. In relation to autistic children in the community, those with higher autism knowledge were significantly more likely to report that they would feel “comfortable” or “very comfortable” in all scenarios (all p < 0.001).

We also hypothesized that non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic adults in their community. Similarly, the majority reported that they would feel “comfortable” or “very comfortable” if an autistic adult moved in next door (68.8%), although slightly fewer said that they would feel “comfortable” or “very comfortable” if an autistic person was appointed as their colleague (60.5%) and again fewer if an autistic person was appointed as their boss (46.4%). Again, participants believed that others would be considerably less likely to feel “comfortable” or “very comfortable” in the same situations (29.2%, 23.7%, and 15.6%, respectively; see Table 3). Supplementary Figure S2 in Supplementary Data S1 shows the same stark differences in the frequency of participants’ reports that they, compared with others, would feel “uncomfortable” or “very uncomfortable” in each of these scenarios.

This difference was significant across all scenarios and irrespective of level of autism knowledge (see Table 4). Participants reported that others would feel less comfortable interacting with autistic adults than they would, across all scenarios, from having an autistic adult move in next door, to an autistic adult being appointed as their boss.

The Kruskal–Wallis test revealed significant differences in comfort levels based on education levels when considering an autistic adult being appointed as a boss or colleague (χ²[6, n = 1519] = 37.639, p < 0.001; χ²[2, n = 1519] = 34.671, p < 0.001, respectively). Post hoc analyses using Dunn’s test indicated that respondents with TAFE education were significantly more likely to report feeling “comfortable” or “very comfortable” with an autistic person being appointed as their colleague or boss compared with those with higher levels of education (both p < 0.001).

In relation to autistic adults in the community, those with higher autism knowledge were again significantly more likely to report that they would feel “comfortable” or “very comfortable” in all scenarios (all p < 0.001).

Attitudes toward autism: Autistic adults and children in the family

We hypothesized that non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic children in their family. Nearly four in 10 of the participants reported that they would feel “comfortable” or “very comfortable” if their child was diagnosed as autistic (37.4%) and more than half (56.2%) if a child of a close family member was diagnosed. As with the other topics, these figures were significantly lower for reports of others feeling “comfortable” or “very comfortable” (17.0% and 20.3%, respectively, see Table 3). Participants reported that others would feel less comfortable having autistic children in their family than they would (see Supplementary Fig. S1 in Supplementary Data S1), and these differences were statistically significant irrespective of autism knowledge levels (see Table 4).

When considering autistic children, those with higher autism knowledge were significantly more likely to report that they would feel “comfortable” or “very comfortable” if the child of a close family member was diagnosed as autistic (p < 0.001), but there was no difference between the high knowledge and low knowledge groups in the scenario relating to their own child.

We hypothesized that non-autistic adults will be more likely to report that others, compared with themselves, would feel uncomfortable having autistic adults in their family. More than half of the participants reported that they themselves would feel comfortable if their partner was diagnosed as autistic (51.7%), a close family member was diagnosed as autistic (58.7%), or a close relative married an autistic person (60.5%) (see Table 3). Again, these figures were lower for reports of others feeling comfortable (21.8%, 26.1%, and 22.8%, respectively) (see Supplementary Fig. S2 in Supplementary Data S1). The pattern of findings was statistically significant irrespective of autism knowledge (see Table 4). The Kruskal–Wallis test revealed significant differences in comfort levels based on education when considering the diagnosis of autism in one’s child (χ²[2, n = 1519] = 20.047, p < 0.001) or the child of a close family member (χ²[2, n = 1519] = 13.835, p < 0.001). In addition, significant differences were observed based on age regarding comfort with a close relative marrying an autistic person (χ²[6, n = 1529] = 23.850, p < 0.001). Post hoc analyses indicated that respondents aged 18–44 were significantly more likely to report feeling “comfortable” or “very comfortable” in these scenarios compared with those aged 65 and older (all p < 0.001).

In relation to autistic adults in the family, those with higher autism knowledge were significantly more likely to report that they would feel “comfortable” or “very comfortable” in all scenarios (all p < 0.001).

Discussion

The majority of the participants agreed that there is a need to find better ways to support autistic people and reported that they would personally like to know more about how to support autistic people. This is consistent with findings from previous research with the general population and with autistic people, which consistently reports a lack of awareness, understanding, and appropriate supports in the community.^8,11,31,32

We hypothesized that non-autistic adults would be more likely to report that others, compared with themselves, will experience negative emotions when meeting autistic people (H1), feel uncomfortable having autistic children in their community and their family (H2), and having autistic adults in their community and their family (H3).

Meeting autistic people

Consistent with H1, and with the BTAE, non-autistic adults reported that their own attitudes toward autistic people are more positive than those of other people in the community. Participants were three times as likely to report that they themselves would feel “comfortable” meeting an autistic person and three times as likely to report that other people would feel “uncomfortable,” “confused,” and “scared.”

Engaging with autistic people in the community

Consistent with H2, and with the BTAE, there were stark differences in participants’ reports of their anticipated level of comfort with close contact and engagement with autistic children, compared with their expectations of other people’s level of comfort. Participants were at least twice, and up to three times, more likely to believe that they (compared with others) would feel comfortable or very comfortable if a family who had an autistic child moved in next door, their child had an autistic classmate, their child became good friends with an autistic child, or their child’s new best friend was autistic. Importantly, they were up to 10 times more likely to report that other people would feel uncomfortable or very uncomfortable, anticipating that approximately one in five people would feel uncomfortable in these situations. The significant literature on, and lived experience of, autistic children and their families^5,6,8,11,18 would suggest that our communities are populated with these “other” people.

The differences were of similar magnitude when participants were asked about engagement with autistic adults. However, it is also important to note that the proportion of people reporting that they as well as others would be comfortable was lower for the situations involving adults than children, consistent with H3 and the findings from our 2017 research.¹¹ This is even more concerning when we consider the numbers who reported that they/others would feel uncomfortable or very uncomfortable if an autistic adult moved in next door (2.3%/18.5%), was appointed as a colleague (4.5%/26.8%), or was appointed as their boss (11.6%/37.9%). It is not surprising that autistic adults consistently report feeling excluded from communities^11,33–35 and workplaces.^36–38

Being related to autistic people

The nuances of the autistic child versus autistic adult response pattern were amplified when participants were considering questions about the hypothetical diagnosis of family members. Participants were twice as likely to report that they (compared with others) would feel comfortable or very comfortable if their child or a child of a close family member was diagnosed as autistic and that they would feel uncomfortable or very uncomfortable if a child of a close family member was diagnosed as autistic. These differences were greater in the case of adult family members. Participants were twice as likely to report that they (compared with others) would feel comfortable or very comfortable if a partner or close family member was diagnosed as autistic, or a close relative married an autistic person, and that they would feel uncomfortable or very uncomfortable if their partner was diagnosed. However, they were three times as likely to report that other people would feel (very)uncomfortable if a close family member was diagnosed as autistic, and five times as likely to report that other people would feel (very)uncomfortable if a close relative married an autistic person.

These findings—in conjunction with previous research that over one-quarter of autistic people and/or parents of autistic people report that there are members of their family they no longer speak to because of the way those people have responded to them/their autistic children¹¹—demonstrate that stigma and discrimination are pervasive in the lives of autistic people.

We were not able to statistically compare these data due to the nature of the questions asked, which were specific to scenarios, and recommended that future research could directly explore differences in non-autistic people’s attitudes toward, and comfort with, interaction with autistic children and adults.

So why are “they” like that?

This was an exploratory study and the data do not provide a definitive explanation for the discrepancies between participants’ reports of their own attitudes and their perceptions of the attitudes of others. However, it does provide a bridge between studies with non-autistic people that report positive attitudes³ and studies with autistic people that report experiences of exclusion, discrimination, and stigmatization.⁸

There are a number of possible explanations for these discrepancies, which are worthy of further exploration if we are to begin to understand and address the systemic discrimination that limits the opportunities for autistic people to fully participate in society.

Our findings are consistent with the BTAE, the tendency for individuals to downplay undesirable attitudes and behaviors and to overreport more desirable ones, as reflected in the consistently more positive reports of own than others’ attitudes toward autistic people. It is also possible that participants’ reports of others’ attitudes, which are unlikely to be influenced by social desirability bias, tap into their implicit feelings. This is the rationale behind the use of projective techniques (asking people to comment on the thoughts or actions of others) in exploring responses to socially sensitive issues.²³

An important finding in the current study that is worthy of further exploration is the significant differences in reported attitudes, and degrees of discrepancy between reported self versus other attitudes, between those with higher and lower levels of autism knowledge. Those with higher levels of autism knowledge reported consistently more positive attitudes (consistent with H4), with the exception of the scenario in which their own child was diagnosed as autistic, and a greater divergence between their own attitudes and their perception of the attitudes of others. An optimistic interpretation of this finding is that knowledge of autism leads to positive attitudes and behaviors toward autistic people. However, given previous research that has demonstrated that higher knowledge may improve explicit but not implicit attitudes,²⁹ it is also possible that those with higher knowledge were more sensitive to the “correct” response and thus more likely to report positive reactions. It is likely that the reality is somewhere between these two extremes. This is supported by the fact that, while the divergence between “self” and “other” reports was greater for those with higher knowledge, the same pattern existed for both groups (see Table 4). It is also supported by the lived experience of autistic people, who consistently experience discrimination and exclusion.

Future research could explore whether in responding to questions about their own attitudes and anticipated responses they were reporting explicit attitudes, whereas in responding to questions about others, freed from self-presentation constraints, they were tapping into implicit attitudes.¹⁷ It is also possible that lack of knowledge as to how to create supportive and inclusive environments³⁹ leads to people with otherwise positive or neutral attitudes being reluctant to interact with autistic people.^b Future research (and public education campaigns) could explore ways to increase autism knowledge in the community, as well as the links between increased knowledge and more positive attitudes, and between positive attitudes and inclusive behaviors.

Conclusion

Our participants report that their attitudes toward autistic people are more positive and inclusive than those of “other” people. Our study finds that non-autistic people’s reports of “other” people’s perceptions of, and responses to, autistic people are more aligned with the experiences of autistic people and with findings from studies of autism attitudes using measures shown to tap into implicit attitudes.^17,18 Future research into community attitudes should utilize measures such as these that address social desirability bias and explore deeply held beliefs and attitudes that may not be expressed in response to direct questions. These are the attitudes we need to change if we are going to build a society that is truly inclusive.

Footnotes

Acknowledgments

The authors would like to express their sincere gratitude to the Expert Autism Advisory Panel—Shadia Hancock (Convenor), Jane Hancock, Timothy Chan, Sarah Chan, Jae Evergreen, Check Tan, and Gabrielle Hall—for their input at all stages of this research. They also thank the many members of the autistic and autism communities who contributed their time to this study.

Authorship Confirmation Statement

S.C.T.-J.: Conceptualization, methodology, validation, investigation, resources, writing—original draft, writing—review and editing, supervision, and funding acquisition. J.L.: Writing—original draft, writing—review and editing, and project administration. S.M.: Formal analysis, data curation, writing—original draft, and writing—review and editing. The article has been submitted solely to Autism in Adulthood.

Author Disclosure Statement

No conflicts of interest to declare.

Funding Information

This research was funded by Amaze, as part of ongoing research into the experiences of autistic people and their families in Australia, known as the “Autism Inclusion Monitor.”

Supplementary Material

a

We thank an anonymous reviewer for raising with us the importance of analysis by autism knowledge.

b

We thank an anonymous reviewer for this suggestion.

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