Healthcare Access for Autistic Adults
A landmark Swedish population study found autistic adults die on average 16 years earlier than the general population, with the gap widening for autistic adults with co-occurring intellectual disability (Hirvikoski et al., 2016).
Documented barriers
- Sensory-hostile clinic environments.
- Interoception differences that make symptom description harder (Nicolaidis et al., 2015).
- Clinicians untrained in autism who interpret masking as coping.
- Diagnostic overshadowing — new symptoms attributed to autism rather than investigated.
What the AASPIRE toolkit recommends
The AASPIRE Healthcare Toolkit, co-developed by autistic adults and clinicians, offers a free Autism Healthcare Accommodations Report a patient can bring to appointments (Nicolaidis et al., 2016).
Practical steps
- Bring a written symptom timeline.
- Ask for the first or last appointment of the day.
- Request written aftercare instructions.
- Bring a support person if helpful.
Sources
- Hirvikoski, T., Mittendorfer-Rutz, E., Boman, M., Larsson, H., Lichtenstein, P., & Bölte, S. (2016). Premature mortality in autism spectrum disorder. British Journal of Psychiatry, 208(3), 232-238. https://doi.org/10.1192/bjp.bp.114.160192
- Nicolaidis, C., et al. (2015). "Respect the way I need to communicate with you": Healthcare experiences of adults on the autism spectrum. Autism, 19(7), 824-831. https://doi.org/10.1177/1362361315576221
- Nicolaidis, C., Raymaker, D., McDonald, K., et al. (2019). The AASPIRE practice-based guidelines. Autism, 23(8), 2007-2019. https://doi.org/10.1177/1362361319830523
- AASPIRE Healthcare Toolkit. https://autismandhealth.org