Perspectives and experiences of physical activity among autistic adults in middle adulthood

Abstract

Physical activity (PA) participation among autistic adults is low; however, it is unclear why this is the case. To date, little research has included the perspectives of autistic adults during middle adulthood to understand how to support their PA and to understand the complexity of their daily lives. Seventeen autistic adults aged 36-59 years participated in two online, semi-structured interviews (N = 34). Reflexive thematic analysis was used to analyze the data, and the socio-ecological model was applied to interpret the themes. Reflexive notes (N = 34) made during the research process also were analyzed to support the rigour of the interpretations. Neuro-normative assumptions about autism and PA, the importance of trust and sensory sensitivities shaped PA participation for these autistic adults. The new concept of neuro-normative assumptions highlights how pervasive assumptions were damaging, made it difficult to build trust and decreased the predilection of PA participation. This article delivers original and significant knowledge and calls on the field to co-produce neurodivergent-informed PA practices that are reflective of the lives, needs and abilities of autistic adults. We conclude the article by highlighting how a trauma-informed approach may have potential value in building trust and supporting autistic adults in PA.Lay AbstractWhat is already known? Autistic adults experience barriers to participating in physical activity (PA), and their rates of participation are low. This is a problem because PA participation can contribute many health and well-being benefits. There is a need for research to better understand how to support their PA participation. Working directly with autistic adults is of utmost importance as minimal research has directly included their perspectives.What this article adds: Seventeen autistic adults from the United Kingdom participated in two online semi-structured interviews (N = 34). Interview data were accompanied by reflexive notes which were a way for the research team to provide preliminary analyses and think about the data during the research process (N = 34). Together, interview transcripts and memos were analyzed to generate themes across the interview transcripts. We used the socio-ecological model to examine the different components that impact PA participation. The study highlights how neuro-normative assumptions about PA, trust and sensory sensitivities shaped PA participation for autistic adults. A lack of understanding and knowledge among movement professionals about autism, their needs, interests and abilities and trust significantly impacted participation. Assumptions and limited understandings about autism limited participation, as the forms of PA available often were not suitable to the diverse needs, interests and abilities of autistic adults.Implications for practice, research or policy: The insights highlight the importance of co-producing neurodivergent-informed PA practices that are reflective of the needs, strengths and abilities of autistic adults. Finally, we outline how the use of a trauma-informed approach to PA may be valuable in building trust and supporting PA participation. This is the first study to use this approach for PA with autistic adults.

Keywords: autistic adults; neuro-normative assumptions; neurodivergent-informed physical activity; physical activity; qualitative research; trauma-informed approach.