Insistence on sameness for food space appropriation: An exploratory study on Brazilians with autism (self-)diagnosis in adulthood.

LAY ABSTRACT: Insistence on sameness is common in autistic individuals and continues into adulthood. Research shows it may be a way to cope with environments because of their sensory sensitivity, intolerance to uncertainty, and anxiety. Understanding the reasons for insistence on sameness from the perspective of autistic adults is important. To study the meanings of insistence on sameness for autistic adults, we interviewed 16 Brazilian autistic adults. All 10 formally diagnosed participants were diagnosed in adulthood. Six participants identified as being on the autism spectrum without formal diagnosis. During the interviews by email, we first asked about participants' experiences with autism diagnosis, either formal diagnosis or self-diagnosis. Then, we asked about their experiences in places for eating out and grocery shopping. We found they tended to always go to the same places and use protective accessories to eat or shop comfortably. But their such behaviors were considered weird habits, first by other people and later by themselves. While trying to control their weird habits because of social pressure, they often suffered anxiety and meltdowns. When they finally learned of their autism in adulthood, they began to better understand who they are and why they experience the environment differently from others. This new understanding taught them that their so-called weird habits are actually part of their authentically autistic ways to cope with the weirder world. This study suggests that autistic adults' insistence on sameness is an authentically autistic way to exercise their right to comfortably co-exist and live as human beings and as themselves.

Preference to Eat Alone: Autistic Adults' Desire for Freedom of Choice for a Peaceful Space.

Backgrounds: Autistic adults tend to prefer eating alone, which may result in further social isolation. This study aims to understand contexts of challenges autistic adults face when eating with other people outside home. Methods: We explored autistic subjectivities actively situated in eating environments. We conducted follow-up individual email interviews with autistic adults diagnosed with an autism spectrum disorder in adulthood (n = 10) and autistic adults without a formal diagnosis (n = 6), both of whom had participated in our prior online survey with Brazilian autistic adults. We used a thematic analysis to gain an in-depth understanding of challenging characteristics of social situations in the eating space. Results: To eat out comfortably, many participants did not talk while eating, chose places without sensory overload, chose places with eatable foods, ate at off-peak hours, used sensory tools, and/or left places when stressed. Participants developed these coping strategies to negotiate incongruences between their autistic personal characteristics and their physical environments. However, there were incongruences between the coping strategies and social contexts with codiners. Participants often could not freely use the strategies-both in work and in casual social situations. This lack of freedom of choice often resulted in feeling uncomfortable, sick, or having meltdowns during or after social dining. Because of these experiences, many participants decided to avoid social dining. Conclusions: The preference to eat alone in autistic adults may reflect their desire for freedom of choice to use coping strategies to eat in a peaceful food space. Creating a peaceful eating environment may be a feasible and humanistic approach to reduce unwanted aloneness and social isolation in autistic adults. Lay summary: Why was this study done?: Eating together with other people is a common activity to socialize and feel a sense of belonging. But autistic adults often prefer to eat alone, though they have a desire to socialize.What was the purpose of this study?: To study challenging aspects of eating out with other people, to understand why some autistic adults prefer to eat alone.What did the researchers do?: We interviewed adults who considered themselves to be on the autism spectrum. Of the 16 interview participants, 10 were formally diagnosed with an autism condition and 6 were not. They once participated in our online survey with Brazilian autistic adults. The interviews were done by email. We asked about eating places and experiences in eating out. We looked for the common themes over all the interview responses.What were the results of the study?: When eating out alone, participants had strategies to eat comfortably. They could eat without talking, choose places without sensory overload, choose places with eatable foods, eat at off-peak hours, use tools such as earphones, or leave the place when stressed. However, they often could not freely do so in both work and casual social situations. They knew that their coping strategies would be considered inappropriate by others. For example, many participants felt pressured to talk while eating. Also, other people had different preferences for the times and places to eat from participants. It was difficult for participants to deal with the stressful environment without using their coping strategies. So, participants often felt uncomfortable, sick, or had meltdowns during or after eating out with others. For these reasons, many of them avoided eating out with others.What do these findings add to what was already known?: Autistic adults' preference to eat alone and difficulty in social situations involving eating have been understood as eating problems in autism. Our findings suggest that some dining companions reduce autistic persons' freedom to eat in comfortable social and physical environments, and that the preference expresses a desire to have such freedom.What are potential weaknesses in the study?: Because we used email interviews, the study did not include any participant without access to email, and participants were all college educated, unlike most Brazilian adults with an autism diagnosis.How will these findings help autistic adults now or in the future?: The findings will help autistic adults by letting others know ways that dining companions potentially reduce autistic persons' freedom to eat comfortably and by inspiring them not to do so. The findings also suggest that society should focus on creating a peaceful eating environment instead of focusing on finding ways to treat autistic aloneness as if aloneness in autism is caused by problems inside of the autistic individual.