“It wasn’t the strategies on their own”: Exploring caregivers’ experiences of accessing services in the development of interventions for autistic people with intellectual disability


Autistic individuals with intellectual disability are at greater risk of experiencing anxiety than their non-autistic peers without intellectual disability. Anxiety in this group may present as behaviour that challenges, often leading families to reach out to healthcare or support services. However, many families experience difficulties accessing services and, due to the lack of research into evidence-based anxiety interventions for people with intellectual disability, may not receive individualised support once in a service. This study explored caregivers’ experiences of accessing services for autistic individuals with intellectual disability, and their considerations when developing new interventions for this population. Interviews and focus groups were completed with 16 caregivers of autistic people with intellectual disability. Reflexive thematic analysis was used to develop five themes about service access experiences, and three themes about caregiver considerations for anxiety interventions. Caregivers reported that their experiences of accessing services did not meet their expectations, and considerations for future anxiety interventions were often reflective of this. Interventions being flexible to family circumstances to aid accessibility, the embedding of peer support in services, and skills that can be generalised across the lifespan could be applied when aiming to improve outcomes and develop interventions for this under-served population. Lay Abstract: Many autistic individuals with intellectual disability experience anxiety, and for those who use few or no words, anxiety may present as behaviour that challenges, such as self-injury and avoiding anxiety-provoking situations. Families report difficulty accessing support from services for autistic individuals experiencing anxiety. Moreover, once receiving support, effective interventions for autistic people with intellectual disability are limited. We completed individual and group discussions with 16 caregivers of autistic people with intellectual disability, to (a) explore their experiences of accessing services for anxiety and/or behaviour that challenges for their child; and (b) understand what matters to caregivers when developing interventions that have been designed for them and the autistic individual with intellectual disability that they support. Caregivers reported that services, in their experience, did not deliver the support that they expected, and that they often needed to ‘fight’ for support. Caregivers considered services and families working together, the inclusion of peer support, and families being offered interventions that are flexible to individual circumstances to be important. These considerations are valuable for clinicians and researchers developing interventions and aiming to improve outcomes for autistic people with intellectual disability and their families.

Publication DOI: https://doi.org/10.1177/13623613231196084
Divisions: College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences
Additional Information: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study was supported by a grant from the Autistica Future Leaders Award (grant number: 7266), and wider infrastructure funding from Cerebra (Cerebra Network for Neurodevelopmental Disorders). © The Author(s) 2023. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Uncontrolled Keywords: access to services,anxiety,autism,challenging behaviour,intellectual disability,intervention,Developmental and Educational Psychology
Publication ISSN: 1461-7005
Last Modified: 16 May 2024 07:28
Date Deposited: 27 Sep 2023 13:27
Full Text Link:
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://journal ... 623613231196084 (Publisher URL)
PURE Output Type: Article
Published Date: 2023-09-15
Published Online Date: 2023-09-15
Accepted Date: 2023-08-02
Authors: Hughes, Jessica
Roberts, Ruth
Tarver, Joanne (ORCID Profile 0000-0003-0555-6043)
Warters-Louth, Cheryl
Zhang, Betty
Southward, Emma
Shaw, Rachel (ORCID Profile 0000-0002-0438-7666)
Edwards, Georgina
Waite, Jane (ORCID Profile 0000-0002-8676-3070)
Pearson, Effie (ORCID Profile 0000-0002-4328-1653)



Version: Published Version

License: Creative Commons Attribution

| Preview

Export / Share Citation


Additional statistics for this record