The 2022 Capstone Editing Thesis Editing Grant Winner

Evaluating the Risk of Homelessness for Autistic Individuals

We are so pleased to (belatedly) announce Elizabeth Osborn as the 2022 Capstone Editing Thesis Editing Grant winner. Elizabeth is completing her PhD in Clinical Psychology at Flinders University with a thesis entitled, ‘Evaluating the Risk of Homelessness for individuals with Autism Spectrum Disorder’.

We are proud to assist Elizabeth with such important research, and we hope that the future publication of this thesis will help reduce the risk of homelessness for autistic people.

Thesis Abstract

A number of risk factors may lead to an individual becoming homeless. Likewise, some factors offer a person protection from homeless cycles. Certain populations may be vulnerable to the risk of homelessness, including individuals with mental health conditions, disabilities and neurodivergence, due to their unique characteristics. The link between autism spectrum disorder (ASD) and homelessness has been given little empirical attention. Yet, a recent systematic review indicated a high prevalence of ASD in homeless communities ranges from 2.8 (O’Donovan et al., 2020) to 50% (Osborn & Young, 2020; Pearson, 2016). Of interest to this thesis is whether there are specific characteristics unique to ASD that may increase vulnerability, identifying both risk and protective factors for this group.

Firstly, a systematic review was conducted using the PRISMA guidelines to develop an in-depth understanding of the research previously conducted. After completing the screening process from the 870 articles, 17 articles were included in the review. A higher rate of autism was highlighted in prior research, and homelessness risk factors attributed to autistic individuals included lack of family relationships, lack of opportunity and co-occurring conditions. Specific autistic traits identified in prior research connected with homelessness included sensory sensitivities, communication differences and rigidity.

To identify relevant autistic traits related to homelessness, qualitative data were obtained from four focus groups, including those on the autism spectrum and currently homeless. Twenty-eight participants (18 homeless and 10 with a diagnosis of ASD) participated in four focus groups to identify what circumstances or behaviours contributed to homelessness. Three ASD traits were identified as contributors to homeless risk: communication differences; ritualised and repetitive behaviours; and sensory sensitivities. This led to an inability to fit into society, impacts on work, practical limitations and a need for support. Family support and specialised support were thought to be the largest protective factors.

Quantitative data were collected from 371 individuals for studies 3 and 4—an online questionnaire compared homeless risk factors and autistic traits across autistic and non-autistic groups. Bayesian hierarchical modelling approaches demonstrated the important contribution of autistic traits in the contribution of homeless risk, particularly in the absence of a diagnosis. Specific attention should be given to ensuring adequate service provision in the presence of autistic traits such as communication differences, sensory preferences, rigidity, attention switching, attention to detail and imagination differences. This was mediated by social support and service involvement. In the absence of service support, families (particularly parents) harbour those with autism from instances of homelessness through strong advocacy and support with ongoing housing. A number of clinical and policy development implications are discussed, including the importance of screening, advocacy and specialised support for those on the autism spectrum.

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