Sander Begeer

Judging one’s own cognitive ability is a core aspect of self-reflection, yet most people overestimate their intelligence. We investigated whether autistic ( n = 284, 18–77 years old) and non-autistic ( n = 63, 18–76 years old) adults differ in this bias. Participants, all naïve to prior IQ testing, completed a brief online cognitive test and provided self-estimates of intelligence. Across groups, self-estimates modestly correlated with test scores ( r = .33). Nearly all non-autistic participants (93.6%) overestimated their ability, whereas autistic participants were more divided: 75.7% overestimated and 24.3% underestimated, yielding a weaker positivity bias overall. This suggests two distinct forms of inaccuracy: a systematic positivity bias in non-autistic individuals versus more variable, sometimes unduly negative self-views in autistic individuals. These could be shaped by stereotypes or social experiences and/or a result of general metacognitive imprecision. These findings highlight both reduced ego-enhancing bias and an overlooked vulnerability, offering a nuanced view of autistic self-perception. Lay Understanding how people judge their own intelligence can tell us a lot about self-confidence and self-perception. In this study, we explored the possible differences between autistic and non-autistic adults in this area. The study included 284 autistic and 63 non-autistic participants, all aged between 18 and 77 years. We removed any participants who reported taking an IQ test in the past to get a more authentic idea of what they thought of themselves and avoid any bias from potentially unreliable online tests. Everyone first rated how intelligent they believed they were and then completed a short online cognitive test capturing the different facets of intelligence. Overall, people’s self-estimates were only moderately related to their actual test scores. The vast majority of non-autistic participants (almost 94%) overestimated their intelligence. Autistic participants showed a different pattern: While the majority (about 76%) also overestimated their intelligence, nearly one in four underestimated it. This means that non-autistic adults tended to show a very strong and consistent “positivity bias”—a common tendency to see oneself in a more favorable light. Autistic adults, however, showed more variation. Most still overestimated their abilities, but others judged themselves harshly relative to their actual performance. The weaker overall self-enhancing bias seen among autistic adults could be seen as a strength, in that it could allow a more realistic self-assessment. However, it could also translate into vulnerability, especially given the finding that autistic individuals showed overly negative self-perceptions more frequently, which could reflect the impact of stereotypes, social experiences, or difficulties with judging their own performance. Overall, the results offer a more nuanced picture of how autistic adults view their own intelligence and highlight often-overlooked vulnerabilities in self-evaluation.

BackgroundTraditionally, research on neurodevelopmental conditions has focused on challenges, while strengths received less attention, despite relevance to clinical practice and well-being. To date, few studies have investigated strengths in children with attention-deficit/hyperactivity disorder (ADHD). Moreover, no studies directly compared strengths of children with ADHD, autistic children, and children with co-occurring ADHD and autism (AuDHD), leaving open questions about specificity of strengths for these groups.MethodFor the current study, we used data from a large Dutch National registry study, In Kaart. We qualitatively investigated parent-reported data from Dutch children (n = 143) aged 5-16 years with (suspected) ADHD, autism or AuDHD. Parents reported on strengths related to the diagnoses of their child. We used content analysis to identify strengths in children with ADHD, in autistic children and in children with AuDHD.ResultsAcross all diagnostic groups, parents reported a wide range of strengths. Children with ADHD and autistic children showed both overlapping and unique strengths, whereas the strengths reported for AuDHD children reflected a combination of both groups. Strengths fell within the categories of ‘Courage’, ‘Higher order cognitive skills’, ‘Humanity’, ‘Justice’, ‘Motor skills’, ‘Temperance’, ‘Transcendence’, ‘Wisdom’ and ‘Other skill’. For children with ADHD, creativity and zest were most prominent, whereas attention to detail and honesty were most prominent in autistic children. ConclusionThe variety and frequency of reported strengths suggest that positive aspects are not uncommon for children with ADHD and/or autism and may offer opportunities for a more balanced perspective on these conditions. Our results can feed strength-based approaches for use in clinical practice, assessment, and support, helping children with ADHD and/or autism flourish.

Social pain sensitivity refers to the tendency to detect and react strongly to cues of social exclusion. Frequent social adversities and specific characteristics may make individuals with autism more sensitive to social pain, yet evidence remains inconsistent. To enhance our understanding, autistic adults aged ≥ 16 years ( n = 1425; M _age = 47.3, SD = 14.2) and allistic adults ( n = 187; M _age = 51.4, SD = 14.6) enrolled in the Netherlands Autism Register (NAR) completed the Social Pain Questionnaire (SPQ). A two‐way ANOVA demonstrated that autistic adults reported significantly higher social pain sensitivity than allistic adults, with a small effect size ( η ² _p = 0.02). Women reported higher social pain sensitivity than men across both groups ( η ² _p = 0.01), and this gender difference was comparable for autistic and allistic adults. Within the autistic group, in a subset of participants with complete data ( n = 234), a hierarchical multiple regression analysis showed that social pain sensitivity was moderately associated with lower self‐esteem ( β = −0.47), but not with cognitive empathy or sensory sensitivity. Exploratory analyses further indicated that self‐esteem fully accounted for the association between autism diagnosis and social pain sensitivity. Consistent with sociometer theory, these results suggest that heightened social pain sensitivity in autistic adults may reflect reduced perceived social acceptance. Our findings highlight the relevance of social adversities for autistic adults and underscore the need for supports that strengthen belonging and reduce socially painful experiences.

An estimated 60% of autistic adults suffer from insomnia symptoms, which significantly impairs daily functioning and wellbeing. This study evaluated the effectiveness of i-Sleep Autism, a 5-week, guided self-help internet-delivered cognitive behavioral therapy-based intervention (ICBT-I) for insomnia in autistic adults. In co-creation with seven autistic adults with sleeping problems, i-Sleep Autism was adapted from i-Sleep, a pre-existing non-autism specific intervention. A total of 163 adults with autism and insomnia (ISI ≥ 10) was randomly allocated to i-Sleep Autism (n = 82) or waitlist control (n = 81; receiving psychoeducation and sleep hygiene). Participants were assessed at baseline (T0), mid-intervention (T1; 3-weeks), post-test (T2; 6-weeks), and follow-up (T3; 6 months) on insomnia severity (primary outcome), pre-sleep arousal, anxiety, depression, daily functioning, and quality of life. In the intervention group, 56.1% completed four, and 50% all five modules. Intent-To-Treat analyses revealed a significant reduction in insomnia severity at T1 and T2 (d = 1.02, 95%CI = [0.65, 1.40]), and cognitive- and somatic pre-sleep arousal at post-test, when comparing intervention to control. The intervention group showed significantly higher quality of life at post-test. At T2, 37.8% of the intervention group versus 11.1% of the control group showed clinically meaningful improvement of insomnia. Effects on insomnia severity were maintained at 6-month follow up. No significant effects were found for anxiety, depression, or daily functioning. This is the first RCT to investigate autism-adapted ICBT-I for autistic adults suffering from insomnia. i-Sleep Autism effectively and sustainably improves insomnia. Additional strategies are needed to support dropouts and those who did not benefit. Statement of Significance Insomnia is very common among autistic adults and has substantial consequences for daily functioning and well-being, yet evidence-based sleep interventions for this group are lacking. This study provides the first randomized controlled evaluation of an internet-delivered cognitive behavioral intervention for insomnia that was adapted in collaboration with autistic adults. The findings demonstrate that autism-adapted, guided, digital sleep interventions can meaningfully improve sleep and related outcomes in autistic adults, with effects that are sustained over time. At the same time, considerable variation in engagement and response highlights the need for further refinement and personalization. Future research should focus on identifying who benefits most, optimizing support for non-responders, and improving accessibility and adherence.

Perceived stress, henceforth stress, refers to the negative feelings and thoughts of an individual when they believe they cannot adequately handle the demands of daily life (Lazarus, 1966). While m...

In face-to-face communication, speakers provide several visual cues that facilitate speech comprehension for the listener. For example, they commonly make up-and-down flicks of the hand, called “beat gestures”, to emphasize a specific part of their speech (e.g., syllables, biasing the perceived lexical stress in words like CONtent vs. conTENT). These cues contribute to audiovisual speech integration, where listeners combine auditory speech with visual information from the speaker. Early research suggests that autistic children may show attenuated audiovisual speech integration effects (i.e., a reduced McGurk effect). However, more recent findings with adults show similar integration of speech and lip movements or meaningful gestures as non-autistic individuals. The present online large-scale study tested whether the timing of beat gestures biases audiovisual stress perception in autistic (N=101) and non-autistic (N=65) adults. Beat gestures affected speech perception to a similar extent in autistic and non-autistic adults. No relationship was observed between audiovisual integration and autistic traits (Autism Quotient-28 scores) or the use and understanding of visual communicative signals and gestures in daily life (Action and Feelings Questionnaire scores). Overall, these results converge with recent findings challenging the notion that audiovisual integration is altered in autism, at least in adulthood.

Autistic people’s minority status makes them more vulnerable to minority stressors, such as stigmatization and victimization, which are linked to greater stress and lower life satisfaction. The Psychological Mediation Framework (PMF) proposes that cognitive, affective, and social-psychological processes help explain the relationships between these stressors and adverse outcomes. This cross-sectional study tested the PMF in autistic adults by examining how two of its key processes, internalized stigma and loneliness, are associated with stress and life satisfaction. Using self-report survey data from 831 autistic participants enrolled in the Netherlands Autism Register (NAR), aged 18–87 years ( M _age = 47.5; SD = 12.5; 408 women, 309 men, and 114 gender-diverse individuals), multiple regression analyses showed that internalized autism-related stigma, emotional loneliness, and social loneliness were each positively associated with stress and negatively associated with life satisfaction. Mediation analyses indicated that both types of loneliness partially mediated the relationship between internalized autism-related stigma and these outcomes. Supporting the PMF, the findings suggest that autism-related stigmas may become internalized and be associated with loneliness, which is linked to greater stress and lower life satisfaction. Future studies should build upon the PMF and explore strategies to mitigate underlying minority stressors. Lay Understanding stress and life satisfaction in autistic adults with the psychological mediation framework Why was this study done? Autistic adults often experience higher levels of stress and lower life satisfaction than non-autistic adults. Recently, research has suggested that these experiences are linked to them being part of a minority group—autistic people. Minorities often experience extra stress from experiences like stigma, sometimes called minority stressors. A theoretical model, the Psychological Mediation Framework (PMF), describes how minority stressors are linked to differences in people’s thoughts, emotions, and feelings. This study examined whether the PMF can also help explain the stress and life satisfaction of autistic adults. We did this by testing whether two important parts of the PMF, internalized autism-related stigma (negative beliefs about being autistic) and loneliness, were linked to their stress and life satisfaction (how content people feel with their lives overall). What did we do? We analyzed data from 831 autistic adults who filled out a survey. In our statistical models (mathematical analyses that test how variables are related), we took into account other factors that are more commonly used to examine which factors were statistically associated with stress and life satisfaction in autistic adults, such as the level of characteristics related to autism and education level. By doing this, we increased the chance that any relationships we found could be attributed to minority stressors. What did we find? Autistic adults who experienced more internalized autism-related stigma, emotional loneliness (feeling disconnected from close relationships), and social loneliness (lacking a broader social network) reported higher stress levels and lower life satisfaction. We also found that autistic adults with more internalized stigma felt lonelier, and this loneliness was linked to higher stress and lower life satisfaction. What do the findings mean? The results suggest that autistic adults may internalize autism-related stigmas, which are linked to greater loneliness, higher stress, and lower life satisfaction. As these findings align with the PMF, we believe future studies should continue using this model. Also, we recommend that researchers should study ways to reduce minority stressors and improve the mental health of autistic adults.

People with autism often face mental health difficulties at rates far exceeding those of the general population. How autistic individuals relate to their autism classification and the autistic community, also known as social identity , may form a protective factor for mental health. However, validated tools to assess social identity in autistic populations are lacking. This study aims to evaluate the Dutch version of the 14-item Social Identity in Autism Questionnaire (SIAQ) and examine associations between social identity and demographic, autism-related, and mental health variables. A total of 1443 autistic individuals from the Netherlands (mean age = 47 years, 54% women, 98% Dutch) completed the SIAQ and measures assessing demographics, autism characteristics, and mental health. Factor analyses revealed a four-factor structure: solidarity (three items, feelings of connection to people with autism), satisfaction (four items, positive feelings about being autistic), centrality (three items, the importance of autism to one’s sense of self), and self-definition (four items, perceived similarity to other autistic people and within the autistic community). Internal consistency was acceptable to excellent. Measurement invariance (scalar level) was found across age, gender, education level, ethnicity, and autism traits. Furthermore, the four factors of social identity were differentially related to age, gender, language preference, time since diagnosis, and autism traits. Higher satisfaction and lower centrality were related to better mental health. To conclude, the SIAQ forms a robust tool to assess social identity in autistic individuals in the Netherlands. Lay People with autism experience mental health challenges much more often than people in the general population. Understanding how autistic people relate to their autism and the autistic community – called autistic social identity – may form an important factor for mental health. However, the lack of reliable tools to measure social identity in autistic people led to this study evaluating the Dutch version of the Social Identity in Autism Questionnaire (SIAQ). Associations between social identity and demographics, autism traits, and mental health were studied. Autistic individuals from the Netherlands ( n = 1443, average age = 47 years; 54% women; 98% Dutch) completed the SIAQ. The results showed that the questionnaire captures four key aspects of social identity: solidarity (feeling connected to other autistic people), satisfaction (positive feelings about being autistic), centrality (how central autism is to one’s identity), and self-definition (seeing oneself as similar to other autistic people and perceiving the autistic community as relatively similar). The questionnaire was reliable as well as suitable to use across diverse groups, including variations in age, gender, education level, ethnicity, and autism traits. Several aspects of social identity were related to gender, age, language preference, time since diagnosis, and autism traits. Importantly, higher satisfaction and lower centrality were associated with better mental health. These findings suggest that in the Netherlands, the SIAQ is a useful tool for understanding how autistic people relate to their autism and the autistic community, and how this relates to wellbeing.

The term virtual autism has recently been used to describe autism-like behaviors in young children following prolonged exposure to screens. The use of the word autism in this context raises conceptual and ethical concerns by reinforcing outdated ideas about parental blame, misrepresenting the nature of autism as we currently understand it, and causing misunderstanding about autism among the general public. We call for more precise and responsible language and advocate for an alternative term that better reflects the environmental basis of the phenomenon, such as screen-related developmental delay . Lay The term virtual autism has been used to describe autistic-like behaviors in young children that result from spending a lot of time using screens. Using the word autism in this context can cause confusion. It may lead people to wrongly believe that autism is caused by screen use and bring back outdated ideas that blame parents. We argue that this term can be misleading for parents, teachers, and the general public. Instead, we suggest using a clearer term like screen-related developmental delay to better reflect the environmental causes of these behaviors.

Historically, diagnostic criteria for autism have been shaped by male-centric childhood presentations, leading to reduced diagnostic accuracy for non-male autistic individuals. We investigated disparities between gender-diverse and cisgender autistic individuals in the age at formal diagnosis, delays between initial suspicion and diagnosis, and the frequency of prior perceived misdiagnoses. We analyzed 2,722 participants predominately late-diagnosed with autism, including 402 gender-diverse individuals. The analysis, controlling for age at participation, revealed that cisgender females were diagnosed at the oldest age, followed by gender-diverse individuals and cisgender males. Autistic gender-diverse individuals received the highest number of co-occurring psychiatric diagnoses and had the highest rates of prior perceived misdiagnosis, followed by cisgender females and cisgender males. These findings highlight the pressing need for diagnostic frameworks that account for gender diversity and actively mitigate biases in clinical practice. Lay Autism is often thought of as a condition that mainly affects boys in childhood. However, research shows that this view can delay or complicate diagnosis for non-male autistic individuals. For instance, research has demonstrated that autistic females are diagnosed later than males. In this study, we examined when and how autism is diagnosed in gender-diverse individuals (people whose gender identity does not align with the sex they were assigned at birth or who identify outside the male/female binary) compared to cisgender men and women (whose gender aligns with their birth sex). We analyzed data from 2,722 Dutch adults with autism, including 402 gender-diverse participants, mostly diagnosed in adulthood. We looked at the age at which participants were diagnosed and how long it took from first suspecting autism to receiving a formal diagnosis. We also examined whether participants had been diagnosed with another psychiatric condition and whether they perceived that diagnosis to be a misdiagnosis. Our results showed that gender-diverse people and cisgender women tend to be diagnosed later than cisgender men. Gender-diverse individuals and women reported being previously diagnosed with other conditions such as personality disorders, which they later believed were incorrect. These results suggest that gender biases still affect autism diagnosis, especially for gender-diverse people and women. Understanding these challenges is important to improve diagnostic practices and ensure more accurate and timely support for everyone on the autism spectrum.