Community Attitudes Toward Meaningful Autism Inclusion

Several tools assess community attitudes toward autism, but they stop short of measuring meaningful inclusion. This study aimed to develop and validate the Meaningful Autistic Inclusion Attitudes (MAIA) scale with input from autistic self-advocates and to examine whether attitudes toward meaningful inclusion differed by state of residence, personal contact with autism, and demographic variables. A total of 772 participants across four U.S. states (Arizona, Florida, Missouri, and Oklahoma) completed the 25-item MAIA and a published scale measuring general attitudes toward neurodiversity (Neurodiversity Attitudes Questionnaire [NDAQ]; 28 items). Using exploratory structural equation modeling, we identified four factors of the MAIA (Capabilities, Interpersonal, Impact, and Building Inclusive Communities) with acceptable-to-good internal consistency and convergent validity with NDAQ scales. Personal contact with autistic people and people with other psychiatric conditions positively predicted two of the four factors (Capabilities and Impact), whereas some types of personal contact negatively predicted the Interpersonal factor. Participants from Arizona reported more positive attitudes toward interpersonal inclusion than participants from the other three states. Differential relationships between demographic variables and the four factors were also observed. If replicated, findings suggest several modifiable factors that could increase effectiveness of initiatives aimed at improving autism inclusion.Lay AbstractThis study describes the development of the Meaningful Autistic Inclusion Attitudes (MAIA) scale, a survey measure to assess community attitudes toward meaningful community inclusion of people with autism. We define meaningful inclusion as inclusion efforts that move beyond acceptance to include an appreciation of the value autistic people can bring to their communities and the belief that investing in inclusion is worthwhile. Prior to this study, existing surveys designed to measure attitudes toward autism focused on negative attitudes (i.e., stigma) and neutral attitudes (i.e., acceptance) and did not include items meant to assess respondents' beliefs about meaningful inclusion. We recruited 772 participants across four U.S. States (Arizona, Florida, Missouri, and Oklahoma) to complete the MAIA. We found that MAIA survey items measure attitudes toward four different areas related to meaningful inclusion: (a) Capabilities of autistic people; (b) Interpersonal inclusion; (c) Impacts of inclusion; and (d) Building inclusive communities. We then compared participant scores in each of these areas to understand whether attitudes toward meaningful inclusion differed by participant state of residence, personal contact with autism, and demographic variables (age, sex, race/ethnicity, education, and income). We found that participants residing in Arizona had more positive attitudes toward interpersonal inclusion than participants in the other three states. Participants who reported any personal contact with autism had more positive attitudes toward the capabilities of autistic people and the impacts of inclusion. In contrast, participants who had friends, relatives, or acquaintances with autism reported less positive attitudes toward interpersonal inclusion than participants who had no personal contact with autism. Finally, we observed differential relationships between demographic variables and the four factors. Together, findings suggest that the MAIA is a promising tool for measuring nuanced differences in attitudes toward meaningful inclusion.