Endorsement of the Neurodiversity Framework and Self-Esteem Among Autistic and Non-Autistic Adults

Background: Many autistic individuals struggle with poor mental health and low self-esteem, in part, due to internalized stigma. Given the strengths-based perspective of the neurodiversity framework, it is likely that endorsing it or its subcomponents could serve as a protective factor against poor mental health and low self-esteem among autistic individuals. 

Methods: The present study sought to investigate (1) the relationship between endorsement of the neurodiversity framework and self-esteem and (2) whether this relationship differed between autistic and non-autistic adults. A diverse sample of 123 autistic adults and 104 non-autistic adults living in the United States completed an online survey. 

Results: Autistic participants reported having significantly lower self-esteem compared with non-autistic participants. We conducted linear regressions, with aspects of the neurodiversity framework as predictor variables, autism status as the moderator, self-esteem as the criterion variable, and demographic differences between autistic and non-autistic samples as control variables. There was a significant interaction between autism status and the Autism as Difference subscale of the neurodiversity framework in predicting self-esteem. In particular, endorsing this facet of the neurodiversity framework was associated with significantly higher self-esteem for autistic participants compared with autistic individuals who endorsed low levels of this facet. However, there was no difference in self-esteem for non-autistic participants who endorsed different levels of the Autism as Difference subscale. 

Conclusion: Although autistic participants indicate worse self-esteem than non-autistic participants, endorsing aspects of the neurodiversity framework may have a buffering effect on this relationship by mitigating aspects of internalized stigma. Further work must be conducted to elucidate causal relations, but the present study sets a foundation for improving mental health in autistic adults.