Autistic and without a home: a systematic review and meta-ethnography of the presence and experiences of homelessness amongst autistic individuals

ABSTRACT

Certain populations are more vulnerable to the cycle of homelessness. We conducted a systematic review to identify studies on autistic individuals within the homeless community, who are a “hard-to-reach” sub-population. Eight Internet-based databases were used, following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. After completing the screening process for 870 articles, 17 were included in the review. We used a critical appraisal skills program to evaluate the risk of bias for these studies. Five articles estimated prevalence rates, thus suggesting an elevated rate of autistic traits in the homeless community of up to 50%. The remaining 12 (two literature reviews and 10 qualitative or mixed-method) reported that the homelessness risk factors amongst autistic individuals are co-occurring conditions, rigidity, and a lack of familial relationships and opportunities. The conclusions of the study are limited by the lack of qualitative data. Future research should focus on rigorous comparative studies of homeless populations with and without autism.

KEYWORDS:

• Autism spectrum disorder
• homelessness
• systematic review
• presence of homelessness
• experiences of homelessness

Acknowledgements

We would like to acknowledge Tammie Foster for her support within the screening stage of this report.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability

The data included in this paper is a synthesis of previously reported data.

Notes

1 Sensory sensitivities may include aversion or seeking behavior related to sensory input such as sound, touch, taste, or light.

2 Google scholar is considered an academic search engine.

3 Homelessness was included in the search terms, as homeless* did not capture all known articles in the first search.

4 Please note we have only been able to provide information available within the papers.

5 It may be beneficial to select specific states within the U.S. with comparable environments to the UK and Australia, including their own unique healthcare system.

Additional information

Notes on contributors

Elizabeth Osborn

Elizabeth Osborn is undertaking a Doctorate of Philosophy (clinical), at Flinders University. Elizabeth has had an interest in homeless research since her honor’s year, with a number of publications related to disaster preparedness and heat. She has considerable experience working within the homeless sector and has worked in youth work, outreach case management and counseling. Elizabeth currently works as a provisional psychologist, specializing in working with trauma and autism.

Robyn Young

Robyn Young's interest in autism began while studying savants as part of her PhD in Savant Syndrome back in the early 90s. This work became the subject of an ABC documentary titled Uncommon Genius. She went on to develop a screening tool for Autistic Disorder suitable for use in children as young as 12 months of age. This tool, known as the Autism Detection in Early Childhood (ADEC; ACER, 2007), clearly operationalizes early behaviors indicative of autism. Together with colleagues at Flinders University she has developed an intervention program called SPECTRA (ACER, 2009). Her work has now turned to older persons with Autism Spectrum Disorder. Her expertise is often sought when ASD persons become unwittingly involved in crime. She is a Professor at Flinders University where she has worked since 1995 and she also consults privately. She has written 4 books in the area of autism, 6 book chapters and more than 70 peer reviewed publications. She regularly prepares reports for court and has appeared as an expert witness in court on more than 20 occasions.