"Autism Diagnosis as a Guide": Taiwanese Adolescents' Own Experiences of Receiving Autism Diagnoses.

Receiving an autism diagnosis can significantly contribute to adolescent identity formation via different processes, such as coping with stigmatization and/or reframing the diagnosis as a foundation for self-understanding and self-acceptance. Despite the presumed importance of cultural context in this regard, little is known about how autistic adolescents experience their autism diagnoses in non-Western countries. We aimed to understand the experiences of Taiwanese autistic adolescents receiving autism diagnoses in a relationship-oriented, non-Western culture. Eight autistic adolescents aged 14-18 years (three assigned-male, five assigned-female) participated in in-depth individual interviews, with data analyzed by reflexive thematic analysis. These Taiwanese autistic adolescents used their autism diagnoses to gain self-understanding and guide social interactions, specifically, (a) to explain past experiences in relation to both positive and negative stereotypes about autism; (b) as a guide to autism knowledge and to provide a framework for modifying one's own behaviors; (c) to seek connections with autistic peers and to be understood by non-autistic people; and (d) to negotiate with the Taiwanese educational system in meeting their needs. This study offers a qualitative, in-depth perspective on how autistic adolescents in a relationship-oriented, non-Western society experience and navigate their autism diagnoses-as a resource for identity construction and social position.Lay AbstractReceiving an autism diagnosis can come with different emotional and cognitive responses, such as feeling stigmatized and/or reframing this experience as a foundation for self-understanding and self-acceptance. This process is especially impactful during the teenage years, when young people typically begin to actively explore who they are. Because most previous research has been conducted in Western countries, we know very little about the experiences receiving an autism diagnosis in non-Western, relationship-oriented cultures, where fitting in with the group is often valued more than standing out. In this study, we interviewed eight autistic adolescents in Taiwan, aged 14-18 years, to understand how they experienced their autism diagnoses. We found that these Taiwanese autistic adolescents used their diagnoses to better understand themselves and guide their interactions with other people. Some used it to explain their past experiences and relieve themselves of guilt. Some said it helped them understand more about their own behavioral tendency and adjust their behavior accordingly. The diagnosis also helped them connect with their autistic peers, communicate effectively with non-autistic people, and ask for support within the school system. This study highlights the voices of Taiwanese autistic teenagers about their experiences of receiving an autism diagnosis. It shows how autism diagnoses can promote self-understanding and social coping.