Can a Culturally Adapted Autism Training Reduce Stigma Towards Autistic People in South Korea?

Authors

Abstract

This randomized controlled trial examined the effectiveness of an online autism training intervention in reducing stigma toward autistic individuals. Participants were 208 Korean undergraduate students who were blinded to group allocation, with 106 assigned to the autism training and 102 assigned to a control intervention. All participants completed an online Qualtrics survey that included a pre-test survey (perceived similarity to different minority groups), the training, and a post-test survey (perceived similarity, stigma toward autistic people, knowledge about autism, confidence in their knowledge, and open-responses question asking for descriptions of autism). We conducted independent sample t tests and a mixed-effects model to examine group-level differences, and a reliable change index (RCI) analysis to examine individual changes in the perceived similarity score. The responses to the open-ended questions were analyzed using qualitative content analysis. Results revealed that the experimental group reported reduced stigma toward autistic individuals, increased perceived similarity with autistic individuals, and increased confidence in their autism knowledge and demonstrated increased knowledge about autism compared to the control group. At the individual level, the RCI analysis indicated that the training was effective for a notable subset of participants (25%). At post-test, the experimental group recognized the strengths of autistic people and described autistic individuals as "people like us," while many in the control group mentioned misconceptions about autism. Future research should employ more robust intervention designs and tailor materials for diverse target populations, including administrators, to foster systemic destigmatization.

1. Geoff Payne , Robert Dingwall , Judy Payne , Mick Carter (1981). Sociology and Social Research .

   Type: Book OpenAlex: https://openalex.org/W595886575

   OpenAlex
2. Hussain Alhejji , Thomas Garavan , Ronan Carbery , Fergal O'Brien , David McGuire (2016). Diversity Training Programme Outcomes: A Systematic Review . Human Resource Development Quarterly, 27(1), 95-149. Wiley.

   Type: Article DOI: 10.1002/hrdq.21221 OpenAlex: https://openalex.org/W1924540830

   Crossref OpenAlex OpenCitations
3. Neil S. Jacobson , Paula Truax (1992). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. In Methodological issues & strategies in clinical research. (pp. 631-648). American Psychological Association.

   Type: Book chapter DOI: 10.1037/10109-042 OpenAlex: https://openalex.org/W4246071266

   Crossref OpenAlex OpenCitations
4. Clara E. Hill (2012). Consensual qualitative research: A practical resource for investigating social science phenomena.

   Type: Book OpenAlex: https://openalex.org/W1507778037

   Crossref OpenAlex
5. Maria Ashworth , Brett Heasman , Laura Crane , Anna Remington (2024). Evaluating the impact of an online autism training on changing employers’ autism knowledge and commitment to inclusion in the workplace . Neurodiversity, 2. SAGE Publications.

   Type: Article DOI: 10.1177/27546330241249266 OpenAlex: https://openalex.org/W4395698547

   Crossref OpenAlex OpenCitations
6. Graham Thornicroft , Charlene Sunkel , Akmal Alikhon Aliev , Sue Baker , Elaine Brohan , Rabih el Chammay et al. (2022). The Lancet Commission on ending stigma and discrimination in mental health . The Lancet, 400(10361), 1438-1480. Elsevier BV.

   Type: Article DOI: 10.1016/s0140-6736(22)01470-2 OpenAlex: https://openalex.org/W4303940215

   Crossref OpenAlex OpenCitations
7. Kimberly A. Neuendorf (2017). The Content Analysis Guidebook . SAGE Publications, Inc.

   Type: Book DOI: 10.4135/9781071873045 OpenAlex: https://openalex.org/W4411746978

   OpenAlex
8. Manuel Barrera , Felipe G. Castro , Lisa A. Strycker , Deborah J. Toobert (2013). Cultural adaptations of behavioral health interventions: A progress report. Journal of Consulting and Clinical Psychology, 81(2), 196-205. American Psychological Association (APA).

   Type: Article DOI: 10.1037/a0027085 OpenAlex: https://openalex.org/W2082609801

   Crossref OpenAlex OpenCitations
9. Kristen Bottema‐Beutel , Micheal Sandbank , Tiffany G. Woynaroski (2023). Overview of Issues in Autism Intervention Research: Research Design and Reporting . Perspectives of the ASHA Special Interest Groups, 8(6), 1238-1247. American Speech Language Hearing Association.

   Type: Article DOI: 10.1044/2023_persp-23-00104 OpenAlex: https://openalex.org/W4387409722

   Crossref OpenAlex OpenCitations
10. ES Bogardus (1933). Bogardus, E. S. (1933). A social distance scale. Sociology and Social Research, 17, 265–271. Sociology and Social Research, 17, 265.

    Type: Other

    Crossref
11. Michele J. Gelfand , Jana L. Raver , Lisa Nishii , Lisa M. Leslie , Janetta Lun , Beng Chong Lim et al. (2011). Differences Between Tight and Loose Cultures: A 33-Nation Study . Science, 332(6033), 1100-1104. American Association for the Advancement of Science (AAAS).

    Type: Article DOI: 10.1126/science.1197754 OpenAlex: https://openalex.org/W2161411308

    Crossref OpenAlex OpenCitations
12. Patrick W. Corrigan , Andrea B. Bink , J. Konadu Fokuo , Annie Schmidt (2015). The public stigma of mental illness means a difference between you and me . Psychiatry Research, 226(1), 186-191. Elsevier BV.

    Type: Article DOI: 10.1016/j.psychres.2014.12.047 OpenAlex: https://openalex.org/W1977911128

    Crossref OpenAlex OpenCitations
13. Monique Botha *Autistic author. Learn more… , Robert Chapman *Autistic author. Learn more… , Morénike Giwa Onaiwu *Autistic author. Learn more… , Steven K. Kapp *Autistic author. Learn more… , Abs S. Ashley *Autistic author. Learn more… , Nick Walker *Autistic author. Learn more… (2024). The neurodiversity concept was developed collectively: An overdue correction on the origins of neurodiversity theory . Autism, 28(6), 1591-1594. SAGE Publications.

    Type: Article DOI: 10.1177/13623613241237871 OpenAlex: https://openalex.org/W4392704062

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
14. Kristen Gillespie-Lynch , Patricia J. Brooks , Fumio Someki , Rita Obeid , Christina Shane‐Simpson , Steven K. Kapp *Autistic author. Learn more… et al. (2015). Changing College Students’ Conceptions of Autism: An Online Training to Increase Knowledge and Decrease Stigma . Journal of Autism and Developmental Disorders, 45(8), 2553-2566. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-015-2422-9 OpenAlex: https://openalex.org/W2039386588

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
15. Kristen Bottema‐Beutel , Josephine Cuda , So Yoon Kim , Shannon Crowley , David Scanlon (2020). High School Experiences and Support Recommendations of Autistic Youth . Journal of Autism and Developmental Disorders, 50(9), 3397-3412. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-019-04261-0 OpenAlex: https://openalex.org/W2980406663

    Crossref OpenAlex OpenCitations
16. Eduardo Hariton , Joseph J Locascio (2018). Randomised controlled trials – the gold standard for effectiveness research . BJOG: An International Journal of Obstetrics & Gynaecology, 125(13), 1716-1716. Wiley.

    Type: Article DOI: 10.1111/1471-0528.15199 OpenAlex: https://openalex.org/W2809266094

    Crossref OpenAlex OpenCitations
17. Jonathan M. Campbell , Jane F. Morton , Kathryn Roulston , Brian D. Barger (2011). A Descriptive Analysis of Middle School Students’ Conceptions of Autism . Journal of Developmental and Physical Disabilities, 23(5), 377-397. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10882-011-9234-4 OpenAlex: https://openalex.org/W2040778531

    Crossref OpenAlex OpenCitations
18. Daniel Morris , Scott Fraser , Richard Wormald (2007). Masking is better than blinding . BMJ, 334(7597), 799-799. BMJ.

    Type: Article DOI: 10.1136/bmj.39175.503299.94 OpenAlex: https://openalex.org/W2059846593

    Crossref OpenAlex OpenCitations
19. Erin M. Buchanan , John E. Scofield (2018). Methods to detect low quality data and its implication for psychological research . Behavior Research Methods, 50(6), 2586-2596. Springer Science and Business Media LLC.

    Type: Article DOI: 10.3758/s13428-018-1035-6 OpenAlex: https://openalex.org/W2789412903

    Crossref OpenAlex OpenCitations
20. Jonathan M. Campbell , Elizabeth A. Caldwell , Kirsten S. Railey , Olivia Lochner , Rachel Jacob , Shelby Kerwin (2019). Educating Students About Autism Spectrum Disorder Using the Kit for Kids Curriculum: Effects on Knowledge and Attitudes . School Psychology Review, 48(2), 145-156. Informa UK Limited.

    Type: Article DOI: 10.17105/spr-2017-0091.v48-2 OpenAlex: https://openalex.org/W2973943284

    Crossref OpenAlex OpenCitations
21. Marieke de Vries , Sabrina Cader , Lucy Colleer , Eleonore Batteux , Meryem Betul Yasdiman , Yih Jiun Tan et al. (2020). University Students’ Notion of Autism Spectrum Conditions: A Cross-Cultural Study . Journal of Autism and Developmental Disorders, 50(4), 1281-1294. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-019-04343-z OpenAlex: https://openalex.org/W2996767613

    Crossref OpenAlex OpenCitations
22. Neil S. Jacobson , Paula Truax (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. American Psychological Association (APA).

    Type: Article DOI: 10.1037/0022-006x.59.1.12 OpenAlex: https://openalex.org/W4235813114

    OpenAlex
23. So Yoon Kim , Jeong Eun Cheon , Young-Hoon Kim (2025). A Cross-Cultural Examination of Blatant and Subtle Dehumanization of Autistic People . Journal of Autism and Developmental Disorders, 55(2), 678-694. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-023-06217-x OpenAlex: https://openalex.org/W4390840976

    Crossref OpenAlex OpenCitations
24. Thomas F. Pettigrew (2008). Future directions for intergroup contact theory and research . International Journal of Intercultural Relations, 32(3), 187-199. Elsevier BV.

    Type: Article DOI: 10.1016/j.ijintrel.2007.12.002 OpenAlex: https://openalex.org/W2140017384

    Crossref OpenAlex OpenCitations
25. Vicky Caron , Nuria Jeanneret , Mathieu Giroux *Autistic author. Learn more… , Lucila Guerrero *Autistic author. Learn more… , Mélanie Ouimet , Baudouin Forgeot d’Arc et al. (2022). Sociocultural context and autistics’ quality of life: A comparison between Québec and France . Autism, 26(4), 900-913. SAGE Publications.

    Type: Article DOI: 10.1177/13623613211035229 OpenAlex: https://openalex.org/W3185575176

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
26. So Yoon Kim , Da‐Yea Song , Kristen Bottema‐Beutel , Kristen Gillespie-Lynch , Eilidh Cage (2023). A systematic review and meta‐analysis of associations between primarily non‐autistic people's characteristics and attitudes toward autistic people . Autism Research, 16(2), 441-457. Wiley.

    Type: Article DOI: 10.1002/aur.2867 OpenAlex: https://openalex.org/W4311199958

    Crossref OpenAlex OpenCitations
27. Steven K. Kapp *Autistic author. Learn more… (2020). Autistic Community and the Neurodiversity Movement . Springer Singapore.

    Type: Book DOI: 10.1007/978-981-13-8437-0 OpenAlex: https://openalex.org/W3205191769

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
28. Peter C Pantelis , Daniel P Kennedy (2016). Estimation of the prevalence of autism spectrum disorder in South Korea, revisited . Autism, 20(5), 517-527. SAGE Publications.

    Type: Article DOI: 10.1177/1362361315592378 OpenAlex: https://openalex.org/W2272295293

    Crossref OpenAlex OpenCitations
29. J Walton (2021). Everyday Multiculturalism in/across Asia . Routledge.

    Type: Book DOI: 10.4324/9781003092766 OpenAlex: https://openalex.org/W4205862302

    Crossref OpenAlex OpenCitations
30. Weol Soon Kim-Rupnow (2005). Disability and Korean Culture . In Culture and Disability: Providing Culturally Competent Services (pp. 115-138). SAGE Publications, Inc..

    Type: Book chapter DOI: 10.4135/9781452232546.n6 OpenAlex: https://openalex.org/W2478994338

    Crossref OpenAlex OpenCitations
31. Dekker, M. (2023). A correction on the origin of the term ‘neurodiversity’. Independent living on the autistic spectrum: Where those who are different find that they’re not alone. Martijn ‘McDutchie’ Dekker [Blog].

    Type: Other

    Crossref
32. Fumio Someki , Miyuki Torii , Patricia J. Brooks , Tatsuya Koeda , Kristen Gillespie-Lynch (2018). Stigma associated with autism among college students in Japan and the United States: An online training study . Research in Developmental Disabilities, 76, 88-98. Elsevier BV.

    Type: Article DOI: 10.1016/j.ridd.2018.02.016 OpenAlex: https://openalex.org/W2795294239

    Crossref OpenAlex OpenCitations
33. Sally Lindsay , Sara Cancelliere (2018). A model for developing disability confidence . Disability and Rehabilitation, 40(18), 2122-2130. Informa UK Limited.

    Type: Article DOI: 10.1080/09638288.2017.1326533 OpenAlex: https://openalex.org/W2614488892

    Crossref OpenAlex OpenCitations
34. Jacquiline den Houting *Autistic author. Learn more… , Monique Botha *Autistic author. Learn more… , Eilidh Cage , Desiree R. Jones , So Yoon Kim (2021). Shifting stigma about autistic young people . The Lancet Child & Adolescent Health, 5(12), 839-841. Elsevier BV.

    Type: Article DOI: 10.1016/s2352-4642(21)00309-6 OpenAlex: https://openalex.org/W3203457579

    Crossref OpenAlex OpenCitations
35. Jessica Dreaver , Craig Thompson , Sonya Girdler , Margareta Adolfsson , Melissa H. Black , Marita Falkmer (2020). Success Factors Enabling Employment for Adults on the Autism Spectrum from Employers’ Perspective . Journal of Autism and Developmental Disorders, 50(5), 1657-1667. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-019-03923-3 OpenAlex: https://openalex.org/W2914690720

    Crossref OpenAlex OpenCitations
36. So Yoon Kim , Kristen Gillespie-Lynch , wn-ho Yoon *Autistic author. Learn more… (2024). A pilot mixed-methods evaluation of an intervention to reduce Korean undergraduates’ stigma toward autistic people . Research in Autism Spectrum Disorders, 113, 102355. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2024.102355 OpenAlex: https://openalex.org/W4392214174

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
37. Michaela DuBay (2022). Cultural Adaptations to Parent-Mediated Autism Spectrum Disorder Interventions for Latin American Families: A Scoping Review . American Journal of Speech-Language Pathology, 31(3), 1517-1534. American Speech Language Hearing Association.

    Type: Article DOI: 10.1044/2022_ajslp-21-00239 OpenAlex: https://openalex.org/W4220798187

    Crossref OpenAlex OpenCitations
38. So Yoon Kim , Jeong Eun Cheon , Kristen Gillespie-Lynch , Jennifer Grandits , Young-Hoon Kim (2023). Explicit stigma and implicit biases toward autism in South Korea versus the United States . Autism, 27(5), 1492-1507. SAGE Publications.

    Type: Article DOI: 10.1177/13623613221140695 OpenAlex: https://openalex.org/W4311515627

    Crossref OpenAlex OpenCitations
39. See Heng Yim , Ulrike Schmidt (2023). The effectiveness and cultural adaptations of psychological interventions for eating disorders in East Asia: A systematic scoping review . International Journal of Eating Disorders, 56(12), 2165-2188. Wiley.

    Type: Article DOI: 10.1002/eat.24061 OpenAlex: https://openalex.org/W4386878304

    Crossref OpenAlex OpenCitations
40. Kristen Gillespie-Lynch , Nidal Daou , Maria-Jose Sanchez-Ruiz , Steven K. Kapp *Autistic author. Learn more… , Rita Obeid , Patricia J. Brooks et al. (2019). Factors underlying cross-cultural differences in stigma toward autism among college students in Lebanon and the United States . Autism, 23(8), 1993-2006. SAGE Publications.

    Type: Article DOI: 10.1177/1362361318823550 OpenAlex: https://openalex.org/W2934509277

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
41. Kristen Gillespie-Lynch , Jennifer B Bisson , Sabine Saade , Rita Obeid , Bella Kofner , Ashley Johnson Harrison et al. (2022). If you want to develop an effective autism training, ask autistic students to help you . Autism, 26(5), 1082-1094. SAGE Publications.

    Type: Article DOI: 10.1177/13623613211041006 OpenAlex: https://openalex.org/W3198012637

    Crossref OpenAlex OpenCitations
42. Koyeli Sengupta , Sanchita Mahadik , Gopika Kapoor (2020). Glocalizing project ImPACT: Feasibility, acceptability and preliminary outcomes of a parent-mediated social communication intervention for autism adapted to the Indian context . Research in Autism Spectrum Disorders, 76, 101585. Elsevier BV.

    Type: Article DOI: 10.1016/j.rasd.2020.101585 OpenAlex: https://openalex.org/W3027058777

    Crossref OpenAlex OpenCitations
43. Julian PT Higgins , Jelena Savović , Matthew J Page , Roy G Elbers , Jonathan AC Sterne (2019). Assessing risk of bias in a randomized trial . In Cochrane Handbook for Systematic Reviews of Interventions (pp. 205-228). Wiley.

    Type: Book chapter DOI: 10.1002/9781119536604.ch8 OpenAlex: https://openalex.org/W2974747689

    Crossref OpenAlex OpenCitations
44. E Goffman (1963). Stigma: Notes on the management of spoiled identity . Stigma: Notes on the management of spoiled identity.

    Type: Other

    Crossref
45. wn-ho Yoon *Autistic author. Learn more… , JaeKyung Seo , Cheolung Je (2024). Korean autistic persons facing systemic stigmatization from middle education schools: daily survival on the edge as a puppet . Frontiers in Psychiatry, 15, 1260318. Frontiers Media SA.

    Type: Article DOI: 10.3389/fpsyt.2024.1260318 OpenAlex: https://openalex.org/W4393277398

    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
46. Luodi Yu , Sheri Stronach , Ashley J Harrison (2020). Public knowledge and stigma of autism spectrum disorder: Comparing China with the United States . Autism, 24(6), 1531-1545. SAGE Publications.

    Type: Article DOI: 10.1177/1362361319900839 OpenAlex: https://openalex.org/W3019388009

    Crossref OpenAlex OpenCitations
47. Satyajeet Tulshidas Patil , Manjiri Chaitanya Datar , Jyoti Vittaldas Shetty , Nilesh Mahadeo Naphade (2021). “Psychological Consequences and Coping Strategies of Patients Undergoing Treatment for COVID-19 at a Tertiary Care Hospital” . Asian Journal of Social Health and Behavior, 4(2), 62-68. Ovid Technologies (Wolters Kluwer Health).

    Type: Article DOI: 10.4103/shb.shb_5_21 OpenAlex: https://openalex.org/W3168111510

    Crossref OpenAlex OpenCitations
48. So Yoon Kim , Kristen Gillespie-Lynch (2023). Do Autistic People’s Support Needs and Non-Autistic People’s Support for the Neurodiversity Movement Contribute to Heightened Autism Stigma in South Korea vs. the US? Journal of Autism and Developmental Disorders, 53(11), 4199-4213. Springer Science and Business Media LLC.

    Type: Article DOI: 10.1007/s10803-022-05739-0 OpenAlex: https://openalex.org/W4294904405

    Crossref OpenAlex OpenCitations
49. So Yoon Kim , Jeong Eun Cheon , Kristen Gillespie-Lynch , Young-Hoon Kim (2022). Is autism stigma higher in South Korea than the United States? Examining cultural tightness, intergroup bias, and concerns about heredity as contributors to heightened autism stigma . Autism, 26(2), 460-472. SAGE Publications.

    Type: Article DOI: 10.1177/13623613211029520 OpenAlex: https://openalex.org/W3184686981

    Crossref OpenAlex OpenCitations
50. So Yoon Kim , Da-Yea Song , Kristen Bottema‐Beutel , Kristen Gillespie-Lynch (2024). Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people . Autism, 28(4), 798-815. SAGE Publications.

    Type: Article DOI: 10.1177/13623613231205915 OpenAlex: https://openalex.org/W4387966327

    Crossref OpenAlex OpenCitations
51. Bruce G. Link , Jo C. Phelan (2001). Conceptualizing Stigma . Annual Review of Sociology, 27(1), 363-385. Annual Reviews.

    Type: Article DOI: 10.1146/annurev.soc.27.1.363 OpenAlex: https://openalex.org/W4213367093

    Crossref OpenAlex OpenCitations
52. Timothy Lim (2009). Who is Korean? Migration, Immigration, and the Challenge of Multiculturalism in Homogeneous Societies . Asia-Pacific Journal, 7(30). Cambridge University Press (CUP).

    Type: Article DOI: 10.1017/s1557466009008407 OpenAlex: https://openalex.org/W4410182540

    Crossref OpenAlex
53. Emma Wray , Umesh Sharma , Pearl Subban (2022). Factors influencing teacher self-efficacy for inclusive education: A systematic literature review . Teaching and Teacher Education, 117, 103800. Elsevier BV.

    Type: Article DOI: 10.1016/j.tate.2022.103800 OpenAlex: https://openalex.org/W4283379398

    Crossref OpenAlex OpenCitations
54. KA Neuendorf (2002). The content analysis guidebook . The content analysis guidebook.

    Type: Other

    Crossref
55. Melvin Seeman , Erving Goffman (1964). Stigma: Notes on the Management of Spoiled Identity. American Sociological Review, 29(5), 770. SAGE Publications.

    Type: Article DOI: 10.2307/2091442 OpenAlex: https://openalex.org/W4297361601

    OpenAlex
56. Statistics Korea. (2022). Multicultural demographic statistics.

    Type: Other

    Crossref