Co-production of a Neurodiversity-Affirmative Anxiety Intervention for Autistic Children

This publication is included in the Autistic Autism Scholarship Project. two authors of this publication are identified as autistic in the project.

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Cullingham, T., Rennard, U., Creswell, C., Milton, D., Buckle, K. L., Godber, L., Gordon, K., Larkin, M., & Green, J. (2023). Co-production of a Neurodiversity-Affirmative Anxiety Intervention for Autistic Children [Preprint]. openRxiv. https://doi.org/10.1101/2023.07.05.23292219

Publication date: 7 Jul 2023 Added to AutiHub: 5 Jul 2026 Type: Preprint Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
9
Publication authors identified as autistic
2 / 9 (22.2%)
  1. Tasha Cullingham
  2. Una Rennard
  3. Cathy Creswell
  4. Damian Milton *
  5. Karen Leneh Buckle *
  1. Lucie Godber
  2. Kate Gordon
  3. Michael Larkin
  4. Jonathan Green

Abstract

Background Mental health difficulties are common for autistic people; however, few interventions have been co-produced with the autistic community. Mental health interventions constructed with a ‘non-autistic lens’ likely miss key understandings from autistic experiences and priorities of the autistic community. Additionally, the style and aims of intervention may be prone to unconscious bias around the pathologisation of autism. Currently, there are limited methodological and practical examples of how to rigorously co-produce mental health interventions with autistic people. This paper details the methodology and processes of co-adapting an intervention for autistic children with anxiety problems. Providing a worked example of co-producing a neurodiversity-affirmative mental health intervention which reflects autistic, parental, academic, and clinical, experience and expertise. Methods We co-adapted content from a brief, parent-led, CBT approach for non-autistic children with anxiety problems to meet the needs of autistic children and their parents. The adaptation for autistic children was co-constructed using processes and strategies adopted from Experience-Based Co-Design (EBCD). The research team, comprising autistic and non-autistic members, worked alongside an expert reference group (ERG). The ERG comprised parents (autistic and non-autistic) of autistic children with anxiety problems, autistic adults with experience of anxiety problems, and clinicians with experience supporting autistic children with mental health difficulties. Data were obtained from qualitative research interviews with autistic children with anxiety problems and parents. These data were considered reciprocally by the research team and the ERG. Results The resulting intervention includes a neurodiversity-affirmative perspective that considers how anxieties for autistic children can emerge from being neurodivergent in a neurotypical world integrated with traditional CBT techniques and understandings of anxiety. Conclusion Successful co-production can help to integrate multiple theoretical backgrounds and result in the creation of interventions that are potentially acceptable to clinicians, autistic people and their family members.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 01:35.

Cited references
21
With a DOI
17
Without a DOI, from raw bibliography text
4
3 / 21 (14.3%) cited references include at least one author identified as autistic.
References with data to complete
4 / 21 (19.0%)
References with detected author names
17 / 21 (81.0%)
Without detected author names
4
Without a structured title
4
Without a stable identifier
4
References with raw author names still to review
4
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
85
From DOI or external metadata
85
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
15
16 / 85 (18.8%) names are linked to an author already present in AutiHub. 69 / 85 (81.2%) names are not yet linked.
Names linked to a person identified as autistic
4 / 85 (4.7%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 4 / 16 (25.0%). Distinct people identified as autistic: 4 / 84 (4.8%).
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