A hostile context, very limited intervention theory and almost no change in outcomes: findings from a systematic realist review of health passports for Autistic adults

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Ellis, R., Williams, K., Brown, A., Healer, E., & Grant, A. (2022). A hostile context, very limited intervention theory and almost no change in outcomes: findings from a systematic realist review of health passports for Autistic adults [Preprint]. openRxiv. https://doi.org/10.1101/2022.12.04.22283076

Publication date: 5 Dec 2022 Added to AutiHub: 5 Jul 2026 Type: Preprint Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
3 / 5 (60.0%)
  1. Rebecca Ellis *
  2. Kathryn Williams *
  3. Amy Brown
  4. Eleanor Healer
  5. Aimee Grant *

Abstract

Abstract Background Autism is a normal part of cognitive diversity, resulting in communication and sensory processing differences, which can become disabling in a neurotypical world. Autistic people have an increased likelihood of physical and mental co-occurring conditions and die earlier than neurotypical peers. Inaccessible healthcare may contribute to this. Autism Health Passports (AHPs) are paper-based or digital tools which can be used to describe healthcare accessibility needs; they are recommended in UK clinical guidance. However, questions remained as to the theoretical underpinnings and effectiveness of AHPs. Methods We undertook a systematic literature search identifying studies focused on AHPs for adults (aged over 16 years) from five databases. Included literature was subjected to realist evaluation. Data were extracted using a standardised form, developed by the research team, which considered research design, study quality for realist review and the C ontext, M echanisms and O utcomes ( CMOs ) associated with each AHP tool. Findings 162 unique records were identified, and 13 items were included in the review. Only one item was considered high quality. Contextual factors focused on the inaccessibility of healthcare to Autistic patients and staff lack of confidence and training in supporting Autistic needs. I nterventions were heterogeneous, with most sources reporting few details as to how they had been developed. The most frequently included contents were communication preferences. M echanisms were often not stated or were inferred by the reviewers and lacked specificity. O utcomes were included in four studies and were primarily focused on AHP uptake, rather than O utcomes which measured impact. Conclusion There is insufficient evidence to conclude that AHPs reduce the health inequalities experienced by Autistic people. Using an AHP tool alone, without the inclusion of the local Autistic community developing the tool, and a wider intervention, such as training for staff or the use of local champions, may mean that AHPs do not trigger any M echanisms, and thus cannot affect O utcomes.

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These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.

Cited references
67
Total cited references integrated for this publication.
Cited references with an identified autistic author
3 / 67 (4.5%)
Cited author occurrences identified as autistic
9 / 256 (3.5%)
Among occurrences linked to AutiHub author records: 9 / 57 (15.8%). Distinct cited authors identified as autistic: 6 / 236 (2.5%).
Cited author occurrences linked to AutiHub author records
57 / 256 (22.3%)
Distinct linked cited authors: 41 / 236 (17.4%)
Linked cited-author occurrences not identified as autistic
48 / 57 (84.2%)
Among linked cited-author occurrences only. Across all cited-author occurrences: 48 / 256 (18.8%). Distinct linked cited authors not identified as autistic: 35 / 41 (85.4%).
  1. M. Nguyen , Nicholas Lennox , R. Ware (2014). Hand‐held health records for individuals with intellectual disability: a systematic review . Journal of Intellectual Disability Research, 58(12), 1172-1178. Wiley.
    Type: Article DOI: 10.1111/jir.12104 OpenAlex: https://openalex.org/W1581522484
    Crossref OpenAlex OpenCitations
  2. Pia Bradshaw , Elizabeth Pellicano , Mieke van Driel , Anna Urbanowicz (2019). How Can We Support the Healthcare Needs of Autistic Adults Without Intellectual Disability? Current Developmental Disorders Reports, 6(2), 45-56. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40474-019-00159-9 OpenAlex: https://openalex.org/W2944177211
    Crossref OpenAlex OpenCitations
  3. Muneef Alshammari , Owen Doody , Ita Richardson (2020). Health Information Systems for Clients with Mild Intellectual and Developmental Disability: A Framework . Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies, 125-132. SCITEPRESS - Science and Technology Publications.
    Type: Article DOI: 10.5220/0008966801250132 OpenAlex: https://openalex.org/W3011228699
    Crossref OpenAlex OpenCitations
  4. Sonia Michelle Dalkin , Joanne Greenhalgh , Diana Jones , Bill Cunningham , Monique Lhussier (2015). What’s in a mechanism? Development of a key concept in realist evaluation . Implementation Science, 10(1), 49-49. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s13012-015-0237-x OpenAlex: https://openalex.org/W1978372683
    Crossref OpenAlex OpenCitations
  5. Lauren Bishop-Fitzpatrick , Amy J. H. Kind (2017). A Scoping Review of Health Disparities in Autism Spectrum Disorder . Journal of Autism and Developmental Disorders, 47(11), 3380-3391. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-017-3251-9 OpenAlex: https://openalex.org/W2740425314
    Crossref OpenAlex OpenCitations
  6. Ruth Northway , Stacey Rees , Michelle Davies , Sharon Williams (2017). Hospital passports, patient safety and person‐centred care: A review of documents currently used for people with intellectual disabilities in the UK . Journal of Clinical Nursing, 26(23-24), 5160-5168. Wiley.
    Type: Article DOI: 10.1111/jocn.14065 OpenAlex: https://openalex.org/W2753412906
    Crossref OpenAlex OpenCitations
  7. Paul Linsley , David Howard , Sara Owen (2015). The construction of context-mechanisms-outcomes in realistic evaluation . Nurse Researcher, 22(3), 28-34. RCN Publishing Ltd..
    Type: Article DOI: 10.7748/nr.22.3.28.e1306 OpenAlex: https://openalex.org/W1990519127
    Crossref OpenAlex OpenCitations
  8. Eilidh Cage , Jessica Di Monaco , Victoria Newell (2019). Understanding, attitudes and dehumanisation towards autistic people . Autism, 23(6), 1373-1383. SAGE Publications.
    Type: Article DOI: 10.1177/1362361318811290 OpenAlex: https://openalex.org/W2901663576
    Crossref OpenAlex
  9. E. De Weger , N. J. E. Van Vooren , Geoff Wong , S. Dalkin , B. Marchal , H. W. Drewes et al. (2020). What’s in a Realist Configuration? Deciding Which Causal Configurations to Use, How, and Why . International Journal of Qualitative Methods, 19. SAGE Publications.
    Type: Article DOI: 10.1177/1609406920938577 OpenAlex: https://openalex.org/W3108923536
    Crossref OpenAlex OpenCitations
  10. Kirsten Corden , Rebecca Brewer , Eilidh Cage (2022). A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People . Review Journal of Autism and Developmental Disorders, 9(3), 386-399. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40489-021-00263-w OpenAlex: https://openalex.org/W3163025874
    Crossref OpenAlex OpenCitations
  11. Catherine H Bell , Sally Muggleton , Deborah L Davis (2022). Birth plans: A systematic, integrative review into their purpose, process, and impact . Midwifery, 111, 103388. Elsevier BV.
    Type: Article DOI: 10.1016/j.midw.2022.103388 OpenAlex: https://openalex.org/W4281485560
    Crossref OpenAlex OpenCitations
  13. David Mason , Barry Ingham , Anna Urbanowicz , Cos Michael , Heather Birtles , Marc Woodbury‐Smith et al. (2019). A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults . Journal of Autism and Developmental Disorders, 49(8), 3387-3400. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-019-04049-2 OpenAlex: https://openalex.org/W2945521062
    AutiHub · Documentation center Crossref OpenAlex OpenCitations
  14. Pia Bradshaw , Claire Pickett , Mieke L van Driel , Katie Brooker , Anna Urbanowicz (2021). Recognising, supporting and understanding Autistic adults in general practice settings . Australian Journal of General Practice, 50(3), 126-130. The Royal Australian College of General Practitioners.
    Type: Article DOI: 10.31128/ajgp-11-20-5722 OpenAlex: https://openalex.org/W3130006675
    Crossref OpenAlex OpenCitations
  15. G. F. Moore , S. Audrey , M. Barker , L. Bond , C. Bonell , W. Hardeman et al. (2015). Process evaluation of complex interventions: Medical Research Council guidance . BMJ, 350(mar19 6), h1258-h1258. BMJ.
    Type: Article DOI: 10.1136/bmj.h1258 OpenAlex: https://openalex.org/W2085001923
    Crossref OpenAlex OpenCitations
  16. Yona Lunsky (2018). Hospital passports require standardisation to improve patient safety and person-centred care for those with intellectual disability . Evidence Based Nursing, 21(2), 56-56. BMJ.
    Type: Article DOI: 10.1136/eb-2018-102869 OpenAlex: https://openalex.org/W2793384283
    Crossref OpenAlex OpenCitations
  17. Ray Pawson , Trisha Greenhalgh , Gill Harvey , Kieran Walshe (2005). Realist review - a new method of systematic review designed for complex policy interventions . Journal of Health Services Research & Policy, 10(1_suppl), 21-34. SAGE Publications.
    Type: Article DOI: 10.1258/1355819054308530 OpenAlex: https://openalex.org/W2145452196
    Crossref OpenAlex OpenCitations
  18. Michelle Lum , Michelle Garnett , Erin O’Connor (2014). Health communication: A pilot study comparing perceptions of women with and without high functioning autism spectrum disorder . Research in Autism Spectrum Disorders, 8(12), 1713-1721. Elsevier BV.
    Type: Article DOI: 10.1016/j.rasd.2014.09.009 OpenAlex: https://openalex.org/W1500757049
    Crossref OpenCitations
  19. Jim Blair (2013). Everybody’s life has worth – Getting it right in hospital for people with an intellectual disability and reducing clinical risks . Clinical Risk, 19(3), 58-63. SAGE Publications.
    Type: Article DOI: 10.1177/1356262213497681 OpenAlex: https://openalex.org/W2317071159
    Crossref OpenAlex OpenCitations
  20. Richard A Sharpe , Whitney Curry , Rachel Brown , Rohit Shankar (2019). A public health approach to reducing health inequalities among adults with autism . British Journal of General Practice, 69(688), 534-535. Royal College of General Practitioners.
    Type: Article DOI: 10.3399/bjgp19x706133 OpenAlex: https://openalex.org/W2983088360
    Crossref OpenAlex OpenCitations
  21. Rory Sheehan , Aarti Gandesha , Angela Hassiotis , Pamela Gallagher , Matthew Burnell , Glyn Jones et al. (2016). An audit of the quality of inpatient care for adults with learning disability in the UK . BMJ Open, 6(4), e010480. BMJ.
    Type: Article DOI: 10.1136/bmjopen-2015-010480 OpenAlex: https://openalex.org/W2337243275
    Crossref OpenAlex OpenCitations
  22. (2019). Learning disabilities: making reasonable adjustments in hospital . Nursing Times, 115, 38.
    Type: Other
    Crossref
  23. Mojgan Mirghafourvand , Sakineh Mohammad Alizadeh Charandabi , Solmaz Ghanbari‐Homayi , Leila Jahangiry , Jila Nahaee , Tahereh Hadian (2019). Effect of birth plans on childbirth experience: A systematic review . International Journal of Nursing Practice, 25(4), e12722-e12722. Wiley.
    Type: Article DOI: 10.1111/ijn.12722 OpenAlex: https://openalex.org/W2944098727
    Crossref OpenAlex OpenCitations
  25. Melanie Yergeau * (2017). Authoring Autism . Duke University Press.
    Type: Book DOI: 10.1215/9780822372189 OpenAlex: https://openalex.org/W2792215074
    AutiHub · Autistic Scholars Crossref OpenAlex OpenCitations
  26. Geoff Wong , Gill Westhorp , Ana Manzano , Joanne Greenhalgh , Justin Jagosh , Trisha Greenhalgh (2016). RAMESES II reporting standards for realist evaluations . BMC Medicine, 14(1), 96. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s12916-016-0643-1 OpenAlex: https://openalex.org/W2464700444
    Crossref OpenAlex OpenCitations
  27. Freda McCormick , Lynne Marsh , Laurence Taggart , Michael Brown (2021). Experiences of adults with intellectual disabilities accessing acute hospital services: A systematic review of the international evidence . Health & Social Care in the Community, 29(5), 1222-1232. Wiley.
    Type: Article DOI: 10.1111/hsc.13253 OpenAlex: https://openalex.org/W3112365733
    Crossref OpenAlex OpenCitations
  28. Sebastian Lemire , Alexander Kwako , Steffen B. Nielsen , Christina A. Christie , Stewart I. Donaldson , Frans L. Leeuw (2020). What Is This Thing Called a Mechanism? Findings From a Review of Realist Evaluations . New Directions for Evaluation, 2020(167), 73-86. Wiley.
    Type: Article DOI: 10.1002/ev.20428 OpenAlex: https://openalex.org/W3091945939
    Crossref OpenAlex OpenCitations
  29. Mary Dixon-Woods , Graham P Martin (2016). Does quality improvement improve quality? Future Hospital Journal, 3(3), 191-194. Elsevier BV.
    Type: Article DOI: 10.7861/futurehosp.3-3-191 OpenAlex: https://openalex.org/W2521189618
    Crossref OpenAlex OpenCitations
  30. Nazish Hashmi , Conor Davidson (2021). Reasonable adjustments for autistic adults . BJPsych Open, 7(S1), S81-S81. Royal College of Psychiatrists.
    Type: Article DOI: 10.1192/bjo.2021.253 OpenAlex: https://openalex.org/W3173926309
    Crossref OpenAlex OpenCitations
  31. Séverine Lalive d’Epinay Raemy , Adeline Paignon (2019). Providing equity of care for patients with intellectual and developmental disabilities in Western Switzerland: a descriptive intervention in a University Hospital . International Journal for Equity in Health, 18(1), 46-46. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s12939-019-0948-8 OpenAlex: https://openalex.org/W2938592760
    Crossref OpenAlex OpenCitations
  32. Layla Haidrani (2017). About Me (autism passport) . Nursing Standard, 31(21), 32-32. RCN Publishing Ltd..
    Type: Article DOI: 10.7748/ns.31.21.32.s37 OpenAlex: https://openalex.org/W2577060706
    Crossref OpenAlex OpenCitations
  33. Janet Diffin , Bronagh Byrne , Helen Kerr , Jayne Price , Aine Abbott , Dorry McLaughlin et al. (2019). The usefulness and acceptability of a personal health record to children and young people living with a complex health condition: A realist review of the literature . Child: Care, Health and Development, 45(3), 313-332. Wiley.
    Type: Article DOI: 10.1111/cch.12652 OpenAlex: https://openalex.org/W2918682934
    Crossref OpenAlex OpenCitations
  34. Jonathan Greenberg , Olga Prushinskaya , Joshua D. Harris , Gillian Guidetti-Myers , Jacqueline Steiding , Gregory S. Sawicki et al. (2018). Utilization of a patient-centered asthma passport tool in a subspecialty clinic . Journal of Asthma, 55(2), 180-187. Informa UK Limited.
    Type: Article DOI: 10.1080/02770903.2017.1323916 OpenAlex: https://openalex.org/W2618573789
    Crossref OpenAlex OpenCitations
  35. (n.d.). DHSC. Autism capabilities framework. 2019. Available at: https://skillsforhealth.org.uk/wp-content/uploads/2020/11/Autism-Capabilities-Framework-Oct-2019.pdf [Accessed: 24 August 2022].
    Type: Other
    Crossref
  36. Marji Erickson Warfield , Morgan K. Crossman , Ann Martha Neumeyer , Julie O’Brien , Karen A. Kuhlthau (2017). Transition tools and access to adult primary care . Advances in Autism, 3(3), 131-141. Emerald.
    Type: Article DOI: 10.1108/aia-02-2017-0006 OpenAlex: https://openalex.org/W2619318494
    Crossref OpenAlex OpenCitations
  37. (n.d.). DHSC and DfE. 2021. The national strategy for autistic children, young people and adults: 2021 to 2026. Available at: https://www.gov.uk/government/publications/national-strategy-for-autistic-children-young-people-and-adults-2021-to-2026/the-national-strategy-for-autistic-children-young-people-and-adults-2021-to-2026 [Accessed: 24 August 2022].
    Type: Other
    Crossref
  38. Sreedharan Geetha Sajith , Yafen Teo , Candice Sarah Ling (2018). Development and Introduction of “Communication Passport” in an Adult Inpatient Psychiatric Unit for Persons With Intellectual Disabilities: A Brief Report from Singapore . Journal of Policy and Practice in Intellectual Disabilities, 15(2), 166-170. Wiley.
    Type: Article DOI: 10.1111/jppi.12235 OpenAlex: https://openalex.org/W2801059229
    Crossref OpenAlex OpenCitations
  39. (n.d.). Welsh Government. 2021. Code of Practice on the Delivery of Autism Services: Supporting Guidance Document, pp: 1–82. Available at: https://gov.wales/sites/default/files/publications/2021-07/code-of-practice-on-the-delivery-of-autism-services-supporting-guidance-document_0.pdf
    Type: Other
    Crossref
  40. (n.d.). NICE. 2012. Autism spectrum disorder in adults: diagnosis and management Clinical guideline. http://www.nice.org.uk/guidance/cg142 [Accessed 4. 2. 22]
    Type: Other
    Crossref
  41. Lorelli S. Nowell , Jill M. Norris , Deborah E. White , Nancy J. Moules (2017). Thematic Analysis . International Journal of Qualitative Methods, 16(1). SAGE Publications.
    Type: Article DOI: 10.1177/1609406917733847 OpenAlex: https://openalex.org/W2763766763
    Crossref OpenAlex OpenCitations
  42. (n.d.). Public Health Wales. 2022. Health Profile: Guidance Notes for Health Professionals. https://phw.nhs.wales/services-and-teams/improvement-cymru/our-work/learning-disability-health-improvement-programme/health-profile/health-profile-for-professionals/guidance-notes-for-health-professionals/ [Accessed: 25/08/2022]
    Type: Other
    Crossref
  43. Marina Heifetz , Yona Lunsky (2018). Implementation and evaluation of health passport communication tools in emergency departments . Research in Developmental Disabilities, 72, 23-32. Elsevier BV.
    Type: Article DOI: 10.1016/j.ridd.2017.10.010 OpenAlex: https://openalex.org/W2766766685
    Crossref OpenAlex OpenCitations
  44. (n.d.). National Autism Society. 2020. [Online] My health passport. https://www.autism.org.uk/advice-and-guidance/topics/physical-health/my-health-passport [Accessed on: 18/10/2022]
    Type: Other
    Crossref
  45. Sophie Sarre , Jill Maben , Clare Aldus , Justine Schneider , Heather Wharrad , Caroline Nicholson et al. (2018). The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals . International Journal of Nursing Studies, 79, 145-153. Elsevier BV.
    Type: Article DOI: 10.1016/j.ijnurstu.2017.11.010 OpenAlex: https://openalex.org/W2769713999
    Crossref OpenAlex OpenCitations
  46. (n.d.). AsIAm. 2022 [Online].[cited 2022, Oct 4]. https://asiam.ie/
    Type: Other
    Crossref
  47. (n.d.). United States Congress. 1990. Americans with Disabilities Act of 1990. 42 U. S. C § 12101.
    Type: Other
    Crossref
  48. Kathryn Skivington , Lynsay Matthews , Sharon Anne Simpson , Peter Craig , Janis Baird , Jane M Blazeby et al. (2021). A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance . BMJ, 374, n2061. BMJ.
    Type: Article DOI: 10.1136/bmj.n2061 OpenAlex: https://openalex.org/W3194472989
    Crossref OpenAlex OpenCitations
  49. Elizabeth Young , Ramanan Aiyadurai , Thivia Jegathesan , Catherine Brown , Nicole Bechard , Ripudaman S. Minhas et al. (2019). Increasing Access to Developmental Services for Children with Autism Spectrum Disorder: The Pediatric Developmental Passport Pilot Randomized Trial . Journal of Autism and Developmental Disorders, 49(12), 4867-4876. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s10803-019-04199-3 OpenAlex: https://openalex.org/W2972243737
    Crossref OpenAlex OpenCitations
  51. (n.d.). Peninsula Health. 2017. The Emergency Department Nurse and Mum making a trip to hospital less stressful for kids with autism. https://www.peninsulahealth.org.au/2017/09/28/emergency-department-nurse-mum-making-trip-hospital-less-stressful-kids-autism/ [Accessed 14. 7. 22]
    Type: Other
    Crossref
  52. Jill F Harris , Leigh P Gorman , Aditi Doshi , Shannon Swope , Shayleigh D Page (2021). Development and implementation of health care transition resources for youth with autism spectrum disorders within a primary care medical home . Autism, 25(3), 753-766. SAGE Publications.
    Type: Article DOI: 10.1177/1362361320974491 OpenAlex: https://openalex.org/W3107102396
    Crossref OpenAlex OpenCitations
  53. Marlene Martelize Kelbrick , Jane Radley , Syeda Shaherbano , Leanne Cook , Andrew Simmons (2015). Autism spectrum disorders: physical health care in a low secure forensic setting . Mental Health Practice, 18(9), 31-37. RCN Publishing Ltd..
    Type: Article DOI: 10.7748/mhp.18.9.31.e963 OpenAlex: https://openalex.org/W4244884673
    Crossref OpenAlex
  54. (n.d.). Westminster Autism Commission. 2016. A spectrum of obstacles: An inquiry into access to healthcare for autistic people. London: Westminster Autism Commission. Available at: https://westminsterautismcommission.files.wordpress.com/2016/03/ar1011_ncg-autism-report-july-2016.pdf [Accessed: 25 August 2022]
    Type: Other
    Crossref
  55. Alice Turnock , Kate Langley , Catherine R.G. Jones (2022). Understanding Stigma in Autism: A Narrative Review and Theoretical Model . Autism in Adulthood, 4(1), 76-91. SAGE Publications.
    Type: Article DOI: 10.1089/aut.2021.0005 OpenAlex: https://openalex.org/W4214570045
    Crossref OpenAlex OpenCitations
  56. Matthew J Page , David Moher , Patrick M Bossuyt , Isabelle Boutron , Tammy C Hoffmann , Cynthia D Mulrow et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews . BMJ, 372, n71. BMJ.
    Type: Article DOI: 10.1136/bmj.n71 OpenAlex: https://openalex.org/W3118615836
    Crossref OpenAlex
  57. Clare-Marie Anderson , Rosie Monardo , Reni Soon , Jennifer Lum , Mary Tschann , Bliss Kaneshiro (2017). Patient Communication, Satisfaction, and Trust Before and After Use of a Standardized Birth Plan. Hawai’i Journal of Medicine & Public Health, 76(11), 305.
    Type: Article OpenAlex: https://openalex.org/W2980688545
    Crossref OpenAlex
  58. Sabine Stamm-Balderjahn , Rebecca Faliniski , Susanne Rossek , Karla Spyra (2019). Development and evaluation of a patient passport to promote self-management in patients with heart diseases . BMC Health Services Research, 19(1), 716-716. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s12913-019-4565-4 OpenAlex: https://openalex.org/W2981081213
    Crossref OpenAlex OpenCitations
  59. (n.d.). Grant, Unpublished.
    Type: Other
    Crossref
  60. Joanne Greenhalgh , Ana Manzano (2022). Understanding ‘context’ in realist evaluation and synthesis . International Journal of Social Research Methodology, 25(5), 583-595. Informa UK Limited.
    Type: Article DOI: 10.1080/13645579.2021.1918484 OpenAlex: https://openalex.org/W3158292257
    Crossref OpenAlex OpenCitations
  61. (n.d.). Perkins, E., & Vanzant, S. 2019. Promoting Better Healthcare Appointments: Let’s Make the Unfamiliar Familiar. EP Magazine. Ep-magazine.com. 50–51.
    Type: Other
    Crossref
  62. Learning Disability Practice (2014). Hospital passports may improve outcomes for patients with autism . Learning Disability Practice, 17(7), 6-6. RCN Publishing Ltd..
    Type: Article DOI: 10.7748/ldp.17.7.6.s5 OpenAlex: https://openalex.org/W4238136044
    Crossref OpenAlex OpenCitations
  63. Susan Brasher , Brandi Middour-Oxler , Rebecca Chambers , Christina Calamaro (2021). Caring for Adults With Autism Spectrum Disorder in the Emergency Department: Lessons Learned From Pediatric Emergency Colleagues . Journal of Emergency Nursing, 47(3), 384-389. Elsevier BV.
    Type: Article DOI: 10.1016/j.jen.2020.12.013 OpenAlex: https://openalex.org/W3132644061
    Crossref OpenAlex OpenCitations
  64. (n.d.). Unitt, I. 2018. The time has not yet come to stop talking about hospital passports.[Internet] Nursing Times. Available: https://www.nursingtimes.net/students/the-time-has-not-yet-come-to-stop-talking-about-hospital-passports-24-12-2018/ [Accessed: 04/10/2022]
    Type: Other
    Crossref
  65. (n.d.). National Development Team for Inclusion. 2020. “It’s Not Rocket Science”. https://www.ndti.org.uk/resources/publication/its-not-rocket-science [Accessed: 04/10/2022]
    Type: Other
    Crossref
  66. (n.d.). Autistic Doctors International (ADI). 2022.[Online] https://autisticdoctorsinternational.com/ [Accessed on: 20/10/2022]
    Type: Other
    Crossref
  67. (n.d.). Maternity Autism Research Group (MARG). 2022.[Online] https://www.maternityautismresearchgroup.co.uk/ [Accessed on: 20/10/2022]
    Type: Other
    Crossref