Measuring Communication and Sensory Barriers and Supports in Autistic Adolescents: Development and Links to Quality of Life

Autistic adolescents experience distinct communication and sensory processing differences that shape their daily interactions, participation, and overall well-being. However, little is known about the specific communication and sensory barriers and supports they perceive, particularly from their own perspectives. Guided by the neurodiversity paradigm, this dissertation conceptualizes communication and sensory differences as natural variations in human experience rather than deficits. The overarching goal is to identify autistic adolescents’ perceived communication and sensory barriers and supports and to examine how these perceptions relate to quality of life. This mixed methods dissertation consists of three interrelated studies. First, a scoping review synthesizes existing research on communication and sensory barriers and supports among autistic adolescents. Second, a qualitative study uses semi-structured interviews with autistic adolescents to explore their lived experiences of communication and sensory environments, including perceived barriers, supports, and their impacts on well-being and daily life. Findings from the scoping review and qualitative interviews inform the development of a novel measure assessing perceived communication and sensory barriers and supports. The third study pilots this newly developed measure in a quantitative sample of autistic adolescents and examines its associations with established measures of quality of life. By integrating evidence from the literature, autistic adolescents’ lived experiences, and quantitative assessment, this dissertation advances a strengths-based understanding of communication and sensory differences. The findings contribute to the development of accessible, autism-affirming measurement tools and inform the design of supportive environments that promote well-being and quality of life among autistic adolescents.