Understanding Ideation in Autism
Authors:   , Field Michelle 
Published: November 2024

Background
Autism spectrum disorder or Autism is a neurodevelopmental disorder that presents with deficiencies in three domains: social functioning, communication and stereotyped behaviour. As a result of these deficits many people with autism access health and social care services. The rate of people diagnosed with autism continues to rise therefore, to meet the demand on services it is important that functional impairments in autism are well understood. This professional doctorate project arose from my observations of autistic children in clinical practice who appeared to be experiencing particular types of functional challenges as a result of ideational difficulties. A literature search framed ideation as a cognitive process that enables humans to form ideas. The purpose of this research is to expand what is known about autistic ideation.
Method
A scoping review confirmed that ideation in autism is deficient. The literature led to hypotheses about how the cognitive functions required for ideation might link to differences in autistic functioning. The scoping review provided the basis for the study. The study aimed to understand better the relationship between cognitive functioning (memory and attention), autistic traits and ideation and to explore the uniqueness of these relationships in autism compared to controls. A quasi-experimental investigation was conducted using a non-randomised sample of 20 autistic adult male participants and 20 well-matched controls. Standardised and norm-referenced tests of ideation, autistic traits and executive functions produced comparative data suitable for quantitative examination.
Results
The results suggest there is a relationship between attention and ideation in people with and without autism. Statistically significant results indicate that memory function relates to ideation abilities. More specifically, these results indicate a relationship between verbal memory, prospective memory and ideation. However, uniquely to the autistic group, a relationship was also found between visual memory and ideation. In both groups a relationship was found between immediate recall and ideation. Also uniquely to the autistic group however, a further relationship between delayed recall and delayed recognition and ideation was found. The statistically significant results indicate a relationship between the degree of autistic traits and ideational abilities. Results showed a relationship between imagination autistic traits and ideation in non-autistic participants only. Similarly, whilst the results provide a positive signal that there is a relationship between attention-switching traits and ideation, only the non-autistic group reached statistical significance. Finally, when looking at the methods used by the participants to generate ideas, the results suggested that the severity of autistic traits related to repetitive ideational responses. However, only in the non-autistic group did results show a relationship between the degree of autistic traits and the chaining of answers (linking next answer to the proceeding answer) despite the autistic group chaining more ideational responses. By evaluating the result of the scoping review, quasi experimental study, and wider literature, a new suggested pathway was formed outlining the potential areas of deficit that could contribute to poor ideation. This involved the consideration of cognitive sub processes, namely association and visuospatial planning in ideation. The impact of ideational difficulties was discussed in line with autistic traits and the impact this could have on daily function.
Conclusion
This study supports the concept that ideation in autism differs from ideation in neurotypical people and that there is a link between memory and attention function and abilities in ideation. This study indicates that ideational abilities relate to the severity of autistic traits. This research contributes to professional knowledge by increasing the theoretical understanding of ideation in autism. It offers guidance for future research and informs a set of clinical recommendations.