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BACKGROUND: We previously reported an association between household chemical exposures and an increased risk of paediatric-onset multiple sclerosis. METHODS: Using a case-control paediatric multiple sclerosis study, gene-environment interaction between exposure to household chemicals and genotypes for risk of paediatric-onset multiple sclerosis was estimated.Genetic risk factors of interest included the two major HLA multiple sclerosis risk factors, the presence of DRB1*15 and the absence of A*02, and multiple sclerosis risk variants within the metabolic pathways of common household toxic chemicals, including IL-6 (rs2069852), BCL-2 (rs2187163) and NFKB1 (rs7665090). RESULTS: 490 paediatric-onset multiple sclerosis cases and 716 controls were included in the analyses. Exposures to insect repellent for ticks or mosquitos (OR 1.47, 95% CI 1.06 to 2.04, p=0.019), weed control products (OR 2.15, 95% CI 1.51 to 3.07, p<0.001) and plant/tree insect or disease control products (OR 3.25, 95% CI 1.92 to 5.49, p<0.001) were associated with increased odds of paediatric-onset multiple sclerosis. There was significant additive interaction between exposure to weed control products and NFKB1 SNP GG (attributable proportions (AP) 0.48, 95% CI 0.10 to 0.87), and exposure to plant or disease control products and absence of HLA-A*02 (AP 0.56; 95% CI 0.03 to 1.08). There was a multiplicative interaction between exposure to weed control products and NFKB1 SNP GG genotype (OR 2.30, 95% CI 1.00 to 5.30) but not for other exposures and risk variants. No interactions were found with IL-6 and BCL-2 SNP GG genotypes. CONCLUSIONS: The presence of gene-environment interactions with household toxins supports their possible causal role in paediatric-onset multiple sclerosis.

This thesis explores how the “hierarchy of impairments” —a collection of prejudices that results in levels of preference for certain types of disabled people over others, while maintaining a general societal preference for non-disabled people—impacted the design, development, management and experience of life in Het Dorp, an accessible urban community for people with physical disabilities in Arnhem, the Netherlands, during its first two decades (1962-1982). Materials analysed included architectural design documents, weekly meeting notes of the Het Dorp management board, media produced for internal and external consumption, contemporary news coverage, contemporary published accounts of residents and researchers, and interviews. Het Dorp arose in the context of the burgeoning Dutch welfare state. Justification of these costs to the public was built through careful selection of early residents, as well as the construction of disabled people as worthy of citizenship via creation of governance structures that gave the appearance of a separate, self-governing community of disabled people. Understanding the hierarchy of impairments provides context for how Het Dorp positioned physically disabled people as a normalisable “model minority.” Resulting displays of normalcy via employment, social participation and self-governance at times differed significantly from the reality of life in Het Dorp. The hierarchy of impairments was embedded at societal and project level, and also internalised by residents. Despite attempts of Het Dorp’s founders to carefully stage-manage the community, residents and some staff recognised the limits of technological solutionism and normalisation to address problems rooted in long-standing attitudes, laws, societal practices and benefits policies. These conflicts were experienced on a personal level, but also gave rise to communal responses and attempts to secure societal change. In sum, the hierarchy of impairments was a key factor

Purpose The purpose of this paper is to reveal barriers and their coherences between discrimination and self-perceived employability which students and employees on the autism spectrum often face and need to overcome. These include discrimination based on disability, when applying for a job or retaining employment. This research located barriers in three different categories: formality – problems that focus on organizational structures in the application process; social – communication and interaction problems; and job demand barriers – obstacles that epitomize work-related strains. Design/methodology/approach Barriers and discrimination can prevent individuals from accessing the labor market which can lead to severe consequences for an individual on the autism spectrum, such as poverty, social deprivation or lack of health promotion and equal treatment. Self-perceived employability can be regarded as an additional strength, as it describes the perception of an individual’s own skills and versatility to acquire and keep a job. In total, 53 German-speaking individuals on the autism spectrum participated in an online survey. Findings Results showed statistically significant coherences between both, formality and social barriers with discrimination. Formality barriers also indicated statistically significant coherences with self-perceived employability. A mediation model with discrimination as mediator between each category of barriers and self-perceived employability was examined. The non-significant results suggest that discrimination does not work as a superior construct but as a sole influence next to barriers and self-perceived employability. Originality/value Individuals on the autism spectrum epitomize a less common research approach. Moreover, diversity policies and practices in the workplace often do not focus on including individuals on the autism spectrum even though the employment rates for this specific group of potential highly qualified employees were re

Purpose This research aims to examine effective support strategies for facilitating employment of autistic students and graduates by answering the following research question: What constitutes effective employment support for autistic students and graduates? Design/methodology/approach Data were collected using the method of empathy-based stories (MEBS) as part of a multinational European project’s Web-based survey. The data consisted of 55 writings about effective strategies and 55 writings about strategies to avoid when working with autistic students and graduates. The material was analysed using qualitative inductive content analysis. Narratives were created to illustrate desirable and undesirable environments and processes as they would be experienced by students, supported by original excerpts from the stories. Findings Analysis revealed that effective employment support for autistic students and graduates comprised three dimensions of support activity: Practices based on the form and environment of support, social interaction support, and autism acceptance and awareness. These dimensions were present in both recommended and not recommended support strategy writings. Originality/value The results add to the literature on autism and employment with its focus on the novel context of autistic university students and graduates. Effective strategies will be based on personcentred planning, to include not only the individual impact of autism, but individual career goals, workplace characteristics in the chosen field, employer needs, and allocation of the right support. There is no one-size-fits-all strategy, but rather an individualised process is needed, focused on identification of strengths, adaptation of employment and work processes, and improved understanding and acceptance of autism by management, colleagues and administration in the workplace.

Although an unprecedented number of autistic students are entering higher education, research focusing on their sense of belonging is scarce. Autistic students’ sense of belonging can be jeopardized due to the students’ encounters with a network of social expectations, activities, responses and biased attitudes. Using a participatory approach, our objective was to examine autistic university students’ perceptions about their sense of belonging whilst at university. The study involved semi-structured interviews with 12 autistic university students and graduates from the Netherlands. Data were analysed using theory-guided content analysis and elaborative coding approaches. Findings indicate that autistic students’ sense of belonging is multi-dimensional, fluid, and located within affective, spatial, temporal, social and political contexts. Our findings offer a novel and theoretically robust framework to conceptualise and further understand the sense of belonging. Important practical implications are also given.

Despite the steps taken to improve support in universities, many students and graduates with autism face a substantial employment gap when completing university as compared to any other student group with disabilities. The literature shows that often students with autism do not have appropriate support to prepare them for entering the workforce. Therefore, it is imperative that this under-researched topic be studied. Utilising a participatory approach, in this article, we sought to investigate perceptions of students and graduates with autism about the employment support they received when preparing for university-to-work transition. The study involved semi-structured interviews with 30 university students and graduates with autism from Finland, France, the Netherlands, and the UK. Data were analysed using an inductive content analysis approach. Findings indicate that organizational enablers consisting of career focused support and internships and practicums facilitated preparation for employment. Supportive and caring relationships emerged as forms of support that included mentors, committed and caring academics, and family members. Further, the findings indicated the aspiration for individualisation that consists of improving work and academic support, and awareness and understanding. These findings have also important practical implications.

In this exploratory case study based on qualitative research, we explore the perspectives and experiences of autistic self-advocates in the Netherlands regarding autism, (self-)advocacy, and consumer-run organizations. The focus of our study is a consumer-run organization by and for adult Persons on the Autism Spectrum in the Netherlands: PAS-Nederland or PAS for short. Our analysis reveals four themes relevant to the acceptance and integration of adults with autism into society and work: (1) invisibility of autistic adults; (2) diversity of the autism spectrum; (3) autistic leadership; and (4) collaboration between people with and without autism. We discuss the practical implications of our findings for the inclusion of people with autism in work and society. Our study underscores the importance of putting autistic people at the center of decision-making processes and solutions aimed at improving their outcomes in society, in general, and in the workplace specifically.