Assessment & Research

Defining autistic burnout through experts by lived experience: Grounded Delphi method investigating #AutisticBurnout.

Higgins et al. (2021) · Autism : the international journal of research and practice 2021
★ The Verdict

Autistic burnout is now defined as a distinct syndrome of exhaustion and skill loss triggered by masking and unaccommodating environments, not depression.

✓ Read this if BCBAs working with autistic teens or adults in clinic, school, or home settings
✗ Skip if Practitioners serving only non-autistic clients or very young children

01Research in Context

01

What this study did

A team of autistic adults and researchers ran three rounds of online surveys. They asked 23 autistic experts to describe burnout in their own words.

The group kept refining the list until everyone agreed. This Delphi method let the community itself define the problem.

02

What they found

The final definition lists five parts: deep exhaustion, pulling away from people, foggy thinking, loss of daily skills, and stronger autistic traits.

The panel said masking and un-supportive settings trigger the crash. They stressed it is not the same as depression.

03

How this fits with other research

Arnold et al. (2023) surveyed 141 autistic adults and found wide agreement with this new definition. Episode length still varies a lot, but the core picture holds.

Mantzalas et al. (2024) turned the definition into a 27-item screening tool. Their data show the Autistic Burnout Measure is ready for clinic use.

Schoondermark et al. (2025) tested a Dutch version in women only and set a 62-point cut-off. This extends the same idea to a specific subgroup.

04

Why it matters

You now have a community-made checklist to spot autistic burnout. Look for sudden skill loss plus exhaustion after long masking. Rule out depression first, then lower demands and boost supports instead of pushing more goals. Track episodes with the new ABM to see if plans are working.

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Add the 27-item ABM to your intake packet and score it before writing any self-care goals.

02At a glance

Intervention
not applicable
Design
methodology paper
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Autistic burnout has been commonly described in social media by autistic people. There is little mention of autistic burnout in the academic literature. Only one recent study has used interviews and reviews of social media descriptions to try to understand autistic burnout. Anecdotally, autistic burnout is a very debilitating condition that reduced people's daily living skills and can lead to suicide attempts. It is suggested that autistic burnout is caused by the stress of masking and living in an unaccommodating neurotypical world. We wanted to create a definition of autistic burnout that could be used by clinicians and the autism community. We used the Grounded Delphi method, which allowed autistic voice to lead the study. Autistic adults who had experienced autistic burnout were considered as experts on the topic, in the co-production of this definition. The definition describes autistic burnout as a condition involving exhaustion, withdrawal, problems with thinking, reduced daily living skills and increases in the manifestation of autistic traits. It is important for future research that there is a specific description of the condition. In practice, it is important for clinicians to be aware that autistic burnout is different from depression. Psychological treatments for depression potentially could make autistic burnout worse. Further awareness of autistic burnout is needed, as well as further research to prove this condition is separate from depression, chronic fatigue and non-autistic burnout.

Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211019858