The prevalence of autistic traits in a homeless population.
One in eight long-term homeless adults may meet autism criteria—screen for autistic traits when you see social isolation without substance use.
01Research in Context
What this study did
Workers at homeless agencies answered a short checklist about long-term homeless adults.
They used DSM-5 autism items, not a full test.
The goal was to see how many might have undiagnosed autism.
What they found
One in eight adults met the autism cutoff.
Another one in twelve showed some traits but fell just below the line.
Most of these people had never been diagnosed.
How this fits with other research
Andrews et al. (2024) asked the same questions on a teen psych unit and got a sky-high rate of 50%.
The numbers look opposite, but both point to the same idea: when people are on the edge of society, autism is easy to miss.
Deserno et al. (2017) and Ferron et al. (2023) add that high traits bring suicide risk and anxiety; shelters should watch for both.
Why it matters
If a client keeps to themselves, avoids eye contact, and follows strict routines, think autism before you label it "resistance."
A quick screen can guide you to quieter rooms, clear instructions, and referrals for full assessment.
Small changes lower stress for the client and make your job easier.
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02At a glance
03Original abstract
Anecdotal evidence suggests that autistic people experience an elevated risk of homelessness, but systematic empirical research on this topic is lacking. As a step towards filling this gap in knowledge, we conducted a preliminary investigation of the prevalence of Diagnostic and Statistical Manual of Mental Disorders (5th ed.) autism symptoms in a group of long-term homeless people. The entire caseload ( N = 106) of a UK homeless outreach team was screened (excluding individuals born outside of the United Kingdom or Republic of Ireland) using an in-depth, semi-structured interview with keyworkers, based on Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic criteria. This showed adequate inter-rater reliability, as well as evidence of criterion and construct validity. Of the sample, 13 people (12.3%, 95% confidence interval (7.0, 20.4)) screened positive, meeting Diagnostic and Statistical Manual of Mental Disorders (5th ed.) autism criteria by keyworker report. A further nine people (8.5%, 95% confidence interval (4.5, 15.3)) were 'marginal', having autistic traits that were not quite sufficient to meet Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Those with elevated autistic traits, compared to those without, tended to be more socially isolated and less likely to use substances. This study has provided initial evidence that autistic traits are over-represented among homeless people and that autistic homeless people may show a distinct pattern of characteristics and needs. Further investigation is required to build upon these provisional findings.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361318768484