Stigma, Stereotypes, and Self-Disclosure: Disability and Empowerment in Older Adults on the Autism Spectrum.

Older adults on the autism spectrum exhibit a broad array of strengths and limitations. While exceptional abilities may be masked by difficulties in presentation and communication, hidden disabilities can lead to unmet needs for accommodation and support. Critical to the recognition of disabilities is subjects' readiness to disclose potentially stigmatizing conditions or concerns-weighing the benefits of self-disclosure (e.g., for effective medical care) versus risks (exposure of weaknesses or vulnerabilities). Strategic self-disclosure, based on reading of immediate social contexts, can be problematic for autistic persons who have difficulty processing social cues demarcating situationally appropriate boundaries. Disclosure of autism by older patients in clinical settings can lead to troubled interactions that reinforce stereotypes of aging conflated with disability and educe implicit biases regarding older patients and autistic persons. Future gerontological research and policy initiatives should be designed to empower older autistic adults (and others with lived experience of disability and marginalization) by including them as expert partners in the quest for needed societal change-challenging ableist assumptions embedded in traditional definitions of successful aging, promoting an open awareness context that normalizes the occurrence of disability, and fostering expectations of interdependence (as opposed to helpless dependency or complete independence).