Social Support, Well-being, and Quality of Life Among Individuals on the Autism Spectrum
interaction between nature and nurture, yet the diagnosis of autism spectrum disorder is used to
classify neurodevelopmental disability mainly on the basis of individual-level social dysfunction.
Self-advocates have organized the neurodiversity movement to reclaim autism as a part of identity
(eg, using identity-first language such as “autistic person,” as in the case of the author, rather
than person-first language such as “person with autism”6,7) and support civil rights. We argue
that social environments contribute substantially to disability and seek quality of life, defined in
terms of “objective” factors of adaptive functioning, such as independent living and employment,
as well as in terms of subjective well-being, which requires self-determination to play as active
a role as possible in making decisions to have the experiences one wants. Yet we argue against
normalization and “cure,” in part because many autistic traits can function in neutral or positive
ways, although other people may misunderstand or stigmatize atypical behaviors.8–10 Indeed, the
following narrative review developed from empirical evidence replicated by independent research
teams argues against a linear relationship between autism symptoms and impaired functioning,
across developmental periods and in multiple domains of both “objective” quality of life and
in subjective well-being. In the following syntheses, I suggest that effective social support and
subjective well-being mediate whether autistic people achieve a high quality of life.