When the environment causes harm: adverse experiences in autistic adults and adults with ADHD

Adversity is not limited to extreme events

Adverse experiences include serious events such as abuse, but harm can also accumulate through repeated situations: being punished for behaviour that nobody has understood, losing jobs because agreed adjustments were not provided, receiving no help with financial problems or being excluded over many years.

The study was published in Scientific Reports on 20 July 2026. It included 123 people aged 18 to 72 who lived in the United Kingdom or the United States. Twenty-one were autistic, 27 had ADHD and 75 had both conditions.

The researchers used thematic analysis to examine the responses. They were not trying to calculate how many autistic people or people with ADHD experience each form of adversity. Their aim was to identify the situations participants described, the factors involved and the outcomes they associated with them.

The experiences were grouped into two categories:

• Marginalisation: job insecurity, financial instability and neglect.
• Mistreatment: bullying, abuse and social exclusion.

This classification shows that adversity does not always arise from one event. Some participants described years of difficulty keeping a job, paying expenses, receiving care or taking part in the same settings as other people.

Four areas associated with adversity

The analysis identified four groups of factors: cognitive, social, emotional and sensory.

Difficulties maintaining attention, organising tasks or managing money appeared in many accounts. Some participants said that relatives, teachers or colleagues considered them lazy or irresponsible. Others associated these difficulties with losing a job, getting into debt or being unable to complete an application for financial support.

Differences in communication and the interpretation of social cues were involved in other situations. Some people did not recognise another person’s intentions, were deceived or were mocked for speaking and relating to others differently. Masking did not necessarily prevent bullying.

Several participants described intense emotional reactions that their families or teachers did not understand. Some were physically punished, insulted or rejected during a meltdown. Responsibility for those acts lies with the people who carried them out, not with the person who was overwhelmed.

Noise, bright lights, physical contact and movement in busy places caused sensory overload for some participants. When other people ignored those needs, some were left isolated or neglected, or were pushed out of school and work.

The study records associations reported by participants. It does not show that a particular characteristic caused a later adverse experience. It does show that misunderstanding, missing adjustments and other people’s responses appeared repeatedly in the accounts.

The reported outcomes

46% of participants described a decline in their mental health. They associated bullying, abuse, exclusion, debt and job loss with anxiety, depression, self-harm or suicidal thoughts.

20% described physical health problems. The study design cannot establish that a specific experience directly caused those problems, but participants associated them with the accumulation of adversity.

Some people identified strengths that they associated with what they had experienced. Resilience and empathy were the most common. Participants also mentioned creativity, independence and problem-solving.

Other people said that adversity had given them no strengths. Suffering should therefore not be presented as an opportunity for growth. An ability developed after harm does not make the harm necessary or beneficial.

What can be changed

The authors identify several areas for adjustment: supporting social relationships, providing help with attention and organisation, responding to intense emotional reactions without punishment and reducing sensory overload.

Schools and workplaces can turn these areas into specific measures:

• Provide clear written instructions.
• Offer spaces with less noise, light or movement.
• Set up accessible ways to ask for help or report a problem.
• Provide the adjustments that have been agreed.
• Investigate bullying without blaming the person experiencing it.
• Avoid automatically treating disorganisation or inattention as laziness.
• Take an account seriously even when the person needs more time to explain it.

Sudden withdrawal, persistent refusal to return to a place or much greater exhaustion than usual are reasons to ask what has happened. These signs have many possible causes and do not prove that mistreatment is occurring.

Prevention requires action towards people who exclude, bully or ignore someone’s needs. Teaching a person to conceal their difficulties more successfully does not prevent other people from abusing them.

What the study still cannot tell us

This was a qualitative study based on a self-selecting sample. It cannot calculate how common these experiences are across the wider population or compare them with the experiences of people who are not autistic and do not have ADHD.

In addition, 75 of the 123 participants were autistic and had ADHD. The findings cannot show which experiences apply specifically to autism, ADHD or the combination of both.

The study also cannot demonstrate that adversity directly caused the reported health problems or strengths. It records how participants themselves associated events across their lives.

The journal has published an early version of the manuscript. It must still go through final editing and may be corrected.