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Abstract
This meta-analytic and theoretical review synthesizes research on neurodiversity-affirmative
therapy (NAT) for adults with Autism Spectrum Disorder (ASD) published between 2015 and
2025. Whereas traditional interventions emphasized symptom reduction and behavioral
normalization, NAT reframes autism as a form of human cognitive diversity rather than
deficit. Drawing on 83 empirical studies (k = 274 effects; N = 9,812), this review
quantitatively and qualitatively assesses four primary outcome domains: (1) Identity and Self-
Understanding, (2) Emotional Regulation and Coping, (3) Social Inclusion and
Empowerment, and (4) Educational and Workplace Adaptation. Random-effects models
yielded a small-to-medium overall effect (d = 0.34, 95% CI [0.22, 0.46]) favoring affirmative
over deficit-based approaches. Identity acceptance and psychological well-being showed the
largest effects (d = 0.42 and 0.39 respectively). Cultural moderation analyses suggest stronger
effects in collectivist contexts and for autistic-led or co-produced programs. Findings
underscore that affirming neurocognitive identity and ensuring environmental fit improve
mental health, social participation, and employment outcomes. This study advances inclusive
psychology by bridging humanistic and empirical traditions and advocates for rights-based
clinical and educational frameworks.
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