In 2021, one in every 127 people were estimated to be on the autism spectrum globally (Santomauro et al., 2021). The number of autistic students at university increasing both in the UK and Europe (Gormley et al, 2024, HESA, 2024) though the number is likely to be higher than official figures because not all choose to disclose (Hull et al., 2017) or have been diagnosed (Doherty et al, 2023). Speech and language are central teaching and learning tools, as they are the means through which teachers instruct, support, and assess students. This has implications for autistic students since they are likely to experience challenges with social communication and interaction (APA 2022).

Our actual and perceived ability to communicate ‘effectively’ (including understanding verbal and non-verbal communication) is influenced by our intersectional experiences, cultural differences and other factors including neurotype. Awareness and adaptation of one’s own communication skills is a key part of practice education including speech and language therapy (SaLT) (Dantuma, 2021). For autistic SaLT students, the core interactional differences between autistic and neurotypical people can pose both challenges and opportunities for those practicing in a majority neurotypical society. However, SaLT, whose aim is to maximise an individual’s communication potential, has been traditionally and historically rooted in a conventional medical paradigm (Pellicano and Houting, 2022).

Practice-based learning is central to professional training and placement experiences affect students’ intention to persist with their studies and employment plans after graduation (Pesonen et al, 2021). Autistic students face significant and unique barriers in both academic and practice-based learning. The social model of disability attributes these barriers to environmental and cultural factors (Rieser, 2023). However, although listening to neurodivergent perspectives can progress equity and deconstruct ableism, research that explores the views, priorities and experiences autistic students have of their interactions within these social and physical environments (i.e. education and employment; Gormely, 2024) is still emerging.

Given this context, we were interested to explore the experience and perceptions of practice-based learning from the perspective of students and recently qualified autistic SaLTs, and their placement educators (some of whom will themselves be autistic). We posed the following research questions:

1. What challenges and support do autistic SaLT students experience during practice-based learning?

2. How much do autistic SaLT students perceive that these practice-based learning experiences contribute to their motivation and identity?

3. What suggestions for support and reasonable adjustments do autistic SaLT students identify during practice-based learning?

By posing the above questions, we set out to address the following objectives:

• To identify effective ways to support placement educators in meeting the needs of this group of students;

• To produce recommendations and resources to support the practice-based education of autistic SaLTs;

• To share the information gained to enable the above to be carried forward into/inform Higher Education Institutes (HEIs) and future workplaces.

Taking a neurodiverse affirming approach, the research adopts a critical realist paradigm (Bhaskar, 1975) to examine lived realities and the internal and external factors that contribute to these.Tension between neurotypical standards deemed ‘professional’ and neurodivergent ways of being are likely to impact engagement and identity and are therefore interrogated by applying the social determination theory of motivation (Deci and Ryan, 2000). Examining autistic SaLT students and practitioners and their placement educators’ experiences of competence, relatedness and autonomy - including how they shape their motivation and identity -has relevance across HEI disciplines, particularly practice-based disciplines like SaLT given the fact that communication underpins teaching, learning and assessment in all fields of education.

This research sought to discover which aspects of practice-based learning are most important from the perspective of autistic SaLT students, practitioners, and their placement educators. Seven autistic level 6 SaLT students, six autistic SaLTs, four autistic SaLT placement educators and five non-autistic placement educators who have supported an autistic SaLT student were recruited opportunistically in Autumn 2024. Recruitment involved emailing and circulating adverts to all HEIs in the UK offering SaLT as an undergraduate route; the RCSLT neurodivergent SaLTs’s and disabled working group; a regional placement educator’s group; and via social media contacts and groups. An exploratory sequential mixed-methods research design (Creswell & Creswell, 2023) was created to investigate the observable and underlying factors involved in the practice-based learning experiences of autistic SLT students. University ethical approval was obtained prior to data collection and responses were recorded anonymously and stored securely and confidentially on encrypted password protected university laptops. Phase one involved an online questionnaire created to explore themes present in the literature and was administered during November-December 2024. This captured both numerical data (e.g. when diagnosed) and descriptive qualitative data from twenty-two participants. Numerical data was analysed using descriptive statistics and descriptive qualitative data was analysed by research assistants trained on inductive reflexive thematic analysis (Joy et al., 2023). Eleven participants took part in phase two, when online semi-structured interviews were conducted in January-February 2025 to probe and further explore the themes identified in phase one using thematic analysis. Finally, six participants took part in the phase 3 focus group interviews to confirm and gain insight into their experience of the identified themes. The focus groups were moderated by the two main research investigators, with two new research assistant being in attendance, who transcribed and analysed the data using a thematic/inductive analytical approach The research team discussed the content, meaning, definitions and conceptual links of the themes generated. This reflexive approach was particularly important given the unique experiences of the research team, all of whom were aware of autism and the range of disability models within education and psychology that contributed to their consideration of themes related to support, diagnosis, identity and belonging (Joy et al., 2023).

Phase one data identified 40% of practicing SLTs who are autistic and 57% of current autistic final year students received their diagnosis after starting their SLT post or studies, and that experience during their practice-based learning or the placement educators supporting this were a catalyst in pursuing this. Phase two findings identified further information around seeking a diagnosis and emotional wellbeing and regulation, and detail about shared understandings (or not), honesty, openness and transparency, and strengths versus prejudicial deficits. Phase three data analysis is currently in the final stages, and includes detail around: • belonging (when safety is/is not present, so when masking is intentional, when true identities are shared or suppressed, and the reality of liminal disability); • competence (purpose and intrinsic motivation versus academic challenges or misinterpretations and ableist barriers which vary depending on placement educator perspectives) and; • autonomy (strategies and adjustments that support and progress success and how the intuition and insight of autistic SaLTs progress their support of clients with speech, language, and communication (SLC) needs). We are already sharing findings in our own university, both with students and placement educators, and are presenting at the National Association of Educators in Practice (UK) in March. Our ECER poster will visually present our findings and so be accessible to those with diverse learning approaches. It will summarise our discussion, the European Speech and Language Therapy Association’s priority of raising awareness of the importance of SLC skills, which impact to lives of million, among policymakers, healthcare providers, and the general public. In line with the Strategy for the rights of persons with disabilities 2021-2030 (European Commission, 2021), the research will contribute to the removal of barriers to learning by enabling access to quality practice education, with implications for equality of opportunity, identity formation, employment possibilities, career trajectory and advocacy.

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