Investigation into Stress Triggers in Autistic Adults for the Development of Technological Self-Interventions
John Joseph McGowan, Iain Peter McGregor · 2023 · Proceedings of the 25th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2023) · doi:10.1145/3597638.3608392
Summary
This paper presents findings from a large-scale online survey of over 200 autistic adults and caregivers, investigating common stress triggers and the role of technology in stress management. The research is the initial phase of a broader project aimed at developing a Stress Management Augmented Reality Tool (SMART) — an application that could monitor real-time biometric data and employ audio-visual entrainment to help autistic users manage stress. The survey collected data across five thematic areas: current uses of technology (474 coded instances), stress triggers (367 instances), sensitivity and perception (245 instances), needs of caregivers (104 instances), and potential for new technology (44 instances). Participants were 76% formally diagnosed autistic adults and 23% caregivers, spanning eleven countries with the majority (85%) in Europe. Ages ranged from 18 to 70 with a mean of 44. The survey covered stress levels across multiple locations (home, office, university, public spaces), sensory sensitivities across six modalities (light, sound, touch, smell, taste, pain), current technology usage and coping strategies, and attitudes toward emerging technologies like VR and AR. Both caregiver and autistic participant perspectives were gathered, providing a comprehensive picture of stress experiences and technological needs.
Key findings
Sound and light were confirmed as the two primary sensory stress triggers for autistic adults. For sound, people shouting (88%), crowds (83%), people eating (58%), and repetitive sounds (58%) were the most distressing. When categorized by source, human-generated sounds caused the most sensitivity (56% mean), followed by technological sounds (45%), and nature sounds (20%). For light, fluorescent strip lighting was the most aversive (45% rated it negatively), while natural daylight, sunrise, and sunset were preferred. Large public events were the most stressful location (mean 4.3/5), while home (2.3) and private car (2.3) were calmest. Unfamiliar people (89%), unfamiliar surroundings (83%), and unwanted touch (84%) were the top overall stress factors. Current coping strategies centered on distraction — 76% used listening to music, 65% watched videos/movies, 63% stimmed, and 58% used fitness routines. Technology-wise, 94% used smartphones and 53% used noise-cancelling headphones. For future technologies, smartphones (78%) and headphones (72%) remained the top choices, but 38% expressed interest in augmented reality and 33% in VR headsets. Over half (53%) rated VR positively and 53% rated AR positively as potential stress management tools.
Relevance
This study provides critical empirical data for designing sensory-aware assistive technologies for autistic adults. The detailed breakdown of stress triggers by sensory modality, source type, and location gives practitioners and developers specific parameters to address. The finding that smartphones and headphones are already the primary coping technologies — and that autistic adults want these same devices enhanced rather than replaced — provides a clear design direction: build stress management features into familiar, portable devices rather than introducing new form factors. The interest in AR (38%) and VR (33%) suggests emerging opportunities, particularly for rehearsing stressful scenarios in controlled environments. The research also validates the importance of multi-sensory approaches to stress management, as autistic individuals experience triggers across all sensory modalities simultaneously. For organizations, the location-based stress data (offices, universities, and public events being highly stressful) reinforces the need for sensory-friendly workplace and public space design. The caregivers' perspective adds another dimension, highlighting that stress indicators like wanting to leave (89%), emotional withdrawal (84%), and avoiding eye contact (73%) are observable signs that could potentially be detected by wearable biosensors.
Tags: autism · stress management · sensory processing · assistive technology · virtual reality · augmented reality · noise sensitivity · wearable technology · self-regulation