Assessing Outcomes of Three Different Museum-based Social Prescription Programs in Autistic Adults

Autism, Autism Spectrum Disorder (ASD, Autistic Spectrum Disorder (ASD)

Autism spectrum disorder, ASD, autism, psychosocial intervention, social participation, community-based intervention, cultural participation, autistic adults, social prescribing, museum-based intervention

This study will examine whether visiting the National Taiwan Museum can support the social and emotional well-being of autistic adults. The research team plans to recruit 90 autistic adults aged 18 to 50 from the Department of Psychiatry at National Taiwan University Hospital. Participants must have average-range intellectual ability and be able and willing to complete the study activities and assessments. People with serious physical or mental health conditions that would prevent full participation will not be included. Participants must also agree to audio and video recording during the activities. After an outpatient doctor confirms eligibility, participants will complete questionnaires and choose one of three museum participation options: 1. Visit the museum once independently. 2. Join five guided museum visits with group discussions. 3. Invite a friend to visit the museum together. Each group will include about 30 participants. For the guided group, each session will last about 90 minutes and include a professional museum tour, a question-and-answer period, time for independent exploration, and a group discussion. Participants will be encouraged to select exhibits that interest them, record their observations, share their thoughts, listen to others, and respond to different viewpoints. The five planned museum themes include Taiwan's history and identity, relationships between people and nature, architecture and living spaces, human evolution and the future, and attitudes toward money and financial planning. The discussions will explore everyday topics such as stereotypes, personal values, preferred living environments, hopes for the future, and managing money. Participants will complete questionnaires before and after the program. These questionnaires will assess areas such as autistic characteristics, social communication, empathy, sensory experiences, comfort with social touch, emotional skills, loneliness, anxiety, depression, and anxiety during social interaction. Participants will also rate how enjoyable, comfortable, safe, interesting, and socially engaging they found the museum activities. The researchers will compare participants' results before and after the program. They will also compare the three participation options to determine whether independent visits, guided group activities, or visiting with a friend produce different outcomes. The overall goal is to understand whether museum-based activities can be used as a form of social prescribing to improve social participation, emotional well-being, confidence, and quality of life among autistic adults.

This study will evaluate a museum-based social prescribing program for autistic adults with average-range intellectual functioning. Social prescribing is a person-centered approach that connects individuals with nonmedical community resources to support health, well-being, and social participation. Although social prescribing has been applied to people with chronic medical and psychiatric conditions, its effectiveness for autistic adults has not been well established. This study is being conducted through collaboration between the Department of Psychiatry at National Taiwan University Hospital and the National Taiwan Museum. Approximately 90 autistic adults will be recruited through the outpatient services of National Taiwan University Hospital. After clinical referral and completion of baseline assessments, participants will select one of three museum participation programs, with a target enrollment of approximately 30 participants per group. Because participants choose their preferred program, assignment is nonrandomized. The three programs are: 1. \*\*Independent Museum Visit:\*\* Participants will visit the National Taiwan Museum once at a time of their choosing. 2. \*\*Guided Museum Program:\*\* Participants will attend five structured group sessions, with approximately 10-15 participants per group. Each session will last approximately 90 minutes and will include a museum-guided introduction, a question-and-answer period, independent exploration of selected exhibits, and a facilitated group discussion. 3. \*\*Museum Visit With a Friend:\*\* Participants will invite a friend or companion to visit the museum with them. The guided program will use permanent museum exhibitions as prompts for social interaction, reflection, and discussion. Proposed themes include stereotypes and personal identity, relationships between people and nature, ideals and realities of living environments, human evolution and the future, and personal attitudes toward money and financial planning. During the discussion period, participants will share observations or photographs from the exhibits, listen to other participants, provide feedback, and express their own perspectives. Quantitative assessments will be administered before participation and, for selected measures, after completion of the assigned museum program. Baseline assessments will characterize autism-related traits, social responsiveness, sensory processing, sensory sensitivity, attitudes toward social touch, emotional functioning, loneliness, anxiety, depression, and social interaction anxiety. Post-program assessments will focus on changes in emotional functioning, loneliness, anxiety, depression, and social interaction anxiety, as well as satisfaction with the museum experience. Participants who complete their selected program may also be invited to take part in a focus group lasting approximately 30-60 minutes. The discussion will explore perceived benefits, difficulties, satisfaction, and recommendations for improving the program. Focus groups will be audio- and video-recorded and transcribed for qualitative analysis. Quantitative analyses will examine within-participant changes in emotional intelligence, loneliness, anxiety, depression, and social interaction anxiety. Differences among the three participation programs will also be evaluated, including differences in activity satisfaction and changes from baseline. Exploratory analyses will examine whether baseline autism-related, social, and sensory characteristics are associated with program response. Qualitative data will be summarized thematically to identify perceived benefits and areas requiring improvement. All research records will be identified by study code rather than participant name. Paper records will be stored in locked cabinets, and electronic files, including audio and video recordings, will be stored on password-protected computers. Study data will be retained for 20 years and then destroyed according to institutional procedures.

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Taiwan