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Spoon theory and energy

Spoon theory and the other energy metaphors autistic people use to explain what an ordinary day costs. Where they came from, why they resonate, what research shows about fatigue, and how little the models themselves have been tested.

Spoon theory and other ways autistic people explain how much energy a normal day takes. Where the ideas came from, why people like them, what scientists know about tiredness, and how little the ideas have been tested.

Last reviewed 12 October 2026 · one person's reading of the research · 28 research and 18 community sources

What people mean Community

In community writing, a spoon is a unit of energy, and a person starts each day with a limited number. Every task costs at least one, including tasks other people do without thinking, such as getting up, showering and getting dressed. In the essay that began it, "when your 'spoons' are gone, they are gone", and borrowing against tomorrow's spoons makes tomorrow harder.c1

Autistic writers use spoons alongside a battery. Megan Anna Neff, an autistic psychologist, describes an "internal battery" that "is always being used, and so it depletes faster than those of your neurotypical peers".c5 She also writes that many autistic people have "a much smaller social battery than the average person", and she budgets "social spoons", which she defines as "energy units that represent my capacity for social interaction".c6 Energy accounting, a method from the autistic psychologist Maja Toudal and Tony Attwood, keeps a running balance instead. It asks people to imagine "an energy bank account" with "withdrawals or deposits of energy" through the day: socializing or a change in routine on one side, solitude, a special interest or sleep on the other.c4

Luke Beardon pairs spoons with "burning matches", an image he borrows from triathlon racing. A racer starts with a set number of matches and burns them steadily, and faster on hard stretches such as cycling uphill; a racer who burns them all before the finish line never finishes.c10 Beardon also describes going below zero. Spending spoons you no longer have means "creating spoons out of nothing", which in his account leads to burnout and "negative energy levels".c10 In a later book he divides energy into nine types, among them social energy and communication energy, so that a person may have "endless physical energy" and still be low on social energy.c11

All of these are metaphors. None measures energy, and no spoon, match or unit in an energy account has a fixed size. They are ways to explain and plan; whether they describe how energy actually works has not been tested (see "Testing the models").

A related term from community writing is dynamic disability. Neff, in a 2026 visual guide, describes a dynamic disability as one "where symptoms and needs shift, and with them capacity and ability fluctuate", so what a person can do on a given day is not fixed.c18 Her examples include chronic pain, a cane needed only at some times, brain fog, energy that falls, and executive function that comes and goes. It carries the same idea as spoon theory and energy accounting, that capacity changes from day to day, and differs in scope: those count out a day's energy, while dynamic disability also covers pain, mobility and thinking that vary. It is community vocabulary rather than a research finding, and no autism study of it was found as of October 2026. The guide does not say where the term came from.

In spoon theory, a spoon stands for a bit of energy. You start each day with only so many spoons. Every task uses at least one, even small ones like getting up or getting dressed.c1 When the spoons are gone, they are gone. You can borrow from tomorrow, but then tomorrow is harder.c1

Autistic writers also talk about a battery. Megan Anna Neff is an autistic psychologist. She says an autistic person's battery is always being used, so it runs down faster.c5 She says many autistic people have a smaller "social battery", the energy for being with people.c6 She calls her energy for people her "social spoons".c6

Energy accounting is another idea. It was made by the autistic psychologist Maja Toudal and Tony Attwood. You picture energy as a bank account.c4 Some things take energy out, like socializing or a change in plans. Other things put energy back, like time alone, a favorite interest or sleep.c4

Luke Beardon also uses "burning matches". The idea comes from long races. A racer starts with a set number of matches. Hard parts of the race, like riding uphill, burn them faster.c10 Beardon says that using spoons you do not have leads to burnout.c10 He also splits energy into kinds, like social energy and energy for talking.c11

All of these are comparisons, not measurements. A spoon has no set size. No one has tested whether energy really works this way.

A related word from community writing is dynamic disability. Megan Anna Neff, an autistic psychologist, wrote a guide about it in 2026. She says that with a dynamic disability, symptoms and needs change, and so does what a person can do.c18 She gives examples. These include pain, a cane she needs only sometimes, brain fog and low energy. Her thinking changes from day to day too. It carries the same idea as spoon theory and energy accounting: a person's capacity changes from day to day. It is not the same, though. Those count the energy a person has in one day. Dynamic disability also covers pain, moving and thinking that change. It is a community word, not a science finding. No study of it in autistic people was found as of October 2026. The guide does not say who came up with the word.

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Community

How the essay that started it and autistic writers describe these ideas. This reports usage; the research is in later sections.

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Community

This part tells you how people use these words. It is not a science finding.

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Where it came from Established

Spoon theory comes from an essay by Christine Miserandino, who has lupus. Late one night in a diner, her best friend, who had been her college roommate, asked what it felt like to have lupus and be sick. Miserandino gathered spoons from the tables and handed them over; her friend counted 12. As the friend listed her day, Miserandino took a spoon for each task, and by the time the friend had, in theory, got ready for work, 6 were left. She chose spoons so that her friend had "something for her to actually hold, for me to then take away", to show what it is like when an illness is in control. She ended by keeping "an extra spoon in my pocket, in reserve."c1

The essay carries the line "© 2003 by Christine Miserandino". The earliest copy found on her website, butyoudontlooksick.com, is dated 18 November 2004.c1 She wrote that her family and friends used spoons as "a code word for what I can and cannot do", and that the idea "isn't just good for understanding Lupus, but anyone dealing with any disability or illness."c1 The essay does not mention autism. By 2021 a study of autistic inertia explained "spoons" to its readers as "a well-known analogy for fatigue and limited resources", citing the 2003 essay.5

Energy accounting reached print later. Its authors describe it as "created by autistic psychologist Maja Toudal and developed with Dr. Tony Attwood", and say it was used clinically "for over 10 years" before their book.c3 The first formal publication found for this entry is that book, published by Jessica Kingsley in December 2024.c2 In the sources searched for this entry, no one is named as the first to use the phrase "social battery"; in research it turns up as participants' own words.

Christine Miserandino has lupus, an illness that can make people very tired and sore. One night in a diner, her best friend asked what being sick felt like.c1 Miserandino grabbed spoons from the tables and handed them over. Her friend counted 12.c1 Miserandino took a spoon away for each task in her friend's day. Before her friend even got to work, only 6 were left.c1

The essay is marked 2003. The oldest copy online is from November 2004.c1 Miserandino said the idea could help anyone with an illness or disability.c1 The essay does not talk about autism. By 2021, a study about autistic people called spoon theory "well-known".5

Energy accounting came later. Its makers say they used it with clients for over 10 years.c3 Their book came out in 2024.c2 No one knows who first said "social battery".

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Established

The origin rests on a dated publication, the essay itself, read in its earliest archived copy. The history of energy accounting comes from its authors and publisher.

Established

We know where spoon theory comes from. It is in a dated essay, and we read the oldest copy we could find.

Why it resonates Community

Writers use these images to explain a cost that other people cannot see. Neff writes that for autistic people "it’s as if your nervous system exists on the outside of your body, fully absorbing every single sensory input, social interaction, and piece of information", and that masking "can drain your battery even faster".c5 Devon Price writes that "Sensory overload, social overwhelm, and the pressures of masking all significantly drain our batteries." Price adds that many autistic people can do a great deal of work in "a single hyperfocused burst", then need "much more rest and recovery".c7 Sol Smith quotes a client, River, who goes out with people only with "a lot of warning", and when "my social battery has to be high".c8 In Megan Griffith's survey of autistic and ADHD adults, one respondent wrote that others "don’t see all the time and energy that went into just showing up here today."c9

Orion Kelly describes what a single task costs. Writing about his own autistic burnout, Kelly says "a shower to me means 22 tasks that I don’t have the energy for."c13

Several writers say the cost arrives late. Daniel Burford writes that "A busy Tuesday can cost you Thursday", and describes losing speech for a few days after one such day.c12 Pat G., one of the autistic adults quoted in a clinicians' guide by Donna Henderson, Sarah Wayland and Jamell White, can manage a party for 30 to 45 minutes and seem fine: "What people don’t recognize is that afterwards, I’m going to collapse for a day and a half and hide."c15 Beardon makes the same point with a day of university lectures, after which a student needs three days to recover, a recovery that "goes unnoticed by everyone else".c10

The images also give permission to say no. Neff uses her social spoons to turn down invitations "without guilt" and to spend her energy on the events she values.c6 Miserandino hoped her friend would complain less when she could not go out to dinner.c1 What drains the battery, in these writers' accounts, is covered in Autistic burnout and Masking.

These ideas help people explain a cost others cannot see. Neff says it is as if an autistic person's nerves take in every sound, touch and word.c5 She says masking, hiding autistic ways, drains the battery even faster.c5 Devon Price says noise, crowds and masking all drain the battery.c7 Price also says many autistic people work in big bursts, then need a lot of rest.c7

Orion Kelly writes about what one task costs. Kelly says that in burnout, a shower feels like 22 tasks he has no energy for.c13 Some writers say the cost comes later. Daniel Burford says a busy Tuesday can cost you Thursday.c12 An autistic adult named Pat G. can handle a party for 30 to 45 minutes. Afterward, Pat collapses for a day and a half and hides.c15

The ideas also make it easier to say no. Neff uses her social spoons to turn down events without feeling bad.c6 Megan Griffith asked autistic adults with ADHD about their lives. One said others "don't see all the time and energy" it takes to show up.c9

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Community

From autistic writers' accounts of what these images explain for them. Whether energy works this way is a research question, covered in the next sections.

Community

This part tells you what autistic writers say. It does not tell you if the ideas are right.

Energy in autistic people's own words Established

When researchers ask autistic adults about tiredness, participants in several studies use the same language as community writers. In a study of autistic burnout based on 19 interviews with autistic adults in the US and 19 public internet sources, participants described their exhaustion "as a depletion of energy from overextending themselves in daily life", and one account called it being drained "like your battery has run dry".1 In Norway, 14 autistic young adults aged 21 to 29, all diagnosed in childhood or adolescence, talked about a "social battery being emptied", and the authors report this was "evident for many of the interviewees".3 In the UK and Luxembourg, 16 autistic adults aged 40 or over described socializing as draining, and the researchers named a theme "managing your social battery".4

Spoons appear too. In focus groups on autistic inertia with 32 autistic adults, one participant said "I have no spoons, as they say".5 In 501 Reddit posts about inertia, mostly from autism forums, some users described having a "limited amount of energy" or "spoons" per day, and keeping check on their energy so as not to overuse it, which they said could lead to burnout.6

A 2025 systematic review of 48 studies of autistic burnout, most of them qualitative and covering about 4,000 autistic people, described burnout as debilitating exhaustion and increased disability. Sensory and social overwhelm and camouflaging were among the contributors participants named, and rest, solitude and sensory relief helped them recover.2 These are participants' own explanations, not tested causes.

Scientists have asked autistic adults how tiredness feels. Many use the same words as the writers above. In one study about burnout, people said their energy ran out from doing too much.1 One said it was "like your battery has run dry".1 In Norway, 14 young autistic adults talked about their social battery being emptied.3 Older autistic adults in the UK and Luxembourg said socializing drained them.4

Some people talked about spoons. Inertia means finding it hard to start or stop things. In a study about inertia, one adult said "I have no spoons".5 On Reddit, some autistic people said they have only so many spoons a day.6

A big review looked at 48 studies about autistic burnout. Feeling worn out was at the center of it.2 Rest, time alone and quiet surroundings helped people recover.2

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Established

Interview studies by at least four independent groups, a Reddit analysis and a systematic review of 48 mostly qualitative studies agree that the language recurs. They show how autistic adults describe their experience, not how energy works. The review includes the burnout study cited here, and one researcher co-wrote the Norwegian and Reddit studies. Reddit posters' diagnoses were not checked. Most participants could put their inner experience into words, and the review's samples were mostly white, female, diagnosed as adults and of at least average intellectual or verbal ability.

Word
Systematic review

A study that searches for every study on a question and combines their findings by a set method.

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Established

Many studies by different teams found the same thing. They show how autistic adults describe their energy. They do not show how energy works.

Word
Burnout

A long stretch of being worn out, when a person may lose skills they usually have.

See also

Fatigue in autistic people Emerging

In a Dutch population study of 35,048 adults, people who reported more autistic traits also reported more fatigue, after allowing for age, sex, education, work and income. The link was slightly stronger in women, and adults whose questionnaire scores suggested probable autism (a questionnaire definition, not a diagnosis) also reported more fatigue. The study measured everything at one time, so it cannot say which comes first.7 In a British birth cohort, children whose parents' ratings put them above a screening threshold for autistic traits at age 7 had higher odds of self-reported chronic disabling fatigue at 18 (odds ratio 1.78). The figure for ADHD traits, rated at age 9, was higher (2.18). A statistical model found a small indirect path through a marker of inflammation measured at age 9. Neither the traits nor the fatigue were clinically assessed.8

Among 290 autistic young adults aged 18 to 26, fatigue was the most common physical symptom: 72.8% had been bothered by it at least a little in the past three months, and sleep problems came next (69.0%). Females had 2 to 4 times the odds of males of reporting any given symptom, and more symptoms went with more depression and anxiety. There was no comparison group, and all of it was self-reported by volunteers.9 In a survey of 973 autistic adults on a Dutch register, with no comparison group, 21% reported a diagnosed central sensitivity syndrome, a group of conditions that includes fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome. Sensory sensitivity and anxiety fully accounted for the statistical link between autistic traits and these symptoms.22 In a later online survey by the same group, mostly of women, 31 autistic adults without a formal diagnosis of such a syndrome (some suspected one) scored higher on a general questionnaire of these symptoms than 98 adults with neither diagnosis nor a suspicion of either.10 In an online survey of 2,305 adults, about half of them autistic and most of them women, self-reported chronic fatigue syndrome was about three times as common in the autistic adults (6.56% against 2.21%).23 In these studies fatigue came with sleep problems, anxiety and depression, and in 114 autistic 15 to 25 year olds, fatigue and depression went together at one point in time, though fatigue did not predict depression two years later.9,28 Part of the link may run through these, so fatigue should not be read as a fixed feature of autism.

Looked at from the other side, results are mixed. In one Swedish clinic study, adults with chronic fatigue syndrome (59 people) did not score higher on an autistic-traits questionnaire than 53 healthy adults, and the authors noted that the choice of questionnaire may matter.11 In the online survey above, adults with a central sensitivity syndrome but no autism diagnosis did report more autistic traits than the comparison group.10 A study of genetic data from the same group as the Dutch population study found that genetic variants linked to an autism diagnosis overlap with those linked to fatigue (genetic correlation 0.33). A test of whether one causes the other, using only three variants each way, found no significant effect; the authors say it lacked power.12

Fatigue means feeling very tired for a long time. A Dutch study asked 35,048 adults about autistic traits and tiredness. People with more autistic traits said they felt more tired.7 This was a little stronger in women.7 The study cannot tell which comes first.7

A British study followed children as they grew up. Children whose parents saw more autistic traits at age 7 were more likely to report disabling tiredness at 18.8 In a study of 290 young autistic adults, tiredness was the most common body problem.9 About 7 in 10 had it. But that study did not compare them with non-autistic people.9

Autistic adults also reported more signs of illnesses like fibromyalgia, which causes pain and tiredness.10 Tiredness often came with poor sleep, worry or low mood.9,28 So some of it may come from those, not from autism itself. Not every study agrees. In one small study, people with chronic fatigue syndrome did not report more autistic traits.11

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Emerging

Two independent population samples find more fatigue with more autistic traits, but both measure traits (self-rated or parent-rated) rather than diagnosis, and fatigue is self-reported. Only the childhood cohort follows people over time. Studies of diagnosed autistic adults are volunteer or register samples, mostly without a comparison group.

What these studies measure

Fatigue here means what people report on a questionnaire. These studies do not measure energy in the body, so they neither support nor test a spoon count or a battery.

Word
Odds ratio

How much more likely an outcome is in one group than another; 1.78 means the odds were 78% higher.

See also
Emerging

Several studies point the same way. But most asked people about one moment in time, and most measured autistic traits, not diagnosis.

What these studies measure

These studies asked people how tired they feel. They did not measure energy in the body. So they do not test spoons or batteries.

See also

Testing the models Hypothesis

In the searches made for this entry, no study had tested spoon theory or energy accounting as a description of how energy works, or as a tool on its own. In research they appear as participants' words (see the previous section) or as one part of a larger program. An eight-week group therapy for social anxiety in autistic adults gave a session to "Sensory overwhelm and spoon theory".20 A program for neurodivergent university students added energy accounting to a session on burnout; its evaluation was still a published plan.21 Neither study separates the effect of the metaphor from the rest of the program. In a long COVID feasibility trial, one of the pacing options was a spoon-based app, and the study reported participants' views and use of the options, not whether pacing reduced symptoms.27

The closest studied model comes from ME/CFS (myalgic encephalomyelitis or chronic fatigue syndrome). The "energy envelope" theory holds that keeping exertion within the energy a person has available may reduce symptoms. In one study, the more people's daily energy use exceeded their perceived energy, the worse their fatigue, pain, mood and functioning.24 In another, overexertion mattered most for people with more energy available.25 A third found a group of patients who stayed closer to their envelope than others yet were the most impaired.26 These studies are correlational, come from one research group, and did not include autistic people.

Social energy has been studied in non-autistic people. In a study that asked 48 adults about their behavior and mood five times a day for 12 days, sociable behavior went with better mood and less fatigue at the time and more fatigue three hours later, and the number of people met statistically mediated the delayed fatigue. Task-focused, conscientious behavior showed the same delayed fatigue, and personality traits did not change either pattern, so introverts did not pay a larger cost.13 The same researcher found the sociable pattern again in 74 people.14 That partly fits the social battery image, but only in people who were not autistic, the delayed tiredness was not specific to socializing, and the two studies come from one author.

A better-known resource model has fared worse. "Ego depletion" is the idea that self-control draws on a limited store that runs down with use. A preregistered test of one standard task pair across 23 laboratories (2,141 people) found an effect close to zero.15 A second, across 36 laboratories (3,531 people), found no evidence for it in its preregistered analyses; an exploratory analysis without its exclusions found a very small effect.16 Those studies tested self-control in laboratory tasks, not daily energy, so they say nothing directly about spoons. They show that a model of the mind as a store that empties can feel right and still fail direct tests.

We found no study that tested whether spoon theory or energy accounting is true or helps on its own. One therapy group for autistic adults included a lesson on spoon theory.20 A program for students included energy accounting.21 But neither could show what the spoon idea did by itself.

Some studies looked at a similar idea in people with ME/CFS, an illness that causes extreme tiredness. People who used more energy than they had tended to feel worse.24 But one group stayed within their energy and still felt the worst.26 None of these people were known to be autistic.

Other studies tested ideas that are a bit like a social battery. In one, 48 adults said how they felt five times a day.13 After being around people, they felt happy at first and more tired three hours later.13 Hard work on tasks did the same thing.13 The same scientist found this again in 74 people.14 None of these people were known to be autistic.

Another idea said self-control is like a tank that runs low. Big tests in dozens of labs did not back it up.15,16 Those tests were about self-control, not daily energy. But they show that an idea can feel right and still fail a test.

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Hypothesis

No study found as of October 2026 has tested spoon theory or energy accounting directly. The nearest evidence is correlational work on a similar model in ME/CFS and studies of related ideas in non-autistic people.

Why a metaphor is hard to test

A spoon has no fixed size and changes from day to day, so almost any day can be described in spoons afterward. A test would need to predict something in advance, such as which days end in a crash.

Hypothesis

We could not find any study that tested spoon theory or energy accounting directly. The closest studies tested similar ideas in other groups of people.

Debates Emerging

One question is whether energy is a daily allowance or a running account. In Miserandino's essay, spoons are handed out each morning and can only be spent or borrowed against, though she adds that "some days I have more spoons then most."c1 Energy accounting adds deposits, activities that restore energy, alongside withdrawals.c4 Daniel Burford, who calls the essay one of the best pieces of explanatory writing about disability, names its gap: "It says nothing about how they come back." Burford sorts recovery into five kinds of rest (sensory, social, cognitive, executive function and masking rest) and writes that a person can be well supplied with one kind and starved of another.c12 Some writers count interests as deposits. Emily R., an autistic adult quoted in the same clinicians' guide, writes: "I think a lot of autistics ‘charge their batteries’ with special interests, in some ways even more so than with sleep."c16

A second is whether counting energy helps. In a 2026 interview study of 15 people with fibromyalgia, one participant said "Today I have ten spoons, tomorrow might only have three, and I have to use wisely". The authors argued, without testing it, that analogies like spoon theory "are not evidence-based and may reinforce symptom-contingent behaviours rather than support progression", meaning that people may rest only in response to symptoms instead of building activity up gradually.18 The ME/CFS energy envelope studies point the other way, linking staying within one's energy to better functioning, though not in every group of patients.24,26 No similar study of autistic people was found as of October 2026. Beliefs may also matter. In studies by one research group, people who believed willpower is not limited showed no drop in self-control after a draining task, and the authors proposed that depletion reflects beliefs.17 In exploratory analyses, the later 36-laboratory test found no sign that willpower beliefs changed its near-zero effect.16 No study found as of October 2026 has tested whether counting spoons changes how tired people feel.

A third is whether the energy belongs to the person or the setting. In the burnout study above, of 19 interviews and 19 online accounts, participants described burnout as what happens when expectations outweigh abilities, with a cumulative load and no relief from it, and the authors called for less discrimination and stigma.1 In interviews with 12 autistic adults, 10 of them women, time with other autistic people felt easier and more comfortable than time with non-autistic people, with whom they had to conform. That study asked about comfort and belonging, not energy.19 Beardon places part of the cost in the company as well: he writes that "engaging socially with some people can actually boost your social energy, whereas others may drain it", and suggests planning around one's starting energy, who will be there and how long it lasts.c11 On the reading these writers and participants offer, the cost of a task depends on the setting and the company as well as the person, which a fixed count of spoons leaves out.

Is energy a set amount each day, or more like a bank account? In spoon theory, you get your spoons each morning.c1 Energy accounting adds things that put energy back.c4 Daniel Burford says spoon theory leaves something out. It tells how spoons get used, but not how they come back.c12 Burford names five kinds of rest, such as calm for your senses and time alone. Having lots of one kind does not make up for missing another.c12 An autistic adult named Emily R. thinks many autistic people charge their batteries with their favorite interests.c16

Does counting spoons help? Scientists who talked with 15 people with fibromyalgia say the idea has not been tested.18 They think it might lead people to rest only when they feel bad, instead of slowly building up.18 Studies of ME/CFS point the other way.24 Nobody has studied this in autistic people. Some scientists thought beliefs about willpower matter.17 A later big test did not find that.16

Is the tiredness in the person, or in the world around them? In one study, autistic adults said burnout came when too much was expected of them.1 In another, autistic adults said being with other autistic people felt easier, though that study did not ask about energy.19 Beardon says some people can add to your social energy, while others drain it.c11 So the cost of a task may depend on where you are and who you are with.

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Emerging

Each position draws on the original essay, the energy accounting authors, other autistic writers or small studies, mostly outside autism. None of the positions has been tested with autistic people.

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Emerging

People argue about these questions. Only a few studies speak to them, and most were not about autistic people.

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From nonspeaking writers Nonspeaking

The nonspeaking activist Amy Sequenzia, quoted by Melanie Yergeau, communicates by supported typing, with a facilitator's touch on her elbow, and describes what typing costs: "When I am finally ready to type, my brain needs to use all the energy available to make my fingers keeps moving." Afterward, she writes, her brain "needs some rest".c14 Grant Blasko, who types independently on an iPad using AAC, writes that he did not realize the energy it took to look less autistic until he reached burnout: "I did not truly realize how much energy I was using to look less autistic until I reached the burnout stage the summer I turned 17."c17

Amy Sequenzia does not speak. She types to communicate, and a helper touches her elbow to help her body. She says typing takes all the energy her brain has.c14 After she types, her brain needs rest.c14 Grant Blasko types on an iPad by himself. He says he did not know how much energy it took to look less autistic until he got burned out.c17

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Nonspeaking

In their own words, written by typing, spelling, handwriting or AAC, some with a communication partner's support. Researchers dispute whether some partner-supported methods let the writer, not the partner, choose the words; the pedia reports these accounts as their writers' and does not settle that question here. The methods and the evidence about who authors the words are set out in Facilitated communication and spelling to communicate.

Nonspeaking

These are the words of people who do not speak and write by typing or spelling. Some use a helper. Researchers disagree about some of those methods. You can read about these methods in Facilitated communication and spelling to communicate.

Sources

Research

  1. 1Raymaker DM, Teo AR, Steckler NA, et al. "Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew": Defining Autistic Burnout. Autism in Adulthood, 2020. https://doi.org/10.1089/aut.2019.0079
  2. 2Ali D, Bougoure M, Cooper B, et al. Burnout as experienced by autistic people: A systematic review. Clinical Psychology Review, 2025. https://doi.org/10.1016/j.cpr.2025.102669
  3. 3Øverland E, Hauge ÅL, Orm S, et al. "I have to charge my social battery": Perspectives from autistic young adults on Quality of Life. Autism, 2024. https://doi.org/10.1177/13623613241245578
  4. 4Viner HE, Yuill N, Costa AP, et al. A qualitative interview study on quality of life and ageing experiences of autistic adults. Communications Psychology, 2024. https://doi.org/10.1038/s44271-024-00142-0
  5. 5Buckle KL, Leadbitter K, Poliakoff E, et al. "No Way Out Except From External Intervention": First-Hand Accounts of Autistic Inertia. Frontiers in Psychology, 2021. https://doi.org/10.3389/fpsyg.2021.631596
  6. 6Ward T, Popazov S, Adams J, et al. Understanding phenomenological experiences of autistic inertia using online community discourse. Communications Psychology, 2026. https://doi.org/10.1038/s44271-025-00386-4
  7. 7Li Y, Xie T, Snieder H, et al. Associations between autistic and comorbid somatic problems of gastrointestinal disorders, food allergy, pain, and fatigue in adults. Autism, 2024. https://doi.org/10.1177/13623613241254619
  8. 8Quadt L, Csecs J, Bond R, et al. Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study. BMJ Open, 2024. https://doi.org/10.1136/bmjopen-2024-084203
  9. 9Williams ZJ, Gotham KO. Current and lifetime somatic symptom burden among transition-aged autistic young adults. Autism Research, 2022. https://doi.org/10.1002/aur.2671
  10. 10Grant S, Norton S, Hoekstra RA. Central Sensitivity Symptoms and Autistic Traits in Autistic and Non-Autistic Adults. Autism Research, 2025. https://doi.org/10.1002/aur.3297
  11. 11Bileviciute-Ljungar I, Maroti D, Bejerot S. Patients with chronic fatigue syndrome do not score higher on the autism-spectrum quotient than healthy controls: Comparison with autism spectrum disorder. Scandinavian Journal of Psychology, 2018. https://doi.org/10.1111/sjop.12451
  12. 12Li Y, Xie T, Vos M, et al. Shared genetic architecture and causality between autism spectrum disorder and irritable bowel syndrome, multisite pain, and fatigue. Translational Psychiatry, 2024. https://doi.org/10.1038/s41398-024-03184-4
  13. 13Leikas S, Ilmarinen V. Happy Now, Tired Later? Extraverted and Conscientious Behavior Are Related to Immediate Mood Gains, but to Later Fatigue. Journal of Personality, 2017. https://doi.org/10.1111/jopy.12264
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