The research, led by Bridgett Kiernan, Micah O. Mazurek, and Rose E. Nevill at the University of Virginia, examined how 138 first responders from 21 agencies responded to a three-hour in-person course called the Autism Response Protocol. The training was developed through an iterative process that drew on the perspectives of autistic people themselves, caregivers, and first responders, and it combined psychoeducation about autism’s core features with evidence-based communication and de-escalation strategies. Participants completed surveys immediately before and after the training, measuring their confidence, self-efficacy, and knowledge about supporting autistic people in emergencies. The researchers then used linear mixed-effects models to see whether gains differed by professional role, personal relationship to autism, and demographic characteristics such as age, gender, and prior training.

The stakes could hardly be higher. Autistic people face elevated rates of co-occurring physical and mental health conditions, including epilepsy, gastrointestinal disorders, anxiety, and depression, and they are far more likely than the general population to experience suicidal ideation and crises requiring urgent intervention. Roughly one in five autistic children has a police interaction before age 21, and nearly half of autistic adults interact with first responders four or more times in their lifetime. Without adequate understanding of autism, responders may misread communication differences or distress behaviors, escalating situations that could have been calmly resolved. The study’s authors point to sobering real-world examples, including a teenager handcuffed while having a seizure and a 25-year-old autistic man shot by police after calling 911 himself for a wellness check.

What makes the new findings particularly valuable is the framework behind them. Rather than treating first responders as a single bloc, the researchers applied role theory, the idea that socially defined roles shape behavior, expectations, and perceived performance demands. A law enforcement officer securing a scene, a firefighter conducting a rescue, an EMS paramedic triaging a patient, and a 911 dispatcher gathering information all operate within distinct organizational cultures and decision-making structures. Those differences, the theory suggests, could influence how trainees absorb and apply autism-related content. The study was among the first to test this idea empirically across four distinct responder professions, including dispatchers, who are often overlooked in autism training research.

The headline result is strikingly simple: everyone improved. Confidence and self-efficacy scores rose significantly from pre- to post-training across all professional roles, and knowledge scores also increased when relationship type was taken into account. No pairwise comparisons of change scores between professional groups reached statistical significance after adjustment for multiple comparisons. In other words, the training worked about equally well for police officers, firefighters, EMS personnel, and dispatchers, a finding that challenges any assumption that autism education is only needed, or only effective, for the officers who make arrests.

Still, the data revealed meaningful nuances. Law enforcement officers entered the training with significantly higher baseline self-efficacy than their EMS counterparts, about 2.34 points higher on the study’s scale, and consequently showed smaller gains. The authors suggest two plausible explanations. The occupational culture of policing, with its greater perceived autonomy and control over decisions, may reinforce efficacy beliefs in ways that protocol-driven roles do not. Alternatively, officers may simply have had more prior exposure to autism and developmental disability training, often through optional Crisis Intervention Team programs. Either way, the smaller improvement among officers likely reflects a ceiling effect rather than resistance to the training, and it suggests that community efforts to train law enforcement may already be paying lasting dividends.

Personal relationships with autistic people told an equally interesting story. Participants with a close relationship to an autistic person, such as a parent, sibling, partner, or being autistic themselves, scored an average of 8.87 points higher on baseline confidence than those with no personal connection, and those with more distal relationships, such as autistic friends or extended family, also started higher. Yet the group with no personal relationship showed the largest gains in self-efficacy, substantially narrowing the gap by the end of training. This pattern carries a practical warning: departments cannot assume that experienced responders have absorbed autism competence through osmosis, nor can they rely on the informal training that responders with autistic family members often provide to colleagues. Formalized instruction, the authors argue, lifts everyone while relieving that unpaid burden.

One curious discrepancy emerged between subjective and objective measures. Confidence and self-efficacy, which are self-rated, improved significantly, while knowledge scores, measured through an 18-item questionnaire, showed a significant main effect of time only in the analyses examining personal relationships, not professional roles. The authors note this mirrors a pattern seen in earlier EMS training research and in medical education studies suggesting that self-efficacy may be a stronger predictor of real-world clinical practice than knowledge alone. If limited self-efficacy undermines the quality of care autistic people receive, then boosting responders’ belief in their own capability may be the training’s most consequential effect, even when quiz scores move less dramatically.

Demographics mattered too, in ways that carry policy implications. Previous autism training predicted larger gains in confidence and self-efficacy, while age showed a more complicated relationship, with older participants reporting slightly lower confidence change scores in one analysis. Notably, younger and more junior responders tended to start with higher knowledge and self-efficacy, possibly because newer workers are more receptive to training and more likely to have encountered it recently. The authors argue this makes a case for mandatory retraining: many U.S. states now mandate autism training for first responders or law enforcement, but few specify how often it must be refreshed. They propose supplementing annual sessions with brief, frequent refresher courses, an approach shown in occupational safety research to help teams maintain skills year-round.

The study is not without limitations, and the authors are candid about them. All participants came from a single southeastern state, and because first responder training is governed largely by state and local law, the findings may not generalize nationally. The sample was also predominantly White, and all outcome measures relied on self-report Likert scales, which are vulnerable to response bias and may not capture actual applied skill. Future research, the team suggests, should incorporate objective measures such as role-plays, simulated scenarios, or on-the-job evaluations. Even so, the core message stands out with unusual clarity for a training study: a three-hour intervention, co-designed with autistic people and delivered by a team that included a firefighter parent of autistic children and a self-advocate, improved confidence and self-efficacy across every role and every relationship type tested. As autism prevalence continues to rise, ensuring that all first responders, not just police, are trained and retrained may be one of the most direct ways to make emergencies less dangerous for autistic people and their families.

Subject of Research: Effects of autism crisis response training on first responders' confidence, self-efficacy, and knowledge across professional and personal characteristics

Article Title: An Examination of First Responder Gains Following an Autism Training Based on Personal and Professional Characteristics

Article References: Kiernan, B., Mazurek, M. O., & Nevill, R. E. (2026). An Examination of First Responder Gains Following an Autism Training Based on Personal and Professional Characteristics. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-026-07520-z

Image Credits: AI Generated

DOI: 10.1007/s10803-026-07520-z

Keywords: autism, first responders, training, law enforcement, EMS, self-efficacy, crisis response, role theory, de-escalation, 911 dispatch, firefighters, Journal of Autism and Developmental Disorders