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Table 8 Themes identified from responses of adults with autism to the following open question: What changes, due to the effects of the COVID-19 regulations on your everyday life, have caused the most stress/anxiety (if any)?

From: The psychological impact of the COVID-19 pandemic on adults with autism: a survey study across three countries

Theme Subtheme Example quote
Groceries Disrupted shopping routines “The unavailability of my specific groceries, for weeks now. Getting to the shop and seeing empty shelves, yet again, bring me to tears. Because it’s something I have absolutely no control over. And having to change what I eat on top of everything else is just too much” p. 611
“Unable to do groceries due to meltdowns/ or panic attacks not sure which of these is the culprit. Sensory overload is entangled with supermarkets on a regular day, with all the change it’s become impossible to do on my own” p. 440
   “shopping—not being able to get my routine food” p. 86
  Social distancing rules “Not being able to go grocery shopping without a lot of anxiety. I only go once a week, whereas I was used to go almost daily. I am very scared about people at the shops not adhering to the rules” p. 432
“Grocery shopping is awful now! It was always awful to begin with, but with all the extra regulations it’s even more stressful now. Constantly having to keep my distance and reminding myself is an extra, unwanted step in this already exhausting process of having to do everything right, having to think of everything. I now come home upset and sweaty every time.” p. 442
Going back to normal   “The sudden change in my routine and then the sudden change in going back to my previous routine when this has ended. My threshold for external stimulus is non-existence now so I am fearful that, when I do return to work, I am going to be exhausted due to sensory overload on my commute to/from work and the social interaction is going to also be exhausting. I am not "masking" anymore and I am concerned I will have forgotten how to do that and how to hide my stimming. The reality is it is probably muscle memory at this point in my life but the exhaustion from external stimuli is worrying me” p. 977
“The relief of not having to mask anymore, but simultaneously the worry I will not be able to join back the rat race as quickly as the others. When things will open back up, expectations of enjoying the social get together will be super high and I will be enormously stressed and out of practice in acting normal” p. 579
“After a few weeks I have now gotten used to this calm pace, these new social rules slowly seem clear to me, so now it gives me a little anxiety that afterwards I will have to get used to the hustle and bustle and chaos again, and having to find my own way in this.” [Translated] p. 317