517367
research-article2014
AUT0010.1177/1362361313517367AutismBölte
Editorial
The power of words: Is qualitative
research as important as quantitative
research in the study of autism?
Honestly, who among us was properly academically
trained to conduct qualitative research? Who can sponta-
neously cite a qualitative study of autism, or would say his
or her favorite study of autism is a qualitative one? Who
thinks qualitative research is as valuable as quantitative
research? Without either qualitative or quantitative evi-
dence for it, only an n = 1 personal experience, I would
assume with good confidence: not many of you, correct?
The number of original studies that use qualitative meth-
ods in respected peer-reviewed journals is negligible com-
pared to quantitative ones. Why is that so?
In this editorial, I will first explain why I think there
still is an implicit attitude among many of my esteemed
peers that the results of qualitative research cannot be
taken seriously, and then argue that disrespect for qualita-
tive research is a well-cultivated myth, and that rigorous
qualitative research is as necessary as quantitative research.
A note of caution for readers: I feel somewhat appointed to
write about these issues, as I have gone through a recent
transition from rather hostile to rather enthusiastic about
qualitative research, which I will describe later.
So, why is there relatively little qualitative research in
autism, and why are related methods not well accepted by
the scientific community? First, I assume, few are well
trained in qualitative research. For most, it is something
that others do, and is viewed as bad (or at best, incomplete)
science. Second, there is perhaps a perceived lack of need;
the main objective of qualitative research is to gain deeper
understanding of human behavior and experiences based
on (a series of) cases. Data from qualitative studies can be
used to generate good hypotheses, for which quantitative
support can be sought, as well to illuminate quantitative
findings. However, many autism researchers are clini-
cians, too. Therefore, they may encounter enough informa-
tive cases in naturalistic settings and gain sufficient insight
into their behavior (“clinical experience”) from which to
derive concrete hypotheses, and to interpret quantitative
data in an insightful fashion. Third, the scientific quality of
many qualitative studies in the autism field is indeed often
low, which further discredits qualitative research as a legit-
imate form of empirical research. Much published qualita-
tive research is too exploratory, with weaknesses in
Autism
2014, Vol. 18(2) 67­–68
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rationale, clarity, documentation, replicability, and sound-
ness of conclusions. I also have observed that in some
qualitative studies, quantitative methods in general or
results from quantitative studies are disparaged, which
demonstrates that inadequate arrogance exists on both
sides of the debate.
Quantitative and qualitative approaches each serve
certain aspects of research; they have specific strengths
and weaknesses, and in the best cases are complemen-
tary (Brown and Lloyd, 2001; Razafsha et al., 2012).
Knowledge is derived from both sources, and mixed
models are becoming more accepted. Qualitative
research helps to ask the right questions, derive hypoth-
eses, and can enable a deeper understanding of certain
processes in humans. Quantitative research should test
hypotheses, and enable the generalizability of findings
to larger populations. For both, standards must be high
for reliability and validity. In qualitative research, rigor
is achieved by the concepts of triangulation, trustworthi-
ness, saturation, flexibility, and applicability (Kisely and
Kendall, 2011).
We at Autism receive an increasing number of submis-
sions using qualitative methods, although the percentage
that we publish is still below the proportion of what we
publish of quantitative submissions. Autism is as open to
publishing qualitative research as quantitative research if
it applies the same high standard of rigor that we expect
from quantitative studies. During 2014, Autism will pub-
lish a special issue on autism and society, covering topics
from dissemination, knowledge translation, and responsi-
ble communication, via public engagement and awareness
as well as stigmatization and societal integration to
empowerment, autism culture, and advocacy organiza-
tions. We have received some promising submissions
using qualitative designs, and look forward to publishing
some of them.
Even though the present issue does not include a quali-
tative study, Autism has published some fine examples of
qualitative research that have improved our understanding
of autism. For instance, Fleischmann (2005) investigating
how parents of children use the Internet. Calder et al.
(2013) examined the nature of children with autism’s
68 Autism 18(2)
perspective on friendships using a mixed qualitative/
quantitative model. Additional favorites published in
other journals are Smith and Sharp (2013) on the impact
of sensory experiences on adults with high-functioning
autism spectrum disorder, and Chen et al. (2013) and Gray
(2006) on parents’ attitudes and experiences regarding
genetic testing, and coping with autism over time, respec-
tively. Such studies give important information to teach-
ers and service providers, new leads for quantitative
studies, new perspectives on ethical implications, and per-
haps enhanced societal awareness.
Before I conclude, I still owe you my little personal
aha! experience concerning the value of qualitative
research, which caused me to reorient and reorganize
some of my clinical research toward favoring more mixed
models of designs. I have been working quite a bit with
manualized group-based social skills training for chil-
dren and adolescents with high-functioning autism spec-
trum disorder (Bölte and Choque-Olsson, 2011; Herbrecht
et al., 2009). Particularly, when we piloted a training pro-
gram in a Swedish clinical setting for a now ongoing
large randomized clinical trial (RCT) multicenter study
(NCT01854346), unstructured post-training interviews
with children, parents, and teachers revealed a multitude
of positive consequences participating individuals asso-
ciated with the intervention, which were obviously not
captured sufficiently by our quantitative measures. These
included a diversity of prosocial incidents such as joining
activities at school, approaching peers and relatives,
increased family communication and decreased family
conflicts, better handling of conflicts and crises but also
reduced feelings of loneliness and hopelessness, and
changed attitudes toward clinical services. These qualita-
tive results changed the choice of outcome measures for
the full trial, and focused interviews were added to the
final design.
To sum up, I hope to convince you that qualitative
research is important, and, provided that scientific rigor
is applied, as important as quantitative research. There
are some good examples of studies that have signifi-
cantly improved our understanding of autism, and I am
sure there is a lot more to come, not least of all in this
journal.
Acknowledgements
Special thanks to my dear editorial colleagues David S Mandell
and Aubyn C Stahmer, for excellent comments and helping a
non-native English speaker to put things stylistically correctly in
this editorial.
References
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Editor
Sven Bölte