Benefits of Life Skill Based Education for Neurodiverse Adults: An Integrative Review and Analysis

An integrative review and analysis was conducted to assess the benefits of teaching Life Skill-Based Education (LSBE) to Neuro Divergent Adults (ND) (i.e., adults with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and/or specific learning difficulties (SLD)). A systematic search of Google, Google Scholar, EBSCO host, and Cochrane Library databases were utilized with date ranging from 2000-2020. A total of 659 hits were obtained before duplicates were removed and inclusion/exclusion criteria, as well as conceptual perspective applied. In summation, 16 articles were thoroughly analysed to evaluate the efficacy of LSBE programs on improving the Quality of Life (QoL) of ND adults. Specifically, ones that cater to the Executive Functioning (EF) challenges often seen in this population, whilst using inclusive approaches. The findings did reveal high potential of LSBE programs to benefit ND adults, where general services currently lack. However, issues such a small sample size and lack of sample diversity limit generalizability of program benefits. Recommendations are to tackle global problems around inclusion and education, for ND adults, at its roots. Greater awareness of LSBE program should be emphasized worldwide, as benefits will likely ensue for all kinds of individuals/neurotypes. Overall, implications target change on a micro, meso and macro level.

• "Do LSBE programs enhance personal management, employment outcomes and social skills needed for daily living?
• Are LSBE programs tailored in an inclusive, culturally appropriate manner whilst addressing the autonomy and human rights of ND adults?" The characteristics of participants has been laid out in Table 1-to distinguish the unique profiles of each group of participants before going on to measure the outcomes of LSBE programs (Demetriou et al., 2018;Katz et al., 2018;Rodríguez, González-Castro, Cueli, Areces, & González-Pienda, 2016). Notes. * Hedge's g represents the effect size and relationship between one group with another-in this case ASD participants to neurotypical participants. It is preferred over Cohen's d for small sample data.

Justification of Methodology
Integrative literature reviews analyze both theoretical and empirical findings (Russell, 2005), allowing for more practical, person-centred solutions to arise from a broader range of studies (Elsbach & van

After Abstract and Title Screening
The included studies, after analyzing abstracts and titles, comprised of adult tailored programs from years 2010-2020. Several articles were excluded due to their focus on children, adolescence, or parents of children/adolescence-or simple were not in English.
Historically, most emphasis had been placed on ND children which has led to bias in helping adults (Camm-Crosbie et al., 2018). Our research aims to bridge this gap by not including children in our analysis, as it is adults with ND that face a "service cliff" (Oswald et al., 2018). Furthermore, articles which had a narrow biomedical focus, or were irrelevant to search criteria and participant demographic (i.e., people with other mental illness/disability such as schizophrenia or Intellectual Disability (ID)) were omitted. Programs conducted in schools and residential settings were also excluded. Low quality 31 Published by SCHOLINK INC.
grey literature was excluded. Although past literature reviews/meta-analysis on the topic proved to be useful to derive relevant search terms, these were excluded from further analysis.

After Full-Text Screening
After full-text screen, 16 articles were included for data extraction and quality assessment purposes.
Despite meeting the requirements of our PICO question, several articles from Cochrane Library were excluded as they were protocols for future or ongoing research, and therefore outcome measures could not be obtained.
One article was excluded since it comprised of a case study with limited substance to the requirements of our PICO question. More importantly, articles which focused on the medical model had to be excluded as they do not fit the inclusive theme of our review-despite the potential quality of the paper. For instance, Laugeson, Gantman, Kapp, Orenski, and Ellingsen (2015)'s use of Empathy Quotient (EQ) scale to measure empathy outcomes in autistic indivuals is controversial due its grounds in the "theory of mind" hypothesis (Brownlow & O'Dell, 2009;Gernsbacher & Yergeau, 2019;Montgomery et al., 2016), and lack of standardized methods (i.e., replicability) (Harrison, Brownlow, Ireland, & Piovesana). Some articles have been included even though they subtly mention theory of mind in their introduction, because they do not include such principles into their program. Furthermore, Markham, Porter, and Ball (2013)'s concept seems to conjure up an innovated idea to teaching the vital LSBE of driving to adults with ADHD. However, their use of behaviour modification methods proves to be an age-old, controversial technique embedded in ableist ideals (O'Leary & O'Leary, 1977;Shyman, 2016). Modern autism research recommends avoiding such ideals to rise above bias, unjust and unethical practices (Kristen Bottema-Beutel, 2020), therefore such papers will be omitted out of this review before data extraction.

Data Extraction
To extract and appraise data of the 16 articles, we used the predetermined criteria of RAAMBO method as per Jackson et al., 2006's system of review. Tables were created using Word, and served as a tool to organise, and evaluate articles during the research process. We have split up the program by participants neurotype: (1) ASD, (2) ADHD and (3) ADHD & ASD combined; ADHD and LD combined. The characteristic of study, in accordance with RAAMBO, has been provided in Table 3 below:  intervention.

Quality Assessment
To assess quality of papers we analysed for potential biases as per Herker (2006) and Godlee and Dickersin (2003), which included: recruitment/selection bias, allocation bias, maintenance/performance bias, exclusion/attrition bias, measurement/detection bias and publication bias. We also looking at study limitations and other pre-determined sets of criteria using the National Institution of Health (NIH, 2014) took kit. This tool kit was used as a guide to assess the wide variety of study designs evident in our review. The results have been categorized into 5 low, 6 medium, and 5 high quality papers, and integrated within Table 3. Due to the level of infancy in this research area, however, us authors have revised papers with a degree of leniency. For instance, much of what has been reviewed are open clinic pilot studies so finding many studies with large sample size/randomization have not been possible.
Quality has been adjusted for as study designs of programs vastly vary.

Conceptual Perspective
In reviewing the literature, we authors reassert a rejection of the medical model, and instead, we have taken a more person-centred, strength-based approach. We believe that this will provide for an inclusive, diversity-focused exploration of programs (Robertson, 2009). Studies that take ground in deficit, anthologizing language have been omitted due to their contentious nature. An example of this would be studies that recommended, or take on from Applied Behavioural Analysis (ABA)-as it often crosses the thin line between intervention and abuse that stems from historical malpractice (Kirkham, 2017;Robison, 2020). Furthermore, programs funding by controversial organisation, such as Autism Speaks, have been rejected. One exception has been made where it has been disclosed that the authors have little to no affiliation with the organisation (Crabtree & Demchick, 2015). Furthermore, the study followed the theoretical lens of occupational justice, which meets the inclusive requirements of our review (Gail, Katherine, Cindy, & Aakifah, 2018). A plethora of limitation such as methodological flaws, false starts and non-inclusive samples (such as gender-bias and racial bias) has led to the inaccurate representation of ND adults (Beck, Lundwall, Gabrielsen, Cox, & South, 2020;Beery & Zucker, 2011;Helmer, Schottdorf, Neef, & Battaglia, 2017;Milner, McIntosh, Colvert, & Happé, 2019;Quinn & Madhoo, 2014;Rogers, 2010). Many women often do not get believed about their challenges, and are misdiagnosed, which leads them to suffer in silence (Bargiela, Steward, & Mandy, 2016;Beck et al., 2020;Helmer et al., 2017;Kuzminski et al., 2019;Leedham, Thompson, Smith, & Freeth, 2020;Olkin, Hayward, Abbene, & VanHeel, 2019;Rogers, 2010). As a result, already marginalized individuals are excluded/discriminated from services that will likely benefit them the most (Holthe & Langvik, 2017;Matheson, Foster, Bombay, McQuaid, & Anisman, 2019).This has led to several repercussions such as: alarmingly high rates of suicide amongst women, and alack of access to healthcare and higher education for women and racial /ethnically diverse individuals (Camm-Crosbie et al., 2018;Cassidy et al., 2019;Kirby et al., 2019).
Programs that are more inclusive have reported benefits for all genders, equally, and is therefore more advantageous (Rucklidge, 2010). We authors feel it is only fair to report extensively, and critically on the demographic of sample and how representative it is of the overall population. In better words, does it only cater to the highly unrepresentative WEIRD population (Western, Educated, Industrialized, Rich and Democratic) (Pollet & Saxton, 2019;Rad, Martingano, & Ginges, 2018)? As mentioned by Azar (2010),-in the American Psychological Association (APA) website-"WEIRD societies represent as much as 80 percent of study participants, but only 12 percent of the world's population-are not only unrepresentative of humans as a species, but on many measures they're outliers" (Azar, 2010, p. 1). In conclusion, our findings, and results with be discussed in line with this conceptual perspective. We will assess the level of full-representation/participation, opposed to partial representation/participation, of ND adults in programs (Matthew, Emily, Amy, & Dominic, 2020).

Results and Discussion
The current review covers both empirical, and qualitative studies which address LSBE for ND adults with ASD (9 programs), ADHD (5 programs), combined ASD/ADHD (1 program) and comorbid learning difficulties (1 program). The findings have been coded, and outcomes analysed in relation to our conceptual perspective, and PICO question.
Based on findings, researchers may not be immune to such bias's when recruiting ASD participants.
Even if the programs have good intent, when they only cater to potential outliers it is ill-representative of the population at large. In comparison, ADHD and combined type programs had a much bigger sample programs, in general, is the lack of socio-economic-status reported. It is rather implied that most participants are recruited from affluent backgrounds. Nonetheless, increasing participant diversity tends to increase sample size, allowing generalizability and feasibility of programs to be more apparent.

Programs for ASD Adults (Improved EF, Daily Living and QoL)
In comparison to typical population, adults with ASD struggle with social communication, adapting to change and often experienced several co-occurring mental health challenges (Demetriou et al., 2018;Johnston et al., 2019;Wallace et al., 2016). Some programs address specific areas, whilst others have touched on many. For instance, Miyajima et al. (2016) program addresses EF in detail (i.e., verbal fluency, flexibility) but also links it to outcomes of social functioning. Others, such as Baker-Ericzén et al. (2018), addresses all three areas more broadly, namely: cognitive enhancement (EF), social skills and employment (daily living).Important vocational outcomes pertaining to daily living were well catered to around: employment (Baker-Ericzén et al., 2018;Nadig et al., 2018;Ward & Esposito, 2019), education (Capriola-Hall et al., 2020;Hillier et al., 2017;Nadig et al., 2018) and leisure (Crabtree & Demchick, 2015;Palmen et al., 2011). All programs were structured in an inclusive manner. Several benefits were reported and are indicative of how LSBE programs can positively affect ASD adults.
A common theme of programs was around improving self-determination levels (a QoL domain) of participants by focus on self-confidence, self-esteem, and self-efficacy (Capriola-Hall et al., 2020;Nadig et al., 2018;Oswald et al., 2018). Targeting this domain seemed to have flow on effects to improving mental health issues such as anxiety, depression and loneliness commonly seen in this population.

Programs for ADHD Adults (Improved EF, Daily Living and QoL)
Compared to the typical population, adults with ADHD struggle in several areas of EF relating to attention, memory, restlessness, time-management, set shifting and emotional dysregulation (Holst & Thorell, 2020;Roselló et al., 2020). As such, they are more prone to lowered self-esteem, sleep problems, anxiety, and depression (Cook, Knight, Hume, & Qureshi, 2014;Michielsen et al., 2013).
Moreover, students with ADHD are often faced with the pressure of performing well at university, to the best of their ability and capacity, despite a lack of accommodation and/or recognition for their challenges (Kwon, Kim, & Kwak, 2018;Taylor, Esmaili Zaghi, Kaufman, Reis, & Renzulli, 2020).
Two LSBE programs were conducted in lab and outpatient settings (Morgensterns et al., 2016;Salomone et al., 2015), whilst the other three programs were pilot studies conducted in a university setting and addressed areas around education (Anastopoulos & King, 2015;Fleming et al., 2015;Hartung et al., 2020). As many adults with ADHD tend to be on medication, another life skill relevant to this population is around its use and regulation (Karlstad et al., 2016;Martinez-Raga, Ferreros, Knecht, de Alvaro, & Carabal, 2016). Many program have included this element, by teaching participant about how to regulate their medicine using psycho educational methods (Hartung et al., 2020). All programs recognize the positive, long-term benefits of LSBE (due to it multimodal approach), where other modes of treatment (such as just pharmaceuticals) may fail or lack in some shape or form.
Although adults with ADHD do struggle with social communication compared to typical peers, their difficulties are generally not as pronounced as with ASD adults (who struggle with pragmatics), and occur for different reasons (relating to EF) (Bora & Pantelis, 2016). Many LSBE programs were conducted in a group environment which help create a sense of social belonging and help with these skills (Morgensterns et al., 2016). Furthermore, much like with ASD programs, many ADHD programs touched on the QoL domain relating to self-determination, which often creates flow on effect to mental health benefits (Salomone et al., 2015).
Although the papers were of medium-high quality, implementing LSBE programs that address real world challenges for ADHD adults is a relatively new concept, and have only been studied over the last 6 years (most studies conducted in year 2015 sufficiently addressed, and would also have benefited from more psychoeducation. Salomone et al. (2015) could have used better scales (such as the Goal Attainment Scale) to measure the outcomes of daily living, and Fleming et al. (2015) findings could have been more robust if conducted on a larger sample. Furthermore, other areas around daily living such as employment or recreational were not explored, despite a growing need (Roselló et al., 2020). In conclusion, the potential of these programs is high (i.e., fairly time and cost effect) if future research attempts to address the gaps of past literature, whilst addressing social challenges when tailoring new programs.

Programs for Combined ASD/ADHD Type (Improved EF, Daily Living and QoL)
Given the high prevalence of the ADHD and ASD comorbid neurotype being an at-risk group for greater EF challenges ( "to enable young people with NDDs to live fulfilling lives, it is crucial that major institutions in society adapt to diversity and facilitate a more sustainable person-environment fit" (Jonsson et al.,p. 10).
The positives of the program include the wide range of QoL domains that are addressed, namely: work, education, finance, household management/housing, health, leisure/participation in society, and relationships/social network. The program acknowledges that several EF challenges exist in this population, but does not explicitly measure them, or structure it within the course. An exception is seen with goal-directed persistent, which is measured using the robust, standardized Goal Attainment Scale (GAS). The results showed that all participants did exceed on at least one QoL life domain, with those in the lower ranges showing a significant increase. However, long term effects of programs were not measured. The program did encourage meaningful participation, by addressing challenges with daily functioning and health outcomes. Psycho education (by employing a guest speaker to share lived experience), social skill training, and Acceptance and Commitment Therapy (ACT) were integrated within program. Multidisciplinary approach was deployed; thus, outcomes can be applied to a range of service settings including mental health and social services.
Caution needs to be applied with results as there were several limitations to study's generalizability and strength of findings. The study does not sufficiently address the unique EF challenges that this neurotype tends to face in line with past literature. The study also lacks an independent outcome rater, session recording, and fidelity score. Sample size was small and missing data was evidence around participant demographics, such as IQ.

Programs for Learning Difficulties (Improved EF, Daily Living and QoL)
Programs appear to be scare for this population. Only one program, from Farmer et al. (2015)'s low quality paper, was tailored towards adults with LD in an inclusive manner, using a Personal Strengths Program (PSP). The program was conducted on university students and consisted of mostly participants with comorbid LD and ADHD. One participant did have just LD, and one just ADHD. There was no mention of how these two participants had their different attentional challenges catered to. The study did not explore how specific characteristics, such as initial self-determination levels, or neurotype impacted results.
The core EF challenges face by this population were broadly addressed within program structure (i.e., emotional control, organization, meta-cognition, and goal directed persistence), but not explicitly

Summary
It is apparent that research into LSBE programs tailored towards ND adults is still at its infancy, despite several reported benefits. No program evaluated in this review statistically compared outcomes to typical population, but rather implies its relevance (i.e., how our target population tend to face greater barriers to full participation in various life domains compared to typical peers). Many of these studies have acknowledged explored this as a result of ableism, lack of accommodation, and bias social structures which too often favour neurotypicals (Jonsson et al., 2019). Furthermore, most of the programs we found were tailored towards adults with ASD and ADHD, with limited exploration into adults with learning difficulties or comorbid types of NDs. Inclusion, diversity, and human rights issues were also evident when critically analyzing the findings.
Given the growing need of reliable services for ND adults, LSBE programs have the potential to www.scholink.org/ojs/index.php/wjer World Journal of Educational Research Vol. 8, No. 4, 2021 57 Published by SCHOLINK INC.
provide promising outcomes (Nadig et al., 2018). Since most LSBE programs use multimodal, inclusive approaches, it addresses issues in an practical, time and cost effective manner (Hartung et al., 2020). Moreover, unlike other treatment approaches that focus on the medical model, inclusive services address the issue as a problem within our society. Take, for instance, the flow on effect that LSBE programs have on increasing employment outcomes (Baker-Ericzén et al., 2018;Ward & Esposito, 2019). This approach not only benefits ND individuals, but society as a whole (Jacob, Scott, Falkmer, & Falkmer, 2015).
"It could be concluded that enhancing the opportunities for adults with ASD to join the workforce is beneficial from a societal perspective, not only from an inclusiveness viewpoint, but also from a strict economic standpoint." (Jacob et al., 2015, p. 39).
The general outcome that can be concluded from this review is the potential LSBE has in improving EF, and consequently QoL for ND adults. It allows for our target population to reach a fairer playing field in several areas of daily living-alongside their typical peers, and even those with other NDs that have more accessible support. Furthermore, LSBE has the potential to bridging the gap between an "us vs them" narrative, by catering to the struggles most adults face, in an inclusive manner. Henceforth, LSBE programs tend to appeal to a variety of stakeholders who can all benefit from this structure (Hartung et al., 2020).

Recommendations
We authors have proposed the following recommendations based on limitations that have been reported in reviewed papers, and critically analysis of these papers through the lens of our conceptual perspective. Implications for policy, research, and development in this area have been discussed:

1 Employ More Neurodivergent Researchers
Neurodivergent voices need to have greater relevance to the broader research a gender around the understanding of their challenges (van den Bosch et al., 2019). New research policies need to encompass the "nothing about us without us" more readily, rather than simply acknowledging its existence-as ND researchers often have remarkable expertise in this field (Fletcher-Watson et al., 2018;Gillespie-Lynch, Kapp, Brooks, Pickens, & Schwartzman, 2017;Milton, 2014 (Johnson, 2011;Kirkham, 2017;Kvaale, Haslam, & Gottdiener, 2013). Make sure this is done in a measurable way, to establish change is conducted with tangibility and transparency.

Deconstruct Ableist, Sexist and Racist Research/Theories
In general, a lot of scientific research has held both racial gender bias which has often led to implying www.scholink.org/ojs/index.php/wjer World Journal of Educational Research Vol. 8, No. 4, 2021 58 Published by SCHOLINK INC.
erroneous findings and claims with little evidence to back it up (Beery & Zucker, 2011;Dotson & Duarte, 2020;Helmer et al., 2017;Roberts, Bareket-Shavit, Dollins, Goldie, & Mortenson, 2020;Rogers, 2010;Snowden, 2003). Thus, it is understandable why discriminatory practices exist in field of ND, which is reflective of the unrepresentative sample demographic seen in several programs (as reported in Table 3). When recruiting participants, future research should be mindful in using tools that hold such bias and try and formulate measurements that detect ND more inclusively (Murray et al., 2017). Greater understanding of how people with ND's present across genders, race, cultures, and other spheres is clearly warranted (Maney, 2016;Rogers, 2010;Teufel & Fletcher, 2016).
In the ASD literature, it is evident that many of these gender bias theories exist at greater rates than with ADHD and learning difficulty literature (Baron-Cohen et al., 2011;Krahn & Fenton, 2012). This could be the reason why higher rates of participant diversity is seen in LSBE programs for people in ADHD programs compared to ASD ones. For instance with the -often over-sighted-neuro-sexist 'male-brain' theories of autism (Krahn & Fenton, 2012) . It states that 76.6% of females with ASD have male brains, and ASD is more of a "male disorder" (Baron-Cohen et al., 2011). Oransky (2019), years later, reported that this study had to be retracted due to research errors acknowledged by the researchers themselves. The findings were, in fact, the complete opposite. Moreover, rates of misdiagnosed and undiagnosed females with ASD/ADHD remain extremely high (Quinn & Madhoo, 2014).With more social awareness, and better diagnostic tools, people from diverse backgrounds can be recognised and recruiting for these LSBE programs.

Fund the Under-Researched Population
As evident in our findings, most research has been tailored towards those with just ASD, and sometimes ADHD, whilst little explores those with complex NDs (combined types) and/or learning difficulties. This is not to take away from the fact that ASD research needs to be conducted more appropriately, but there still requires more recognition for ADHD and learning difficulty research in general.

Fund Research for Adults with ADHD and Combined ASD/ADHD Type
Reasons for a lack of funding may revolve around: (a) the negative attitude's surroundings ADHD amongst professionals, academic and society (Fuermaier et al., 2012;Mulholland, 2017), and (b) scarcity in data regarding people with ADHD-as reported by the Victorian Government Department of Education (2007). Of the limited data that is available in however, it is reported that students with ASD/ADHD combined type are the most vulnerable to full, meaningful participation than those with or without other disabilities (Elias & White, 2018;Mulholland, 2017). A submission to address the data, and higher educational problem was made to the Royal Commission in Victoria-indicated evidence of the ongoing issue (Holmes, 2019). In addition, we recommend that health professionals in this field are made more aware of how ASD/ADHD can often coexist and possible formulate new diagnostic tools to detect this co-occurrence.

Fund Research for Adults with Specific Learning Difficulties (SLD)
Despite clear evidence that learning difficulties persist into adulthood (Gerber, 2011), there is a general lack of research conducted in this area. In our review only one program existed. This highlights how little services cater to and recognise this population. As mentioned by Taymans and Kosaraju (2012), there still remains a disagreement on how to even define SLD. Without addressing the roots of the problem, by funding more research in this area to understanding specific learning difficulties, progression in the field will continue to be minimal (Kohli, Sharma, & Padhy, 2018).
Clearly, there is substantial variability and disagreement among professionals about the definition of SLD. Even though the label of SLD has been recognized since the 1960s, it is a disability construct that is still being formed and refined. Clearly, there is substantial variability and disagreement among professionals about the definition of SLD. Even though the label of SLD has been recognized since the 1960s, it is a disability construct that is still being formed and refined.
Furthermore, much like with ADHD research, studies into adults with learning difficulties have consistently noted how challenges tend to represent in the educational settings (McDowell, 2018;Taymans & Kosaraju, 2012). Thus, it could be beneficial to create more awareness in university and education settings around this issue-to bring our understanding to a greater forefront. In our review it was also noted that the only program that did cater to learning difficulties was of low quality. As such, very little can be concluded in this area without conducted larger scale research.

Outcome Specific to LSBE Programs for Neurodivergent Adults
A common limitation reported in almost all LSBE programs was small the same size, which can be by addressed by targeting the above points. Through increasing diversity, and decreasing gender, ethnic and racial bias, key limitations especially evident in ASD programs may be addressed. As described above, the problem is incredibly deep rooted and reflects the issue we have in both our society and academia at large. Yet, by increasing sample size and participant diversity, a plethora of benefits will be evident such as: providing generalizability and represent ability of findings, with greater statistical potential and validity. More robust research designs can be implemented as size of population increases (such as RCT trials and larger scale studies), allowing for services to take on this model with greater confidence (Hartung et al., 2020;Morgensterns et al., 2016). Moreover, LSBE has the potential to reach global heights, whilst accommodating several of its users using: online or face-to-face methods, individual and/or group formats, and embracing the potential of Virtual Reality (VR) (Ward & Esposito, 2019).

Advertise LSBE Broadly to All Neurotypes
Since this area of research is at its infancy, it may be beneficial to advertise the LSBE to all neurotypes, whilst still acknowledging the unique challenges of ND adults. It could be a good step to increasing awareness of the potential such programs can bring, and ultimately lead to greater government funding in this area. It may also help bridge the gaps between the "us" vs "them" narrative, by showcasing the true powers of inclusive practice.

Example and Evidence
In Adelaide, Australia, City of Onkaparinga Council has advertised LSBE program for adults (Slessor, 2019). The director of the program reported that responses to the program had been overwhelming-as places filled up just within two days. Moreover, eight undergraduate students -from a thematic, qualitative study-felt strongly about the importance and efficacy of LSBE programs being taught to them (Nair & Fahimirad, 2019). It could even allow for more productive discussions around how our social structures (Ito, 2018), and notion of normality (Freud, 1999), limit all of us in some shape or form. Further scientific exploration into this area may be beneficial.

Conclusion
Although some LSBE programs for ND individuals do exist in residential settings ( et al., 2016) or those who 'slip through the cracks' to general to service access. Often the biggest barrier is around the misconception that ND adults will learn these skills on their own-despite years of evidence suggesting otherwise (Cronin, 1996). For instance, Taylor and Seltzer (2011) finds that autistic individuals have worse employment outcomes than both the typical population, and even other disabilities such as intellectual (ID).
Criticisms of the current education system suggests that too much emphasis is being placed on cognitive and vocational skills opposed to psychosocial ones (Prajapati, Sharma, & Sharma, 2016).
Although the Dolores framework is still used in the 21 st century, reforms are needed in to context of education and employment to address this issue (Olaniran, 2016;van Laar, van Deursen, van Dijk, & de Haan, 2020). Formal education is important, but a review of the literature suggests that teaching life skills can help bridge the gaps between basic functioning and thriving in life, especially for the ND population (Prajapati, 2016).
pitfalls of biomedical and medicalized perspectives in par with calls for reform to age-old practises (Deacon, 2013;Lake, 2017;. People with psychiatric labels, or disability labels often prefer to be described as "neurodivergent" (ND) or having a "neurodivergence". For example, people with neurodevelopmental disorders (e.g., ASD, ADHD and Dyslexia), disabilities (e.g., Cerebral Palsy) acquired neurodiversities (e.g., Traumatic Brain Injury), mental illness (e.g., Borderline Personality Disorder, C-PTSD) or comorbidities (e.g., ASD with C-PTSD) may all identity as neurodiverse. This is often because negative connotations attached towards may psychiatric and disability labels exist, often leading to the re-stigmatisation and marginalisation of already marginalised individuals (Gillespie-Lynch, 2017).
Alternative language -like that pertaining to neurodiversity-is all-inclusive, and helps dispel myths birthed of injustices (Fenton, 2007).

Neurotypical (NT)
, on the other hand, is a label that describes those who do not display characteristics of autism or another neurodivergence (Tan, 2018). The term attempts to address the pitfalls of using 'us vs them' narratives, and notions of 'normal is superior'. This term is sometimes used in research, but more so satirically by neurodivergent advocates (Brownlow, 2010).
Neurotype is, for the most part, is non-dichotomous, and used to refer to a particular group of individuals who share similar brain structures and/or functioning (Jollans & Whelan, 2018). Essentially, the blending of the words "neurological type", per "neurotype" can mean either/both neurodiverse and neurotypical. Several self-advocates have argued -in accordance with social theories of disability-that The neurodiverse movement is a social justice movement founded on principles pertaining to the social model of disability. It advocates for the civil and political rights, equality, respect, and full societal inclusion of neurodivergent individuals (Graby, 2015;Dyck, 2020;Arnold, 2017). The movement can be incredibly advantageous to making positive, progressive changes in various spheres of society (Nicolaidis, 2012;Graby, 2015). Nonetheless, like many other social movements, the neurodiverse movement has been fraught with some criticism and debate (Ortega, 2009). This is often due to the understanding of neurodiversity taken out of context and misconstrued for what it truly intends to represent (Ortega, 2009;Houting, 2018).
Life Skills have been widely defined by various stakeholders and policy makers over the years due to their multidimensional and dynamic nature (Behera, 2015). As noted by Singh (2003) translates across various situations (e.g., education, workplace, home, community, formal and informal settings), and domains of human existence (e.g., health, environment, gender, politics, culture, lifespan).
Due to such complexities and context-driven variables, there remains no one universally accepted definition and use for the term (Jones & Parker, 2014). However, common themes or elements can be observed and articulated in line with the topic of our literature review.
We authors feel the definition most suited to capture the essence of life skills is from The World Health Organization (WHO 1999, p. 1): "the abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life". Specifically, WHO lists 10 "life skills" pertaining to psychosocial competencies, and encompassing some important elements (Behera, 2015). Namely: self-awareness, critical thinking, problem solving, creative thinking, decision-making, interpersonal relationship, empathy, effective communication, coping with stress, and coping with emotions (WHO, 1999, p.3).
In addition to the WHO definitions, and in relation to the context of neurodiversity and adulthood, we will integrate Cronin (1996)'s definition into our review: "life skills are tasks and behaviours needed to allow for the independent functioning of an individuals into adulthood." The International Bureau of Education (IBE) views life skills as assets that can strengthen the personal management, and social skills needed for daily living. It conceptualizes this in par with Delores four pillars of learning-a concept extracted from the 1996 Delores Report (Olaniran, 2016). Developments of the Delores report with Dolores four pillars have had global implications, with the use of life skill integrated in schools and adult curriculum worldwide.
For context, the Delores four pillars was created by the Delores Commission, who laid the foundations to, and influenced global policies around the educational system using humanistic approaches (Tawil & Locatelli, 2015). The framework essentially comprised of: knowledge and critical thinking skills (learning to know), practical skills (learning to do), personal skills (learning to be) and social skills (learning to live together) (Behera, 2015). The psycho-social life skills fall under learning: to know, to be and to live together.

Life Skills Based Education (LSBE)
is an approach that aims to cultivate life skills through evidence -driven, skill-based, learner-focused interventions that use practical and interactive methods to learning (UNICEF, 2003).
The World Health Organisation's (WHO) Department of Mental Health state that LSBE should ideally be: "designed to facilitate the practice and reinforcement of psychosocial skills in a culturally and developmentally appropriate way; it contributes to the promotion of personal and social development, the prevention of health and social problems, and the protection of human rights" (1999, p.3).
Cronin (1996) systematic literature review, reveals that the outcomes of an effective LSBE programs can be measured by: "analysing an individuals' level of enhanced community adjustment, independent functioning and quality of life" (1996, p.53).
Life skill training can also provide various mental health benefits that meet the needs of modern society (Jamali, 2016). As we see deep cultural shifts, and changes in lifestyle, demands for life skill training increase (Gerami, 2015).Integrating digital skill training, and the digitalization of life skill programs can further meet the technological demands of living in the 21 st century (van Laar, 2020). Although research acknowledges and reports several benefits of LSBE-a potential lack of research in this area leaves several questions to why, and how it works unanswered (Jones, 2014;Nasheeda, 2018).