Including Autistic Adults With Profound Support Needs in Speech-Language Pathology Research: Barriers and the Accessibility, Consent, Communication, Equity, Stakeholder Leadership, and Sustainability (ACCESS) Framework

Purpose: Autistic adults with profound support needs remain underrepresented in speech-language pathology research, particularly when studies require spoken responses, standardized task completion, independent participation, or conventional demonstrations of comprehension. This article examines this underrepresentation and its epistemic, clinical, and ethical consequences; identifies key methodological and procedural barriers to inclusion in speech-language pathology research; and introduces Accessibility, Consent, Communication, Equity, Stakeholder Leadership, and Sustainability (ACCESS) as an organizing framework for planning communication research. Method: This non–data-based article synthesizes scholarship in participatory and inclusive autism research, augmentative and alternative communication and communication rights, disability research ethics, and equity-oriented research design. This synthesis informs the analysis of barriers to inclusion and the development of ACCESS. Conclusions: The underrepresentation of autistic adults with profound support needs limits the relevance, validity, and equity of the evidence informing communication-related clinical practice and service delivery. ACCESS treats its six components as interrelated design conditions for inclusive research, with implications for research design and implementation, clinical and community partnerships, and institutional support. As a preliminary framework, ACCESS can guide the design of rigorous speech-language pathology research that more validly captures participants' communication and supports meaningful research participation.