1
|
Herrick SJ, Lu W, Oursler J, Beninato J, Gbadamosi S, Durante A, Meyers E. Soft skills for success for job seekers with autism spectrum disorder. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Direct Skills Teaching (DST) is a method for distilling a skill into digestible components for ease of teaching and learning of a new skill. Job retention is a complex phenomenon requiring numerous social competencies that include verbal and non-verbal fluency among others. Individuals with Autism Spectrum Disorder (ASD) often struggle with social communication and therefore are at a disadvantage in employment settings; even when otherwise qualified for the position. OBJECTIVE: This preliminary pilot study tested the feasibility of a DST group intervention to assist individuals with ASD with work-related soft skills, with a particular focus on informal conversational skills. METHODS: Eight master’s level Rehabilitation Counseling students facilitated groups of adults with autism spectrum disorder seeking employment. Student facilitators followed the Conversing with Others manualized curriculum, designed to teach workplace based informal conversational soft skills. Participant feedback was sought both pre and post intervention, and student facilitators recorded their observations of each group session. RESULTS: The initial findings support the feasibility of soft-skills training for work-related conversational skills teaching for job seekers with ASD. The results also supported the need for significant adjustments to the intervention as well as any future studies of the small group intervention Conversing with Others. CONCLUSIONS: Workplace conversational skills can be facilitated in a small group setting. Master’s level counselors-in-training, were able to follow a manualized DST soft-skills small group.
Collapse
Affiliation(s)
- Samantha J. Herrick
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Weili Lu
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Janice Oursler
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - John Beninato
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Sharon Gbadamosi
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Alison Durante
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Elizabeth Meyers
- Veterans Administration, U.S. Department of Veterans Affairs, Washington, DC, USA
| |
Collapse
|
2
|
Baker-Ericzén MJ, Smith L, Tran A, Scarvie K. A Cognitive Behavioral Intervention for Driving for Autistic Teens and Adults: A Pilot Study. AUTISM IN ADULTHOOD 2021; 3:168-178. [PMID: 36601464 PMCID: PMC8992894 DOI: 10.1089/aut.2020.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background For many autistic individuals approaching adulthood, interventions to promote skills toward independence are lacking. Driving is an important ability to cultivate as it may be a critical step to attaining independence, securing and maintaining work, and fostering relationships. Only about one third of able autistic individuals drive independently, and fear to drive is a common reason for not driving. Methods This initial pilot study was a 3-month open trial to investigate the feasibility, acceptability, and initial estimates of outcomes for the newly developed Cognitive Behavioral Intervention for Driving (CBID) intervention, a manualized curriculum to enhance executive functioning (EF) and emotional regulation (ER) skill development for driving, combined with individualized commentary-based driving simulator practice, in autistic teens and adults within a community research environment. Nineteen participants received the CBID intervention in 1.5-hour group sessions for 10 weeks, across two cohorts, with approximately five individualized driving simulator sessions. Data were collected on anxiety symptoms, driving cognitions, driving attitudes, and simulated driving performance at pre- and post-intervention assessments. Results Program completion rate was 81%. Participants and parents rated both the intervention and simulator practice sessions with high satisfaction. All the participants (100%) reported both a positive attitude change (interest toward driving) and a desire to drive in the future at the post-intervention assessment. Significant changes occurred for driving cognitions, attitudes, and behaviors, and 47% of participants obtained a driver's permit or license by 2 months post-intervention. Conclusions For autistic individuals, the CBID intervention appeared to directly impact the pursuit toward driving goals by both increasing driving attitudes and behaviors and reducing anxiety/apprehension. This highlights the need for driving intervention programs designed specific to autistic teens/adults that focus on EF and ER skills coupled with individualized simulator practice. CBID could be provided in community services to increase the number of autistic individuals driving. Lay summary Why was this study done?: Driving contributes greatly to independence in many teens and adults. Anxiety can act as a barrier to that independence by affecting driving attitudes, ability and performance. Autistic individuals are often affected by anxiety, executive functioning, and emotion regulation challenges. Previous studies show that virtual reality training and Cognitive Behavioral Therapy (CBT), separately, can reduce driving anxiety in autistic individuals and support driving skills. However, to date, no studies have developed and tested a manualized intervention specific to driving that combines such methods.What was the purpose of this study?: The goal of this study was to develop and test a group intervention, called Cognitive Behavioral Intervention for Driving (CBID), combined with individualized, coached driving simulator practice to help reduce fears and increase cognitions, attitudes and performance towards driving. The study examined the following questions: 1) Do autistic individuals actively participate in CBID? 2) Do autistic participants like CBID? and 3) Are autistic participants more prepared to drive after taking part in CBID than they were before they participated in the program?What did the researchers do?: After developing the CBID intervention with community member involvement, the researchers ran 2 intervention groups and individualized driving simulator sessions to a total of 19 enrolled participants. The group intervention focused on strengthening executive functioning and emotion regulation skills in 1.5 hour sessions over 10 weeks and 5, 1 hour driving simulator sessions. Researchers compared data on participant anxiety levels, driving cognitions, attitudes, and performance before and after the intervention.What were the results of the study?: Most of the participants completed the program (81%) and all (100%) rated satisfaction with the group and simulator practice. All (100%) of the participants changed attitudes towards driving. Participants had higher levels of positive thoughts about driving, better attitudes towards wanting to drive and less driving errors (like speeding, collisions, crossing lanes) on the driving simulator after completing CBID. Almost half (47%) of participants obtained a driver's permit or license by 2 months after the intervention.What do these findings add to what was already known?: This study adds a new option of an integrated approach, CBID, for addressing driving anxiety or apprehension. It provides initial findings of the value of incorporating executive functioning skills with traditional cognitive behavior therapy for enhancing driving readiness.What are the potential weaknesses in the study?: This study contained a small sample size that was mostly white male participants. This limits generalizing the results to a representative diverse population. It also did not have a control group or use randomization which means that results can't be interpreted as causal at this time. There was no information about participants obtaining permit/licensure later than 2 months after CBID so it is unclear if some participants require more time to pursue a license. There was no follow up to understand if participants continued to feel comfortable driving overtime.How will these findings help autistic adults now or in the future?: This study showed that it's possible to combine virtual reality training and Cognitive Behavioral Therapy into one driving readiness program. The new CBID program may help autistic adults by addressing multiple aspects of what they need to be ready to drive. Since the study used previously tested strategies, enrolled a community sample, manualized the program, and used a services approach, it was designed for broad distribution to other community settings.
Collapse
Affiliation(s)
- Mary J. Baker-Ericzén
- Department of Administration, Rehabilitation and Post-Secondary Education, Interwork Institute, San Diego State University, San Diego, California, USA.,Child and Adolescent Services Research Center, Rady Children's Hospital San Diego, San Diego, California, USA.,Address correspondence to: Mary J. Baker-Ericzén, PhD, Child and Adolescent Services Research Center, Rady Children's Hospital San Diego, 3020 Children's Way MC 5033, San Diego, CA 92123, USA
| | - Lauren Smith
- University of California, San Diego, La Jolla, California, USA
| | - Anh Tran
- Child and Adolescent Services Research Center, Rady Children's Hospital San Diego, San Diego, California, USA.,University of California, San Diego, La Jolla, California, USA
| | - Kathleen Scarvie
- Child and Adolescent Services Research Center, Rady Children's Hospital San Diego, San Diego, California, USA.,University of California, San Diego, La Jolla, California, USA
| |
Collapse
|
3
|
Kose LK, Fox L, Storch EA. Effectiveness of Cognitive Behavioral Therapy for Individuals with Autism Spectrum Disorders and Comorbid Obsessive-Compulsive Disorder: A Review of the Research. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2018; 30:69-87. [PMID: 29568212 PMCID: PMC5858576 DOI: 10.1007/s10882-017-9559-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Autism spectrum disorders (ASD) and obsessive-compulsive disorder (OCD) are highly comorbid, precipitating an urgent need to identify evidence-based practices that might be used to address this comorbidity exclusively. The aim of this study was to conduct a review of intervention research and clinical reports to examine the use of cognitive behavioral therapy (CBT) with individuals who have comorbid ASD and OCD. Based on the pre-determined review inclusion criteria, 11 studies were included in the review: three randomized control trials (RCT), one case controlled study, two single subject experimental designs, and five case studies. These studies offer promising data on the use of CBT interventions for individuals with ASD and comorbid OCD as well as for individuals with OCD and comorbid ASD when standard CBT protocol is enhanced with modifications such as parental involvement, increased use of visuals, personalized treatment metaphors, self-monitoring, positive reinforcement, and use of clear language and instructions. Limitations and implications for future research and practice are discussed.
Collapse
Affiliation(s)
- Leman Kaniturk Kose
- Department of Child & Family Studies, University of South Florida, 4202 E. Fowler Avenue MHC2312, Tampa, FL 33612, USA
| | - Lise Fox
- Department of Child & Family Studies, University of South Florida, 4202 E. Fowler Avenue MHC2312, Tampa, FL 33612, USA
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, 880 6th Street South, St. Petersburg, FL 33701, USA
| |
Collapse
|
4
|
Burkhart K, Knox M, Hunter K. Cognitive-Behavioral Therapy in the Treatment of Internalizing Disorders in High-Functioning Youth with Autism Spectrum Disorder. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2017. [DOI: 10.1007/s10879-017-9374-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
5
|
Anderberg E, Cox JC, Neeley Tass ES, Erekson DM, Gabrielsen TP, Warren JS, Cline J, Petersen D, South M. Sticking with it: Psychotherapy outcomes for adults with autism spectrum disorder in a university counseling center setting. Autism Res 2017; 10:2048-2055. [PMID: 28815985 DOI: 10.1002/aur.1843] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/28/2017] [Accepted: 06/26/2017] [Indexed: 11/10/2022]
Abstract
Young adults with autism spectrum disorders (ASD) experience high rates of comorbid mental health concerns in addition to distress arising from the core symptoms of autism. Many adults with ASD seek psychological treatment in outpatient facilities in their communities that are not specifically geared toward individuals with ASD. However, few studies have looked at the effectiveness of standard psychotherapeutic care in adults with ASD. This study aimed to discover how individuals with ASD fare in psychotherapy within a college counseling setting, compared to their neurotypical peers. Clients with ASD (n = 76) or possible ASD (n = 91) were retrospectively identified from counseling center case notes. Data from the Outcome Questionnaire-45 (OQ) were retrieved for each therapy session as a measure of client distress. Clients with ASD showed no difference in level of distress at intake compared to their neurotypical peers (n = 21,546), and improved about the same amount from pre- to post-treatment. However, students with ASD stayed in treatment for significantly more sessions than neurotypical clients, and took significantly longer to achieve maximum improvement on OQ reports. Results are discussed with implications for university and other community based treatment settings. Autism Res 2017, 10: 2048-2055. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY This study aimed to discover how individuals with autism spectrum disorders (ASD) fare in psychotherapy within a university counseling setting, compared to their neurotypical peers. Clients with ASD showed no difference in level of distress at intake compared to their neurotypical peers, and improved about the same amount from pre- to post-treatment. However, students with ASD stayed in treatment for significantly more sessions than neurotypical clients, and took significantly longer to achieve maximum improvement on Outcome Questionnaire-45 reports.
Collapse
Affiliation(s)
- Emily Anderberg
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Jonathan C Cox
- Counseling and Psychological Services Center, Brigham Young University, Provo, Utah
| | | | - David M Erekson
- Counseling and Psychological Services Center, Brigham Young University, Provo, Utah
| | - Terisa P Gabrielsen
- Counseling Psychology and Special Education, Brigham Young University, Provo, Utah
| | - Jared S Warren
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Jared Cline
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Devin Petersen
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Mikle South
- Department of Psychology and Neuroscience Center, Brigham Young University, Provo, Utah
| |
Collapse
|
6
|
Walters S, Loades M, Russell A. A Systematic Review of Effective Modifications to Cognitive Behavioural Therapy for Young People with Autism Spectrum Disorders. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0072-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
7
|
The Association Between Social Skills and Mental Health in School-Aged Children with Autism Spectrum Disorder, With and Without Intellectual Disability. J Autism Dev Disord 2016; 45:2487-96. [PMID: 25758822 DOI: 10.1007/s10803-015-2411-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with social skills deficits and co-occurring mental health difficulties. ASD frequently co-occurs with Intellectual Disability (ID). There is scant literature exploring the association between social skills and mental health in children with ASD, with or without ID. Participants were 292 children aged six to 13 with ASD (217 without ID; 76 with Mild ID). Parents and teachers rated social skills and mental health using standardised questionnaires. Greater mental health difficulties were associated with greater social responsiveness difficulties and poorer social skills across the sample. Effect sizes were large. Social skills explained a significant proportion of the variance in mental health scores across the sample. The study has important implications for treatment and future research.
Collapse
|
8
|
Rosen TE, Connell JE, Kerns CM. A Review of Behavioral Interventions for Anxiety-Related Behaviors in Lower-Functioning Individuals with Autism. BEHAVIORAL INTERVENTIONS 2016. [DOI: 10.1002/bin.1442] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Tamara E. Rosen
- A.J. Drexel Autism Institute; Drexel University; Philadelphia PA USA
- Stony Brook University; Stony Brook NY USA
| | - James E. Connell
- A.J. Drexel Autism Institute; Drexel University; Philadelphia PA USA
| | - Connor M. Kerns
- A.J. Drexel Autism Institute; Drexel University; Philadelphia PA USA
| |
Collapse
|
9
|
Kreslins A, Robertson AE, Melville C. The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health 2015; 9:22. [PMID: 26120361 PMCID: PMC4482189 DOI: 10.1186/s13034-015-0054-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 06/08/2015] [Indexed: 12/28/2022] Open
Abstract
Anxiety is a common problem in children and adolescents with autism spectrum disorder (ASD). This meta-analysis aimed to systematically evaluate the evidence for the use of psychosocial interventions to manage anxiety in this population. Cognitive behavioural therapy (CBT) was the primary intervention modality studied. A comprehensive systematic search and study selection process was conducted. Separate statistical analyses were carried out for clinician-, parent-, and self-reported outcome measures. Sensitivity analyses were conducted by removing any outlying studies and any studies that did not use a CBT intervention. A subgroup analysis was performed to compare individual and group delivery of treatment. Ten randomised control trials involving a total of 470 participants were included. The overall SMD was d = 1.05 (95 % CI 0.45, 1.65; z = 3.45, p = 0.0006) for clinician- reported outcome measures; d = 1.00 (95%CI 0.21, 1.80; z = 2.47, p = 0.01) for parent-reported outcome measures; and d = 0.65 (95%CI -0.10, 1.07; z = 1.63, p = 0.10) for self-reported outcome measures. Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment. However, the results of self-reported outcome measures failed to reach significance. The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment. The main limitations of this review were the small number of included studies as well as the clinical and methodological variability between studies.
Collapse
Affiliation(s)
- Ance Kreslins
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
| | - Ashley E. Robertson
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
| | - Craig Melville
- Institute of Health and Wellbeing, University of Glasgow, 1st Floor Admin Building Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, Scotland
| |
Collapse
|