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Li C, Cheung WC, Burke MM, Taylor JL, DaWalt LS. Examining the associations among knowledge, empowerment, and advocacy among parents of transition-aged youth with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2080-2089. [PMID: 38270137 PMCID: PMC11269520 DOI: 10.1177/13623613231221126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
LAY ABSTRACT Parents of individuals with autism face many challenges in finding appropriate services and support for their children, and they also play an important role in advocating for their children's rights and needs. Despite the increasing availability of advocacy programs, it is still uncertain how to best encourage parents to advocate for their children. This study explored the connection between parents' knowledge and sense of empowerment, and how these factors relate to three types of advocacy activities (i.e. individual, peer, and systemic). The findings reveal that feeling empowered has a greater impact on advocacy than simply having knowledge. In addition, the study found that individual advocacy correlates to more peer advocacy, which also correlates to more systemic advocacy. These results can help researchers and professionals to better develop programs to increase parent advocacy and, in turn, help improve the lives of individuals with autism.
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Ferrante C, Sorgato P, Fioravanti M, Pacione L, Arduino GM, Ghersi S, Scattoni ML, Servili C, Salomone E. Supporting Caregivers Remotely During a Pandemic: Comparison of WHO Caregiver Skills Training Delivered Online Versus in Person in Public Health Settings in Italy. J Autism Dev Disord 2024; 54:765-784. [PMID: 36454366 PMCID: PMC9713075 DOI: 10.1007/s10803-022-05800-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/05/2022]
Abstract
Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed.
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Affiliation(s)
- Camilla Ferrante
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Paola Sorgato
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Mariachiara Fioravanti
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Laura Pacione
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Giuseppe Maurizio Arduino
- Centro Autismo e Sindrome di Asperger, Ospedale Regina Montis Regalis Mondovì, Mondovì (Cuneo), Italy
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
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Taylor JL, DaWalt LS, Burke MM, Slaughter JC, Xu M. Improving parents' ability to advocate for services for youth with autism: A randomized clinical trial. Autism Res 2023; 16:1976-1988. [PMID: 37551665 PMCID: PMC10615697 DOI: 10.1002/aur.3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 07/16/2023] [Indexed: 08/09/2023]
Abstract
Youth with autism face challenges accessing services as they transition to adulthood. Improving parents' ability to advocate for services on behalf of their youth may be an effective way to improve service access and ultimately transition outcomes in this group. In this study, we tested whether participating in an advocacy intervention improved parents' ability to advocate for services for their transition-aged youth with autism. One hundred and eighty-five parents of youth with autism ages 16-26, recruited across three states in the U.S., were randomized to one of two experimental conditions. The treatment condition received the ASSIST program, a 12-week (24-h) group-based intervention. The control condition received the same written materials as the treatment condition. Primary outcomes for this report-parent advocacy ability-were collected at baseline (prior to randomization) and post-test (immediately after the treatment group finished the 12-week program) by survey. After taking ASSIST, the treatment condition had greater gains than controls in knowledge of adult services (B = -1.62, CI = -2.33 to -0.90) and perceived advocacy skills (B = -0.19, CI = -0.33 to -0.04). Participants who had less knowledge, lower perceived advocacy skills, and less active coping styles at baseline had the greatest treatment gains. Findings suggest that ASSIST is effective in improving parent advocacy ability and may be most beneficial for parents who experience greater challenges advocating for their son/daughter with autism. Future research will examine whether gains in parent advocacy ability leads to improvements in service access and post-school outcomes for transition-age youth with autism.
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Affiliation(s)
- Julie Lounds Taylor
- Department of Pediatrics and Vanderbilt Kennedy Center, Vanderbilt University Medical Center
| | | | - Meghan M. Burke
- Department of Special Education, University of Illinois at Urbana-Champaign
| | | | - Meng Xu
- Department of Biostatistics, Vanderbilt University Medical Center
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Lee CE, Choi M. Feasibility of school-based parent support groups for transition-aged youth with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1179-1187. [PMID: 37461331 DOI: 10.1111/jar.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 04/30/2023] [Accepted: 07/02/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Parents experience difficulties supporting children with intellectual disabilities when they exit the school system. One promising way to mitigate this problem is to set up school-based parent support groups. This study aimed to examine the development and feasibility of school-based parent support groups in South Korea designed to connect parents of transition-aged youth with intellectual disabilities. METHODS This qualitative study included 29 participants. Five focus groups and seven individual interviews were conducted with parents as co-researchers. Data were analysed using thematic analysis. RESULTS Participants reported meaningful experiences after participating in the parent support groups. However, it is critical to consider the following components to promote their feasibility: clearly defined roles, small group meetings, school-based initiatives, and collaboration. CONCLUSIONS Parent support groups could be a valuable way to promote parental empowerment. Implications for future practices are suggested.
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Affiliation(s)
- Chung Eun Lee
- Department of Education, Sungshin Women's University, Seoul, Republic of Korea
| | - Minsik Choi
- Department of Secondary Special Education, Kangnam University, Yongin-si, Republic of Korea
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5
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Carter EW, Lanchak ER, Guest L, McMillan ED, Taylor JL, Fleming LP, Dao A. Family Perspectives on the Complexities of Pursuing Integrated Employment for Adults With Intellectual and Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:219-236. [PMID: 37104859 DOI: 10.1352/1944-7558-128.3.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/10/2022] [Indexed: 05/25/2023]
Abstract
The road to employment is not often easy for individuals with intellectual and developmental disabilities (IDD). Families know firsthand the complexities and challenges of obtaining employment for their members with extensive support needs. The purpose of this qualitative study was to identify the critical barriers they encounter in this important pursuit. We interviewed 60 parents (and other caregivers) whose family members with intellectual disability and/or autism had sought and/or obtained paid work. The difficulties they described were extensive and multifaceted. Specifically, participants identified 64 different barriers attributed to six primary areas: individuals, families, schools, service systems, workplaces, and communities. Their unique insights amplify the need for new approaches for promoting integrated employment. We offer recommendations for research and practice aimed at better understanding and ameliorating barriers to meaningful work for adults with IDD.
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Affiliation(s)
- Erik W Carter
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Emily R Lanchak
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Laura Guest
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Elise D McMillan
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Julie Lounds Taylor
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Laurie P Fleming
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Ahn Dao
- Ahn Dao, Vanderbilt University. Erik. W. Carter is now at Baylor University
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Aleman‐Tovar J, Burke MM, Monárrez E. Mexican–American
caregivers' perceptions of a
culturally adapted
transition planning program for youth with autism. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Meghan M. Burke
- Department of Special Education University of Illinois Urbana‐Champaign Champaign Illinois USA
| | - Edwin Monárrez
- Department of Special Education University of Illinois Urbana‐Champaign Champaign Illinois USA
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Burke MM, Cheung WC, Li C, DaWalt L, Segal J, Taylor JL. Parental Perceptions of Service Access for Transition-Aged Youth With Autism During COVID-19. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 60:369-381. [PMID: 36162047 PMCID: PMC9942276 DOI: 10.1352/1934-9556-60.5.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/27/2022] [Indexed: 06/16/2023]
Abstract
Services are critical for youth with autism spectrum disorder (ASD), especially during the transition to adulthood. Under the best of circumstances, though, it can be difficult to access needed adult services. With COVID-19, services were more difficult to obtain and retain. In this study, we explored parent perceptions of accessing new services and maintaining current services during the first year of the COVID-19 pandemic. Structured interviews were conducted with 65 parents of transition-aged youth (aged 16-26) with ASD living in three states (IL, TN, and WI) in the United States. None of the participants reported receiving new services during the pandemic, and many struggled to access services via online applications. In addition, participants reported that service suspensions and changes in modality (e.g., from in-person to telehealth) were spearheaded by professionals and not families. Participants, especially those in TN, were more likely to pay out-of-pocket for services during the COVID-19 pandemic to compensate for service disruptions. Implications for research and practice are discussed.
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Affiliation(s)
- Meghan M Burke
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - W Catherine Cheung
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - Chak Li
- Meghan M. Burke, W. Catherine Cheung, and Chak Li, University of Illinois at Urbana-Champaign
| | - Leann DaWalt
- Leann DaWalt, University of Wisconsin at Madison
| | - Jordan Segal
- Jordan Segal and Julie Lounds Taylor, Vanderbilt University Medical Center
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Shea L, Tao S, Marcus SC, Mandell D, Epstein AJ. Medicaid Disruption Among Transition-Age Youth on the Autism Spectrum. Med Care Res Rev 2022; 79:525-534. [PMID: 34632834 PMCID: PMC10775849 DOI: 10.1177/10775587211051185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Enrollment in Medicaid facilitates access to needed services among transition-age youth on the autism spectrum and youth with intellectual disability (ID). There are long-standing programs to ensure that individuals with ID remain enrolled as they age; similar programs for autistic youth are newer, not as widespread, and may not be as effective. We compared Medicaid disenrollment and re-enrollment between transition-age youth on the autism spectrum, youth with ID, and youth with both diagnoses using a national claims-based prospective cohort study from 2008 through 2012. Autistic youth were most likely to disenroll and least likely to re-enroll. Disenrollment peaked for all three groups at ages 19 and 21. Transition-age youth on the autism spectrum experience more disruptions in access to Medicaid-reimbursed services than youth with ID. More equitable Medicaid enrollment options for autistic individuals are needed to ensure their access to critical health care as they age.
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Affiliation(s)
| | - Sha Tao
- Drexel University, Philadelphia, PA, USA
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Keller R, Ardizzone F, Finardi C, Colella R, Genuario C, Lopez M, Salerno L, Nobile E, Cicinelli G. Real-Life Social-Skills Training and Motor-Skills Training in Adults With Autism Spectrum Disorder: The Con-Tatto Project Walking Down the Francigena Route. Front Psychiatry 2022; 13:846619. [PMID: 35573346 PMCID: PMC9096446 DOI: 10.3389/fpsyt.2022.846619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with an early onset and a genetic and epigenetic component. ASD is characterized by deficits in socio-emotional reciprocity, impaired verbal and non-verbal communication skills, and specific difficulties in developing and maintaining adequate social relationships with peers. Indeed, restricted, repetitive patterns of behavior, interests, or activities are required by DSM-5 diagnostic criteria. Autistic people usually need an unchanging environment (or in any case predictable and stable) and may have hypo- or hyper-sensitivity to sensory inputs. The onset of clinical symptoms occurs during the early years of life. Social skills competence is a significant therapeutic aim to be pursued when addressing ASD core symptoms. Several considerable motor difficulties (87%) in people with autism spectrum disorder in adulthood have been found. The Con-tatto project developed a project addressing social, physical, and mental health difficulties in real-life walking down the Francigena route for 9 days with 12 autistic people, by (1) Implementing daily sessions of social skills training program whose abilities were addressed to be immediately generalized and used throughout the day. (2) Educational movement and walking activity programs were led by a fitness coach. (3) The creation of walking peers' social community with a strong and relevant impact on adults with ASD social life respecting every person's individuality. (4) Provision of social reinforcers to reduce the stigma of people with autism and the experienced perception of low self-esteem, especially when they are bullied.
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Affiliation(s)
- Roberto Keller
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | - Fabio Ardizzone
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | - Caterina Finardi
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | - Rosa Colella
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | | | - Manuel Lopez
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | | | - Emanuela Nobile
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
| | - Giovanni Cicinelli
- Adult Autism Center, Mental Health Department ASL Città di Torino, Turin, Italy
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Eun Lee C, Shogren KA, Segal J, Pezzimenti F, Aleman-Tovar J, Taylor JL. Goal attainment scaling-community-based: A method to incorporate personalized outcomes into intervention research with youth and adults on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:178-187. [PMID: 34128405 PMCID: PMC8671567 DOI: 10.1177/13623613211024492] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT Among people with autism-all who have the same diagnosis-there are major differences on a nearly limitless number of areas, such as language, daily living skills, intellectual ability, sensory difficulties, and physical and mental health diagnoses. Despite these many differences, the targeted outcomes of intervention studies are often measured the same way across autistic adults, including outcomes such as getting a job, achieving greater independence, or getting more services. People have different goals and abilities, and it is important to have a way for intervention studies to measure outcomes in a way that is more personal to each individual. To address this issue, we developed a new approach-called "Goal Attainment Scaling-Community-based" or GAS-CB-to measure individualized outcomes across different research settings. In this article, we describe the need for individualized outcomes in autism intervention research and current approaches to gathering these outcomes, with our discussion focused on a method called goal attainment scaling. We then describe reasons why current goal attainment scaling approaches might not be useful in intervention research that takes place in the community. Finally, we discuss a new goal attainment scaling approach (GAS-CB) that can be flexibly used for research participants with very different characteristics.
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Affiliation(s)
- Chung Eun Lee
- Vanderbilt University Medical Center, Nashville, USA
| | - Karrie A. Shogren
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, USA
| | - Jordan Segal
- Vanderbilt University Medical Center, Nashville, USA
| | | | | | - Julie Lounds Taylor
- Vanderbilt University Medical Center, Nashville, USA,Vanderbilt Kennedy Center, Nashville, USA
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Lee CE, Burke MM, DaWalt LS, Li C, Taylor JL. The role of parental advocacy in addressing service disparities for transition-aged youth on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1001-1006. [PMID: 34841922 DOI: 10.1177/13623613211057660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT It can be difficult for youth on the autism spectrum to get the services they need after they leave high school. Because of this, many studies have examined the different factors that are related to service access. These studies have shown that youth on the autism spectrum who belong to an underrepresented racial or ethnic group or whose families have lower incomes are less likely to receive the services that they need. However, it is difficult or impossible to change things like race/ethnicity or family income. It is important to also identify factors that might improve service access that we can change. One potential factor that fits into this category is parental advocacy activities. Using data collected from 185 parents of youth on the autism spectrum, we found that more parental advocacy activities were related to youth receiving more services, even after accounting for variables related to the functioning of the youth (e.g. whether they have an intellectual disability, their autism symptom severity) and demographic information about the family (e.g. state in which they live, parental race/ethnicity, and family income). Our findings suggest that building parental advocacy skills may be one important way to increase the number of services that youth on the autism spectrum receive as they transition to adulthood.
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Affiliation(s)
| | | | | | - Chak Li
- University of Illinois Urbana-Champaign, USA
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