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Patten KK, Murthi K, Onwumere DD, Skaletski EC, Little LM, Tomchek SD. Occupational Therapy Practice Guidelines for Autistic People Across the Lifespan. Am J Occup Ther 2024; 78:7803397010. [PMID: 38758762 DOI: 10.5014/ajot.2024.078301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
IMPORTANCE Occupational therapy practitioners need evidence to support interventions that promote subjective well-being among autistic people and their families through optimal engagement and participation in occupations. OBJECTIVE These Practice Guidelines are informed by systematic reviews to expand knowledge of interventions that promote access, inclusion, engagement, and optimal participation in occupations that are meaningful to autistic people. Our intent was to foster occupational therapy practitioners' clinical decision-making and reasoning when working with autistic people and their care partners. METHOD These Practice Guidelines were developed on the basis of four systematic reviews, supporting evidence and literature, along with continued revisions and integration through an iterative and collaborative process. RESULTS A total of 98 articles were included in the systematic reviews, which are the foundation for practice recommendations in these guidelines. Forty-eight of the systematic review articles were used to inform the clinical recommendations included in these Practice Guidelines. CONCLUSIONS AND RECOMMENDATIONS Strong to moderate evidence indicates the need for multidisciplinary, goal-oriented interventions to support autistic people in different contexts. Although there is only emerging evidence in the inclusion of autistic people's strengths, interests, and perspectives to guide occupational therapy interventions, such practices can enhance the delivery of neurodiversity-affirming and trauma-informed practices. In addition, evidence is needed to support participation in activities of daily living (ADLs) for autistic youths. We recommend the use of strengths-based language to describe autistic people and the use of environmental adaptations, care partner education, and coaching to enhance occupational therapy service delivery. Plain-Language Summary: The literature is sparse regarding neurodiversity-affirming and trauma-informed practices for autistic youths, as well as for participation in activities of daily living (ADLs). These Practice Guidelines provide new information on positive mental health development; self-determination; ADLs, instrumental ADLs, play, and leisure occupations for children, adolescents, and adults; person-centered planning for adolescents and adults; and rest and sleep. Information on health management is also provided. Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel et al., 2021; Kenny et al., 2016). However, we respect the use of person-first language and have made a conscious decision to include research articles that have used this language.
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Affiliation(s)
- Kristie K Patten
- Kristie K. Patten, PhD, OT/L, FAOTA, is Counselor to the President and Professor, Department of Occupational Therapy, New York University, New York, NY
| | - Kavitha Murthi
- Kavitha Murthi, MSc(OT), FHEA(UK), OTR, is PhD Candidate, Department of Occupational Therapy, New York University, New York, NY
| | - Dora D Onwumere
- Dora D. Onwumere, MS, OTR/L, is PhD Candidate, Department of Occupational Therapy, New York University, New York, NY
| | - Emily C Skaletski
- Emily C. Skaletski, MOT, OTR/L, is PhD Candidate, Department of Kinesiology, University of Wisconsin-Madison
| | - Lauren M Little
- Lauren M. Little, PhD, OTR/L, FAOTA, is Associate Dean of Research, College of Health Sciences, and Associate Professor, Occupational Therapy, Rush University, Chicago, IL
| | - Scott D Tomchek
- Scott D. Tomchek, PhD, OTR/L, FAOTA, is Professor, Department of Pediatrics, Division of Developmental Behavioral Pediatrics, School of Medicine, University of Louisville, Louisville, KY
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Rosenau KA, Kim J, Cho ACB, Seltzer M, Ugueto AM, Weisz JR, Wood JJ. Meta-analysis of Psychotherapy for Autistic Youth. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01686-2. [PMID: 38580853 DOI: 10.1007/s10578-024-01686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 04/07/2024]
Abstract
In order to provide more individualized support, it is imperative to further understand the effectiveness of different types of psychotherapy on the clinical areas of need common in autistic youth (Wood et al. in Behav Ther 46:83-95, 2015). Randomized controlled trials of psychotherapy for autistic youth were included if published in English, included random assignment to treatment or control group, required a previous diagnosis of autism, had a mean age of 6-17 years, and provided outcome measure data from both intervention and control groups. A total of 133 measures were coded across 29 studies and included 1464 participants with a mean age of 10.39 years (1.89). A small mean effect size (0.38,95% CI [0.26, 0.47]) was found overall, with the largest effects for cognitive behavioral therapies on autism-related clinical needs (0.81) and overall mental health (0.78). The results show the significant impact of psychotherapy interventions for autistic youth. Additional research should further assess the details of the most effective psychotherapies for each area of clinical need.
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Affiliation(s)
- Kashia A Rosenau
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
| | - Junok Kim
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - An-Chuen Billy Cho
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - Michael Seltzer
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
| | - Ana M Ugueto
- University of Texas Health Science Center at Houston, Houston, USA
| | | | - Jeffrey J Wood
- School of Education and Information Studies, University of California Los Angeles, Los Angeles, USA
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Lenders M, Ouwens MA, Wilting RMHJ, Videler AC. First things first: An exploration of the effects of psychoeducation for older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231219745. [PMID: 38197411 DOI: 10.1177/13623613231219745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
LAY ABSTRACT After receiving an autism diagnosis, psychoeducation (i.e. information regarding autism) is a first intervention. We adjusted a psychoeducation program that was originally developed by the Dutch Association for Autism for older adults to enhance its feasibility and efficacy in later life. We expected that participants would report an increase in knowledge and acceptance of the diagnosis and that people close to them would also observe this. Indeed, we found this and participants and those close to them agreed on this. Furthermore, we found some evidence that older autistic adults were better at coping with their autism. We found no positive intervention effects on psychological distress. The feedback of participants and informants about the psychoeducation program was largely positive. In future research, we advise using larger group samples and larger time scales and we also advise to further adjust the program to the needs and requirements of older adults, and to help older autistic adults to construct a new narrative of themselves, and the life they have lived, in the light of the recent autism diagnosis.
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Affiliation(s)
| | | | | | - Arjan C Videler
- GGz Breburg, The Netherlands
- Tilburg University, The Netherlands
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Oshima F, Takahashi T, Tamura M, Guan S, Seto M, Hull L, Mandy W, Tsuchiya K, Shimizu E. The association between social camouflage and mental health among autistic people in Japan and the UK: a cross-cultural study. Mol Autism 2024; 15:1. [PMID: 38178255 PMCID: PMC10768303 DOI: 10.1186/s13229-023-00579-w] [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: 08/08/2023] [Accepted: 12/10/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To examine the relationship between social camouflage and mental health in Japanese autistic adults and make an international comparison with a sample from the UK. METHODS This study analysed secondary data of participants with a self-reported diagnosis of autism from Japan (N = 210; 123 men and 87 women) and the UK (N = 305; 181 women, 104, men, and 18 nonbinary). The relationships between the quadratic term of the Camouflaging Autistic Traits Questionnaire and mental health scales, including depression and anxiety, were assessed. RESULTS The UK sample showed linear relationships, whereas the Japanese sample showed significant nonlinear relationships. The quadratic terms of the Camouflaging Autistic Traits Questionnaire slightly explained generalised anxiety (β = .168, p = .007), depression (β = .121, p = .045), and well-being (β = - .127, p = .028). However, they did not explain the association between social anxiety and the Camouflaging Autistic Traits Questionnaire. LIMITATIONS Participants had self-reported diagnoses, and while the autism-spectrum quotient provides a cut-off value for screening, it does not enable confirming diagnoses. Mean scores of the Japanese version of the Camouflaging Autistic Traits Questionnaire were lower as compared to the original CAT-Q, which implies that the social camouflage strategy types used by autistic people in Japan and the UK could differ. The cross-sectional design limits causal inferences. CONCLUSION In the UK, more social camouflage was associated with poorer mental health scores, whereas too little or too much social camouflage was associated with a low mental health score in Japan. The Japanese population is seemingly less aware of and educated on autistic characteristics and considers 'average' behaviour a good thing. This could influence Japanese autistic people's social camouflage use, differing from that of autistic people in the UK. The differences in the relationship between social camouflage and mental health between Japan and the UK could be associated with national-level divergence regarding the culture of autism.
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan.
| | - Toru Takahashi
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masaki Tamura
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Siqing Guan
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
| | - Laura Hull
- Centre for Academic Mental Health, Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Mandy
- Research Department for Clinical, Educational & Health Psychology, University College London, London, UK
| | - Kenji Tsuchiya
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, Chiba, 260-8670, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University; Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Helleseth MM, McAleavey AA, Moltu C. Case report: A dual case study of how clinical feedback can be a communication aide and influence therapeutic work. Front Psychol 2023; 14:1199431. [PMID: 38152559 PMCID: PMC10752420 DOI: 10.3389/fpsyg.2023.1199431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/30/2023] [Indexed: 12/29/2023] Open
Abstract
Background While routine outcome monitoring and clinical feedback may improve outcomes after psychotherapy, results from efficiency studies have been mixed. Moreover, how clinical feedback is implemented influences how it works for patients and clinicians, and working mechanisms are hitherto not thoroughly explored. Researchers have argued that inviting and using feedback from patients is best conceived of as a clinical skill. In this paper, we use case study methodology to explore and describe feedback's functions within three clinical skill themes: actualizing alliance work, concretizing change and stagnation and verbalizing the non-verbal. Case presentation Sonja is a young adult patient with a trauma background. She has a history of serious suicide attempts and distrust in relationships. She attended psychotherapy for eight months. Harald is a middle-aged man with a stable family. Traumatic events in his past has made him conceal own needs and developing depression. He attended psychotherapy for 19 months. Case material include the patient's clinical feedback over a range of life areas, medical health notes and the therapist's process notes. Conclusion Clinical feedback can be a positive supplement to the therapeutic work and process. The importance of making this as a joint tool between the client and the therapist is significant.
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Affiliation(s)
| | | | - Christian Moltu
- District General Hospital of Førde, Førde, Norway
- Department of Health and Caring Sciences, Western Norway University of Applied Science, Bergen, Norway
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Oshima F, Mandy W, Seto M, Hongo M, Tsuchiyagaito A, Hirano Y, Sutoh C, Guan S, Nitta Y, Ozawa Y, Kawasaki Y, Ohtani T, Masuya J, Takahashi N, Sato N, Nakamura S, Nakagawa A, Shimizu E. Cognitive behavior therapy for autistic adolescents, awareness and care for my autistic traits program: a multicenter randomized controlled trial. BMC Psychiatry 2023; 23:661. [PMID: 37679711 PMCID: PMC10485995 DOI: 10.1186/s12888-023-05075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 08/02/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Autistic people demonstrate focused interests, sensitivity to sensory stimulation, and, compared with the general population, differences in social communication and interaction. We examined whether a combination of the Awareness and Care for My Autistic Traits (ACAT) program and treatment-as-usual is more effective than only treatment-as-usual in increasing the understanding of autistic attributes, reducing treatment stigma, and improving mental health and social adaptation among autistic adolescents and their parents/guardians. METHODS Forty-nine adolescents and their parents/guardians were randomly assigned to either a combination of ACAT and treatment-as-usual or only treatment-as-usual. The combined group received six weekly 100-minute ACAT sessions, while the treatment-as-usual group received no additional intervention. The primary outcome was the change in understanding of autistic attributes (Autism Knowledge Quiz-Child), administered from pre- to post-intervention. The secondary outcomes included the change in Autism Knowledge Quiz-Parent, reduced treatment stigma, and improved mental health and social adaptation among autistic adolescents and their parents/guardians. A primary outcome measure scale was scored by assessors who were blind to the group assignment. RESULTS The combined group (both autistic adolescents and their parents/guardians) showed an increase in Autism Knowledge Quiz scores compared to those in the treatment-as-usual group. Autistic adolescents in the combined group also demonstrated a decrease in treatment-related stigma and an improvement in general mental health compared to those in the treatment-as-usual group, while there were no group differences in the change in social adaptation. For parents/guardians, there were no group differences in the change in treatment-related stigma, general mental health, adaptive skills, or attitudes toward their children. CONCLUSIONS The ACAT program could be an effective treatment modality to increase the understanding of autistic attributes among both autistic adolescents and their parents/guardians. The ACAT program positively affects self-understanding, reduces treatment stigma, and stabilizes behavioral issues for autistic adolescents as a part of mental health measures, but it does not effectively reduce treatment barriers or improve mental health for parents/guardians. Further research should consider whether additional support for parents/guardians could be beneficial. TRIAL REGISTRATION The study was registered in UMIN (UMIN000029851, 06/01/2018).
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan.
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan.
| | - William Mandy
- Research Department of Clinical, Educational & Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Minako Hongo
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Aki Tsuchiyagaito
- Laureate Instituto for Brain Research, 6655 S Yale Ave, Tulsa, OK, 74136, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Siqing Guan
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yusuke Nitta
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
| | - Toshiyuki Ohtani
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
- Safety and Health Organization, Chiba University, Chiba, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University Ibaraki, Medical Center, 3-20-1 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan
| | - Noriko Takahashi
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Noriyuki Sato
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Shizuka Nakamura
- Fukushima University Child Mental Health-Care Center, 1 Kanayagawa, Fukushima, 960-1296, Japan
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuouku, 260-8670, Chiba, Japan
- Division of Cognitive Behavioral Science, United Graduate School of Child Development, Chiba University, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, University of Fukui, Chiba, Japan
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Cooper K, Butler C, Russell A, Mandy W. The lived experience of gender dysphoria in autistic young people: a phenomenological study with young people and their parents. Eur Child Adolesc Psychiatry 2023; 32:1655-1666. [PMID: 35377050 PMCID: PMC8977566 DOI: 10.1007/s00787-022-01979-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/14/2022] [Indexed: 12/19/2022]
Abstract
Gender dysphoria is distress in relation to incongruence between an individual's gender and sex assigned at birth. Gender clinics offer support for gender dysphoria, and there is a higher prevalence of autism in young people attending such clinics than in the general population. We aimed to investigate the lived experiences of autistic young people who have experienced gender dysphoria, and their parents, using a multi-perspectival IPA design. Young autistic people aged 13-17 years (n = 15), and their parents (n = 16), completed in-depth interviews about the young person's experience of gender dysphoria. We analysed each individual transcript to generate individual themes, and for each of the dyads, developed themes which acknowledged the similarities and differences in parent-child perspectives. The first superordinate theme was coping with distress which had two subordinate themes; understanding difficult feelings and focus on alleviating distress with external support. This theme described how young people were overwhelmed by negative feelings which they came to understand as being about gender incongruence and looked to alleviate these feelings through a gender transition. The second superordinate theme was working out who I am which had two subordinate themes: the centrality of different identities and needs and thinking about gender. This theme described how young people and their parents focused on different needs; while young people more often focused on their gender-related needs, parents focused on autism-related needs. We conclude that young people and parents may have different perspectives and priorities when it comes to meeting the needs of autistic young people who experience gender dysphoria.
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Affiliation(s)
- Kate Cooper
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY, UK.
| | - Catherine Butler
- Department of Psychology, University of Exeter, EX4 4QG, Exeter, UK
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY, UK
| | - William Mandy
- Department of Clinical, Educational, and Health Psychology, UCL Research, Gower Street, London, WC1E 6BT, UK
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Lodewyk K, Bagnell A, Courtney DB, Newton AS. Review: Adverse event monitoring and reporting in studies of pediatric psychosocial interventions: a systematic review. Child Adolesc Ment Health 2023. [PMID: 37463769 DOI: 10.1111/camh.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Adverse event monitoring in studies of psychotherapy is crucial to clinical decision-making, particularly for weighing of benefits and harms of treatment approaches. In this systematic review, we identified how adverse events are defined, measured, and reported in studies of psychosocial interventions for children with mental disorders. METHOD Medline, PsycINFO, Embase, ProQuest Dissertations and Theses Global, and the Cochrane Library were searched from January 2011-January 2023, and Google Scholar from January 2011-February 2023. English language experimental and quasi-experimental studies that evaluated the efficacy or effectiveness of psychosocial interventions for childhood mental disorders were included. Information on the definition, assessment, and report of adverse events was extracted using a checklist based on Good Clinical Practice guidelines. RESULTS In this review, 117 studies were included. Studies most commonly involved treating anxiety disorders or obsessive-compulsive disorder (32/117; 27%); 44% of the experimental interventions tested (52/117) were cognitive behavioral therapies. Adverse events were monitored in 36 studies (36/117; 31%) with a protocol used in 19 of these studies to guide monitoring (19/36; 53%). Twenty-seven different events were monitored across the studies with hospitalization the most frequently monitored (3/36; 8%). Event severity was fully assessed in 6 studies (17%) and partially assessed in 12 studies (33%). Only 4/36 studies (11%) included assessing events for cause. CONCLUSIONS To date, adverse events have been inconsistently defined, measured and reported in psychosocial intervention studies of childhood mental health disorders. Information on adverse events is an essential knowledge component for understanding the potential impacts and risks of therapeutic interventions.
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Affiliation(s)
| | | | - Darren B Courtney
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Piltz VJ, Halldner L, Markus JF, Fridell A, Bölte S, Choque Olsson N. Symptom similarities and differences in social interaction between autistic children and adolescents with and without ADHD. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
AbstractAutism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two often co-occurring neurodevelopmental conditions. Nevertheless, there is limited research about symptom differences between ASD and ASD + ADHD groups. This study examined differences in social interaction and communication between children and adolescents with ASD and with ASD + ADHD. A total of 112 participants were identified from two clinical trials. Fifty-six children and adolescents with ASD aged 8–17 years were matched for age, gender and general intelligence quotient with fifty-six children and adolescents with ASD + ADHD. Group differences in scores on the Autism Diagnostic Observation Schedule were analysed. Our results showed that participants with ASD and with ASD + ADHD had similar profiles of social communication interaction challenges and restricted behaviour. However, items assessing gestures: Conventional, Instrumental or Informational Gestures and Empathic or Emotional gestures showed significant differences between the groups suggesting that the ASD + ADHD group used descriptive gestures to communicate to a greater extent than the ASD group. These findings suggest that children and adolescents in both groups have similar difficulties in social communication and interaction with observed differences in the use of gestures. Possible reasons and implications for the differences in the use of gestures are discussed.
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Albaum CS, Vashi N, Bohr Y, Weiss JA. A Systematic Review of Therapeutic Process Factors in Mental Health Treatment for Autistic Youth. Clin Child Fam Psychol Rev 2023; 26:212-241. [PMID: 35999330 PMCID: PMC9879813 DOI: 10.1007/s10567-022-00409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
Understanding the role of therapeutic process factors in treatment change may prove useful for discerning why some autistic youth benefit from psychosocial interventions that target emotional and psychological aspects of mental health, while others do not. The aim of the current study was to synthesize what is currently known about therapeutic process factors in mental health treatment of emotional and psychological challenges for autistic youth, regarding how process factors have been measured in past research, and the relation between process factors and treatment outcome. A systematic review of the literature was conducted to narratively synthesize all articles published up until June 2021. Methodological quality of included studies was appraised. Twenty-five studies met inclusion criteria. Process factors assessed across studies included relational factors; treatment expectations, readiness, and satisfaction; and treatment engagement from youth and their parents. Process-outcome associations were reported for a limited number of constructs. There is a limited, albeit growing, body of high-quality research evaluating the role of process factors in the treatment of mental health issues for autistic youth. Future research should continue to examine process factors in relation to treatment outcome, and validate measures to accurately capture process-related constructs in mental health treatment for this population. Greater understanding of therapy processes can lead to developing evidence-informed strategies that clinicians can implement to promote positive expectations, relationships, and engagement.
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Affiliation(s)
- Carly S Albaum
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Nisha Vashi
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Yvonne Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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Patten K, Murthi K, Chen YL, Onwumere D, Shore S. Interventions That Foster Self-Determination in Autistic Individuals (2013-2021). Am J Occup Ther 2023; 77:7710393120. [PMID: 37540792 DOI: 10.5014/ajot.2023.77s10012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from a systematic review that examined interventions to support and improve self-determination for autistic1 individuals.
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Affiliation(s)
- Kristie Patten
- Kristie Patten, PhD, OT/L, FAOTA, is Professor, Department of Occupational Therapy and Counselor to the President, New York University
| | - Kavitha Murthi
- Kavitha Murthi, MS, OTR/L, FHEA, is PhD candidate, Department of Occupational Therapy, New York University, Steinhardt School of Culture, Education and Human Development
| | - Yu-Lun Chen
- Yu-Lun Chen, PhD, OT/L, is Postdoctoral Fellow, Social Determinants of Health and Disability Outcomes Research Laboratory, Center for Outcomes and Assessment Research & Center for Spinal Cord Injury Research, Kessler Foundation
| | - Dora Onwumere
- Dora Onwumere, MS, OTR/L, is PhD student, Department of Occupational Therapy, New York University, OT Supervisor, New York City Department of Education
| | - Stephen Shore
- Stephen Shore, EdD, is Clinical Associate Professor, Department of Special Education, Adelphi University
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Innovations of the ICD-11 in the Field of Autism Spectrum Disorder: A Psychological Approach. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e10005. [PMID: 36760320 PMCID: PMC9881114 DOI: 10.32872/cpe.10005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022] Open
Abstract
Background This article aims to explain and elaborate upon the recently released ICD-11 criteria for Autism Spectrum Disorder (ASD, World Health Organization), which endorse a medical model. Method We integrate insights from several disciplines (e.g., psychology, linguistics, sociology and lived experiences) to reflect the scientific and ethical insights derived from the biopsychosocial, neurodiversity perspective on autism. Results First, we describe the core domains of ASD's behavioural characteristics and then the lifetime, developmental perspective on the manifestations of these behaviours. Subsequently, we discuss potential underlying neuropsychology, related behaviours (i.e. associated features/conditions) and we consider some similarities and differences with the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM 5, American Psychological Association). Conclusions Recommendations for clinical application are provided. For instance, diagnostic classification in clinical practise should be a means to provide proper, suitable care, and therefore all diagnostic assessments should be used to tailor interventions and/or care to the capacities and genuine needs of the people that ask for professional help.
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Preliminary efficacy of cognitive-behavioral therapy on emotion regulation in adults with autism spectrum disorder: A pilot randomized waitlist-controlled study. PLoS One 2022; 17:e0277398. [PMID: 36417403 PMCID: PMC9683545 DOI: 10.1371/journal.pone.0277398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/11/2022] [Indexed: 11/26/2022] Open
Abstract
Previous studies have demonstrated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in children on the autism spectrum. However, no studies have elucidated the clinical utility of cognitive-behavioral therapy in improving emotion regulation in autistic adults. The aim of the present pilot study was to explore the preliminary clinical utility of a group-based cognitive-behavioral therapy program designed to address emotion regulation skills in autistic adults. We conducted a clinical trial based on a previously reported protocol; 31 participants were randomly allocated to the intervention group and 29 to the waitlist control group. The intervention group underwent an 8-week program of cognitive-behavioral therapy sessions. Two participants from the intervention group withdrew from the study, leaving 29 participants (93.5%) in the group. Compared with the waitlist group, the cognitive-behavioral therapy group exhibited significantly greater pre-to-post (Week 0-8) intervention score improvements on the attitude scale of the autism spectrum disorder knowledge and attitude quiz (t = 2.21, p = 0.03, d = 0.59) and the difficulty describing feelings scale of the 20-item Toronto Alexithymia Scale (t = -2.07, p = 0.04, d = -0.57) in addition to pre-to-follow-up (Week 0-16) score improvements on the emotion-oriented scale of the Coping Inventory for Stressful Situations (t = -2.14, p = 0.04, d = -0.59). Our study thus provides preliminary evidence of the efficacy of the group-based cognitive-behavioral therapy program on emotion regulation in autistic adults, thereby supporting further evaluation of the effectiveness of the cognitive-behavioral therapy program in the context of a larger randomized clinical trial. However, the modest and inconsistent effects underscore the importance of continued efforts to improve the cognitive-behavioral therapy program beyond current standards.
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Ferenc K, Płatos M, Byrka K, Król ME. Looking through rainbow-rimmed glasses: Taking neurodiversity perspective is related to subjective well-being of autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221135818. [DOI: 10.1177/13623613221135818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Finding new ways of supporting the well-being of autistic adults is an essential goal for research and practice. We tested the predictive value of attitudes towards autism (as neurodiversity or as a disorder) and identification with other autistic people, on the psychological distress and self-esteem of autistic adults ( n = 109). Adopting a neurodiversity attitude not only predicted higher self-esteem but also served as a protective factor against the negative impact of identification with other autistic people on psychological distress. These findings show that clinicians should be sensitive to the way autistic people understand autism and the extent to which they identify with the autism community, as these factors relate to their well-being. Lay abstract Autistic adults experience a high level of distress. Finding new ways to support their well-being is an important goal for researchers and clinicians. We assessed the way autistic adults view their autism, as a disorder or as a type of mind (neurodiversity), and the level they integrate with other autistic people, and we checked how those factors contribute to their well-being. People who see autism rather as a type of mind than as a disorder had higher self-esteem. People who view themselves as more similar to other autistic people felt more stressed, but this result was not accurate for people who view autism as a type of mind. Clinicians should be sensitive to the way autistic people understand autism and to what extent they identify with the autism community, because it may relate to their well-being.
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Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
| | - Mateusz Płatos
- University of Warsaw, Poland
- Association for Social Innovation ‘Mary and Max’, Poland
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15
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Cooper K, Russell AJ, Lei J, Smith LG. The impact of a positive autism identity and autistic community solidarity on social anxiety and mental health in autistic young people. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:848-857. [PMID: 36062470 PMCID: PMC10074754 DOI: 10.1177/13623613221118351] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Autism is a diagnosis given to individuals by professionals but is also increasingly seen as an identity which an individual can choose for themselves. We wanted to explore how having autism as an identity affects autistic young people. There is evidence that autistic adults have better psychological well-being when they feel more solidarity with other autistic people and feel positively about being autistic. We know that autistic teenagers often feel anxious in social situations. Having a positive autism identity might help alleviate social anxiety associated with being autistic. We wanted to find out if autistic young people who felt more solidarity with other autistic people, and had more positive feelings about autism, had better psychological well-being and less social anxiety. We asked 121 autistic people aged 15-22 years to complete some questionnaires. These questionnaires asked about the young person's autism traits, social anxiety, and psychological well-being. The questionnaires also asked how satisfied they felt to be autistic (satisfaction) and how much solidarity they felt with the autism community (solidarity). We found that autistic young people who had higher autism satisfaction had better psychological well-being and lower social anxiety. Young people who felt more solidarity with other autistic people had higher psychological well-being. There was no association between autism solidarity and social anxiety. We conclude that is important to support autistic young people to develop positive feelings about autism and to feel solidarity with other autistic people.
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16
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Morsa M, De Andrade V, Alcaraz C, De La Tribonnière X, Rattaz C, Baghdadli A. A scoping review of education and training interventions in Autism Spectrum Disorder. PATIENT EDUCATION AND COUNSELING 2022; 105:2850-2859. [PMID: 35618551 DOI: 10.1016/j.pec.2022.05.012] [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: 09/15/2021] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Autism Spectrum Disorder (ASD) is a chronic neurodevelopmental disorder. Living with ASD requires that individuals and parents develop skills in order to cope with daily life. Education interventions are recommended to support them. This study aims to get an overview of education and training interventions in ASD. METHODS A scoping review of international literature was conducted. RESULTS 43 articles were analyzed. Four main types of intervention stand out: support groups, parental training; psychoeducation; therapeutic patient education. However, the majority of publications is focused on the parents rather than on individuals living with ASD, and the needs assessments identified focused on general needs rather than educational needs. CONCLUSION While educational interventions for parents and individuals with ASD are now encouraged, considerable heterogeneity is observed. But this variety is not based on a reasoned approach to matching supply and needs. Future studies could focus more on the educational needs of individuals with ASD. PRACTICE IMPLICATIONS Overview of education and training interventions in ASD help health care providers to better understand the strengths and limitations of their interventions.
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Affiliation(s)
- Maxime Morsa
- Université Sorbonne Paris Nord, Laboratoire Educations et Promotion de la santé, LEPS, UR 3412, F-93430, Villetaneuse, France.
| | - Vincent De Andrade
- Université Sorbonne Paris Nord, Laboratoire Educations et Promotion de la santé, LEPS, UR 3412, F-93430, Villetaneuse, France
| | - Céline Alcaraz
- CRA-LR, CeAND - University Hospital Center of Montpellier, France
| | - Xavier De La Tribonnière
- Transversal Patient Education Unit (UTEP), University Hospital Center of Montpellier, France; University of Montpellier School of Medicine, France
| | - Cécile Rattaz
- CRA-LR, CeAND - University Hospital Center of Montpellier, France
| | - Amaria Baghdadli
- CRA-LR, CeAND - University Hospital Center of Montpellier, France; University of Montpellier School of Medicine, France; CESP Laboratory INSERM, France
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17
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Hidalgo N, Sjöwall D, Agius H, Byström C, Brar A, Borg J, Hirvikoski T. Psychoeducational group intervention for intellectually able adults with autism and their close relations (Prisma) - an open feasibility study. BMC Psychiatry 2022; 22:556. [PMID: 35986348 PMCID: PMC9389708 DOI: 10.1186/s12888-022-04134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) in adulthood is associated with severe impairments in functioning and poor health, while ASD is also affecting close relations. Accessible first-line interventions addressing the complex clinical needs and care coordination are lacking. METHODS This study investigated the feasibility and preliminary effects of a new psychoeducational intervention (Prisma) developed for intellectually able adults with ASD and their close relations in an outpatient setting. The manualized Prisma intervention consist of four weekly group sessions guided by trained group leaders and providing information about autism, support, and services. Feasibility was examined through treatment completion rate and group-level comparisons between intervention completers and non-completers (Student's t-test, Fisher's exact test, and Pearson's chi-squared test). Perceived treatment credibility was investigated by within-group comparisons of participant's self-ratings from pre-intervention to post-intervention, as well as by group leaders' ratings using an adjusted questionnaire. Treatment satisfaction was examined quantitatively regarding the session evaluations (Student's t-tests), as well as by a qualitative thematic analysis of participants' feedback. Preliminary efficacy was studied using paired t-tests (pre- and post-intervention). RESULTS Completion rate was 77% (n = 71 of the 92 adults with ASD) and 73% (n = 69 of the 94 close relations), respectively. Participants considered Prisma to be an acceptable intervention indicated by increases in treatment credibility and expectations from pre- to post-intervention. The group leaders reported treatment credibility in the same range as the participants. Both autistic adults and their close relations reported good treatment satisfaction for each session, while the qualitative thematic analysis indicated that Prisma could be improved by enhancing active participation. This participant feedback will be used to further improve the intervention for an upcoming RCT. Preliminary analyses of effects showed promising results with an increase in knowledge of ASD and some indications for improvements in relationship quality, mental health, quality of life, acceptance of diagnosis and burden of care. CONCLUSIONS Overall, results indicate that the Prisma is a feasible and acceptable first-line intervention in outpatient services. Randomized controlled trials are needed to further corroborate the evidence base of this novel intervention. TRIAL REGISTRATION Clinicaltrials.org NCT0446097, retrospectively registered July 8th 2020.
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Affiliation(s)
- Nathaniel Hidalgo
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, R5:02, Stockholm, Sweden
- Region Stockholm, Stockholm, Sweden
| | - Douglas Sjöwall
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden
| | - Hanna Agius
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden
| | - Caroline Byström
- Psychiatric Services, Stockholm Health Care Services,, Region Stockholm, Stockholm, Sweden
- Modigo AB, Odengatan 69, 113 22, Stockholm, Sweden
| | - Annika Brar
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jacqueline Borg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, R5:02, Stockholm, Sweden
| | - Tatja Hirvikoski
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden.
- Habilitation and Health, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
- Center for Psychiatry Research, Center for Neurodevelopmental Disorders at KarolinskaInstitutet (KIND), CAP Research Center, Region StockholmGävlegatan 22B, SE-11330, Stockholm, Sweden.
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18
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Mandy W. Six ideas about how to address the autism mental health crisis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:289-292. [PMID: 35109701 DOI: 10.1177/13623613211067928] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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19
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Patafio B, Miller P, Baldwin R, Taylor N, Hyder S. A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes and behaviours. Early Interv Psychiatry 2021; 15:1470-1501. [PMID: 33393231 DOI: 10.1111/eip.13109] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 12/20/2022]
Abstract
AIM The onset of mental illness is most common in adolescence, therefore mental health promotion efforts frequently target this age group. Evaluation literature in this area is largely segmented into specific domains in terms of settings, countries, and/or groups of young people, but an overall understanding and comparison across these areas is lacking. The current review aims to provide such an overview of interventions/programs which attempt to improve adolescents' mental health literacy, attitudes/stigma and behaviours. METHODS A systematic mapping review synthesized the strengths and weaknesses of published interventions/programs to improve mental health outcomes in youth. Ten databases and grey literature sources were searched, and results were categorized according to sample, location/setting, type of information presented, delivery and testing procedures, mental health outcome/s evaluated, and limitations. RESULTS One hundred and forty articles met the inclusion criteria; 126 were original records and 14 were reviews. Mental health literacy and attitudes/stigma were examined most frequently, and studies were predominantly conducted in school-based environments and high income economies. Intervention/program effectiveness varied across outcome/s measured, setting, and control group usage, with mental health literacy exhibiting the most positive changes overall. Common limitations included no long-term follow up or control group inclusion. CONCLUSIONS Despite generally positive changes seen throughout studies in this area, effectiveness differed across a range of methodological domains. Most research is conducted in schools and higher income economies, but the lack of investigation in other contexts (i.e., internet or community) or lower income countries suggests our understanding in this area is constrained.
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Affiliation(s)
- Brittany Patafio
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Peter Miller
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Ryan Baldwin
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Nicholas Taylor
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
| | - Shannon Hyder
- School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia
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20
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Triantafyllopoulou P, Clark-Hughes C, Langdon PE. Social Media and Cyber-Bullying in Autistic Adults. J Autism Dev Disord 2021; 52:4966-4974. [PMID: 34799787 PMCID: PMC8604200 DOI: 10.1007/s10803-021-05361-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
Social media can lead to rejection, cyber-bullying victimisation, and cyber-aggression, and these experiences are not fully understood as experienced by autistic adults. To investigate this, 78 autistic adults completed self-report measures of social media use, cyber-bullying victimisation, cyber-aggression, and self-esteem. High levels of social media use were found to be associated with an increased risk of cyber-victimisation; whereas self-esteem was positively correlated with feelings of belonging to an online community and negatively correlated with feelings of being ignored on social network sites and chat rooms. Future studies are needed to further investigate the experience of cyber-bullying victimisation of autistic adults.
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Affiliation(s)
| | - Charlotte Clark-Hughes
- Tizard Centre, University of Kent, Cornwallis North East, Canterbury, CT2 7NF, Kent, England
| | - Peter E Langdon
- Centre for Educational Development, Appraisal, and Research (CEDAR) and Centre for Mental Health and Wellbeing Research, University of Warwick, Coventry, CV4 7AL, England
- Rainbow Unit, Coventry and Warwickshire Partnership NHS Trust, Birmingham, B37 5RY, England
- Herefordshire and Worcestershire Health and Care NHS Trust, Worcester, WR5 1JR, England
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21
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Leadbitter K, Buckle KL, Ellis C, Dekker M. Autistic Self-Advocacy and the Neurodiversity Movement: Implications for Autism Early Intervention Research and Practice. Front Psychol 2021; 12:635690. [PMID: 33912110 PMCID: PMC8075160 DOI: 10.3389/fpsyg.2021.635690] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 11/13/2022] Open
Abstract
The growth of autistic self-advocacy and the neurodiversity movement has brought about new ethical, theoretical and ideological debates within autism theory, research and practice. These debates have had genuine impact within some areas of autism research but their influence is less evident within early intervention research. In this paper, we argue that all autism intervention stakeholders need to understand and actively engage with the views of autistic people and with neurodiversity as a concept and movement. In so doing, intervention researchers and practitioners are required to move away from a normative agenda and pay diligence to environmental goodness-of-fit, autistic developmental trajectories, internal drivers and experiences, and autistic prioritized intervention targets. Autism intervention researchers must respond to these debates by reframing effectiveness, developing tools to measure autistic prioritized outcomes, and forming partnerships with autistic people. There is a pressing need for increased reflection and articulation around how intervention practices align with a neurodiversity framework and greater emphasis within intervention programmes on natural developmental processes, coping strategies, autonomy, and well-being.
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Affiliation(s)
- Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Karen Leneh Buckle
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
- The Autscape Organisation, Coventry, United Kingdom
| | - Ceri Ellis
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United Kingdom
| | - Martijn Dekker
- The Autscape Organisation, Coventry, United Kingdom
- The European Council of Autistic People, Prague, Czechia
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22
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Crane L, Hearst C, Ashworth M, Davies J, Hill EL. Supporting Newly Identified or Diagnosed Autistic Adults: An Initial Evaluation of an Autistic-Led Programme. J Autism Dev Disord 2021; 51:892-905. [PMID: 32266684 PMCID: PMC7954714 DOI: 10.1007/s10803-020-04486-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sixteen adults (diagnosed or self-identified as autistic) participated in one of two iterations of a ten-week autistic-led programme, aimed at helping autistic adults learn more about autism within a peer group context. Motivations for taking part in the programme included a desire for: (1) exploration of autism; (2) empowerment; and (3) the development of practical strategies and coping mechanisms. Interviews were conducted upon completion of the programme and again 6 months later. Using thematic analysis, three themes were identified: (1) appreciation of the autistic-led nature of the programme; (2) unity in diversity; and (3) developing a positive, practical outlook on autism. These promising initial results highlight the value of autistic-led peer support for those recently diagnosed/identified as autistic.
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Affiliation(s)
- Laura Crane
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK.
- Department of Psychology, Goldsmiths, University of London, London, UK.
| | | | - Maria Ashworth
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Jade Davies
- Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, 55-59 Gordon Square, London, WC1H 0NU, UK
| | - Elisabeth L Hill
- Department of Psychology, Goldsmiths, University of London, London, UK
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23
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Prevention in Autism Spectrum Disorder: A Lifelong Focused Approach. Brain Sci 2021; 11:brainsci11020151. [PMID: 33498888 PMCID: PMC7911370 DOI: 10.3390/brainsci11020151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a complex highly heritable disorder, in which multiple environmental factors interact with the genes to increase its risk and lead to variable clinical presentations and outcomes. Furthermore, the inherent fundamental deficits of ASD in social attention and interaction critically diverge children from the typical pathways of learning, "creating" what we perceive as autism syndrome during the first three years of life. Later in life, training and education, the presence and management of comorbidities, as well as social and vocational support throughout the lifespan, will define the quality of life and the adaptation of an individual with ASD. Given the overall burden of ASD, prevention strategies seem like a cost-effective endeavour that we have to explore. In this paper, we take a life course approach to prevention. We will review the possibilities of the management of risk factors from preconception until the perinatal period, that of early intervention in the first three years of life and that of effective training and support from childhood until adulthood.
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Oshima F, William M, Takahashi N, Tsuchiyagaito A, Kuwabara H, Shiina A, Seto M, Hongo M, Iwama Y, Hirano Y, Sutoh C, Taguchi K, Yoshida T, Kawasaki Y, Ozawa Y, Masuya J, Sato N, Nakamura S, Kuno M, Takahashi J, Ohtani T, Matsuzawa D, Inada N, Kuroda M, Ando M, Hori A, Nakagawa A, Shimizu E. Cognitive-behavioral family therapy as psychoeducation for adolescents with high-functioning autism spectrum disorders: Aware and Care for my Autistic Traits (ACAT) program study protocol for a pragmatic multisite randomized controlled trial. Trials 2020; 21:814. [PMID: 32993775 PMCID: PMC7526096 DOI: 10.1186/s13063-020-04750-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background One aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents. Methods This multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording. Discussion It is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD. Trial registration UMIN Register 000029851. Registered on January 06, 2018
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Affiliation(s)
- Fumiyo Oshima
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan.
| | - Mandy William
- Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Noriko Takahashi
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan.,Laureate Instituto for Brain Research, Tulsa, OK, USA
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akihiro Shiina
- Chiba University Center for Forensic Mental Health, Chiba, Japan
| | - Mikuko Seto
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Minako Hongo
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yui Iwama
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Chihiro Sutoh
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Kayoko Taguchi
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Yohei Kawasaki
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshihito Ozawa
- Biostatistics Section, Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Jiro Masuya
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan.,Department of Psychiatry, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Noriyuki Sato
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Shizuka Nakamura
- Fukushima University Child Mental Health-Care Center, Fukushima, Japan
| | - Masaru Kuno
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Jumpei Takahashi
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Toshiyuki Ohtani
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Daisuke Matsuzawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Naoko Inada
- Department of Psychology, Faculty of Liberal Arts, Teikyo University, Tokyo, Japan
| | - Miho Kuroda
- Department of Human Care, Nagoya University of Arts and Sciences, Nagoya, Japan
| | - Mika Ando
- Department of Psychiatry, Hibarigaoka Hospital, Fukushima, Japan
| | | | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana Chuouku, Chiba, 260-8670, Japan
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"I'm Proud to be a Little Bit Different": The Effects of Autistic Individuals' Perceptions of Autism and Autism Social Identity on Their Collective Self-esteem. J Autism Dev Disord 2020; 51:704-714. [PMID: 32607798 PMCID: PMC7835309 DOI: 10.1007/s10803-020-04575-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to identify the attributes that autistic people perceive as positively and negatively impacting on their identity and wellbeing. In Study 1, we recruited 140 autistic participants for an online survey. Participants completed autism social identification and collective self-esteem measures and listed attributes they associated with autism. In Study 2, we conducted focus groups with 15 autistic people to explore how positively they perceived the attributes of autism. Participants then discussed the autism attributes in relation to their own experiences and identity. We found a positive relationship between the number of positive attributes participants associated with autism, and their collective self-esteem, to the extent that they identified with other autistic people.
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Roughan LA, Parker JR, Mercer L. Improving interventions for parents of children and young people with autism spectrum disorder (ASD) in CAMHS. BMJ Open Qual 2019; 8:e000261. [PMID: 31206044 PMCID: PMC6542546 DOI: 10.1136/bmjoq-2017-000261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 09/21/2018] [Accepted: 03/20/2019] [Indexed: 11/04/2022] Open
Abstract
With ever increasing recognition and diagnosis of autism spectrum disorders (ASD) in children within mainstream schooling, there was a need for City and Hackney Child and Adolescent Mental Health Services to develop innovative interventions to meet the needs of a large client group, with limited clinician resource. The importance of psychoeducation about ASD for parents of children recently diagnosed is understood; however, feedback from our service users highlighted the additional need for ongoing access to a network of professional support. Using quality improvement (QI) methodology, we aimed to develop a sustainable regular group programme that was relevant for parents. The total number of parents attending each monthly group over a specific period of time was tracked (from February 2015 to May 2017). A service user questionnaire was devised to gain feedback from each group on parental confidence in managing a child with ASD and their satisfaction. These were given to parents at the end of each group. The Plan Do Study Act cycles were applied and evaluated in the QI framework to assess the impact of the following change ideas: letter reminders, a focus group, an email information and reminder system, and a parent co-lead group. Overall, attendance at the monthly groups increased and remained stable. Satisfaction with the groups was high (eg, 91% of the attendees were either 'Quite Satisfied' or 'Extremely Satisfied'). Of those attending, 82% reported increases in their own confidence in managing their child with ASD. The QI approach allowed us to systematically develop efficient systems and cost-effective ways to run interventions within our ASD pathway. Parents reported high levels of satisfaction with the groups and increased confidence in their ability to parent their child with ASD.
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Affiliation(s)
- Laura Ann Roughan
- City and Hackney CAMHS, East London NHS Foundation Trust, London, UK
| | - Jenny Ruth Parker
- City and Hackney CAMHS, East London NHS Foundation Trust, London, UK
| | - Louise Mercer
- City and Hackney CAMHS, East London NHS Foundation Trust, London, UK
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27
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Stenberg U, Haaland-Øverby M, Koricho AT, Trollvik A, Kristoffersen LGR, Dybvig S, Vågan A. How can we support children, adolescents and young adults in managing chronic health challenges? A scoping review on the effects of patient education interventions. Health Expect 2019; 22:849-862. [PMID: 31131527 PMCID: PMC6803408 DOI: 10.1111/hex.12906] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/20/2019] [Accepted: 04/18/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This scoping review aims to give a comprehensive and systematic overview of published evaluations and the potential impact of patient education interventions for children, adolescents and young adults who are living with chronic illness and/or impairment loss. Methods Relevant literature published between 2008 and 2018 has been comprehensively reviewed, with attention paid to variations in study, intervention and patient characteristics. Arksey and O'Malley's framework for scoping studies guided the review process, and thematic analysis was undertaken to synthesize extracted data. Results Of the 7214 titles identified, 69 studies were included in this scoping review. Participant‐reported benefits of the interventions included less distress from symptoms, improved medical adherence and/or less use of medication, and improved knowledge. The majority of studies measuring physical activity and/or physiologic outcomes found beneficial effects. Interventions were also beneficial in terms of decreased use of urgent health care, hospitalization, visits to general practitioner and absence from school. By sharing experiences, participants had learned from each other and attained new insight on how they could manage illness‐related challenges. Discussion Study results corroborate previous research suggesting that different types of patient education interventions have a positive impact on children, adolescents and young adults, but research on this field is still in a starting phase. The results summed up in the current review supports the utility of patient education interventions that employ behavioural strategies tailored to the developmental needs of children, adolescents and young adults with different cultural backgrounds.
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Affiliation(s)
- Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | | | - Anne Trollvik
- Institute of Nursing, Faculty of Public Health, Inland Norway University of Applied Sciences, Elverum, Norway
| | | | | | - André Vågan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
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Sankey C, Girard S, Cappe E. Evaluation of the social validity and implementation process of a psychoeducational program for parents of a child with Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:101-111. [PMID: 34141403 PMCID: PMC8115530 DOI: 10.1080/20473869.2019.1598721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 02/08/2019] [Accepted: 03/20/2019] [Indexed: 06/12/2023]
Abstract
The aim of this study was to assess the social validity and document the implementation of a psychoeducational program designed to support parents after their child's diagnosis, from both parents' and professionals' perspectives. A complete version (five workshops and five individual follow-ups) and a shortened version (five workshops only) of the program were evaluated. Parents filled in satisfaction questionnaires after every workshop and at the end of the program. Professionals who facilitated the program filled in a specially designed questionnaire to rate the quality of the program and of its implementation, the fidelity of implementation and the parents' responsiveness. In addition, video recordings of the workshops allowed an objective assessment of the fidelity of implementation. Attendance rates were high; parents were satisfied and felt they had made progress. Professionals evaluated positively the quality of the program and of its implementation, and felt parents were responsive. However, minor adaptations had to be made. The program has good social validity, which allowed easy and satisfying implementation, but it does require some flexibility. Overall, this study provides useful insight on the implementation process that may help clinical services to use this evidence-based program effectively.
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Affiliation(s)
- Carol Sankey
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
| | - Sophie Girard
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
| | - Emilie Cappe
- Université Paris Descartes, Sorbonne Paris Cité, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Boulogne-Billancourt, France
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Crane L, Jones L, Prosser R, Taghrizi M, Pellicano E. Parents' views and experiences of talking about autism with their children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1969-1981. [PMID: 30915857 DOI: 10.1177/1362361319836257] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The way an autism diagnosis is disclosed to parents has been found to play a crucial role in their acceptance of, and the way they cope with, their child's diagnosis. Yet, research into parents' subsequent experiences of disclosing a diagnosis to their children, and talking to their families about autism more generally, is limited. Using an online survey, the current study examined 558 parents' experiences of talking about autism with their autistic and non-autistic children. Results demonstrated that most parents (n = 379, 67.9%) had told their autistic children about their diagnosis. Despite few parents (n = 163, 20.4%) receiving advice or support regarding the disclosure of the diagnosis, those that had disclosed felt satisfied with the process (n = 319, 84.2%) and felt confident in talking about autism with their children (n = 339, 92.4%). Those who had not told their autistic children about the diagnosis largely planned to discuss this with their child in the future (n = 100, 73.5%), felt confident in doing so (n = 95, 70.9%) and were satisfied with their decision (n = 95, 70.4%). Analysis of open-ended data, using thematic analysis, highlighted the importance of openness and the need to tailor explanations to individual children's needs, while acknowledging that disclosure could often be challenging for parents.
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Cooper K, Smith LGE, Russell A. Social identity, self-esteem, and mental health in autism. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/ejsp.2297] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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