Carers' experiences of being exposed to challenging behaviour in services for autism spectrum disorders

Burnout in providers serving individuals with ASD: The impact of the workplace

Increased levels of burnout have been demonstrated for providers serving individuals with Autism Spectrum Disorder (ASD). Given higher levels of burnout are linked with a number of negative physical and psychological outcomes, it is important to understand predictors of burnout to inform prevention and intervention strategies. Leiter and Maslach (1999) provide a framework for conceptualizing burnout within an organizational context according to six areas of work-life. The present study examines the relation between the six areas of work-life and burnout in staff providing direct care services to individuals with ASD. A total of 149 providers completed an online survey consisting of the Maslach Burnout Inventory (MBI; Maslach, Jackson, & Leiter, 1997), the Areas of Work-life Survey (AWS; Leiter & Maslach, 1999), and additional questions about training and supervision. The areas of workload, reward, fairness, and values emerged as the best predictors of burnout. While workload, fairness, and values predicted emotional exhaustion, values and reward predicted personal accomplishment, and values alone predicted depersonalization. Lower levels of training satisfaction and frequency of supervision were related to burnout. Findings provide direction regarding which aspects of the workplace may be most relevant for this workforce and how these areas may be targeted for change.

Implementing a video-based intervention to empower staff members in an autism care organization: a qualitative study

Background

Implementing good-quality health and social care requires empowerment of staff members within organizations delivering care. Video Interaction Guidance (VIG) is an intervention using positive video feedback to empower staff through reflection on practice. This qualitative study explored the implementation of VIG within an autism care organization in England, from the perspective of staff members undergoing training to deliver VIG.

Methods

Semi-structured interviews were conducted with a purposive sample of 7 participants working within the organization (5 staff undergoing training to deliver VIG; 2 senior managers influencing co-ordination of training). Participants were asked about their views of VIG and its implementation. The topic guide was informed by Normalization Process Theory (NPT). Data were analysed inductively and emerging issues were related to NPT.

Results

Five broad themes were identified: (1) participants reported that they and other staff did not understand VIG until they became involved, initially believing it would highlight negative rather than positive practice; (2) enthusiastic feedback from staff who had been involved seemed to encourage other staff to become involved; (3) key implementation challenges included demands of daily work and securing managers’ support; (4) ideas for future practice arising from empowerment through VIG seemed difficult to realise within an organizational culture reportedly unreceptive to creative ideas from staff; (5) individuals’ emotional responses to implementation seemed beyond the reach of NPT, which focused more upon collective processes.

Conclusions

Implementation of VIG may require recognition that it is not a ‘quick fix’. Peer advocacy may be a fruitful implementation strategy. Senior managers may need to experience VIG to develop their understanding so that they can provide appropriate implementation support. NPT may lack specificity to explain how individual agency weaves with collective processes and social systems to embed innovation in routine practice. This exploratory study has provided broad insights into facilitators and barriers to the implementation of an intervention to empower staff within an autism care organization. Further research is needed into similar interventions, including a focus upon staff members’ emotional responses and resources, and how such interventions may relate to the culture of the organization in which implementation occurs.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1820-9) contains supplementary material, which is available to authorized users.

Psychological impacts of challenging behaviour and motivational orientation in staff supporting individuals with autistic spectrum conditions

Despite increased risk of experiencing challenging behaviour, psychological impacts on community and residential staff supporting adults with autistic spectrum conditions are under-explored. Studies examining related roles indicate protective psychological factors may help maintain staff well-being. This study investigated relationships between motivational orientation (eudaimonic or hedonic), challenging behaviour frequency and type (physical, verbal or self-injurious) and psychological impacts (anxiety, depression and life satisfaction). Participants (N = 99) were recruited from six organisations providing autism-specific adult services within Scotland. A series of binary logistic regressions demonstrated weekly challenging behaviour exposure (compared to monthly or daily) significantly increased the likelihood of anxiety caseness. Increased eudaimonic motivation significantly reduced the likelihood of anxiety caseness while also predicting higher life satisfaction. Furthermore, having high levels of eudaimonic motivation appeared to moderate the impact of weekly challenging behaviour exposure on anxiety. No motivational orientation or challenging behaviour factor significantly predicted depression. This sample also demonstrated higher anxiety, lower depression and equivalent life satisfaction levels compared with general population norms. The results highlight the need for considering staff's motivational orientations, their frequency of exposure to challenging behaviour, and both positive and negative psychological outcomes, if seeking to accurately quantify or improve well-being in this staff population.

Formation of functional areas in the cerebral cortex is disrupted in a mouse model of autism spectrum disorder

Background

Autism spectrum disorders (ASD) are a group of poorly understood behavioural disorders, which have increased in prevalence in the past two decades. Animal models offer the opportunity to understand the biological basis of these disorders. Studies comparing different mouse strains have identified the inbred BTBR T + tf/J (BTBR) strain as a mouse model of ASD based on its anti-social and repetitive behaviours. Adult BTBR mice have complete agenesis of the corpus callosum, reduced cortical thickness and changes in early neurogenesis. However, little is known about the development or ultimate organisation of cortical areas devoted to specific sensory and motor functions in these mice that may also contribute to their behavioural phenotype.

Results

In this study, we performed diffusion tensor imaging and tractography, together with histological analyses to investigate the emergence of functional areas in the cerebral cortex and their connections in BTBR mice and age-matched C57Bl/6 control mice. We found evidence that neither the anterior commissure nor the hippocampal commissure compensate for the loss of callosal connections, indicating that no interhemispheric neocortical connectivity is present in BTBR mice. We also found that both the primary visual and somatosensory cortical areas are shifted medially in BTBR mice compared to controls and that cortical thickness is differentially altered in BTBR mice between cortical areas and throughout development.

Conclusions

We demonstrate that interhemispheric connectivity and cortical area formation are altered in an age- and region-specific manner in BTBR mice, which may contribute to the behavioural deficits previously observed in this strain. Some of these developmental patterns of change are also present in human ASD patients, and elucidating the aetiology driving cortical changes in BTBR mice may therefore help to increase our understanding of this disorder.

Electronic supplementary material

The online version of this article (doi:10.1186/s13064-015-0033-y) contains supplementary material, which is available to authorized users.