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Löthberg M, Hirvikoski T, Girdler S, Bölte S, Jonsson U. Support in Daily Living for Young Adults with Neurodevelopmental Conditions in Sweden: A Qualitative Description of Current Practice. J Autism Dev Disord 2024; 54:3043-3058. [PMID: 37219792 PMCID: PMC10203681 DOI: 10.1007/s10803-023-06014-6] [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] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
In Sweden, people living independently and requiring daily living support can access 'housing support', a form of practical, educational, and social support provided by the municipalities. About two-thirds of those receiving this support have neurodevelopmental conditions, primarily autism or ADHD. Many are young adults in the process of adapting to new roles and expectations in different life domains, including education, work, and accommodation. This study aimed to provide a qualitative description of support workers' views on current practice in housing support for young adults (aged 18 to 29) with neurodevelopmental conditions. Semi-structured telephone interviews were conducted with 34 housing support workers across 19 Swedish regions. An inductive qualitative content analysis approach was used. The interviews depicted a complex service, subject to organizational aspects (roles, responsibilities, availability, and allocation), the joint effort of key players (young adults, relatives, and support workers), and practical aspects of service provision (finding common ground for the work, and delivery of support). Some elements of the service were poorly designed for the target group. The support workers expressed a need for more knowledge about neurodevelopmental conditions, but also described new insights related to remote delivery of support. The results raise important questions about how housing support should be organized and delivered to strike the right balance between support and autonomy, meet specific needs, and ensure equal services across municipalities. Future research should adopt multiple perspectives and approaches, to help translate best practice and available evidence into a flexible and sustainable service.
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Affiliation(s)
- Maria Löthberg
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Tatja Hirvikoski
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Habilitation and Health, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
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Ferguson EF, Barnett ML, Goodwin JW, Vernon TW. "There is No Help:" Caregiver Perspectives on Service Needs for Adolescents and Adults with Profound Autism. J Autism Dev Disord 2024:10.1007/s10803-024-06451-x. [PMID: 38963473 DOI: 10.1007/s10803-024-06451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
The underrepresentation of individuals with profound autism (who require 24/7 access to care) in autism research has resulted in limited knowledge about their service needs and a lack of evidence-based practices tailored to those needs. This study explored caregiver perspectives on service needs, barriers to accessing care, and treatment priorities to guide treatment development and improvement of service delivery. A sequential mixed-methods design integrated quantitative survey data (n = 423; Mage = 18.89 years; 26.7% female) with qualitative interviews (n = 20) with caregivers of adolescents and adults with profound autism. Quantitative findings indicated regular socialization opportunities were the most frequently endorsed unmet service need (60.3% of caregivers), followed by primary health care with autism-trained staff (59.3%), social skills instruction (55.8%), life skills instruction (51.3%), and behavioral support (47.3%). Higher likelihood of needing social activity groups was associated with elevated emotional reactivity, higher language level, minoritized ethnicity, and lower household income. Greater need for specialized primary health care was associated with lower income, while the need for social and life skills instruction was associated with increased age and elevated dysphoria. Qualitative analysis identified 10 themes that converged and expanded quantitative findings by highlighting a pervasive shortage of individualized, goal-oriented services, common barriers to care, and the priority of developing centralized treatment settings that coordinate care throughout adulthood. This study identified pressing service needs for adolescents and adults with profound autism in the United States. These insights are crucial for improving the accessibility and quality of clinical care.
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Affiliation(s)
- Emily F Ferguson
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, 401 Quarry Rd, Stanford, CA, 94305-5719, USA.
| | | | | | - Ty W Vernon
- University of California, Santa Barbara, CA, USA
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Øverland E, Hauge ÅL, Orm S, Øie MG, Skogli EW, Pellicano E, Andersen PN. "I have to charge my social battery": Perspectives from autistic young adults on Quality of Life. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1369-1381. [PMID: 38629698 DOI: 10.1177/13623613241245578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
LAY ABSTRACT In this study we have asked a group of autistic young adults to describe what is important for their quality of life. The 14 participants (aged 21-29 years) were recruited from a 10-year follow-up study of autistic people. During interviews, our participants described the importance of having relationships with family, friends and pets. Having meaningful activities and being able to immerse themselves in particular interests was also reported to be important for a good quality of life. Interests had also guided their choice of what to study and what to do for work. They also spoke of how communication problems with professionals, bullying and sensory and emotional overload could have a negative impact on quality of life. Future interventions should focus on how professionals can help autistic people to connect to people/animals and meaningful activities, as the participants described this as important for having a good quality of life. These findings may be helpful in enhancing how passions and interests can be seen as opportunities for both academic and work careers for autistic people. Future research and interventions should also look at the communication barriers between autistic people and professionals, and how two-way understanding can be improved.
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Affiliation(s)
- Elisabeth Øverland
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Stian Orm
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
| | | | - Erik Winther Skogli
- Innlandet Hospital Trust, Norway
- Inland Norway University of Applied Sciences, Norway
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Szechy KA, Turk PD, O'Donnell LA. Autism and Employment Challenges: The Double Empathy Problem and Perceptions of an Autistic Employee in the Workplace. AUTISM IN ADULTHOOD 2024; 6:205-217. [PMID: 39139509 PMCID: PMC11317796 DOI: 10.1089/aut.2023.0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Background High unemployment rates are found among autistic adults. Difficulties with social functioning in non-autistic workplaces can be significant barriers to employment success. Autistic social functioning challenges in non-autistic spaces have traditionally been attributed to assumed impairments in Theory of Mind (ToM). Alternatively, the Double Empathy Problem (DEP) posits that autistic social challenges arise not from assumed impairments within the autistic person but instead from mutual misunderstandings in the autistic/non-autistic social interaction. The purpose of this study was to compare the ToM impairments explanation of autistic social functioning with the DEP, within the context of autistic employee social functioning in a non-autistic workplace. Methods This study compared autistic and non-autistic participants' ability to accurately interpret the behaviors of an autistic employee at work. A sample of 254 participants (173 non-autistic and 81 autistic) read a vignette about a hypothetical autistic employee having difficulty coping in the workplace. Participants answered open-ended questions regarding their interpretation of the employee's behavior and emotional state. Results A significantly greater proportion of autistic participants (50.7%) accurately interpreted the behavior of the employee compared with non-autistic participants (31.2%) (χ 2 = 8.65, p = 0.003). Autistic participants with the highest behavior interpretation scores had significantly higher mean self-reported autism traits scores (M = 26.8) compared with autistic participants who scored lowest on behavior interpretation (M = 19.3, p < 0.001). The opposite relationship was found for non-autistic participants. Conclusions Results from this study contribute to evidence supporting the DEP, shifting the paradigm of autistic social functioning away from a deficit model and toward addressing mutual misunderstandings in the autistic/non-autistic social interaction. The pattern of findings between neurotype groups by behavior interpretation abilities on an autism traits measure points to mutual misunderstandings as a clash of neurologically different social cultures. Addressing the DEP in the workplace would contribute to removing barriers to successful employment for autistic adults.
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Affiliation(s)
- Kathryn A. Szechy
- Faculty of Arts, Humanities, and Social Sciences, School of Social Work, University of Windsor, Windsor, Canada
| | - Pamela D. Turk
- State of Michigan, Department of Health and Human Services, Lansing, Michigan, USA
| | - Lisa A. O'Donnell
- School of Social Work, Wayne State University, Detroit, Michigan, USA
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Moser C, Smith DaWalt L, Burke MM, Taylor JL. Emerging adulthood in autism: Striving for independence or interdependence? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1325-1327. [PMID: 38581260 DOI: 10.1177/13623613241245647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
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Németh V, Győri M, Ehmann B, Völgyesi-Molnár M, Stefanik K. "…in the middle of nowhere…" Access to, and quality of, services for autistic adults from parents' perspectives: a qualitative study. Front Psychiatry 2024; 15:1279094. [PMID: 38501092 PMCID: PMC10946251 DOI: 10.3389/fpsyt.2024.1279094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction Adequate education, employment, and services for autistic individuals contribute significantly to their and their parents' quality of life. Services and support for adults are dramatically more limited than those for children. The main purpose of this study was to explore how parents perceive factors supporting/hindering access to services, and how they assess the quality of services. Methods Qualitative data provided by 12 parents via a semi-structured interview with a broader focus on parental quality of life and its factors were analyzed. Their autistic children were between 20 and 34 years of age. A thematic analysis was performed on parts of the narratives on their adult periods of life. Results A complex pattern of parental perception of supportive and hampering factors influencing access to services unfolded. The sparsity of services/activities and reliable information on them made the space for autonomous decisions on service take highly limited. Parents have modest expectations on quality of services, evaluating them along two key aspects: a safe, positive atmosphere, and communication between parents and professionals. Other aspects of individualized autism-specific support were not or just rarely mentioned. Discussion Parents perceive themselves as investing a lot of effort and resources in getting some form of regular service and/or activity for their adult child. However, these parental efforts often fail, their child becoming inactive, and dependent on their presence. This suggests system-level problems with services for autistic adults in Hungary, with literature showing it is not specific to this country.
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Affiliation(s)
- Vivien Németh
- Bárczi Gusztáv Faculty of Special Needs Education, Institute of Special Needs Education for People with Atypical Behavior and Cognition, Eötvös Loránd University (ELTE), Budapest, Hungary
- Hungarian Academy of Sciences (HAS) – Eötvös Loránd University (ELTE) ‘Autism in Education’ Research Group, Budapest, Hungary
- Faculty of Education and Psychology, Doctoral School of Education, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Miklós Győri
- Hungarian Academy of Sciences (HAS) – Eötvös Loránd University (ELTE) ‘Autism in Education’ Research Group, Budapest, Hungary
| | - Bea Ehmann
- Hungarian Academy of Sciences (HAS) – Eötvös Loránd University (ELTE) ‘Autism in Education’ Research Group, Budapest, Hungary
- HUN-REN Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Budapest, Hungary
| | - Márta Völgyesi-Molnár
- Bárczi Gusztáv Faculty of Special Needs Education, Institute of Special Needs Education for People with Atypical Behavior and Cognition, Eötvös Loránd University (ELTE), Budapest, Hungary
- Hungarian Academy of Sciences (HAS) – Eötvös Loránd University (ELTE) ‘Autism in Education’ Research Group, Budapest, Hungary
| | - Krisztina Stefanik
- Bárczi Gusztáv Faculty of Special Needs Education, Institute of Special Needs Education for People with Atypical Behavior and Cognition, Eötvös Loránd University (ELTE), Budapest, Hungary
- Hungarian Academy of Sciences (HAS) – Eötvös Loránd University (ELTE) ‘Autism in Education’ Research Group, Budapest, Hungary
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Hantman RM, Johnston EB, Tager-Flusberg H. Parental Perspectives: How Sensory Sensitivities Impact the Transition to Adulthood in Adolescents and Young Adults with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:544-562. [PMID: 36402934 PMCID: PMC9676764 DOI: 10.1007/s10803-022-05815-5] [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] [Accepted: 11/03/2022] [Indexed: 11/21/2022]
Abstract
Sensory sensitivities are common in autism spectrum disorder (ASD) and impact daily life, but research has largely focused on children, neglecting older individuals. Likewise, while there is research regarding parental concerns for their autistic children's transition to adulthood, little is known about the role of sensory sensitivities. To address this gap, 66 parents of autistic adolescents and young adults were interviewed and their responses were qualitatively analyzed. All parents believed their children's sensory sensitivities impacted their transition to adulthood, primary developmentally/psychologically, interpersonally/socially, and managerially. These beliefs did not significantly differ by child characteristics, such as age and ASD severity. Parent perceptions were modality and context specific. Given these findings, transition planning should consider individual's specific sensory sensitivities to optimize independence.
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Affiliation(s)
- Rachel M Hantman
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA.
- Department of Psychology, University of South Carolina, Columbia, SC, USA.
| | - Emily B Johnston
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
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Shea LL, Wong MY, Song W, Kaplan K, Uppal D, Salzer MS. Autistic-Delivered Peer Support: A Feasibility Study. J Autism Dev Disord 2024; 54:409-422. [PMID: 36369602 PMCID: PMC9652131 DOI: 10.1007/s10803-022-05816-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 11/13/2022]
Abstract
Peer support has been an undeveloped pathway for filling the service gap and to generate employment opportunities for autistic individuals. Peer supports have been deployed widely in mental health and among veterans and understanding the utility of this service modality among autistic individuals illuminates opportunities for research, policy, and practice. This study examined characteristics of participants in an autistic-delivered peer support program and reports on use of and satisfaction with the program. Half of autistic participants had a co-occurring mental health diagnosis. Participants reported multiple areas of unmet needs and participant satisfaction with the program was high (90%). The findings of this study point toward autistic-delivered peer support as a promising avenue for future development.
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Affiliation(s)
- Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Mi-Yeet Wong
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Wei Song
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA, 19122, USA
| | - Katy Kaplan
- Community Behavioral Health, 801 Market St, Philadelphia, PA, 19107, USA
| | - Disha Uppal
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Mark S Salzer
- College of Public Health, Temple University, 1101 W Montgomery Avenue, Philadelphia, PA, 19122, USA
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Orsmond GI, Krishnan SG, Munsell EGS, Cohn ES, Coster WJ. Describing Outcomes in Autistic Young Adults One Year After High School Graduation. J Autism Dev Disord 2024:10.1007/s10803-023-06152-x. [PMID: 38285097 DOI: 10.1007/s10803-023-06152-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE Research documents poor outcomes for autistic adults in the domains of employment, independent living, and social relationships. Measurement and sample limitations in prior studies may have amplified past estimates of poor outcomes. The goal of the current study was to improve upon past approaches and to create and describe a measurement approach to capture adult outcomes that reflected the context of young adulthood and the perspectives of autistic individuals, pairing objective outcome indicators with subjective satisfaction indicators. METHODS Thirty-six autistic young adults (mean age 19.8 years) and a parent completed self-report surveys. Using these data, we defined an objective and subjective (i.e., satisfaction) outcome indicator in each of three domains: productivity (employment or post-secondary education), social well-being (frequency of contact with friends), and living situation (autonomy). RESULTS Three-quarters of young adults experienced at least 5 out of 6 positive outcomes. Over 90% were engaged in school, work, or a structured transition program, and an equal percentage were satisfied with their productivity activity. Over three-quarters of adults had a good amount of contact with friends and were satisfied with their social life. Most young adults had a moderate level of autonomy in their daily lives, and all were satisfied with their living situation. CONCLUSION Tailoring outcome measurement approaches specifically for autistic young adults provided a more optimistic portrayal of outcomes than previously noted in the literature. The approach used better reflects a neurodiversity approach and may be useful for evaluating the effectiveness of transition services or interventions.
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Affiliation(s)
- Gael I Orsmond
- Department of Occupational Therapy, Boston University, 635 Commonwealth Ave, Boston, MA, 02215, USA.
| | - Sharada G Krishnan
- Department of Occupational Therapy, Boston University, 635 Commonwealth Ave, Boston, MA, 02215, USA
| | | | - Ellen S Cohn
- Department of Occupational Therapy, Boston University, 635 Commonwealth Ave, Boston, MA, 02215, USA
| | - Wendy J Coster
- Department of Occupational Therapy, Boston University, 635 Commonwealth Ave, Boston, MA, 02215, USA
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Low HM, Zainal MS, Pang JC, Ang Y, de Vries M. Self-reported autistic traits and psychosocial outcomes among university students in Malaysia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:174-186. [PMID: 37128140 DOI: 10.1177/13623613231167501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
LAY ABSTRACT Most research on autism spectrum conditions is done on young children and not as much on young adults with autism spectrum conditions. Because of this, not much is known about how common autism spectrum conditions are in young adults and how they affect their mental and social health, especially in Southeast Asia. Based on self-reports, 2.8% of the 2732 university students we looked at in Malaysia might have been diagnosed or thought to have an autism spectrum condition. Students who said they had or thought they had autism spectrum conditions had lower self-efficacy, more stress and a lower quality of life than students who said they did not have autism spectrum conditions. The results showed that university students with autism spectrum condition are more likely to have bad psychological and social outcomes than their peers without autism spectrum condition. Also, the link between autistic traits and psychosocial outcomes could depend on the culture.
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Song W, Salzer MS, Kaplan K, Wong MY, Uppal D, Shea LL. Short Report on Effectiveness of an Autistic-Delivered Peer Support Program: Preliminary Results. Community Ment Health J 2024; 60:154-159. [PMID: 37555891 DOI: 10.1007/s10597-023-01174-2] [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: 04/29/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023]
Abstract
There is little research on the effectiveness of autistic peer-delivered services. This study examines early outcomes associated with the Community Autism Peer Specialist program (CAPS), which was created in partnership with autistic individuals and is delivered by autistic adults who have received training in the delivery of peer support services to enhance the community functioning of autistic youth and adults. A single group pre-test/post-test design was used to examine early outcomes in the areas of independent living needs, social functioning, service engagement, and quality of life. A total of 23 individuals with autism aged 14-41 years were included in the study. Reductions were found in social functioning impairments and unmet needs after three months in the program. Participants also reported greater engagement in mental health services and activities that promote wellness compared with before the program. This study suggests that peer support services delivered by autistic peers may be an effective intervention approach for autistic youth and adults. Future studies with a more rigorous study design (e.g., randomized controlled trials), a larger sample size, and longer-term outcome measurements are needed to further investigate the effectiveness of CAPS and similar autistic-delivered services.
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Affiliation(s)
- Wei Song
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Mark S Salzer
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Katy Kaplan
- Community Behavioral Health, Philadelphia, PA, USA
| | - Mi-Yeet Wong
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Disha Uppal
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
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Mohammad S, de Ruijter MJT, Rukh G, Rask-Andersen M, Mwinyi J, Schiöth HB. Well-being spectrum traits are associated with polygenic scores for autism. Autism Res 2023; 16:1891-1902. [PMID: 37602645 DOI: 10.1002/aur.3011] [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: 04/27/2023] [Accepted: 07/29/2023] [Indexed: 08/22/2023]
Abstract
Individuals with autism spectrum disorder (ASD) tend to experience lower well-being as demonstrated mostly for children and adolescents in epidemiological studies. A further investigation of inclusive well-being, in terms of five well-being spectrum (5-WBS) traits including neuroticism, depression, loneliness, life satisfaction, and positive affect, among adults with ASD may deepen our understanding of their well-being, and lead to the possibility to further modify societal supportive mechanisms for individuals with ASD. This study aims to investigate if a genetic predisposition for ASD is associated with 5-WBS traits using polygenic risk score (PRS) analysis. PRS for ASD were calculated based on the latest genome-wide association study of ASD by the Psychiatric Genetics Consortium (18,381 cases, 27,969 controls) and were created in the independent cohort UK Biobank. Regression analyses were performed to investigate the association between ASD PRS and 5-WBS traits in the UK Biobank population including 337,423 individuals. ASD PRS were significantly associated with all 5-WBS traits, showing a positive association with the negative WBS traits, neuroticism (max R2 = 0.04%, p < 1 × 10-4 ), depression (max R2 = 0.06%, p < 1 × 10-4 ), loneliness (max R2 = 0.04%, p < 1 × 10-4 ), and a negative association with the positive WBS traits, life satisfaction (max R2 = 0.08%, p < 1 × 10-4 ), positive affect (max R2 = 0.10%, p < 1 × 10-4 ). The findings suggest that adults carrying a high load of risk single nucleotide peptides (SNPs) for ASD are more likely to report decreased well-being. The study demonstrates a considerable connection between susceptibility to ASD, its underlying genetic etiology and well-being.
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Affiliation(s)
- Salahuddin Mohammad
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Markus J T de Ruijter
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Gull Rukh
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mathias Rask-Andersen
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Jessica Mwinyi
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
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Lamash L, Gal E, Yaar E, Bedell G. SPAN Website for Remote Intervention with Autistic Adolescents and Young Adults: Feasibility and Usability. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1514. [PMID: 37761475 PMCID: PMC10530180 DOI: 10.3390/children10091514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Adolescents and young adults (AYA) with autism spectrum disorders (ASD) report less functional independence and social participation than their neurotypical peers. Remotely delivered interventions may allow autistic AYA to promote their independence, social participation, and wellbeing as they transition to adulthood. Social Participation and Navigation (SPAN) is a technology-based remotely delivered intervention initially developed for AYA with acquired brain injuries. The SPAN (website, application, and intervention manual) was modified to address the needs of AYA with autism (SPAN-ASD). This study examined the SPAN-ASD website and web application's feasibility and usability. Participants comprised 12 autistic AYA and 18 practitioners (all occupational therapists) with more than 1 year of experience in working with autistic AYA. All navigated the SPAN-ASD website and goal-management application. Practitioners completed the SPAN-ASD components and the Usefulness, Satisfaction, and Ease of Use questionnaires; AYA completed the System Usability Scale. The practitioners' average feasibility scores ranged from 4.30 to 4.68 (high); the overall usability score was 5.77 (good). The autistic AYA rated SPAN-ASD as a good, acceptable, and useful tool. Content analysis and item-level ratings indicated some needed improvements. Practitioners and autistic AYA perceived the SPAN-ASD website and application as highly feasible and usable, with excellent potential for technology-supported interventions.
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Affiliation(s)
- Liron Lamash
- Department of Occupational Therapy, University of Haifa, Mount Carmel, Haifa 3498838, Israel; (L.L.); (E.Y.)
| | - Eynat Gal
- Department of Occupational Therapy, University of Haifa, Mount Carmel, Haifa 3498838, Israel; (L.L.); (E.Y.)
| | - Einat Yaar
- Department of Occupational Therapy, University of Haifa, Mount Carmel, Haifa 3498838, Israel; (L.L.); (E.Y.)
| | - Gary Bedell
- Department of Occupational Therapy, Tufts University, Medford, MA 02155, USA;
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Mason D, Milner V, Clark L, Kelly E, Pyefinch R, Happé F. Autistic People and Moving Home: A Systematic Review. AUTISM IN ADULTHOOD 2023; 5:236-247. [PMID: 37663439 PMCID: PMC10468557 DOI: 10.1089/aut.2022.0016] [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: 11/19/2022]
Abstract
Background While many studies have examined where and with whom autistic people live, very few have looked at autistic people's experience of moving home. Choosing where to live, and being able to move residence, could be important for autonomy, and we therefore undertook a systematic review to identify studies about autistic adults' experience of moving home. Methods We entered search terms relevant to autism and moving home into six databases and Google Scholar. After screening the titles and abstracts, we identified a final set of articles and screened the full text. We then checked the reference lists for potentially relevant articles; then, we conducted a search for articles that cited our final set of articles. Three raters assessed each included article for methodological quality. Results The search strategy identified a total of 311 articles (initial search, ancestry searching, articles from other sources). After deduplication, we screened a total of 165 articles for eligibility. A final set of seven articles was identified. Our narrative synthesis of the articles suggests that both autistic people and the relatives of autistic people think living independently is a source of positive personal development. However, autistic people reported that poor employment prospects impacted on their financial independence and hence independent living. Parents highlighted concerns about their offspring's personal care, safety, and the difficulty of navigating the housing system for those autistic people with co-occurring intellectual disability. Conclusions Taken together, our review suggests that autistic people and those who care for them have a positive view of independent living and are aware of the barriers to achieving this. Our review highlights a gap in the understanding of autistic adults' experience of moving home. We briefly describe our ongoing research project [the "Moving (as an) Autistic Person" project] exploring autistic people's experiences of moving house.
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Affiliation(s)
- David Mason
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Victoria Milner
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lauren Clark
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Emily Kelly
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Rebekah Pyefinch
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Francesca Happé
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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15
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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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16
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Carter EW, Lanchak ER, Guest L, McMillan ED, Taylor JL, Rowley H. "More Than a Paycheck": Parent Perspectives on Meaningful Work for Individuals With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:145-157. [PMID: 36996279 DOI: 10.1352/1934-9556-61.2.145] [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: 02/24/2022] [Accepted: 05/27/2022] [Indexed: 05/16/2023]
Abstract
Increasing employment outcomes for individuals with intellectual and developmental disabilities (IDD) remains an enduring emphasis of research, policy, and practice. Parents are often primary partners in the pursuit of meaningful work for their family members with IDD. This qualitative study examined the views of 55 parents regarding the importance of this pursuit and the features of employment that matter most to them. Participants discussed a range of reasons they valued employment for their family members with IDD, including factors that extended beyond a paycheck. Likewise, they described an array of features that they considered to be important to their family member thriving in the workplace (e.g., inclusivity, match with interests, opportunities for growth). We offer recommendations for promoting integrated employment among families and conceptualizing employment outcomes within future research.
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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 and Julie Lounds Taylor, Vanderbilt University Medical Center
| | - Julie Lounds Taylor
- Elise D. McMillan and Julie Lounds Taylor, Vanderbilt University Medical Center
| | - Hannah Rowley
- Hannah Rowley, Vanderbilt University. Erik W. Carter is now at Baylor University
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17
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Roux AM, Shea LL, Steinberg H, Rast JE, Anderson KA, Hotez E, Rosenau K, Kuo A, Assing-Murray E, Shattuck PT. Evidence from the Autism Transitions Research Project (2017-2022): Capstone review and services research recommendations. Autism Res 2023; 16:480-496. [PMID: 36622799 DOI: 10.1002/aur.2890] [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: 10/04/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023]
Abstract
Few funding sources have explicitly supported systems-wide research to identify mechanisms for improving access, service delivery, outcomes and wellbeing for autistic transition-age youth and young adults. We aimed to integrate findings from research produced through a five-year federal Autism Transition Research Project (ATRP) cooperative agreement. This capstone review sought to: (1) map the body of scientific evidence that emerged from this federal award, and (2) identify remaining evidence gaps to inform future autism transition services research. We used scoping review methods to assess 31 ATRP-funded published scientific studies. We charted study characteristics, topical domains, socio-ecological levels of variables, focus on equity, and inclusion of autistic participants. We evaluated how these topics were addressed across studies to identify continued gaps in the evidence base. Compared to prior published reviews and research agendas, we found improvements in characterization of study participants, broader examination of socio-ecological correlates, and examination of multiple outcome domains. However, we also identified continued deficits in inclusion of autistic study participants, use of multisectoral data, and research with a strong focus on equity. Our recommended priorities for autism transition services research to facilitate healthy life outcomes and wellbeing included: continued analysis of population-level data and improved data infrastructure; development of service delivery methods and interventions that target marginalized groups; expanded research to inform improvements in the performance and coordination of complex service ecosystems that interface with autistic youth; and bolstering the roles of autistic research participants.
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Affiliation(s)
- Anne M Roux
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lindsay L Shea
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Hillary Steinberg
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jessica E Rast
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kristy A Anderson
- School of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Emily Hotez
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Kashia Rosenau
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Alice Kuo
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Evva Assing-Murray
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland, USA
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18
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Lamash L, Gal E, Bedell G. Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023:15394492221146726. [PMID: 36644845 DOI: 10.1177/15394492221146726] [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: 01/17/2023]
Abstract
Remote interventions can uniquely benefit and significantly increase the motivation/engagement of autistic adolescents and young adults (AYA) in intervention processes. The evidence-based, technology-based Social Participation and Navigation (SPAN), originally a remote intervention for AYA with traumatic brain injuries, shows great promise for autistic AYA. This formative evaluation aimed to inform SPAN adaptations for autistic AYA. Fifteen researcher and clinician stakeholders provided feedback and modification recommendations via a semistructured interview. Stakeholders described potential participants who might benefit, intervention goals, intervention delivery procedures, and additional program-content and technology suggestions, including original components to preserve or adjust. Findings provided a basis for developing a new SPAN-ASD website and intervention manual. The next steps include assessing website usability and feasibility and a pilot implementation study of SPAN-ASD with autistic AYA.
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19
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Berg KA, Ishler KJ, Lytle S, Kaplan R, Wang F, Olgac T, Miner S, Edguer MN, Biegel DE. "Don't Promise Something You can't Deliver:" Caregivers' Advice for Improving Services to Adolescents and Young Adults with Autism. AUTISM RESEARCH AND TREATMENT 2023; 2023:6597554. [PMID: 36998713 PMCID: PMC10049841 DOI: 10.1155/2023/6597554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 04/01/2023]
Abstract
Approximately 50,000 youths with autism spectrum disorders (ASD) exit U.S. high schools yearly to enter adult systems of care, many of whom remain dependent on family for day-to-day care and service system navigation. As part of a larger study, 174 family caregivers for adolescents or young adults with ASD were asked what advice they would give service providers about how to improve services for youth with ASD. Reflexive thematic analysis identified a framework of five directives: (1) provide a roadmap to services; (2) improve service access; (3) fill gaps to address unmet needs; (4) educate themselves, their families, and society about autism; and (5) operate from a relationship-building paradigm with families. Education, health, and social service providers, as well as policymakers, can use these directives to better assist youth with ASD and their families in the transition to adulthood.
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Affiliation(s)
- Kristen A. Berg
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
- 2Center for Health Care Research and Policy, The MetroHealth System, 2500 MetroHealth Dr, Cleveland, OH 44109, USA
| | - Karen J. Ishler
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Sarah Lytle
- 3University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
| | - Ronna Kaplan
- 4Cleveland State University, College of Health, 2121 Euclid Ave, Cleveland, OH 44115, USA
| | - Fei Wang
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Tugba Olgac
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Stacy Miner
- 3University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA
- 5Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - Marjorie N. Edguer
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
| | - David E. Biegel
- 1Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
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20
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Yngve M, Lidström H, Hemmingsson H, Ekbladh E. Establishment in productive occupations and perceived work ability among former students with special educational needs one year after upper secondary education. Work 2022; 75:85-95. [PMID: 36591681 DOI: 10.3233/wor-220057] [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: 12/28/2022] Open
Abstract
BACKGROUND Establishment in productive occupations i.e. work and further studies, is challenging for students who experience special educational needs (SEN). OBJECTIVE The study aim was to investigate productive occupations and perceived work ability one year after upper secondary education among former students with SEN who had received a student-centred information and communication technology (ICT) intervention. METHODS Questionnaire data on productive occupations (n = 81) were complemented with the semi-structured Worker Role Interview (WRI) concerning perceived work ability (n = 20), in an embedded mixed methods design. Group comparisons between participants who were and were not established in productive occupations were performed. Written notes from the WRI were analysed with a deductive content analysis. RESULTS Findings demonstrated that almost two-thirds (63% n = 51) of the former students with SEN were established in productive occupations. The established group had to a higher extent obtained pass grades and had to a lesser extent received time-assisting ICT. Managing daily routines in combination with a productive role in a satisfactory manner was perceived as most challenging for the participants in relation to their work ability. CONCLUSION The results indicate that students with SEN need person-centred support to handle difficulties both in and outside upper secondary school to promote the transition from school to establishment in productive occupations.
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Affiliation(s)
- Moa Yngve
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helene Lidström
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | - Elin Ekbladh
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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21
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Cao S, Wang Y, Yang X, Jin Q, Hui-Michael Y, Xie D. Key competencies of students with autism spectrum disorders: Perspectives of Chinese teachers and parents. Front Psychol 2022; 13:1054249. [PMID: 36619026 PMCID: PMC9813226 DOI: 10.3389/fpsyg.2022.1054249] [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: 09/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Well-defined key competencies for students with autism spectrum disorders (ASD) help develop curriculum and pedagogies that emphasize what students with ASD are expected to learn, to know and to do. Most of the current research on the key competencies of ASD is theoretical and based on the social and cultural backgrounds of western countries. The key competencies defined by most of the research lack of the support of empirical evidence. This study sought to identify the key competencies of school-age students with ASD from the perspectives of teachers and parents. Based on the review of existing key competencies frameworks, a key competencies instrument that consisted of 76 learning outcome items in eight domain areas was developed. An online survey to explore the teachers' and parents' views of the key competencies was conducted with 1,618 teachers and 2,430 parents of students with ASD across China. The results showed that teachers believed that the key competencies should consist of eight domain areas including social-communication, learning skills, healthy living, play, motor, emotion, sensory processing, and cognition, while the cognition related competencies were not recognized by parents. The competencies in social-communication, learning skills, healthy living had higher variance contribution. From the perspective of teachers, the variance contribution of social communication was the highest, while from the perspective of parents, the variance contribution of learning skills was the largest. Taken together, the key competencies framework for students with ASD should include eight dimensions and 75 learning outcome items. The similarities and differences between the perspectives of the two group were discussed. The findings could provide empirical data to assist in developing educational guidelines and guide the development of models of support for students with ASD.
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Affiliation(s)
- Shuqin Cao
- School of Special Education, Zhejiang Normal University, Hangzhou, China
| | - Yixin Wang
- School of Special Education, Zhejiang Normal University, Hangzhou, China
| | | | - Qiqin Jin
- School of Special Education, Zhejiang Normal University, Hangzhou, China
| | - Ying Hui-Michael
- Department of Special Education, Rhode Island College, Providence, RI, United States
| | - Dongjie Xie
- School of Special Education, Zhejiang Normal University, Hangzhou, China,*Correspondence: Dongjie Xie, ✉
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22
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Øverland E, Hauge ÅL, Orm S, Pellicano E, Øie MG, Skogli EW, Andersen PN. Exploring life with autism: Quality of Life, daily functioning and compensatory strategies from childhood to emerging adulthood: A qualitative study protocol. Front Psychiatry 2022; 13:1058601. [PMID: 36506426 PMCID: PMC9732257 DOI: 10.3389/fpsyt.2022.1058601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction This study aims to investigate self-perceived quality of life, daily functioning, and the use of compensatory strategies in emerging adults with autism. Methods and analysis Participants will be recruited from the Lillehammer Neurodevelopmental 10-year follow-up study (LINEUP), with the aim of 15 individual in-depth interviews. Subsequently, two focus groups with clinicians will be invited to reflect on the themes found in the individual interviews. All interviews will be recorded and analyzed using reflexive thematic analysis. Ethics and dissemination The study is approved by the Regional Committee for Medical Research Ethics in South-East Norway. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations. To reach the broader autistic and autism communities, the findings will be shared with the Autism Society at national and local meetings, in their membership magazine, and on their social media channel.
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Affiliation(s)
- Elisabeth Øverland
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Åshild Lappegard Hauge
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Tesfaye R, Courchesne V, Mirenda P, Mitchell W, Nicholas D, Singh I, Zwaigenbaum L, Elsabbagh M. Autism voices: Perspectives of the needs, challenges, and hopes for the future of autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1142-1156. [PMID: 36329663 DOI: 10.1177/13623613221132108] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Autism Voices study draws on novel inclusive methods to obtain the first-person experiences of autistic youth with a range of cognitive and verbal abilities. Thirty-one autistic youth were interviewed with a strength-based protocol, enabling them to provide responses in the modality of their choice. Dynamics between youth and their environments such as home, school, and community were explored. Youth were questioned about their interests, plans for the future, experiences with various emotions, and experience of autism. Based on a thematic analysis, six themes emerged: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. The experiences described by autistic youth parallel many of the aspirations and challenges of typically developing adolescents, while being uniquely shaped by their autism. We discuss how these insights shared by autistic youth can facilitate active involvement in their communities, promote well-being, and promote optimal transition into adulthood. Autism Voices demonstrates that partnering with multiple stakeholders and the use of inclusive methodologies are pivotal steps toward capturing the voices of all autistic youth. Lay abstract Currently, our understanding of the adolescent period for autistic youth has relied on the expertise of researchers, clinicians, parents, and teachers, yet rarely involves their unique first-person experiences. Our study attempted to understand the experiences and perspectives of autistic adolescents in their home, school, and community environments using the Autism Voices protocol, a semi-structured interview specifically designed and tailored to engage with autistic youth with various language and intellectual levels. The analysis of the 31 interviews conducted with autistic adolescents aged 11–18 years highlighted six themes: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. These results highlight similarities and differences in the adolescent experiences of autistic youth compared to their typically developing peers. Our findings suggest that by removing assumptions about the experiences of autistic individuals and investing in inclusive interview methods, we can faithfully capture the experiences of autistic youth regardless of their communication and cognitive abilities. Being able to capture and amplify these diverse voices will facilitate the active involvement of autistic communities in research and clinical and policy decisions that impact them.
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Bottema-Beutel K, LaPoint SC, Kim SY, Mohiuddin S, Yu Q, McKinnon R. An evaluation of intervention research for transition-age autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:890-904. [PMID: 36189778 DOI: 10.1177/13623613221128761] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT In this study, we assess the quality of intervention research that focuses on autistic youth who are 14-22 years old. We found 193 different studies on this topic, and carefully reviewed them. Most of these studies tested strategies that were behavioral. This means that they used procedures like prompting and rewards to change participants' behavior. We found that the majority of studies had problems that make it hard to determine whether or not the intervention worked. The problems related to how researchers designed their studies, and how they measured the study outcomes. We also found that researchers rarely tried to find out if the strategies they studied had unintended negative effects for participants. Because of these issues, we make suggestions for how researchers might design better studies that will let people know how well the strategies worked.
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25
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Agarwal R, Wuyke G, Sharma U, Burke SL, Howard M, Li T, Sanchez M, Bastida E. Stress and Anxiety Among Parents of Transition-Aged Children with Autism Spectrum Disorder: a Systematic Review of Interventions and Scales. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022; 11:1-23. [PMID: 36065251 PMCID: PMC9434067 DOI: 10.1007/s40489-022-00340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 08/12/2022] [Indexed: 11/06/2022]
Abstract
The period between adolescence to young adulthood can be stressful for parents of transition-aged children (14 to 22 years old) with autism spectrum disorder. A systematic review was undertaken to examine if existing interventions address the unique parental stressors of this phase and if the scales used to measure parental stress and anxiety are suitable for this group. Of the 9813 studies screened, only 13 studies met the inclusion criteria. Findings indicated that interventions focused on mindfulness, social functioning, or multiple components, of which only two addressed the transition period and only three specifically targeted parents of this age group. Moreover, of the six scales which assessed stress or anxiety, none were designed for these parents. Findings highlight the urgent need for more suitable scales and targeted interventions.
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Affiliation(s)
- Rumi Agarwal
- FIU Embrace, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Gabriella Wuyke
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Utsav Sharma
- College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32611 USA
| | - Shanna L. Burke
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Melissa Howard
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
| | - Elena Bastida
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199 USA
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26
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Connor A, Fabrizi SE, Nasamran A, Sung C. Near-Peer Facilitation of a Soft Skills Program for Young Adults With Autism. Am J Occup Ther 2022; 76:23314. [PMID: 35759360 DOI: 10.5014/ajot.2022.048207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Young adults with autism spectrum disorder (ASD) experience poor employment outcomes. Teaching soft skills and using peer-based interventions improve outcomes for people with ASD. OBJECTIVE To evaluate the preliminary efficacy of a soft skills intervention and the feasibility of delivery to a group of young adults with ASD by near-peer occupational therapy master's-level students. DESIGN Pretest-posttest single-group design. SETTING College campus. PARTICIPANTS Convenience sample of 14 young adults (M age = 21.57 yr) with ASD. INTERVENTION The Assistive Soft Skills and Employment Training (ASSET) program is a 12-session, manualized, soft skills group intervention previously validated with the ASD population. Topics include communication, attitude and enthusiasm, teamwork, networking, professionalism, and stress management. OUTCOMES AND MEASURES Social functioning, self-efficacy, and adaptive behavior were measured preintervention and immediately postintervention using standardized self-report rating scales. Participant satisfaction and experience were assessed using program-specific measures. RESULTS Participants made statistically significant improvements, with medium to large effect sizes in social functioning, self-efficacy, and adaptive behavior. They reported high levels of satisfaction and a positive experience with the program content and delivery. CONCLUSIONS AND RELEVANCE This study provides evidence of participant satisfaction and perceived soft skills improvement and confidence, in addition to the preliminary efficacy of master's-level students as near-peer facilitators of the ASSET program with an ASD population. What This Article Adds: The results suggest that trained and supervised master's-level students can effectively deliver a manualized intervention as near-peer facilitators, elicit positive feedback and high levels of participant satisfaction, and replicate and extend previously reported participant gains.
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Affiliation(s)
- Annemarie Connor
- Annemarie Connor, PhD, OTR/L, is Associate Professor and Director of the Community Autism Network, Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers;
| | - Sarah E Fabrizi
- Sarah E. Fabrizi, PhD, OTR/L, is Associate Professor and Interim Program Director, Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers
| | - Amy Nasamran
- Amy Nasamran, PhD, is Fellow, Center for Research in Autism, Intellectual, and other Neurodevelopmental Disabilities, Michigan State University, East Lansing
| | - Connie Sung
- Connie Sung, PhD, CRC, LPC, is Associate Professor, Department of Counseling, Educational Psychology & Special Education, Michigan State University, East Lansing
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Courchesne V, Tesfaye R, Mirenda P, Nicholas D, Mitchell W, Singh I, Zwaigenbaum L, Elsabbagh M. Autism Voices: A novel method to access first-person perspective of autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1123-1136. [PMID: 34482746 PMCID: PMC9340132 DOI: 10.1177/13623613211042128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
LAY ABSTRACT The perspective of autistic individuals is often left uncaptured, and as a result they are often excluded from making decisions that impact them. Conventional communication can be challenging for many autistic individuals, especially those who are minimally verbal or who have an associated intellectual disability. Currently, a lack of appropriate methods to capture voices across the spectrum is a barrier. In the present study, we developed the Autism Voices protocol using universal design principles to capture the perspectives and experiences of autistic youth with a range of language or intellectual abilities. This protocol was then used with 33 autistic youth aged 11 to 18 years. A scoring rubric was developed to capture the unconventional communication used by the participants and the mitigation strategies used by interviewers to facilitate the interview. Many components of the protocol were found to effectively facilitate communication between the participant and interviewer, including the use of picture cards to support verbal questions/prompts, the fact that participants could respond with their preferred communication methods (writing, texting, pointing), and the fact that interviews were applied flexibly to adapt to each participant. Unconventional communication and mitigation strategies were mostly observed in interviews with minimally verbal individuals, but a fine-grained analysis showed participants were still communicating something through this unconventional communication. Our protocol could help promote the inclusion of more autistic individuals in research and showed that unconventional modes of communication like echolalia provide an understanding that participants' are invested in conversations and certain topics are more meaningful than others.
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Marcotte J, Grandisson M, Milot É. What makes home environments favorable to independence: perspectives of autistic people and their parents. Disabil Rehabil 2022; 45:1684-1695. [PMID: 35583496 DOI: 10.1080/09638288.2022.2074153] [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: 11/03/2022]
Abstract
PURPOSE Few autistic adolescents and adults manage to integrate a home that enables them to fully exercise their independence, even if that is a desire shared by many of them. Creating residential environments that are favorable to their independence at home is a promising, yet poorly explored, avenue. The aim of this study conducted in Québec (Canada) is to identify the main environmental factors influencing their independence at home from the perspectives of autistic people and their parents. MATERIALS AND METHODS The walking interview method was used to collect the perspectives of 10 dyads composed of an autistic person and at least one of their parents. RESULTS Participants identified several factors, including: (a) support from parents, (b) support from extended social network, (c) a physical environment that meets one's needs, (d) clear time indicators, (e) opportunities to perform life habits in other settings, and (f) support from professionals. They also gave many examples of concrete ways to implement these factors at home and suggested elements to consider when modifying the home environment. CONCLUSIONS The results emphasize the need to involve both autistic people and their parents during the evaluation and implementation of these factors to optimize their benefits. IMPLICATIONS FOR REHABILITATIONModifying the residential environments of autistic people is a promising way to foster their independence at home.The environmental factors of supportive home environments identified in this study can be used as a starting point when designing home environments for autistic people.As the needs and preferences of autistic people vary, they must be involved in the selection and the implementation of modifications in their home environments.Parents have a key role to play to support the development of their youth's independence at home.
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Affiliation(s)
- Justine Marcotte
- Université Laval, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Quebec City, Quebec, Canada
| | - Marie Grandisson
- Université Laval, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Quebec City, Quebec, Canada.,Department of Rehabilitation, Université Laval, Quebec City, Canada
| | - Élise Milot
- Université Laval, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Quebec City, Quebec, Canada.,School of Social Work and Criminology, Université Laval, Quebec City, Canada
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Song W, Nonnemacher SL, Miller KK, Anderson K, Shea LL. Living arrangements and satisfaction of current arrangement among autistic adults reported by autistic individuals or their caregivers. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1174-1185. [DOI: 10.1111/jar.13003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/18/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Wei Song
- College of Public Health Temple University Philadelphia Pennsylvania USA
| | - Stacy L. Nonnemacher
- Pennsylvania Department of Human Services, Office of Developmental Programs Bureau of Supports for Autism and Special Populations Harrisburg Pennsylvania USA
| | - Kaitlin Koffer Miller
- A.J. Drexel Autism Institute, Policy and Analytics Center Drexel University Philadelphia Pennsylvania USA
| | - Kristy Anderson
- A.J. Drexel Autism Institute, Drexel University Philadelphia Pennsylvania USA
| | - Lindsay L. Shea
- A.J. Drexel Autism Institute, Drexel University Philadelphia Pennsylvania USA
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Crowley S. Interventions for Transition-Age Youth With Disabilities: A Meta-Analysis of Group Design Studies. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:169-193. [PMID: 35443051 DOI: 10.1352/1944-7558-127.3.169] [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: 08/25/2020] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
This meta-analytic review investigated interventions for transition-age youth diagnosed with autism, intellectual disability, or extensive support needs. Nineteen group design studies with 215 effect sizes met inclusion criteria. A robust variance estimation procedure that accounts for the clustering effect sizes within studies was used to synthesize effect sizes within each intervention and outcome type. Occupational Therapy/Physical Therapy interventions have significant and positive effects on gross motor outcomes (g = 0.73, p < 0.01). All remaining interventions and outcomes could not be synthesized due to a limited number of studies, but are further described in a narrative manner. Recommendations for future research include improving the methodological quality of intervention studies and further analyzing the effects of interventions for transition-age youth.
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Song W, Salzer MS, Nonnemacher SL, Miller KK, Shea LL. Living arrangements and community participation among autistic adults: Exploring the possible influences of living alone or with others. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 124:104213. [PMID: 35290949 DOI: 10.1016/j.ridd.2022.104213] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND With the increasing prevalence of autistic individuals, it is greatly needed to examine the factors impacting their community participation experiences. Where autistic adults live and how that may be related to their participation and quality of life is one environmental factor that has received little attention. AIMS This study explored the association between living arrangements in the community and community participation for autistic adults. METHOD This study used data from a statewide survey of autistic adults (N = 744) to investigate the relationship between living arrangements (live alone with or without support, live with roommate/spouse, or live with family) and the amount, breadth, and sufficiency of community participation. RESULTS After controlling for sociodemographic and clinical factors known to be associated with community participation, autistic adults living with family members participated less frequently in community activities over 30 days than those living with a roommate/spouse. However, they experienced similar levels of sufficiency with their participation. Autistic adults living alone with support reported the lowest levels of sufficiency with their participation, although the amount and breadth of their participation were no different from other adults. CONCLUSION These findings have several implications for providing support to enable autistic adults to participate in the areas that are important to them and to the extent they desire. Future research is needed to gain a better understanding of how interests and expectations for participation may be influenced by living situations.
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Affiliation(s)
- Wei Song
- College of Public Health, Temple University, 1700 N. Broad St., Suite 313, Philadelphia, PA 19122, USA.
| | - Mark S Salzer
- Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities, Temple University, 1700 N. Broad St., Suite 304, Philadelphia, PA 19122, USA
| | - Stacy L Nonnemacher
- Bureau of Supports for Autism and Special Populations, Pennsylvania Department of Human Services, 801 Market St., Philadelphia, PA 19107, USA
| | - Kaitlin Koffer Miller
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, USA
| | - Lindsay L Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, USA
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Finch TL, Mackintosh J, Petrou A, McConachie H, Le Couteur A, Garland D, Parr JR. "We couldn't think in the box if we tried. We can't even find the damn box": A qualitative study of the lived experiences of autistic adults and relatives of autistic adults. PLoS One 2022; 17:e0264932. [PMID: 35286347 PMCID: PMC8920184 DOI: 10.1371/journal.pone.0264932] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 02/19/2022] [Indexed: 11/18/2022] Open
Abstract
Autistic children grow to become autistic adults, and autism is increasingly diagnosed in adulthood and later life. This qualitative study aimed to understand experiences of autism throughout adulthood. A national cohort study of autistic adults and relatives of autistic adults (ASC-UK), enabled purposive recruitment of a diverse sample. Semi-structured interviews were conducted with 29 autistic adults (aged 20-71 years), mostly diagnosed in adulthood, and 16 relatives (aged 31-81 years) of autistic adults diagnosed across both childhood and adulthood (including some with learning disability). Interview topics included health, relationships, education, employment, quality of life and everyday experiences. Thematic analysis of the accounts of the autistic adults identified six key themes relating to their experiences: (1) diagnosis as validating yet limiting; (2) supportive and non-supportive social agents; (3) the "invisibility" of the needs of autistic adults; (4) health in the context of autism; (5) staying 'outside' the circle; and (6) multiple lives with autism. Data from relatives about autistic adult experiences gave additional perspectives on these themes. Experiences reported in other studies-of 'difference' from others, challenges of social engagement, and learning to 'conform' to society's expectations-were evident and relevant to male and female autistic adults, across all age groups, and unrelated to stage of life when diagnosed. Some expressed disappointment with their lives, but others were proud of their achievements. Education and employment, whilst challenging for many, were also rewarding for some. Health care and social services were often experienced as inaccessible, inappropriate, or lacking understanding of the individual's needs. We conclude that greater public understanding of autism as experienced in adulthood is needed. Key priorities are improving the availability of 'appropriate' health and social care services for autistic adults and families, and providing practical support to enable enhanced participation in life.
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Affiliation(s)
- Tracy L. Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Joan Mackintosh
- Newcastle University, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Alex Petrou
- Newcastle University, Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - Helen McConachie
- Newcastle University, Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | - Ann Le Couteur
- Newcastle University, Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
| | | | - Jeremy R. Parr
- Newcastle University, Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom
- Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Cheak-Zamora N, Tait A, Coleman A. Assessing and Promoting Independence in Young Adults with Autism Spectrum Disorder. J Dev Behav Pediatr 2022; 43:130-139. [PMID: 34636359 DOI: 10.1097/dbp.0000000000001021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Quality of life, independence, and employment outcomes are poor for young adults with autism spectrum disorder (YA-ASD). This study explored the desires and experiences of YA-ASD as they transition into adulthood. METHODS Fifteen YA-ASD, age 18 to 25 years, were recruited from autism spectrum disorder centers, participant registries, and social media advertising. Interested individuals completed a survey and individual interview. Semistructured interview guides included questions about transition experiences, current independence, and future goals. Interview transcripts were analyzed using thematic analysis. RESULTS The desire of young adults with autism spectrum disorder for independence was shown within 4 themes. YA-ASD described their vision of adulthood along with their need for improved skills in driving, living independently, and decision-making. CONCLUSION The findings indicate YA-ASD desire to be independent but lack the specific support services to get there.
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Affiliation(s)
- Nancy Cheak-Zamora
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
| | - Andrew Tait
- Department of Biological Sciences, College of Arts and Science, University of Missouri, Columbia, MO
| | - Ann Coleman
- Department of Health Sciences, School of Health Professions, University of Missouri, Columbia, MO
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Opportunities for Inclusion and Engagement in the Transition of Autistic Youth from Pediatric to Adult Healthcare: A Qualitative Study. J Autism Dev Disord 2022; 53:1850-1861. [PMID: 35262827 PMCID: PMC10123038 DOI: 10.1007/s10803-022-05476-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 10/18/2022]
Abstract
Transitioning autistic youth from pediatric to adult healthcare requires coordination of multiple stakeholders, including youth, caregivers, and pediatric and adult care providers, whose interests at times overlap but often differ. To understand barriers and facilitators to inclusive transition experiences, we conducted thematic analysis of interviews with 39 stakeholders from the same large, integrated healthcare system. We identified three major themes: (1) Navigating the healthcare transition without guidance, (2) Health consequences of a passive healthcare transition, and (3) Strategies for inclusion and continuous engagement. Facilitators included gradual transition planning, a warm handoff between providers, and support of shared healthcare decision-making. Providers also sought clinical tools and logistical supports such as care coordinators and longer transition-specific visit types to enhance patient-centered care.
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Kirby AV, Diener ML, Dean EE, Darlington AN, Myers A, Henderson J. Autistic Adolescents' and Their Parents' Visions for the Future: How Aligned are They? AUTISM IN ADULTHOOD 2022; 4:32-41. [PMID: 35663130 PMCID: PMC8992901 DOI: 10.1089/aut.2020.0061] [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] [Indexed: 10/20/2022]
Abstract
Introduction The expectations individuals hold about the future can influence the decisions they make toward achieving their goals. Existing research suggests parents of autistic adolescents hold expectations about the future that are significantly related to the postsecondary outcomes they achieve. However, less research exists about the adolescents' own expectations and the extent to which autistic adolescents and their parents agree about the future. Methods We used a scoring procedure to "quantitize" semi-structured interview data about what 46 adolescent-parent dyads envisioned for the future of the autistic adolescent across three areas of adulthood (postsecondary education, employment, and living situation). Adolescents ranged in age from 13-19 years (85.1% male) and were able to participate in a verbal interview. We scored the dyads' interviews on the extent to which they agreed or disagreed about the postsecondary future of the adolescent, as well as whose expectations were higher (when they differed). Results Proportions of agreement and disagreement did not significantly differ, demonstrating moderate agreement. Notably, fewer than half (37.0-47.8%) of adolescents and their parents partly or strongly agreed about their visions for the future in each of the three areas. Only 17.4% of dyads partly or strongly agreed across all three areas, and 23.9% did not agree in any area. When adolescents' and parents' views differed, adolescents were significantly more likely to have a higher expectation across all three areas (ps < 0.01). Conclusions Future research is needed to examine differences in autistic adolescents' and parents' visions of the future, and to explore interventions to support families to work toward shared goals for the future. This study contributes to a growing body of literature emphasizing the importance of including the perspectives of autistic adolescents in research and for them to have an active and substantial role in their own transition planning.
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Affiliation(s)
- Anne V. Kirby
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA.,Address correspondence to: Anne V. Kirby, PhD, OTR/L, Department of Occupational and Recreational Therapies, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA
| | - Marissa L. Diener
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA
| | - Evan E. Dean
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Amber Nowell Darlington
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA
| | - Alyssa Myers
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA
| | - Jarrett Henderson
- Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City, Utah, USA
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Correale C, Borgi M, Cirulli F, Laghi F, Trimarco B, Ferraro M, Venerosi A. The Impact of Health and Social Services on the Quality of Life in Families of Adults with Autism Spectrum Disorder (ASD): A Focus Group Study. Brain Sci 2022; 12:brainsci12020177. [PMID: 35203938 PMCID: PMC8869802 DOI: 10.3390/brainsci12020177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Autism spectrum disorder (ASD) is a complex developmental condition that affects the whole family. The gap between childrens’ needs and their satisfaction, especially regarding what concerns the presence of social and healthcare services, is still a source of burden, particularly after the transition to adulthood. Our study aimed to gather a comprehensive view on how parents of adults with ASD perceive (and interact with) health and social services, and how the provision of care impacts family quality of life with the aim to advise ASD intervention programs. The goal is to identify specific areas of change useful to influence autism intervention strategies so that they more effectively meet the needs of young people with autism and their families. Methods: We conducted two focus groups with parents of young adults with ASD. A semi-structured focus group methodology was adopted. The QoL conceptual framework guided data collection and analysis as part of a directed theory-driven content analysis approach. Results: The lack of structured care pathways and the low level of integration of different services were the main limits reported by parents during the focus group, while a shared positive perception of the experience conducted together as caring families emerged. Conclusions: The experience here reported claims for a greater role of the institutions in order to facilitate the building of networks that are really inclusive for persons with autism in society and to support the implementation of innovative solutions for the welfare system. Furthermore, parents stressed the need for the provision of support to the family.
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Affiliation(s)
- Cinzia Correale
- Cooperativa Sociale Agricola Integrata «Giuseppe Garibaldi», 00179 Rome, Italy; (C.C.); (B.T.); (M.F.)
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.B.); (F.C.)
| | - Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.B.); (F.C.)
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.B.); (F.C.)
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Barbara Trimarco
- Cooperativa Sociale Agricola Integrata «Giuseppe Garibaldi», 00179 Rome, Italy; (C.C.); (B.T.); (M.F.)
| | - Maurizio Ferraro
- Cooperativa Sociale Agricola Integrata «Giuseppe Garibaldi», 00179 Rome, Italy; (C.C.); (B.T.); (M.F.)
| | - Aldina Venerosi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.B.); (F.C.)
- Correspondence:
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Shogren KA, Mosconi MW, Raley SK, Dean EE, Edwards B, Wallisch A, Boyd B, Kiblen JC. Advancing the Personalization of Assessment and Intervention in Autistic Adolescents and Young Adults by Targeting Self-Determination and Executive Processes. AUTISM IN ADULTHOOD 2021; 3:289-299. [PMID: 36601638 PMCID: PMC8992922 DOI: 10.1089/aut.2021.0010] [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: 01/07/2023]
Abstract
As autistic adolescents and young adults navigate the transition to adulthood, there is a need to partner with them to identify strengths and needed supports to enable goal-directed actions. This article conceptually integrates research on self-determination, defined by Causal Agency Theory, and executive processes in autism to provide direction for future research and practice. We describe how integrating research on self-determination and executive processes could enable autistic adolescents and young adults to be engaged in the process of assessing executive processes and self-determination. We discuss how this can better inform personalization of supports for self-determination interventions by focusing on support needs related to executive processes, including inhibitory control and cognitive flexibility, from a strengths-based perspective. We discuss how this can enable self-determination interventions that promote outcomes aligned with the values of the autistic community.
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Affiliation(s)
- Karrie A. Shogren
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Matthew W. Mosconi
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Sheida K. Raley
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Evan E. Dean
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Ben Edwards
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Anna Wallisch
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Brian Boyd
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
| | - Jessie C. Kiblen
- Kansas University Center on Developmental Disabilities, University of Kansas, Lawrence, Kansas, USA
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Remington A, Heasman B, Romualdez AM, Pellicano E. Experiences of autistic and non-autistic individuals participating in a corporate internship scheme. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:201-216. [PMID: 34151609 PMCID: PMC8750129 DOI: 10.1177/13623613211025115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Autistic people have significant challenges in obtaining and maintaining
employment yet there remains a shortage of research in this area, especially
research directly comparing the experiences of autistic individuals to their
non-autistic colleagues in the same organisation. The present study examined the
experiences of autistic and non-autistic interns, and their managers, taking
part in a corporate internship scheme. Data were gathered via semi-structured
interviews and online questionnaires prior to, and following, the internship.
Many commonalties were identified, with both groups of interns and managers
sharing positive journeys through the internship. Specific issues raised by
autistic interns centred around impact of prior employment experiences, mental
health and communication. Compared to managers of non-autistic interns, managers
of autistic interns reported having a greater range of pre-internship concerns,
including concerns about providing the right level of support, communicating
successfully and being equitable in treatment of all employees. Structured
delegation of tasks and flexible communication were successful strategies used
by managers to support autistic interns; clear communication and more consistent
support were perceived to benefit both intern groups. The findings highlight
specific challenges experienced by autistic individuals in the workplace and
suggest effective ways to ensure that autistic interns succeed alongside
non-autistic peers.
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Matthews NL, Christenson K, Kiefer S, Smith CJ. A mixed-methods examination of the gap between intelligence and adaptive functioning in autistic young adults without intellectual disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2317-2330. [PMID: 34075794 DOI: 10.1177/13623613211018334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Adaptive functioning describes the age-appropriate skills necessary for independent living. Research suggests that autistic children, adolescents, and adults who do not have an intellectual disability demonstrate adaptive functioning challenges relative to their intellectual ability. Thus, even though many of these individuals have the intellectual capacity to excel in mainstream educational and vocational settings, their adaptive functioning challenges may serve as an obstacle to independence. The research on adaptive functioning in autistic adults is focused on statistical analysis of standardized assessments (e.g. parent-report on multiple choice questionnaires). Qualitative research that examines the narratives of young adults and their parents is needed to better understand adaptive functioning in young adults and their resulting service needs. This study combined statistical analysis of standardized assessments with qualitative analysis of interview responses from autistic young adults without intellectual disability and their parents. Findings replicated previous reports of adaptive functioning challenges and identified influences on adaptive functioning development, consequences of independence, and service needs. Taken together, findings indicate the need for interventions and services that facilitate adaptive functioning development in autistic adolescents and young adults and provide insight into potential intervention targets and strategies.
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Affiliation(s)
| | | | - Sarah Kiefer
- Southwest Autism Research and Resource Center, USA
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Munsell EGS, Schwartz AE. Youth Experiences of the IDEA-Mandated Transition Planning Process: a Metasynthesis of Youth Voices. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Young Adults on the Autism Spectrum and Early Employment-Related Experiences: Aspirations and Obstacles. J Autism Dev Disord 2021; 51:88-105. [PMID: 32356082 DOI: 10.1007/s10803-020-04513-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In the United States, employment outcomes for young adults with an autism spectrum disorder (ASD) are poor, with many unemployed, underemployed, or otherwise unable to achieve their potential regardless of cognitive ability. To explore employment expectations and experiences, qualitative interviews were conducted with 12 young adults with ASD and 28 parents. Transcripts were analyzed using the constant comparative method associated with a grounded theory approach. Three major themes emerged: Employment Aspirations and Potential, Challenges of Job Finding and Keeping, and Differing Parent and Young Adult Work-Related Roles and Views. Issues discussed include the need to foster meaningful pre-employment opportunities, acknowledge the role of families in employment issues, provide ASD-focused workplace support, and effectively coordinate intersecting systems (e.g., schools, agencies, employers).
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42
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Connor A, Sung C, Strain A, Zeng S, Fabrizi S. Building Skills, Confidence, and Wellness: Psychosocial Effects of Soft Skills Training for Young Adults with Autism. J Autism Dev Disord 2020; 50:2064-2076. [PMID: 30879257 DOI: 10.1007/s10803-019-03962-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Recognizing that social functioning and mental health are linked to social participation and employment outcomes, this pilot study examined the preliminary outcomes of an eight-session, work-related social skills training program designed for young adults with high-functioning autism (HFASD). Results indicate statistically significant improvements in social cognition, social function, and social confidence. Furthermore, participants (n = 26) reported statistically significant reductions in anxiety, and a trend toward lessening depressive symptoms. These results suggest that: (1) social skills training is suitable for individuals with HFASD and clinically-significant levels of anxiety and/or depression, and (2) bolstered social functioning may have broader, cyclical impacts on social confidence, psychological wellness, and social and vocational participation in this population.
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Affiliation(s)
- Annemarie Connor
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Connie Sung
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, USA.
| | - Alicia Strain
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, USA
| | - Songtian Zeng
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, USA
| | - Sarah Fabrizi
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
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Weiss JA, Lai JKY, Lee V, Lunsky Y. Predictors of Changes in Daily Activity in Transition-Age Autistic Youth. Autism Res 2020; 14:324-332. [PMID: 32902130 DOI: 10.1002/aur.2371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/04/2020] [Accepted: 07/21/2020] [Indexed: 11/06/2022]
Abstract
Transitioning into adulthood is fraught with challenges for autistic youth. A greater understanding of the facilitators of community involvement in school and employment during this period is warranted. The current study examines changes in service need and receipt, and the stability of accessing daily structured activities, for autistic young adults over their transition period compared to adolescents and adults that did not enter the transition period. Baseline caregiver survey data were taken from the Canadian Autism Spectrum Disorders Alliance National Autism Needs Assessment Survey in 2014, and caregivers (n = 304) completed the same set of questions in 2017 about sociodemographic factors, clinical need, service receipt and typical weekday activities. Three cohorts were compared: (1) pretransition age youth, (2) transition-age youth, and (3) young adults who were past transition age. Results suggest that transition-age youth were found to have a unique set of priority service needs compared to pre transition-age adolescent and to adult groups, and both transition-age and adult groups had lower levels of priority service receipt compared to pretransition-age adolescents. The transition-age group experienced the greatest loss of structured weekday activity between time points, and were more likely than pretransition-age adolescents to not have structured weekday activities at Time 2. A recovery of structured daily activity was not observed in young adults. Our results highlight the tumultuous nature of the transition period for autistic youth, which continues into adulthood, and the urgent need for supports during this time. LAY SUMMARY: This research highlights that autistic young people who are transitioning to adulthood are at greatest risk of losing structured weekday activities, and that once in adulthood, many continue to struggle to obtain meaningful community engagement. These results can help guide the design of adolescent and young adult transition programs.
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Affiliation(s)
- Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jonathan K Y Lai
- Canadian Autism Spectrum Disorder Alliance, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Lee
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Vocational Rehabilitation Service Utilization and Employment Outcomes Among Secondary Students on the Autism Spectrum. J Autism Dev Disord 2020; 51:212-226. [PMID: 32399821 DOI: 10.1007/s10803-020-04533-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
U.S. policy interventions encourage earlier provision of Vocational Rehabilitation (VR) services to support students and youth with disabilities such as autism spectrum disorder (ASD) during the transition from school to work. We analyzed Rehabilitation Services Administration (RSA-911) data using multivariable logistic regression to determine the association of VR services receipt with employment outcomes for students ages 16-21, same-age non-student youth and young adults with ASD. Students with autism received job-related services (job search, job placement, and on-the-job supports) at rates significantly below comparison groups, even though odds of successful employment at VR exit were significantly higher if they received these services. Findings suggest that rates of employment among students with autism might be improved with intentional delivery of job-related services.
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Kirby AV, Diener ML, Adkins DE, Wright C. Transition preparation activities among families of youth on the autism spectrum: Preliminary study using repeated assessments across a school year. PLoS One 2020; 15:e0231551. [PMID: 32298327 PMCID: PMC7161970 DOI: 10.1371/journal.pone.0231551] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/25/2020] [Indexed: 11/18/2022] Open
Abstract
Much is still unknown about the transition to adulthood for youth with autism spectrum disorder (ASD), including what preparation activities best support positive adult outcomes. Parents play a crucial role in the transition planning and preparation process, yet the existing literature lacks detailed information about parent perceptions about transition preparation activities. To examine family transition preparation activities, we conducted a ten-month study of the transition preparation process of 15 families of youth with ASD across an academic year. Youth were ages 14-17 and 93% male. We collected data on transition preparation activity time spent and parent satisfaction over twenty data collection points. We used multi-level modeling to determine longitudinal trajectories of parent-reported preparation for the transition to adulthood based on endorsed transition preparation activities. Findings from this preliminary study revealed that discussions about the future were the most commonly endorsed activities, while social activities were most associated with increased parental perception of transition preparation over time. This study expands understanding of various transition preparation activities engaged in by families of youth with ASD during high school, though research with a larger and more diverse sample is needed to extend findings.
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Affiliation(s)
- Anne V. Kirby
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, Salt Lake City, UT, United States of America
| | - Marissa L. Diener
- Department of Family and Consumer Studies, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States of America
| | - Daniel E. Adkins
- Department of Sociology, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States of America
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, UT, United States of America
| | - Cheryl Wright
- Department of Family and Consumer Studies, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States of America
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How should we support young people with ASD and mental health problems as they navigate the transition to adult life including access to adult healthcare services. Epidemiol Psychiatr Sci 2020; 29:e90. [PMID: 31915102 PMCID: PMC7214707 DOI: 10.1017/s2045796019000830] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
For young people with autism spectrum disorder (ASD), the transition from childhood to adulthood especially for those with additional mental health problems can be challenging. Increasing numbers of young people attending child and adolescent mental health services (CAMHS) have a recognised diagnosis of ASD. What are the outcomes of these young people when they are discharged from CAMHS and how best can services support their needs? In this editorial we consider the emerging literature on transition for young people with long-term conditions and in particular those with ASD. Longer term studies suggest that the outcomes for individuals with ASD across the ability range is mostly poor and that healthcare transfer has generally not been managed well, with service users often reporting a lack of appropriate types of support. Encouragingly there is an increasing awareness of the need to support young people with long-term conditions as they negotiate the many developmental tasks of transition to adulthood. However, less is known about the experiences and aspirations of autistic individuals of all abilities as they transition to adulthood. This knowledge can inform a more nuanced approach to identifying developmentally appropriate outcomes. Recent studies with cognitively able young people with ASD, highlight some features in common with young people with long-term conditions but also the importance of identifying ways to foster underlying skills and the ability of young people with ASD to develop and maintain relationships. Child-focussed and adult-orientated healthcare services need to work directly with autistic individuals and their support networks to facilitate successful engagement with services and enable adults to manage their mental health needs. There is an urgent need to investigate the implementation and effectiveness of research and clinical guideline recommendations that aim to increase wellbeing, health self-efficacy and improve the mental health outcomes for autistic adults.
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Shattuck PT, Garfield T, Roux AM, Rast JE, Anderson K, Hassrick EM, Kuo A. Services for Adults With Autism Spectrum Disorder: a Systems Perspective. Curr Psychiatry Rep 2020; 22:13. [PMID: 32026004 PMCID: PMC7002329 DOI: 10.1007/s11920-020-1136-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW We review original research about services for adults on the autism spectrum published from January 2013 through December 2018. The main aim is to characterize the topical and methodological aspects of research about services. We review research on services related to employment, living in the community, and social participation. We compare our results with those from a similar review published in 2012 to assess progress and identify where new directions in research about services for adults with autism are needed. RECENT FINDINGS We found the evidence base about services for adults on the autism spectrum remains very small and highly variable in aims and methods. There is wide variability in methods used to define sampling frames and recruit participants. Most studies focus on employment. Almost no studies examine the overall ecosystem of services serving autistic adults. Few studies use a conceptual framework for understanding access to, or improvement of, services. The small size of the extant research coupled with inconsistent quality prevents the accumulation of new knowledge in ways that would significantly inform the improvement of systems of care for the growing population of adults on the autism spectrum.
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Affiliation(s)
- Paul T. Shattuck
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Tamara Garfield
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Anne M. Roux
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Jessica E. Rast
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Kristy Anderson
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Elizabeth McGhee Hassrick
- 0000 0001 2181 3113grid.166341.7A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA USA
| | - Alice Kuo
- 0000 0000 9632 6718grid.19006.3eUCLA School of Medicine, Los Angeles, CA USA
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Jonsson U, Coco C, Fridell A, Brown S, Berggren S, Hirvikoski T, Bölte S. Proof of concept: The TRANSITION program for young adults with autism spectrum disorder and/or attention deficit hyperactivity disorder. Scand J Occup Ther 2019; 28:78-90. [PMID: 31790309 DOI: 10.1080/11038128.2019.1695933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The support needs of people with neurodevelopmental disorders are not sufficiently met during the initial years of adulthood. AIM To evaluate feasibility and preliminary effects of a novel programme designed to empower young adults with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD) to make progress within significant life domains (i.e. work, education, finance, housing/household management, health, leisure/participation in society, and relationships/social network). MATERIAL AND METHOD TRANSITION is a 24-week programme that combines group-based workshops with personalised support based on goal attainment scaling. The study enrolled 26 young adults (50% females; age 17-24 years) in the normative intellectual range, diagnosed with ASD (n = 8), ADHD (n = 4), or both (n = 14). The intervention was delivered by the regular staff of publicly funded psychiatric services in Stockholm, Sweden. RESULTS The programme was possible to implement with minor deviations from the manual. Participants and staff generally viewed the intervention positively, but also provided feedback to guide further improvement. There was a high degree of attendance throughout, with 21 participants (81%) completing the programme. All completers exceeded their predefined goal expectations within at least one domain. CONCLUSIONS The TRANSITION-programme is a promising concept that deserves further evaluation.
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Affiliation(s)
- Ulf Jonsson
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Christina Coco
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Anna Fridell
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Sara Brown
- The Swedish Prison and Probation Service, Norrköping, Sweden
| | - Steve Berggren
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden
| | - Tatja Hirvikoski
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Habilitation and Health, Stockholm County Council, Stockholm, Sweden
| | - Sven Bölte
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, CAP Research Centre, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Services, Stockholm, Sweden.,Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia
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Baker-Ericzén MJ, Brookman-Frazee L, Brodkin ES. Accelerating research on treatment and services for transition age youth and adults on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 22:2-5. [PMID: 29369717 DOI: 10.1177/1362361317738646] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lindsay S, Cagliostro E, Leck J, Stinson J. Career aspirations and workplace expectations among youth with physical disabilities. Disabil Rehabil 2019; 43:1657-1668. [PMID: 31589070 DOI: 10.1080/09638288.2019.1671505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE Youths with disabilities have lower employment rates than youths without disabilities, which are often a result of inaccessible environments, employer's lack of knowledge about people with disabilities and discriminatory attitudes. Exploring youths' career aspirations is important because it can prompt or hinder career planning, and contribute to youths' preparation for adult life. The purpose of our study was to explore the career aspirations and workplace expectations of youths with physical disabilities. METHOD We drew on qualitative discussion forum data from a larger study focusing on employment preparation e-mentoring intervention for youths with physical disabilities. Our sample comprised 44 youths aged 15-25 years (mean age 18.9, 47% female) with physical disabilities. We analyzed the data using a qualitative, content analysis approach. RESULTS Youths described several areas that helped to develop their occupational capacity including self-advocacy, pursuing post-secondary education, volunteering/co-op, family support, and social networks. Areas where youths anticipated encountering occupational constraints involved: transportation, attitudes and discrimination, physicality of work and self-care, communication skills, and finding work or volunteer positions. Youths' expectations for the workplace included: disability disclosure and requesting accommodations, and a respectful environment. CONCLUSIONS Our findings highlighted that youths with physical disabilities had diverse career aspirations that are shaped by various occupational capacities and constraints.Implications for rehabilitationYouth with physical disabilities may need further support with accessing and navigating public transportation independently to gain employment, and also developing their communication skills, specifically how to disclose their condition to employers and coping with potential discrimination.Clinicians and educators should help youth with disabilities to gain exposure to a variety of career options (including STEM) while supporting them to find accessible positions that are compatible with their abilities.Clinicians and educators could consider helping to foster self-advocacy skills among youth with disabilities which are needed to disclose their condition and request accommodations.
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Affiliation(s)
- Sally Lindsay
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Joanne Leck
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Jennifer Stinson
- Hospital for Sick Children, Toronto, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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