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Leadbitter K, Harrison L, Langhorne S, Ellis C, Smallman R, Pearson A, Hackett L, Kroll L, Dunkerley A, Beach H, Gilbert J, van Gils A, Hutton T, Green J, Bee P. The development, feasibility and acceptability of Empower-Autism: A new psychoeducational and psychotherapeutic programme for caregivers of children recently diagnosed with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241274566. [PMID: 39291754 DOI: 10.1177/13623613241274566] [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: 09/19/2024]
Abstract
LAY ABSTRACT What is already known about the topic?Parents and carers face many challenges following their child's autism diagnosis. They often look for information, and social and emotional support. There has been relatively little research into how best to provide this support and this means that there is no evidence to guide the delivery of services. Studies have suggested that an approach called Acceptance and Commitment Therapy can help parents and carers with their adjustment and emotional wellbeing.What does this article add?This article describes the development of a new group-based programme to address the diverse needs of caregivers after their child's autism diagnosis. The new programme was developed with caregivers, autistic people and professionals. It was called Empower-Autism and contained lots of information about autism and strategies to support autistic children, alongside therapeutic aspects based on Acceptance and Commitment Therapy. The programme was delivered to 29 parents/carers in three groups. Attendance at the groups was satisfactory. Both parents/carers and facilitators liked and valued the programme and found it accessible. They made suggestions for improvements. After the programme, parents and carers described improved wellbeing. They felt more positive and more connected to other people. They also described parenting their child in a more informed and sensitive way.Implications for practice, research or policyThe new programme is being tested within a large clinical trial. If there are positive results, the programme could be recommended for delivery and this would address an important gap in evidence-based practice.
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Affiliation(s)
| | | | | | | | | | | | | | - Leo Kroll
- Pennine Care NHS Foundation Trust, UK
| | | | | | | | | | | | - Jonathan Green
- The University of Manchester, UK
- Manchester University NHS Foundation Trust, UK
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Frigerio A, Knight T, Rella R, Sinigaglia E, Camussi E, Montali L. Experiences of parenting for autistic children in Australia and Italy: a qualitative cross-cultural comparison. Front Psychol 2024; 15:1409234. [PMID: 39161689 PMCID: PMC11330893 DOI: 10.3389/fpsyg.2024.1409234] [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: 04/16/2024] [Accepted: 07/22/2024] [Indexed: 08/21/2024] Open
Abstract
Introduction Parents vary in their gradual adaptation to the demands of caring for an autistic child. Their experiences can be positive, negative, or a combination of both, depending on the severity of the cases and various personal and social factors. Cross-cultural comparisons can aid in understanding how contextual factors, such as the availability of social and health services, and cultural factors, such as family relationships and the distribution of care burden, may influence the caregiving experience. However, there is a limited amount of cross-cultural research on this topic, which is almost exclusively quantitative. Aims and methods From an ecocultural perspective, our interview-based study aimed to explore the experiences of Australian (15) and Italian (11) parents of autistic children living in their respective countries. Results The analysis identified three main themes. Life through autism, autism through life: coexisting with an unexpected life partner, Parenting autistic children: reorganization of parents' subjectivity and familiar dynamics, and The unseen side of disability: autism communities between inclusion and segregation. Discussion Our comparative approach reveals both commonalities and differences between the two groups of participants. The similarities support features previously identified in the literature: the emotional and physical burden on parents and the positive impact on parental identity. The differences relate to the diagnostic process, interactions with health professionals, the impact of autism on family dynamics and parental perspectives, and the role assigned to siblings. Despite facing similar challenges, these differences reveal how Italian and Australian parents articulate different understandings linked to social and cultural differences.
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Affiliation(s)
| | - Tess Knight
- Cairnmillar Institute, Hawthorn East, VIC, Australia
| | - Riccardo Rella
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Elena Sinigaglia
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Lorenzo Montali
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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O'Neill S, O'Donnell GM. Identifying autistic children: Priorities for research arising from a systematic review of parents' experiences of the assessment process. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241243107. [PMID: 38659201 DOI: 10.1177/13623613241243107] [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: 04/26/2024]
Abstract
LAY ABSTRACT Hearing about parents' experiences of having their child recognised as autistic could help improve the supports offered to parents. Our article may also help guide future research on this topic. We made a list of the type of research that interested us. We searched the studies already completed, only studying the research that matched our interests. After reading the studies, we rated their quality using the Critical Appraisal Skills Programme tool.It became clear that parents went through four phases during the identification process. The first phase occurred before their child was identified as autistic. The second involved the actual assessment of their child. Parents' emotional reactions to the news were the focus of the third phase. The final phase occurred after their child was identified as autistic. We discuss the findings of our research. As there are sensitivities involved in conducting research on this topic, we identify how researchers can ensure that their research is of the best quality. We are committed to respecting the human rights of all involved, so we emphasise the need for professionals to develop good relationships with the parents of autistic children. Researchers have recently come to see autism as typical of human diversity. We encourage the professionals involved to adopt this understanding of autistic children and make practical suggestions to enable them to do so.
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Li G, Zarei MA, Alibakhshi G, Labbafi A. Teachers and educators' experiences and perceptions of artificial-powered interventions for autism groups. BMC Psychol 2024; 12:199. [PMID: 38605422 PMCID: PMC11010416 DOI: 10.1186/s40359-024-01664-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Artificial intelligence-powered interventions have emerged as promising tools to support autistic individuals. However, more research must examine how teachers and educators perceive and experience these AI systems when implemented. OBJECTIVES The first objective was to investigate informants' perceptions and experiences of AI-empowered interventions for children with autism. Mainly, it explores the informants' perceived benefits and challenges of using AI-empowered interventions and their recommendations for avoiding the perceived challenges. METHODOLOGY A qualitative phenomenological approach was used. Twenty educators and parents with experience implementing AI interventions for autism were recruited through purposive sampling. Semi-structured and focus group interviews conducted, transcribed verbatim, and analyzed using thematic analysis. FINDINGS The analysis identified four major themes: perceived benefits of AI interventions, implementation challenges, needed support, and recommendations for improvement. Benefits included increased engagement and personalized learning. Challenges included technology issues, training needs, and data privacy concerns. CONCLUSIONS AI-powered interventions show potential to improve autism support, but significant challenges must be addressed to ensure effective implementation from an educator's perspective. The benefits of personalized learning and student engagement demonstrate the potential value of these technologies. However, with adequate training, technical support, and measures to ensure data privacy, many educators will likely find integrating AI systems into their daily practices easier. IMPLICATIONS To realize the full benefits of AI for autism, developers must work closely with educators to understand their needs, optimize implementation, and build trust through transparent privacy policies and procedures. With proper support, AI interventions can transform how autistic individuals are educated by tailoring instruction to each student's unique profile and needs.
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Affiliation(s)
- Guang Li
- School of History, Capital Normal University, Beijing, China
| | | | | | - Akram Labbafi
- Maraghe Branch, PhD Candidate of English Language Teaching, Islamic Azad University, Teheran, Iran
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Anthony H, Reupert A, McLean L. Parent experiences of specific learning disorder diagnosis: A scoping review. DYSLEXIA (CHICHESTER, ENGLAND) 2024; 30:e1757. [PMID: 38176422 DOI: 10.1002/dys.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/15/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024]
Abstract
The purpose of this review was to scope the quantity and methodological characteristics of the current literature examining parent and caregivers' perspectives of specific learning disorder (SLD) diagnosis, synthesise key findings and highlight gaps in the current literature. A systematic search was conducted for the period January 2013 to March 2023. Twenty-three articles, representing 1796 parents and caregivers across seven countries, underwent data extraction. The review highlighted considerable variability regarding the main aim and scope of each included study and that most studies used qualitative or mixed method methodology. Three central parts of the diagnostic experience were identified: pathway to assessment, assessment process, and advocating and coordinating support post-diagnosis. A final theme, broader social and political issues, was also identified. The findings highlight that parents of children with SLDs experienced a similar battle to obtain a diagnosis and access post-diagnostic support as parents of children with other neurodevelopmental disorders. This provides some evidence that, internationally, parent needs in the time surrounding SLD diagnostic assessment are not being met, with substantial barriers to timely assessment and inadequate post-diagnosis support. Future research and implications for practice are explored.
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Affiliation(s)
- Hayley Anthony
- Faculty of Education, School of Educational Psychology and Counselling, Monash University, Clayton, Victoria, Australia
| | - Andrea Reupert
- Faculty of Education, School of Educational Psychology and Counselling, Monash University, Clayton, Victoria, Australia
| | - Louise McLean
- Faculty of Education, School of Educational Psychology and Counselling, Monash University, Clayton, Victoria, Australia
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Fletcher-Watson S. What's in a name? The costs and benefits of a formal autism diagnosis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:257-262. [PMID: 37997793 DOI: 10.1177/13623613231213300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
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Al Awaji NN, Al-Taleb SM, Albagawi TO, Alshammari MT, Sharar FA, Mortada EM. Evaluating Parents' Concerns, Needs, and Levels of Satisfaction with the Services Provided for ASD Children in Saudi Arabia. J Multidiscip Healthc 2024; 17:123-146. [PMID: 38222477 PMCID: PMC10785689 DOI: 10.2147/jmdh.s447151] [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: 10/29/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024] Open
Abstract
Background Supporting children with autism spectrum disorder (ASD) and their parents is vital in improving their children's abilities and their parents' ability to care for them. Thus, parents' perceptions of and levels of satisfaction with the services provided for their children must be assessed. Aim This study aimed to understand parents' perceptions of and satisfaction with the speech-language services (SLS) provided for ASD children in different health facilities in Saudi Arabia. Methods This cross-sectional study included 109 parents of ASD children. The survey included five sections dealing with (1) general information about the child; (2) assessment of the child's ASD characteristics (including their age when diagnosed, when they first noticed symptoms, and their speech, language, and communication abilities); (3) the reasons for enrollment in SLS sessions; (4) questions about SLS; and (5) parents' perceptions of SLS, satisfaction with the service, descriptions of their children's progress, and the respect and support they received. Results Parents' satisfaction levels were significantly higher when they had easy access to SLS, sufficient information and support, proper training in applying therapy exercises at home, and perceived respect and support from speech and language pathologists (SLPs). The reasons for discontinuing SLS included high session costs, the need for initial behavioral sessions, the lack of qualified SLPs, the end of the sessions, the lack of improvement, the nonavailability of specialized centers, and parents' dependence on home training only. They also sought opportunities for work and education, continuous and intensive SLS sessions, reduced costs, centers for adults with ASD, and accessible schools. Parents' main concerns were their children's poor speech and language skills, independence, and social acceptance. Conclusion and Implications The study highlighted the importance of understanding parents' experiences with SLS, identifying the factors that enhance SLS use by ASD children, and improving parents' satisfaction with such services.
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Affiliation(s)
- Nisreen Naser Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Sumaih Mohammed Al-Taleb
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Teef Olayan Albagawi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Maram Taleb Alshammari
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Fay Abdullah Sharar
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Eman M Mortada
- Health Sciences department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
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Powell L, Wheeler G, Redford C, Stott J. The suitability and acceptability of a co-designed prototype psychoeducational activity book for autistic children aged five-eleven years. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241234648. [PMID: 38426035 PMCID: PMC10903197 DOI: 10.1177/23969415241234648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Background and aims Evidence suggests that autistic children and young people (CAYP) can benefit from age-appropriate psychoeducation. Co-design is a methodology that iteratively involves end users and stakeholders in producing an intervention which may increase engagement and impact. Few age-appropriate co-designed psychoeducation resources for autistic CAYP exist. Therefore, a paper-based resource was co-designed for autistic CAYP who attend mainstream primary education. The resource aims to educate CAYP about their autism and provide strategies to support them to live well with their autism. Methods This paper describes the evaluation of the prototype resource through online workshops with 12 families and input from four specialist clinicians. The suitability and acceptability of the resource was explored, and sketch notes were taken for respondent validity and engagement purposes. Results A reflexive thematic analysis identified six themes and two subthemes: (1) content appropriateness (subtheme: strategies and unpredictability); (2) relating to content, (3) feelings and emotions, (4) terminology (subtheme: literal thinking); (5) positivity, and (6) communication aid. Suggested improvements were also identified. Results suggest the resource is suitable and acceptable. Conclusions Future intervention development research may consider individual differences of autistic CAYP and the co-design of resources for other age groups of neurodiverse populations.
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Affiliation(s)
- Lauren Powell
- School of Education, University of Sheffield, Sheffield, UK
| | - Gemma Wheeler
- Children and Young People MedTech Co-operative, National Institute for Health and Care Research, London, UK
| | - Chris Redford
- Chris Redford, Design and Illustration, Sheffield, UK
| | - Jonathan Stott
- Child Orientated Mental Health Innovative Collaboration, University of York, York, UK; Tees, Esk and Wear Valleys NHS Foundation Trust, UK
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Dunn ZD, Gowda A, Horsfall Turner IC. The viability of a proposed psychoeducational neurodiversity approach in children services: The PANDA (the Portsmouth alliance's neuro-diversity approach). Clin Child Psychol Psychiatry 2024; 29:198-212. [PMID: 37311174 DOI: 10.1177/13591045231184121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
People with Neurodevelopmental (ND) conditions are often unfairly stereotyped by society, without fully appreciating their strengths. As a result, their advantageous behaviours may be overlooked or ignored. Despite wide psychoeducation on ND in society there is a push from the scientific and ND community to move from a binary diagnostic system to an approach that encompasses the spectrum experienced by individuals. In view of this, we have developed the Portsmouth Alliance Neuro-Diversity Approach (PANDA), a coproduced method which helps facilitate understanding, communication and early support for individuals who may be Neuro-Diverse. 51 young people, their parents and attached professionals participated in the approach's feasibility to improve wellbeing and symptom management measured by quantitative and qualitative means. Results showed a significant improvement in the child's wellbeing, but not symptom management. Overall, this indicates the PANDA could facilitate a more holistic approach for referrals, information gathering, psychoeducation and cross-system relationship building to be used in conjunction with a traditional pathway. Though, this study is limited in scope, its main purpose is to inform future development of the approach. Additionally, more research investigating the specific narrative, and separate structure of the PANDA would be required to highlight the strengths and limitations of implementation.
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Affiliation(s)
- Zach D Dunn
- Children and Adolescent Mental Health Service, Solent NHS Trust, Portsmouth, UK
| | - Asha Gowda
- Children and Adolescent Mental Health Service, Solent NHS Trust, Portsmouth, UK
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Abd Latif MH, Wan Ismail WS, Abdul Manaf MR, Abdul Taib NI. Factors Influencing Despair, Self-blame, and Acceptance Among Parents of Children with Autism Spectrum Disorder (ASD): A Malaysian Perspective. J Autism Dev Disord 2023:10.1007/s10803-023-06155-8. [PMID: 37987948 DOI: 10.1007/s10803-023-06155-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE Accepting and adapting to the child's diagnosis of Autism Spectrum Disorder (ASD) can be challenging for parents. We aimed to assess domains of parental adjustment namely despair, self-blame, and acceptance among parents whose children were diagnosed with ASD. METHODS A cross-sectional study was conducted among 111 parents of children with autism who attended Child and Adolescent Psychiatry Unit (CAPU), in a university teaching hospital in Kuala Lumpur, Malaysia. Sociodemographic profiles of both parents and children were gathered. Parental adjustment focusing on parental self-blame, despair and acceptance were assessed using self-reported questionnaires namely Adjustment to the Diagnosis of Autism (ADA). RESULTS Higher level of despair was associated with parents who have medical illness (β = 0.214, p = 0.016) and children who received antipsychotic medications (β = 0.329, p < 0.001). Parents with tertiary education (β = -0.207, p = 0.023) and those with autistic child attended school (β = -0.200, p = 0.037) have lower level of despair. Parents with medical illness (β = 0.245, p = 0.008), child receiving antipsychotic medications (β = 0.251, p = 0.005), Chinese ethnicity (β = 0.185, p = 0.04), and child's gender (β = 0.283, p = 0.003) were significantly associated with higher level of self-blame. Lower acceptance was found among Chinese parents (β = -0.264, p = 0.005) while married parents had higher acceptance levels (β = 0.215, p = 0.022). CONCLUSION Parental adjustment involving domains of despair, self-blame, and acceptance were significantly associated with ethnicity of parents, educational level, parents' marital status and medical illness, as well as the ASD children's schooling status and type of medications used.
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Affiliation(s)
- Muhammad Hanif Abd Latif
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Wan Salwina Wan Ismail
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia.
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia.
| | - Mohd Rizal Abdul Manaf
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, 56000, Malaysia
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Nur Iwana Abdul Taib
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, 94300, Malaysia
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Feng Y, Li Y, Zhou X, Qin X, Deng T, Liu S, Zhang L. Predictors of posttraumatic growth in 475 Chinese parents of children newly diagnosed with autism spectrum disorder. J Pediatr Nurs 2023; 73:e469-e476. [PMID: 37867033 DOI: 10.1016/j.pedn.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/14/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE To examine the predictive effects of children's symptom severity, rumination, parental self-efficacy, and social support on posttraumatic growth (PTG) in parents of autistic children. DESIGN AND METHODS Parents (n = 475) completed the demographic questionnaire, Posttraumatic Growth Inventory, Autism Behavior Checklist, Event Related Rumination Inventory, Parenting Sense of Competence, and Social Support Rating Scale in a cross-sectional survey conducted in a tertiary hospital in Guangzhou, China, between September 2019 and January 2021. Multiple linear regression analyses were conducted using SPSS version 25.0. RESULTS The PTG score was positively associated with rumination (r = 0.325, P < 0.05), parental self-efficacy (r = 0.219, P < 0.05), and social support (r = 0.374, P < 0.05). Multiple linear regression analysis revealed that household income (β = 0.095, P < 0.05), intrusive rumination (β = -0.100, P < 0.05), deliberate rumination (β = 0.391, P < 0.001), subjective support (β = 0.239, P < 0.001), and children's daily living skills deficiencies as perceived by parents (β = 0.107, P < 0.05) significantly predicted PTG, accounting for 33.3% of the variance [F(P) = 13.444, P < 0.001]. CONCLUSIONS Psychosocial factors (rumination and subjective support) are essential to facilitate PTG in parents whose children are newly diagnosed with autism. PRACTICE AND IMPLICATIONS With the consideration of different sociodemographic features, clinicians and researchers are encouraged to explore cognitive-based psychosocial interventions targeting parents' psychological growth and parenting training programs targeting autistic children's self-care ability.
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Affiliation(s)
- Yongshen Feng
- School of Nursing, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yongmei Li
- Child Development Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou 510630, China.
| | - Xuezhen Zhou
- Nursing department, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510200, China
| | - Xiuqun Qin
- Child Development Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou 510630, China
| | - Tao Deng
- School of Nursing, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shaofei Liu
- School of Nursing, Sun Yat-Sen University, Guangzhou 510080, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-Sen University, Guangzhou 510080, China.
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Rivard M, Morin D, Coulombe P, Morin M, Mello C. The Diagnostic Period for Autism: Risk and Protective Factors for Family Quality of Life in Early Childhood. J Autism Dev Disord 2023; 53:3755-3769. [PMID: 35917021 DOI: 10.1007/s10803-022-05686-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
During the diagnostic evaluation period for autism or intellectual disability (ID), families of young children are at risk for poor adjustment. The present study aimed to document family quality of life (FQOL), along with associated risk and protective factors, during this critical step of families' services trajectory. FQOL was measured in a large sample of families of children recently diagnosed with a neurodevelopmental disorder and examined in relation to the type of services received, children's clinical profile, and family variables. FQOL was related to types of services, children's challenging behavior, parenting stress, and several aspects of family composition and status. These findings highlight a need for mental health support for parents, coaching interventions for challenging behaviors, and family-centered supports.
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Affiliation(s)
- Mélina Rivard
- Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, H3C 3P8, Montréal, Québec, Canada.
| | - Diane Morin
- Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, H3C 3P8, Montréal, Québec, Canada
| | | | - Marjorie Morin
- Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, H3C 3P8, Montréal, Québec, Canada
| | - Catherine Mello
- The Pennsylvania State University - Berks, 19610, Reading, PA, USA
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Rivard M, Morin M, Rochefort C, Morin D, Mello C. Barriers and facilitators to accessibility, continuity, validity, flexibility, and provider-family relationship along the diagnostic pathway in developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104570. [PMID: 37423052 DOI: 10.1016/j.ridd.2023.104570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/12/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Parents of children with developmental disabilities must navigate a complex network to obtain a diagnosis and interventions for their child. However, their subjective experience of this journey has yet to be analyzed through the lens of a theorical framework that could support research, organizational program evaluation, and facilitate providers' reflection on how to enhance families' diagnostic services trajectory. AIMS This study sought to examine the diagnostic journey as experienced by 77 parents whose children were recently diagnosed with developmental disabilities (e.g., autism, intellectual disability) in the metropolitan area of Montréal, Québec (Canada). METHODS AND PROCEDURES A mixed qualitative content analysis approach was used to describe their perspective on barriers and facilitators in reference to the five dimensions of the Evaluation of the Trajectory Autism for Parents (ETAP) model (Rivard et al., 2020): accessibility, continuity, validity, flexibility, and provider-family relationship. OUTCOMES AND RESULTS The barriers and facilitators related to systemic factors identified by parents were consistent with the five dimensions outlined by the ETAP model. However, beyond these characteristics of the service delivery system, parents additionally identified their own, personal facilitators CONCLUSIONS AND IMPLICATIONS: This study supports the relevance of the ETAP framework to understanding the experience of families seeking a diagnosis. It also reinforces the potential contributions of this model to organize extant and future research as well as structure program evaluation and improvements.
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Affiliation(s)
- Mélina Rivard
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada.
| | - Marjorie Morin
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Corinne Rochefort
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Diane Morin
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Catherine Mello
- The Pennsylvania State University - Berks, State College, Reading, PA 16801, United States
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Cooper K, Mandy W, Butler C, Russell A. Phenomenology of gender dysphoria in autism: a multiperspective qualitative analysis. J Child Psychol Psychiatry 2023; 64:265-276. [PMID: 36089890 PMCID: PMC10087378 DOI: 10.1111/jcpp.13691] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Autistic people are overrepresented in gender clinic settings, but limited evidence is available to guide clinical decision making for this patient group. We aimed to generate a comprehensive understanding of the phenomenology of gender dysphoria in autistic people. METHODS We conducted a multi-perspectival interpretative phenomenological analysis (IPA), from five different perspectives; autistic young people and adults with experience of gender dysphoria, parents of young people, and clinicians working with autistic people with gender dysphoria in both adult and young person settings (n = 68). RESULTS IPA analysis resulted in two themes, 'discovering gender identity' and 'the complexities of moving towards gender comfort'. Participants agreed that there was often an interaction between gender dysphoria and features of autism such as sensory sensitivities. There was relative consensus across groups about the need for autism adaptations to be made in gender clinics. Autistic adults were more likely to see autism as an important identity than young people, but both groups were clear that autism did not impair their understanding of gender. In contrast, some parents and clinicians working with young people expressed concern that autism did impact self-understanding. DISCUSSION While the groups tended to agree on the ways in which particular features of autism can compound gender dysphoria, there were a range of perspectives on the ways in which autism impacted on self-knowledge. CONCLUSION Recommendations for adaptations when working with autistic people with gender dysphoria are presented.
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Affiliation(s)
- Kate Cooper
- Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, UK
| | - William Mandy
- Research Department of Clinical, Educational, and Health Psychology, London, UK
| | | | - Ailsa Russell
- Department of Psychology, Centre for Applied Autism Research, University of Bath, Bath, UK
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Bui TA, Pohl M, Rosenfelt C, Ogourtsova T, Yousef M, Whitlock K, Majnemer A, Nicholas D, Demmans Epp C, Zaiane O, Bolduc FV. Identifying Potential Gamification Elements for A New Chatbot for Families With Neurodevelopmental Disorders: User-Centered Design Approach. JMIR Hum Factors 2022; 9:e31991. [PMID: 35984679 PMCID: PMC9440405 DOI: 10.2196/31991] [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: 07/13/2021] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Chatbots have been increasingly considered for applications in the health care field. However, it remains unclear how a chatbot can assist users with complex health needs, such as parents of children with neurodevelopmental disorders (NDDs) who need ongoing support. Often, this population must deal with complex and overwhelming health information, which can make parents less likely to use a software that may be very helpful. An approach to enhance user engagement is incorporating game elements in nongame contexts, known as gamification. Gamification needs to be tailored to users; however, there has been no previous assessment of gamification use in chatbots for NDDs. OBJECTIVE We sought to examine how gamification elements are perceived and whether their implementation in chatbots will be well received among parents of children with NDDs. We have discussed some elements in detail as the initial step of the project. METHODS We performed a narrative literature review of gamification elements, specifically those used in health and education. Among the elements identified in the literature, our health and social science experts in NDDs prioritized five elements for in-depth discussion: goal setting, customization, rewards, social networking, and unlockable content. We used a qualitative approach, which included focus groups and interviews with parents of children with NDDs (N=21), to assess the acceptability of the potential implementation of these elements in an NDD-focused chatbot. Parents were asked about their opinions on the 5 elements and to rate them. Video and audio recordings were transcribed and summarized for emerging themes, using deductive and inductive thematic approaches. RESULTS From the responses obtained from 21 participants, we identified three main themes: parents of children with NDDs were familiar with and had positive experiences with gamification; a specific element (goal setting) was important to all parents, whereas others (customization, rewards, and unlockable content) received mixed opinions; and the social networking element received positive feedback, but concerns about information accuracy were raised. CONCLUSIONS We showed for the first time that parents of children with NDDs support gamification use in a chatbot for NDDs. Our study illustrates the need for a user-centered design in the medical domain and provides a foundation for researchers interested in developing chatbots for populations that are medically vulnerable. Future studies exploring wide range of gamification elements with large number of potential users are needed to understand the impact of gamification elements in enhancing knowledge mobilization.
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Affiliation(s)
- Truong An Bui
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - Megan Pohl
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Cory Rosenfelt
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Tatiana Ogourtsova
- Feil & Oberfeld Research Centre of the Jewish Rehabilitation Hospital - Centre intégré de santé et de services sociaux de Laval (CISSS Laval), Centre for Interdisciplinary Research of Greater Montreal (CRIR), Laval, QC, Canada
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Mahdieh Yousef
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Kerri Whitlock
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Annette Majnemer
- School of Physical & Occupational Therapy, Faculty of Medicine and Health Sciences, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - David Nicholas
- Central and Northern Alberta Region, Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Carrie Demmans Epp
- EdTeKLA Research Group, Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - Osmar Zaiane
- Department of Computing Science, University of Alberta, Edmonton, AB, Canada
| | - François V Bolduc
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Leadbitter K, Smallman R, James K, Shields G, Ellis C, Langhorne S, Harrison L, Hackett L, Dunkerley A, Kroll L, Davies L, Emsley R, Bee P, Green J. REACH-ASD: a UK randomised controlled trial of a new post-diagnostic psycho-education and acceptance and commitment therapy programme against treatment-as-usual for improving the mental health and adjustment of caregivers of children recently diagnosed with autism spectrum disorder. Trials 2022; 23:585. [PMID: 35869533 PMCID: PMC9306249 DOI: 10.1186/s13063-022-06524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autism is a neurodevelopmental disability affecting over 1% of UK children. The period following a child's autism diagnosis can present real challenges in adaptation for families. Twenty to 50% of caregivers show clinically significant levels of mental health need within the post-diagnostic period and on an ongoing basis. Best practice guidelines recommend timely post-diagnostic family support. Current provision is patchy, largely unevidenced, and a source of dissatisfaction for both families and professionals. There is a pressing need for an evidenced programme of post-diagnostic support focusing on caregiver mental health and adjustment, alongside autism psycho-education. This trial tests the clinical and cost-effectiveness of a new brief manualised psychosocial intervention designed to address this gap. METHODS This is a multi-centre two-parallel-group single (researcher)-blinded randomised controlled trial of the Empower-Autism programme plus treatment-as-usual versus usual local post-diagnostic offer plus treatment-as-usual. Caregivers of children aged 2-15 years with a recent autism diagnosis will be recruited from North West England NHS or local authority centres. Randomisation is individually by child, with one "index" caregiver per child, stratified by centre, using 2:1 randomisation ratio to assist recruitment and timely intervention. Empower-Autism is a group-based, manualised, post-diagnostic programme that combines autism psycho-education and psychotherapeutic components based on Acceptance and Commitment Therapy to support caregiver mental health, stress management and adjustment to their child's diagnosis. The comparator is any usual local group-based post-diagnostic psycho-education offer. Receipt of services will be specified through health economic data. PRIMARY OUTCOME caregiver mental health (General Health Questionnaire-30) at 52-week follow-up. SECONDARY OUTCOMES key caregiver measures (wellbeing, self-efficacy, adjustment, autism knowledge) at 12-, 26- and 52-week follow-up and family and child outcomes (wellbeing and functioning) at 52-week endpoint. SAMPLE N=380 (approximately 253 intervention/127 treatment-as-usual). Primary analysis will follow intention-to-treat principles using linear mixed models with random intercepts for group membership and repeated measures. Cost-effectiveness acceptability analyses will be over 52 weeks, with decision modelling to extrapolate to longer time periods. DISCUSSION If effective, this new approach will fill a key gap in the provision of evidence-based care pathways for autistic children and their families. TRIAL REGISTRATION ISRCTN 45412843 . Prospectively registered on 11 September 2019.
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Affiliation(s)
- Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
| | - Richard Smallman
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Kirsty James
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Gemma Shields
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Ceri Ellis
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Sophie Langhorne
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Louisa Harrison
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Latha Hackett
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Leo Kroll
- Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Linda Davies
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Penny Bee
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
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Morin M, Rivard M, Morin D, Mello C, Coulombe P. Parents' satisfaction with a Canadian pilot clinic to reduce waiting lists for the assessment and diagnosis of autism spectrum disorder and intellectual disability in young children. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1186-1198. [PMID: 35638232 DOI: 10.1111/jar.13012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND A large body of evidence suggest that parents of young children with autism spectrum disorder or intellectual disability experience low levels of satisfaction with the diagnostic evaluation process. This study sought to document parents' satisfaction with the services of a pilot clinic implemented in Québec, Canada. METHOD Two-hundred fifty-nine (259) parents were recruited following their child's diagnosis. A mixed methods approach was used to investigate parents' satisfaction globally and with specific aspects of the assessment process. RESULTS Parents expressed overall high satisfaction with the assessment process. Parental satisfaction with specific aspects of the assessment process was negatively related to paternal stress, fathers' unemployment and household income and positively related to maternal stress. CONCLUSIONS This pilot clinic could meet parents' needs at this crucial moment in their care and services trajectory. The factors associated with satisfaction in the present study may inform future improvements to its services.
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Affiliation(s)
- Marjorie Morin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mélina Rivard
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Diane Morin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Catherine Mello
- Department of Psychology, Penn State University, Berks, Pennsylvania, USA
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Guillon Q, Baduel S, Bejarano-Martín Á, Canal-Bedia R, MagÁn-Maganto M, FernÁndez-Álvarez C, Martín-Cilleros MV, SÁnchez-Gómez MC, García-Primo P, Rose-Sweeney M, Boilson A, LinertovÁ R, Roeyers H, Van der Paelt S, Schendel D, Warberg CK, Cramer S, Narzisi A, Muratori F, Scattoni ML, Moilanen I, Yliherva A, Saemundsen E, Jonsdottir SL, Efrim-Budisteanu M, Arghir A, Papuc SM, Vicente A, Rasga C, Xenia Kafka J, Poustka L, Kothgassner OD, Kawa R, Pisula E, Sellers T, Posada de la Paz M, Rogé B. Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2136-2150. [PMID: 35261293 DOI: 10.1177/13623613221080318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Renata LinertovÁ
- Canary Island Foundation for Health Research (Fundación Canaria de Investigación Sanitaria/FUNCANIS) and Health Service Research Network for Chronic Diseases (Red de Investigación en Servicios de Salud en Enfermedades Crónicas/REDISSEC), Spain
| | | | | | - Diana Schendel
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.,Aarhus University, Denmark.,Drexel University, USA
| | | | | | | | | | | | - Irma Moilanen
- University of Oulu, Finland.,Oulu University Hospital, Finland
| | | | | | | | | | - Aurora Arghir
- Victor Babes - National Institute of Pathology, Romania
| | | | - Astrid Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | - Celia Rasga
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
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19
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Crompton CJ, Hallett S, McAuliffe C, Stanfield AC, Fletcher-Watson S. "A Group of Fellow Travellers Who Understand": Interviews With Autistic People About Post-diagnostic Peer Support in Adulthood. Front Psychol 2022; 13:831628. [PMID: 35369218 PMCID: PMC8964394 DOI: 10.3389/fpsyg.2022.831628] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Receiving a diagnosis of autism in adulthood can be a life changing event, impacting identity, relationships, and mental health. A lack of post-diagnostic support has been highlighted by autistic adults, their allies, clinicians, and service providers. It can be a source of distress for autistic adults, reinforcing feelings of social isolation and rejection. Peer support could be a cost-effective, flexible, and sustainable model to provide community-based support for autistic adults. However, there is little research on the value of peer support, despite calls from the autistic community. This qualitative study explored autistic experiences and needs post-diagnosis, identifying specific ways that peer support may benefit them, and exploring the limitations of peer support. Twelve autistic adults who had all received an autism diagnosis in adulthood completed a semi-structured interview focussing on the diagnostic experience, post-diagnostic support needed and provided, engagement with the autistic community, and post-diagnostic peer support. Thematic analysis of interview transcripts resulted in four themes: (1) Mismatch in support needed and provided; (2) Community connection; (3) Flexible and personalised support; and (4) Sustainability. Participants indicated that peer support may be a useful mechanism to support autistic adults' post-diagnosis and offers unique opportunities not available through other support channels. Though informal peer support exists, it could be more sustainable and effective if well-supported and funded.
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Affiliation(s)
- Catherine J. Crompton
- Patrick Wild Centre, Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Sonny Hallett
- The Autistic Mutual Aid Society Edinburgh, Edinburgh, United Kingdom
| | | | - Andrew C. Stanfield
- Patrick Wild Centre, Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Sue Fletcher-Watson
- Salvesen Mindroom Research Centre, University of Edinburgh, Edinburgh, United Kingdom
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Jones M, Falkmer M, Milbourn B, Tan T, Bölte S, Girdler S. The Core Elements of Strength-Based Technology Programs for Youth on the Autism Spectrum: A Systematic Review of Qualitative Evidence. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00302-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractStrength-based programs that incorporate technology have gained increasing popularity as an approach to improve outcomes for individuals with autism spectrum disorder (ASD). Despite this, the core elements of strength-based technology programs remain poorly described. This study aimed to identify the core elements of strength-based technology programs for youth with ASD through a systematic review of the literature. Electronic databases were searched for qualitative studies delivering strength-based technology-driven interventions to youth on the spectrum. Ten of the 874 studies identified met the criteria. Qualitative analysis revealed three core elements of strength-based technology programs for this population: mutual respect, demonstrating skills, and interests. The findings underpin the design of future strength-based technology programs for youth with ASD.
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21
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Lampos V, Mintz J, Qu X. An artificial intelligence approach for selecting effective teacher communication strategies in autism education. NPJ SCIENCE OF LEARNING 2021; 6:25. [PMID: 34471124 PMCID: PMC8410830 DOI: 10.1038/s41539-021-00102-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
Effective inclusive education is key in promoting the long-term outcomes of children with autism spectrum conditions (ASC). However, no concrete consensus exists to guide teacher-student interactions in the classroom. In this work, we explore the potential of artificial intelligence as an approach in autism education to assist teachers in effective practice in developing social and educational outcomes for children with ASC. We form a protocol to systematically capture such interactions, and conduct a statistical analysis to uncover basic patterns in the collected observations, including the longer-term effect of specific teacher communication strategies on student response. In addition, we deploy machine learning techniques to predict student response given the form of communication used by teachers under specific classroom conditions and in relation to specified student attributes. Our analysis, drawn on a sample of 5460 coded interactions between teachers and seven students, sheds light on the varying effectiveness of different communication strategies and demonstrates the potential of this approach in making a contribution to autism education.
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Affiliation(s)
- Vasileios Lampos
- Department of Computer Science, University College London, London, UK.
| | - Joseph Mintz
- Institute of Education, University College London, London, UK.
| | - Xiao Qu
- Institute of Education, University College London, London, UK
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22
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Myers L, Karp SM, Dietrich MS, Looman WS, Lutenbacher M. Family-Centered Care: How Close Do We Get When Talking to Parents of Children Undergoing Diagnosis for Autism Spectrum Disorders? J Autism Dev Disord 2021; 51:3073-3084. [PMID: 33140145 PMCID: PMC8349341 DOI: 10.1007/s10803-020-04765-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2020] [Indexed: 12/16/2022]
Abstract
Autism spectrum disorder (ASD) affects 1:59 children, yet little is known about parents' perceptions of family-centered care (FCC) during the diagnostic process leading up to diagnosis. This mixed-methods study explored key elements of FCC from 31 parents of children recently diagnosed with ASD using parallel qualitative and quantitative measures. Parents rated highly their receipt of FCC and discussed ways providers demonstrated FCC. However, the majority of parents indicated that the period when their child was undergoing diagnosis was stressful and reported symptoms of depression and anxiety. The study points to ways in which health care providers can enhance FCC provided to families when a child is undergoing ASD diagnosis.
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Affiliation(s)
- Lynnea Myers
- Gustavus Adolphus College, 800 College Avenue West, Saint Peter, MN, 56082, USA.
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Stockholm, Sweden.
| | - Sharon M Karp
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN, USA
| | - Mary S Dietrich
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN, USA
- Vanderbilt University School of Medicine, 1161 21st Avenue South, Nashville, TN, USA
| | - Wendy S Looman
- University of Minnesota School of Nursing, 308 SE Harvard Street, Minneapolis, MN, USA
| | - Melanie Lutenbacher
- Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN, USA
- Vanderbilt University School of Medicine, 1161 21st Avenue South, Nashville, TN, USA
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Mo S, Viljoen N, Sharma S. The impact of socio-cultural values on autistic women: An interpretative phenomenological analysis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:951-962. [PMID: 34388943 PMCID: PMC9014764 DOI: 10.1177/13623613211037896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
It is well recognised that culture plays an important role in how people
experience the world. However, there is limited knowledge on the
impact of socio-cultural norms and values on the lives of autistic
women. This qualitative study used individual semi-structured
interviews to explore how eight cis-gendered autistic women, without
co-occurring intellectual disabilities, describe dominant
socio-cultural beliefs, values and norms and their influence on their
own sense of self. Findings elucidated three interdependent themes
related to the ‘pervasive influence of cultural values’,
‘individualisation as an autistic woman’ and ‘social connectivity’.
Autistic women described how they experienced their environments and
made choices about their place within the dominant culture and the
impact of these decisions on their identities and experience. The
findings of this study have implications for the continued need to
shift societal and clinical attitudes towards understanding and
appreciating diversity among autistic women.
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Affiliation(s)
| | - Nina Viljoen
- Hertfordshire Partnership University NHS Foundation Trust, UK
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24
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Brown M, Marsh L, McCann E. Experiences of fathers regarding the diagnosis of their child with autism spectrum disorder: A narrative review of the international research. J Clin Nurs 2021; 30:2758-2768. [PMID: 33951251 DOI: 10.1111/jocn.15781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/16/2021] [Accepted: 03/23/2021] [Indexed: 01/08/2023]
Abstract
AIM AND OBJECTIVES The aim of this systematic review was to identify the views and experiences of fathers regarding their child's Autism Spectrum Disorder diagnosis. BACKGROUND The diagnosis of a child's Autism Spectrum Disorder may be a stressful experience, creating uncertainty for parents. There has been a limited research focus on the views and experiences of fathers in relation to the diagnosis of Autism Spectrum Disorder of their child. DESIGN A systematic literature review of quantitative, qualitative and mixed-methods research studies. DATA SOURCES Academic Search Complete, CINAHL, MEDLINE and PsycINFO. METHODS From August to October 2020, two authors independently performed a systematic data extraction and appraised the studies using a recognised instrument. The PRISMA checklist was used in the review. RESULTS Nine papers met the inclusion criteria. Four themes emerged: (a) gradual recognition of developmental delay, (b) an emotional time, (c) coping and adaptation and (d) ongoing adjustments to the fathering role. CONCLUSIONS Nurses and other professionals need to work collaboratively with fathers to improve their experiences and provide supports at the time of Autism Spectrum Disorder diagnosis.
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Affiliation(s)
| | - Lynne Marsh
- School of Nursing and Midwifery, Belfast, UK
| | - Edward McCann
- School of Nursing and Midwifery, University of Dublin, Trinity College, Dublin, Ireland
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Bendik LA, Spicer-White F. The untold perspective: Parents' experiences of the autism spectrum disorder assessment process when the child did not receive a diagnosis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1761-1770. [PMID: 33840207 DOI: 10.1177/13623613211003741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autism is diagnosed by a process of child assessment and parental interview. It has been well-documented by parents of children who received a diagnosis of autism, that the process can be lengthy and cause distress for families. Nevertheless, the outcome often compensated for the difficult assessment journey as it enables families to gain access to further information, support and intervention. However, less is known about the assessment process from parents who undertake the same process but at the end are told their child does not meet the diagnostic criteria, meaning no diagnosis is given. We interviewed six parents in North Wales, whose child did not receive a diagnostic of autism following an assessment. During the interview, parents were asked about their experience of the autism assessment process. We found that parents reflected on their experience according to three themes: (1) parents tried to navigate how they could make sense of their child being different despite not receiving a diagnosis; (2) parents referred to the assessment process as a journey, which encompassed many emotional and psychological components and (3) parents discussed what it was like to hear a non-diagnosis outcome, in terms of feeling relieved, confused and raising questions for the child's future. These findings are important for professionals working in autism assessment services to help improve the assessment process for families, particularly when the assessment does not result in a diagnosis.
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26
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Critchley E, Cuadros M, Harper I, Smith-Howell H, Rogish M. A parent-sibling dyadic interview to explore how an individual with Autism Spectrum Disorder can impact family dynamics. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103884. [PMID: 33556700 DOI: 10.1016/j.ridd.2021.103884] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics. AIMS To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown. METHODS Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis. RESULTS Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support. CONCLUSIONS The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics.
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Affiliation(s)
- Emma Critchley
- Department of Psychology, University of York, Heslington, York, YO10 5DD, UK.
| | - Michelle Cuadros
- Department of Psychology, University of York, Heslington, York, YO10 5DD, UK
| | - Ina Harper
- Department of Psychology, University of York, Heslington, York, YO10 5DD, UK
| | - Harry Smith-Howell
- Department of Psychology, University of York, Heslington, York, YO10 5DD, UK
| | - Miles Rogish
- Department of Psychology, University of York, Heslington, York, YO10 5DD, UK
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Evans K, van der Meer L, Eggleston MJF, Taylor LJ, Thabrew H, Waddington H, Whitehouse AJO. A Survey of Autistic Adults from New Zealand on the Autism Diagnostic Process During Adolescence and Adulthood. J Autism Dev Disord 2021; 52:771-781. [PMID: 33788075 DOI: 10.1007/s10803-021-04983-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/28/2022]
Abstract
The diagnostic experiences of autistic adults in New Zealand have not been investigated and little is known globally about autistic adults' satisfaction with the autism diagnostic process. This study describes the diagnostic experiences of 70 autistic adults living in New Zealand and explores how these experiences are related to satisfaction during three stages of the diagnostic process. The results show that autistic adults were reasonably satisfied with the early query and diagnostic assessment stages, but were dissatisfied with the post-diagnostic support stage, with significant unmet needs. Dissatisfaction during the post-diagnostic support stage was also related to satisfaction during previous stages and poor coordination of supports. Suggestions are made on how to improve the autism diagnostic pathway for autistic adults in New Zealand.
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Affiliation(s)
- Kiah Evans
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, WA, 6872, Australia. .,School of Allied Health, Curtin University, Perth, WA, Australia. .,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Larah van der Meer
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.,Autism New Zealand, Lower Hutt, New Zealand.,School of Education, Victoria University of Wellington, Wellington, New Zealand
| | | | - Lauren J Taylor
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Hiran Thabrew
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Hannah Waddington
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Andrew J O Whitehouse
- Telethon Kids Institute, University of Western Australia, PO Box 855, Perth, WA, 6872, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.,School of Psychological Science, University of Western Australia, Perth, WA, Australia
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28
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Makino A, Hartman L, King G, Wong PY, Penner M. Parent Experiences of Autism Spectrum Disorder Diagnosis: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00237-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThe purpose of this review was to identify the quantity, breadth, and methodological characteristics of literature examining parent perspectives of autism spectrum disorder diagnosis, synthesize key research findings, and highlight gaps in the current literature. A systematic search was conducted for the period January 1994–February 2020. One hundred and twenty-two articles underwent data extraction. The majority of studies took place in Europe and North America in high-income countries. Over half of the studies used qualitative methodology. Four key components of the diagnostic experience were identified: journey to assessment, assessment process, delivery of the diagnosis and feedback session, and provision of information, resources, and support. Themes of parental emotions and parental satisfaction with the diagnostic process were also found.
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Anderberg E, South M. Predicting Parent Reactions at Diagnostic Disclosure Sessions for Autism. J Autism Dev Disord 2021; 51:3533-3546. [PMID: 33387242 DOI: 10.1007/s10803-020-04817-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 11/26/2022]
Abstract
Receiving a diagnosis of autism for their child can be a pivotal moment for parents, yet there is little research about how providers can predict parent reactions and adjust their feedback. We investigated factors related to parent reactions during the disclosure session using interviews with providers (n = 6), a parent focus group (n = 10), and a mixed-methods survey of parents (n = 189) of recently diagnosed children. Parents' prior knowledge of autism and anxiety about diagnosis predicted emotional reactions and readiness for next steps. Families anxious about receiving a diagnosis are most in need of information but may leave the session feeling lost and unprepared. Providers can promote positive emotional reactions for parents and prevent confusion by increasing their own positivity, warmth, respect, clarity, and confidence.
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Affiliation(s)
- Emily Anderberg
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Lurie Center for Autism, Massachussetts General Hospital, Lexington, MA, USA
| | - Mikle South
- Department of Psychology, Brigham Young University, Provo, UT, USA.
- Neuroscience Center, Brigham Young University, Provo, UT, USA.
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Understanding autism spectrum disorder and coping mechanism by parents: An explorative study. Int J Nurs Sci 2020; 7:413-418. [PMID: 33195753 PMCID: PMC7644554 DOI: 10.1016/j.ijnss.2020.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/14/2020] [Accepted: 08/20/2020] [Indexed: 11/21/2022] Open
Abstract
Objective This study aimed to explore the perceptions of parents of children with autism spectrum disorder (ASD) and their coping strategies. Methods The data of the study was collected using face-to-face semi-structured interviews. The participants were purposefully selected from the three schools in Mpumalanga Province because they had children diagnosed with ASD and data was analyzed using thematic content analysis. In this study, primary caregivers were selected. In the end, 12 women were interviewed, and the data saturation was reached. Ethical considerations and measures to ensure trustworthiness were carried out throughout the study. Results The findings revealed two themes: caregivers' understanding and misconceptions of ASD and coping mechanisms used in dealing challenges of caring for a child with ASD; and five subthemes: lack of knowledge, cultural beliefs, prayer, strong support system, and acceptance. Conclusion Based on the findings, more awareness campaigns should be done on ASD to increase parents' understanding of the condition. Understanding the cultural beliefs of parents regarding ASD may assist health care professionals in developing care practices that are accepted in their culture, and may enhance parents' coping skills.
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Parents' views and experiences of the autism spectrum disorder diagnosis of their young child: a longitudinal interview study. Eur Child Adolesc Psychiatry 2020; 29:1143-1154. [PMID: 31686239 DOI: 10.1007/s00787-019-01431-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/24/2019] [Indexed: 01/16/2023]
Abstract
Parents are valuable stakeholders in research, clinical practice and policy development concerning autism spectrum disorder (ASD). Little is known, however, about how parents view and experience an ASD diagnosis. We investigated the evolution of parents' views and experiences of the ASD diagnosis before, right after and 12 months after their child was diagnosed. Seventeen Flemish parents waiting for their young child's diagnostic ASD assessment participated in a longitudinal study consisting of three in-depth interviews. They described their views and experiences concerning their child's ASD diagnosis at three separate moments: (T1) prior to a diagnostic ASD assessment; (T2) immediately after their final feedback session at the end of the assessment; and (T3) 12 months later. Interviews were digitally recorded, transcribed and analysed in Nvivo 11 according to the procedures of interpretative phenomenological analysis. We extracted three themes from the interview material throughout the parental journey: (T1) expecting certainty and exculpation; (T2) vulnerabilisation of the child; and (T3) pragmatic attitude and some disappointment. At T3, the parents overall had come to value the diagnosis because of two reasons: they were satisfied with their child's entitlement to ASD-related support at school, and with the diagnosis' impact on the child's relationships with parents and teachers. Many parents experienced their child with an ASD diagnosis as vulnerable, and themselves as acutely responsible for his development and future. Our findings may lead to a higher satisfaction with the clinical trajectory in both clinician and parents by inspiring a conversation between them about parents' evolving views, hopes and concerns related to their child's ASD diagnosis.
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Papoudi D, Jørgensen CR, Guldberg K, Meadan H. Perceptions, Experiences, and Needs of Parents of Culturally and Linguistically Diverse Children with Autism: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00210-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractA scoping review of studies carried out in the UK and the USA was conducted to explore the perceptions, experiences, and needs of culturally and linguistically diverse families of children with autism. Overall, 32 articles met the inclusion criteria, 25 studies were conducted in the USA and 7 studies in the UK. Four themes emerged including (a) knowledge and beliefs about autism and their impact on the family; (b) autism and family life; (c) family experiences of accessing services and support, and parents’ needs; and (d) multilanguage. Findings highlighted that family perceptions of autism are influenced by an often-reported lack of knowledge; experiences include social stigma as well as difficulties in having access to services. Needs indicate the development of culturally sensitive interventions, information in multiple languages, and parent–professional collaboration. Implications for research, policy, and practice are included.
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Gentles SJ, Nicholas DB, Jack SM, McKibbon KA, Szatmari P. Coming to understand the child has autism: A process illustrating parents' evolving readiness for engaging in care. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:470-483. [PMID: 31508991 PMCID: PMC6985991 DOI: 10.1177/1362361319874647] [Citation(s) in RCA: 14] [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: 12/16/2022]
Abstract
LAY ABSTRACT What is already known about the topic? Parents of children with autism often learn about their child's autism before diagnosis and can spend long periods seeking care (including assessment) before receiving a diagnosis. Meanwhile, parents' readiness to engage in care at this early stage can vary from parent to parent. What this paper adds? This study revealed how parents come to understand their child has autism-on their own terms, rather than from just talking to professionals. It also explained how parents' growing awareness of their child's autism leads them to feel more motivated to engage in care by seeking information and pursuing services. Four "optional steps" described how parents' growing readiness to engage in care at this early stage can vary, depending on their personal process. Implications for practice, research, or policy The results suggest ways that professionals can be more sensitive (a) to parents' varying awareness of autism and (b) to their varying readiness for being involved in early care. They also suggest ways to tailor parent supports to their individual situation and design care that is more family centered. Not all parents want high levels of involvement. Depending on their personal process, some parents may need care and support that is directed at them before feeling ready for professionals to engage them in care directed at the child.
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