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Martinez-Donate AP, Zumaeta-Castillo C, Yamasaki Y, Perez C, Martinez O, Hassrick EM, Ventimiglia J, Lazo-Elizondo M. Feasibility and acceptability of CRiSOL: A pilot peer-based intervention to address syndemic health issues afflicting Latino immigrants in the U.S. PLoS One 2023; 18:e0287248. [PMID: 37874795 PMCID: PMC10597517 DOI: 10.1371/journal.pone.0287248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/01/2023] [Indexed: 10/26/2023] Open
Abstract
Substance use, HIV/AIDS, domestic violence and mental health (SAVAME) are syndemic health issues that disproportionately burden Latinos in the U.S. Yet, there are limited evidence-based interventions to address these interrelated syndemic issues and their shared socio-ecological determinants. This study sought to test the feasibility and acceptability of CRiSOL, a peer-based, resilience-focused intervention to reduce the impact of the SAVAME syndemic on Latino immigrants. Fifteen Latino immigrant community leaders were recruited and trained to serve as health promotion agents in their naturally existing social networks. The training was implemented with high fidelity, received with high satisfaction by the peer leaders, and associated with significant improvements in their knowledge, leadership skills, and social capital. During an 8-month outreach phase, nine leaders remained active in the program and documented 825 one-on-one interactions with community members, during which they provided advice/counseling (52.2% of interactions), health information/education (32.5%), referrals to health and social services (38.5%), food aid (39.9%), and service navigation/assistance (10.2%). While future research must be conducted to establish the effectiveness of CRiSOL, findings from this pilot evaluation indicate the feasibility, acceptability, and high level of reach of this intervention and suggest significant potential to reduce the SAVAME syndemic burden in Latino communities.
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Affiliation(s)
- Ana P. Martinez-Donate
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Claudia Zumaeta-Castillo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Yoshiaki Yamasaki
- The Philadelphia AIDS Consortium (TPAC)/World Health Care Infrastructures (WHCI), Philadelphia, Pennsylvania, United States of America
| | - Cristina Perez
- The Philadelphia AIDS Consortium (TPAC)/World Health Care Infrastructures (WHCI), Philadelphia, Pennsylvania, United States of America
| | - Omar Martinez
- College of Medicine, University of Central Florida, Orlando, Florida, United States of America
| | - Elizabeth McGhee Hassrick
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Jonas Ventimiglia
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, United States of America
| | - Mariana Lazo-Elizondo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, United States of America
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Low MY, McFerran KS, Viega M, Carroll-Scott A, McGhee Hassrick E, Bradt J. Exploring the lived experiences of young autistic adults in Nordoff-Robbins music therapy: An interpretative phenomenological analysis. Nordic Journal of Music Therapy 2022. [DOI: 10.1080/08098131.2022.2151640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Ming Yuan Low
- Music Therapy, Berklee College of Music, Boston, MA, USA
| | | | - Michael Viega
- John J. Cali School of Music, Montclair State University, Montclair, NJ, USA
| | - Amy Carroll-Scott
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Joke Bradt
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, USA
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Martinez-Donate AP, Dsouza N, Cuellar S, Connor G, Zumaeta-Castillo C, Lazo-Elizondo M, Yamasaki Y, Perez C, Carroll-Scott A, Martinez O, Hassrick EM. Provider perceptions of availability, accessibility, and adequacy of health and behavioral services for Latino immigrants in Philadelphia: a qualitative study. BMC Public Health 2022; 22:1645. [PMID: 36042441 PMCID: PMC9427076 DOI: 10.1186/s12889-022-14066-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Latino populations in the United States are disproportionately affected by substance use, HIV/AIDS, violence, and mental health issues (SAVAME). A growing body of evidence demonstrates the syndemic nature of SAVAME and the need for integrated strategies to reduce their impact. This study sought to understand the network of SAVAME services for Latino immigrants in Philadelphia to inform future interventions for SAVAME prevention and mitigation. METHODOLOGY Key informant interviews (N = 30) were conducted with providers working in Latino-serving organizations providing SAVAME services. Interviews were analyzed using thematic coding and grounded theory. RESULTS Latino-serving providers perceived a large need for, and important limitations in the availability, accessibility, and adequacy of SAVAME services for Latino immigrants. Gaps were seen as especially acute for mental health and substance use services, partly because of insufficient funding for these services. Latino immigrants' lack of health insurance, immigration status, limited English proficiency (LEP), stigma surrounding SAVAME issues, and limited knowledge of available services were identified as significant barriers preventing access to services. Providers noted that scarcity of well-trained, culturally competent, and ethnically concordant providers reduced the adequacy of SAVAME services for Latino immigrant clients. The small size, low levels of infrastructure, and limited capacity were reported as additional factors limiting the ability of many Latino-serving organizations to adopt a syndemic approach in the prevention and treatment of SAVAME services. CONCLUSIONS The results call for changes in the structure of funding streams and communitywide strategies to foster collaboration across SAVAME providers working with Latino immigrant clients.
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Affiliation(s)
- Ana P. Martinez-Donate
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Nishita Dsouza
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Sierra Cuellar
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Gabrielle Connor
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Claudia Zumaeta-Castillo
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Mariana Lazo-Elizondo
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | | | - Cristina Perez
- WOAR Philadelphia Center Against Sexual Violence, Philadelphia, PA USA
| | - Amy Carroll-Scott
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA
| | - Omar Martinez
- grid.264727.20000 0001 2248 3398College of Public Health, Temple University, Philadelphia, PA USA
| | - Elizabeth McGhee Hassrick
- grid.166341.70000 0001 2181 3113Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA USA ,grid.166341.70000 0001 2181 3113A.J. Drexel Autism Institute, Drexel University, PA Philadelphia, USA
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Schendel D, Roux AM, McGhee Hassrick E, Lyall K, Shea L, Vivanti G, Wieckowski AT, Newschaffer C, Robins DL. Applying a public health approach to autism research: A framework for action. Autism Res 2022; 15:592-601. [PMID: 35199493 DOI: 10.1002/aur.2689] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/20/2021] [Accepted: 02/08/2022] [Indexed: 12/26/2022]
Abstract
Most published autism research, and the funding that supports it, remains focused on basic and clinical science. However, the public health impact of autism drives a compelling argument for utilizing a public health approach to autism research. Fundamental to the public health perspective is a focus on health determinants to improve quality of life and to reduce the potential for adverse outcomes across the general population, including in vulnerable subgroups. While the public health research process can be conceptualized as a linear, 3-stage path consisting of discovery - testing - translation/dissemination/implementation, in this paper we propose an integrated, cyclical research framework to advance autism public health objectives in a more comprehensive manner. This involves discovery of primary, secondary and tertiary determinants of health in autism; and use of this evidence base to develop and test detection, intervention, and dissemination strategies and the means to implement them in 'real world' settings. The proposed framework serves to facilitate identification of knowledge gaps, translational barriers, and shortfalls in implementation; guides an iterative research cycle; facilitates purposeful integration of stakeholders and interdisciplinary researchers; and may yield more efficient achievement of improved health and well-being among persons on the autism spectrum at the population-level. LAY SUMMARY: Scientists need better ways to identify and address gaps in autism research, conduct research with stakeholders, and use findings to improve the lives of autistic people. We recommend an approach, based in public health science, to guide research in ways that might impact lives more quickly.
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Affiliation(s)
- Diana Schendel
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Anne M Roux
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | | | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | | | - Craig Newschaffer
- College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diana L Robins
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
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Hassrick EM, Holmes LG, Sosnowy C, Walton J, Carley K. Benefits and Risks: A Systematic Review of Information and Communication Technology Use by Autistic People. Autism Adulthood 2021; 3:72-84. [PMID: 36601264 PMCID: PMC8992882 DOI: 10.1089/aut.2020.0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Communication via the internet is a regular feature of everyday interactions for most people, including autistic people. Researchers have investigated how autistic people use information and communication technology (ICT) since the early 2000s. However, no systematic review has been conducted to summarize findings. Objective This study aims to review existing evidence presented by studies about how autistic people use ICT to communicate and provide a framework for understanding contributions, gaps, and opportunities for this literature. Methods Guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA) statement, we conducted a comprehensive review across five databases, searching for studies investigating how autistic youth and adults use ICT to communicate. Authors reviewed the articles for inclusion and assessed methodological quality. Results Thirty-two studies met the eligibility criteria, including 19 quantitative studies, 12 qualitative studies, and 1 mixed methods study, with data from 3026 autistic youth (n = 9 studies) and adults (n = 23 studies). Ratings suggest that the evidence base is emergent. Underrepresented groups in the sample included autistic women, transgendered autistic people, non-White autistic people, low income autistic people, and minimally speaking and/or autistic adults with co-occurring intellectual disability. Three main themes emerged, including variation in ICT communication use among autistic youth and adults, benefits and drawbacks experienced during ICT communication use, and the engagement of autistic youth and adults in the online autism community. Conclusions Further exploration of the positive social capital that autistic people gain participating in online autism communities would allow for the development of strengths-based interventions. Additional research on how autistic people navigate sexuality and ICTs is needed to identify mechanisms for reducing vulnerability online. Additional scholarship about underrepresented groups is needed to investigate and confirm findings regarding ICT communication use for gender, racial, and socioeconomic minority groups. Lay summary What was the purpose of this study?: People use the internet to communicate (talk and connect) with one another. Some research has found that autistic people may prefer to communicate using the internet instead of in person. Over the past 20 years, there has been research about how autistic people use the internet. To understand what research has discovered so far, we collected published research about how autistic youth and adults use the internet to communicate.What did the researchers do?: We used scientific best practices as described in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to collect research about how autistic people us the internet to communicate. We included research that uses words (qualitative research) and numbers (quantitative research). First, we searched several places that list research studies to find research on autistic people and the internet. Then, we removed research that did not fit what we were looking for (our criteria). Finally, we then read the full articles, collected their most important findings, and looked for patterns.What do these findings add to what is already known?: Thirty-two studies met our criteria, including 19 studies that used closed-ended survey questions that tested relationships between variables, 12 studies that used open-ended interviews and looked for patterns and connections among participants, and 1 mixed methods study. In total, 3026 autistic youth of ages 10-17 years (number of participants = 9 studies) and adults (number of participants = 23 studies) participated in these 32 studies. We rated each of the 32 studies for quality and learned that the evidence base is preliminary, meaning that more rigorous high-quality studies are needed before we can be confident in the findings. We found three main themes: (1) differences in the ways that autistic youth and adults used the internet to communicate, (2) benefits and drawbacks experienced when using the internet to communicate, and (3) the engagement of autistic youth and adults in the online autism community. Some of the benefits of social media for autistic people include more control over how they talk and engage with others online and a greater sense of calm during interactions. However, findings suggest some drawbacks for autistic people, including continued feelings of loneliness and the desire for in-person friendships. Social media provides opportunities for autistic people to find others on the autism spectrum and form a stronger identity as part of the autism community. The study also showed that there is little research about autistic women, autistic transgender people, autistic racial/ethnic minorities, or autistic people from lower socioeconomic status (SES) groups.What are potential weaknesses of this study?: We only included research in scientific articles, and there may be useful information on this topic in books, student research, or online.How will these findings help young adults on the autism spectrum now or in the future?: This study can help identify gaps and opportunities for new research, support the importance of online autistic communities, and suggest possible training opportunities about how to support autistic people when they use the internet for communication.
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Affiliation(s)
- Elizabeth McGhee Hassrick
- The A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA.,Address correspondence to: Elizabeth McGhee Hassrick, PhD, The A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, USA
| | - Laura Graham Holmes
- The A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA.,Silberman School of Social Work at Hunter College, New York, New York, USA
| | - Collette Sosnowy
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jessica Walton
- The A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kathleen Carley
- Institute for Software Research, School of Computer Science, Carnegie Mellon University, Pittsburg, Pennsylvania, USA
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Iadarola S, Pellecchia M, Stahmer A, Lee HS, Hauptman L, Hassrick EM, Crabbe S, Vejnoska S, Morgan E, Nuske H, Luelmo P, Friedman C, Kasari C, Gulsrud A, Mandell D, Smith T. Mind the gap: an intervention to support caregivers with a new autism spectrum disorder diagnosis is feasible and acceptable. Pilot Feasibility Stud 2020; 6:124. [PMID: 32944273 PMCID: PMC7487627 DOI: 10.1186/s40814-020-00662-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 08/03/2020] [Indexed: 11/12/2022] Open
Abstract
Introduction Children with autism spectrum disorder (ASD) benefit when their caregivers can effectively advocate for appropriate services. Barriers to caregiver engagement such as provider mistrust, cultural differences, stigma, and lack of knowledge can interfere with timely service access. We describe Mind the Gap (MTG), an intervention that provides education about ASD, service navigation, and other topics relevant to families whose children have a new ASD diagnosis. MTG was developed via community partnerships and is explicitly structured to reduce engagement barriers (e.g., through peer matching, meeting flexibility, culturally-informed practices). We also present on the results of a pilot of MTG, conducted in preparation for a randomized controlled trial. Methods MTG was evaluated using mixed methods that included qualitative analysis and pre/post-test without concurrent comparison group. Participants (n=9) were primary caregivers of children (ages 2-7 years) with a recent ASD diagnosis and whose annual income was at or below 185% of the federal poverty level. In order to facilitate trust and relationship building, peer coaches delivered MTG. The coaches were parents of children with ASD who we trained to deliver the intervention. MTG consisted of up to 12 meetings between coaches and caregivers over the course of 18 weeks. Coaches delivered the intervention in homes and other community locations. Coaches shared information about various “modules,” which were topics identified as important for families with a new ASD diagnosis. Coaches worked with families to answer questions, set weekly goals, assess progress, and offer guidance. For the pilot, we focused on three primary outcomes: feasibility, engagement, and satisfaction. Feasibility was measured via enrollment and retention data, as well as coach fidelity (i.e., implementation of MTG procedures). Engagement was measured via number of sessions attended and percentage completion of the selected outcome measures. For completers (n=7), satisfaction was measured via a questionnaire (completed by caregivers) and open-ended interviews (completed by caregivers and coaches). Results We enrolled 56% of referred caregivers and 100% of eligible families. Retention was high (78%). Coaches could deliver the intervention with fidelity, completing, on average, 83% of program components. Engagement also was high; caregivers attended an average of 85% of total possible sessions and completed 100% of their measures. Caregivers indicated moderately high satisfaction with MTG. Qualitative data indicated that caregivers and coaches were positive about intervention content, and the coach-caregiver relationship was important. They also had suggestions for changes. Conclusion Mind the Gap demonstrates evidence of feasibility, and data from the pilot suggest that it addresses intervention engagement barriers for a population that is under-represented in research. The results and suggestions from participants were used to inform a large-scale RCT, which is currently underway. Overall, MTG shows promise as an intervention that can be feasibly implemented with under-resourced and ethnic minority families of children with ASD Trial registration This study is registered with ClinicalTrials.gov: NCT03711799.
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Affiliation(s)
- Suzannah Iadarola
- University of Rochester Medical Center, 601 Elmwood Ave, Box 671, Rochester, NY 14642 USA
| | - Melanie Pellecchia
- University of Pennsylvania, 3535 Market St, 3rd floor, Philadelphia, PA 19104 USA
| | - Aubyn Stahmer
- University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
| | - Hyon Soo Lee
- University of California, Los Angeles, UCLA Semel Institute 68-268, Los Angeles, CA 90024 USA
| | - Lindsay Hauptman
- University of California, Los Angeles, UCLA Semel Institute 68-268, Los Angeles, CA 90024 USA
| | | | - Samantha Crabbe
- University of Pennsylvania, 3535 Market St, 3rd floor, Philadelphia, PA 19104 USA
| | - Sarah Vejnoska
- University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
| | - Elizabeth Morgan
- University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
| | - Heather Nuske
- University of Pennsylvania, 3535 Market St, 3rd floor, Philadelphia, PA 19104 USA
| | - Paul Luelmo
- San Diego State University, 5500 Campanile Dr, San Diego, CA 92182 USA
| | - Chris Friedman
- Drexel University, 3020 Market Street
- Suite 560, Philadelphia, PA 19104 USA
| | - Connie Kasari
- University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
| | - Amanda Gulsrud
- University of California, Los Angeles, UCLA Semel Institute 68-268, Los Angeles, CA 90024 USA
| | - David Mandell
- University of Pennsylvania, 3535 Market St, 3rd floor, Philadelphia, PA 19104 USA
| | - Tristram Smith
- University of Rochester Medical Center, 601 Elmwood Ave, Box 671, Rochester, NY 14642 USA
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McGhee Hassrick E, Sosnowy C, Graham Holmes L, Walton J, Shattuck PT. Social Capital and Autism in Young Adulthood: Applying Social Network Methods to Measure the Social Capital of Autistic Young Adults. Autism Adulthood 2020; 2:243-254. [PMID: 32954220 PMCID: PMC7497874 DOI: 10.1089/aut.2019.0058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Social isolation is a core challenge associated with autism. Interpersonal relationships and the resources and support embedded in the social networks of autistic young adults could impact key adult outcomes, including quality of life, mental health, employment, and independence. However, little research systematically measures the networks of autistic young adults and network impact on key adult outcomes. This article demonstrates how social network analysis can be adapted for the field of autism to measure young adult networks. We provide examples as to how this approach could be implemented to yield key insights into the amount and quality of interpersonal relationships and the types of resources embedded in the networks of autistic young adults. The network protocol was feasibility tested with autistic adults during the posthigh school transition period (n = 17, 19–27 years). The parents of three of the recruited young adults also successfully completed a complementary network survey, allowing for the inclusion of the parent-reported network using duocentric network analysis, never before applied to parent–child networks. The implementation data collected from the study suggest feasibility of egocentric and duocentric approaches, with several important modifications to adapt the measure for the field of autism. The future potential of social network research for understanding autism in adulthood is discussed. What was the purpose of this study? Many autistic young adults are disconnected from people, communities, and organizations that could provide them with valuable social resources to support their transition to adulthood. This study tests the feasibility of using social network methods to measure the resources that autistic young adults gain from their social connections. Future studies using our social network measure might provide valuable information about possible interventions that could help autistic youth acquire the social resources needed for successful adult outcomes. What did the researchers do? To test the feasibility of our social network measure, 17 autistic adults, between the ages of 19 and 27 years, were recruited to complete a survey about their social connections and the resources provided to them by their social connections. The parents of three of the autistic adults were also surveyed to provide information about the social connections that they relied on to help their autistic young adult to transition successfully. What were the results of the study? All participants successfully completed our survey online. We analyzed the network data to illustrate what types of information the survey produced. We demonstrated how the survey captures different types of support that people gained from their networks. We also used network pictures to show how network measures characterize connections among supporters of autistic young adults. This research successfully lays the groundwork for future studies to test whether the social resources young adults on the autism spectrum receive from their networks impact their adult outcomes. What do these findings add to what is already known? We know very little about the social networks for young adults on the autism spectrum. Also, no studies have used duocentric network analysis to measure the social capital of youth and their parents together. This project produced new useful ways of collecting social network data from young autistic adults that will produce knowledge about how to help young adults on the autism spectrum build networks that will yield the social resources needed to support positive adult outcomes. What are potential weaknesses of this study? The study was only designed to test the feasibility of the social network measure and does not provide generalizable information about how networks might impact outcomes. Also, the social network measure only allowed participants to identify five people, possibly under-reporting the actual size and composition of autistic young adult networks. How will these findings help young adults on the autism spectrum now or in the future? If future research suggests that social network factors help young adults on the autism spectrum to improve outcomes, then network interventions, guided by social network data, can be created.
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Affiliation(s)
- Elizabeth McGhee Hassrick
- Lifecourse Outcomes Program, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Collette Sosnowy
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Laura Graham Holmes
- Lifecourse Outcomes Program, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jessica Walton
- Clinical Mental Health Counseling, Lock Haven University, Lock Haven, Pennsylvania, USA
| | - Paul T Shattuck
- Lifecourse Outcomes Program, A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania, USA
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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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Stahmer AC, Vejnoska S, Iadarola S, Straiton D, Segovia FR, Luelmo P, Morgan EH, Lee HS, Javed A, Bronstein B, Hochheimer S, Cho E, Aranbarri A, Mandell D, Hassrick EM, Smith T, Kasari C. Caregiver Voices: Cross-Cultural Input on Improving Access to Autism Services. J Racial Ethn Health Disparities 2019; 6:752-773. [PMID: 30859514 PMCID: PMC6936957 DOI: 10.1007/s40615-019-00575-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 01/16/2023]
Abstract
Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.
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Affiliation(s)
- Aubyn C Stahmer
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA.
| | - Sarah Vejnoska
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Suzannah Iadarola
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Diondra Straiton
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
- Department of Psychology, Michigan State University, 316 Physics, Rd., East Lansing, MI, 48824, USA
| | - Francisco Reinosa Segovia
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Paul Luelmo
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
- Department of Special Education, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Elizabeth H Morgan
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Hyon Soo Lee
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Asim Javed
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Briana Bronstein
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Samantha Hochheimer
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - EunMi Cho
- College of Education, California State University, Sacramento, 6000 J St., Sacramento, CA, 95819, USA
| | - Aritz Aranbarri
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
- Mental Health Department, Sant Juan de Deu Barcelona Children's Hospital, Itaka Building 1st floor, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - David Mandell
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Elizabeth McGhee Hassrick
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street | Suite 560, Philadelphia, PA, 19104, USA
| | - Tristram Smith
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Connie Kasari
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
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Stahmer AC, Suhrheinrich J, Schetter PL, Hassrick EM. Correction to: Exploring multi-level system factors facilitating educator training and implementation of evidence-based practices (EBP): a study protocol. Implement Sci 2018; 13:59. [PMID: 29685159 PMCID: PMC5911968 DOI: 10.1186/s13012-018-0750-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- Aubyn C Stahmer
- University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95819, USA. .,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA. .,Center of Excellence in Developmental Disabilities, University of California, Davis, Sacramento, USA. .,Child and Adolescent Services Research Center, San Diego, USA.
| | - Jessica Suhrheinrich
- College of Education, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.,Child and Adolescent Services Research Center, San Diego, USA
| | - Patricia L Schetter
- University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95819, USA.,Center of Excellence in Developmental Disabilities, University of California, Davis, Sacramento, USA
| | - Elizabeth McGhee Hassrick
- Life Course Outcomes Research Program at AJ Drexel Autism Institute, Drexel University, 3020 Market St, St 560, Philadelphia, PA, 19104, USA
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Abstract
OBJECTIVES The treatment of autism requires complex, multimodal interventions, provided by parents and providers across settings. As young adults with autism spectrum disorder (ASD) transition into adulthood, new stakeholders are added to support planning for postsecondary employment. In this article, we investigate the use of dynamic social network measures that describe the resources of young adults throughout transition. METHODS A longitudinal, dynamic social network survey (Social Dynamics of Intervention [SoDI]) was conceptualized, designed, and conducted as a feasibility test, measuring changes in collaboration among parents and school staff members who provided interventions for children with ASD in 2 urban public schools. Using the SoDI, we tracked the following over time: the team who provided interventions, their locations, the interventions they provided, the autism trainings they attended, and the density of the team's problem-solving network for the child. RESULTS Using the SoDI, we successfully identified stakeholders across settings who provided interventions for each child. Results indicated variation in the density of problem-solving and trust related to ASD intervention across teams as well as variation in intervention and autism knowledge networks during the school year. Adaptations of the SoDI for mapping pre- and posttransition resources and social connectivity across stakeholders for young adults with ASD are proposed in the Discussion section. CONCLUSIONS Dynamic social network approaches can be used to capture changes in intervention, autism knowledge, and social connectivity, providing informative descriptive data about how vocational rehabilitation policies might increase employment supports during the transition process for young adults with ASD.
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Affiliation(s)
| | - Paul Shattuck
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania; and
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Nuske HJ, McGhee Hassrick E, Bronstein B, Hauptman L, Aponte C, Levato L, Stahmer A, Mandell DS, Mundy P, Kasari C, Smith T. Broken bridges-new school transitions for students with autism spectrum disorder: A systematic review on difficulties and strategies for success. Autism 2018; 23:306-325. [PMID: 29458258 DOI: 10.1177/1362361318754529] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Transitioning to a new school is often challenging for students with autism spectrum disorder. Few studies have examined the transition needs of students with autism spectrum disorder or the benefits of specific supports. This review synthesizes research findings on the difficulties that school transitions pose for students with autism spectrum disorder and their parents and teachers, and the strategies used to support students and parents during school transition. The review included 27 studies (10 examining the transition to primary school, 17 the transition to secondary school), with data from 443 students with autism spectrum disorder, 453 parents, and 546 teachers, across four continents (North America, Europe, Africa, and Australia). Studies reported that children with autism spectrum disorder struggled with anxiety and increased social pressure, their parents felt overwhelmed with complex placement decisions and worried about the well-being of their children, and teachers strove to provide appropriate supports to their students with autism spectrum disorder, often with inadequate resources. Findings indicated that the most useful strategies involved helping the student adjust to the new school setting, individualizing transition supports, clarifying the transition process for parents, and fostering communication both between the sending and receiving schools, and school and home.
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