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Ryan J, Brown HM, Borden A, Devlin C, Kedmy A, Lee A, Nicholas DB, Kingsley B, Thompson-Hodgetts S. Being able to be myself: Understanding autonomy and autonomy-support from the perspectives of autistic adults with intellectual disabilities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241254432. [PMID: 38757674 DOI: 10.1177/13623613241254432] [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: 05/18/2024]
Abstract
LAY ABSTRACT Autistic young adults with intellectual disabilities want to be autonomous but are less autonomous than other people. However, they can be autonomous with appropriate support. We wanted to learn how we can support autistic adults with intellectual disabilities to be more autonomous. We designed our study with help from five autistic community partners to make sure the research was relevant to autistic people and would improve their lives. We talked with eight autistic young adults with intellectual disabilities about autonomy. We defined "talk" as verbal language, as well as non-verbal cues such as body language, facial expressions, vocalizations, and laughter. We did art projects and played games while we talked. We met in small groups over multiple sessions. Our participants told us that being autonomous meant being able to be themselves. They told us three main ways to support their autonomy: (1) having choice and control, (2) being able to communicate in their own way, and (3) being in a safe environment. Families, support staff, and caregivers can use this information to help autistic young adults with intellectual disabilities to be autonomous.
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Baiden KMP, Williams ZJ, Schuck RK, Dwyer P, Wang M. The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults. J Autism Dev Disord 2024:10.1007/s10803-024-06297-3. [PMID: 38470531 DOI: 10.1007/s10803-024-06297-3] [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: 02/17/2024] [Indexed: 03/14/2024]
Abstract
Many in the autistic community have expressed concerns regarding the use of behavioral interventions with autistic children, suggesting that these interventions may not be socially valid. Though behavioral interventions have evolved to be more naturalistic and child-centered, little structured research has been done to explicitly seek autistic perspectives on the acceptability of specific components of behavioral interventions. Autistic adults (N = 235) were recruited online to take the Autism Intervention Attitudes Scale (AIAS), a questionnaire designed to gather feedback on common intervention goals and practices. Results indicate that participants find goals and practices that highlight quality of life, safety, and autistic interactions acceptable, while those that focus on normalization based on neurotypical standards are not. An exploratory graph analysis revealed three communities of goals ("uncontroversial goals", "controversial goals", and "social goals"). Comparison between naturalistic and structured intervention components additionally showed that autistic participants favored naturalistic strategies. These findings are in line with known criticisms of behavioral intervention from autistic adults, but also provide more information on the specific ways in which behavioral interventions can be reformed. This information can guide professionals in the development of appropriate goals and decisions around intervention planning.
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Affiliation(s)
- Kaitlynn M P Baiden
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA.
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, USA
| | - Rachel K Schuck
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA
| | - Patrick Dwyer
- Department of Psychology, University of California, Davis, Davis, USA
- Center for Mind and Brain, University of California, Davis, Davis, USA
- Olga Tennison Autism Research Centre (OTARC), School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Mian Wang
- Gevirtz Graduate School of Education, University of California, Santa Barbara, USA
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Schuck RK, Dwyer P, Baiden KMP, Williams ZJ, Wang M. Social Validity of Pivotal Response Treatment for Young Autistic Children: Perspectives of Autistic Adults. J Autism Dev Disord 2024; 54:423-441. [PMID: 36427175 PMCID: PMC10821825 DOI: 10.1007/s10803-022-05808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/27/2022]
Abstract
The social validity of autism behavioral intervention has been questioned. Naturalistic Developmental Behavioral Interventions (NDBIs) attempt to address some concerns, but it is unclear whether autistic people consider NDBIs socially valid. Social validity of an NDBI, Pivotal Response Treatment (PRT), was investigated through autistic adults commenting on videos of autistic children receiving PRT. Qualitative coding of responses generated three themes: respect for individuals; assessment of intervention implementation; and socioemotional considerations. Although video brevity limits the scope of the present study's conclusions, participants highlighted PRT components that appeared socially valid (e.g., reinforcing attempts, following the child's lead) and aspects appearing invalid (e.g., overemphasis on spoken language). Therefore, adjustments appear necessary for PRT to be fully acceptable to the autistic community.
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Affiliation(s)
- Rachel K Schuck
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA.
| | - Patrick Dwyer
- Department of Psychology, University of California, Davis, Davis, USA
- Center for Mind and Brain, University of California, Davis, Davis, USA
| | - Kaitlynn M P Baiden
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, USA
| | - Mian Wang
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, 93106-9490, USA
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O'Hagan B, Foster S, Ursitti A, Crable EL, Friedman AJ, Bartolotti L, Krauss S. Elucidating the Perspectives of Autistic Youth About Their Health Care Experiences: A Qualitative Study. J Dev Behav Pediatr 2024; 45:e39-e45. [PMID: 37871276 DOI: 10.1097/dbp.0000000000001228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/29/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Autistic individuals have higher rates of co-occurring medical conditions and service use. However, autistic individuals and their families also reported lower satisfaction with health care service delivery. Previous studies described health care experiences of autistic adults, but less is known about those of autistic adolescents and young adults. This study aimed to qualitatively describe the health care experiences of autistic youth. METHODS Four longitudinal/serial focus groups were conducted with 8 autistic adolescents and young adults. Participants were members of an autistic patient advisory board, which is part of a broader initiative at a large, urban, safety-net hospital to improve the health care experiences of autistic patients. Focus groups were conducted virtually and were audio-recorded. Audio recordings were transcribed and verified for accuracy. Transcripts were consensus-coded with an inductive approach using tenets of grounded theory. RESULTS Findings included 4 recurring themes: accessibility and accommodations, barriers of health service use, patient involvement in health care decisions, and facilitators of patient-clinician relationship. Participants noted that visit preparation, sensory items, and repeated positive interactions with clinician were helpful to build a positive health care experience. CONCLUSION Our findings support previous research that suggest the need to individualize care, ensure availability of accommodations, apply flexibility in practice whenever possible, and increase health care professional knowledge about this unique patient population.
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Affiliation(s)
- Belinda O'Hagan
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
| | - Sarah Foster
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
| | - Amy Ursitti
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
| | - Erika L Crable
- San Diego Department of Psychiatry, University of California, Child and Adolescent Research Center, La Jolla, CA
| | - Alexander J Friedman
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
| | - Lauren Bartolotti
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
| | - Shari Krauss
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, Boston MA; and
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Schmidt M, Newbutt N, Lee M, Lu J, Francois MS, Antonenko PD, Glaser N. Toward a strengths-based model for designing virtual reality learning experiences for autistic users. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613231208579. [PMID: 37937531 DOI: 10.1177/13623613231208579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
LAY ABSTRACT Virtual reality has been studied for its potential in supporting individuals with autism, but existing research often focuses on deficits and lacks consideration of individual preferences and strengths. This article introduces a framework that emphasizes the strengths and abilities of autistic individuals when designing virtual reality interventions. It builds upon an existing taxonomy of educational technology affordances and extends it to align with the unique needs of autistic individuals. The framework provides guidance for incorporating virtual reality technology that supports and amplifies autistic strengths, such as visual perception and response to positive feedback. The framework has implications for practice, research, and policy. For practitioners, it offers a tool for designing virtual reality experiences that cater to the strengths of autistic individuals, enhancing engagement and educational outcomes. Researchers can utilize the framework to guide the development of user-centered virtual reality interventions and expand our understanding of the potential benefits of virtual reality for autistic populations. Policymakers and educators can consider this framework when incorporating virtual reality into educational settings, ensuring that virtual reality technology is used in a way that aligns with the strengths and needs of autistic learners. Overall, the framework promotes a strengths-based approach in utilizing virtual reality technology for individuals with autism, fostering inclusivity and maximizing the benefits of immersive experiences.
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Affiliation(s)
| | | | | | - Jie Lu
- University of Florida, USA
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Filgueira LMDA, Brilhante AVM, Sá ARD, Colares MSF. Development of a participatory research strategy involving autistic people with different levels of support needs. CIENCIA & SAUDE COLETIVA 2023; 28:1501-1512. [PMID: 37194882 DOI: 10.1590/1413-81232023285.15282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/24/2022] [Indexed: 05/18/2023] Open
Abstract
This article describes the development of a participatory methodological study involving autistic people with varying levels of support needs in the design and validation of an instrument devised to assess the effects of social isolation during the COVID-19 pandemic and the strategies used to cope with the crisis. The development of the instrument involved the following stages: Definition of the domains to be assessed (researchers in consultation with experts and autistic people); Design of the instrument (researchers with the co-participation of autistic people); Validation of the instrument (by experts and autistic people, led by the researchers); and Final approval of the instrument (co-participation between researchers and autistic people). In addition to making the instrument more robust, the participation of autistic people in the design and application of the instrument reinforced the importance of strategies to include autistic people in research as both study participants and co-researchers.
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Affiliation(s)
- Leila Maria de Andrade Filgueira
- Faculdade de Psicologia, Universidade de Fortaleza (Unifor). Av. Washington Soares 1321, Edson Queiroz. 60811-905 Fortaleza CE Brasil.
| | | | - Adrianna Reis de Sá
- Programa de Pós-Graduação em Saúde Coletiva e Bioética, Universidade de Brasília. Brasília DF Brasil
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Waisman TC, Williams ZJ, Cage E, Santhanam SP, Magiati I, Dwyer P, Stockwell KM, Kofner B, Brown H, Davidson D, Herrell J, Shore SM, Caudel D, Gurbuz E, Gillespie-Lynch K. Learning from the experts: Evaluating a participatory autism and universal design training for university educators. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:356-370. [PMID: 35652315 DOI: 10.1177/13623613221097207] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Autistic university students have many strengths. They also go through difficulties that professors may not understand. Professors may not understand what college life is like for autistic students. They might judge autistic students. A team of autistic and non-autistic researchers made a training to help professors understand autistic students better. This training also gave professors ideas to help them teach all of their students. Ninety-eight professors did an online survey before the autism training. They shared how they felt about autism and teaching. Before our training, professors who knew more about autism appreciated autism more. Professors who thought people should be equal and women also appreciated autism more. Then, 89 of the professors did our training and another survey after the training. This helped us see what they learned from the training. They did one more survey a month later. This helped us see what they remembered. Our training helped professors understand and value autism. It also helped them understand how they can teach all students better. The professors remembered a lot of what we taught them. This study shows that a training that autistic people helped make can help professors understand their autistic students better.
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Vidal VG, Wachholtz DP, Mattie LJ, DeThorne LS. It Takes a Community: How Environmental Systems Construct (In)Competence in Autistic Peer Interactions. Lang Speech Hear Serv Sch 2023; 54:63-81. [PMID: 35985325 DOI: 10.1044/2022_lshss-22-00028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE This study aims to illustrate how environmental systems shape the peer interactions of an autistic student within the classroom. METHOD Drawing on the bioecological model of human development, this situated discourse analysis used thematic coding and microanalysis to examine data from semistructured interviews and 10 sessions of direct classroom observations of a 9-year-old autistic student and his classroom communication partners. RESULTS Convergent data across participants, time, and data sources revealed the following systemic influences on peer interaction: predominant medicalized view of autism (macrosystem), educational practices (exosystem), misaligned roles across adults and peers in the classroom (mesosystem), and multimodal opportunities for direct interaction that were supported by objects and physical contact and inhibited by rapid pacing (microsystem). CONCLUSIONS Findings illustrate the environmental complexities associated with the development of peer interactions for autistic students. We offer explicit clinical implications for how environmental factors can be addressed in the school-based eligibility determination process and in the Individualized Education Program.
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Affiliation(s)
- Veronica G Vidal
- Department of Speech-Language Pathology, Universidad de los Andes, Santiago, Chile.,Department of Epidemiology and Health Studies, Universidad de los Andes, Santiago, Chile
| | - Daniela P Wachholtz
- Department of Occupational Therapy, Universidad de los Andes, Santiago, Chile
| | - Laura J Mattie
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign
| | - Laura S DeThorne
- Department of Speech, Language, and Hearing Sciences, Western Michigan University, Kalamazoo
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Boucher TQ, McIntyre CL, Iarocci G. Facilitators and Barriers to Physical Activity Involvement as Described by Autistic Youth with Mild Intellectual Disability. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 7:1-13. [PMID: 36532952 PMCID: PMC9742026 DOI: 10.1007/s41252-022-00310-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Objectives Physical activity involvement among autistic youth and youth with an intellectual disability is significantly lower than the general population. Few studies have included youth with comorbid diagnoses of ASD and intellectual disability. Fewer studies collect information from the youth themselves. This study examined barriers and facilitators to physical activity in autistic youth with mild intellectual disability using semi-structured interviews with youth and through caregiver reports. Methods Fourteen caregivers and their children ages 8 to 16 years old participated. Caregivers completed a questionnaire about their thoughts on their child's physical activity while their children completed the semi-structured interview. A descriptive phenomenological approach was followed. Results Four themes were inductively identified: intrapersonal barriers (factors that are within the person which impede physical activity involvement, such as exhibiting challenging behaviors that inhibit engagement), interpersonal barriers (factors external to the person, such as lack of community support), intrapersonal facilitators (factors within the person that enhance physical activity involvement, such as being intrinsically motivated to improve skills), and interpersonal facilitators (external factors such as supports from caregivers). Conclusions Interviewing youth is important to capture a holistic picture of factors influencing physical activity. Future research may focus on implementing and assessing the efficacy of strategies to address the barriers facing youth diagnosed with ASD and intellectual disability. Supplementary Information The online version contains supplementary material available at 10.1007/s41252-022-00310-5.
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Affiliation(s)
- Troy Q. Boucher
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
| | - Cassia L. McIntyre
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
| | - Grace Iarocci
- Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia V5A 1S6 Canada
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Tesfaye R, Courchesne V, Mirenda P, Mitchell W, Nicholas D, Singh I, Zwaigenbaum L, Elsabbagh M. Autism voices: Perspectives of the needs, challenges, and hopes for the future of autistic youth. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1142-1156. [PMID: 36329663 DOI: 10.1177/13623613221132108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Autism Voices study draws on novel inclusive methods to obtain the first-person experiences of autistic youth with a range of cognitive and verbal abilities. Thirty-one autistic youth were interviewed with a strength-based protocol, enabling them to provide responses in the modality of their choice. Dynamics between youth and their environments such as home, school, and community were explored. Youth were questioned about their interests, plans for the future, experiences with various emotions, and experience of autism. Based on a thematic analysis, six themes emerged: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. The experiences described by autistic youth parallel many of the aspirations and challenges of typically developing adolescents, while being uniquely shaped by their autism. We discuss how these insights shared by autistic youth can facilitate active involvement in their communities, promote well-being, and promote optimal transition into adulthood. Autism Voices demonstrates that partnering with multiple stakeholders and the use of inclusive methodologies are pivotal steps toward capturing the voices of all autistic youth. Lay abstract Currently, our understanding of the adolescent period for autistic youth has relied on the expertise of researchers, clinicians, parents, and teachers, yet rarely involves their unique first-person experiences. Our study attempted to understand the experiences and perspectives of autistic adolescents in their home, school, and community environments using the Autism Voices protocol, a semi-structured interview specifically designed and tailored to engage with autistic youth with various language and intellectual levels. The analysis of the 31 interviews conducted with autistic adolescents aged 11–18 years highlighted six themes: (1) autistic identities, (2) thinking about the future, (3) seeking social connection on their own terms, (4) seeking autonomy, (5) school as both a stressor and social facilitator, and (6) experiences of stress and anxiety. These results highlight similarities and differences in the adolescent experiences of autistic youth compared to their typically developing peers. Our findings suggest that by removing assumptions about the experiences of autistic individuals and investing in inclusive interview methods, we can faithfully capture the experiences of autistic youth regardless of their communication and cognitive abilities. Being able to capture and amplify these diverse voices will facilitate the active involvement of autistic communities in research and clinical and policy decisions that impact them.
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Schuck RK, Tagavi DM, Baiden KMP, Dwyer P, Williams ZJ, Osuna A, Ferguson EF, Jimenez Muñoz M, Poyser SK, Johnson JF, Vernon TW. Neurodiversity and Autism Intervention: Reconciling Perspectives Through a Naturalistic Developmental Behavioral Intervention Framework. J Autism Dev Disord 2022; 52:4625-4645. [PMID: 34643863 PMCID: PMC9508016 DOI: 10.1007/s10803-021-05316-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/25/2022]
Abstract
Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals.
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Affiliation(s)
- Rachel K Schuck
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA.
| | - Daina M Tagavi
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Kaitlynn M P Baiden
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Patrick Dwyer
- Department of Psychology, University of California, Davis, Davis, CA, USA
- Center for Mind and Brain, University of California, Davis, Davis, CA, USA
| | - Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | - Anthony Osuna
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Emily F Ferguson
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Maria Jimenez Muñoz
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Samantha K Poyser
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
| | | | - Ty W Vernon
- Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA, USA
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O'Hagan B, Sonikar P, Grace R, Castillo D, Chen E, Agrawal M, Dufresne S, Rossetti Z, Bartolotti L, Krauss S. Youth and Caregivers' Perspective on Teens Engaged as Mentors (TEAM): An Inclusive Peer Mentoring Program for Autistic Adolescents. J Autism Dev Disord 2022; 53:2219-2231. [PMID: 35386062 DOI: 10.1007/s10803-022-05543-w] [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: 03/20/2022] [Indexed: 11/26/2022]
Abstract
Past studies indicate that many autistic youth benefit from support with developing social relationships, exploring leadership opportunities, and engaging in post-secondary education. Teens Engaged as Mentors (TEAM) is an innovative mentoring program that provides socialization and community engagement opportunities in a safe environment for youth with and without autism. This qualitative study explored how participants and their caregivers perceived participation in TEAM. Stakeholder focus groups were conducted annually from 2016 to 2020 with 16 autistic mentees (ages 9-13), 30 autistic and neurotypical mentors (ages 14-21), and 30 caregivers. Participants reported enjoying TEAM because of increased socialization opportunities, which promoted friendships and openness toward others. Caregivers reported growth in their children's social skills and confidence throughout their participation.
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Affiliation(s)
- Belinda O'Hagan
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA.
| | - Pooja Sonikar
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Boston University, Boston, MA, USA
| | - River Grace
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
- University of Floria College of Medicine, Gainesville, USA
| | - Dasha Castillo
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Emily Chen
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Malhaar Agrawal
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Simone Dufresne
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
- Tufts University, Medford, MA, USA
| | - Zach Rossetti
- Boston University Wheelock College of Education & Human Development, Boston University, Two Silber Way, Boston, MA, 02215, USA
| | - Lauren Bartolotti
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
| | - Shari Krauss
- Division of Developmental and Behavioral Pediatrics, Boston Medical Center, 801 Albany St Floor 1 East, Boston, MA, 02119, USA
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Beauchamp MLH, Amorim K, Wunderlich SN, Lai J, Scorah J, Elsabbagh M. Barriers to access and utilization of healthcare services for minority-language speakers with neurodevelopmental disorders: A scoping review. Front Psychiatry 2022; 13:915999. [PMID: 36090362 PMCID: PMC9453304 DOI: 10.3389/fpsyt.2022.915999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Minority-language speakers in the general population face barriers to accessing healthcare services. This scoping review aims to examine the barriers to healthcare access for minority-language speakers who have a neurodevelopmental disorder. Our goal is to inform healthcare practitioners and policy makers thus improving healthcare services for this population. INCLUSION CRITERIA Information was collected from studies whose participants include individuals with a neurodevelopmental disorder (NDD) who are minority-language speakers, their family members, and healthcare professionals who work with them. We examined access to healthcare services across both medical and para-medical services. METHOD Searches were completed using several databases. We included all types of experimental, quasi-experimental, observational and descriptive studies, as well as studies using qualitative methodologies. Evidence selection and data extraction was completed by two independent reviewers and compared. Data extraction focused on the barriers to accessing and to utilizing healthcare for minority-language speakers with NDDs. The search process and ensuing results were fully reported using a diagram from the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review. RESULTS Following the database search, a total of 28 articles met our final selection criteria and two articles were hand-picked based on our knowledge of the literature, for a total of 30 articles. These studies revealed that minority-language speakers with NDDs and their families experience several barriers to accessing and utilizing healthcare services. These barriers, identified at the Systems, Provider and Family Experience levels, have important consequences on children's outcomes and families' well-being. DISCUSSION While our review outlined several barriers to access and utilization of healthcare services for minority-language speakers with NDDs and their families, our findings give rise to concrete solutions. These solutions have the potential to mitigate the identified barriers, including development and implementation of policies and guidelines that support minority-language speakers, practitioner training, availability of referral pathways to appropriate services, access to tools and other resources such as interpretation services, and partnership with caregivers. Further research needs to shift from describing barriers to examining the efficacy of the proposed solutions in mitigating and eliminating identified barriers, and ensuring equity in healthcare for minority-language speakers with NDDs.
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Affiliation(s)
| | - Kaela Amorim
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - Jonathan Lai
- Autism Alliance of Canada and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Julie Scorah
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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