Multi-family Group Psychoeducation for Young Adults with ASD

针对患有自闭症谱系障碍的年轻人的多家庭团体心理教育

• 批准号: 8755467
• 负责人: Leann Smith DaWalt
• 金额: $ 18.81万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8755467
• 关键词: Acute; Address; Adolescent; Adult; Affect; Autistic Disorder; Behavioral; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Climate; Communities; Controlled Study; Data; Developmental Disabilities; Diagnosis; Distress; Education; Educational Curriculum; Effectiveness; Emotional Stress; Employment; Exercise; Expressed Emotion; Family; Feedback; Focus Groups; Goals; Grant; Health; Home environment; Hour; Individual; Intellectual functioning disability; Intervention; Intervention Studies; Knowledge; Legal; Life; Measures; Mediating; Mental Health; Modeling; Occupations; Outcome; Parents; Participant; Personal Satisfaction; Problem Solving; Quality of life; Randomized; Recruitment Activity; Reporting; Research; Risk; Role; Sampling; Schools; Services; Severities; Staging; Stress; Suggestion; Symptoms; Testing; Training; Unemployment; United States National Institutes of Health; Ursidae Family; Work; autism spectrum disorder; base; care burden; community setting; coping; disability; falls; high school; improved; intervention effect; meetings; programs; psychoeducation; public health relevance; randomized trial; satisfaction; social; therapy design; young adult

DESCRIPTION (provided by applicant): Autism spectrum disorders (ASDs) are developmental disabilities that affect approximately 1 in 88 children in the US (CDC, 2012). Although there is evidence of reduction in severity of symptoms from childhood to adulthood, ASD is a lifelong disability requiring ongoing support. Following high school exit, there is a significant loss of services for young adults with ASD, with many having no meaningful daytime activities. In our previous research, we have found that over 25% of adults with ASD who do not have an intellectual disability (ID) are disengaged from work or post-secondary education (Taylor & Seltzer, 2011). Further, despite a pressing need for research and interventions during this stage of life, there is a paucity of programs for adults with ASD and there are no empirically based interventions designed for their families (Taylor, Dove, et al., 2012). The proposed study addresses this gap and focuses on young adults with ASD who are disengaged from work or post-secondary education. Past research has demonstrated that family psychoeducation programs can reduce high levels of stress and emotional intensity in the family, known as expressed emotion (EE), and that this reduction leads to better outcomes for individuals with mental health conditions (McFarlane, Dixon, Lukens, & Lucksted, 2003). Our preliminary experimental work has shown similar benefits of psychoeducation for adolescents with ASD and their families, with evidence that parent and adolescent mental health and adaptive outcomes can be optimized during the transition out of high school. Based on our previously-developed psychoeducation model with adolescents with ASD, we propose to (1) develop a new psychoeducation intervention entitled Working Together, for use with disengaged young adults with ASD (without ID) and their families, and (2) conduct a randomized waitlist control study of the effect of this intervention in a community sample. We will conduct focus groups to adapt and develop the curriculum and pilot the curriculum with 7 families to determine feasibility and acceptability. Next, 56 families of disengaged young adults with ASD (defined as working/in school < 10 hours per week) who live at home will be recruited to participate in the intervention and randomly assigned to either the intervention or a waitlist control condition. The Working Together intervention will involve 2 individual-family joining sessions, 8 weekly group sessions, and 3 booster sessions for adults and their parents (who meet separately). Mediating (family capacity, family climate) and outcome variables (engagement in adult roles, adult behavioral functioning,) will be measured at baseline and at 3, 6, 9, and 12 months. We hypothesize that families randomized into the initial intervention condition will show greater improvements in adult role engagement, adult behavioral functioning, and family capacity and greater decreases in EE (a measure of family climate) compared to families in the waitlist control condition.

描述（由申请人提供）：自闭症谱系障碍 (ASD) 是一种发育障碍，影响美国大约每 88 名儿童中就有 1 名（CDC，2012）。尽管有证据表明从儿童期到成年期症状的严重程度有所减轻，但自闭症谱系障碍是一种终生残疾，需要持续的支持。高中毕业后，患有自闭症谱系障碍的年轻人的服务大幅减少，许多人没有任何有意义的白天活动。在我们之前的研究中，我们发现超过 25% 的患有自闭症谱系障碍（ID）的成年人没有智力障碍（ID），他们脱离了工作或高等教育（Taylor & Seltzer，2011）。此外，尽管在生命的这个阶段迫切需要研究和干预，但针对患有自闭症谱系障碍的成年人的项目却很少，而且没有经验丰富的研究和干预措施。 为他们的家庭设计的干预措施（Taylor, Dove, et al., 2012）。拟议的研究解决了这一差距，重点关注那些脱离工作或高等教育的患有自闭症谱系障碍的年轻人。过去的研究表明，家庭心理教育计划可以减少家庭中的高水平压力和情绪强度，即表达情绪（EE），并且这种减少可以为患有心理健康问题的个人带来更好的结果（McFarlane、Dixon、Lukens 和 Lucksted，2003）。我们的初步实验工作表明，心理教育对患有自闭症谱系障碍的青少年及其家人有类似的好处，有证据表明，在高中毕业的过渡过程中，父母和青少年的心理健康和适应性结果可以得到优化。基于我们之前针对患有自闭症谱系障碍 (ASD) 的青少年开发的心理教育模型，我们建议 (1) 开发一种名为“共同努力”的新心理教育干预措施，用于患有自闭症谱系障碍 (ASD) 的青少年（无智力障碍）及其家人，以及 (2) 在社区样本中开展一项随机候补对照研究，以了解该干预措施的效果。我们将组织焦点小组来调整和开发课程，并在 7 个家庭中进行试点，以确定可行性和可接受性。接下来，将招募 56 个在家中居住的、患有自闭症谱系障碍 (ASD) 的年轻人（定义为每周工作/在校时间 < 10 小时）的家庭参与干预措施，并随机分配到干预组或候补控制组。一起工作干预将包括 2 次个人家庭加入会议、8 次每周小组会议以及 3 次成人及其父母（分开会面）的加强会议。中介（家庭能力、家庭氛围）和结果变量（成人角色参与度、成人行为功能）将在基线以及 3、6、9 和 12 个月时进行测量。我们假设随机进入初始干预条件的家庭将在成人方面表现出更大的改善 与候补名单控制条件下的家庭相比，角色参与度、成人行为功能和家庭能力以及 EE（家庭气氛的衡量标准）有更大的下降。