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）是影响美国88名儿童中约1个的发育障碍（CDC，2012年）。尽管有证据表明从儿童期到成年的症状严重程度降低，但ASD是终生的残疾，需要持续支持。高中退出后，对于ASD的年轻人来说，服务损失很大，许多人没有有意义的白天活动。在我们先前的研究中，我们发现，没有智障的ASD成年人中有25％的成年人（ID）与工作或专上教育脱离（Taylor＆Seltzer，2011年）。此外，尽管在生命的这一阶段强迫进行研究和干预措施，但对于ASD的成年人来说仍然很少，并且在经验上没有 为家庭设计的基于干预措施（Taylor，Dove等，2012）。拟议的研究解决了这一差距，并专注于患有ASD的年轻人，他们脱离工作或大专教育。过去的研究表明，家庭心理教育计划可以减少家庭中高水平的压力和情感强度，称为表达情绪（EE），并且这种减少会为患有心理健康状况的人带来更好的结果（McFarlane，Dixon，Dixon，Lukens，Lukens，Lukens和Lucksted，2003年）。我们的初步实验工作显示了与ASD及其家人的青少年相似的心理教育好处，并有证据表明，在高中过渡期间，可以优化父母和青少年的心理健康和适应性结果。根据我们先前与ASD的青少年建立的心理教育模型，我们建议（1）开发一种新的心理教育干预措施，该干预措施有助于共同努力，与患有ASD（无ID）的脱离年轻人（无ID）及其家人一起使用，以及（2）进行该干预术对社区样本的效果进行随机的侍应仪对照研究。我们将进行焦点小组以适应和开发课程，并用7个家庭进行课程，以确定可行性和可接受性。接下来，将招募56个脱离ASD的年轻人（定义为工作/在学校<10个小时）的年轻人，他们将被招募在家中，以参加干预措施，并随机分配给干预措施或候补名单控制条件。工作的干预措施将涉及2个个人加入会议，8个每周的小组会议和成人及其父母的3次助推器会议（分别见面）。介导（家庭能力，家庭气候）和结果变量（成人角色，成人行为功能的参与）将在基线和3、6、9和12个月时测量。我们假设随机进入初始干预条件的家庭将显示成人的进步 与在候补名单控制条件下的家庭相比，EE的角色参与，成人行为功能和家庭能力以及EE（家庭气候的衡量标准）的降低。