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: 9118786
• 负责人: Leann Smith DaWalt
• 金额: $ 22.58万
• 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 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9118786
• 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; Disabled Persons; 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; Secondary 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; 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，在美国约有1/88的儿童受到影响（CDC，2012）。虽然有证据表明从儿童到成年的症状严重程度有所减轻，但ASD是一种终身残疾，需要持续的支持。高中毕业后，ASD年轻人的服务有很大的损失，许多人没有有意义的日间活动。在我们之前的研究中，我们发现超过25%的ASD成年人没有智力障碍（ID），他们没有工作或中学后教育（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ASD成年人的项目很少，并且没有经验性的研究。 为他们的家庭设计的基于干预措施（Taylor，Dove，et al.，2012年）。这项拟议的研究解决了这一差距，并重点关注那些脱离工作或中学后教育的ASD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，称为表达情绪（EE），这种减少会为心理健康状况的个体带来更好的结果（McFarlane，狄克逊，Lukens，& Lucksted，2003）。我们的初步实验工作表明，心理教育对ASD青少年及其家庭有类似的好处，有证据表明，父母和青少年的心理健康和适应性结果可以在高中毕业过渡期间得到优化。基于我们先前开发的ASD青少年心理教育模型，我们建议（1）开发一种新的心理教育干预措施，名为“一起工作”，用于ASD（无ID）的年轻成年人及其家庭，（2）在社区样本中进行随机等待名单对照研究。我们将组织焦点小组，调整和发展课程，并在7个家庭中试行课程，以确定其可行性和可接受性。接下来，将招募56个居住在家里的ASD（定义为每周工作/上学< 10小时）的年轻成年人家庭参与干预，并随机分配到干预或等待控制条件。共同工作干预将包括2个个人家庭加入会议，8个每周小组会议，以及3个成人及其父母（单独见面）的助推器会议。将在基线和3、6、9和12个月时测量中介变量（家庭能力、家庭气候）和结果变量（参与成人角色、成人行为功能）。我们假设，随机分配到初始干预条件的家庭将显示出更大的改善， 角色参与，成年人的行为功能，和家庭能力和更大的减少EE（家庭气候的措施）相比，家庭在候补名单控制条件。