Multi-family Group Psychoeducation for Young Adults with ASD

描述(由申请人提供)：自闭症谱系障碍(ASD)是一种发育障碍，在美国大约每88名儿童中就有1名受到影响(CDC，2012年)。尽管有证据表明，从儿童到成年，症状的严重程度有所减轻，但自闭症是一种终生残疾，需要持续的支持。高中毕业后，为患有自闭症的年轻人提供的服务大幅减少，许多人没有有意义的白天活动。在我们之前的研究中，我们发现，超过25%的患有自闭症的成年人没有智力残疾(ID)，他们脱离了工作或中学后教育(Taylor&Seltzer，2011)。此外，尽管在生命的这个阶段迫切需要研究和干预，但针对成人自闭症的计划很少，而且没有经验性的 以家庭为基础的干预措施(Taylor，Dove等人，2012年)。这项拟议的研究解决了这一差距，并将重点放在患有自闭症的年轻人身上，他们脱离了工作或接受了高等教育。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，即所谓的情绪表达(EE)，并且这种减少会为有心理健康问题的个人带来更好的结果(McFarlane，Dixon，Lukens，&Lucksted，2003)。我们的初步实验工作已经显示，心理教育对患有自闭症的青少年及其家庭有类似的好处，证据表明，父母和青少年的心理健康和适应结果可以在高中毕业后的过渡期间得到优化。基于我们先前开发的青少年ASD心理教育模式，我们建议(1)开发一种新的心理教育干预措施，名为Working Together，用于患有ASD(无ID)的无职业青少年及其家人，以及(2)在社区样本中对这种干预措施的效果进行随机等待名单对照研究。我们将组织焦点小组对课程进行调整和开发，并与7个家庭一起试点课程，以确定可行性和可接受性。接下来，56个家庭将被招募参加干预，并随机分配到干预或等待名单控制的条件下。这些家庭是指患有自闭症(定义为每周工作/上学和10小时)的自闭症患者。共同工作干预将包括2次个人-家庭加入会议，8次每周小组会议，以及3次成人和他们的父母(分别见面)的助教会议。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、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在成人中将显示出更大的改善 与等待名单控制条件下的家庭相比，角色投入、成人行为功能和家庭能力以及EE(家庭气氛的一种衡量标准)的下降幅度更大。

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.