Youth with autism spectrum disorder are a vulnerable, often poorly understood patient group, who may experience periodic and chronic health challenges, in addition to their primary developmental social and communication problems. Developmental and behavioural challenges can complicate management of acute health-care needs. To date, there is an absence of empirical research exploring the hospital experiences of children and youth with autism spectrum disorder, their families and their health-care providers. Therefore, the purpose of this study was to understand these experiences in order to inform hospital-based care. A total of 42 participants were interviewed (youth with autism spectrum disorder, their parents and health-care providers) at one of two Canadian paediatric hospitals, representing 20 distinct cases of patients with autism spectrum disorder. Results from the qualitative analyses indicated that patients with autism spectrum disorder faced several challenges in the context of health-care delivery in the hospital setting, as did their families and health-care provider team. Problems identified included communication and sensory challenges, and the degree of flexibility of health-care providers and the hospital organization. Supportive health-care providers were those who acknowledged parents as experts, inquired about the requirements of patients with autism spectrum disorder and implemented strategies that accommodated the unique clinical presentation of the individual patient. These recommendations have wide-reaching utility for hospital and health-care practices involving this patient group.
The employment rate among persons with autism spectrum disorder has been noted as unacceptably low. Employment-support services are increasingly linked to the potential for favorable job outcomes, yet little is known about employment-support practices and the outcome of these interventions. This mixed-methods study examined employment-support resources for persons with autism spectrum disorder. An online survey was completed by 137 senior clinicians or administrators in employment-support programs in Canada. Additionally, 122 follow-up interviews were conducted with individuals with autism spectrum disorder (n = 71) and their parents/caregivers (n = 51). Findings indicate that the quality and beneficial impact of employment-support services for adults with autism spectrum disorder may be more favorably perceived by employment-support personnel than by individuals with autism spectrum disorder and their families. Furthermore, employment-support personnel were more disparaging about autism spectrum disorder vocational support capacity within their community, compared to their own programs. Individuals with autism spectrum disorder and their families seek services that support both accessing and retaining employment. Capacity-building in employment support for youth and adults with autism spectrum disorder is recommended, based on a reported insufficiency of, and a lack of evidence guiding, existing services. Program recommendations and an emerging model for integrated vocational support in autism spectrum disorder are offered.
Background Individuals with intellectual disabilities respond to loss in similar ways to other individuals. Bereavement interventions, whether provided individually or in a group, need to be planned according to the person's understanding, presenting symptoms, psychological functioning and support system. Measuring the effectiveness of such interventions is critical in order to increase our knowledge of useful interventions for this population. The present authors discuss individual and group bereavement therapy, and outline the goals and approaches used in their bereavement groups for adults with intellectual disabilities.
Methods Individuals referred for bereavement group therapy were interviewed and assessed prior to their participation in the group. Measures of depression, anxiety, and knowledge of death and bereavement issues were administered before and after group participation.
Results Scores for depression were significantly lower following group participation. However, scores for anxiety were mild and not significantly reduced. The participants' understanding and knowledge of the bereavement process did not improve significantly. When those with single and dual diagnosis were considered separately, those with a dual diagnosis experienced a significant decrease in depression, while those with a single diagnosis did not. Furthermore, depression scores for those with a dual diagnosis were generally higher.
Conclusions The present preliminary investigation of therapeutic outcomes for bereavement group intervention suggests little change in anxiety and knowledge of death/bereavement issues, but significant improvement in symptoms of depression for participants, particularly those with a dual diagnosis. The weaknesses of the present study are discussed along with possible improvements for future studies.
Over the past decade, there has been a growing interest in adults on the autistic spectrum, and more recently, the challenges related to aging in this population. A two-day Think Tank meeting, focused on aging in autism, was convened amongst international leaders in the field of autism research and practice. This meeting included a series of presentations addressing the current status of aging research, followed by discussions regarding priorities going forward. Attendees shared their thoughts and concerns regarding community services, government policies, societal perspectives and physical and mental health. The goal of these discussions was to consider systematic approaches aimed at providing meaningful supports that can ensure a quality of life for seniors on the autism spectrum.
This article describes clinical experiences of therapists with autistic clients during early stages of the COVID-19 pandemic while engaged in remote intervention in Canada. The authors polled their team of mental health clinicians through an email questionnaire and infused their own practice experiences to summarize mental health themes, and adaptation to technology-based intervention. Clinicians shared responses to the pandemic and reported on their transition to remote intervention.
Clinicians in the field of autism are increasingly identifying individuals with Asperger syndrome. Individual and family therapy for individuals with this condition has received little attention in the literature. This article presents three case examples of individual and family therapy with male adolescents diagnosed with Asperger syndrome. Common presenting issues and treatment interventions are summarized that may apply to others diagnosed with this condition.note The names used in each case study were changed to protect the identity of the young men and their families. keywords adolescents; Asperger syndrome; family therapy; individual therapy autism 3(3)
Family and treatment historyBrian was the first-born of two boys. His mother reported that, although he was a bright baby, he was extremely irritable and prone to temper outbursts. When Brian was 3 years old, his father left the family. Although teachers in his first years of schooling noted that Brian had a likeable personality, they also observed chronic problems in the areas of impulsivity, social skills, behaviour, anxiety, organization and egocentricity. He was then moved to a private school for children with learning difficulties and received play therapy. Over the following years, Brian had numerous psychological and psychiatric assessments. At the age of 14, his behaviour became very difficult at home; there was conflict between him and his mother, and Brian had begun to threaten her physically. He was admitted to a residential treatment centre where he participated in individual, group and family therapy. At the age of 15, Brian was diagnosed with Asperger syndrome. Shortly after this, he was prescribed Buspar (buspirone) which his family doctor later changed to Paxil (paroxetine).
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