Accelerating research on treatment and services for transition age youth and adults on the autism spectrum

Baker-Ericzén, Mary J.; Brookman‐Frazee, Lauren; Brodkin, Edward S.

doi:10.1177/1362361317738646

Cited by 23 publications

(21 citation statements)

References 46 publications

(45 reference statements)

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“…[3][4][5] Despite growing evidence suggesting that autistic adults may benefit from additional support around transition periods, little empirical research has considered how autistic adults experience pregnancy and parenting. [6][7][8] Pregnancy and the transition to parenthood are critical windows for adult health. 9 Given the myriad biopsychosocial changes associated with becoming a parent, this transition period greatly influences health trajectories, and known disparities in later health outcomes may be linked to risk factors originally emerging during the perinatal period.…”

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confidence: 99%

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

McDonnell

DeLucia

2021

Autism in Adulthood

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Background: Strikingly little research has considered how autistic adults experience pregnancy and parenthood, two key transition periods in adult development with potentially far-reaching implications for physical and psychosocial health outcomes across the lifespan. This article reviews the research on pregnancy and parenthood among autistic adults, to summarize existing research and identify future directions to advance this critical area of study. Methods: We conducted a systematic review of the literature on pregnancy and parenthood among autistic adults. Researchers extracted selected articles for key information, including methodology and sample size, study location, demographic characteristics of participants, measurement approaches, and key study findings. Results: Overall, we identified 13 studies that used a range of quantitative and qualitative approaches to study pregnancy experiences and outcomes and parenthood among autistic adults. The findings show that autistic adults (1) experience difficulties and dissatisfaction communicating with health care providers throughout pregnancy and birth, (2) are more likely to experience depression during and after pregnancy, and (3) experience higher rates of pregnancy complications, including preterm birth, cesarean delivery, and pre-eclampsia. During parenthood, autistic adults report lower parenting competence, experience parenthood as isolating, have difficulty communicating with professionals about their child and are questioned by providers about their ability to parent, experience high rates of involvement with child protective services, and express a desire for increased parenting support. Autistic adults also reported parenting strengths, including high levels of finding parenthood rewarding and putting their children's needs ahead of their own. Conclusions: A key limitation of the literature is the significant lack of sociodemographic diversity among participants, the small number of existing studies, and reliance on cross-sectional mono-method designs. Future research should be conducted in partnership with autistic adults to develop assessment and intervention approaches for supporting pregnancy health and parental well-being among diverse and underserved communities.

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confidence: 99%

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

McDonnell

DeLucia

2021

Autism in Adulthood

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“…Introduction F or many autistic individuals approaching adulthood, interventions to promote skills toward independence are lacking. 1 Driving is an important ability to cultivate as it may be a critical step to attaining independence, securing and maintaining work, and fostering relationships. 2 Recent literature reveals that only 24%-34% of autistic individuals without intellectual disability drive independently.…”

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confidence: 99%

A Cognitive Behavioral Intervention for Driving for Autistic Teens and Adults: A Pilot Study

Baker-Ericzén

Smith

Tran

et al. 2021

Autism in Adulthood

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Background: For many autistic individuals approaching adulthood, interventions to promote skills toward independence are lacking. Driving is an important ability to cultivate as it may be a critical step to attaining independence, securing and maintaining work, and fostering relationships. Only about one third of able autistic individuals drive independently, and fear to drive is a common reason for not driving. Methods: This initial pilot study was a 3-month open trial to investigate the feasibility, acceptability, and initial estimates of outcomes for the newly developed Cognitive Behavioral Intervention for Driving (CBID) intervention, a manualized curriculum to enhance executive functioning (EF) and emotional regulation (ER) skill development for driving, combined with individualized commentary-based driving simulator practice, in autistic teens and adults within a community research environment. Nineteen participants received the CBID intervention in 1.5-hour group sessions for 10 weeks, across two cohorts, with approximately five individualized driving simulator sessions. Data were collected on anxiety symptoms, driving cognitions, driving attitudes, and simulated driving performance at pre-and post-intervention assessments. Results: Program completion rate was 81%. Participants and parents rated both the intervention and simulator practice sessions with high satisfaction. All the participants (100%) reported both a positive attitude change (interest toward driving) and a desire to drive in the future at the post-intervention assessment. Significant changes occurred for driving cognitions, attitudes, and behaviors, and 47% of participants obtained a driver's permit or license by 2 months post-intervention. Conclusions: For autistic individuals, the CBID intervention appeared to directly impact the pursuit toward driving goals by both increasing driving attitudes and behaviors and reducing anxiety/apprehension. This highlights the need for driving intervention programs designed specific to autistic teens/adults that focus on EF and ER skills coupled with individualized simulator practice. CBID could be provided in community services to increase the number of autistic individuals driving.

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“…Some interventions focus primarily on educator and parent coaching (e.g., COMPASS) [Ruble, McGrew, Snell‐Rood, Adams, & Kleinert, 2019], on transition planning (e.g., BOOST‐A) [Hatfield, Falkmer, Falkmer, & Ciccarelli, 2018], or on preparing for competitive employment (e.g., Project SEARCH Plus ASD) [Wehman et al, 2019]. Additional evidence is likely needed to improve the situation beyond the autistic individual, such as the capabilities of the target contexts (e.g., colleges, employer setting) to create more accepting environments [Accardo et al, 2019; Nicholas et al, 2017; Wehman et al, 2014], and on ensuring that multiple service systems are involved (e.g., health, vocational, education, community and social services) [Baker‐Ericzén, Brookman‐Frazee, & Brodkin, 2018].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Changes in Daily Activity in Transition‐Age Autistic Youth

et al. 2020

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Transitioning into adulthood is fraught with challenges for autistic youth. A greater understanding of the facilitators of community involvement in school and employment during this period is warranted. The current study examines changes in service need and receipt, and the stability of accessing daily structured activities, for autistic young adults over their transition period compared to adolescents and adults that did not enter the transition period. Baseline caregiver survey data were taken from the Canadian Autism Spectrum Disorders Alliance National Autism Needs Assessment Survey in 2014, and caregivers (n = 304) completed the same set of questions in 2017 about sociodemographic factors, clinical need, service receipt and typical weekday activities. Three cohorts were compared: (1) pretransition age youth, (2) transition‐age youth, and (3) young adults who were past transition age. Results suggest that transition‐age youth were found to have a unique set of priority service needs compared to pre transition‐age adolescent and to adult groups, and both transition‐age and adult groups had lower levels of priority service receipt compared to pretransition‐age adolescents. The transition‐age group experienced the greatest loss of structured weekday activity between time points, and were more likely than pretransition‐age adolescents to not have structured weekday activities at Time 2. A recovery of structured daily activity was not observed in young adults. Our results highlight the tumultuous nature of the transition period for autistic youth, which continues into adulthood, and the urgent need for supports during this time. Lay Summary This research highlights that autistic young people who are transitioning to adulthood are at greatest risk of losing structured weekday activities, and that once in adulthood, many continue to struggle to obtain meaningful community engagement. These results can help guide the design of adolescent and young adult transition programs.

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Accelerating research on treatment and services for transition age youth and adults on the autism spectrum

Cited by 23 publications

References 46 publications

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

A Cognitive Behavioral Intervention for Driving for Autistic Teens and Adults: A Pilot Study

Predictors of Changes in Daily Activity in Transition‐Age Autistic Youth

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