Emerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. Parents of autistic children, adolescents, and adults ( N = 54) were randomly assigned to either complete a brief group-based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. The primary outcome was depression symptoms and secondary outcomes included stress, goal attainment, positive affect, ACT psychological processes, child mental health, and family functioning. Mixed effects linear models testing Group × Time interaction indicated the Treatment group ( n = 27) demonstrated greater post-intervention improvements than the Waitlist group ( n = 27) in parent depression ( p = .03, d = −0.64) and family distress ( p = .04, d = −0.57). Treatment group parents also reported greater short-term gains in positive affect ( p =< .001, d = 0.77) and personal goal attainment ( p = .007, d = 0.80), compared to the Waitlist group. Although there was no significant Group × Time interaction for other outcomes, stress ( b = −2.58, p = .01), defusion ( b = −3.78, p = .001), and experiential avoidance ( b = −4.22, p = .01) showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggest that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children. Lay abstract Parents of autistic children commonly experience difficulties with their own mental health. This study looked at the effects of a brief group-based Acceptance and Commitment Therapy program, developed for parents of autistic children, youth, and adults. ACT focuses on increasing psychological flexibility, which is the ability to be mindful and accepting of difficult thoughts and experiences, shown to be important for mental wellness. Participants included 54 parents of autistic people, ages 3–34. Parents were randomly divided into two groups: a Treatment group that received the intervention right away, and a Waitlist group that completed the program after the Treatment group completed the trial. All parents filled out questionnaires right before the program began, and at 3, 7, and 17 weeks after randomization. Compared to the group that was waiting to participate in the program, parents in the Treatment group reported greater improvements in depression and family distress, and these improvements were still present 4 months later. Parents in the Treatment group also reported short-term improvements in their positive feelings and personal goals, compared to those waiting. Results showed that ACT may help improve some aspects of mental health for parents of autistic children, but further research is recommended.
Abstract Aims To describe and compare population‐level aspects of diabetes and diabetes primary care among people with and without intellectual and developmental disabilities. Methods Administrative health data accessed from the Institute for Clinical Evaluative Sciences was used to identify a cohort of Ontarians with and without intellectual and developmental disabilities between the ages of 30 and 69 years ( n = 28 567). These people were compared with a random sample of people without intellectual and developmental disabilities ( n = 2 261 919) according to diabetes prevalence, incidence, age, sex, rurality, neighbourhood income and morbidity. To measure diabetes primary care, we also studied hospitalizations for diabetes‐related ambulatory care‐sensitive conditions. Results Adults with intellectual and developmental disabilities had a consistently higher prevalence and incidence of diabetes than those without intellectual and developmental disabilities. Disparities in prevalence between those with and without intellectual and developmental disabilities were most notable among women, younger adults and those residing in rural or high income neighbourhoods. In terms of hospitalizations for diabetes‐related ambulatory care‐sensitive conditions, people with intellectual and developmental disabilities were 2.6 times more likely to be hospitalized. Conclusions Adults with intellectual and developmental disabilities are at high risk of developing and being hospitalized for diabetes. The findings of the present study have a number of important implications related to the early detection, prevention and proper management of diabetes among adults with intellectual and developmental disabilities.
Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD.
BACKGROUND: Although aging persons with cognitive disabilities may benefit from information technologies (IT), researchers have identified barriers affecting their IT use. However, most studies do not emphasize the needs and experiences reported by these users themselves. OBJECTIVE: To identify factors affecting IT use from the perspective of aging persons with cognitive disabilities. METHODS: We conducted a scoping review of peer-reviewed studies published between January 2008 and December 2018 that investigated IT use by aging persons with cognitive disabilities as reported by these individuals. Factors affecting participants’ IT use were synthesized through a thematic analysis of relevant studies’ findings. RESULTS: Seven studies were included in our analysis. We found technology-related (accessibility, usefulness, cost), social (support, stigma and other social pressure), and personal (experience with IT, attitudes toward IT use, functional limitations, life situation) factors related to participants’ IT use. Stigma was identified as a key barrier to IT use that has been underestimated in previous quantitative research. CONCLUSIONS: Understanding the role that stigma plays in the use and adoption of technology among aging persons with cognitive disabilities is critical to developing successful strategies to promote this population’s IT use.
ABSTRACT Parents of autistic children are at a higher risk for mental health problems, including anxiety, depression, and stress. Cognitive behavior therapy (CBT) that targets children's emotion regulation may have an indirect influence on parent outcomes, especially if they play a supporting role in their child's intervention. However, most CBT interventions have been carried out in highly controlled research settings and there are a few studies that examined parental outcomes after participating in autistic child‐focused CBT within a community setting. The current study examined parent outcomes (i.e., mental health problems, mindful parenting, and parenting practices) following a community‐based CBT program with concurrent parent involvement for autistic children, as well as associations between changes in parent and child outcomes (i.e., autism symptoms and emotion dysregulation). Participants included 77 parent–child dyads across seven community organizations in Ontario, Canada. Parents reported improved mindful parenting and positive parenting practices post‐intervention, and no significant changes in their mental health. Multiple mediation analyses revealed that positive changes in parent outcomes (i.e., mindful parenting and parenting practices) were associated with positive changes in child emotion regulation. These positive changes in parenting practices mediated the relationship between mindful parenting and child emotion regulation. Results suggest that participating in community‐based CBT is mutually beneficial for autistic children and their parents, particularly in improving parenting behaviors.
Abstract There are significant research gaps with regard to understanding and addressing the mental health concerns of adults with intellectual and developmental disabilities (IDD) and their families. In this article, we reflect on research we have carried out about mental health and IDD prior to and during the pandemic in Ontario, Canada. We aim to address how partnering with people with IDD, family caregivers, service providers, and policy makers can help accelerate needed progress in this area. We conclude with some lessons learned during the pandemic about what to emphasize in building and maintaining such partnerships.
Challenges with functional communication (e.g., language use in situational contexts), are a core feature of autism. Challenges in functional communication are related to social interaction difficulties and may impact engagement in interventions such as cognitive-behavioural therapy (CBT). CBT is a common intervention used to support emotion regulation and social skills development in autistic children. Programming relies on the participant’s ability to engage in complex language. The present study examined whether the functional communication level of autistic children (8-12 years) impacted social skills and emotion regulation development after participation in a CBT-based program. Repeated measures ANOVAs revealed no significant differences in emotion regulation, however, there was a significant main effect for social skills, based on functional communication levels. T-tests revealed significant improvements for all measures in the clinically significant functional communication group, but not the at-risk or non-significant groups. These results illustrate the importance of considering functional communication levels in autistic children.
Adolescents and young adults with an autism spectrum disorder (ASD) are often prescribed psychotropic medications to treat mental health and behavioral issues, and parents of these individuals play a crucial role in overseeing this care. Despite this, little is known about parents’ experiences managing and monitoring their child’s medication treatment, or their experience interacting with prescribing health care providers. To learn more about parents’ perspectives on psychotropic medication use in their adolescent or young adult with ASD, a focus group was conducted with seven mothers whose adolescent or adult child with ASD was prescribed one or more psychotropic medications. Results are summarized according to emergent themes including parent perception of child experience with medication, side effects, medication efficacy, medication monitoring, expertise issues, and service issues. Parents also provided medication recommendations, including a desire for health care providers with greater expertise in ASD, information on medication, and tools for medication monitoring.
