Transitioning Together: A Multi-family Group Psychoeducation Program for Adolescents with ASD and Their Parents

  • Leann Smith DaWalt
  • Jan S. Greenberg
  • Marsha R. Mailick
Original Paper

Abstract

Currently there are few evidence-based programs available for families of individuals with ASD during the transition to adulthood. The present study provided a preliminary evaluation of a multi-family group psychoeducation intervention using a randomized waitlist control design (n = 41). Families in the intervention condition participated in Transitioning Together, an 8-week program designed to reduce family distress and improve social functioning for adolescents. Findings indicated significant improvements in parental depressive symptoms and problem solving from pre- to post-intervention for parents in the intervention condition but not for parents in the control condition. Social interactions also improved for youth in the intervention condition relative to controls. Parents reported satisfaction with the program and particularly valued the opportunity to interact with other families.

Keywords

Autism spectrum disorder Adolescence Multi-family group psychoeducation Transition 

References

  1. Abbeduto, L., Seltzer, M. M., Shattuck, P., Krauss, M. W., Orsmond, G., Murphy, M. M., & Floyd, F. (2004). Psycyhological well-being and coping in mothers of youths with autism, down syndrome, or fragile X syndrome. American Journal on Mental Retardation, 109(3), 237–254.CrossRefPubMedGoogle Scholar
  2. Abidin, R. R. (1997). Parenting stress index: A measure of the parent-child system. In C. P. Zalaquett, R. J. Wood (Eds.), Evaluating stress: A book of resources (pp. 277–291). Lanham, MD: Scarecrow Education.Google Scholar
  3. Azad, G. F., Reisinger, E., Xie, M., & Mandell, D. S. (2016). Parent and teacher concordance on the social responsiveness scale for children with autism. School Mental Health 8, 368–376.CrossRefPubMedGoogle Scholar
  4. Barker, E. T., Hartley, S. L., Seltzer, M. M., Floyd, F. J., Greenberg, J. S., & Orsmond, G. I. (2010). Trajectories of emotional well-being in mothers of adolescents and adults with autism. Developmental Psychology, 47(2), 551–561.Google Scholar
  5. Baker, J., Smith, L. E., Greenberg, J. S., & Seltzer, M. M. (2011a). Change in maternal criticism and behavior problems in adolescents and adults with autism across a seven-year period. Journal of Abnormal Psychology 120(2), 465CrossRefPubMedPubMedCentralGoogle Scholar
  6. Baker, J. K., Seltzer, M. M., & Greenberg, J. S. (2011b). Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism. Journal of Family Psychology, 25(4), 601–609.CrossRefPubMedPubMedCentralGoogle Scholar
  7. Barker, E. T., Seltzer, M. M., & Smith, L. E. (2013). Chronic parenting stress in mothers of adolescents and adults with autism: Vulnerability and resilience. In C. R. Martin, V. R. Preedy & V. B. Patel (Eds.), The comprehensive guide to autism. London: Springer.Google Scholar
  8. Bengtson, V. L., & Schrader, S. S. (1982). Parent–child relationship. In D. J. Mangon & W. A. Peterson (Eds.), Research instruments in social gerontology (Vol. 2, pp. 115–185). Minneapolis: University of Minnesota Press.Google Scholar
  9. Blacher, J., & McIntyre, L. L. (2006). Syndrome specificity and behavior disorders in young adults with intellectual disability: Cultural differences in family impact. Journal of Intellectual Disability Research, 50, 184–198.CrossRefPubMedGoogle Scholar
  10. Bishop-Fitzpatrick, L., Mazefsky, C. A., Minshew, N. J., & Eack, S. M. (2015). The relationshiop between stress and social funcitoning in adults with autism spectrum disorder and without intellectual disability. Autism Research, 8, 164–173.CrossRefPubMedGoogle Scholar
  11. Bruininks, R., Woodcock, R., Weatherman, R., & Hill, B. (1996). Scales of independent behavior–revised comprehensive manual. Itasca, IL: Riverside Publishing.Google Scholar
  12. Borkowski, J. G., Akai, C. E., & Smith, L. E. (2006). The art and science of prevention: Characteristics of effective prevention. In J. G. Borkowski & C. M. Weaver (Eds.), The culture of prevention: Using science and art to promote healthy development (pp.55–82). Baltimore, MD: Paul H. Brookes.Google Scholar
  13. Chiquelho, R., Neves, S., Mendes, A., Relvas, A. P., & Sousa, L. (2011). ProFamilies: A psychoeducational multi-family group intervention for cancer patients and their families. European Journal of Cancer Care, 20, 337–344.CrossRefPubMedGoogle Scholar
  14. Christensen, D. L., Baio, J., Braun, K. V., et al. (2016). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2012. MMWR Surveillance Summary, 65, 1–23.CrossRefGoogle Scholar
  15. Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health: Claremont Symposium on applied social psychology. Newbury Park, CA: Sage.Google Scholar
  16. Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the Social Responsiveness Scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33, 427–433.CrossRefPubMedGoogle Scholar
  17. Dixon, L., Adams, C., & Lucksted, A. (2000). Update on family psychoeducation for schizophrenia. Schizophrenia Bulletin, 26, 5–20.CrossRefPubMedGoogle Scholar
  18. Dykens, E. M., Fisher, M. H., Taylor, J. L., Lambert, W., & Miodrag, N. (2014). Reducing distress in mothers of children with autism and other disabilities: A randomized trial. Pediatrics, 134, 454–e463.CrossRefGoogle Scholar
  19. Eisenhower, A. S., Baker, B. L., & Blacher, J. (2005). Preschool children with intellectual disability: Syndrome specificity, behavior problems, and maternal well-being. Journal of Intellectual Disability Research, 49, 657–671.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Esbensen, A. J., Bishop, S. L., Seltzer, M. M., Greenberg, J. S., & Taylor, J. L. (2010). Comparisons between individuals with autism spectrum disorders and individuals with Down syndrome in adulthood. American Journal of Intellectual and Developmental Disabilities, 115(4), 277–290.CrossRefGoogle Scholar
  21. Essex, E. L., Seltzer, M. M., & Krauss, M. W. (1997). Residential transitions of adults with mental retardation: Predictors of waiting list use and placement. American Journal of Mental Retardation, 101(6), 613–629.PubMedGoogle Scholar
  22. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175–191.CrossRefPubMedGoogle Scholar
  23. Greenberg, J. S., Seltzer, M. M., Hong, J., & Orsmond, G. I. (2006). Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. American Journal of Mental Retardation, 111, 229–249.CrossRefPubMedGoogle Scholar
  24. Gurney, J., Fritz, M., Ness, K., Sievers, P., Newschaffer, C., & Shapiro, E. (2003). Analysis of prevalence trends of autism spectrum disorder in Minnesota. Archives of Pediatrics and Adolescent Medicine, 157, 622–627.CrossRefPubMedGoogle Scholar
  25. Hastings, R. P., & Lloyd, T. (2007). Expressed emotion in families of children and adults with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 13, 339–345.CrossRefPubMedGoogle Scholar
  26. Hayes, S. A., & Watson, S. L. (2013). The impact of parenting stress: A meta-analysis of studies comparing the experience of parenting stress in parents of children with and without an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43, 629–642. doi: 10.1007/s10803-012-1604-y.CrossRefPubMedGoogle Scholar
  27. Henninger, N. A., & Taylor, J. L. (2012). Outcomes in adults with autism spectrum disorders: a historical perspective. Autism: The International Journal of Research and Practice, 17, 103–117.CrossRefGoogle Scholar
  28. Howlin, P., Good, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45(2), 212–229.CrossRefPubMedGoogle Scholar
  29. Howlin, P., & Moss, P. (2012). In review: Adults with autism spectrum disorders. Canadian Journal of Psychiatry, 57(5), 275–283CrossRefPubMedGoogle Scholar
  30. Karst, J. S., Van Hecke, A. V., Carson, A. M., Stevens, S., Schohl, K., & Dolan, B. (2015). Parent and family outcomes of PEERS: A social skills intervention for adolescents with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 752–765.CrossRefPubMedGoogle Scholar
  31. Konstantareas, M. M., Homatidis, S., & Plowright, C. M. (1992). Assessing resources and stress in parents of severely dysfunctional children through the Clarke modification of Holroyd’s questionnaire on resources and stress. Journal of Autism and Developmental Disorders, 22, 217–234.CrossRefPubMedGoogle Scholar
  32. Koren, P. E., DeChillo, N., & Friesen, B. J. (1992). Measuring empowerment in families whose children have emotional disabilities: A brief questionnaire. Rehabilitation Psychology, 37, 305–321.CrossRefGoogle Scholar
  33. Krauss, M. W., Seltzer, M. M., & Jacobson, H. T. (2005). Adults with autism living at home or in non-family settings: Positive and negative aspects of residential status. Journal of Intellectual Disability Research, 49, 111–124.CrossRefPubMedGoogle Scholar
  34. Kring, S. R., Greenberg, J. S., & Seltzer, M. M. (2008). Adolescents and adults with autism with and without co-morbid psychiatric disorders: Differences in maternal well-being. Journal of Mental Health Research in Intellectual Disabilities, 1, 53–74.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Kuhn, J., Borjas, S., & Smith, L. (2015). Cultural and linguistic adaptation of an education and support program for families with adolescents with autism. Poster presented at the 2015 Association of University Centers on Disability Annual Conference, Washington, DC.Google Scholar
  36. Laugeson, E. A., Gantman, A., Kapp, S. K., Orenski, K., & Ellingsen, R. (2015). A randomized controlled trial to improve social skills in young adults with autism spectrum disorder: The UCLA PEERS program. Journal of Autism and Developmental Disorders 45, 3978–3989.CrossRefPubMedGoogle Scholar
  37. Lounds, J., Seltzer, M.M., Greenberg, J.S., & Shattuck, P. (2007). Transition and change in adolescents and young adults with autism: Longitudinal effects on maternal well-being. American Journal on Mental Retardation, 112(6), 401–417. doi:10.1352/0895-8017.CrossRefPubMedGoogle Scholar
  38. Maenner, M., Smith, L., Hong, J., Makuch, R., Greenberg, J., & Mailick, M. (2013). An evaluation of an activities of daily living scale for adolescents and adults with developmental disabilities. Disability and Health Journal, 6, 8–17.CrossRefPubMedGoogle Scholar
  39. Magaña, A., Goldstein, M., Karno, M., Miklowitz, D., Jenkins, J., & Falloon, I. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Research, 17, 203–212.CrossRefPubMedGoogle Scholar
  40. McFarlane, W. R. (2002). Multifamily groups in the treatment of severe psychiatric disorders. New York: Guilford Press.Google Scholar
  41. McFarlane, W. R., Dixon, L., Lukens, E., & Lucksted, A. (2003). Family psychoeducation and schizophrenia: A review of the literature. Journal of Marital and Family Therapy, 29, 223–245.CrossRefPubMedGoogle Scholar
  42. Montes, G., & Halterman, J. S. (2006). Psychological functioning and coping among mothers of children with autism: A population-based study. Pediatrics, 119, 1040–1046. doi: 10.1542/peds.2006-2819.CrossRefGoogle Scholar
  43. Neece, C. L. (2014). Mindfulness-based stress reduction for parents of young children with developmental delays: Implications for parental mental health and child behavior problems. Journal of Applied Research in Intellectual Disabilities, 27, 174–186.CrossRefPubMedGoogle Scholar
  44. Ng, S. M., Li, A. M., Lou, V. W. W., Tso, I. F., Wan, P. Y. P., & Chan, D. F. Y. (2008). Incorporating family therapy into asthma group intervention: A randomized waitlist-controlled trial. Family Process, 47, 115–130.CrossRefPubMedGoogle Scholar
  45. Odom, S. L., Duda, M., Kucharczyk, S., Cox, A., & Stabel, A. (2014). Applying an implementation science framework for adoption of a comprehensive program for high school students with autism spectrum disorder. Remedial and Special Education, 35(2), 123–132.CrossRefGoogle Scholar
  46. Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism and Developmental Disorders, 34(3), 245–256.CrossRefPubMedGoogle Scholar
  47. Orsmond, G. I., & Seltzer, M. M. (2009). Adolescent siblings of individuals with an autism spectrum disorder: Testing a diathesis-stress model of sibling well-being. Journal of Autism and Developmental Disorders, 39(7), 1053–1065. doi:10.1007/s10803-009-0722-7.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Rutter, M., Bailey, A., & Lord, C. (2003). Social communication questionnaire (SCQ). Los Angeles: Western Psychological Services.Google Scholar
  49. Sanford, M., Boyle, M., McClearly, L., Miller, J., Steele, M., Duku, E., et al. (2006). A pilot study of adjunctive family psychoeducation in adolescent major depression: Feasibility and treatment effect. Journal of American Academy of Child and Adolescent Psychiatry, 45, 386–395.CrossRefGoogle Scholar
  50. Seltzer, M. M., Shattuck, P., Abbeduto, L., & Greenberg, J. S. (2004). The trajectory of development in adolescents and adults with autism. Mental Retardation Developmental Disabilities Research Reviews, 10, 234–247.CrossRefPubMedGoogle Scholar
  51. Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism and Developmental Disorders, 33, 565–581.CrossRefPubMedGoogle Scholar
  52. Seltzer, M. M., Greenberg, J. S., Hong, J., Smith, L. E., Almeida, D. M., Coe, C., & Stawski, R. S. (2010). Maternal cortisol levels and child behavior problems in families of adolescents and adults with ASD. Journal of Autism and Developmental Disorders, 40, 457–469.Google Scholar
  53. Shattuck, P. T., Narendor, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129(6), 1042–1049.CrossRefPubMedPubMedCentralGoogle Scholar
  54. Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 13, 129–135.Google Scholar
  55. Shattuck, P. T., Wagner, M., Narendorf, S., Sterzing, P., & Hensley, M. (2011). Post-high school service use among young adults with an autism spectrum disorder. Archives of Pediatric and Adolescent Medicine, 165, 141–146.CrossRefGoogle Scholar
  56. Singer, G. H. S., Ethridge, B. L., & Aldana, S. I. (2007). Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: A meta-analysis. Mental Retardation and Developmental Disabilities Research Reviews, 13, 357–369.CrossRefPubMedGoogle Scholar
  57. Smith, L. E., & Anderson, K. A. (2014). The roles and needs of families of adolescents with ASD. Remedial and Special Education, 35, 114–122.CrossRefPubMedGoogle Scholar
  58. Smith, L. E., Greenberg, J. S., Seltzer, M. M., & Hong, J. (2008). Symptoms and behavior problems of adolescents and adults with autism: Effects of mother-child relationship quality, warmth, and praise. American Journal on Mental Retardation, 113, 378–393.CrossRefGoogle Scholar
  59. Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2012a). Adults with autism: Outcomes, family effects, and the multi-family group psychoeducation model. Current Psychiatry Reports, 14, 732–738.Google Scholar
  60. Smith, L. E., Maenner, M. J., & Seltzer, M. M. (2012b). Developmental trajectories in adolescents and adults with autism: The case of daily living skills. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 622–631.CrossRefPubMedPubMedCentralGoogle Scholar
  61. Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2014). The family context of autism spectrum disorders: Influence on the behavioral phenotype and quality of life. Child and Adolescent Psychiatric Clinics of North America, 23, 145–155.Google Scholar
  62. Smith, L. E., Hong, J., Seltzer, M. M., Greenberg, J. S., Almeida, D. M., & Bishop, S. (2010). Daily experiences among mothers of adolescents and adults with ASD. Journal of Autism and Developmental Disorders, 40, 167–178.CrossRefPubMedGoogle Scholar
  63. Taylor, J. L., & Seltzer, M. M. (2010). Changes in the autism behavioral phenotype during the transition to adulthood. Journal of Autism and Developmental Disorders, 40, 1431–1446.CrossRefPubMedPubMedCentralGoogle Scholar
  64. Taylor, J. L., & Seltzer, M. M. (2011a). Changes in the mother-child relationship during the transition to adulthood for youth with autism spectrum disorder. Journal of Autism and Developmental Disorders, 41, 1397–1410.CrossRefPubMedPubMedCentralGoogle Scholar
  65. Taylor, J. L., Henninger, N. A., Mailick, M. R. (2015). Longitudinal patterns of employment and postsecondary education for adults with autism and average-range IQ. Autism: The International Journal of Research and Practice. doi:10.1177/1362361315585643.Google Scholar
  66. Taylor, J. L., & Mailick, M. R. (2014). A longitudinal examination of 10-year change in vocational and educational activities for adults with autism spectrum disorders, 50, 699–708. Developmental Psychology. doi:10.1037/a0034297.
  67. Taylor, J. L., Seltzer, M. M. (2011b). Employment and post-secondary educational activities for young adults with autism spectrum disorders during the transition to adulthood. Journal of Autism and Developmental Disorders, 41(5), 566–574.CrossRefPubMedPubMedCentralGoogle Scholar
  68. Taylor, J. L., Smith, L. E., & Mailick, M. R. (2014). Engagement in vocational activities promotes behavioral development for adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 44, 1447–1460. doi:10.1007/s10803-013-2010-9.CrossRefPubMedPubMedCentralGoogle Scholar
  69. Vaugh, C., & Leff, J. (1976). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.CrossRefGoogle Scholar
  70. Weiss, M. J. (2002). Hardiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism: The International Journal of Research and Practice, 6, 115–130.CrossRefGoogle Scholar
  71. Woodman, A. C., Smith, L. E., Greenberg, J. S., & Mailick, M. R. (2016). Contextual factors predict patterns of change in functioning over 10 years among adolescents and adults with autism spectrum disorders. Journal of Autism and Developmental Disorders, 46, 176–189.CrossRefPubMedPubMedCentralGoogle Scholar
  72. Young, M. E., & Fristad, M. A. (2007). Evidence based treatments for bipolar disorder in children and adolescents. Journal of Contemporary Psychotherapy, 37, 157–164.CrossRefGoogle Scholar
  73. Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20, 649–655.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Leann Smith DaWalt
    • 1
  • Jan S. Greenberg
    • 1
  • Marsha R. Mailick
    • 1
  1. 1.Waisman CenterUniversity of Wisconsin-MadisonMadisonUSA

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