June 25th, 2010 Posted in Communication Skills, Research, Social Skills | No Comments »
Timothy D. Perry, M.A., Betty M. Rupp, B.S., Lauren M. Turner Brown, Ph.D. & David L. Penn, Ph.D
Introduction
Interest in developing interventions to address the unique needs of adolescents with high-functioning autism (HFA) has increased in recent years (Tantum, 2003; White et. al., 2009). Despite this interest, however, the treatment needs of this population remain poorly understood (Tse, et. al., 2007). From a developmental perspective, impairment and distress may increase during adolescence as the social milieu broadens and teens with HFA become more aware of their social disabilities (Klin & Volkmar, 2000; Sukhodolsky, et. al., 2008).
The purpose of the present qualitative study was to inform the development of a psychosocial group intervention to address social cognitive difficulties experienced by teens with HFA. The intervention was conceived as a modification of a group treatment for adults with HFA (Turner Brown, et. al., 2007).
More broadly, this research will add to the existing empirical data regarding the needs of adolescents with HFA and issues to consider when designing treatments for this population.
Method & Data Analysis
Participants:
A total of 17 individuals took part in focus groups divided into three sessions. Group 1(N=6) was composed of adolescents with HFA (ages 16-20). All of these teens were male, Diagnosis of FSIQ were confirmed by record. Group 2 (N+7) was composed of parents and family members of adolescents with HFA. Five of these individuals identified as mothers of teens with HFA. 1 identified as the father of a teen with HFA, and 1 identified as a brother of a teen with HFA. All of these group members served as primary care provider for their family member with autism. Group 3 (N+4) was composed of professional service providers working with adolescents with HFA. These professionals included 1 therapist, 2 teacher, and 1 social group leader all of whom had at least 5 years of experience working with this population. All participants were recruited through community fliers with the assistance of local autism support service agencies. All participants were compensated for their time.
Procedure:
Each group member met for 1 hour and 15 minutes during which they were asked a series of 17 questions intended to elicit their points of view on important treatment topics, treatment needs and considerations when implementing treatments with this population. Though all groups were asked identical questions, the adolescent group also received written versions of the questions, the adolescent group also received written versions of the questions and were asked to use this list to follow along with the facilitators. Sessions were facilitated by two members of the research team involved in treatment development. Sessions were transcribed by trained research assistants and were verified by grop participants and group facilitators.
Data Analysis:
Following verification, group transcripts were individually reviewed for emerging themes in an iterative process. After preliminary review, the transcripts were coded and dominant themes were complied. Following this process, areas of concordance and divergence were considered along with their implications for treatment development.
Conclusions:
Several areas of agreement emerged from the data. For example, all groups agreed on the central role of parents in any intervention for adolescents, but disagreed as to how this inclusion might be implemented. The parent/family group tended to support partial inclusion of parents in the therapy group. Adolescents and professionals viewed parents participation as equally instrumental, but thought it should occur outside of the group, The groups also endorsed increasing social understanding as important, but adolescents and parents tended to focus on educating peers and teachers about autism to a greater extent than professionals. Professionals focused more on improving social understanding among adolescents with autism themselves.
All groups made mention of bullying as a concern of this population. The issue was especially salient, however to the adolescent group who spent a significant portion of their focus group session discussing their experiences of bullying and possible solutions. Though this concern is clearly not limited to adolescents with autism, this group is likely especially susceptible to bullying due to their difficulty recognizing behavior targeted by their peers and adjusting it. Similarly, findings that parents/family members found restricted interest to be a troubling issue for this group and professionals endorsed problems of social motivation make sense given the contexts in which they encounter adolescents with HFA and the frustrations associated with those settings. Interestingly, parents/family members and professionals cited dating as an important issue for this group whereas the adolescents themselves did not. This result is likely reflective of the manner in which these groups reference typically development in their concerns to a greater extent than individuals with autism.
Important to the success of any intervention is achieving buy in from the consumers and their interested parties. Incorporating these concerns in designing interventions, then, adds to likelihood of efficacious findings.