Communicating with children with autism spectrum disorder and their families: a practical introduction

Impaired communication and social interaction are symptoms central to autism spectrum disorder (ASD). Children or young people with ASD have varied intellectual ability, learning difficulty, and needs. For caregivers and health care professionals providing care to children with ASD, many challenges are encountered in everyday conversations. Enhanced knowledge of the spectrum and understanding the child or young person with ASD may improve conversation and social experiences. This article provides a practical introduction for health professionals seeking to improve their interaction with young people with ASD. Fictional vignettes, in which children with ASD are seeking care and support are presented, followed by discussion on communicating with children with ASD.     

Autism Spectrum Disorder: The Impact of Stressful and Traumatic Life Events and Implications for Clinical Practice

Research findings suggest that behavioral interventions are effective in improving educational outcomes and fostering skill development in people with autism spectrum disorder (ASD). However, high rates of comorbidity between ASD and other psychological disorders, including depression and anxiety, indicate that standard behavioral approaches are not adequately addressing issues related to mental health in this population. Research emerging since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is advancing our understanding of the nature of childhood stress and trauma in people with ASD and its subsequent impact on mental health and wellbeing. Mounting evidence for stress and trauma as a risk factor for comorbidity and the worsening of core ASD symptoms may intimate a shift in the way clinical social workers and other clinical practitioners conceptualize and approach work with this population to include trauma-focused assessment strategies and clinical interventions. Future directions for research to better understand the nature of childhood stress and trauma and improve mental health in this population are also discussed.     

An exploratory investigation of social workers’ knowledge and attitudes about autism

ABSTRACT

Although researchers continue to generate knowledge concerning autism, few have investigated social workers’ understanding about this condition. In this exploratory study, we surveyed licensed social workers (n = 793) to examine social workers’ understanding and attitudes about autism. Overall, we found social workers have accurate knowledge and hold strengths-based attitudes about autism and persons on the autism spectrum. Factors significantly associated with accurate autism knowledge were having special training in autism, having present clinical involvement with autism, and knowing someone on the autism spectrum. Implications for social work practice, education and training, and future research, are discussed.     

Effects of autism spectrum disorder on parental employment in the United States: evidence from the National Health Interview Survey

Using results of the US National Health Interview Survey (US-NHIS) for the years 1998–2013 we investigated the impact of having a child with autism spectrum disorder (ASD) on parents’ work behavior. After controlling for numerous background characteristics, we found that having a child with ASD lowered the number of hours of market work per week and the number of months of market work in the previous year for mothers. For fathers, having a child with ASD also reduced the number of hours of market work per week and the number of months of market work in the previous year. However, the magnitude of the effects were smaller for fathers than for mothers, and more sensitive depending on whether the estimates were derived from a linear regression model or propensity score models. Some evidence was also found that the impact of having a child with ASD on parents’ market work depended on whether or not the child with ASD also had an intellectual disability, the parent’s education level, immigration status, and parent race/ethnicity.     

An Empowerment Approach in Teaching a Class about Autism for Social Work Students

Social workers are being asked to respond to the rapidly increasing number of individuals and families affected by Autism Spectrum Disorders (ASD). However, the curricula in schools of social work have limited content on disabilities. This article describes a course which prepares social work students for work with individuals with ASD through an empowerment approach in an ever-changing socio-cultural and political environment. This approach changes the focus of disabilities from a narrow perspective on particular services and rehabilitation to a broader concern with human rights, social inclusion and quality of life. The article describes the development of the course in collaboration with a university disability program, the areas of emphasis for the course (family focused, interdisciplinary, lifespan) and the multiple modes of delivery. The implications of teaching the course as an elective or as integrating it further into the curriculum are discussed.     

Serving the needs of immigrant families of children with autism

The growing influx of immigrant families into the USA necessitates an understanding of how these families manage mental health disorders. Few studies have documented the ways in which autism spectrum disorders (ASD) are understood across different immigrant groups. This lack of knowledge creates barriers for practitioners who are encountering immigrant families in their practice. The present paper provides a conceptual framework of how cultural values and beliefs shape the way diagnosis, etiology and treatment of ASD is perceived by both immigrant families and western practitioners and how differences in perspectives may create obstacles in treatment planning. A review of the literature describing practical and cultural barriers to mental health access and research among immigrant populations is also presented. Finally, recommendations are offered to practitioners, families and individuals with ASD to aid in increasing understanding and collaboration among these populations when designing and implementing treatment interventions.     

“At a moment,you could collapse”: Raising children with autism in the West Bank

The current qualitative study examined knowledge, attitudes, burdens and coping strategies related to caring for a child with an autism spectrum disorder (ASD) in the West Bank. Based on a sample of 24 Palestinian parents, the study found that parents struggled with financial stressors, child behavioral and medical challenges, and depression. Few parents were aware of ASDs prior to their children's diagnoses. Furthermore, discrimination and stigma from extended family members and the larger community intensified parents' feelings of shame and experiences of social isolation. While some parents coped by withdrawing from the community or denying the diagnosis, others aimed to increase social interactions and access information. Religious coping was found to be partly adaptive for some of the participants. The study underscored the vital need to increase community awareness of ASDs and increase social support for parents in the West Bank.     

Quirky kids: fathers’ stories of embracing diversity and dismantling expectations for normative play with their children with autism spectrum disorder

Abstract

Anchored in critical disability studies, we used a narrative methodology to study fathers’ stories of play interactions with their children with autism spectrum disorder (ASD). Three narratives convey how father–child interactions unfold and how patterns of interaction respond to, redefine and resist societal norms. Narratives of action demonstrate fathers’ responses to societal norms, while narratives of adjustment depict how fathers have redefined expectations of their children in the context of play. Narratives of acceptance demonstrate fathers’ attunement to, and acceptance of, their children’s preferred play interests and a resistance to play norms. We argue that fathers’ stories represent a step towards emancipating play for children with ASD in that fathers’ appreciation of their children’s quirky play accentuates the relational and social capabilities of children, thus countering deficit interpretations of the abilities of children with autism more broadly.     

Mediating self‐hood: exploring the construction and maintenance of identity by mothers of children labeled with autism spectrum disorder

Based on the findings of a qualitative study, this article describes how mothers of children labeled with autism spectrum disorder (ASD) mediate for their children in interactions with those who are unfamiliar with ASD. Data were collected through in‐depth interviews and participant observations. Findings indicate that mothers mediate for their children because they perceive hostility and lack of accommodation for their children on the part of unfamiliars. As they mediate, mothers attempt to construct and maintain positive identities for their children by explaining and reframing their children’s behaviors to influence the interpretations and responses of unfamiliars. I argue that in these interactions mothers function as proxy selves for their children because they are attempting to influence the perceptions others develop of their children, thus shaping their children’s social identity in the process. The findings of this study demonstrate the active, interpretive role that many mothers of children with autism play as they continually sort and assess information in order to determine what is in the best interests of their children. Further, the findings presented here demonstrate the social nature of self‐hood and identity, that all people involve others in the performance of their self‐hood. In this way and others, people labeled with ASD have much in common with those considered normal.     

Stress and Marital Satisfaction of Parents to Children Diagnosed With Autism

This investigation expanded on previous research conducted among parents caring for a child who is diagnosed with an autism spectrum disorder (ASD). An online web survey was used to collect data from 253 parents caring for a child with a diagnosis of ASD. Both parents reported elevated levels of parental stress associated with caring for the child on the spectrum. Lower levels of marital satisfaction were found in both parents. About 13% of the parents met the diagnostic criteria for major depressive disorder, and about 15% of the parents met the diagnostic criteria for generalized anxiety disorder. Although the majority of the sample was female (94%), significant differences were found between males and females in relation to meeting the diagnostic criteria for major depressive disorder and for generalized anxiety disorder. Higher levels of stress were associated with higher number of generalized anxiety disorder and major depressive disorder symptoms. Findings from this study indicate how vulnerable parents, especially mothers, are in relation to caring to a child diagnosed with ASD.     

Autism spectrum disorder and the science of social work: A grand challenge for social work research

The social work profession has not yet taken a leadership role in addressing the myriad of challenges that individuals on the autism spectrum encounter across the lifespan. In this essay, we argue that social workers are well equipped to engage in research and practice aimed at promoting full and meaningful inclusion in society, as well as social and economic justice, for individuals on the autism spectrum. We highlight short- and long-term goals that provide the social work profession with a framework to engage in research, practice, education, and advocacy aimed at supporting individuals on the autism spectrum and their families.     

Appreciating the world of autism through the lens of video interaction guidance: an exploration of a parent’s perceptions,experiences and emerging narratives on autism

This study seeks to identify understandings and narratives around autism spectrum disorder (ASD) through the application of video interaction guidance (VIG). In adopting a social constructionist approach, the case study used a person-centred model to explore a parent’s experiences and emerging narratives of ASD through the lens of VIG. Findings of the current study suggest that VIG offers an effective tool for in-depth exploration of complex, multi-storied understandings of ASD and the perceived parental role. The intervention was perceived to promote greater awareness of the child’s communication skills, beyond the ‘common’ understandings of ASD, by providing a novel outsider perspective on interactions. The intervention also promoted parental efficacy through recognition of parenting skills in supporting the development of strength-based narratives. VIG was seen to provide a platform for an exploration of existing narratives and the construction of new, preferred realities.     

Reconceptualizing Autism: An Alternative Paradigm for Social Work Practice

Autism is a complex, often misunderstood condition. More than a neurological disorder, autism can also be viewed as a different cognitive style or an alternative way of perceiving and reacting to the world. As more individuals on the autism spectrum are making themselves known, social workers must be open to using new paradigms to meet the needs of this unique population. This article explores how horizontal diversity and neurodiversity can be used to expand the ways social workers conceptualize autism and, consequently, how they work with persons on the autism spectrum and their families.     

Factors That May Influence Parent Treatment Decision Making for Young Children with Autism Spectrum Disorder

ABSTRACT

The number of interventions available for children with autism spectrum disorder (ASD) has expanded greatly in recent years, although relatively little is known about the factors that influence family caregivers as they make treatment decisions for their children. This study involved a statewide survey of parents of young children with ASD to examine the relative weights of the factors that influenced their treatment decisions. Results suggested that caregivers rely on their own intuition for much decision making, although selected professionals are also influential. Implications for professionals working with children with ASD and their families are discussed.     

Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social‐Communicative Difficulties in Infants at High Risk for Autism

When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain subclinical variability in social functioning, 9‐month‐olds, with or without a family history of ASD, viewed emotionally expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye‐tracking. Infants at high risk for ASD with no subsequent clinical diagnosis (HRA‐) and low‐risk controls (LRC) showed similar face scanning and attention to eyes and mouth; attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. As a group, HRA‐ showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18‐month social‐communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9‐month pupil size and 18‐month social‐communicative behavior in HRA‐.The present findings point to heightened autonomic arousal in HRA‐. Further, with greater arousal relating to worse social‐communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.     

Are curriculum decisions based on the evidence? How social work faculty members make choices in curriculum decisions

An important step in translating evidence-based practice and empirically supported interventions into large-scale service improvements is to develop an understanding of practitioners' education and training in these practices. This understanding begins with discovering the factors that influence the decision-making process by social work faculty regarding curriculum content for master's level social work programs. This exploratory study uses quantitative and qualitative survey data to examine the decision-making process used by 42 master's level social work programs to select the models of direct practice taught in their master's level social work programs, and whether evidence-based practice and research evidence influences those decisions. We investigate faculty perceptions of curriculum effectiveness and discuss implications of our findings for social work educators making content and organization decisions regarding master's level social work curriculum.     

Globalization and Social Work Education: Evaluation of Student Learning in a Macro Practice Class

This paper presents a model for infusing content on economic globalization into macro social work practice classes and assesses student learning in a class on social movements and social action. The analysis of student papers and survey data indicates that students increased their understanding of globalization processes and developed an enhanced commitment to addressing global social problems. The infusion approach adopted, however, was limited in the extent to which it helped students feel prepared for internationally oriented careers. Implications for addressing international content in social work education are discussed.     

A behavioral economic theory of cue-induced attention- and task-switching with implications for neurodiversity

I present a stylized, analytical model of cue-induced attention- and task-switching — with a proposed neurobiological interpretation of the model’s features — to organize available empirical evidence on two widely-studied neurodevelopmental conditions: attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Specifically, I use this framework to show how a systematic tendency to underestimate the opportunity costs of attention- and task-switching can give rise to several empirically-observed behavioral patterns in ADHD, and that the opposite tendency can give rise to empirically-observed behavioral patterns in ASD. While drawing on various economic concepts to formally express its predictions, the model offers new and inter-related conceptualizations of ADHD and ASD — as viewed through a behavioral microeconomic lens — that may be useful for understanding some subtypes and symptoms.     

Spirituality in Latino families of children with autism spectrum disorder

Research on Latino parents of children with intellectual and developmental disabilities (IDD) suggests that these parents often use spirituality to conceptualize and to cope with their child’s diagnosis. However, there are no studies that examine religion among Latino parents of children with autism spectrum disorders (ASD). The current study explores how Latino parents of children with ASD incorporate spirituality into their conceptualizations of their child’s disability. In the current study, 34 Latina mothers of children with ASD were interviewed about autism-related services, family characteristics, and cultural beliefs including spiritual beliefs. Thematic analysis of the transcribed interview data relating to spiritual beliefs was conducted for the present study. Most mothers endorsed beliefs that their child with a disability was a message from God. Within this theme, mothers reported beliefs that their child was a blessing from God, a test from God, a sign from God or that the parent was special. Other parents believed that having a child with a disability was not an act of God, but related to biomedical factors, and another group of parents was unsure about the spiritual meaning of their child with a disability. Lastly, some mothers reported that their larger cultural group believed that having a child with a disability was a punishment or a negative sign from God but they markedly rejected that conception. These findings suggest that providers working with Latino families of children with ASD should acknowledge the importance of spirituality for these families.