Family Strengthening Therapy for ASD families in the Child Welfare System

Family Strengthening Therapy for ASD families in the Child Welfare System
Kristina Nofsinger
Southern New Hampshire University

     Experiencing trauma at any age or stage in development can interrupt the development of critical adaptive emotional skills. This is especially true for children entering into the child welfare system. During this time, they will experience different family life, different culture, different routines, and a different school. Current research has consistently yielded important results with regards to attachment and trauma such as early intervention is key to treating children who have suffered trauma (Cook-Cottone, 2004; Fenning, Baker, & Juvonen, 2011; Holmes Levy, Smith, Pine, & Neese, 2015; Leenarts Diehle, Doreleijers, Jansma, & Lindauer, 2012; Weiner, Schneider, & Lyons, 2009) and disruption in attachment follows children throughout their life affecting all other areas in their life (Cook-Cottone, 2004; Jaudes,Weil, Prior, Sharp, Holzberg, & McClelland, 2016; Holmes et al., 2015; Leenarts et al., 2013; Weiner et al., 2009). However, little research exists regarding this already vulnerable subpopulation and the outcomes for children with cognitive disabilities who are placed into care.
     What causes a person to think and act the way that they do is more than just synaptic processes (Myers & Twenge, 2017). In any given situation a person may be heavily influenced by the culture in which they were raised, the accumulated social knowledge they have obtained through years of experience, or simply by their gender (Fenning, Baker, & Juvonen, 2011; Matthews, Ly, & Goldberg, 2014; Myers & Twenge, 2017). This give and take within a person’s ecosystem provides a foundation for communication and understanding the world (Fenning et al., 2011; Helt & Fein, 2015; Myers & Twenge, 2017) Therefore, the proper development and acquisition of these skills is crucial (Jaudes et al., 2016; Fenning et al., 2011; Hastings & Beck, 2004; Helt & Fein, 2015).
Developing these skills not only makes communication possible, but provides a way for individuals to belong as part of a group. Helt and Fein (2015) found that emotions were so socially influential that just hearing others laugh could increase positive mood. Matthews et al. (2014) found that ASD students who are academically prepared for college often do not stay in school because they do not feel they belong socially. As children develop along a continuum, positive social relationships remain a vital part of their well-being (Fenning et al., 2011; Hastings & Beck, 2004; Jaudes et al., 2016; Meyers & Twenge, 2017).
      Previous studies have mainly focused on peer relationships among elementary age children when testing social interactions among those with cognitive disabilities (Matthews et al., 2014). Matthews et al. (2014) recognized the need to test the positive results against the young adult crowd entering post-secondary school where very little research existed. Helt and Fein (2016) found that prior research of ASD only tested either facial feedback or social input against typically developing children, but never both factors together. In the same mindset, Jaudes et al. (2016) recognized that children within the child welfare system were consistently measured against children outside of the welfare system. This prior research was unable to adequately measure the deficits that disruptions in parent-child interactions might have caused (Fennings et al., 2011; Jaudes et al., 2016). Theories and research on parent-child relationships have been around since Vygotsky, however, there is still a lack of research with regards to developmental delays and the effects on socio-emotional development in middle childhood (Fennings et al., 2011). This lack of research also carries over into the bidirectional relationship of parents of children with cognitive disabilities and how stress effects treatment outcomes. Many studies have shown that parents report higher stress levels when they care for children with disabilities, stressed parents parent differently, and that intense stress lowers the ability for parents to learn new skills (Hastings & Beck, 2014). As so, treating a child with special needs requires more than just the cognitive treatment. Hastings and Beck (2004) recognized the critical role that caregivers and family play in the life of children with disabilities. In their study, they suggested that the stress of the family would affect the child and thus, the outcome of any treatment directly.
Taking into account all former findings, the value of social influence cannot be understated. Research has shown that social input is a significant part of development for both a typically developing child and a child with disabilities (Fenning et al., 2011; Helt & Fein, 2016; Jaudes et al., 2016; Matthews et al., 2014; Myers & Twenge, 2017). Disruption of social development can have effects that last a lifespan, however, positive results can also be achieved through awareness, ecosystem style treatment, and early intervention (Fenning et al., 2011; Hastings & Beck, 2004; Helt & Fein, 2016; Jaudes et al., 2016; Matthews et al., 2014).

Many researchers have tested the effects of parent-child relationships through the lifespan of a child and, therefore, we know that disruptions in these relationships negatively impact everything from future relationships to academics (Cook-Cottone, 2004; Fenning et al., 2011; Flemons et al., 2011; Holmes et al., 2015; Leenarts et al., 2012; Myers & Twenge, 2016; Weiner et al., 2009). Previous studies have looked specifically at those with developmental delays and found that factors in a child’s ecosystem can have a negative impact on their life outcome (Fenning et al., 2011; Hastings & Beck, 2004; Helt & Fein, 2016; Jaudes et al., 2016; Matthews et al., 2015). However, none of the relevant studies have tested the parent-child relationships against children who routinely are exposed to trauma and/or neglect such as in the foster care system. If each child with ASD and their family who entered into the foster care system were to receive family strengthening therapy (FST) based on the ecosystems theory, would the CANS score of the child be comparable to that of a non-foster ASD peer? This is an area where I would love to conduct future research.
References
Cook-Cottone, C. (2004). Childhood Posttraumatic Stress Disorder: Diagnosis, Treatment, and School Reintegration. School Psychology Review, 33(1), 127-139.
Fenning, R. M., Baker, B. L., & Juvonen, J. (2011). Emotion discourse, social cognition, and social skills in children with and without developmental delays. Child Development82(2), 717-731. doi:10.1111/j.1467-8624.2010.01569.x
Flemons, D., Liscio, M., Gordon, A. B., Hibel, J., Gutierrez-Hersh, A., & Rebholz, C. L. (2010). Fostering solutions: Bringing brief-therapy principles and practices to the child welfare system. Journal of Marital and Family Therapy36(1), 80-95. doi:10.1111/j.1752-0606.2009.00181.x
Hastings, R. P., & Beck, A. (2004). Practitioner review: Stress intervention for parents of children with intellectual disabilities. Journal of Child Psychology and Psychiatry45(8), 1338-1349. doi:10.1111/j.1469-7610.2004.00357.x
Helt, M. S., & Fein, D. A. (2015). Facial feedback and social input: Effects on laughter and enjoyment in children with autism spectrum disorders. Journal of Autism and Developmental Disorders46(1), 83-94. doi:10.1007/s10803-015-2545-z
Holmes, C., Levy, M., Smith, A., Pinne, S., & Neese, P. (2014). A model for creating a supportive trauma-informed culture for children in preschool settings. Journal of Child and Family Studies24(6), 1650-1659. doi:10.1007/s10826-014-9968-6
Jaudes, P. K., Weil, L. E., Prior, J. M., Sharp, D. P., Holzberg, M., & McClelland, G. M. (2016). Wellbeing of children and adolescents with special health care needs in the child welfare system. Children and Youth Services Review70, 276-283. doi:10.1016/j.childyouth.2016.09.024
Leenarts, L. E., Diehle, J., Doreleijers, T. A., Jansma, E. P., & Lindauer, R. J. (2012). Evidence-based treatments for children with trauma-related psychopathology as a result of childhood maltreatment: a systematic review. European Child & Adolescent Psychiatry22(5), 269-283. doi:10.1007/s00787-012-0367-5
Matthews, N. L., Ly, A. R., & Goldberg, W. A. (2014). College students’ perceptions of peers with autism spectrum disorder. Journal of Autism and Developmental Disorders45(1), 90-99. doi:10.1007/s10803-014-2195-6
Myers, D. G., & Twenge, J. M. (2017). Social psychology (12th ed.). New York, NY: McGraw-Hill Education.

Weiner, D. A., Schneider, A., & Lyons, J. S. (2009). Evidence-based treatments for trauma among culturally diverse foster care youth: Treatment retention and outcomes. Children and Youth Services Review31(11), 1199-1205. doi:10.1016/j.childyouth.2009.08.013
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