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青少年至成年期自闭症和其他发育障碍患者家庭支持的纵向混合方法特征描述。

A Longitudinal Mixed-Methods Characterization of Family Support from Adolescence to Young Adulthood in Autism and Other Developmental Disabilities.

机构信息

Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.

出版信息

J Autism Dev Disord. 2024 Sep;54(9):3225-3241. doi: 10.1007/s10803-023-06070-y. Epub 2023 Sep 5.

Abstract

Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.

摘要

尽管在有自闭症或其他发育障碍(DD)青年的家庭中,照顾责任和支持需求会随着生命历程而持续存在并演变,但对于他们成年后的支持情况知之甚少。因此,本研究采用混合方法,考察了自闭症或 DD 青年过渡到成年期期间,正式和非正式家庭支持的变化和稳定性。126 名自闭症或 DD 青年的照顾者在五个时间点(从青春期[16 岁]到青年期[22 岁])完成了家庭支持量表的修改版,包括开放式问题。照顾者报告说,家庭成员提供的非正式支持是最常用、最有帮助和最有价值的支持来源,具有相对稳定性。相比之下,随着时间的推移,报告的正式支持(如专业人士、学校)的有用性、使用和价值下降。定性内容分析揭示了高度有价值的支持的特征,包括支持类型(如工具性或情感性)和支持来源的特征(如他们的理解)。随着时间的推移,对情感支持的重视程度超过了工具性支持,尤其是对于能力较弱的成年人的照顾者。伙伴关系和可靠性是支持来源的高度有价值的特征。这些发现符合社会护航观点,可能反映了自闭症患者或 DD 患者及其家庭经历的“服务悬崖”。随着时间的推移,社交网络缩小,成年后正式服务的可用性降低,剩余的支持来源,特别是来自家庭成员的支持,变得越来越重要。

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