The Adult Transition Challenge of Autistic Individuals and the Way Ahead

Autism is a life-long neurodevelopmental condition characterized by difficulties in social communication, restricted and repetitive behaviors, and sensory processing issues. In India, there is a huge question mark regarding autistic individuals after they transition into adulthood, more specifically in housing and work options. In this chapter, beginning from the general considerations for upbringing of an autistic individual, attention is given to the need for future planning of autistic adults, more specifically in residential options. Some of the major residential centres are described followed by projections on establishing residential facilities. Following this, examples of life skills training, employment, and inclusion initiatives taking place in India are mentioned. Finally, research directions and other expectations aimed at increasing support for parents and siblings and also improving the lives of individuals on spectrum are discussed.

COHERENCE OF PUBLIC POLICIES IN POLAND IN THE PERSPECTIVE OF THE PROCESS ON REACHING COMPLETED ADULTHOOD

The issue of transition into adulthood, treated as a complex, multi-dimensional and multi-stage social process, is not explicitly an object of interest to public policies, including social policy. The context of the life course policy mentioned in the analyzes is justified by the institutionalization of tasks related to functioning in society typical of completed adulthood: completing education, taking up employment, setting up your own household and family. The so-called delayed transition into adulthood means an increasingly later implementation of these tasks. The barriers to reaching completed adulthood discussed in the article mean that this process becomes a social problem that should be prevented by public activities. The article synthetically summarizes the results of the research “Public policies for full adulthood in Poland” (National Science Center No. 2014/15/B/HS5/03284). The aim of the considerations is to indicate the level of coherence and coordination in the creation and implementation of political and institutional instruments that would support young adult Poles in the process of reaching full adulthood in the above-mentioned dimensions. The conclusions from the research prove the need to separate the transition to adulthood regime in Polish social policy (public policies).

“That’s the whole thing about vaping, it’s custom tasty goodness”: a meta-ethnography of young adults’ perceptions and experiences of e-cigarette use

Background E-cigarettes are increasing in popularity, particularly among young adults. With public health organisations contesting the possible benefits of e-cigarettes, research is required to explore young adults’ use of e-cigarettes as a smoking cessation and recreational tool. This study examined existing qualitative data to understand how transition into adulthood and issues of identity affect young adults’ perceptions and experiences of e-cigarette use. Methods A meta-ethnography was conducted to examine how young adults perceive and use e-cigarettes. Data were synthesised using Noblit and Hare’s (1988) meta-ethnographic approach. Bronfenbrenner’s socio-ecological model (1979) was used to conceptualise themes and map findings. Results A total of 34 studies were included in the review. Young adults viewed e-cigarettes as a safer alternative to traditional cigarette smoking and perceived e-cigarettes as an effective cessation tool. Users were able to personalise their e-cigarette use due to the variety of flavours and devices available. E-cigarettes were found to be a sociable tool as they allowed users to align themselves with their peers who used e-cigarettes and facilitated use within smoke-free environments. Young adults demonstrated high levels of self-efficacy with regards to obtaining e-cigarettes from various retailers and were active consumers of e-cigarette marketing. Conclusion This meta-ethnography provides an in-depth insight into social norms around e-cigarette use and beliefs that e-cigarettes could be a safer alternative to traditional cigarettes. As young adults increasingly engage with e-cigarettes, there is a need for informed policy decisions regarding appropriate use. Engagement with e-cigarettes is often reflected within social media, so this medium could be a key platform for creating tailored interventions which inform young adults about the appropriate use of these products.

Dialectical behaviour therapy ‘Skills for Living’ for young people leaving care: A qualitative exploration of participants’ experiences

It is acknowledged that care leavers experience an accelerated transition into adulthood, despite often having complex psychosocial needs with limited support networks. The ‘Skills for Living’ programme was designed to improve the psychological wellbeing of care leavers and offers an adapted Dialectical Behaviour Therapy skills group as its primary intervention. This paper provides a qualitative evaluation of the programme. Semi-structured interviews were undertaken with 10 participants, and the data were analysed using thematic analysis ( Braun & Clarke, 2006 ). Four key themes emerged: ‘Initial Apprehension and Reluctance to Participate’, ‘Connection, Understanding and Validation’, ‘Confidence with Social Skills’, and ‘Emotional Acceptance and Self-Soothing’. Clinical implications and recommendations are discussed.

Prevention and early intervention of depression in young people: an integrated narrative review of affective awareness and Ecological Momentary Assessment

Depression has a devastating impact on young people around the world. This impact is pervasive and long-long lasting, still causing havoc as young people transition into adulthood. Prevention and timely early intervention efforts are necessary to lessen the disease burden of depression in young people. There is some evidence for the effectiveness of existing prevention and early intervention programs when delivered early. However, there is no consensus on what the active ingredients of these programs are. Identifying these ingredients is important because focusing on those that have maximal benefit will help to minimise the costs and resourcing of (already intensive) therapeutic approaches. We explored whether, and in what circumstances, affective awareness (i.e., knowing how one feels) is a candidate for protecting against and decreasing vulnerability to depression in young people. We specifically looked at how Ecological Momentary Assessment methods (EMA) were used to measure and/or increase affective awareness. We integrated three streams of data, including narrative review findings, perspectives from young people and psychologists, and publicly available information online (e.g., discussion forums). Across data sources, we found converging evidence that affective awareness is important in the prevention and early intervention of depression although there were considerable gaps in knowledge. More work needs to be done with young people and their health care teams to build affective awareness in the right way, at the right time, with individual differences in mind. The identification of how EMA can be best incorporated into young people’s lives to facilitate these outcomes is also needed.

Syndromic craniosynostosis

Syndromic craniosynostoses result from a complex interaction between genetic factors, molecular and cellular events, as well as mechanical and deformational forces. They can all have secondary effects on growth and development. Approximately 180 craniofacial syndromes have been identified and it is thought that about 15% of all craniosynostoses are syndromic. They are due to genetic mutations and among the most common are mutations in the fibroblast growth factor receptor 2 gene (FGFR2). Multidisciplinary care for craniofacial patients is considered the optimal model of care and is based on the concept of management during childhood, the transition into adulthood, and finally support and treatment throughout adulthood.

Sustainability of Adaptive Life Skills Learned: What Happens After Groups End?

Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. This project brings to our attention OT's important role in meeting the ever-changing service needs of individuals with autism spectrum disorder (ASD) as they transition into adulthood. Comparative analysis of pretest, posttest, and maintenance assessment scores offers insight into changes and begins an important discussion of how we can improve and sustain adaptive life skills in adolescents with ASD for the long-term goal of changing their trajectory for greater independence. Primary Author and Speaker: Elizabeth Grant Additional Authors and Speakers: Shirley O'Brien, Geela Spira Contributing Authors: Scott Tomchek

Healthcare providers’ discussions regarding transportation and driving with autistic and non-autistic patients: A brief report

Objective: To characterize healthcare and behavioral service providers’ transportation-related discussions with their autistic and non-autistic patients.Method: Seventy-eight providers completed a cross-sectional survey assessing their transportation discussions with patients. We used Mann-Whitney U tests and chi-square tests to compare differences in provider reports by patient diagnosis.Results: Compared with one in two providers who reported they discuss transportation with non-autistic patients, only one in five have these conversations with their autistic patients. Few (8%) providers felt prepared to assess driving readiness in autistic patients, yet only a quarter refer patients elsewhere.Conclusion: There is a critical need to develop resources for use in medical settings to effectively support autistic adolescents’ independence and mobility as they transition into adulthood.

Perceptions on adolescents’ friendly health services concepts and the use of health services by adolescents in Kavango region, Namibia

Background: The objective of this study was to determine the perceptions on adolescents’ friendly health services concepts and the use of health services by adolescents in Kavango region, Namibia.Methods: A cross-sectional analytical study was conducted using mixed methods - quantitative and qualitative approaches among 350 school learners and 150 school drop-out adolescents. In total a sample of 540 was utilized. The stratified random sampling techniques were used in the selections of the circuit and the schools. Structured questionnaires were used in face-to-face interviews, and in depth interviews were conducted among the key informants (25 teachers) and as well with 15 school learners.Results: Illustrated the following: there was a statistically highly significant association between adequate confidentiality, last visit at the health facility and both sexually transmitted infections and visited health facility (p=0.004 respectively). A statistically significant association was found between all visits to health facilities, pamphlets and talks on contraceptives; visit to health facilities, comfortable and contraceptives talks (p=0.001 respectively). Additionally, there was a statistically significant association respectively between both contraceptives used and number of times services sought and between services, pamphlets and contraceptives with a (p 0.010<0.05).Conclusions: The youth need health services that are sensitive to their unique stage of biological, cognitive, and psychosocial transition into adulthood. Health services that are more accessible and acceptable to adolescents and made more youth-friendly.