Safe Dates for Teens with High Functioning-Autism Spectrum Disorder

Safe and Healthy Dating Online Class for Teenagers with Autism Spectrum Disorder

Overview of the Study

The overarching goal of this study is to adapt the evidence-based Families for Safe Dates curriculum for adolescents with HF-AS. While Families for Safe Dates was designed to be a self-paced curriculum using a series of pamphlets (10 sessions), based on previous work adapting interventions for children with HF-AS, we propose to adapt it to be a 5-session, online, once a week, interactive educational group.

Our specific objectives are to:

(1) explore the perspectives of adolescents with HF-AS and their parents about what they would want to learn as part of a healthy dating relationships curriculum

(2) session by session, adapt the Safe Dates for Families dating violence curriculum in partnership with 6-8 HF-AS youth and their parents; and

(3) pilot-test the curriculum with a group of 6-8 youth participants and their parents to assess its acceptability and feasibility.

Background

Dating and sexual violence is a substantial problem for people with HF-AS.

Approximately 10% of all U.S. high school-attending boys and 20% of girls report experiencing physical and/or sexual dating violence each year.

One study found that relative to adults without ASD, adults with ASD had 2.4 times the odds of having experienced sexual coercion or rape.3

Youth with HF-AS may be at elevated risk for dating violence victimization in particular for two key reasons. First, youth with ASD are more likely than their peers to be exposed to family violence, a known risk factor for dating violence. Second, healthy romantic relationships and sexuality are an important part of developmental growth, so the fact that a key feature of HF-AS is difficulty with peer interaction and appraisal of relationships is problematic.

Few HF-AS-specific training programs exist to support the development of healthy dating and sexual behavior for adolescents with HF-AS. There are several evidence-based curricula to address healthy dating relationships with the general population, including school-based programs like Safe Dates, the Fourth R, and Shifting Boundaries.8-10 However, the effectiveness of these programs with HF-AS youth has not been researched.

Adaptation Phase

Recruitment and Participants

Following the Community-Based Participatory Research (CBPR) methodology for the adaptation phase, we will recruit a group of youth with HF-AS, ages 12-16, who receive medical care at one of three Boston-based hospitals (Boston Medical Center, Children’s Hospital Boston, and Mass General Hospital for Children). Along with school-based special education specialists with ASD experience, autism resource specialists, and ASD community advocates (all from the greater Boston area) who will aid in determining the appropriate population for the initial pilot testing.

Eligible adolescents will be those with a diagnosis of HF-AS, are in the appropriate age group, speak English, are willing to commit to two hours per month for 3 months to this project, and have one or more parents who are also willing to participate in these twice-monthly meetings.

Data Collection

We will hold a series of key informant interviews at the outset in order to gather information about what parents and youth would want taught in a healthy relationships class and probe to get details about ideal delivery format, length of activities, content and guidance about successful social skills coaching they have enjoyed previously. In addition, we will interview school-based special education specialists, autism resource specialists, and ASD community advocates to elicit their ideas.

Using Aarons’ Scaling-out framework for adaptation as a guide,12 we will go session-by-session through the 10 sessions of Families for Safe Dates on twice-a-month online “virtual hangouts” that will last 1 hour each time (covering 2 sessions per hangout). We have used virtual hangouts successfully for prior projects.

Pilot Test Phase

We will recruit a new cohort of youth and parents for a pilot-test of the adapted curriculum. Youth and parents will participate in pre- and post-curriculum evaluation data collection sessions so that we can subsequently refine and improve the adapted curriculum. Youth and parents will receive a $20 Amazon.com gift card for each session (both adaptation and pilot-test cohorts).

Data will be stored in a state-of-the-art REDCap database hosted by Boston University. Data cleaning, coding of qualitative data, and data analyses will be conducted by the research team members who have collectively published approximately 200 peer-reviewed papers using both qualitative and quantitative methods.

Collaborators

Megan Bair-Merritt, MD, MSCE

Associate Professor of Medicine, Department of Pediatrics, BUSM

Director, BMC Pediatrics Center for the Urban Child and Healthy Family

Expertise:  Dating violence and parenting intervention development and evaluation

Sarabeth Broder-Fingert, MD

Assistant Professor of Medicine, BUSM

Expertise: Development and evaluation of interventions to meet the needs of youth and adults with autism

Emily F. Rothman, ScD

Associate Professor, Community Health Sciences Department, Boston University SPH

Expertise: Dating violence intervention development and evaluation

References

  1. Presmanes Hill A, Zuckerman K, Fombonne E. (2015). Epidemiology of Autism Spectrum Disorders. In: Robinson-Agramonte MdlA, ed. Translational Approaches to Autism Spectrum Disorder. Cham: Springer International Publishing:13-38.
  2. van Schalkwyk GI, Volkmar FR. (2017). Autism Spectrum Disorders: Challenges and Opportunities for Transition to Adulthood. Child and adolescent psychiatric clinics of North America. 26(2):329-339.
  3. Brown-Lavoie SM, Viecili MA, Weiss JA. (2014). Sexual knowledge and victimization in adults with autism spectrum disorders. Journal of autism and developmental disorders. 44(9):2185-2196.
  4. Mandell DS, Walrath CM, Manteuffel B, Sgro G, Pinto-Martin J. (2005). Characteristics of children with autistic spectrum disorders served in comprehensive community-based mental health settings. Journal of autism and developmental disorders. 35(3):313-321.
  5. Dube SR, Anda RF, Felitti VJ, Edwards VJ, Croft JB. (2002). Adverse childhood experiences and personal alcohol abuse as an adult. Addictive Behaviors. 27(5):713-725.
  6. Allely CS. (2015). Experiences of prison inmates with autism spectrum disorders and the knowledge and understanding of the spectrum amongst prison staff: a review. Journal of Intellectual Disabilities and Offending Behaviour. 6(2):55-67.
  7. Barnett JP. (2017). Intersectional harassment and deviant embodiment among Autistic adults: (dis)ability, gender and sexuality. Cult. Health Sex. 19(11):1210-1224.
  8. Foshee VA, Bauman KE, Ennett ST, Suchindran C, Benefield T, Linder GF. (2005). Assessing the Effects of the Dating Violence Prevention Program “Safe Dates” Using Random Coefficient Regression Modeling. Prev. Sci. 6(3):245.
  9. Miller E, Tancredi DJ, McCauley HL, Decker MR, Virata MCD, Anderson HA, Stetkevich N, Browne EW, Moideen F, Silverman JG. (2012). “Coaching Boys into Men”: A Cluster-Randomized Controlled Trial of a Dating Violence Prevention Program. J. Adolesc. Health. 51(5):431-438.
  10. Taylor BG, Stein ND, Mumford EA, Woods D. (2013). Shifting Boundaries: An Experimental Evaluation of a Dating Violence Prevention Program in Middle Schools. Prev. Sci. 14(1):64-76.
  11. Visser K, Greaves-Lord K, Tick NT, Verhulst FC, Maras A, van der Vegt EJM. (2017). A randomized controlled trial to examine the effects of the Tackling Teenage psychosexual training program for adolescents with autism spectrum disorder. J. Child Psychol. Psychiatry. 58(7):840-850.
  12. Aarons GA, Sklar M, Mustanski B, Benbow N, Brown CH. (2017). “Scaling-out” evidence-based interventions to new populations or new health care delivery systems. Implementation Science. 12(1):111.

Share this: