This week Bower Place received formal notification that the practice has been accepted as an NDIS registered provider. In the Complex Needs Clinic practitioners work with whole families, offering specialist positive behaviour support and intervention in the context of family therapy. The environment in which the child lives plays a crucial role in their social, emotional and academic development, so a prime focus of work is on interrupting negative cycles which undermine optimal growth for all family members, including the identified client.
Raising a child on the autism spectrum can be challenging and require extensive resources, including speech and occupational therapy, social skills development and attendance at special needs units or schools. These effective treatments address specific challenges that individuals on the spectrum face, and work to bridge developmental gaps in the early intervention approaches. In addition children and adolescents on the spectrum also require a calm and consistent environment where their needs are supported by caregivers.
Raising a child on the spectrum presents significant challenges for those that care for them, such as higher levels of stress, distress, fatigue, anxiety, depression symptoms (Cadman 2012; Firth 2013; Giallo 2013; Hoefman 2014) as well as experience concerns about their parental efficacy and coping (Karst 2012). The stressors include meeting the child’s individual needs, accessing resources, finding time to attend therapeutic appointments, while also dealing with the personal losses of unfulfilled dreams and ambitions for the child and family. Siblings may be faced with the embarrassment of public attention to their autistic brother or sister, jealousy for the loss of parental attention and frustrations at increased levels of responsibility in helping raise an autistic child (Green 2009), although findings are less consistent in this area (Meirsschaut 2011).
All this can manifest as stress, anxiety and depression in families, compromising the nurturing environment these children require. Fractured family environments may result in children acting out and limit their ability to progress. This sets up a negative cycle, where increased acting out and challenging behaviours create additional strain and fractures in the family, impacting further on the child and producing even more difficult behaviour. Such negative cycles develop over years and become entrenched and manifest in the patterns of interactions in families, resulting in ever increasing strain on the relationships and ultimately splitting families apart.
These patterns are best addressed by family therapy, an approach that engages the whole family and other systems involved in the child’s life to interrupt the cycle and work with all members to develop more positive and cohesive environments at home. Interventions can address broad factors and patterns that may contribute to challenging behaviours and support the identification of strategies to promote cohesion within system; create open dialogue between carers around marital relationships, coping, and positive parental mental health; as well as provide a supportive therapeutic space for siblings to explore their concerns or unanswered questions (Spain et al 2015).
Cadman T, Eklund H, Howley D, Hayward H, Clarke H, Findon J, et al. Caregiver burden as people with autism spectrum disorder and attention-deficit/hyperactivity disorder transition into adolescence and adulthood in the United Kingdom. Journal of the American Academy of Child and Adolescent Psychiatry 2012; 51(9):879-88.
Family Therapy for Autism: A Tool for Generating Positive Cycles. http://www.childandfamilymentalhealth.com/disability-and-families/family-therapy-and-autism-time-for-a-second-look/
Firth I, Dryer R. The predictors of distress in parents of children with autism spectrum disorder. Journal of Intellectual and Developmental Disability 2013;38(2):163-71.
Giallo R, Wood CE, Jellett R, Porter R. Fatigue, wellbeing and parental self-efficacy in mothers of children with an autism spectrum disorder. Autism 2013; 17(4):465-80.
Hoefman R, Payakachat N, Van Exel J, Kuhlthau K, Kovacs E, Pyne J et al. Caring for a child with autism spectrum disorder and parents’ quality of life: application of the CarerQol. Journal of Autism and Developmental Disorders 2014;44(8):1933-45. [doi: 10.1007/s10803-014-2066-1].
Karst JS, Van Hecke AV. Parent and family impact of autism spectrum disorders: a review and proposed model for intervention and evaluation. Clinical Child and Family Psychology Review 2012;15(3):247-77. [
Meirsschaut M, Warreyn P, Roeyers H. What is the impact of autism on Mother-child interactions within families with a child with autism spectrum disorder? Autism Research 2011;4(5):358-67.
Spain D, Sin J, Paliokosta E, Furuta M, Chalder T, Murphy DG, Happé FG. Family therapy for autism spectrum disorders. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD011894. DOI: 10.1002/14651858.CD011894.