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Krauss et al 2005

Page history last edited by Chris Barthold 3 years ago

Krauss, M.W., Seltzer, M.M., and Jacobson, H.T. (2005).  Adults with autism living at home of in non-family settings: positive and negative aspects of residential status.  Journal of Intellectual Disability Research, 49, 111-124.

 

  • what are the positives and negatives to having an adult with autism live at home versus a residential placement?
    • family and non-family settings
    • maternal involvement
    • impressions of quality of life
  • family life-cycle theory - young adulthood is the launching stage
    • often put off
      • family preferences
      • lack of alternatives
    • 60% of adults with intellectual disabilities live with their parents in the US
    • part of a large longitudinal study (other parts described in other reviews)
    • adult services are not mandatory - must advocate to secure services
  • launching period - stressful
    • dependency
    • no autonomy
    • vulnerability
    • behavioral concerns
    • social communication
    • family related
    • educational programming
    • professional relationships
    • independence and futurs
      • will the system be able to meet their needs?
      • parenting responsibilities are much greater than anticipated
  • very little study of this phase in the life cycle
    • parents - major role
    • stay involved when chidlren are out of the home
    • mothers especially involved
  • advantages of out of home placement (Baker & Blacher 2002)
    • better services, more peace of mind
    • disadvantages - not able to be there
      • complex
    • small samples limit the generalizability of the findings
    • most adolescents live with families - as they get older they tend to move out (1/3 - less than those with other IDs)
  • current study research questions
    • positive and negative aspects
    • contact with child
    • changes in mother's lives
  • participants - from a larger longitudinal study
    • 133 families
    • 84 lived in non-family setting
    • 49 lived at home
    • average age of child = 31.9 years
  • procedures
    • mothers filled out a questionnairre
      • qualitiative questions and quantitiative questions
      • in-home interviews?  Never discussed after this
    • qualitative - what are the positives and negatives of the living situation
    • rated several questions related to quality of life on a 1-7 scale
    • how often the mothers had contact with their child (if out of the house)
    • satisfaction was also rated
  • analysis
    • transcribed and coded for themes (tradition?)    
      • family benefits/negatives
      • child benefits/negatives
      • parent benefits/negatives
    • checked for gender differences but did not seem to report - did I miss this somewhere?
  • results
    • co-residing mothers
      • most of the children had never lived outside the home
      • 46% family benefits, 34.7% child benefits, 19% mother benefits
      • enhanced family quality
      • love shared
      • helps out around the house
      • changed for the better
      • getting good care
      • secure at home
      • interactions with the family
      • happy and prefers the situation (child)
      • mother benefits
        • peace of mind
      • negatives
        • problems for the family
        • dealing with problem behavior
        • limitations on activities and stress
        • sibling difficulties
        • lack of challenges at home
        • lack of services for the child
        • stress of caregiving/living alone
        • parental isolation and lack of freedom
        • respite care
        • concerns about the future
    • parents who live apart from their child
      • average age 26.7 years
      • 73% in residential programs
      • benefits
        • calmer family life
        • better relationship between parent and child
        • marital relationship
        • siblings
        • don't have to deal with behavioral issues or stresses
        • learn new skills
        • increased confidence and independence
        • more structured life
        • better programs and activities
        • more age appropriate
        • parents have more free time
        • more peace of mind
        • can pursue full time employment
      • negatives
        • staff are not well trained
        • worry about care and supervision
        • lack of individuality and programs
        • not enough activities and challenges
        • staff turnover
        • exploitation of the child
        • less well groomed
        • not as close with the family
        • child was lonliet
        • miss their children
        • guilt about living away
        • distance from children
        • not knowing the details of their child
        • management of problem behavior
        • still very much the caregiver
        • some regretted that they were not the caregiver
    • people who live with their children rate the quality slightly more negatively than those who live apart (but statitically significant)
    • parental contact with children living apart
      • half visit at least weekly or several times a week
      • high levels of involvement
      • talk with the children on a regular basis (for verbal kids)
      • most talked at least weekly with program staff
    • Changes in the family life
      • more free time
      • less fatigue
      • worries more about the future since they moved out
      • no change in lonliness, financial situation, emotional involvement, and feeling needed
        • mothers who worried more had less favorable appraisals of how the situation was working out
        • greater feelings of being needed had less favorable appraisals of the situation
  • Discussion
    • many different impacts - complicated
    • this study - focused on the impact of ASD - understudied
    • residential status makes a difference for the entire family according to mothers
    • living away from home
      • postive benefits for the child, less for the family
      • at home - more benefits for the family, less for the child
    • living at home makes family more enjoyable - stressors are dealing with problem behavior
    • mother seems to benefit less than the child or the family as whole
    • expressed tradtiionallly maternal feelings
    • seems to be some advantage to living apart
      • however, the issue is much more complex than that
    • lots of contact between the child and the families
    • caregiving no matter where the child lives
    • less common for children with ASD to live at home
    • IMPORTANT TO TAKE A LIFESPAN PERSPECTIVE 
    • limitations
      • qualtitative data - not done as a face-to-face interview
      • responses only from the mother - other family members might have answered differently
      • still a good study

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