Effective Educational Inclusion of Students on the Autism Spectrum

Beginning with early efforts to prepare preschool aged children with autism to join their peers in regular education classes, there has been a continuing interest in including children with autism spectrum disorders (ASDs) in regular education classes. A modest body of literature has explored ways to enhance the social interactions of children with ASDs and to more fully integrate them into academic and co-curricular experiences with their peers. These efforts have shown benefits to the children with ASDs as well as their peers in specifically defined situations. While there remains a serious lack of rigorous research in this area and a clear need for additional study regarding the long term impact of full inclusion on both groups of children, the existing research provides some interim strategies for professionals working with these children.     

Psychotherapy for Individuals with Autism Spectrum Disorders

Individuals with autism spectrum disorders (ASDs) present unique challenges for psychotherapists. Those with autism, Asperger’s Disorder and pervasive developmental disorder-not otherwise specified (PDD-NOS) show impairments in social communication and social relationships as well as unusual behavioral features that set them apart from peers. Further, individuals affected with autism spectrum disorders may experience anxiety, depression, obsessive–compulsive disorder and other psychiatric symptoms that can be distressing and, at times, disabling. At present, there is limited information regarding evidence-based approaches for addressing either core impairments of ASDs or associated conditions in a psychotherapy setting. Nevertheless, information about how persons with ASD experience their world and learn can provide clues about what interventions might be useful to assist them such that they can reach their fullest potential. From this standpoint, new or modified approaches to therapy can be tested and further refined to provide a more comprehensive understanding of the psychotherapeutic challenges and the most efficacious therapeutic approach to maximize functioning in this population.     

Marital Satisfaction Prior to Couples Therapy

SUMMARY

The author predicted that couples would begin therapy with a high potential for separation or divorce and with one partner significantly more dissatisfied than the other. Using the Index of Marital Satisfaction (Hudson, 1982), 24 couples were studied using a practitioner-researcher model. Although the first hypothesis was not confirmed at the level of prediction, partners were found to be at a level of dissatisfaction close to the predicted levels. A highly significant statistical difference (p = .0001) was observed between the satisfaction levels of the partners in the couples. Based upon the research findings, some clinical wisdom was revised and other beliefs were confirmed.     

Story Recall and Narrative Coherence of High-Functioning Children with Autism Spectrum Disorders

Previous research has found few quantitative differences between children with high-functioning autism spectrum disorders (ASDs) and well-matched controls in the length, complexity, and structure of their narratives. Researchers have noted, however, that narratives of children with ASDs have an unusual and idiosyncratic nature. This study provides an analysis of narratives in 17 children with high-functioning ASDs and 17 typically developing children matched on age, gender, language abilities, and cognitive abilities. We examined story recall and narrative coherence. The study revealed no group differences in story length or syntactic complexity. Children with ASDs also did not differ from controls in their use of the gist of a story to aid recall, or in their sensitivity to the importance of story events. Children with ASDs did, however, produce narratives that were significantly less coherent than the narratives of controls. Children with ASDs appeared less likely to use the gist of the story to organize their narratives coherently. These findings are discussed with regard to their relationship to other cognitive and linguistic difficulties of children with ASDs.     

Experiences Delivering a Marital Intervention for Couples With Children With Autism Spectrum Disorder

Previous researchers have indicated that parents of children with autism spectrum disorder (ASD) are vulnerable to relationship stress, lower marital satisfaction, and potential relationship dissolution. We describe the experiences of three couples who participated in a 10-week, in-home couples therapy intervention using Emotionally Focused Therapy (EFT). Each couple and their progress through the intervention are described using therapist and supervisor reflections, and qualitative evaluation interviews with the participants after termination. Based on the experiences of the couples, we conclude that couples would benefit from an in-home couples therapy intervention aimed to strengthen their relationships.     

Love in Action: An Integrative Approach to Last Chance Couple Therapy

This article presents an integrative approach to the special challenges of therapy with couples on the brink of dissolution or divorce—who often describe this therapy as their “last chance.” In some, one partner is considering ending the relationship, and in others, both partners are considering ending it. Often, these couples have had prior dissatisfying experiences in couple therapy. Four types of last chance couples are described: high‐conflict couples; couples in which partners have differing goals for their lives or different timelines for reaching shared goals; couples in which one or both partners have acted in a manner that violates the values, expectations, emotional comfort, or safety of the other; and couples in which there has been a gradual loss of intimacy. The Therapeutic Palette, a multiperspectival, theoretically eclectic integrative approach, is enlisted as a general framework for selecting and sequencing use of particular theories and their associated practices, based on the three “primary colors” of couple therapy: time frame/focus, level of directiveness, and change entry point. An additional complementary framework, the creative relational movement approach, is proposed to provide an integrative frame encompassing both language‐based and action‐based practices, suggesting that meaning is held and expressed as much through interaction or “relational motion” as it is through language. Principles of change are described. Due to the couple's level of crisis and desire for immediate evidence of possible improvement, priority is given to action‐based interventions in early stages of therapy, by engaging couples in “experiments in possibility.” Typical action approaches are described. An extended vignette follows.     

Communication,conflict, and commitment: insights on the foundations of relationship success from a national survey

The key relationship dynamics of communication, conflict, and commitment were investigated using data from a randomly sampled, nationwide phone survey of adults in married, engaged, and cohabiting relationships. Findings on communication and conflict generally replicated those of studies using more indepth or objective measurement strategies. Negative interaction between partners was negatively associated with numerous measures of relationship quality and positively correlated with divorce potential (thinking or talking about divorce). Withdrawal during conflict by either or both partners, though quite common, was associated with more negativity and less positive connection in relationships. The most frequently reported issue that couples argue about in first marriages was money, and in re-marriages it was conflict about children. Overall, how couples argue was more related to divorce potential than was what they argue about, although couples who argue most about money tended to have higher levels of negative communication and conflict than other couples. Further, while the male divorce potential was more strongly linked to levels of negative interaction, the female was more strongly linked to lower positive connection in the relationship. Consistent with the commitment literature, higher reported commitment was associated with less alternative monitoring, less feeling trapped in the relationship, and greater relationship satisfaction.     

Perceived Marital Problems in Taiwan

With the expansion of the practice of marriage and family therapy outside of the U.S. and Western Europe, it important to gain a better understanding of family interaction and processes in other cultures and countries. Several studies have examined the problems that couples experience in the United States, but little is understood about problems that couples in Asia experience. In this study, perceptions of relationship problems experienced by 213 married couples living in urban Taiwan were examined. Results indicated that raising children and communication were the two problems most frequently reported by both husbands and wives. Among eight relationship problem areas, the only gender difference was in the area of communication, with wives significantly more likely to report it as a problem. An examination of within-dyad agreement indicated that couples generally had high consensus regarding relationship problems. Implications of this research for culturally-sensitive MFT practice are discussed.     

A Developmental–Behavioral Approach to Outpatient Psychotherapy with Children with Autism Spectrum Disorders

Over the course of development, children with autism spectrum disorders (ASDs) may present with an array of behavioral symptoms in addition to the primary impairments in language, socialization, and repetitive/restricted interests. These developmental challenges allow outpatient psychotherapists the opportunity to provide helpful clinical services to children and adolescents with ASDs. This can be best accomplished by combining behavioral strategies that are typically effective with children with ASDs with evidence-based approaches helpful for other psychiatric conditions. Four case examples are provided that review how to use both ASDs and general child clinical interventions with children with ASDs and their families.     

Understanding autism: how family therapists can support parents of children with autism spectrum disorders

The number of children diagnosed with an Autism Spectrum Disorder has increased dramatically in the last 20 years. Parents of children with autism experience a variety of chronic and acute stressors that can erode marital satisfaction and family functioning. Family therapists are well-suited to help parents stay connected to each other as they create a "new normal." However, family therapists need updated information about autism, and they need to understand how family therapy can help parents of children with autism. Because having a child with autism affects multiple domains of family life, this paper explores how family therapists can utilize an integrative approach with parents, enabling them to flexibly work with the domains of action, meaning, and emotion.     

Treatment‐as‐Usual for Couples: Trajectories Before and After Beginning Couple Therapy

Couple therapy has been shown to be a meaningful way to improve couples’ relationships. However, less information is known about couples’ functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community‐based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted‐time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples’ relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples’ functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.     

Sub‐threshold autism traits: The role of trait emotional intelligence and cognitive flexibility

Theory and research suggests that features of autism are not restricted to individuals diagnosed with autism spectrum disorders (ASDs), and that autism‐like traits vary throughout the general population at lower severities. The present research first investigated the relationship of autism traits with trait emotional intelligence and empathy in a sample of 163 adults aged between 18 and 51 years (44% male). It then examined performance on a set of tasks assessing social cognition and cognitive flexibility in 69 participants with either high or low scores on ASD traits. Results confirm that there is pronounced variation within the general population relating to ASD traits, which reflect similar (though less severe) social‐cognitive and emotional features to those observed in ASDs.     

An approach to preventing coparenting conflict and divorce in low-income families: strengthening couple relationships and fostering fathers' involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.     

Couple Conflict in Parents of Children with versus without Autism: Self-Reported and Observed Findings

We compared the couple conflict of parents of children with autism spectrum disorder (ASD) to a comparison group of parents of children without disabilities using self-reported and observational measures. In total, 178 couples who had a child with ASD (aged 5–12 years) and 174 couples who had children without disabilities (aged 5–12 years), recruited from a Midwestern state in the United States, reported on couple conflict in everyday life and engaged in an observed couple conflict interaction. Parents of children with ASD reported more frequent, severe, and unresolved couple problems than the comparison group. Parents who had a child with ASD were observed to have less engaged, balanced, and cooperative couple conflict interactions, but demonstrated more positive affect and sensitivity towards one another, than parents in the comparison group. Group differences had small effect sizes. Findings have implications for marital therapy and relationship education programs.     

A qualitative examination of the work–family interface: Parents of children with autism spectrum disorder

Within the work–family literature little is known about the work–family challenges and opportunities faced by families that have one or more children with autism spectrum disorder. However, it has been consistently demonstrated that parents of children with autism spectrum disorder are at a higher risk of experiencing a host of negative outcomes. Using a qualitative design, within grounded theory, the present study sheds light on the needs, experiences, and challenges that parents of children with autism spectrum disorder face and also offers insight into ways to expand the scope of work–family research in this area. The present research provides evidence of how the family domain can greatly impact experiences and decisions made in the work domain for families with special needs. The present research adds to the small but growing literature examining the interplay between home and work life for families with special needs and demonstrates that this is an important research domain in need of additional conceptual and empirical consideration.     

Divorce therapy: an in-depth survey of therapists' views

In-depth interviews were conducted with 21 highly experienced therapists on the criteria of a constructive divorce, the obstacles to achieving such a divorce, and the strategies and tactics of divorce therapy. The primary criterion of a constructive divorce was the successful completion of the process of psychic separation and the protection of the welfare of minor children. Therapy may focus on the decision to get divorced and/or the negotiation of the terms of a divorce settlement. Three types of therapeutic strategies were identified: reflexive intervention by which the therapist orients himself to the marital problems and attempts to gain the trust and confidence of the partners; contextual interventions by which he tries to promote a climate conducive to decision-making; and substantive interventions intended to produce resolution on terms the therapist has come to believe are inevitable or necessary. The nascent state of divorce therapy as an area of therapeutic specialization is noted. The problem of diagnostic criteria for divorce, the relationship between therapists and lawyers, the nature and consequence of therapist impartiality, and the degree to which therapists should mediate the terms of divorce are considered central issues meriting further study.     

Separation/divorce sexual assault: The current state of social scientific knowledge

Many contend that the logical solution to woman abuse in marriage/cohabitation is for women to exit through legal separation, divorce, or other means. However, a growing body of empirical work shows that separation or divorce does not necessarily solve the problem of woman abuse. For example, in addition to experiencing lethal or nonlethal forms of physical violence and psychological abuse, many women who try to leave, or who have left their male partners, are sexually assaulted. The main objective of this paper is to critically review the extant empirical and theoretical work on separation/divorce sexual assault. Suggestions for future research and theorizing are also provided.     

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples’ interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other’s immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally‐encoded emotional arousal (f₀) was measured during couples’ (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner’s f₀ dynamics had immediate and long‐term associations with the other partner’s satisfaction. Partners were less satisfied if the other partner (a) expressed higher f₀ overall and (b) escalated more in f₀ across the conversation. Yet, partners were more satisfied when their f₀ escalated across the conversation. Also, women specifically were more satisfied if their f₀ remained elevated longer before regulating back to their emotional baseline. Thus, higher f₀ was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner—particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner’s happiness. These findings challenge us to think of ways to address this “win–lose” scenario so that couples can balance both partners’ emotional needs and preserve relationship quality across the life span.     

Every time you go away: changes in affect, behavior, and physiology associated with travel-related separations from romantic partners

This study investigated changes in day-to-day affect, behavior, and physiology (hypothalamic-pituitary-adrenocortical axis activity) associated with temporary physical separations from romantic partners (such as those brought about by work-related travel). Daily diaries and measures of salivary cortisol were collected from 42 couples over a 21-day period that was timed to coincide with a naturally occurring 4- to 7-day separation. There were significant changes from preseparation to separation and from separation to reunion in the quality of partners' interactions, their positive and negative affect, sleeping problems, subjective stress, physical symptoms, and cortisol levels. Separation and reunion effects were generally more pronounced in homebound partners, partners with high attachment anxiety, and partners who had less contact with each other during the separation. Separation and reunion effects were not moderated by relationship length, relationship satisfaction, how often couples underwent separations, or the presence of children in the home. The results are discussed with respect to the role of daily proximity and contact between partners for day-to-day affective and physiological regulation.