Adapting Cognitive Behavioral Therapy – Insomnia (CBT-i) for Autistic Adolescents and Adults
Disturbed sleep is associated with increased mortality, cardiovascular disease, diabetes, obesity, accidents, anxiety and depression, and low physical activity (Luyster et al., 2012). Cognitive behavioral therapy for insomnia (CBT-i) is the front-line evidence-based treatment for chronic insomnia. However, barriers exist in the implementation of CBT-i across different populations, such as autistic adolescents and adults. although transition-aged adolescents and young adults with autism spectrum disorder (ASD), without a co-occurring intellectual disability, are at a higher risk for insomnia than those in the general population (Baker & Richdale, 2015), these individuals face serious challenges accessing evidence based interventions, such as CBT-i. Autistic adolescents and adults face multiple challenges accessing healthcare services due to a) a lack of providers trained to work with this population (Nicolaidis et al. 2015); b) poor physician-patient communication (Nicolaidis et al. 2014); and c) few clinicians who understand the heterogeneity in characteristics and challenges exhibited by autistic individuals (Nicolaidis et al. 2014). Further, there are few clinicians and specialists willing to work with autistic individuals (Maddox et. al 2019). Maddox and Colleagues found that clinicians were less likely to intend to work with autistic clients and reported lower levels of self-efficacy to work with this population. Finally, few evidence-based interventions (EBI’s) have been adapted for this population and the clinicians who would deliver them. Implementation of CBT-i for ASD requires adaptations to meet the needs of both clinicians and autistic clients.
Autistic Employment Patterns and Profiles (AUT EMPLOY) Study
The Autistic Employment Patterns and Profiles (AUT EMPLOY) Study is a national online study investigating overarching patterns in factors related to employment outcomes, such as unemployment, underemployment, and employment instability. Factors examined under this study include individual characteristics (autism identity, autistic camouflaging, self-management skills, and special interests), past employment and education experiences, and current employment environment, climate, and support. The study’s primary empirical goal is to identify subgroups (profiles) of autistic adults across the factors outlined above using latent profile analysis (LPA) and test whether these profiles meaningfully relate to employment outcomes.
Multi-Component Self-Determination Program Study
Spectrum Pathways is an individualized research program focused on helping adults on the autism spectrum identify and attain their goals. The program contains two parts. The first part is a five-day immersion that takes place in a variety of locations in Nashville, Tennessee, such as the Nashville Zoo, the Frist Center for the Visual Arts, and the Vanderbilt Recreation and Wellness Center. During that week, multiple topics, such as setting and attaining goals, self-advocacy, making healthy choices, and stress management, are covered. The second part is a three-month period during which participants continue pursuing their goals in their own community with an opportunity to receive weekly coaching calls to help support them in their goal process. They also have an opportunity to attend monthly community outings.
This study is not currently recruiting participants. If you are an adult who has a documented ASD diagnosis, are between the ages of 18 – 35, and have exited the high school system, you may be eligible to participate in this study in the future. If you are interested in this study, please contact us at spectrum.forLIFE@vanderbilt.edu. As part of your participation in this study, you will talk to a doctor or nurse about your medical history, wear an activity watch, and complete surveys at the beginning and end of the program.
Autism Spectrum Identity Project
This study uses the social theory of stigma and the psychological framework of stereotype threat to examine identity on the autism spectrum. Specifically, this research examines how adults on the spectrum vary in their identification with the autism spectrum and how that variation relates to postsecondary outcomes of education, employment, and sociopsychological health. Major findings from this project are described on the publications page. Analyses of this large data-set are currently ongoing.