Abstract

Although children with secure attachment are known to have better outcomes, fostering secure attachment in an infant/toddler at risk for autism spectrum disorder is challenging. Some of the challenges stem from bi-directional, negative and ambiguous interaction sequences between the child and caregiver that cause emotional dysregulation and undermine caregiver confidence setting the stage for perpetual miscuing and misattunement— a pattern that can impact the entire family system leaving the child, caregiver, and family vulnerable to stress, anxiety, depression, and isolation.

Although the etiology of autism is a matter of intensive and ongoing research spanning many disciplines, there is converging agreement that there are familial (genetic), environmental (toxins), and nurturing factors. Caregivers who believe they played some part in their child’s diagnosis often carry guilt and shame—and regardless are subject to public opinion which can be harsh and judgmental when the child does not conform to social and behavioral norms.

As a program development with a logic model and evaluation plan, Connected Families is designed to support the caregivers and families of infants/toddlers at risk for autism spectrum disorder (ASD) with the goals of fostering congruent communication and increased secure attachment interactions between caregiver and child; improving caregiver support; and families’ abilities to adapt to the changing needs of the neurodiverse child throughout development. First, using the caregiver-infant/toddler dyad as the agent of change, Connected Families first offers positive behavior support to the child and instruction to the caregiver. Second, caregivers attend the Connected Families Caregiver Group where they can connect with their own needs and goals; discover the challenges associated with ASD surrounding attachment; discuss and parenting models and positive behavior support while also having the opportunity to process experiences allowing each participant the opportunity to “feel felt.” In addition, caregivers can learn filial play skills allowing for child-centered interaction with the caregiver. Video recordings are shared within the group and members deconstruct interactions and together identify unique communication characteristics of the infant/toddler and opportunities for caregiver engagement to promote secure attachment interactions with the caregiver functioning as both the secure base for the child’s exploration and the safe haven to which the child returns when distressed. Finally, caregivers, siblings and other family members are offered the opportunity to participate in family therapy. The family therapy component is inherently systemic and structurally informed—therefore focused on rebalancing the family subsystems and addressing roles and responsibilities within the family system in a culturally sensitive manner. The purpose of family therapy is to challenge existing homeostasis that increases potential for isolation of family members and the collective decreased likelihood of family members attaining full potential, and to foster the family’s ability to adapt to better support infant/toddler progression through developmental milestones.

Connected Families is distinctive from programs that focus on behavior and instead highlights the importance of relationship and the central role of marriage and family therapists in delivery of services to the infant/toddler , caregiver, and family system to benefit of healthy communities.

LLU Discipline

Marital and Family Therapy

Department

Counseling and Family Sciences

School

School of Behavioral Health

First Advisor

Nichola Ribadu

Second Advisor

Zephon Lister

Third Advisor

Sarah Harris-Elisabeth Bollens

Degree Name

Doctor of Marital and Family Therapy (DMFT)

Year Degree Awarded

2019

Date (Title Page)

6-2019

Language

English

Library of Congress/MESH Subject Headings

Autism Spectrum Disorder; Program Development; Family therapy; Attachment behavior in infants

Type

Doctoral Project

Page Count

xiv, 186 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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