Articlesummary with Supporting and hindering environments for participation of adolescents diagnosed with autism spectrum disorder: A scoping review by Krieger a.o. - 2018

What is meant with ¨participation¨?

Participation is defined as involvement in life situations. It indicates how someone´s life is interwoven with the social life of their family, friends, community, and society. It includes feelings of belonging and engagement. It involves performing activities alone and/or socially (social participation). Participation is influenced by environments, which are defined as the physical, social, and attitudinal environments in which people live. Environments can support or hinder participation.

What is Kaplan´s reasonable person model?

Kaplan´s reasonable person model is a psychological framework that argues that people are at their best when their informational needs are met. It stresses the reciprocal aspects of person-environment interaction. It distinguishes between supporting environments and hindering environments. Supporting environments address the human desire to explore, understand, be part of a solution, enhance competence, and participate with others towards meaningful goals. Hindering environments prevent people from participation.

Why is it important to investigate the environments of adolescents with autism spectrum disorder (ASD) in relation to participation?

There is a knowledge gap with regards to research in autism focusing on adolescence and the role of environments. Adolescents with autism spectrum disorder (ASD) are exposed to many different and some unknown environments due to necessary developmental transitions. But it is still unknown what environments hinder or support these transitions. Information about the environment and participation is important for those who work with adolescents with ASD, to help them establish environments that support participation or remove those that hinder participation, to avoid socially counterproductive outcomes.

Which two themes are identified as crucial for supporting and hindering environments for participation in adolescents with ASD?

Analysis revealed two themes as important for understanding supporting and hindering environments for participation. For both there were also subthemes identified which will be talked about further below. These themes provide a helpful summary of the key environments which impact adolescents with ASD. The two main themes:

• Providing security describes how an environment provides adolescents with personally perceived security to support their participation or hinders it by neglecting security issues (resulting in intimidation and/or fear).
• Helping to connect addresses how environments help to create and strengthen social relationships with others and contribute to friendship and a sense of belonging.

What subthemes are identified with regards to providing security?

There are three subthemes within the main theme providing security:

• Parental environment: The way parents provide security and protection as a precondition for participation.
• Physical environment: The impact that physical aspects of the environment (like noise, smells, lights, and space) have on the security perception and participation.
• Informational environment: The comprehensibility of environments.

What subthemes are identified with regards to helping to connect?

There are four subthemes within the main theme helping to connect:

• Familial environments: The conditions provided by family, parents, siblings, grandparents, or family friends.
• Friendships with peers and classmates: The environments provided by classmates at school or peers in the community.
• Service and staff: The availability and characteristics of services and how the staff providing these services influence social connectedness.
• Reception of outing and attitudes of environments: The way ASD is handled by the environment and how attitudes of others influence relationships and participation.

In the context of defining supportive or hindering environments, what is meant with ¨tension in participation¨?

There were ambiguities discovered regarding participation that influenced attempts to define supportive or hindering environments. To not exclude them, the term ¨tension in participation¨ was introduced. This refers to dilemmas regarding the participation of adolescents with ASD. Three subthemes were revealed that appeared to be important:

• Isolation and solitary participation: being deprived of participation with others. This can be described by words like exclusion, bullying, and loneliness.
• Participation in disability-related groups: friendships and joint activities with other young people with disability.
• Normalcy and differences: the balancing of being different and the need to fit in.

What are important characteristics of supporting environments especially for adolescents with ASD compared to adolescents without ASD?

For adolescents with ASD the security function of parents is very important as well as providing agency and control over the physical environment. Adolescents with ASD have a reduced ability to derive information from social contexts, so an information-sensitive environment with structure and predictability can contribute to a sense of security and more appropriate responses. Adolescents with ASD want to be connected and experience relationships, intimacy, and a sense of belonging. This can be supported by visiting public spaces and work internships. Finally, participation in disability-related social groups and friendships with other adolescents with ASD allows the formation of a positive identity and an escape from the constant pressure to fit in.