Supporting Youth with ASD to Better Cope with Stress through Destress for Success: An Exploratory Study

Background: Adolescence is marked by the development of important skills and physiological changes, increasing vulnerability to stress and the onset of mental health disorders in some adolescents. Adolescents with ASD might experience more stress than those with a typical development during social interactions, as suggested by high cortisol activity during social interaction and in the evening which is illustrative of stressful experiences during the day. Chronic (i.e. repeated and prolonged) stress induces excessive wear of biological systems and increases the risk of physical and psychological pathologies such as depression and anxiety, co-occurring conditions that undermine quality of life in youths with ASD. It thus becomes relevant to support teens in the prevention of chronic stress. Destress for Success^c was developed by the Center for Studies on Human Stress (CSHS). Destress for success^c includes 5 workshops of 50 minutes, each addressing a theme: (a) universal components of stress; (b) cognitive assessment; (c) problem solving in a stressful setting; (d) emotional regulation strategies and (e) problem-centered strategies. This program has been validated with a sample of adolescents with typical development. We conducted a first study, in collaboration with the CSHS, with a group of seven male adolescents with ASD (age range 12.11. to 15.6, mean 14.04 y.o.). Objectives: The objectives were 1- to evaluate the relevance and feasibility of the evaluation protocol, and 2- to estimate the potential adaptations to make the program relevant for adolescents with ASD. Methods: Estimation of the potential effects of the program are studied according to pre and post-tests study design, combining stress-related physiological measure (salivary cortisol taken at wakening, 30 minutes later, 4pm and bedtime) and psychological measures (adaptive behavior and emotion recognition). Qualitative analyses of satisfaction questionnaires completed individually by the participants and their parents, and a journal completed by the trained clinician added to the comprehension of the program's potential. Results: The results show an increase in the adolescents' sense of control (F = 4.42; p<.05), a decrease in depressive symptoms (F= 4.51; p<.05), as well as an improvement in the recognition of emotions of joy (F = 9.75, p <.01) and anger (F = 4.6, p<.05). The group daily cortisol pattern at pre-test revealed a reverse profile, were cortisol at wakening is higher than at bedtime. One week following completion of the 5 workshops, mean group cortisol pattern showed expected daily profile. However, the difference was not statistically significant. Conclusions: This exploratory study supports the relevance to pursue validation of the adapted program based on the potential effects detected. Adaptations were mainly made to the animation of the program to make it more meaningful for adolescents with ASD. For example, we added visual aids, examples taken from the youths’ experience and there were fewer participants taking part in the group. Conclusions also emphasize the importance of parental involvement to promote generalization.