World Autism Awareness Day: adapting the Respect Young People's Programme

Ahead of World Autism Awareness Day, we spoke with Justine, from our Young People’s Service, about how the team has supported practitioners to adapt the Respect Young People’s Programme, our programme for young people using abuse in their family relationships, so that young autistic people can engage in a way that benefits them and accounts for their additional needs.

Before we explore this, it’s important to establish that ‘young autistic people’ refers to a hugely diverse group, with a whole range of strengths and challenges. Most will never behave abusively to those close to them, but for those who do, adapting the programme can support meaningful engagement and better outcomes for families.

What is the Respect Young People’s Programme, and why are these adaptations needed?

The Respect Young People’s Programme (RYPP) is our intervention for families where children or young people aged between 8 and 18 are abusive or violent towards the people close to them, particularly their parents or carers. This is known as child/adolescent to parent violence/abuse – or CAPVA for short.

CAPVA can affect any family, but we know there is a high prevalence of young autistic people in RYPP caseloads. An analysis of RYPP cases in Swindon Youth Restorative Justice Service in 2018 found that 47% of their cases involves a young person with an autism diagnosis, and practitioners indicate that proportions may be even higher, representing as much as 60% of their caseloads.

Why are so many autistic young people referred to the Respect Young People’s Programme?

When practitioners work with autistic young people using abuse, it’s vital that they understand the context in which that happens, and how the young person’s condition influences the way they experience the world and interact with the people close to them.

Whilst aspects of coercive control are still present in cases where young people have an autism diagnosis, often their use of violence and abusive behaviour has an “emotional dysregulation” component to it. This refers to a difficulty monitoring and controlling the intensity and expression of emotions. In autistic young people, this can present alongside a need to communicate frustration or control the stressors of their environment.

Anxiety can also be a factor in the use of abuse. Autistic young people are more likely to be experiencing other mental health problems (67%) than neurotypical peers (24%), with many of these problems linked to anxiety. We know from research that these higher levels of anxiety can be linked to higher levels of behaviour problems and physical aggression.

Other challenges can include communication, empathy and concentration, and we know that in itself, simply being identified as different can be frustrating for young people. Some are angry at their parents for pursuing diagnosis, which can impact on their familial relationships.

How does autism impact how young people engage with the programme, and how do you adapt it to support them?

We want RYPP practitioners to help each young person to get the most they can out of the programme, and this means shaping it around their needs. We know that some autistic young people can struggle with concentration, communication, and understanding other people’s thoughts and feelings, so information on those needs can help practitioners to determine a plan for the young person.

Having a greater number of shorter sessions can be helpful when it comes to concentration, and the use of more physical and visual methods can support with communication needs. For example, young people might better understand their anger by drawing an outline of a person on paper and drawing the physical indicators of anger on the body. Keeping messages simple and “low demand” can also be helpful, and using prompt cards can help young people remember key messages in the programme.

For some autistic young people, being in social situations or discussing feelings can be stressful. When this is the case, it can help to have walking sessions or sessions involving an activity that takes the focus off the emotional element.

It’s also important to consider the physical, sensory and environmental needs of autistic young people. For example, some enjoy the feeling of containment and safety that comes from physical pressure or a safe space, others might benefit from a sensory box containing items they find calming. Practitioners can also adjust the lighting, the level of clutter in the room, the amount of space between chairs, among other things. We sometimes work with occupational therapists to support with these needs.

Perspective building is another key objective of the RYPP, helping young people to understand the impact of their behaviour on others. As autism can impact the development of that skill, we’re working to create resources to support this understanding.

How are parents supported?

Information is definitely the first step. RYPP practitioners offer both parents and young people separate education sessions to learn more about autism and how it affects the way the young person understands and experiences the world around them. This can help families understand why the young person might respond the way they do, and it can help practitioners dispel feelings of blame and establish a rapport with the family.

Another key element is establishing a level of predictability and consistency. Parents of  autistic young people can be reticent to assert boundaries with their children out of fear that it could result in a meltdown. In the long term, this can reinforce a dynamic where the young person isn’t used to being told ‘no’, which can mean the young person holds the power in the family home. We work with them to explore, identify and articulate young people’s triggers, and help them manage them together. This also involves creating and holding clear, consistent boundaries. Once established, this predictability can be reassuring, and can reduce levels of anxiety.

Finally, it’s important to acknowledge that it can be very hard and very lonely parenting a child who is using abuse, and many parents say they struggle to cope. A key part of the programme is ensuring that parents feel supported emotionally, as well as with knowledge and guidance – reassuring them that change is possible, and that you’re there to help that happen.