Background Modern slavery is a complex global health problem that includes forced labor exploitation. An ecological systems perspective is needed to understand how contextual upstream and midstream factors contribute to labor exploitation, and how disruptive societal challenges, such as infectious disease pandemics, may exacerbate established pathways leading to exploitation. Accumulation of familial and societal risk factors likely heightens vulnerability; for instance, economic precarity for an individual interacts with poor livelihood options and lack of social welfare supports increasing their likelihood of accepting exploitative labor. However, few frameworks exist that account for the accumulation of and interdependence between risk factors at different levels and across contexts. Objective Using an ecological systems framework, we review literature on the pathways leading to labor exploitation, with the aim of developing a conceptual model grounded in existing research. Next, we discuss how pathways in this conceptual model are likely exacerbated by the COVID-19 pandemic. This conceptual model can guide future research to detect modifiable factors and strategic points of intervention. Methods A critical review of research articles and gray literature was performed with a primary focus on sub-Saharan Africa. The review utilized various scholarly databases to identify perspectives from multiple disciplines and to more fully account for complex processes linked to labor exploitation. Results A conceptual model of these pathways was developed that emphasizes established determinants and risk factors for labor exploitation in sub-Saharan Africa. The model highlights how the COVID-19 pandemic may have exacerbated these pathways. Conclusions Future studies should carefully examine the direct and indirect pathways, accumulation of and interactions between factors, and specific external and personal stressors. Interdisciplinary research on multilevel interventions is needed to guide solutions to prevent the persistent problem of labor exploitation.

ABSTRACT Background Modern slavery is a complex global health problem that includes forced labor exploitation. An ecological systems perspective is needed to understand how contextual upstream and midstream factors contribute to labor exploitation, and how disruptive societal challenges, such as infectious disease pandemics, may exacerbate established pathways leading to exploitation. Accumulation of familial and societal risk factors likely heightens vulnerability; for instance, economic precarity for an individual interacts with poor livelihood options and lack of social welfare supports increasing their likelihood of accepting exploitative labor. However, few frameworks exist that account for the accumulation of and interdependence between risk factors at different levels and across contexts. Objective Using an ecological systems framework, we review literature on the pathways leading to labor exploitation, with the aim of developing a conceptual model grounded in existing research. Next, we discuss how pathways in this conceptual model are likely exacerbated by the COVID-19 pandemic. This conceptual model can guide future research to detect modifiable factors and strategic points of intervention. Methods A critical review of research articles and gray literature was performed with a primary focus on sub-Saharan Africa. The review utilized various scholarly databases to identify perspectives from multiple disciplines and to more fully account for complex processes linked to labor exploitation. Results A conceptual model of these pathways was developed that emphasizes established determinants and risk factors for labor exploitation in sub-Saharan Africa. The model highlights how the COVID-19 pandemic may have exacerbated these pathways. Conclusions Future studies should carefully examine the direct and indirect pathways, accumulation of and interactions between factors, and specific external and personal stressors. Interdisciplinary research on multilevel interventions is needed to guide solutions to prevent the persistent problem of labor exploitation.

Although individuals with autism are at greater risk of mental health challenges than others, we know little about the relationship between the mental health of older adults (50+) and autism because they are less likely to be diagnosed. Identifying the risk and protective factors that are associated with mental health can increase educational awareness, inform clinical practice, and provide information to help diagnose and treat older adults with autism. This study used longitudinal panel data of the 2008–2016 waves of the Health and Retirement Study. It estimated individual random-effect models by interacting a genetic propensity toward autism and early life experiences to test whether the latter has a moderating effect on the relationships between genetics and the Center for Epidemiologic Studies Depression (CES-D) score, self-reported depression, and history of psychiatric problems. Results suggest that individuals with a higher genetic propensity for autism are less likely to develop psychiatric problems if they report a positive maternal relationship early in life. Further, a combined effect of police encounters early in life and genetic risk for autism is associated with higher CES-D scores, increased odds of self-reported depression, and a history of psychiatric problems. Clinical applications of these findings include the need to establish and support high-quality relationships by addressing both child and caregiver needs. Further, these findings support the need to design and implement proactive interventions to teach police and autistic individuals how to successfully navigate these encounters.

There is a need for strengths-based intervention approaches for autistic youth during the transition to adulthood. In the current study, we explored parent perspectives about youth strengths during adolescence. We combined data from three studies which included semi-structured interviews about parents’ perspectives on preparing for adulthood with autistic youth. Total participants included 39 parents of 41 autistic youth (ages 12–19 years, 88% male). Parents of autistic youth described many strengths of their children in the context of conversations about the transition to adulthood. Thematic analysis revealed three subthemes under the broad theme of parental perceptions of strengths: diverse strengths and skills, strengths counterbalanced by challenges, and strengths with supports. Diverse strengths and skills were further categorized using content analysis and included intelligence, creativity, physical abilities, and self-care skills, which notably include some areas often perceived as weaknesses for autistic people. The findings demonstrate that parents are an important source of information about youth strengths during transition planning processes. Understanding the types of strengths that parents observe in their autistic sons and daughters can help inform the development of strengths-based interventions capable of supporting the transition to adulthood. Lay abstract Autism is a condition frequently characterized by social and communication challenges. Because most research focuses on understanding and reducing challenges, less is known about the strengths of autistic individuals. This is especially true of those who are transitioning into adulthood. We designed this research study to provide information about how parents perceive the strengths of their autistic adolescent children prior to the transition. We reviewed 39 parent interviews from previous research about how they prepare their autistic sons and daughters for adulthood. Without prompting, parents identified many strengths of their autistic children. Diverse strengths and skills they identified included intelligence, creativity, physical abilities, and self-care skills. These strengths are interesting, as they cover traits that are often thought of as areas of difficulty for autistic youth. However, parents also talked about strengths alongside challenges, and how specific supports would be needed to help their sons and daughters fully realize their strengths. These findings are important, as they help us know more about the strengths of autistic youth and how strengths can be supported when preparing for adulthood. Our findings also help reveal strengths that are particularly apparent during the transition to adulthood.

IMPORTANCE:Parents play an essential role in the transition to adulthood for autistic youth, yet often feel they do not have adequate training and resources. OBJECTIVE:To evaluate data on the preliminary efficacy of and collect participant feedback about the Maximizing Adolescent Post-Secondary Success (MAPSS) intervention. DESIGN:Single-group, pretest-posttest pilot study. SETTING:Clinic. PARTICIPANTS:Twenty-two families of autistic youth (ages 13-19 yr, 72.7% male). INTERVENTION:MAPSS is a group intervention for parent-youth dyads that is designed to guide parents in facilitating the development of independent skills for adulthood. Outcomes and Measures: Measures included the Transition Preparation Activities Measure (T-PAM), Family Empowerment Scale (FES), 10-item Perceived Stress Scale (PSS-10), Adulthood Expectations Questionnaire (AEQ), Adaptive Behavior Assessment System-Third Edition (ABAS-3), and a study-specific participant feedback survey. RESULTS:Frequency of transition preparation activities (T-PAM) significantly increased from before to after the intervention, and although the frequency of preparation activities decreased by 1-mo follow-up, it remained significantly higher than at baseline. Parent self-efficacy (FES), parent expectations (AEQ), and parent sense of control over outcomes (AEQ) also significantly increased from preintervention to follow-up; however, parent coping (PSS-10) was unchanged. Youth self-care skills (ABAS-3) demonstrated improvements 6 mo after the completion of the intervention, although other areas of adaptive behavior did not significantly change. Feedback from parents suggested they had positive experiences and felt the intervention was beneficial. CONCLUSIONS AND RELEVANCE:Our data suggest that the MAPSS intervention is an appropriate candidate for larger, controlled clinical trials. What This Article Adds: With additional evidence, this intervention can offer guidelines for occupational therapists to work with autistic youth and their parents to prepare for adulthood.

Background and Objectives: This study explored whether the intensity of cognitive activities could moderate the relationship between a genetic predisposition for developing Alzheimer's disease (AD) and cognitive functioning among older adults in the United States. Furthermore, we examined whether the same moderating effects were dependent on different measures of cognition. Research Design and Methods: We used a data set from the 2000-2014 waves of the Health and Retirement Study and the Consumption and Activities Mail Survey. Our sample included 3,793 individuals aged 50 or older. We used the polygenic score (PGS) for AD as a genetic trait for cognitive functioning. Reading, listening to music, using a computer, playing cards/games/solving puzzles, singing/playing musical instruments, and creating art and crafts were included as cognitive activities, and TV viewing as passive activities. We used total cognition, fluid intelligence, and crystallized intelligence as proxies for cognitive functioning. Growth-curve models were conducted. Results: After controlling for covariates, we found that reading books, using a computer, and playing cards/games/solving puzzles had a positive effect on cognitive functioning. An additional hour spent reading books moderated the negative effect of AD PGS on cognition. The measure of fluid, when compared with crystallized intelligence, appeared to drive these results. Discussion and Implications: Reading could be a protective factor against cognitive decline among older adults who are genetically predisposed to developing AD. Implications for individuals, caregivers, clinicians, and policymakers are suggested. Furthermore, the onset of AD in those at greater genetic risk may be delayed with this intervention.

The purpose of this reflective essay is to advance the importance and value of participant-oriented research (POR) at research universities by providing lessons learned and best practices based on a case study of community collaboration as it relates to a strengths-based educational model for students with autism. This evidence-based program’s success centers on the inclusion of students, parents and community partners in the design, delivery and evaluation of the program. This program exemplifies how POR can effectively address complex social issues by emphasizing interactions with community partners and underserved populations who provide critical input on interventions, programs and services that are designed with and for them. We propose that it is time to engage with this viable research methodology that transcends service and offers a pragmatic and progressive approach to creating both trust and relevance with university and community partnerships. Bench science and experimental designs are complemented by the inclusion of POR to address complex social issues.

Successful performance on the water-level task, a common measure of spatial perception, requires adopting an environmental, rather than object-centered, spatial frame of reference. Use of this strategy has not been systematically studied in prepubertal children, a developmental period during which individual differences in spatial abilities start to emerge. In this study, children aged 8 to 11 reported their age and gender, completed a paper-and-pencil water-level task, and drew a map of their neighborhood to assess spontaneous choice of spatial frame of reference. Results showed a surprising lack of age or gender difference in water-level performance, but a significant effect of spatial frame of reference. Although they made up only a small portion of the sample, children who drew allocentric maps had the highest water-level score, with very high accuracy. These results suggest that children who adopt environmental-based reference frames when depicting their familiar environment may also use environmental-based reference frame strategies to solve spatial perception tasks, thereby facilitating highly accurate performance.

Much is still unknown about the transition to adulthood for youth with autism spectrum disorder (ASD), including what preparation activities best support positive adult outcomes. Parents play a crucial role in the transition planning and preparation process, yet the existing literature lacks detailed information about parent perceptions about transition preparation activities. To examine family transition preparation activities, we conducted a ten-month study of the transition preparation process of 15 families of youth with ASD across an academic year. Youth were ages 14-17 and 93% male. We collected data on transition preparation activity time spent and parent satisfaction over twenty data collection points. We used multi-level modeling to determine longitudinal trajectories of parent-reported preparation for the transition to adulthood based on endorsed transition preparation activities. Findings from this preliminary study revealed that discussions about the future were the most commonly endorsed activities, while social activities were most associated with increased parental perception of transition preparation over time. This study expands understanding of various transition preparation activities engaged in by families of youth with ASD during high school, though research with a larger and more diverse sample is needed to extend findings.

The purpose of this reflective essay is to advance the importance and value of participant-oriented research (POR) at research universities by providing lessons learned and best practices based on a case study of community collaboration as it relates to a strengths-based educational model for students with autism. This evidence-based program’s success centers on the inclusion of students, parents and community partners in the design, delivery and evaluation of the program. This program exemplifies how POR can effectively address complex social issues by emphasizing interactions with community partners and underserved populations who provide critical input on interventions, programs and services that are designed with and for them. We propose that it is time to engage with this viable research methodology that transcends service and offers a pragmatic and progressive approach to creating both trust and relevance with university and community partnerships. Bench science and experimental designs are complemented by the inclusion of POR to address complex social issues.

BACKGROUND: Compared with people with other disabilities, individuals with autism spectrum disorder (ASD) have the lowest rates of employment and switch jobs at a higher frequency. Thus, understanding how to support workplace success for people with ASD is important. OBJECTIVE: Grounded in an ecological conceptual model, this study explores the dual employment perspectives of adults with ASD and supervisors who worked with individuals with ASD. METHODS: Using participatory research methods, a purposive sample of ten adults with ASD (all verbal with high school diplomas) and ten supervisors participated in semi-structured interviews on employment experiences. Qualitative analyses were used to identify themes. RESULTS: Four major themes emerged from an ecological framework to create a strong person-environment fit in the workplace: 1) building on interest/experiences/strengths/skills, 2) reducing social demands, 3) clear communication and expectations, and 4) ASD awareness for work environment. Comparisons between the two groups of participants showed substantive differences in expectations and accommodations. CONCLUSIONS: Supervisors, although eager to employ individuals with ASD, could benefit by employing an ecological model to successful employment. Results indicate that multiple lenses on the process of employment for those with ASD can lead to better outcomes in the workplace.

Few autism programmes address the needs of adolescents and young adults, and those that do are unlikely to include individuals with autism in the design and evaluation of the programme. This study involved nine youth with autism (ages 16-25) in the development and evaluation of a peer teaching programme where they taught three-dimensional modelling to other students with autism spectrum disorder. The methodology was participant-oriented research where the students with autism were co-designers and programme evaluators in the research. This approach highlighted their unique strengths and abilities and shifted the power such that they were leaders and not simply the recipients of knowledge from instructors. Four themes emerged through the qualitative analysis of the students' perceptions of the peer teaching programme: 1) the meaning of peer teaching, 2) motivations for peer teaching, 3) challenges and 4) coping with the challenges of the role.

Choreografish is a virtual reality, therapeutic arts engagement leveraging participatory research and design to collaborate with young adults with autism spectrum disorder (ASD). The research team was motivated by the social anxiety some with ASD have, and the attendant difficulties accessing art forms that may actually play well to Autism Spectrum Advantages (ASA). This project was co-designed with youth with ASA to explore the use of VR and choreographic thinking to empower users and designers to engage with the arts and self-manage anxiety. This paper describes the project, and gives a brief design history of Choreografish.

This article describes a university-community collaboration in which an inter-professional team partnered to provide students with autism spectrum disorder (ASD) a paid job opportunity to apply 3D modelling skills for a local construction company. Providing meaningful vocational opportunities to improve the transition to adulthood for individuals with ASD is imperative, as individuals with ASD have unemployment rates that are some of the highest of all disabilities. This novel evidence-supported educational program was designed to develop 3D technology skills, explore vocational careers and promote social engagement through shared interests for transition-age youth with ASD. Both parents and students reported many successful outcomes, including increase in student self-confidence, social and technology skill development and the opportunity for vocational exploration by these young people. Implications of the case study are reported in relation to university-community partnerships and the critical role of community collaboration in addressing the high rates of unemployment in individuals with autism.

This study examines the correlates of creative potential in preschool children, with a focus on children's social behavior. Ninety-four preschool-aged children, their mothers, and teachers participated in the study. Mothers completed a questionnaire measure of children's shyness, and teachers reported on children's levels of shyness, prosocial behavior, and aggression. Children completed Torrance's Thinking Creatively in Action and Movement. Results indicated that imagination was predicted by lower levels of shyness and greater prosocial behavior, whereas divergent thinking was predicted by older child age and teacher ratings of aggression. Implications for promoting young children's creative potential in the classroom are discussed.

Many people perceive autism spectrum disorder (ASD) as a childhood disorder, yet ASD is a lifelong condition. Although little is known about the mental and physical health issues of aging individuals with ASD, there are increasing numbers of older adults being diagnosed with ASD. Although there has been a recent "call to action" (to address lack of knowledge and the dearth of services and programs for aging individuals with autism, the authors think it is also important for those who are involved in educational programs related to gerontology and geriatrics settings to be aware of "autism aging." This term conceptualizes the demographics, person and contextual factors, and intellectual awareness of the trends and patterns of ASD as a life course challenge and opportunity for well-being and quality of life. The purposes of this article are to (1) provide a general overview of autism issues and to examine several dimensions of ASD in the context of the emergent and relevant scholarship in the adult and aging domain, (2) propose how to address the "gap" in the literature on autism and aging in terms of a conceptual model and by improving the methodology, and (3) to discuss the implications of these dimensions for educators in gerontology and geriatrics, and for those professionals who work in clinical and health care services. It is the goal of the authors to have this article represent a general introduction to ASD and to be a part of the foundation for educational awareness for educators in gerontology and geriatrics.

BACKGROUND: Within a life span approach, introducing opportunities to explore careers through activities of interest provide ways for children to learn to explore, problem solve, and envision a future for themselves. However, little information exists about programs to promote social engagement and to explore potential career interests for youth with autism.OBJECTIVE: Explore engagement and learning in a technology-based extracurricular program (called iSTAR) for youth with autism.METHODS: The researchers used a qualitative approach with grounded-theory analysis to explore the processes that contributed to engagement and learning for youth with autism in an technology-based extracurricular program.FINDINGS: Youth Centered Learning and Opportunities to Demonstrate Skills emerged as themes that illuminated the processes by which engagement and learning occurred for the youth in the iSTAR program. Interest in the graphics program stimulated interactions amongst the youth with each other and with the adults. Modeling, demonstration, and scaffolded questioning supported engagement and learning for all the youth. Providing structure, encouraging choices, and following the youths' lead provided bridges for sharing and learning about the technology program.CONCLUSIONS: Career exploration through use of interests in technology can provide opportunities for youth with autism to develop social and technical skills needed later for employment. Providing an environment that recognizes and builds on the youths' strengths and supports their autonomy and choices are critical components to promote their positive development and career potential.