It takes a village: Redefining expanded kin and other social networks in the treatment of childhood autism

Recent epidemiological findings suggest that with a diagnosis of an autism spectrum disorder in 1 in 166 children each year in the U.S., 1 in 46 families also will be affected. The unique stressors of autism in these families typically include social isolation and financial burden. The need to provide the minimum treatment recommended by the Surgeon General of the United States of nearly 40 hours a week of specialized therapy, coupled with typically disruptive behavioral symptoms and concomitant medical problems of many children on the spectrum, adds additional challenges for family members, particularly for working mothers. The presence of mental illness and family dysfunction can also impair the ability of family members to provide a diagnosed child with appropriate treatment. Family members of autistic children are more likely to experience significant levels of depression, anxiety, and marital distress than members of the general population, including those who have children with mental retardation. Although family therapy remains an essential mode of treatment for nuclear families, it is recommended here that the social network of the family be expanded significantly to include grandparents, other extended family members, neighbors, church and other community groups, and formal and informal support groups with significant benefit for both the identified child and the affected family. For example, the role of active grandparent can be expanded to include geographically distant and foster grandparents. In response to social isolation, the use of technology, including the Internet, will be discussed as a unique mode of social and informational support. Various case examples will be used to illustrate the benefits of such an expanded approach in family based treatment.