Difficulties regulating emotions during periods of distress may contribute to the high rates of co-occurring depression and anxiety in autistic adults. The emotional support plan (ESP) is a brief intervention designed to support autistic adults to use positive coping skills during periods of distress. Thirty-six autistic adults participated in studies to assess the acceptability of the ESP intervention to cope with stressors during the COVID-19 pandemic and postsecondary education and feasibility of the study design elements to inform future trials. Most participants reported using strategies from their ESP; 86%–89% reported the intervention had a positive impact on them and 67%–71% would recommend it to another person. Completion of weekly monitoring and outcome assessments were high; ecological momentary assessment was more variable. The current results provide preliminary support for the acceptability of the ESP intervention. Important insights were also gained to inform feasibility of the design to assess its potential efficacy in future studies. While further research is clearly needed, the brief nature of the ESP may provide benefit as a starting point for those who may be proactively seeking support to cope with anticipated stressors or those who would benefit from guidance to promote emotion regulation during stressful life events. Lay abstract Autistic adults may have difficulty coping during stressful periods, which could make them more vulnerable to depression and anxiety. We designed the emotional support plan (ESP) to help autistic people find ways to cope in stressful situations. Thirty-six autistic adults created an ESP and answered questions about their opinions of the ESP. Most autistic adults found the ESP to have a positive impact on them and many would recommend the ESP to another person. Feedback from autistic adults suggested ways that we might test the ESP in future studies. Overall, autistic adults in this study found the ESP to be useful and a worthwhile intervention to study more in the future. While more research is clearly needed, we hope that the brief nature of the ESP will make it helpful for autistic people who are trying to handle negative feelings during stressful life events.

Aggression is a known contributor to burnout and caregiver instability among direct support professionals (DSPs) caring for adults with developmental disabilities. However, few studies have explored the differential effects of aggression subtypes on caregivers and what implications these may have for intervention planning. This longitudinal study examined whether different types of aggression were associated with greater burnout and instability in DSPs. Ninety DSPs reported on their experiences working with aggressive clients with developmental disabilities at baseline and at a 3-month follow-up. Participants were roughly representative of the population of DSPs in the United States. Verbal aggression and reduced length of time knowing the aggressive adult significantly predicted caregiver instability, with participants who had stopped working with the aggressive adult experiencing significantly worse verbal aggression than participants who were still working with the adult at follow-up. Hostile affect significantly predicted burnout. Verbal aggression and hostility, which are less frequently targeted for intervention as more dangerous forms of aggression, pose risks for caregivers and therefore warrant active attention through intervention. DSPs would benefit from training on how to diffuse and redirect verbal aggression and hostility, as well as use coping strategies to mitigate against the negative emotional effects of aggression.

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