“ This Home Still Stands ”: Systemic Reorganization of Family Communication Through Orchestra Participation Among Adolescents with Autism Spectrum Disorder

Autism spectrum disorder (ASD) can place sustained strain on family communication and relational equilibrium. Existing interventions have often emphasized symptom management or parent-mediated strategies, leaving less clear how disrupted family communication is reorganized over time. Guided by family systems theory, this qualitative case study examines communicative change in relation to long-term orchestra participation among families of adolescents with ASD in Shanghai, China. Data include in-depth interviews, prolonged participant observation, and supplementary digital and documentary materials from the Shanghai Angel Autism Salon. Findings indicate that families often described a post-diagnosis communicative deadlock characterized by boundary contraction, role polarization, ambiguous loss, and stigma-related withdrawal. Orchestra participation was associated with a socio-musical environment that reduced exclusive reliance on verbal communication, supported competence-oriented communication, and enabled adolescents to be recognized as contributors to collective activity. Public performance further reframed social evaluation as recognition and reconstructed mianzi (面子, social reputation and standing), with some families reporting more open external boundaries and greater paternal involvement. Over time, these patterns were associated with more resilient forms of family adaptation. The study conceptualizes collective arts participation as a relational health communication intervention shaped by stigma and family reputation.