Improving Transition Outcomes for Youth with Autism through Parent Advocacy Training: A Multi-State Randomized Controlled Trial

项目摘要 在本研究中，我们对180个家庭进行了随机对照试验，以检验其有效性 家长宣传培训，以改善自闭症谱系障碍青年向成年的过渡 （ASD）。高中毕业后的几年是一个关键的时期，要么使或打破一个 成功过渡到成年。如果他们不顺利，脱离中学后教育，工作， 社交孤立可能会持续到整个成年期，导致巨大的社会成本。尽管压力 在这个动荡的时期，我们需要更好地支持患有ASD的年轻人，很少有针对这些年轻人的干预措施， 开发的，测试的更少。我们的初步工作已经证明了12周父母的有效性 针对父母代表其子女倡导服务能力的培训计划（称为 “志愿人员宣传方案-过渡期”，在改善患有 自闭症相对于等待名单对照组，父母参加VAP-T的年轻人更有可能是 他们获得了更多的学校服务和成人服务。的 拟议的项目以四个重要方面的试点工作为基础：1）通过修改VAP-T 内容，使其在全国适用，并测试VAP-T是否有效时，提供三个 州; 2）将患有自闭症谱系障碍的后代的观点纳入干预和数据收集中; 3）通过 研究VAP-T影响青年结果的机制;以及4）通过探索 参与和因素，中度治疗反应。我们假设参与VAP-T将 提高父母的宣传能力，从而提高就业率、中学后教育率、社会 参与和获得服务。我们将通过随机分配 患有ASD的过渡年龄青年（16-26岁）的父母接受治疗或仅使用材料的活动对照 组，并跟踪家庭超过3年。我们提出了四个具体目标：（1）使用多位点随机- 对照试验，以检查VAP-T参与是否增加父母的宣传能力（即干预 （2）测试参加VAP-T是否会改善青年的成果（就业、就业后 （3）在向成年过渡的过程中， 父母倡导能力的哪些方面介导了VAP-T参与和青少年之间的关系 结果;和（4）探讨治疗反应的调节因素和参与的障碍， 干预通过严格测试一种新的干预措施，以改善ASD青少年向成年的过渡， 拟议的研究解决了2016-7跨机构自闭症所确定的关键需求领域 协调委员会战略计划。该项目将产生一种新的干预措施，以改善 这是一个可以通过国家和地方机构在全国范围内传播的ASD青年。

PROJECT SUMMARY In the proposed research, we conduct a randomized-controlled trial with 180 families to test the effectiveness of a parent advocacy training to improve the transition to adulthood for youth with autism spectrum disorder (ASD). The years immediately after high school exit are a critical time period that either makes or breaks a successful transition to adulthood. If they don't go well, disengagement from post-secondary education, work, and social isolation can persist throughout adulthood, leading to significant societal costs. Despite the pressing need to better support youth with ASD during this turbulent time, few interventions for these youth have been developed and even fewer tested. Our preliminary work has demonstrated the efficacy of a 12-week parent training program targeting parents' ability to advocate for services on behalf of their offspring (called the “Volunteer Advocacy Program-Transition” or VAP-T), in improving the transition to adulthood for youth with ASD. Relative to a wait-list control group, youth whose parents participated in the VAP-T were more likely to be employed or in post-secondary education, and they received more school-based and adult services. The proposed project builds on this pilot work in four important ways: 1) by making modifications to the VAP-T content to make it nationally-applicable and testing whether the VAP-T is effective when delivered across three states; 2) by incorporating the perspective of offspring with ASD into the intervention and data collection; 3) by examining mechanisms by which the VAP-T influences youth outcomes; and 4) by exploring barriers to participation and factors that moderate treatment response. We hypothesize that participating in the VAP-T will improve parents' advocacy ability, leading to higher rates of employment, post-secondary education, social participation, and service access for youth with ASD. We will test this hypothesis by randomly assigning parents of transition-aged youth with ASD (ages 16-26) to either a treatment or active, materials-only control group, and following families over 3 years. We propose four Specific Aims: (1) To use a multi-site randomized- controlled trial to examine whether VAP-T participation increases parent advocacy ability (i.e. the intervention target); (2) To test whether participating in the VAP-T leads to improved youth outcomes (employment, post- secondary education, social participation, service access) during the transition to adulthood; (3) To examine which aspects of parent advocacy ability mediate the relations between VAP-T participation and youth outcomes; and (4) To explore moderators of treatment response and barriers to participation in the intervention. By rigorously testing a new intervention to improve the transition to adulthood for youth with ASD, the proposed research addresses an area of critical need as identified by the 2016-7 Interagency Autism Coordinating Committee Strategic Plan. The project will result in a new intervention to improve outcomes for youth with ASD that can be disseminated through state and local agencies across the nation.