Stepped Transition in Education Program for Emerging Adults with Autism: Pilot Effectiveness Trial

新兴成人自闭症教育计划的逐步过渡：试点有效性试验

• 批准号: 10569919
• 负责人: Susan Williams White
• 金额: $ 22.35万
• 依托单位: UNIVERSITY OF ALABAMA IN TUSCALOOSA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569919
• 关键词: Address; Adolescent and Young Adult; Adult; Advocate; Aftercare; Age; Attitude; Behavior; Characteristics; Client; Clinic; Clinical; Clinical effectiveness; Communities; Consolidated Framework for Implementation Research; Cultural Sensitivity; Data; Economic Burden; Education; Educational Curriculum; Effectiveness; Effectiveness of Interventions; Employment; Enrollment; Face; Family; Feedback; Future; Goals; Hybrids; Impairment; Independent Living; Individual; Informal Social Control; Interpersonal Relations; Intervention; Interview; Life; Light; Mediating; Mediation; Methods; Modeling; Occupations; Outcome; Outcome Assessment; Participant; Persons; Population; Practical trial; Preparation; Program Effectiveness; Provider; Public Health; Qualitative Methods; Quality of life; Randomized; Randomized, Controlled Trials; Readiness; Regulation; Reporting; Research; Sampling; Secondary Schools; Self Determination; Self Perception; Site; Social Interaction; Speed; Structure; Students; Testing; Thinking; Training; Translations; Unemployment; Vocation; Vocational rehabilitation; active control; adolescent with autism spectrum disorder; adult with autism spectrum disorder; autism spectrum disorder; clinical practice; college; community clinic; community engagement; contextual factors; design; effectiveness testing; effectiveness trial; emerging adult; evidence base; follow-up; functional independence; functional outcomes; high school; implementation barriers; implementation design; implementation facilitators; implementation/effectiveness; impression; improved; improved outcome; individuals with autism spectrum disorder; informant; peer; post implementation; post intervention; primary outcome; programs; self reliance; services as usual; skill acquisition; skills; stakeholder perspectives; success; teleconsultation; young adult; young adult with autism spectrum disorder

PROJECT SUMMARY The long-term goal of this research is to improve adult outcomes for people with autism spectrum disorder (ASD). Adolescents and young adults with ASD tend to have worse outcomes, with respect to employment, education, and quality of life, than neurotypical peers. These outcomes include under-enrollment into college, unemployment, and limited functional independence. Research-informed transition planning that addresses core impairments in skills related to adult autonomy, including self-knowledge, self-determination, and self- regulation, may improve outcomes for this growing population. In prior research, we developed a stakeholder- involved transition program (STEPS: Stepped Transition in Education Program for Students with ASD) and found it to be feasible, acceptable, and efficacious. Data from a small randomized controlled trial (RCT) focusing on feasibility indicated that it was acceptable to participants and suggested STEPS was effective in improving readiness for transition to adulthood. We will now test the effectiveness of STEPS, and engagement of target mechanisms, in partnership with four community agencies. This study is designed as a Hybrid Type 1, which focuses primarily on intervention effectiveness with a secondary focus on factors related to implementation. We assess the immediate (post-treatment) and longer-term (six month follow-up) clinical outcomes of adult functional outcomes and vocational engagement. We will also determine the degree to which STEPS leads to change in the theoretical mediating mechanisms (i.e., adult autonomy skills) and formally test mediation (i.e., the degree to which change in adult autonomy skills leads to change in adult functional outcomes). From the providers, we will seek qualitative information on implementation such as thoughts on STEPS’ cultural sensitivity, and quantitative data on the appropriateness, feasibility, and acceptability of STEPS. We also track providers’ sustained use of STEPS with their clients in the six months after study enrollment has ended. This research will produce findings that have the potential to shift clinical practice related to transition to adulthood for people with ASD. In light of the fact that approximately 70,000 people with ASD age into adulthood every year and the economic burden associated with ASD, the potential public health impact of this research is considerable.

项目摘要 这项研究的长期目标是改善自闭症谱系障碍患者的成年结局 （ASD）。患有ASD的青少年和年轻人在就业方面往往有更糟糕的结果， 教育和生活质量，比神经正常的同龄人。这些结果包括大学入学率不足， 失业和有限的功能独立性。以研究为依据的过渡规划， 与成人自主性相关的技能的核心障碍，包括自我认识，自我决定和自我 监管，可能会改善这一不断增长的人口的结果。在之前的研究中，我们开发了一个利益相关者- 参与过渡计划（STEPS：ASD学生教育计划的分步过渡）， 发现它是可行的，可接受的，有效的。来自小型随机对照试验（RCT）的数据 强调可行性的研究表明，参与者可以接受STEPS，并认为STEPS在以下方面是有效的： 提高向成年过渡的准备程度。我们现在将测试STEPS的有效性， 目标机制，与四个社区机构合作。本研究被设计为混合1型， 它主要关注干预的有效性，其次关注与以下方面有关的因素： 实施.我们评估了即刻（治疗后）和长期（6个月随访）临床 成人功能成果和职业参与的成果。我们还将确定 该步骤导致理论中介机制的改变（即，成人自主能力）和 正式测试中介（即，成人自主技能的变化在多大程度上导致成人 功能性成果）。我们将从供应商那里寻求有关实施情况的定性信息，例如 对STEPS文化敏感性的思考，以及关于适当性、可行性和 步骤的可接受性。我们还跟踪供应商在六个月内与客户持续使用STEPS的情况 研究入组结束后。这项研究将产生的发现，有可能改变临床 与ASD患者向成年过渡有关的实践。鉴于大约有7万人 ASD患者每年都会进入成年期，与ASD相关的经济负担， 这项研究对公众健康的影响是相当大的。