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.

项目概要 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 （自闭症谱系障碍）。患有自闭症谱系障碍的青少年和年轻人往往在就业、 受教育程度和生活质量高于正常同龄人。这些结果包括大学入学率不足， 失业和有限的职能独立性。以研究为依据的过渡规划，旨在解决 与成人自主相关的核心技能障碍，包括自我认识、自决和自我认知 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—— 涉及的过渡计划（STEPS：自闭症谱系障碍学生教育计划的逐步过渡）以及 认为该方案可行、可接受且有效。来自小型随机对照试验 (RCT) 的数据 重点关注可行性，表明参与者可以接受，并建议 STEPS 在以下方面是有效的： 提高向成年过渡的准备度。我们现在将测试 STEPS 的有效性和参与度 与四个社区机构合作制定目标机制。这项研究被设计为混合类型 1， 主要关注干预效果，其次关注与以下因素相关的因素： 执行。我们评估即时（治疗后）和长期（六个月随访）临床 成人功能结果和职业参与的结果。我们还将确定程度 哪些步骤导致理论中介机制（即成人自主技能）的变化以及 正式测试调解（即成人自主技能的变化导致成人自主技能变化的程度） 功能结果）。我们将从提供商处寻求有关实施的定性信息，例如 关于 STEPS 文化敏感性的思考，以及关于适当性、可行性和可行性的定量数据 步骤的可接受性。我们还跟踪提供商在六个月内与其客户持续使用 STEPS 的情况 研究注册结束后。这项研究将产生有可能改变临床的发现 与自闭症谱系障碍患者过渡到成年相关的实践。鉴于大约 70,000 自闭症谱系障碍 (ASD) 患者每年都会进入成年期，以及与自闭症谱系障碍 (ASD) 相关的经济负担、潜在的 这项研究对公共健康的影响是相当大的。