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

项目总结 这项研究的长期目标是改善自闭症谱系障碍患者的成人结局。 (ASD)。在就业方面，患有自闭症的青少年和年轻人的结局往往更差， 受教育程度和生活质量都高于神经型同龄人。这些结果包括大学入学人数不足， 失业，以及有限的职能独立性。以研究为基础的过渡规划，解决 与成人自主有关的技能的核心障碍，包括自我认识、自我决定和自我评价 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：针对自闭症学生的阶段性过渡教育计划)和 认为这是可行的、可接受的和有效的。一项小型随机对照试验(RCT)的数据 对可行性的关注表明，参与者可以接受它，并建议的步骤在 改善向成年期过渡的准备情况。我们现在将测试步骤和参与度的有效性 与四个社区机构合作，建立目标机制。这项研究被设计为杂交类型1， 主要关注干预效果，其次关注与以下因素相关的因素 实施。我们评估即刻(治疗后)和长期(6个月随访)的临床 成人功能结果和职业投入的结果。我们还将确定达到的程度 哪些步骤导致理论中介机制(即成人自主技能)的变化 正式测试中介(即，成人自主技能的变化导致成人变化的程度 功能结果)。我们将从供应商那里获取有关实施的定性信息，例如 关于STEP的文化敏感性的思考，以及关于STEP的适当性、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STEP的情况 在学习注册结束后。这项研究将产生有可能改变临床情况的发现 自闭症患者向成年期过渡的相关实践。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、潜力 这项研究对公共卫生的影响是相当大的。

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.