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According to a 2013 study, approximately 17% of autistic adults ages 21 to 25 live independently compared to 34% of their non-autistic peers. Yet, only 5% of autism-related research focuses on transition and adult outcomes, despite the fact that autistic adults have less favorable outcomes with respect to quality of life, employment, and education than their non-autistic peers.

Research-informed transition planning that addresses core impairments in skills needed for autonomous and independent living, including self-knowledge, self-determination, and self-regulation, may improve outcomes for this growing population. In an OAR-funded study, researcher Susan White, Ph.D., professor and director of the Center for Youth Development and Intervention at the University of Alabama, will examine the effectiveness of The Stepped Transition in Education Program (STEPS), to determine its usefulness in building those skills.

STEPS was developed to facilitate the successful transition to adulthood by promoting essential skills for adult autonomy, including self-knowledge, self-determination, and self-regulation. STEPS has been found to improve readiness for the transition from high school and college as well as reduce depression symptoms. In her study, “Improving Outcomes in Autism: Community Implementation of Stepped Transition in Education Program,” Dr. White and her research team will test its effectiveness in a community setting.

Methodology

The research team will partner with the North Georgia Autism Foundation (NGAF), a 501c3 non-profit that provides free community-based autism support and case management to families in nine Georgia counties, to help recruit participants, coordinate the programming, and identify five counselors at its affiliated community agencies as interventionists. The research team will recruit 25 autistic young adults between the ages of 16 and 25 to participate. A parent/caregiver must also participate.

Phase 1: Modifying STEPS for Community Providers

The study is made up of two phases. In Phase 1, a workgroup will modify STEPS for use by community-based providers. In addition to the research team, the workgroup will include autistic youth and their parents as well as NGAF providers and administrators. Over a series of three interactive workshops, the research team will gather feedback from the workgroup on specific STEPS components as well as how to best implement the program, including provider training. The goals of Phase 1 are to:

• Identify needs (e.g., agency staffing, fiscal considerations) that may be specific to community implementation.
• Engage in advance problem solving, such as family engagement and attendance.
• Inform provider training to ensure the rigor of the program is maintained, while being flexible with respect to adaptations that will promote adoption.
• Promote success of the study via stakeholder input on factors such as recruitment, staffing, and support needs.

Phase 2: Implementation

Implementation will begin with a one-day, in-person training for counselors, led by Dr. White and another member of the research team. They will introduce and explain the theoretical basis of STEPS, prior research, the STEPS manual and its implementation, and study design, followed by demonstration, interactive case discussions, and role-play. The research team will also provide consultation to the counselors weekly during the program.

Counselors will work individually in person with participants in 12 sessions over 14 weeks. The sessions will involve didactic and experiential learning of self-knowledge, self-determination, and self-regulation skills, with practices geared toward the client’s goals, such as joining a new group. Throughout the intervention, the counselors will hold brief Zoom or phone checks-ins as needed with the participants to remind them about practices and planned activities related to program goals and to provide encouragement.

Evaluation

Dr. White and her team will use two primary outcome measures: one that measures autonomy, employment (including readiness), social functioning, and satisfaction and another that assesses vocational engagement. Because STEPS participants might be bound for higher education or training, not employment, this outcome is adapted to include actively working toward a degree. In addition, they will use several measures to determine changes in self-knowledge, self-determination, and self-regulation.

Implementation of the program will also be evaluated, through counselor interviews as well as participant and parent surveys and attendance records. Dr. White will also use the counselor interviews to support adaptation and refinement of the programs and its materials.

Outcomes

This research will inform the nature of transition programming for transition-age autistic youth and potentially improve adult outcomes for this growing population. The deployment-based research model will allow the program to be more quickly translated into practice. Given the lack of evidence-based programming designed for this population, the possible impact of this work is substantial.

Sherri Alms is the freelance editor of The OARacle, a role she took on in 2007. She has been a freelance writer and editor for more than 20 years.