Transcript Working with Others Skills - The POP Lab

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A Transition Support Program for young adults with
Autism Spectrum Disorders: Preliminary
results from a quasi-RCT
Keeley White, MA, Tara Flanagan, PhD & Aparna Nadig, PhD
McGill University
Abstract
Table 1. Participant Characteristics
Variable
The difficulties characterizing Autism Spectrum Disorder
(ASD) are often associated with childhood; however, ASD is
a lifespan diagnosis that continues to impact opportunities in
the community (Graetz, 2010). There is a significant gap in
knowledge of and transition support for adults on the
spectrum, which has grave consequences for individuals and
their families (Howlin et al., 2004) and for society given the
financial burden of long-term care (Ganz, 2007).
In this study we assessed the effectiveness of our 10-week
Transition Support Program focused on communication,
self-determination, and working with others skills. Eight
young adults with a high functioning ASD between 18 and 30
years old participated in the study. A self-report questionnaire
was used to assess their needs and skills in the three target
domains pre- and post-program. Qualitatively, participants
reported lower skills before the program across the three
domains, followed by medium to high skills post-program.
Overall, participants found the program to be informative and
a positive experience.
Introduction
M
SD
18.75
Age
1.035
Min
18
Results
Max
20
Verbal IQ (WASI) *
110.50
17.992
85
136
Nonverbal IQ
(Raven’s Matrices) **
61.38
25.247
36
95
Working with Others
 Good attendance rates, with a mean of 84% attendance
over the 10 week program across the two cohorts.
 Participants reported lower skills before the program
across the three domains, followed by medium to high
skills post-program.
Note: * Standard Score ** Percentile
Pre-Skills Level
6
5
4
3
 Overall, low average to very superior verbal IQs and
average to superior nonverbal IQs
 All participants were either entering or attending college
(post high school) or university
 Only 2 participants had part-time jobs
Social Communication
2
1
Pre-Skills Level
7
0
Public vs Priv
Procedures
Self-determination Skills
 Defined as acting as the primary causal agent in one’s life
and making choices that affect quality of life (Wehmeyer,
2007)
 Recognized as a modality to facilitate better quality of life
and transitional outcomes, such as employment,
independent living and community involvement (Hendricks &
Wehman, 2009)
Working with Others Skills
 Peer relationships and the work social environment can be
especially challenging for individuals with ASD
Participants
Electronic
7
3
6
 The program was implemented in Montreal, Quebec,
Canada.
 Prior to the session we conducted an intake interview with
inclusion measures (NVIQ, language level, ASD
diagnosis), a needs assessment and a self-report of skill
level across the three domains.
 The Transition Support Program curriculum includes
three domains with five modules each:
2
5
4
1
3
0
Initiating
Listening
Perspective
Impression
Sarcasm
2
Non-verbal
1
Post-Skills Level
0
Public vs Priv
7
Conflict
Partners
low skill
6
Big Picture
med skill
Contributions
Electronic
high skill
 Self-reported qualitative changes in knowing your context
and in what makes good partners
 Percentage of change: 100% decrease in low skills;
33.3% increase in medium skills; 76.5% increase in high
skills.
3
2
1
Social'
Communication'
Self/
Determination'
Working'with'
Others'
0
Initiating
Listening
Perspective
low skill
Initiating'
Preferences,'
Interests,''
and'Strengths'
Knowing'your''
Context'
'
Problem-Solving'
What'makes''
Good'Partners'
'
'
Listening'
'
Impression
med skill
Sarcasm
high skill
 Self-reported qualitative changes in initiating, perspective
taking, impression making, and sarcasm
 Percentage of change: 100% decrease in low skills; 12%
decrease in medium skills; 100% increase in high skills
Self-Determination
Making'an''
Impression'
Self-Advocacy'
'
Preventing'and''
Resolving'Conflict'
'
Pre-Skills Level
7
Perspective''
Taking'
Self-Regulation'
'
Getting'the''
Bigger'Picture'
'
Discussion
Non-verbal
6
 Participants reported greater skills post-program across the
three domains, with the largest gains observed in socialcommunication skills.
 Self-reported skill level may not accurately reflect the
changes in social, communication and self-determination
skills post program.
 More objective and long term outcome measures are
required.
 Our focus on a myriad of social, communication and selfdetermination skills will provide young adults with ASD with
the tools to gain access to community, educational and
employment opportunities in adulthood.
5
Non-Verbal'
Communication'
Choice-Making'
'
Teamwork'
'
 Curriculum modules were selected according to the
expressed needs of the participants.
Future Directions
4
3
2
1
0
Domain
Social
Communication
Cohort 1
Prob solving
Cohort 2
Initiating, Perspective
Initiating, Impression
Taking & Impression Making Making, Listening,
Perspective Taking
SelfDetermination
Sensory, Self-Advocacy,
Choices & Problem Solving
Self-Regulation & Choice
Making
Working with
Others
Conflict & Partners
Conflict, Partners &
Teamwork
Sensory
Choices
Self Advocacy
Interests
Resources
Post-Skills Level
8
7
6
5
 We will continue to recruit 32 young adults with ASD using
a “staggered enrollment trial,” a variant of an RCT, to more
comprehensively test the effectiveness and social validity
of our program.
 Objective outcome measures will be employed, including
social problem solving stories, quality of life and selfdetermination measures.
 Content specific assessment questions will be included
within each module.
4
3
References
2
Eight young adults (1 female, 7 males) between 18 and 30
years old (M = 19, SD = 1.035), who met criteria for an ASD
based on the Social Communication Questionnaire (SCQ;
Rutter, Bailey, & Lord, 2003) participated in the transition
support program. The 8 young adults participated in 2
separate cohorts of 4 people.
Big Picture Contributions
8
4
4
Communication Skills
 Social communication is a central area of challenge
 In adulthood, these difficulties may exacerbate or lead to
problems with friendships, romantic relationships, daily living
and vocational success.
Partners
Post-Skills Level
5
5
The childhood focus in autism research and intervention
renders many young adults without proper support in crucial
outcome areas, such as independence and life skills
(Burgess & Gutstein, 2007). Given increased identification of
ASD in recent years, the growing population of young adults
with ASD is faced with financial concerns, unemployment,
social inclusion and community involvement difficulties, and
a lack of services designed to meet their specific needs. Our
Transition Support Program was developed to cater to
participants’ self-expressed needs in communication, selfdetermination and working with others skills, which have
been associated with better quality of life.
Conflict
6
 The young adults participated in the 10-week Transition
Support Program (2-hour per week in a group session with
4 participants, led by two facilitators)
 Participants completed a post-program evaluation and
self-report of their skill level across the three domains.
 “For each of the areas listed below, please circle the
response that best represents your skills in the area
(low, medium, high).”
1
0
Prob solving
Sensory
low skill
Choices
med skill
Self Advocacy
Interests
Resources
high skill
 Self-reported qualitative changes in self-regulation, selfadvocacy, and resources.
 Percentage of change: 86% decrease in low skills; 15%
decrease in medium skills; 14.3% increase in high skills.
 Burgess, A. F., & Gutstein, S. E. (2007). Quality of life for people with autism: Raising the
standard for evaluating successful outcomes. Child and Adolescent Mental Health, 12, 8086.
 Hendricks, D. R. & Wehman, P. (2009). Transition from school to adulthood for youth with
autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24,
77-88.
 Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcomes for children with
autism. Journal of Child Psychology and Psychiatry, 45, 212-229.
 Ganz, M. L. (2007). The lifetime distribution of the incremental societal costs of autism.
Archives of Pediatrics and Adolescent Medicine, 161, 343-349.
 Wehmeyer, M. L. (2005). Self-determination and individuals with severe disabilities:
Reexamining meanings and misinterpretations. Research and Practice in Severe
Disabilities, 30, 113-120.
This project would not have been possible without funding from the Max Bell Foundation and the participants in this study.