Examining the Efficacy of the T-STEP
Condition: Autism Spectrum Disorder
MeSH terms: Autism Spectrum Disorder
Study type: Interventional

Summary: 
      The objective of this study is to evaluate the TEACCH School Transition to Employment and
      Post-Secondary Education (T-STEP) Program. Through randomized assignment young adults (18-21
      year-old) with ASD will participate in the full T-STEP Program or a counseling only
      condition. Effectiveness will be assessed by caregiver report (social communication,
      executive function, employment readiness), self-report (self-determination, coping,
      depression), and behavioral observation (i.e., a mock employment experience). The long-term
      impact of this intervention is to promote a more positive quality of life for young adults
      with high functioning ASD including increased postsecondary education completion, employment,
      self-determination, and decreased difficulties with coping and depression.
    

Detailed description: 
      The purpose of the proposed study is to conduct an alternative treatment randomized clinical
      trial (RCT) to examine the efficacy of the TEACCH School Transition to Employment and
      Postsecondary Education (T-STEP) Program, a 12-week transition intervention targeting
      specific challenges that young adults with ASD experience in executive function, social
      communication, and emotion regulation including group intervention, internship, and
      counseling services, compared to counseling services only. The investigator predicts that the
      full T-STEP program (community college course, internship, counseling) will lead to improved
      short-term and long-term outcomes compared to counseling services only.

      One cohort will be conducted per semester at two different community colleges with the
      specific semester counterbalanced across years. Each site will run one to two cohorts per
      year. The study will be conducted for three years. Students will be enrolled in the study
      after screening inclusion criteria have been met.

        1. Screening. After contact, initial eligibility criteria will be confirmed during a phone
           screening documenting age, previous diagnosis of ASD, and completion, or in the final
           year of completing, a high school diploma.

        2. Pre-Assessment. Young adults and caregivers will complete an assessment at their
           regional community college or via video visit (depending on COVID-19 restrictions) to
           verify eligibility. Following verification students will be randomized to the T-STEP
           Comprehensive intervention or the Counseling Only intervention.

           The statistician will use a random number generator to assign participants to the T-STEP
           Comprehensive intervention condition or the Counseling Only condition. The statistical
           consultant will use a random number generator to assign participants to the T-STEP
           Comprehensive intervention condition or the Counseling Only condition. Assignment will
           be made separately at each site and with equal numbers assigned to each condition. This
           will ensure that equal numbers of participants are assigned to each condition across
           sites per year.

        3. Baseline. Baseline assessments are estimated to take 2 hours (1 hour for behavioral
           measures; 1 hour for self-report paper and pencil measures). Caregiver measures are
           estimated to take 1 to 1.5 hours. Assessments will take place on the community college
           campus or via video visit (depending on COVID-19 restrictions).

        4. Intervention. Both treatment conditions will be offered free of charge through our
           partnership with participating community colleges. Participants in both groups will
           complete 12-weeks of treatment as described below. All sessions will occur at regional
           community college campuses via video sessions, or via a hybrid approach with some
           sessions virtually and some sessions on campus (depending on COVID-19 restrictions).

           T-STEP Intervention Condition. The T-STEP is a comprehensive 12-week transition program
           that will be delivered in a community college setting. The curriculum includes 36 hours
           of group-based instruction delivered within a traditional school academic semester
           (i.e., 24 ninety-minute classes across 12 weeks). Students also participate in a weekly
           community-based internship to practice the skills learned in the intervention group (2
           hours per week for 12 weeks). In addition, students participate in 12 hours of
           manualized individual counseling services that are traditionally available on a college
           campus (e.g., job exploration/career counseling, academic counseling, and self-advocacy
           counseling).

           Counseling Only Intervention Condition. Participants in the Counseling Only condition
           will receive the same manualized counseling sessions that are included in the T-STEP
           program described above. Specifically, 12 hours of individual counseling focused on job
           exploration/career counseling, academic counseling, and self-advocacy counseling.

        5. Post-Intervention (Post-Test) & Follow-Up. Participants in both conditions will complete
           post-assessments immediately following treatment and a follow-up assessment 4 months
           (week 28) after finishing the treatment. All assessments will take place on the
           community college campus or via video visit (depending on COVID-19 restrictions). Both
           assessments will take approximately 2 hours to complete by students with ASD and 35
           minutes to complete by caregivers. Assessments will be completed by research assistants
           who are unfamiliar to participants.
    

Intervention name(s): TEACCH School Transition to Employment and Postsecondary Education (T-STEP); Counseling Services Alone
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The T-STEP Program is a 12-week transition intervention targeting specific challenges that young adults with ASD experience in executive function, social communication, and emotion regulation including group intervention, internship, and counseling services; The Counseling Services Alone Intervention will receive 12 hours of individual counseling focused on job exploration/career counseling, academic counseling, and self-advocacy counseling.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The statistician will use a random number generator to assign participants to the T-STEP Intervention condition or the Counseling Only Intervention condition. Assignment will be made separately at each site and with equal numbers assigned to each condition. This will ensure that equal numbers of participants are assigned to each condition across sites per year.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Transition; High-Functioning; Social Skills; Executive Functioning; Self-Advocacy; Higher Education; Career Exploration