Facilitating Employment for Youth With Autism
Condition: Autism Spectrum Disorder; Autism; Asperger Syndrome; Pervasive Developmental Disorder; Adolescent Development
MeSH terms: Autistic Disorder; Autism Spectrum Disorder; Developmental Disabilities; Asperger Syndrome
Study type: Interventional

Summary: 
      This study will test the efficacy of a nationally recognized employment training and
      placement program (Project SEARCH) when applied to youth with Autism Spectrum Disorders. It
      is designed to examine a single overall research question:

      Research Question: To what extent does a collaborative, employer-based employment training
      and placement program improve the employment outcomes, need for support, social
      responsiveness, self-determination, and quality of life of young adults with ASD 18-21 served
      in public special education programs?
    

Detailed description: 
      In this project, the investigators propose testing the efficacy of the Project SEARCH model
      that has been successfully implemented for youth with ASD at one site in a 300-bed hospital
      in Richmond, VA. The investigators will accomplish this by continuing the Project SEARCH
      study that has been implemented for youth with ASD and expanding this model to two additional
      sites in Virginia. The investigators also propose expanding the current randomized clinical
      trial protocol to the two new sites. In doing so, the investigators will be able to further
      develop the model while also assessing the strength of the relationship between the
      intervention and outcomes achieved. Additionally, the investigators will identify
      programmatic and individual factors that affect successful employment outcomes as well as
      other critical behaviors that are essential for youth with ASD to exhibit such as
      socialization, communication, independence and self management. Finally, through the proposed
      project the investigators will be able to provide evidence to guide decisions related to
      fidelity of implementation of the components necessary to replicate Project SEARCH for youth
      with ASD.

      Hypotheses: There are one primary and six secondary endpoints under investigation in the
      proposed study: (1) Employment status upon completion of the program, 90 days post
      completion, and 12 months post completion (primary); (2) wage upon completion, 90 days post
      completion, and 12 months post completion; and (3) number of hours worked per week upon
      completion, 90 days post completion, and 12 months post completion. In addition, the effect
      of the intervention on (4) student support needs, (5) social responsiveness, and (6)
      self-determination will be explored. Hypotheses related to these endpoints, or dependent
      variables, include:

        -  Hypothesis I -- Young adults who participate in an employer-based employment training
           and placement program will demonstrate a higher rate of employment than those in the
           control condition.

        -  Hypothesis II -- Young adults who participate in a work-based employment training and
           placement program will earn higher wages on average at project completion compared to
           those in the control condition.

        -  Hypothesis III -- Young adults who participate in a work-based employment training and
           placement program will work more hours per week on average than those in the control
           condition.

        -  Hypothesis IV -- Young adults who participate in a work-based employment training and
           placement program will reduce their need for employment supports compared to those in
           the control condition, as measured by the Employment Subscale of the Support Intensity
           Scale.

        -  Hypothesis V -- Young adults who participate in a work-based employment training and
           placement program will increase their social responsiveness skills compared to those in
           the control condition, as measured by the Social Responsive Scale (SRS-2).

        -  Hypothesis VI -- Young adults who participate in a work based employment training and
           placement program will increase their self-determination skills compared to those in the
           control condition, as measured by the Arc's Self-Determination Scale (Adolescent
           Version).

        -  Hypothesis VII - Young adults who participate in a work based employment training and
           placement program will increase their quality of life compared to those in the control
           condition, as measured by the Quality Metrics Health Outcomes SF-36v2.
    

Intervention name(s): Project SEARCH Plus ASD Supports
Intervention type(s): Behavioral
Intervention description(s): Project SEARCH is an intensive 9-month job training program where youth with developmental disabilities in their last year of high school are embedded in a large community business such as a hospital, government complex, or banking center (Daston et al., 2012). Students with developmental disabilities who participate in this model rotate through three 10-12 week internships within the business where they log approximately 720 hours of internship time learning marketable skills while receiving supported employment. They also get 180 hours of classroom time at the business for a total of approximately 900 hours embedded in the business setting. In addition to these important training components, Project SEARCH requires collaboration between multiple community partners to support students in attaining employment upon completion of the program. Collaborations include students with developmental disabilities and their family, a LEA, a local CRP, the state VR, and a host business.
Other intervention name(s): PS+ASD
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Non-pharmacologic randomized clinical trial and followed the Non-pharmacological Consolidated Standards of Reporting Trials Statement recommendations to conduct the research (CONSORT; Boutron, Altman, Moher, Schulz, & Ravaud, 2017)
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Autism; ASD; Competitive Integrated Employment; Project SEARCH; Outcomes; Support Intensity