A Peer-mediated Vocational Social Skills Program for Young Adults With Autism
Condition: Autism Spectrum Disorder High-Functioning
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      The Assistive Social Skills and Employment Training program (ASSET) is an
      occupationally-based, work-related social skills intervention, designed to address the
      pre-employment and mental health needs of young adults with high-functioning autism in
      school-to-work transition. Knowing that occupational therapy (OT) services designed to
      address the post-secondary transition needs of this population have been largely unexplored,
      and recognizing the need for OT students to gain practical experience facilitating
      psychosocial groups, this study seeks to: (1) evaluate program impacts on participants'
      psychosocial functioning and work readiness, and (2) pilot the use of OT students as group
      facilitators. The study will follow a mixed-methods, single group design, using
      questionnaires and interviews to assess skills, confidence, and psychological wellness before
      intervention, immediately after, and at follow-up. OT students will also be interviewed and
      complete pre- and post-intervention assessments of clinical self-efficacy and stress. This
      project supports the AOTF's objectives by: (1) building OT academic program capacity to
      partner with university services and the autism community to improve transition outcomes in
      an underserved group, (2) laying the groundwork for larger, more rigorous studies of ASSET's
      effectiveness, and (3) gathering pilot data to support future grant applications at the
      federal level.
    

Detailed description: 
      There are two specific aims of this study. First, researchers will test the effects of the
      ASSET Program on: (a) improving social function, work-related social skills, and
      self-efficacy (primary outcomes), and (b) psychological wellness (secondary outcome) using a
      quasi-experimental, single group, time series design. Secondly and concurrently, researchers
      will collect pilot data on the "near peer" mediation aspects of the intervention from the
      perspectives of OT students and ASSET group participants. Specifically, researchers will
      measure occupational therapy student facilitators' perceived stress, clinical self-efficacy,
      and educational value of the experience; and collect data on ASSET participants' ratings of
      the quality of the facilitation as delivered by occupational therapy graduate students.

      Design: Using a quasi-experimental, repeated time series design, this convergent parallel
      mixed-methods pilot study will use quantitative data to measure change in primary and
      secondary outcomes, while qualitative data (session feedback forms, pre/post/follow-up
      interviews) will be collected in order to compare or relate themes to the quantitative
      findings. Building from the results of our earlier work using professional facilitators, the
      following two aims will be examined. Psychometric properties of instruments are available in
      the Appendices.

      AIM 1: Evaluate the effects of the ASSET program on the social function, work-related social
      skills knowledge, confidence (primary outcomes) and psychological wellness (secondary
      outcomes) of a group of college students with HFASD immediately after the 13-week
      intervention delivered by graduate students and at 3-month follow-up.

      Research Questions and Hypotheses:

      Q1: Is ASSET associated with improvements in work-related social skills knowledge, social
      function, and social self-efficacy when facilitated by OTS? H1: Immediately post
      intervention, on average, ASSET participants will show statistically significant improvements
      in primary outcomes (work-related social skills knowledge, social function, and social
      self-efficacy).

      H2: At three-month follow-up, on average, ASSET participants will show declines in primary
      outcomes, yet scores will remain above baseline and at statistically significant levels.

      H3: Immediately post intervention, on average, ASSET participants will show clinically
      significant improvements in secondary mental health outcomes (anxiety and depression);
      however, these gains may not reach the level of statistical significance.

      H4: At three-month follow-up, on average, ASSET participants will show continued improvements
      in secondary mental health outcomes (anxiety and depression), with improvements in anxiety
      reaching a level of statistical significance when compared to baseline.
    

Intervention name(s): Assistive Soft Skills & Employment Training (ASSET)
Intervention type(s): Behavioral
Intervention description(s): The ASSET curriculum covers six key social skill areas: (a) Communication; (b) Networking; (c) Attitude & Enthusiasm; (d) Teamwork; (e) Problem Solving & Critical Thinking; and (f) Professionalism, as well as new content added based on our pilot findings (Mental Health; Stress Management and Self-Advocacy; and Awareness of Self & Others). The schedule includes two sessions for Communication and Professionalism, and a graduation session; thus, bringing the total number of sessions to 13. The structural elements of the training format include didactic lecture, experiential activities, group discussions, role-plays, performance feedback,and weekly take-home assignments. A key element is a social hour following each 90-minute session, in which participants practice learned skills while sharing a meal.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: vocational rehabilitation; Mental health; social skills; employment