Clinical trial NCT02439671: Transition Support Program for Young Adults With Autism Spectrum Disorders
Official title: A Service Delivery Model to Better Support Young Adults With Autism Spectrum Disorders in the Transition From School to the Community
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Autism Spectrum Disorder
Keywords: Transition Support Program for young adults
Lead sponsor: McGill University
Sponsor class: OTHER
First posted: 2015-05-12
Enrollment: 34
Sex: ALL
Minimum age (years): 18
Maximum age (years): 30
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study investigates a service delivery model to better support young adults with autism spectrum disorders (ASD) in the transition from school to the community. The effectiveness of the "McGill Transition Support Program", a small-group format intervention (meeting once a week for 2 hours over 10 weeks) focusing on communication, self-determination and working with others skills, is measured by multiple pre- and post-program-assessments in a "staggered enrollment trial", a variant of a randomized controlled trial (RCT).

Detailed description: 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. There is currently a very significant gap in support services for young adults with ASDs that has grave consequences both for individuals and their families in terms of vocational success and social inclusion and for society as a whole in terms of the financial burden of long-term adult care.

Individuals on the higher end of the autism spectrum do not have intellectual disability and possess good language skills. Yet they often show significant difficulty with applying their skills during demanding social interactions, which is detrimental to their ability to form relationships and navigate interactions in the workplace. In the few studies of outcomes of adults with ASD it is reported that fewer than 5% of adults at the highest end of the spectrum were living independently and only 12% were employed viably. This underscores the tremendous need for targeted services for young adults with ASD without intellectual disability.

The McGill Transition Support Program was developed to target participants' self-expressed needs in communication, self-determination and working with others skills, which have been associated with better quality of life. Besides the intake, pre- and post-program measures sessions, the participants, aged 18 - 30 years, take part in ten 2-hour group meetings. The study design has been termed a "staggered enrollment trial", that is participants were randomly assigned to take part in the program in the next available cycle or to the waiting list for a subsequent cycle. Pre- and post-program assessment include social problem solving stories, quality of life and self-determination measures, a communication task and a needs and skills questionnaire.

Eligibility criteria: Inclusion Criteria:

* proficient and able to communicate in English
* between the ages of 18 and 30 years upon entering the study
* ASD classification according to scores on either or both the Social Communication Questionnaire-Lifetime (SCQ) and the Autism Diagnostic Observation Schedule-2 (ADOS-2, Module 4 revised algorithm)
* Either or both non-verbal IQ, assessed by Raven's Progressive Matrices, or verbal IQ assessed by Wechsler Abbreviated Scales of Intelligence, verbal subtests, in the normal range

Exclusion Criteria:

* current enrollment in another similar transition support service, that is, a group-format service that has the goals of improving the areas of social interaction and communication, self-determination and advocacy, and working with others skills

Primary outcomes:
measure: Change in Social problem-solving task (Channon & Crawford, 2010)
timeFrame: 4-6 weeks prior to session, 4-6 weeks after session
measure: Change in Arc's Self-Determination Scale (SDS; Wehmeyer & Kelchner, 1995)
timeFrame: 4-6 weeks prior to session, 4-6 weeks after session, and 12 month follow-up post-Program
measure: Change in Quality of Life Questionnaire (Shalock & Keith, 1993)
timeFrame: 4-6 weeks prior to session, abridged version: 4-6 weeks after session and 12 month follow-up post-Program
Secondary outcomes:
measure: Curriculum-specific workbook questions
timeFrame: every week for 9 weeks at the end of group intervention meetings
measure: Participant Program Evaluation Survey (Flanagan & Nadig, 2012)
timeFrame: 4-6 weeks after Program and 12 month follow-up post-Program
measure: Parent Program Evaluation Survey (Flanagan & Nadig, 2012)
timeFrame: 4-6 weeks after Program
measure: Questionnaire on vocational, educational and living situation outcomes
timeFrame: 12 month follow-up post-Program
measure: Communication task (Nadig, Vivanti, & Ozonoff, 2009)
timeFrame: 4-6 weeks prior to session, 4-6 weeks after session
Other outcomes:
Locations:
city: Montreal
country: Canada
facility: McGill University
state: Quebec
Study officials:
affiliation: School of Communication Sciences and Disorders, McGill University
name: Aparna Nadig, Ph.D.
role: PRINCIPAL_INVESTIGATOR
affiliation: Department of Educational and Counselling Psychology, McGill University
name: Tara Flanagan, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Nadig A, Vivanti G, Ozonoff S. Adaptation of object descriptions to a partner under increasing communicative demands: a comparison of children with and without autism. Autism Res. 2009 Dec;2(6):334-47. doi: 10.1002/aur.102.
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citation: Flangan T, Nadig A. Transition Support Needs Assessment. 2012
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citation: Lord C, Rutter M, DiLavore PC, Risi S. Autism Diagnostic Observation Schedule (ADOS). 1999. Los Angeles, CA: Western Psychological Association.
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citation: Schalock R, Keith K. Quality of Life Questionnaire. 1993, 2004 Revision. Worthington, OH: IDS Publishing.
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citation: Wehmeyer ML. Student self-report measure of self- determination for students with cognitive disabilities. Education and Training in Mental Retardation and Developmental Disabilities. 1996;31:282-293.
citation: Wehmeyer ML, Kelchner K. The Arc's Self-Determination Scale. 1995. Arlington, TX: Arc National Headquarters.
citation: Nadig A, Flanagan T, White K, Bhatnagar S. Results of a RCT on a Transition Support Program for Adults with ASD: Effects on Self-Determination and Quality of Life. Autism Res. 2018 Dec;11(12):1712-1728. doi: 10.1002/aur.2027. Epub 2018 Nov 19.