An Assessment of Needs to Guide a Transition Support Program for Young Adults with ASDs

Background:

There is a very significant gap in support services for young adults with Autism Spectrum Disorders (ASDs). Lack of support in the transition between secondary school and adulthood may have consequences both for individuals with ASDs and their families in terms of employment and social inclusion (Howlin, 2005). As Burgess and Gutstein (2007) highlight, the proliferation of ASD diagnoses has not been met with an increased interest in the lifespan development of persons with ASDs nor in their quality of life (QOL) which may leave many adolescents and young adults without proper support and scaffolding in other crucial outcome areas associated with successful transitions into adulthood (McGovern & Sigman, 2005).

Objectives:

To establish participant needs in the creation of a transition support program for young adults with ASDs. To explore the use of QOL as a possible outcome measure of intervention with young adults on the spectrum.

Methods:

Participants in this pilot phase of an RCT transition support program were 6 young adults (3 females) on the ASD spectrum, aged between 18 and 30 (M = 23, SD = 2.97), who all met criteria for an ASD based on the Social Communication Questionnaire (SCQ; Rutter, Bailey, & Lord, 2003) and the Autism Diagnostic Observation Schedule(ADOS; Lord, Rutter, DiLavore, & Risi, 1999).

Participants completed a needs assessment questionnaire and the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993). The needs assessment questionnaire consisted of open-ended and Likert-type questions regarding desired topics, instructional strategies, learning styles, and assessments of needs and skills (low, medium, high) in the areas of communication, self-determination and working with others. The QOL.Q has 4 subscales: Satisfaction, Competence/Productivity, Empowerment/Independence, and Social Belonging/Community Integration and scores are combined into an overall QOL score.   

Results:

In response to the open-ended questions, participants reported interest in learning more about decision-making processes, managing change or unexpected situations, managing social interactions in the workplace, and exploring interests. Most reported learning best in small groups, in quiet environments, through the visual modality and through hands-on approaches such as role-playing. The participants mostly reported mid range skills and needs in the areas of communication, self-determination, and working with others. But, self-determination skills were mentioned in the high needs category by 50% of the participants.

The program curriculum was tailored to the group based on the results from the needs assessments, and the material was differentiated accordingly. The 6 young adults then participated in weekly two-hour small group sessions for ten weeks. QOL assessments were completed pre and post program. The pre-program QOL scores varied among the participants though all were commensurate with or higher than the scores reported for the norming sample. The pre/post QOL patterns seem highly nuanced and are explored further in a figure.

Conclusions:

The results from this pilot study point to the utility of data from needs assessments for interventions and for more accessible curricula for young adults on the spectrum. QOL as an intervention outcome needs further exploration but has implications for transition programs.