A Pilot RCT for Adults with ASD: The Interview Skills Curriculum

Background:   Outcomes for adults with ASD indicate low rates of competitive employment, independent living, and friendships; even for those with normal IQ (Howlin et al., 2004). Social-pragmatic deficits are a significant source of impairment for individuals with ASD regardless of cognitive or language ability (Carter et al., 2005) and may serve as a critical target area to improving adult outcomes. This submission presents data from a pilot RCT to test the effects of a job interview skills curriculum for adults with ASD funded by Autism Speaks.

Objectives:  The purpose of this study was to evaluate the effects of the Interview Skills Curriculum’ for young adults with ASD. We hypothesized that adults who receive ISC would show significant gains in targeted social and pragmatic skills between baseline and 6-month follow up.

Methods: Twenty-eight adults diagnosed with ASD were recruited to participate in this research. Participants ranged in age from 18 to 36 years (M = 24.5, SD = 5.2), scored above 70 on an abbreviated test of intelligence (M = 103.0, SD = 14.7), but showed significant deficits on the Vineland Adaptive Behavior Composite (M = 77.4, SD = 11.6). Pairs of participants were matched on cognitive level and randomly assigned to one of two groups: ISC or waitlist control.  ISC is a manualized 12-week, low-intensity group-delivered intervention aimed at increasing social-pragmatic skills essential to the context of the job interview. Mock job interviews conducted pre- and post-treatment served as the primary source of data collection.  Volunteer professionals unknown to the research participants conducted video-recorded mock interviews with scripted questions tailored to match participant career interests.  Interviews were scored by a trained undergraduate coder blind to group assignment and interview timing. Inter-observer reliability was calculated for approximately 20% of the data yielding an average percent agreement of 92.6%

Results: Preliminary analyses (i.e., independent-samples t-tests; Chi-square tests) confirmed that the experimental and control groups were not different at baseline in terms of age, ADOS total scores, the Vineland Adaptive Behavior Composite, IQ scores, performance during the mock interview, or participants’ educational attainment, (p > .50). In addition, key analyses were conducted to evaluate the effect of ISC on gains in the participants’ observed performance during the mock interview. Consistent with recommendations for clinical trials (Fitzmaurice et al., 2004), gains in performance scores were quantified as residual gain scores. Results revealed that the experimental group showed larger gains in mock interview performance than the control group, t (22) = 2.14, p < .05 (large effect size, Glass’s delta = .87). In the experimental condition, mean performance scores increased from 18.75 (SD = 3.6) to 20.75 (SD = 2.8) between pre and post assessments, while the scores in the control condition remained unchanged, 18.79 (SD = 2.55) and 18.83 (3.12), respectively.

Conclusions:  The results of this study indicate that a brief, low-intensity treatment can significantly improve the social-pragmatic skills critical to a successful job interview for young adults with ASD. These findings will be discussed in terms of clinical implications and future research directions.