A Pilot Test of Adult Social Knowledge (ASK) Workshop: An Intervention to Improve Outcomes in Young Adults with ASD

Friday, May 13, 2016: 11:30 AM-1:30 PM
Hall A (Baltimore Convention Center)
T. Oswald1, L. Gilhooly2, J. B. McCauley3, L. Libero4, R. Hansen5, P. C. Mundy6, A. M. Iosif7, S. J. Rogers4, A. C. Stahmer3, P. Schetter8, S. Ruder8, R. May9 and M. Solomon10, (1)2825 50th Street, University of California at Davis MIND Institute, Sacramento, CA, (2)UC Davis MIND Institute, Davis, CA, (3)University of California at Davis MIND Institute, Sacramento, CA, (4)University of California at Davis, Sacramento, CA, (5)Pediatrics and the MIND Institute, University of California Davis, Davis, CA, (6)Education and Psychiatry, University of California at Davis, Sacramento, CA, (7)Public Health Sciences, University of California Davis, Davis, CA, (8)MIND Institute, UC Davis, Sacramento, CA, (9)Alta California Regional Center, Sacramento, CA, (10)MIND Institute, Sacramento, CA

Adult outcomes are alarmingly poor for people with Autism Spectrum Disorder (ASD). Over 50% of these individuals were not pursuing post-secondary education or gainfully employed in the 2 years after high school (Shattuck et al., 2012). Adults with ASD, compared to other disability groups, have the worst social and vocational outcomes, experience a higher burden of health and mental health issues and report low levels of life satisfaction (Howlin et al., 2004; Taylor & Mailick, 2014). Half a million children with ASD will enter adulthood in the coming decade (CDC, 2014). Services for adults with ASD that assist with this life transition are urgently needed.


To develop and pilot test the curriculum for Adult Social Knowledge (ASK) Workshop—a 19-week, 1 ½ hours/week intervention to improve functional outcomes for young adults with ASD (18-24 years of age). The ASK curriculum was adapted from the Functional Adaptive Skills Training (FAST; Patterson et al., 2006) and the Social Adjustment Enhancement intervention (Solomon et al., 2004), using Android technology, to target three pivotal areas of adult functioning: (1) Planning & Organization, (2) Social Skills & Interpersonal Communication, and (3) Communication in the Work Place & Community Engagement. Parents attended a concurrent support group that also provided information about community resources


Analyses are for nine (2 female) adults with community diagnoses of ASD without intellectual disability. Pre-test and Post-test assessments were conducted using the ASEBA Adult Self-Report (ASR; Achenbach & Rescorla, 2003) subscales of “Attention Problems” (measuring planning and organization problems) and “Depression”, as well as the WHO Quality of Life BREF Self-Report “Social Relationships” subscale (WHOQOL-BREF; WHOQOL Group, 1997). Univariate statistical tests were used. 


A paired samples t-test revealed a statistically significant reduction in planning and organization problems from pre-test (M = 70.13; SD = 12.65) to post-test (M = 65.25; SD = 7.70), based on the ASR Attention Problems subscale, t(7) 2.41, p < .05, with a large effect size (Cohen’s d = .85). Though not statistically significant, a medium effect size (Cohen’s d = .72) was found for the reduction in ASR depression levels from pre-test (M = 66.75; SD = 11.76) to post-test (M = 62.38; SD = 7.96), t(7) 2.05, p = .08. Additionally, a medium effect size (Cohen’s d = .56) for improvements in social relationships as measured by the WHOQOL-BREF were found for pre-test (M = 53.13; SD = 35.06) to post-test (M = 61.46; SD = 28.50), although this was not statistically significant, t(7) = -1.60, p = .15. High levels of satisfaction also were reported by young adults and their parents during a focus group at the conclusion of the trial. 


Given that participants in the ASK Workshop reported fewer planning/organization problems and depressive symptoms and greater social relationships after the intervention and expressed high satisfaction with the program, we are refining the curriculum in preparation for a wait list controlled experimental therapeutics trial, that will test improvements in cognitive control as a mechanism of therapeutic change, to begin shortly.