The Transition to Secondary Education for Young People with Autism Spectrum Disorder (ASD): A Controlled Trial of the Systemic Transition in Education Programme for ASD (STEP-ASD)

Friday, May 15, 2015: 3:30 PM
Grand Ballroom B (Grand America Hotel)
W. Mandy1, M. Murin2, O. Baykaner2, J. Hellriegel3, S. Staunton4, S. Anderson5 and D. H. Skuse6, (1)Behavioural and Brain Sciences Unit, UCL Institute of Child Health, London, United Kingdom, (2)Great Ormond Street Hospital, London, United Kingdom, (3)UCL, london, United Kingdom, (4)Institute of Child Health, Dublin, Ireland, (5)Behavioural and Brain Sciences Unit, Institute of Child Health, UCL, London, United Kingdom, (6)Institute of Child Health, London, United Kingdom

In most western cultures, the early stages of the transition from childhood to adolescence include a move from primary to secondary education. This is a major ecological shift, characterised by an escalation of the social, emotional, academic and organisational demands made upon an individual. It represents a critical period at the start of adolescence: a successful move to secondary school provides a foundation for meeting future developmental challenges; whereas a failed school transition can trigger difficulties that cascade throughout the teenage years and beyond. No empirical studies have described the school transition for people with autism spectrum disorder (ASD); and no validated interventions exist to manage this crucial moment in the development of people on the autistic spectrum.


To study the transition from mainstream primary to secondary school of young people with ASD; to develop an intervention that promotes good outcomes during school transition; and to estimate the feasibility and efficacy of this intervention.


Over a period of three years, 42 children with ASD (80% male, mean IQ = 85.92, mean age = 11.14 years), were assessed before and after they had made the transition from mainstream primary to secondary school. In the first two years, the young people (n=26) received management as usual (MAU); and focus groups were conducted with children, parents and teachers. On the basis of this information, the Systemic Transition in Education Package for ASD (STEP-ASD) was designed. This is a manualised, ecological intervention: it effects modifications of the school environment, to reduce maladaptation by improving the fit between the individual with ASD and their environment.  In the final year of the study, STEP-ASD was implemented with 16 children with ASD. The primary outcome was Total Problems score of the Strengths and Difficulties Questionnaire (SDQ), by teacher report. Transition trajectories were compared for young people who received STEP-ASD and those who had MAU.


During transition, in the control (MAU) group SDQ scores increased by 0.6 SD, but in the Intervention group they had decreased -5.20 SD (p< 0.01). All results were adjusted for gender, social deprivation score, OFSTED primary and secondary ratings and IQ. No child in STEP-ASD received additional psychiatric or other treatment as a consequence of the intervention. Teachers, children and parents reported high levels of satisfaction with STEP-ASD.


This non-randomised controlled trial suggests that the STEP-ASD approach may reduce difficulties at school for children with ASD as they embark upon adolescence. This shows the value of interventions that seek to reduce maladaptation by taking a manualised approach to modifying the environments in which people with ASD function.