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