Maximizing Adolescent Post-Secondary Success: Development and Refinement of a Novel Intervention for Parents of Youth with ASD

Background: Adolescence is a critical time during which families of adolescents with autism spectrum disorder (ASD) plan and prepare for the future. Recent evidence suggests that parents’ expectations during adolescence act as significant mediators of key outcomes for adults with ASD (Kirby, 2016). Studies have also found that higher expectations for the future and higher parental self-efficacy are associated with more family engagement in positive post-secondary preparation activities (e.g., social activities, volunteer work/employment, parent-youth discussions about the future, working toward goals; Holmes et al., under review).

Objectives: To develop and refine a novel intervention to provide support for parents of youth with ASD, focused on increasing positive post-secondary preparation activities by addressing parents’ expectations and self-efficacy related to preparing youth for adulthood.

Methods: As part of the intervention development process, we followed 15 parent-youth dyads (youth with ASD and without intellectual disability) over nine months to understand day-to-day concerns and approaches to preparing for adulthood. Informed by that preliminary work, published empirical findings, and psychological theories (i.e., self-efficacy theory, expectancy-value theory), we developed a five-week group intervention: Maximizing Adolescent Post-Secondary Success (MAPSS). An interdisciplinary research team collaborated throughout the MAPSS intervention development process. We then recruited families to participate in a first iteration of the program (n=4 mothers of youth with ASD and their sons, ages 14-16). Sessions were 90 minutes per week for five weeks and included a concurrent life skills group for the youth with occasional interaction with parents (e.g., during weekly goal setting). Parent participants were required to be a primary caregiver of an adolescent (ages 14-18 years) with ASD in high school and anticipating receipt of a high school diploma. Upon completion, we collected participant feedback about the program. The primary outcome measure was the Transition Preparation Activities Measure (T-PAM; Kirby, n.d.), secondary measures included the Competency factor of the Family Empowerment Scale (Koren et al., 1992) and Adulthood Expectations Questionnaire (AEQ; Kirby, n.d.), all of which were administered at baseline and at program completion.

Results: Seventy-five percent of participants remained in the program (n=1 dropped out due to a family emergency, but completed an exit interview to provide feedback). Table 1 contains summary participant feedback about the program. Pre- and post-study T-PAM results supported the primary hypothesis. After the five-week program, overall preparation rating increased 13%, overall worry for the future rating decreased 12%, and endorsement of preparation activities increased 7%. No notable changes were identified on the secondary measures.

Conclusions: Results of the first iteration of the MAPSS group suggest it was well-received by participants and provided appropriate content. We did see modest improvements in primary outcome measures but not in secondary measures; the team is reviewing appropriateness of secondary measures as well as adjustments to the content to more effectively target those outcomes. Participant suggestions for improvement included expanding the content focused on adolescent motivation and incorporating more parent-youth combined activities, which will be explored prior to further pilot testing. Future research will include measuring long-term outcomes (i.e., post-secondary outcomes).