Evaluation of the BOOST-a Transition Planning Program for Adolescents on the Autism Spectrum: Quasi-Randomised Controlled Trial and Process Evaluation

Background: The Better OutcOmes & Successful Transitions for Autism (BOOST-A^TM) is an online, autism-specific, transition planning program that prepares students for leaving school. The program was developed as the majority of existing transition planning programs are focused on people with a disability in general and may not meet the specific need of adolescents on the autism spectrum. In addition, there are methodological limitations to many of the studies determining their effectiveness.

Objectives: A quasi-randomized controlled trial was conducted to evaluate the effectiveness of BOOST-A^TM in enhancing self-determination. In addition, a process evaluation was conducted to determine the effectiveness, usability, and barriers and facilitators to using BOOST-A^TM.

Methods: Participants were adolescents on the autism spectrum enrolled in Years 8 to 11 in Australian schools (N=94). Participants were blinded to the trial hypothesis and were allocated to a control (n=45) or intervention (n=49) group. Over a 12 month period, the intervention group used BOOST-A^TM while the control group engaged in regular practice. The primary outcome was self-determination and secondary outcomes included career planning and exploration, quality of life, environment support, and domain specific self-determination. Data were collected from parents and adolescents. A process evaluation was conducted after the trial to allow adolescents on the autism spectrum (n=33) and their parents (n=39) from the intervention group to provide feedback via an online questionnaire. Of these, 13 participants were interviewed to gain further in-depth information about their experiences using BOOST-A^TM. Data were analysed using descriptive statistics and thematic analysis.

Results: No significant differences were found in overall self-determination between groups. Significant differences in favor of the intervention group were found in three areas: opportunity for self-determination at home (parent report); career exploration (parent and adolescent report); and transition-specific self-determination (parent report). Themes identified in the process evaluation found that the BOOST-A^TM encouraged participants to take action to overcome an inertia that accompanied their fear leaving school. It also supported the development of new insights about interests and strengths that led to clearer plans for the future. Adolescents described feeling empowered in the transition planning process as a result of the strengths-focus of BOOST-A^TM. Some participants did not find the program helpful; mainly because they did not have a champion to support them to take action in the transition planning process.

Conclusions: The findings provide preliminary evidence that BOOST-A^TM can enhance some career-readiness outcomes. Overall self-determination was not significantly greater in the intervention group and the process evaluation revealed why BOOST-A^TM was beneficial for some participants more than others.