Improving Social Motivation, Competency, and Empathy in Young Adults with ASD: Results from a RCT of the START Adult Program

Background: Individuals with ASD often face tremendous challenges during the transition to adulthood (Barnhill, 2007; Engstrom, Ekstrom, & Emilsson, 2003; Howlin, 2000; Hurlbutt & Chalmers, 2004). Specifically, a sharp increase in social and independent living demands are often paired with an equally jarring reduction is crucial support services. The transition to post-secondary and vocational settings requires a number of interrelated social readiness skills, including adequate social motivation and competency to successfully navigate interactions across novel situations and settings. Fortunately, there is a growing recognition of the need to address the unique socialization difficulties of this burgeoning population (Williams-White et al, 2007). Intervention programs specifically designed to equip young adults with a variety of socialization strategies may hold promise for improving their experienced success during this daunting time of transition and change.

Objectives: To evaluate preliminary outcomes associated with participation in the Social Tools And Rules for Transitions (START) Program for Young Adults in the context of a randomized controlled trial.

Methods: A randomized controlled trial was used to investigate outcomes associated with the START for young adults group intervention model. The participants were young adults (aged 18-25) with an ASD diagnosis who had a verbal IQ over 70 and fluent language use. Participants were randomly assigned to immediate or waitlist control groups for 20 weeks. Those in the immediate treatment group participated in the START program for young adults, a weekly 90-minute peer-facilitated experiential socialization program based loosely on the structure of the adolescent model (Vernon, Miller, Ko, Barrett, McGarry, 2017). Program components included a weekly social outing with a same-aged peer, free socialization periods, an interactive social topic discussion, structured games and activities, and individual check-in and check-out sessions. Weekly topics included crucial conversation skills, relationship maintenance, dating and romantic relationships, social momentum, employment, and shared living space considerations. Measures included the Social Motivation & Competency Scale (SMCS), Empathy Quotient (EQ), Behavior Assessment System for Children Third Edition (BASC-3) – College Self-Report, and Social Responsiveness Scale (SRS). Data is being analyzed with a mixed Group X Time mixed MANOVA with follow-up ANOVAs for individual variables.

Results: Data from 22 participants analyzed thus far are indicative of significant Group X Time differences on both the SMCS and EQ Scores. Additional analyses of the BASC-3 subscales and SRS scores are currently underway.

Conclusions: Preliminary results are indicative of significant improvements in START participants' social motivation, competencies, and empathy. These data indicate that this comprehensive socialization intervention may hold promise for improving the complex, multifaceted social vulnerabilities of young adults with ASD. During a time in which social demands shift dramatically, this program appears to significantly improve social motivation to engage with peers, the competencies to facilitate successful interactions, and empathy to foster deeper personal and professional relationships.