Self-Determination in Transition-Aged Individuals with Autism Spectrum Disorder

Poster Presentation
Thursday, May 2, 2019: 11:30 AM-1:30 PM
Room: 710 (Palais des congres de Montreal)
B. Tomaszewski1, L. G. Klinger2, M. R. Klinger3, A. F. Berman4 and C. E. Pugliese5, (1)Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)TEACCH Autism Program; Psychiatry, University of North Carolina, Chapel Hill, NC, (3)UNC TEACCH Autism Program, Chapel Hill, NC, (4)Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, (5)Children's National Health System, Washington, DC
Background: Self-determination refers to an individual’s causal agency in their own lives and is associated with positive post-secondary outcomes in individuals with disabilities and young adults with ASD. Few studies focus on examining self-determination in this population. Identifying predictors of self-determination from multiple perspectives may inform important intervention targets for transition-aged individuals with ASD.

Objectives: The purpose of the current study was to examine associations between autism symptoms, executive function, depression symptoms, and self-determination using parent-report and self-report in transition-aged individuals with ASD.

Methods: Participants included 124 transition-aged individuals with ASD without intellectual disability ages 14-21 (Mean= 17.6 years) drawn from two sites, North Carolina and Washington, D.C. Parents completed questionnaires of autism symptoms using the Social Responsiveness Scale, executive function using the Behavior Rating Inventory of Executive Function (BRIEF) and self-determination using the AIR Self-Determination Scale (AIR-SDS; Wolman et al., 1994). The AIR-SDS parent-report assesses three domains: Ability, Opportunities at Home, and Opportunities at School. The ability domain assesses whether an individual has the knowledge to make choices and decisions, plan and set goals, and the skills to reach their goals. The opportunity domain assesses whether an individual has opportunities in their environment to use their abilities. Individuals with ASD completed the AIR-SDS self-report and a questionnaire on depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD). The AIR-SDS self-report assesses two domains: Capacity and Opportunity. The capacity domain includes ability, knowledge, and perceptions of self-determination.

Results: The AIR-SDS demonstrated internal consistency for both parent report (Cronbach’s α=.88) and self-report (Cronbach’s α=.91). Parent and self-report total scores were not significantly correlated (r=.16, p=.12). Parents (M=69.1) reported significantly higher levels of total self-determination than students (M=54.1, t[94]=11.89, p<.001). Multivariate multiple regressions were performed to examine the extent to which the General Executive Composite on the BRIEF T-score, SRS Total T-score, and CESD sum predicted domains of parent-reported and self-reported self-determination. Executive function accounted for 31% of the variance in overall parent-reported self-determination. Specifically, decreased executive function difficulties were significantly associated with parent-reported increased ability (B=-.03, p< .001,η2=.19) and increased opportunities at home (B=-.03,η2=.16,p<.001) controlling for age, autism symptoms, and depression. Decreases in age were significantly associated with parent-reported increased opportunities at home (B=-.06,η2=.07,p=.03). Depression accounted for 8% of the variance in overall self-reported self-determination. Specifically, decreased depression symptoms were significantly associated with self-reported increased capacity (B=-.02, p< .001,η2=.06) and increased self-reported increased opportunity (B=-.02, p=.03,η2=.06) controlling for age, executive function, and autism symptoms.

Conclusions: Overall, parent and self-report AIR-SDS appear to be internally reliable measures, although are not related to each other. The lack of association between these measures suggests the importance of incorporating multiple perspectives when measuring outcomes. Parents of younger adolescents with increased every day executive function skills reported higher levels of self-determination. Adolescents with less symptoms of depression reported higher levels of self-determination. Thus, self-determination may be a meaningful outcome measure for interventions targeting executive function and emotion regulation.