Social Validity of the Working Together Intervention for Young Adults Wtih ASD and Their Families

Background: A growing population of adults with autism spectrum disorder (ASD) has spurred increased interest in developing interventions to support positive outcomes across the life course. We developed a multi-family psychoeducation model, Working Together, designed for young adults with ASD and their families. The Working Together model adapts an approach commonly used with individuals with varying mental health conditions (McFarlane, 2002) and applies it to families of individuals with ASD, resulting in improvements in behavior and employment.

Objectives: The present study examined the social validity of the Working Together program for adults with ASD and their families. Qualitative and quantitative data were collected from young adults with ASD and their parents to examine their satisfaction with and level of engagement throughout the program as well as knowledge gained and personal goals achieved.

Methods: Data were drawn from the Working Together study, a multi-site randomized waitlist control trial which tested the Working Together intervention. Families were eligible to participate if they had a young adult with a diagnosis of ASD without intellectual disability, who co-resided with their parents, and who was disengaged from educational/employment activities (<10 hours per week). Forty-nine families enrolled in the study. The intervention included 8 weekly group sessions, 2 individual family sessions, 3 monthly group booster sessions, and a method for providing ongoing resources and referrals. Session topics for young adults and parents included goal setting, problem-solving, coping strategies, planning for independence, employment, community/relationships, personal safety, and health and well-being. At each session, interventionists rated participant engagement and participants rated satisfaction. Participants also reported on what they learned from the program at the completion of the intervention. Measures of goal attainment were assessed at baseline and post-intervention.

Results: Preliminary analysis of data from 36 families indicated that 100% of parents and adults with ASD were satisfied or very satisfied with the program. Observational weekly engagement ratings indicated that 82% of young adults and 93% of parents were mostly/clearly engaged, on average, across sessions (interrater agreement was 87%). Young adults demonstrated more variability in engagement ratings, showing the clearest engagement during sessions involving coping strategies and employment information; there was less engagement during community/relationships and personal safety sessions. Qualitative analysis of exit interview data from the young adults suggested common themes that promoted positive changes including learning how to solve problems and learning how to help themselves. Parent exit interview data revealed common themes around learning to better understand their young adult, gaining skills to help support their adult in their journey to independence, and appreciation for the information provided during the intervention. Almost 80% of adults with ASD achieved at least one of their goals. Analysis of results is ongoing.

Conclusions: Findings highlight the social validity of the intervention for the targeted end users of the program, young adults with ASD and their parents. These findings, in conjunction with achievement of program goals of reduced behavior problems and increased rates of employment, support the potential of this program to enhance functioning of adults with ASD.