Stepped Transition to Employment and Postsecondary Education Success (STEPS) for Adolescents and Adults with Autism: Community Implementation Pilot Trial

Abstract

Background: Programming to optimize successful transition into adulthood and build skills for independence is consistent with the goal of improving autonomous living among adults with autism, which is a top stakeholder-identified priority. There has been surprisingly little research; however, on structured curricula targeting transition into adulthood.

Objective: This formative community pilot trial of Stepped Transition to Employment and Postsecondary Education Success (STEPS) was designed to test feasibility and effectiveness as implemented by community-based providers and, secondarily, to identify factors that affect implementation.

Methods: This was a 2-phase study. Phase 1 involved engagement with a group of community stakeholders to identify factors likely to influence implementation of STEPS. Phase 2 involved an open pilot trial of STEPS. In the Hybrid Type 1 trial, 24 adolescents and young adults with autism received STEPS in their communities at a local agency unaffiliated with the research study.

Results: Based on stakeholder input (Phase 1), several adjustments were made to the program before implementation (eg, increased attention to building client motivation and clarification of the role of caregivers). Stakeholders and providers indicated that STEPS could be successfully delivered and adopted in the community. From the pilot (Phase 2), results indicate feasibility of study procedures and intervention implementation, supporting future larger-scale implementation. Satisfaction (eg, how helpful and beneficial) with the program was reported as moderate or higher by the participants, and the only 2 drops occurred before the program start. Caregiver-rated transition readiness significantly increased from baseline to end point (P<.001), as well as some domains of functional independence (finance management, self-care, and engagement in the community; all P<.05). Employment and education status at the end point did not yield a clear pattern indicating a positive or negative impact of the program.

Conclusions: This pilot study supports the feasibility, acceptability, and effectiveness of STEPS as delivered by community providers.

Keywords: adult; autism; community; intervention; transition.