Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Young adults with autism experience postsecondary challenges transitioning to work. This study extends work on a previously validated manualized soft-skills group intervention by examining the feasibility of having OT fieldwork students deliver the intervention as near-peer facilitators. Results include gains in social and adaptive functioning. The use of fieldwork students as group facilitators shows potential to elicit additional positive change in this population.
Primary Author and Speaker: Annemarie Connor
Additional Authors and Speakers: Sarah Fabrizi
Contributing Authors: Amy Nasamran, Connie Sung
PURPOSE: Employment is an important part of adulthood. Many young adults with Autism Spectrum Disorder (ASD) want to work but often have significant challenges obtaining and maintaining employment (Shattuck et al., 2012), partly due to social-communication difficulties. Few interventions have been developed to teach soft skills, or the social-communication skills necessary for workplace success, but outcomes are promising (e.g., Nicholas et al., 2019). While peer-mediation is an evidenced-based approach to teaching skills to individuals with ASD (Chang & Locke, 2016), interventions utilizing peers to teach work-related soft skills to young adults with ASD have yet to be examined. This study extends previous work on the Assistive Soft Skills & Employment Training (ASSET) program (Connor et al., 2019), a manualized group-based soft skills intervention for young adults with ASD, by examining the effects and feasibility of having near-peer (i.e., similar age/stage) occupational therapy master's-level students deliver the intervention.
DESIGN: This study used a quasi-experimental, pre- and post-test single group design. Fourteen participants, 10 males and 4 females, with ASD, with a mean age of 21.57 (SD = 3.57), completed the ASSET program. Participants were selected using the following criteria: 17-29 years of age, previous diagnosis of autism, identified social problems, fluent verbal communication, ability to read and comprehend questionnaires. Seventeen candidates were screened and 14 (82%) qualified. Retention was 100%.
METHOD: Self-report instruments were used to measure pre- to post-program effects. Social skills were assessed using the Social Responsiveness Scale-2. Self-efficacy was examined using the General Self Efficacy Scale and Perceived Empathic Self-Efficacy Scale. Adaptive behavior was assessed using the Adaptive Behavior Assessment System-3. Client satisfaction and perceived soft skills improvement and confidence were measured for the seven soft skills constructs targeted in the intervention. A focus group was conducted 3 months after intervention to investigate skills generalization and participant perceptions of the near-peer approach. Paired sample t-tests and Wilcoxon signed-rank test were used to compare outcomes.
RESULTS: Results indicated medium-sized improvements in overall social function (d = 0.54; p = .02), social communication (d = 0.47; p = ), and social motivation (d = 0.51; p = .04). Participants showed significant improvements in general self-efficacy (d = 0.79; p = .002) and perceived empathy self-efficacy (d = 0.64; p = .004) post intervention. Significant gains (d = 0.54; p = .03) were also made in adaptive behavior. Preliminary results of the 3-month post-intervention focus group in conjunction with the favorable post-test user rating profile (M = 4.47/5, strongly agree, SD = 0.38) indicated high levels of participant satisfaction with the near-peer delivery, along with moderately-improved soft skills confidence (M = 4.18/5, SD = 0.67) and perceived improvement (M = 3.41/4, SD = 0.55). Focus group data indicate that participants appreciated the humor, comradery, and lessened power differential in this near-peer delivery.
CONCLUSION: This study supports the preliminary efficacy of occupational therapy master's students as near-peer facilitators of a manualized soft skills training program for young adults with ASD. Compared to previous studies (e.g., Connor et al., 2019), this near-peer facilitation was associated with additional significant, clinically meaningful gains in social motivation and adaptive behavior. In sum, the use of fieldwork students as group facilitators shows potential to elicit additional, positive change in this population.
References
Chang, Y. C., & Locke, J. (2016). A systematic review of peer-mediated interventions for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 27
, 1-10. https://doi.org/10.1016/j.rasd.2016.03.010
Connor, A., Sung, C., Strain, A., Zeng, S., & Fabrizi, S. (2019). Building skills, confidence, and wellness: Psychosocial effects of soft skills training for young adults with autism. Journal of Autism and Developmental Disorders, 1-13. https://doi.org/10.1007/s10803-019-03962-w
Nicholas, D. B., Mitchell, W., Zulla, R., Solomatin, E., & Qi, S. (2019). A review of CommunityWorks Canada: Toward employability among high school-age youth with autism spectrum disorder. Global Pediatric Health, 6. https://doi.org/10.1177/2333794X19885542
Shattuck, P. T., Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129(6), 1042-1049. https://doi.org/http://dx.doi.org/10.1542/peds.2011-2864
