This project seeks to evaluate the feasibility and acceptability of a remote metacognitive strategy training intervention in transition-age autistic adolescents and young adults and a primary caregiver. We will also conduct limited efficacy testing.
Autistic adolescents aged 13-21 AND one primary parent, guardian, or caregiver aged 18 or older
At least one year remaining in high school
Ability to engage in reciprocal conversation
Ability to provide informed consent/assent as part of an adapted procedure designed to prevent coercion and protect the rights of autistic adolescents with or without intellectual disability
Severe or profound intellectual disability (IQ<35)
Severe mental health conditions that interfere with ability to participate in the intervention
Currently enrolled in community-based transition services redundant with remote PREP
Crossover
Pathways and Resources for Engagement and Participation (PREP)
BehavioralPathways and Resources for Engagement and Participation (PREP) is a collaborative problem-solving intervention that targets environmental barriers-physical, social, attitudinal, familial, and institutional-while leveraging adolescent and family strengths. Caregivers are integrated as key supports. The five-step process includes: (1) make goals, (2) map out a plan, (3) make it happen, (4) measure outcomes, and (5) move forward. We will set four activity-based transition goals using the Transition Planning Inventory-2nd Edition and Goal Attainment Scaling. Providers will use guided discovery to help adolescents and caregivers identify strategies that modify activities or environments to support participation in transition activities. Adolescents and caregivers will implement strategies between sessions and revise strategies with the provider in future sessions if unsuccessful. Participants will complete 12 weekly 60-min remote PREP sessions over 12-16 weeks.
Acceptability of Intervention Measure (AIM)
Measure of intervention acceptability. Self-report Likert scale from 1 -completely disagree to 5 - completely agree
Semi-Structured Interview
A brief interview to gather participant perceptions of the intervention, including their perceived benefit and practicality of the intervention and suggestions for improvement for the intervention. Data will be qualitative interview transcripts.
Participation and Environment Measure - Child and Youth
Caregiver proxy report measure of adolescent activity participation at home, school, and in the community. Caregivers rate adolescents' participation frequency (0 - never to 7 - daily) and involvement (1 - minimally involved to 5 - very involved). Higher scores represent better adolescent participation.
Youth, Young Adult Participation and Environment Measure
Self-report measure of adolescent and young adult activity participation at home, school, and in the community. Adolescents and young adults rate their participation frequency (0 - never to 7 - daily) and involvement (1 - minimally involved to 5 - very involved). Higher scores represent better adolescent participation.
Patient-Reported Outcomes Measurement Information System Pediatric Global Health Measure 7+2
Informant and self-report questionnaire of adolescent and young adult physical and mental health. Item responses range from 1 - poor to 5 - excellent. Higher scores represent better health.
Transition Readiness Scale
Informant and self-report measure of adolescent transition readiness (education, work, independent living). Self-report scale that ranges from 1 - not true for me/my child to 4 - true for me/my child. Higher scores represent better transition readiness.
Transition Planning Inventory - 3rd Edition
A four-section survey about student preferences and interests for post-secondary outcomes. Respondents identify a goal for work, school, or independent living and answer five open-ended questions related to their goal. Qualitative responses will be used to co-create goals for intervention sessions.
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