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The increasing population of youth with ASD transitioning into adults is a focus of attention due research showing consistent and persistent deficits across cognitive, social, and vocational domains, indicating a need for effective treatments. Such cognitive and social skill deficits have been identified as major challenges to employment success for these adults. This study developed a novel, integrated community-based intervention, Supported employment, Comprehensive Cognitive Enhancement & Social Skills (SUCCESS) intervention, a manualized “soft skills” curriculum used within community vocational programs. A pilot study was conducted to obtain estimates of effects of outcomes which include cognitive skills and social skills for emerging adults with ASD.
Methods:
A total of 18 emerging adults participated in an open trial pilot study of the SUCCESS program to date with another 20 estimated to have participated by Jan 2017. SUCCESS, delivered weekly for 90minutes, includes active group participation during a simulated work meeting within a larger vocational training program in community services. The program involves 25 sessions over 6 months with first half of the curriculum teaching executive functioning skills such as attention, learning, memory, cognitive flexibility, problem solving, goal oriented thinking and contextual awareness. The second half teaches social communication skills including social conversation (giving and receiving compliments, feedback and help), social relationships, initiations and social networking (including do’s & don’ts of social media). Pre and post assessments include a full battery of assessments with the Behavior Rating Inventory of Executive Function- Adult Version (BRIEF-A) and Social Responsiveness Scale-2 (SRS-2) adult, Social Skills Performance Assessment (SSPA), Delis-Kaplan Executive Functioning Scale (DKEFS), daily living, work performance and quality of life. Multiple informants were used (participant, caregiver, job coach). The majority of participants were male (84%), white race/ethnicity (84%) and all graduated with a high school diploma. Some were involved with various social services: 42% disability services, 26% department of rehabilitation, 11% social security income.
Results:
Participants improved their SRS-2 social awareness and social motivation scores (both Cohen’s d>0.89 and p<.05). They also improved their overall interactions with a ‘coworker’ (Cohen’s d=0.97, p<0.05) and ‘boss’ (Cohen’s d=0.96, p<0.05) during SSPA role-plays. The largest effects during the role-plays were improved body language and connectedness with the coworker (both Cohen’s d>1.40 and p<0.05) and perspective-taking and facial expressions with the boss (both Cohen’s d>1.20 and p<0.05). We also observed improved problem-solving, deductive reasoning, and spatial planning (all Cohen’s d>0.80 and p<.05), and improvement in self-monitoring, planning, and task monitoring (all Cohen’s d>1.00 and p<.05). Lastly, 43% of trainees were employed at 8 months compared to 11% of trainees who were employed at baseline.
Conclusions and Implications:
This study demonstrates that it is feasible to develop the “soft skills”, a cluster of cognitive abilities and social graces that make someone a good employee and compatible to work with, within a community supported employment environment for emerging adults with ASD. Specifically, the SUCCESS program shows promise for positive impacting emerging adults by improving their vocational readiness and augmenting existing vocational services for individuals with ASD and possibly others.