Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 16, 2024
Date Accepted: Jul 6, 2025
STEPS for Autistic Adolescents and Adults: A 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 autistic adults, 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 STEPS (Stepped Transition to Employment and Postsecondary Education Success) 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 two-phase study. Phase 1 involved engagement with a group of community stakeholders to identify factors likely to influence ultimate implementation of STEPS. Phase 2 involved an open pilot trial of STEPS. In the Hybrid Type 1 trial, 24 autistic adolescents and young adults 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 prior to implementation (e.g., increased attention to building client motivation, 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. Caregiver-rated transition readiness significantly increased from baseline to endpoint, as well as some domains of functional independence (finance management, self-care, engagement in the community). Employment and education status at endpoint did not yield a clear pattern indicating positive or negative impact of the program.
Conclusions:
This pilot study supports the feasibility, acceptability, and effectiveness of STEPS as delivered by community providers. Clinical Trial: This trial was pre-registered with ClinicalTrials.gov (Identifier NCT05581069).
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