Project Activities
This project followed up with youth and young adults with autism who participated in the initial efficacy study of the CSESA model to evaluate the model's impact on their longer-term in-school and post-school outcomes. The research team also examined variables that may moderate or mediate long-term intervention effects. Multilevel modeling was used to determine the efficacy of CSESA for improving student outcomes.
Structured Abstract
Setting
Research took place in high schools and communities in urban, suburban, and rural areas of North Carolina, Wisconsin, and California.
Sample
There were 216 caregivers and 154 autistic youth who had participated in the treatment and control groups of the original CSESA efficacy study and again participated in this follow-up study (41% and 30% of the original sample respectively). Youth were at different points in their secondary school careers when the original study took place (ages 13 - 20), and follow-up data collection occurred 2-4 years after the intervention ended, with few students still in high school and most who had exited school.
The CSESA model was a comprehensive ASD intervention that was implemented in 30 high schools over a 2-year period. As part of the professional development foundation, school-based teams received training and ongoing coaching in the use of individualized assessments, goal writing, and the implementation of various interventions and evidence-based practices based on student needs and goals. The specific intervention practices focused on four domains — academic literacy, independence and behavior, peer and social competence, and transition and families.
Research design and methods
The original efficacy study of the CSESA model was a cluster randomized controlled trial in which 60 schools were stratified by school district (or demographic characteristics if there was only one school in a district) and randomly assigned to the intervention or control condition. Staff at each school then recruited students with autism to participate in the program. Data were collected on school-wide program quality, student outcomes, and family outcomes pre- and post-intervention. The current study followed students who participated in the original study. In the first of the project, the research team collected follow-up data from the first CSESA cohort and in the second year, from the second cohort. For students who were still in school, teachers and other school staff assisted in developing an assessment schedule within the school prior to the disruption caused by COVID (which then limited data collection with this small subsample of the population). For students who exited high school, data collection took place in their homes or via Zoom/phone after the start of the COVID-19 pandemic.
Control condition
Students in the control condition of the original study received services as usual.
Key measures
The research team used a subset of the same standardized measures used in the original study to assess student and family outcomes for the sample of students who are still in high school. These included the Scales of Independent Behavior, AIR Self Determination Scale, Social Responsiveness Scale-2, Zarit Burden Inventory, and a researcher-developed assessment of work-based learning. For the students who were no longer in high school, measures included questionnaires on employment, postsecondary education, and community integration. More specifically, the follow-up questionnaires for parents assessed adult life domains (i.e., employment, post-secondary education, access to adult services, community engagement, and independent behavior) and the questionnaire for former students focused on the individuals' satisfaction with their current involvement in educational, vocational, and community activities. Potential moderators included student characteristics (e.g., IQ, ASD severity), family characteristics (e.g., socioeconomic status), and community characteristics (e.g., poverty level, availability of services). Student characteristics were assessed using data derived from the original study, family characteristics were measured using a parent-report demographic survey, and community characteristics will be gleaned from U.S. Census data. Potential mediators include student outcomes at the end of the original efficacy study and ASD program quality.
Data analytic strategy
For the primary analyses, the research team used multilevel regression models with students nested within schools. To examine mediation and moderation, the researchers used multilevel structural equation models.
Key outcomes
The main findings of this project, as reported by the Principal Investigator, are as follows:
- There were no significant differences on the in-school and out-of-school measures for youth who were enrolled in the CSESA condition when compared to youth who were enrolled in the SAU condition in the original CSESA study. Therefore, the team did not investigate mediation.
- Moderation analyses were not suggestive of any strong effects related to CSESA.
- Though the findings did not indicate differences between groups, there is still a great deal to learn from this data set. This is a large, contemporary, diverse group of autistic youth and young adults providing current data on their post high school experiences, and there is much to learn from their perspective, as well as their caregivers.
- 68% of the young adults across both conditions reported that they had attended classes post high school and 67% reported they had a job after graduation. 86% indicated they had friends and 69% reported that they liked their life when interviewed. Caregivers indicated that 85% of the young adults lived in the family home, while 4% lived independently.
- In follow-up interviews, 73% of the young adults said they liked high school, but only 50% said it prepared them for their life post high school. Less than half (48%) said they felt prepared for work and taking courses post high school. The young adults noted several areas for additional consideration in their high school programming, including arranging for more opportunities to practice social interactions; teaching budgeting and paying bills as part of math content; offering more supported opportunities for Driver’s Education; encouraging participation in extracurricular activities; and allowing more time for exploration of job/career options.
People and institutions involved
IES program contact(s)
Project contributors
Products and publications
Project website:
Publications:
ERIC Citations: Find available citations in ERIC for this award here.
Available data:
The data will be available on the UNC Dataverse once the initial five manuscripts have been written, https://dataverse.unc.edu/. Interested individuals can reach out to Dr. Kara Hume, kara.hume@unc.edu.
Additional project information
Additional online resources and information:
https://www.facebook.com/csesa.asd
https://www.pinterest.com/autismprojectsatfpg/_created/
Related projects
Questions about this project?
To answer additional questions about this project or provide feedback, please contact the program officer.
