Symposia
Autism Spectrum and Developmental Disorders
Alexis Brewe, M.A.
The University of Alabama
Northport, Alabama
Susan White, Ph.d., ABPP
Doddridge Saxon Chair in Clinical Psychology
University of Alabama
Tuscaloosa, Alabama
Background: Emerging adulthood is a period of heightened risk for autistic people. In fact, autistic people experience lower rates of employment and postsecondary school enrollment compared to their age- and ability-matched peers. The Stepped Transition in Education Program for Students with Autism (STEPS) is a comprehensive transition support and intervention program that has demonstrated initial feasibility and efficacy with improving transition readiness in a randomized controlled trial. However, STEPS has not yet been used by, or tested within, a community-based agency. The current study aimed to optimize STEPS by leveraging stakeholder feedback on barriers and facilitators related to community implementation.
Methods: Autistic young adults (n=7; M age: 18.14 years; 42.86% female), caregivers (n=7; M age: 50.40 years; 85.71% female), and professionals working in transition-related fields (n=15; M age: 46.75 years; 73.33% female) completed semi-structured interviews to identify barriers and facilitators to implementing STEPS in community-based agencies, by community providers. Interview questions were structured within the Exploration, Preparation, Implementation, and Sustainment framework (Aarons et al., 2011). Audio interview recordings were transcribed and coded using Nvivo software.
Results: A thematic analysis qualitative approach revealed themes of significant barriers and facilitators grouped within four domains spanning across the stages of program preparation, implementation, and sustainment: innovation factors related to the fit of STEPS with autistic individuals and organizations (e.g., program structure, content, applicability); inner context factors related to organizations’ capacity to implement and sustain STEPS; outer context factors related to the community (e.g., characteristics of consumers, community attitudes, state policies); and bridging factors across the inner and outer contexts (e.g., partnerships between the STEPS developer and organizations, state contracts).
Conclusions: Integrating the perspectives of both consumers and providers during program development and refinement is crucial to successful dissemination and implementation. Implications for STEPS optimization, as well as practical recommendations that could be applied to other work translating clinical interventions into community-based settings will be provided.