Autism and Secondary Transition Annotated Bibliography

(Prepared for NSTTAC by Kelly Kelley and Melissa E. Hudson)

Autism is a complex disorder with an unknown cause (NINDS, 2008). Autism Spectrum Disorder (ASD) is classified under a broader term called Pervasive Developmental Disorders (PDD) which includes several other more specific PDDs (a) Autistic Disorder, (b) Asperger's Disorder, (c) Pervasive Development Disorder-Not Otherwise Specified (PDD-NOS), (d) RettDisorder, and (e) Childhood Disintegrative Disorder (Adreon & Durocher, 2007).

Due to the recent changes in identification procedures of individuals with autism on this broader spectrum, there has been increased national attention to meeting the needs of students classified. In fact, between 1994 and 2006, the number of 6 to 17-year-old children classified as having ASD in public special education programs increased from 22,664 to 211,610 (NINDS, 2008). Along with this increasing trend, there is a need to identify effective evidence-based practices to respond to the demands of this growing population.

The purpose of this annotated bibliography is to summarize for special education professionals and researchers what is currently known related to individuals with ASD and secondary transition skills. To date, information was located on the topics of postsecondary education, self-determination, community behavior, independent living, and employment.

Reference

National Institute of Neurological Disorders and Stroke. (2008). NINDS autism information page [Fact sheet]. Retrieved from http://www.ninds.nih.gov/disorders/autism/detail_autism.htm

Skills for POSTSECONDARY EDUCATION

Adreon, D., & Durocher, J. S. (2007). Evaluating the college transition needs of individuals with high-functioning autism spectrum disorders. Intervention in School and Clinic, 42, 271-279. [Descriptive]

  • Discussed the related difficulties across various domains such as socialization, communication, academic functioning, independent daily living skills, choosing a college, and self-advocacy for individuals with high-functioning autism
  • Recommended strategies for a smooth transition from high school to postsecondary education for students with autism (e.g., reduced course loads, taking summer courses or courses while attending high school, avoiding classes back to back, taking time to participate in orientation activities to learn about the college campus and registration procedures).

Browning, J., Osborne, L. A., & Reed, P. (2009). A qualitative comparison of perceived stress and coping in adolescents with and without autism spectrum disorders as they approach leaving school. British Journal of Special Education, 36(1), 36-43. [Qualitative]

  • Included 10 students with autism spectrum disorders (ASD) and seven without a diagnosis having a mean age of 15
  • Compared stress experiences during final educational transitions between students with and without ASD using an interpretive phenomenology analysis on a range of qualitative data (e.g., interviews, diaries, drawings)
  • Results indicated all participants experienced various stressors such as fear of being harmed and maintaining relationships with others when considering postsecondary options
  • Implications for practice indicated supports for students with ASD should be more available in schools; existing supports should be stronger and more visible in schools; students with ASD should be taught how to recognize and deal with stress; and support groups are needed to provide social support and supported social encounters for individuals with ASD

VanBergeijk, E., Klin, A., & Volkmar, F. (2008). Supporting more able students on autism spectrum: College and beyond. Journal of Autism & Developmental Disorders, 38, 1359-1370. [Descriptive]

  • Provides recommendations for families, educators, and students who are on the autism spectrum in areas of academics, independent living, social, vocational, and counseling for a smooth high school to college transition
  • Provides recommendations to universities for providing training to students in the areas of communication, social skills, and independent living through social skills groups, psychoeducational groups, directive counseling, vocational training, and life coaching to accommodate for students with ASD.

Skills for SELF-DETERMINATION

Arndt, S. A., Konrad, M., & Test, D. W. (2006). Effects of the self-directed IEP on student participation in planning meetings. Remedial and Special Education, 27, 194-207. [Experimental]

  • Included five high school students ages 14-18 in self-contained settings with intellectual disabilities, autism, behavioral-emotional disabilities, and/or nonverbal learning disabilities
  • Taught students how to direct their own IEP meetings through model-lead-test instructional procedures using the Self-Directed IEP
  • Results from this study validate the effectiveness of using the Self-Directed IEP package to teach students with autism how to advocate for themselves through participation in IEP planning meetings
  • Future research is needed to examine the effectiveness of the Self-Directed IEP with more students with autism.

Fullerton, A., & Coyne, P. (1999). Developing skills and concepts for self-determination in young adults with autism. Focus on Autism and Other Developmental Disabilities, 14, 42-52. [Experimental]

  • Included 23 students ages 16-28 with autism and/or Asperger's syndrome
  • Taught both parents and students about autism, communication skills, life planning, and goal setting. A qualitative design was used to gather pretest-posttest interviews from students and parents.
  • Findings from students suggest that classes on self-determination topics related to autism were helpful and interactions between other individuals with autism and their families was beneficial
  • Findings from parents suggests that classes offered around communication skills had an impact on their child's development
  • Suggestions for supporting self-determination for individuals with autism included exploring the student's ways of thinking, expanding students' choices, and helping student's self-monitor their goal attainment

Hammer, M. R. (2004). Using the self-advocacy strategy to increase student participation in IEP conferences. Intervention in School & Clinic, 39, 295-300. [Experimental]

  • Included three students ages 12-13 with learning disabilities, selective mutism, Tourette syndrome, obsessive compulsive disorder, attention-deficit disorder, and/or pervasive developmental disorder from a private school setting in a self-contained classroom
  • Taught students how to respond to IEP related questions and share specific information with members of the IEP team through procedures such as IPLAN and SHARE Self-Advocacy Strategy CD-ROM
  • Results indicated using the Self-Advocacy Strategy has potential for future use by educators and students with varying disabilities and grade levels including autism
  • Future research is needed to examine the effects of using the Self-Advocacy Strategy with generalization across disabilities, settings, and age groups

Mason, C. Y., McGahee-Kovac, M., Johnson, L., & Stillerman, S. (2002).Implementing student-led IEPs: Student participation and student and teacher reactions. Career Development for Exceptional Individuals, 25, 171-192. [Experimental]

  • Included 43 students in grades 9-11 with learning disabilities, autism, Landau-Kleffner, mental retardation, traumatic brain injury, and/or physical disabilities
  • Students were trained by teachers in how to lead their own IEP meetings using the Student-led IEPs: A Guide for Student Involvement over six instructional sessions
  • Results from general and special educators indicated that student led IEPs improved the overall process. Student results indicated that students could explain the IEP process and the importance; they understood their disability, strengths, weaknesses and accommodations; and they realized the benefits of leading the IEP meeting
  • Future research is needed to determine the level of involvement necessary for students to lead their IEP meetings and the amount of time needed for student preparation

Schall, C. M., & McDonough, J. T. (2010). Autism spectrum disorders in adolescence and early adulthood: Characteristics and issues. Journal of Vocational Rehabilitation, 32, 81-88. [Descriptive]

  • The authors compared the characteristics of autism, Aspergers disorder, and PDD-NOS in adolescents and young adults (Table 1) and described some of the issues faced by individuals with ASD, their families, and support providers through case studies of three young adults.
  • Changes in behavior and characteristics in ASD in adolescence and early adulthood are also described (Table 2).
  • The case studies highlight some of the unique challenges faced by transition teams while students with ASD are in school (e.g., the need for self determination skills rather than compliance and career awareness), as well as the supports needed after leaving school (e.g., positive behavior supports at work and on-going, intensive social skill instruction).

Stowitschek, J. J., Laitinen, R., & Prather, T. (1999). Embedding early self-
determination opportunities in curriculum for youth with developmental disabilities using natural teaching incidents. Journal for Vocational Special Needs Education, 21, 15-26. [Experimental]

  • Included five junior high and seven high school students ages 12-17 with developmental delay, mental retardation, multiple handicaps, and/or autism
  • Taught students to make appropriate choices in asking for assistance and respecting the preferences of others in daily school routines using the Transition Choices Program (TCP)
  • Results from this group study indicate students' performance with choice making and preference awareness increased with TCP instruction
  • Future research is needed to follow up with students that have received TCP instruction in order to assess how this instruction influences lifelong transition skills

Skills for INCREASING APPROPRIATE COMMUNITY BEHAVIOR

Carr, E. G., & Carlson, J. (1993). Reduction of severe behavior problems in the community using a multicomponent treatment approach. Journal of Applied Behavior Analysis, 26, 157-172. [Experimental]

  • Included three individuals ages 16-18 with autism living in a group home who exhibited a history of serious behavior problems in community settings including aggression, property destruction, self-injurious behaviors, and tantrums which led to being excluded from participating in community activities (e.g., shopping expeditions).
  • Taught individuals to reduce severe behaviors using a multicomponent treatment intervention consisting of five procedures which included choice, embedding, functional communication training, building tolerance for delay of reinforcement, and presentation of discriminative stimuli for nonproblem behaviors
  • Results indicated all three individuals were able to complete a shopping expedition in the community with virtually no problem behavior after receiving the multicomponent treatment intervention
  • Future research is needed in other various community settings (e.g., restaurants, movie theatres, shopping malls) to increase effectiveness and generalization of this particular multicomponent treatment intervention

Frea, W. D. (1997). Reducing stereotypic behavior by teaching orienting responses to environmental stimuli. Research and Practice for Persons with Severe Disabilities, 22, 28-35. [Experimental]

  • Included two students ages 15 and 23 with autism functioning within the mild-severe range of intellectual disabilities
  • Taught students to increase orienting responses and comment on external stimuli in community settings using gesturing and verbal prompting
  • Results indicated an increase in verbal responding to environmental stimuli and decreases in stereotypic behaviors
  • Future research is needed to assist individuals who engage in stereotypic behavior to become more involved in their surroundings

Koegel, R. L., & Frea, W. D. (1993). Treatment of social behavior in autism through the modification of pivotal social skills. Journal of Applied Behavior Analysis, 26, 369-377. [Experimental]

  • Included two students ages 13 and 16 with autism functioning within the mild range of intellectual disabilities
  • Examined the acquisition of individual social communicative behaviors (e.g., feasibility of modifying social behaviors, overall social appropriateness of children's conversational interactions) and generalization across other social behaviors
  • Results indicated (a) high-functioning children with autism were able to modify their social communicative behaviors during conversational interactions following training, (b) the behaviors appeared to be part of the response class as changes also occurred in untreated behaviors, and (c) these changes were broad enough to be noticed and judged as favorable by non-disabled individuals unaware of the study
  • Future research should combine functional analysis research and response-class formation research when examining social communicative behaviors

Lee, S. H., Simpson, R. L., & Shogren, K. A. (2007). Effects and implications of self-management for students with autism: A meta-analysis. Focus on Autism and Other Developmental Disabilities, 22, 2-13. [Literature Review]

  • Included eleven peer-reviewed single-subject research studies between 1992-2001 on self-management strategies and autism
  • Percentages of nonoverlapping data (PND) between treatment and baseline phases were calculated for overall self-management intervention effect
  • Results from the meta-analysis revealed 78 unique PND scores with an overall mean PND of 81.9% representing an effective treatment
  • Findings provide preliminary generic support for the efficacy of self-management interventions on increasing appropriate behaviors among students with autism

Morrison, L., Kamps, D., Garcia, J., & Parker, D. (2001). Peer mediation and monitoring strategies to improve initiations and social skills for students with autism. Journal of Positive Behavior Interventions, 3, 237-250. [Experimental]

  • Included four students ages 10-13 with autism selected from a group participating in a longitudinal study
  • Taught students social skills and monitoring for appropriately requesting, commenting, and sharing during leisure activities (e.g., games, activities)
  • Results indicated that teaching social skills using peer mediation, self-monitoring, peer monitoring, and reinforcement was effective in increasing initiations by students with autism to their peers during game play
  • Future research is needed to investigate the effects of student choice in the selection of activities and to examine the responses between performance data and specific materials

Skills for INDEPENDENT LIVING

Gentry, T., Wallace, J., Kvarfordt, C. & Lynch, K. B. (2010). Personal digital assistants as cognitive aids for high school students with autism: Results of a community-based trail. Journal of Vocational Rehabilitation, 32, 101-107. [Experimental]

  • Evaluated effects of PDA training on the efficacy of 22 high school student volunteers with ASD to use PDAs in their everyday life.
  • Two measures were used to evaluate the impact of the training pre/post intervention: (a) The Canadian Occupational Performance Measure (COPM) and (b) The Functional Assessment Tool for Cognitive Assistive Technology (FATCAT).
  • Results indicated all participants (a) improved self-estimation of occupational performance in everyday life tasks, (b) increased in satisfaction with performance, and (c) routinely used the PDA as a task management tool during the eight weeks following training.

Haring, T. G., Breen, C. G., Weiner, J., Kennedy, C. H., & Bednersh, F. (1995). Using videotape modeling to facilitate generalized purchasing skills. Journal of Behavioral Education, 5, 29-53. [Experimental]

  • Included six students ages 10-16 with mental retardation and autism
  • Taught students purchasing skills using videotape modeling across three stores and in vivo instruction in one store
  • Results indicated a greater frequency of independent purchases for all participants across multiple stores after vivo training in one store and video training in one to three additional stores
  • Future research is needed to examine the use of verbalization during videotape instruction in comparison to modeling procedures alone.

Haring, T. G., Kennedy, C. H., Adams, M. J., & Pitts-Conway, V. (1987). Teaching generalization of purchasing skills across community settings to autistic youth using videotape modeling. Journal of Applied Behavior Analysis, 20, 89- 96. [Experimental]

  • Included three 20-year old students with autism and developmental delay
  • Taught students purchasing skills within the school and various community settings, generalization training was conducted using videotaping in three community settings
  • Results indicated that videotape modeling procedures and training of shopping skills in natural environments using a task analysis were effective strategies for promoting generalization of purchasing skills across participants
  • Future research is needed to investigate the effects of videotape modeling on other behavioral techniques for promoting generalization across varied community settings and disability categories

MacDuff, G. S., Krantz, P.J., & McClannahan, L. E. (1993). Teaching children with autism to use photographic activity schedules: Maintenance and generalization of complex response chains. Journal of Applied Behavior Analysis, 26, 89-97. [Experimental]

  • Included four participants ages 9-14 with autism and long histories of disruptive behavior (e.g., aggression, tantrums, running away)
  • Taught individuals to use pictorial schedules along with graduated guidance to increase their on-task and on-schedule behaviors in a community-based Teaching-Family Model group home
  • Results indicated that photographic schedules enabled participants to exhibit lengthy (e.g., up to one hour) and complex chains of on-task behavior (e.g., home living, recreational repertoires)

Mechling, L. C. (2004). Effects of multimedia, computer-based instruction on grocery shopping fluency. Journal of Special Education Technology, 19, 23-34. [Experimental]

  • Included three students ages 13-19 with mild to moderate intellectual disabilities, cerebral palsy, epilepsy, and/or autism
  • Taught students grocery shopping skills using constant time delay (CTD) procedures and a multimedia computer-based instruction (CBI) program
  • Results indicated all students were able to increase their grocery shopping fluency with a 12-item grocery list and generalize grocery shopping skills more effectively with the CTD and multimedia CBI interventions
  • Future research is needed with multimedia CBI taught simultaneously with instruction in natural environments

Mechling, L. C., & Gast, D. L. (2003). Multi-media instruction to teach grocery word associations and store location: A study of generalization. Education and Training in Developmental Disabilities, 38, 62-76. [Experimental]

  • Included three students ages 11-18 with mild to moderate disabilities, cerebral palsy, and/or autism
  • Taught students to locate grocery items using aisle signs and multi-media instruction simulations with constant time delay (CTD) procedures
  • Results indicated all three students were able to match words from a grocery list to grocery store aisle signs and generalize skills across one other grocery store using a multi-media program of simulated instruction.
  • Future research is needed to examine simulation instruction combined with community based instruction

Mechling, L. C., Gast, D. L., & Langone, J. (2002). Computer-based video instruction to teach persons with moderate intellectual disabilities to read grocery aisle signs and locate items. The Journal of Special Education, 35, 224-240. [Experimental]

  • Included four participants ages 9-17 with moderate intellectual disabilities, cerebral palsy, Down syndrome, and/or autism
  • Taught students to decode words found in grocery store aisles and how to locate items using a task analysis with system of least prompts and computer-based video instruction
  • Results indicated that all students increased their ability to read grocery aisle heading words and locate grocery items with the use of photography and shopping lists
  • Future research should examine effects of CBI video training in combination with teaching grocery shopping skills in natural environments.

Skills for EMPLOYMENT

Barnhill, G. P. (2007). Outcomes in adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 22, 116-126. [Descriptive]

  • Provided a parent's perspective on current research of adult outcomes for individuals with Asperger syndrome
  • Areas discussed included: (a) employment issues; (b) comorbid mental health conditions; (c) physical health conditions and neurological/sensory issues; (d) social cognition; (e) problems in the legal system; (f) mortality rates; (g) increased public awareness, education, recognition; and (h) gaps in education services and employment opportunities
  • Future research is needed on assisting individuals with AS so they can be successful in the workforce and various available housing options

Chappel, S. L., & Somers, B. C. (2010). Employing persons with autism spectrum disorders: A collaborative effort. Journal of Vocational Rehabilitation, 32, 117-124. [Descriptive]

  • Described strategies school systems and their vocational rehabilitation partners could use to work cooperatively to improve outcomes for student with ASD.
  • Strategies included (a) linking with VR and other community agencies early, (b) considering the student's strengths and passions, (c) teaching self-advocacy, (d) teaching the social skills needed in the work place, (d) providing work experiences prior to graduation, and (e) choosing suitable work environments and educate the employers and employees.

Hendricks, D. (2010). Employment and adults with autism spectrum disorders: Challenges and strategies for success. Journal of Vocational Rehabilitation, 32, 125-134. [Descriptive]

  • Reviewed evidence based research related to employment for individuals with ASD including (a) benefits of employment, (b) state of employment, (c) obstacles to employment, (d) current service options, and (e) in depth review of supports needed for employment
  • Strategies for employment success included; finding good job matches; supportive supervisors and co-workers; on-the-job training; work place modifications (e.g., environmental assessments, clearly defined work tasks, restructured job duties, a consistent schedule, use of organizers to structure work, activity schedules, down time alternatives); and extended long-term support as needed.

Higgins, K. K., Kocha, L. C., Boughfmana, E. M., & Vierstrab, C. (2008). School to work transition and Asperger's Syndrome. Work, 31, 291-298. [Descriptive]

  • Identified psychosocial and vocational characteristics of people with Asperger's Syndrome, supports needed to be successful in the workplace, and specific work related challenges of Asperger's Syndrome
  • Research indicated career education should have a dual focus to increase awareness of career opportunities compatible with abilities and interests of people with Asperger's Syndrome and provide them with practice opportunities to improve their general employment skills and enhance self-confidence
  • Implications for practice for transition teams included: (a) emphasizing avenues of relevant work experiences such as part-time jobs, internships, service learning, and community-based work experiences; (b) assisting students in writing resumes highlighting their skills and relevant experience; (c) providing students with scripts, role-play scenarios, and immediate constructive feedback; (d) assisting in stress management training, tutoring, peer supports, faculty mentorships, career counseling, and referral to campus resources; and (e) providing job coach services that should include vocational training, restructuring of job duties, ensuring that employees complete job duties in appropriate manner and provide appropriate follow-up services
  • Additional implications for practice included: (a) assisting and remedying problematic behaviors; (b) assisting employees with concentration by purchasing noise-cancelling headsets, relocating employee's office space away from audible and visual distractions, and installing cubicle walls to reduce visual distractions; and (c) communicating with employers about the advantages of hiring individuals with Asperger's Syndrome such as cognitive abilities, attention to detail, loyalty, and dependability

Hume, K., & Odom, S. (2007). Effects of an individual work system on the independent functioning of students with autism. Journal of Autism and Developmental Disorders, 37, 1166-1180. [Experimental]

  • Included three individuals ages 6-20 with autism in various work and individual play settings
  • Taught 20 year old student how to use an individual work system to increase their independent work production
  • Results from this study indicated that using an individual work system for adults with autism can be effective for increasing independence and task production
  • Future research is needed to examine the effects of using individual work systems across academic, self-help, job skills, and leisure skill domains for individuals with autism

McDonough, J. T., & Revell, G. (2010). Accessing employment supports in the adult system for transitioning youth with autism spectrum disorders. Journal of Vocational Rehabilitation, 32, 89-100. [Descriptive]

  • Described primary employment and related service systems students with ASD, their parents, and school transition teams need to know about when transitioning from school to adult service providers
  • Two case studies of individuals with ASD were included to illustrate the importance of being well-informed about resources at the community and state level and of learning how to network effectively among these resources.

Schall, C. M. (2010). Positive behavior support: Supporting adults with autism spectrum disorders in the workplace. Journal of Vocational Rehabilitation, 32, 109-115. [Descriptive]

  • Reviewed evidence based positive behavior support (PBS) practices for supporting individuals with ASD in supported and competitive workplaces.
  • Discussed challenges to providing PBS in the workplace including (a) the public context, (b) smaller number of paid support staff available to implement the intervention, (c) limited access to staff with behavioral expertise, and (d) lower tolerance to invest time and resources to implement PBS intervention.
  • Included and described PBS strategies (a) antecedent strategies and ecological modifications, (b) replacement behaviors and new skills, and (c) consequential strategies.
  • Questions posed by the authors for future research (a) What assessments and types of work supports are most likely to increase success in the work place without disruption? (b) What array of supports will lead to independence/interdependence at work? (c) What types of assessments, interventions, and data collection procedures are most acceptable to employers? (d) What work support models result in the highest level of successful placement for individuals with ASD? 
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