High School SUCCESS: Vocational Soft Skills Program for Transition Age ASD Youth
Principal Investigator(s): Mary Baker-Ericksen, Ph.D. SDSU
Co-Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Bonnie Kraemer Ph.D. SDSU, Caren Sax, Ph.D. SDSU
This study has the potential to make a significant public health impact by developing a standardized curriculum, High School SUCCESS, to increase neurologist and social cognitive skills leading to improved postsecondary outcomes (postsecondary education and employment) for transition-age youth with Autism Spectrum Disorders (ASD) in community school settings. Exploration of program level variables as existing transition secondary school programs curriculum/interventions, planning and service delivery frameworks, training and professional competencies and collaboration among stakeholders and individual level variables including the associations between cognitions, social cognitive skills, functioning, postsecondary outcomes, self-confidence and quality of life will be conducted. These results will make a significant contribution to the minimal services research directed towards transition programming and transition-age youth with ASD.
Funding Information: NIMH, R34, 5R34MH111491-02
Study time period: 12/1/2016 - 11/30/2020
Applying Team Charters to Improve Distance Training Outcomes for Autism Interventions in Public Mental Health Services and Schools
Principal Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Aubyn Stahmer, Ph.D. UC Davis
The purpose of this R34 is to develop and test a team charter-enhanced implementation strategy for distance training to increase the reach and effectiveness of two evidence-based intervention practices (EBPs) for autism across two public service systems. Our research groups have adapted, tested, and implemented autism EBPs across two service systems: AIM HI (“An Individualized Mental Health Intervention for Autism”) in publicly funded mental health services and CPRT (“Classroom Pivotal Response Teaching”) in public school classrooms. The implementation strategy appears to be less effective when EBP training is provided from a distance, resulting in fewer providers completing training. Thus, geographic distance is a barrier for children and families needing care, and for high-quality provider training. Although there are many advantages to distance training, and this will be increasingly required with the sustained impact of COVID-19, preliminary data from our current trials reveal several challenges with providing high-quality EBP training and ongoing consultation/coaching remotely. Distance training requires effective and efficient coordination between individuals with different roles and backgrounds. Thus, we propose to co-create and pilot test a team charter-enhanced implementation strategy using “team charters” to increase the reach of Autism EBPs through distance training.
Funding Information: NIMH, P50, MH126231
Study time period: 2022 - 2027
Adapting an ASD Executive Functioning Intervention for Implementation in Children’s Mental Health Services
Principal Investigator(s): Kelsey Dickson, Ph.D. University of Oregon
Co-Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Gregory Aarons, Ph.D. UC San Diego, Lauren Kenworthy, Children's National, Laura Anthony, Ph.D. University of Colorado, Scott Roesch, Ph.D. San Diego State University
The aims of the current project are to use an implementation science framework to: 1) conduct a needs and context assessment to inform the systematic adaptation of an ASD EF intervention (Unstuck and on Target [UOT]) for implementation in child mental health services; 2) systematically adapt UOT and develop a corresponding plan; and 3) conduct a feasibility pilot test of the adapted intervention and corresponding implementation plan in community mental health settings.
Funding Information: NIMH, K23, K23MH115100
Study time period: 2018 - 2023
EXamining interventions to PRomote Executive function and Social Skills
Principal Investigator(s): Jessica Steinbrenner, Ph.D. University of North Carolina, Laura Hall, Ph.D. San Diego State University, Bonnie Kramer, Ph.D. San Diego State University, Kelsey Dickson, Ph.D. University of Oregon, Sam Odom, Ph.D. University of North Carolina, Ann Sam, Ph.D. University of North Carolina
From 2008-2017, the percentage of youth with autism (i.e., aged 12-17) receiving special education services in the public schools has increased by 174% (U.S. Department of Education, 2020). This acceleration in enrollment in special education has created a great need for determining intervention approaches that (a) meet the learning needs of students with ASD in public schools, (b) are efficacious, and (c) can be implemented by service providers in authentic (school) settings. Researchers have developed social skills (SS) and executive functioning (EF) training programs for children and youth with ASD, buy only two have been specifically developed for schools: the Program for the Education and Enrichment of Relational Skills (PEERS; Laugeson, et al., 2014) and the Unstuck and On Target (UOT; Strang et al., in press) training programs, which address the areas of SS and features of EF, respectively. However, neither have been examined in a cluster randomized control trial in public middle school settings. The goal of this project is to examine the initial efficacy of the PEERS and UOT programs when implemented in public, middle school settings. This project employs a unique dual efficacy, active contact-control design. This design will allow us to test both a social skills (SS) and an executive function (EF) training intervention for middle school students with autism spectrum disorders (ASD). A unique advantage in this study is that PEERS and UOT have great procedural similarities, different outcomes, and can act as active contact controls for each other.
Funding Information: U.S. Department of Education Institute of Education Sciences, Goal 2, R324A210163
Study time period: 2021 - 2026
Hybrid Effectiveness-Implementation Trial of an Executive Functioning Intervention for Children's Mental Health Services
Principal Investigator: Kelsey Dickson, Ph.D. University of Oregon
Co-Investigator(s): Lauren Brookman-Frazee, Ph.D. UC San Diego, Laura Anthony, Ph.D. University of Colorado, Sarah Kennedy, Ph.D. University of Colorado, Scott Roesch, Ph.D. San Diego State University
Autism is a highly prevalent neurodevelopmental condition, affecting 1 in 36 youth. The annual cost in the U.S. of autism was $223 billion in 2020 and is estimated to rise to $589 billion by 2030. Outcomes are poor and care disparities and high rates of unmet service needs are common. Mental health services play a key role in caring for autistic youth. There have been efforts to develop evidence-based interventions (EBIs) with the potential to lessen the public health burden of autism. Yet, research indicates limited community EBI penetration. There is an urgent need to focus on EBIs that improve mental health services for autism and optimize outcomes for this priority, complex population. Executive functioning (EF) is a potent mechanism underlying autism and commonly co-occurring mental health conditions. EF impairments (e.g., inflexibility, poor goal setting, poor planning) contribute to negative outcomes spanning multiple areas (e.g., academic, vocational, health). Our work underscores the impact of EF deficits on mental health services, including its transdiagnostic impact on the majority of children served in this setting and its role as a barrier to psychotherapy engagement and progress. EF is responsive to treatment, and mental health therapists cite a significant need and motivation for EF treatments, making EF EBIs highly relevant for community mental health settings. However, EF EBIs have not been widely used and tested in such settings. Autism EBIs, or those developed or adapted for autistic youth, have the potential to enhance mental health services, in addition to improving service quality for the populations targeted (e.g., autism). This is due to the specific components and strategies incorporated into the EBI to enhance its impact and fit. We propose a Hybrid Type 2 randomized trial examining the effectiveness and implementation of an autism EF EBI (Unstuck and On Target) in community mental health settings. Unstuck and On Target is a cognitive-behavioral EF intervention effective for autism. With NIMH funding (K23MH115100;), Unstuck and On Target was systematically adapted for and tested in mental health settings, with a pilot test suggesting its preliminary effectiveness, high fidelity, and use beyond autism. Findings have the potential to transform implementation and service quality for the high priority population of autistic youth as well as youth generally. Aim 1. Evaluate the effectiveness and implementation of an autism EBI (Unstuck and On Target), relative to a non-autism transdiagnostic intervention (Unified Protocol for Children) for autistic youth. Aim 2. Evaluate mediators of EBI training effects to confirm engaged change mechanisms of clinical and implementation outcomes. Aim 3. Explore the generalized effects of EBI training on reach and improved psychotherapy quality with non-autistic youth.
Funding Information: NIMH, R01, R01MH137179
Study time period: 2024 – 2029
Redesigning an Autism Evidence-Based Practice Implementation Toolkit for Middle and High Schools
Principal Investigator(s): Kelsey Dickson, Ph.D. University of Oregon, Jill Locke, Ph.D. University of Washington
Co-Investigator(s): Amy Drahota, Ph.D. Michigan State, Scott Roesch, Ph.D. San Diego State University
For the more than 450,000 autistic adolescents served in public schools, there is an urgent need for additional supports that address ongoing challenges to educators’ successful selection and delivery of autism evidence- based practices (EBPs). The proposed innovative redesign of an autism implementation toolkit (entitled ACT SMART) targeting EBP decision-making for middle and high schools has the potential to meet the need for systematic supports for the selection and implementation of appropriate EBPs that considers the needs of schools, educators, and autistic adolescents. The aims of the current project are to: 1) Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers who serve autistic adolescents; 2) Conduct prototyping and usability field testing of the redesigned ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools.
Funding Information: NIMH, R21, 5R21MH130793
Study time period: 2022 – 2025
Team Effectiveness Factors in the Implementation of Autism Evidence-Based Practices
Principal Investigator(s): Allison Jobin, Ph.D. California State Univeristy San Marcos, Lauren Brookman-Frazee, Ph.D. UC San Diego, Aubyn Stahmer, Ph.D. UC Davis
Co-Investigator(s): Elizabeth Rangel, Ph. D., UC Davis, Patricia Schetter, M.Ed. Placer County Office of Education, Katherine Williams, Ph.D., Rady Children's Hospital-San Diego
The purpose of this R03 is to identify specific team-based inputs and processes of evidence-based practice (EBP) leadership teams associated with effective implementation of autism EBPs in community settings. Despite the importance of leadership teams in children’s mental health and education services, there is minimal research on effective teams for autism EBP implementation. Team effectiveness research (TER) specifies team-level factors as key levers impacting outcomes. Little research has attempted to understand these factors and how they are involved within EBP leadership teams, which has potential to improve their impact and scalability. Applying a community-partnered approach, this project capitalizes on existing data from statewide implementation trials to improve understanding of the role of teams in EBP implementation outcomes and has the potential to inform development of team-based implementation strategies to further promote effective autism EBP implementation efforts. We will apply secondary coding and analysis of team characteristics and in-group process data from a team-based EBP implementation strategy across two service systems to: (1) Identify team inputs associated with implementation outcomes, and (2) Identify team processes associated with implementation outcomes. Together, findings related to potent team-based factors (i.e. team inputs, key processes) will support a larger-scale project to develop and test an EBP implementation team toolkit for school and youth mental health services in collaboration with community partners.
Funding Information: NIMH, P50, MH126231
Study time period: 2023 - 2024
A Hybrid Effectiveness-Implementation Trial Of A School Based Executive Function Treatment For Transition Age Youth With Autism
Principal Investigator: Cara Pugaliese, Ph.D. Children’s National Hospital
Co-Investigator(s): Kelsey Dickson, Ph.D. University of Oregon, Lauren Kenworthy, Ph.D. Children’s National Hospital, Laura Anthony, Ph.D. University of Colorado
Individuals without intellectual disability make up the fastest-growing subgroup of autism spectrum disorders, but as few as 9% reach full functional independence as adults. This project tests the effectiveness of a novel school-based executive function intervention for transition-age youth with autism, to improve flexible problem- solving and planning skills that drive pivotal adult outcomes. If successful, the proposed project will demonstrate the widespread effectiveness and feasibility of an accessible intervention to improve transition outcomes for youth with autism that can be rapidly disseminated and implemented by schools across the nation.
Funding Information: NIMH, R01, R01MH124772
Study time period: 2021-2025
Examining the Efficacy of Project ImPACT for Toddlers
Principal Investigators: Sarah Rieth, Ph.D. San Diego State University, Sarah Dufek, Ph.D. UC Davis, Aubyn Stahmer, Ph.D. UC Davis, Scott Roesch, Ph.D. San Diego State University, Jeffrey Hoch, Ph.D. UC Davis
This Efficacy and Follow-up project tests the effects of Project ImPACT, a naturalistic development behavioral intervention (NDBI) for young children with autism and their families implemented within the public early intervention system. Project ImPACT for Toddlers was adapted by a community-academic collaborative to meet the needs of providers, families, and funding agencies and be feasible for community agencies. Through a randomized wait-list-control design, the effects of Project ImPACT will be examined on provider, parent, and child outcomes including provider and parent fidelity, parent responsiveness, and child social-communication and adaptive skills.
Funding Information: U.S. Department of Education, National Center for Special Education Research, Efficacy and Follow-Up, R324A190076
Study time period: 2019 - 2024
Expanding the PUENTE Network to Meet Emerging Needs
Principal Investigators: Sarah Rieth, Ph.D. San Diego State University, Lauren Brookman-Frazee, Ph.D. UC San Diego, Brenda Bello-Vazquez, San Diego Regional Center
Close examination of administrative claims data for services to individuals with developmental disabilities idenitifed spending disparities for Latinx families compared to non-Latinx families. In consultation with stakeholders, a short-term parent-to-parent psychoeducation and empowerment intervention was established and delivered to families of adolescents. Program evaluation data indicated a need for ongoing support and connection in order to further support family engagementi n the service system. This projects provides ongoing group support for families who graduate from the PUENT psychoeducation program; and (2) provides access to individual components the PUENTE curriculum through multiple community facing avenues (e.g., promotoras presenting PUENTE content within existing community groups/events and holding SDRC office hours). Specifically, a PUENTE network will be co-designed with multiple stakeholders and then pilot tested to assess feasibility, reach, and acceptability.
Funding Information: California Department of Developmental Services, Service Access and Equity, 22-SDRC-01
Study time period: 2023 - 2024
A Hybrid Effectiveness-Implementation RCT of Virtual Interview Training for Autistic Transition-Age Youth
Principal Investigator(s): Matthew Smith, Ph.D. University of Michigan, Mary Baker-Ericzen, Ph.D. San Diego State UniversityCo-Investigator(s): Jessica Suhreinrich, Ph.D. San Diego State University
This project evaluates the effectiveness of Virtual Interview Training for Transition Age Youth (VIT) at enhancing employment and mental health outcomes for autistic transition-age youth engaged in school-based pre-employment transition services (ETS). In collaboration with members of the autism community, we created a virtual job interview training program using virtual reality and artificial intelligence technology to help autistic students answer job interview questions. We want to test if this program helps students with autism improve their job interview skills, become less nervous about job interviews, and increase their access to jobs. This program includes an educational component (information about the job search and application process), practice completing online job applications, and mock interviews with a virtual reality interviewer.
We are currently seeking community partners in high schools and vocational programs. Participants are eligible if they are autistic, between the ages of 16-26 years old, and have a 4th grade reading comprehension level. Students, staff, and programs are compensated for their participation. Participants will also maintain their access to the software once the study is complete, so they can continue to practice their interview skills. If you are interested in participating in this study, please contact us at autismstudyarpe@sdsu.edu.
Funding Information: NIMH, R01, R01MH132656-01
Additional Information: Video on the Rita & Travis training software
Adapting and Implementing an Integrated Care Model for Youth with Autism Spectrum Disorder and Psychiatric Comorbidity
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego
The study used implementation science theory and methods and a research-community partnership approach to: 1) identify targets to improve mental health screening and linkage to mental health services in primary care for children with autism, 2) adapt integrated care procedures into “Access To Tailored Autism INtegrated Care,” ATTAIN, to facilitate identification of mental health problems and linkage to evidence-based care for youth with autism, and 3) conduct an open trial feasibility pilot test of ATTAIN in pediatric primary care.
Funding Information: NIMH, K23
Study time period: 2017 - 2022
Refining and Implementing Technology-Enhanced Family Navigation to Promote Early Access and Engagement with Mental Health Services for Youth with Autism
Principal Investigator(s): Nicole Stadnick, Ph.D., MPH UC San Diego
Co-Investigator(s): Sonya Negriff, Kaiser Permanente
This proposal aims to test the effectiveness and implementation of technology-enhanced family navigation to promote early access to, and engagement in evidence-based mental health care for children (ages 5-13 years) with autism spectrum disorder plus mental health comorbidity.
Funding Information: NIMH, R34, 5R34MH120190-03
Study time period: 8/15/20 - 6/30/23