The Role of Acceptance in the Transition to Adulthood: A Multi-Informant Comparison of Practitioners, Families, and Youth with Autism

Development and Further Content Validation of the Motivation Assessment Tool for Physical Activity (MATPA) Among Children with Autism Spectrum Disorder

This study describes the content validity process, focusing on children, to create and validate a tool for assessing motivation toward out-of-school physical activity (PA) among children with autism spectrum disorder (ASD) aged 6 to 17 years. Additionally, it establishes the eligible verbal communication age range necessary for its application. The initial development and content validity process with external experts is described elsewhere (An et al., 2025 under review). The MAT-PA was iteratively refined during the content validity process with twenty children (two with version 0.1, ten with version 0.2, and eight with version 0.3). Modifications were made based on feedback from children who completed the entire interview. The Vineland Adaptive Behavior Scales, Second Edition (VABS-2), assessed the age-equivalent for daily verbal communication skills required for the MAT-PA. Feedback from the twelve children who completed the entire interview process (two with version 0.1, six with version 0.2, and four with version 0.3) provided evidence supporting the tool's content validity. Challenges with attention spans and verbal abilities limited full participation from the remaining eight children. Parent-reported VABS-2 scores indicated that the MAT-PA is suitable for children with ASD who have verbal communication skills equivalent to 3-year-olds (receptive) and 6-year-olds (expressive). The MAT-PA is the first tool specifically designed to explore the psychological needs and behavioral regulation of children with ASD, providing evidence of content validity. Future work should focus on improving the tool's reliability for trial integration, exploring its applicability across diverse contexts, and leveraging technology to boost scalability and impact.

The Effectiveness of the Turkish Version of the Responsive Teaching Program Applied as an Online Group Intervention on Autistic Children and Their Fathers: A Randomized Control Study

The purpose of this study was to explore the effectiveness of the Turkish Version of the Responsive Teaching program applied as an online group intervention on autistic children and their fathers. In this study, conducted with pre-test-post-test control group experimental design, 20 father-child pairs were randomly assigned to the experimental and control groups. This study's independent variable was the implementation of the Turkish Version of the Responsive Teaching (TV-RT) program (TV-RT) applied as an online group intervention. The dependent variables of this study were (a) fathers' interactional behaviors, (b) fathers' ability to use TV-RT strategies, (c) children's interactional behaviors, (d) children's ability to use TV-RT pivotal behaviors, (e) children's social interaction behaviors (typical social interaction and autistic interaction), and (f) the opinions of the fathers and mothers of the children in the experimental group about the program and results. Data were collected with the Turkish Version of the Maternal/Parent Behavior Rating Scale (M/PBRS-TV) to measure fathers' interactional behaviors; the Responsive Teaching-Parent Strategy Profile (RT-PSP) to measure fathers' level of use of the TV-RT strategies; the Turkish Version of the Child Behavior Rating Scale (CBRS-TV) to measure children's interactional behaviors; the Responsive Teaching-Pivotal Behavior Profile (RT-PBP) to measure children's level of displaying TV-RT pivotal behaviors; and the Turkish Version of the Social Interaction Assessment Instrument (SIAI-TV) to measure children's social interaction behaviors (typical social interaction and autistic interaction). In addition, social validity data were collected from the fathers and mothers in the experimental group through satisfaction questionnaires. Results revealed that the fathers of autistic children who received the intervention differed significantly on the use of TV-RT strategies and the quality of interactional behaviors from the fathers who did not receive the intervention. On the other side, autistic children in the experimental group showed significant progress on interactional behaviors, TV-RT pivotal behaviors, and social interaction behaviors and improved changes on autistic interaction behaviors. Fathers who participated in the online group TV-RT program, and their wives (mothers) as outside observers, reported high satisfaction with the program. Results were discussed extensively, and future suggestions are provided.

Health care transition quadruple aim outcomes for IDD: Scoping review

Purpose

Structured HCT models addressing planning, transfer, and integration into adult care for adolescents and young adults with childhood-acquired chronic conditions are becoming more prevalent. However, consensus on outcome measures to assess health care transition (HCT) interventions particularly for intellectual and developmental disabilities (IDD) population is lacking. This scoping review identified potential HCT outcome measures for young adults (aged 18-26) with IDD using the Quadruple Aim Framework.

Methods

On August 6, 2021 and April 27, 2023, Medline Ovid, Embase, Web of Science, PsycINFO, and Cochrane databases were searched using the terms "young adult," "intellectual disability," "developmental disability, "cognitive dysfunction," "autism," "cerebral palsy," "spina bifida," and "transition to adult care." Searches were limited to publications in English and published from 2000 to present. Observational and experimental (qualitative or quantitative) studies were included if participants were young adults (median/mean ages 18-26) with IDD (Autism, cerebral palsy, Down syndrome, spina bifida, or other IDD-related conditions) and study outcomes addressed one of the Quadruple Aim domains (population health, patient/family experience, cost/utilization, and healthcare provider/caregiver experience). Studies were excluded if participants had attention deficit/hyperactivity disorder or learning disability only, if outcomes were primarily educational or vocational, or if publications were reviews, abstracts, or not in English.

Results

One hundred and three articles were included data extraction. Articles were categorized under the Quadruple Aim domains: Population Health (43), Patient/Caregiver Healthcare Experience included (23), Cost/Utilization (24), and Healthcare Provider/Caregiver Experience (15). Most articles were observational and utilized a variety of assessments or internally developed questions as measures.

Conclusions

While studies describing HCT outcomes for the IDD population are limited and measures are inconsistent, studies pertaining to Quadruple Aim outcomes identified in this review can further direct efforts towards consensus and standardization of HCT outcome measures to address the needs of individuals with IDD, their families, and caregivers/providers.

Same Transition, Different Perspectives: Comparing Dyadic Interviews with Autistic Young Adults and Parents

Introduction

The transition to young adulthood can be a turbulent life stage, and this is often magnified for autistic youth. Young adults frequently profess different goals and values than their parents. While there is some indication in autism research about how parents, and to a lesser extent, autistic young adults, feel about this transition, little research leverages dyadic interviews with both populations or has used this method with Black and/or low-income families.

Method

We conducted four sets of dyadic interviews with autistic young adults and their parents who live together.

Results

We identified three key themes that both groups found important to the transition: independence, structured transition, and interpersonal relationships. However, we found that how the groups conceptualized these themes were divergent and revealed differences in goals and values. Parents were more oriented toward long-term normative views of fulfillment, whereas young adults spoke about what was meaningful to them currently.

Conclusion

This work has implications for changes to how autism research will conceptualize the transition to young adulthood and how we can create better social opportunities for this population.

Community brief

Why is this an important issue?: Autistic adults are at risk for difficulties getting work and education, which can lead to them feeling alienated or unfulfilled. Most research on autistic people becoming adults is based on White people with more cultural and financial resources and does not ask autistic people themselves or their families with them. Research is needed to improve transition outcomes for these underresearched and underserved groups.What was the purpose of this study?: This study explored how autistic youth and their parents thought about and experienced the transition to adulthood out of an urban, low-resourced school district.What did the researchers do?: Researchers interviewed four parents and four autistic youth. Three families were Black, and one family was White and from a low-income household. All autistic youth had received special education services, needed support to transition to adulthood, and had finished high school 1 to 6 years before the study. The young adults lived with their mothers and received support from them for daily tasks. We interviewed the parents and then the youth. In some cases, youths joined parents' interviews or parents joined youths' interviews to provide help with remembering information or giving answers.What were the results of the study?: Researchers identified three themes. First, parents and youth thought about independence differently. Parents focused more on work and financial independence. Youth focused more on social aspects of work and having independence in daily activities such as shopping. The second theme was that youth and parents approached ongoing structured supports differently. Youth reported positive experiences with a range of services but did not discuss the need for ongoing supports like their parents did. Third, youth emphasized the importance of social relationships and opportunities to connect with peers through shared interests.What do these findings add to what was already known?: We learned that standard questions about transition may not reflect how autistic youth and their parents think about becoming an adult. Interviewing families coming out of a predominantly Black and low-income urban school district helped us to understand how these groups experience and think about the transition to adulthood, even though they did not use these identities as a logic for how they thought about young adulthood. This suggests that parent and youth perspectives differ in groups that are not usually well represented in research studies related to transition for autistic youth.What are potential weaknesses in the study?: This study only included a small number of youth and parents. These results do not represent all Black autistic youth or low-income autistic youth coming from urban school districts. Families who are less connected to services may have been less likely to hear about or take part in the study.How will these findings help autistic adults now or in the future?: These findings could inform the development of better interviewing approaches and research to address the needs of diverse autistic youth entering adulthood. This work could improve transition support. Parents, youth, support providers, and researchers may think about adulthood differently. Improved support could help build mutual understanding and coordination around youths' and their families' goals.

Barriers to Providing Transitional Supports for Autistic Students: Insights of School Professionals

Following high school exit, many autistic young adults are not enrolled in post-secondary education or employed, and few are engaged in community activities. This disengagement among autistic young adults may be a result of the limited or inadequate supports provided to autistic transition-age youth in schools. Therefore, the purpose of the current study is to explore how school professionals report preparing transition-age autistic youth for adulthood and the barriers that make it difficult for school professionals to provide quality transition services. We surveyed 21 school professionals who work with transition-age autistic students. The survey solicited descriptions of transition supports provided to youth, and barriers that make it difficult for school professionals to provide high quality transition supports. Qualitative content analysis was used to identify themes from the data. Participants described barriers related to the autistic youth they taught or supported, their families, the classroom environment, and the community. Barriers were either framed as deficits inherent to autistic students and their families, or larger systemic issues that make it challenging to implement high quality transition supports. We recommend implementation of autism-specific trainings within teacher preparation programs and school districts, professional development opportunities that create spaces for educators to challenge and resist deficit views of autism, and development of strengths-based transition programs that are implemented by school-based professionals who work with autistic students.

Elucidating the Perspectives of Autistic Youth About Their Health Care Experiences: A Qualitative Study

OBJECTIVES

Autistic individuals have higher rates of co-occurring medical conditions and service use. However, autistic individuals and their families also reported lower satisfaction with health care service delivery. Previous studies described health care experiences of autistic adults, but less is known about those of autistic adolescents and young adults. This study aimed to qualitatively describe the health care experiences of autistic youth.

METHODS

Four longitudinal/serial focus groups were conducted with 8 autistic adolescents and young adults. Participants were members of an autistic patient advisory board, which is part of a broader initiative at a large, urban, safety-net hospital to improve the health care experiences of autistic patients. Focus groups were conducted virtually and were audio-recorded. Audio recordings were transcribed and verified for accuracy. Transcripts were consensus-coded with an inductive approach using tenets of grounded theory.

RESULTS

Findings included 4 recurring themes: accessibility and accommodations, barriers of health service use, patient involvement in health care decisions, and facilitators of patient-clinician relationship. Participants noted that visit preparation, sensory items, and repeated positive interactions with clinician were helpful to build a positive health care experience.

CONCLUSION

Our findings support previous research that suggest the need to individualize care, ensure availability of accommodations, apply flexibility in practice whenever possible, and increase health care professional knowledge about this unique patient population.

Feasibility of a Remote-based Nutrition Education and Culinary Skills Program for Young Adults With Autism Spectrum Disorder

OBJECTIVE

To evaluate the feasibility of a remote-based nutrition education and culinary skills program for young adults with autism spectrum disorder (ASD).

METHODS

Thirteen young adults with ASD (26.6 ± 4.4 years; 77% male) participated in a remote-based nutrition program twice a week over 12 weeks. Principles of Social Cognitive Theory were used to develop the curriculum, which focused on nutrition education and meal preparation. Feasibility was assessed through attendance records, retention rates, duration/frequency of participant engagement, session notes, and participant interviews.

RESULTS

The program had a 13% refusal rate and a 7% attrition rate. Participants had a session attendance rate of 83%. Session notes revealed that the remote format offered several methods of participant communication and captured evidence of family support. Interview themes included increased nutrition-related knowledge, self-efficacy, and behavioral capability.

CONCLUSIONS AND IMPLICATIONS

The remote-based nutrition program met feasibility benchmarks for adherence and retention and was well-accepted by participants. A remote-based format for nutrition interventions can reach a wider range of young adults with ASD; however, input from the target population should be considered in the development of the program.

A systematic review on autistic people's experiences of stigma and coping strategies

Autism can be understood as a concealable stigmatized identity. This is the first systematic review to synthesize the literature on autistic people's experiences of stigma and coping strategies. 2877 studies were screened and 27 were included in this review. The reviewed literature demonstrates that autistic individuals are acutely aware of being stereotyped, judged, and discriminated by others. Autistic people also show signs of internalizing stigma, rendering them more vulnerable to low self-worth and poorer mental health. To manage the impact of stigma, the included studies suggest that autistic individuals may use these strategies: concealment and camouflaging, selective disclosure and self-advocacy, as well as positive reframing and reconstructing identity. However, the evidence is limited and mixed in terms of how helpful and effective these strategies are. Future studies should include autistic populations with a wider range of intellectual abilities and explore interventions that can support autistic people in managing stigma to supplement interventions that seek to reduce stigma towards autistic people. The power of language in perpetuating and challenging stigma also has important implications for research and practice, underscoring the need for researchers and practitioners to reflect carefully on the messages they are communicating about autism.