Factors Influencing Participation Outcomes of Young Adults with Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) are consistently described in extant literature to struggle with crucial aspects of adult participation--specifically, participation in employment, daily living independence, and social relationships. The purpose of this project was to enhance understanding of factors that influence these outcomes for young adults with ASD. Three specific aims were addressed, each with a distinct methodological approach. First, a systematic review of the literature was conducted to identify key longitudinal factors that predicted participation outcomes; twelve publications--reporting on eight unique studies--were included. Significant longitudinal predictors of outcomes resulting from the review included personal characteristics, individual functioning (e.g., cognition, language skills, independence), family context (e.g., household income, parent education, family support), services, peer influence, and health status. Next, secondary data from a national, longitudinal sample of youth with ASD (the National Longitudinal Transition Study-2; NLTS2) were utilized to test a structural equation model which revealed parent expectations as a significant mediator of the paths from family background and functional performance to young adult participation outcomes; significant indirect paths were identified from family background, functional performance, and gender to outcomes. Finally, qualitative interviews were conducted with seven mothers of adolescent males with ASD to explore factors that contribute to the development of their expectations for their sons' futures. Three themes were identified which describe influences on mothers' expectations: (1) characteristics and experiences of youth; (2) maternal perceptions, beliefs, and emotions; and (3) stereotypes, stories, and society. The mothers also described the approaches they use to plan and prepare their sons for adulthood. These approaches were reflective of their expectations which helps explain why parent expectations predict to young adult outcomes. Findings across the three aims led to identification of key factors that influence the outcomes of young adults with ASD as well as understanding of complex interconnections and relationships among factors. The results build upon existing empirical and theoretical work related to the transition to adulthood for individuals with ASD and contribute novel insights relevant for future research and clinical practice.Doctor of Philosoph