Orsmond Gael I, Krishnan Sharada G, Munsell Elizabeth G S, Cohn Ellen S, Coster Wendy J
Department of Occupational Therapy, Boston University, 635 Commonwealth Ave., Boston, MA, 02215, USA.
Pearson Assessments, San Antonio, TX, USA.
J Autism Dev Disord. 2025 Mar 13. doi: 10.1007/s10803-025-06782-3.
The aim of the present longitudinal study was to identify malleable factors during the last year of high school that predicted post-school outcomes in autistic youth one year after high school graduation. We then explored whether depressive symptoms in high school mediated the associations between other malleable factors and post-school outcomes. Thirty-two autistic youth and a parent completed surveys during the youth's final year of high school (T1) and one-year post-high school graduation (T2). Malleable factors measured at T1 included social communication skills, executive functions, responsibility for daily tasks, and depressive symptoms. The T2 young adult outcome measure included both objective and subjective indicators of productivity, social well-being, and autonomy in living situation. All malleable factors except social communication skills were significantly correlated with young adult outcomes. T1 executive functions, responsibility for daily tasks, and depressive symptoms jointly predicted 40.2% of the variance in young adult outcomes. Only depressive symptoms explained a significant amount of unique variance in young adult outcomes. In addition, depressive symptoms mediated the predictive association between executive functioning and young adult outcomes. The findings suggest that depressive symptoms may be a key intervention target for autistic high school students. Adapting cognitive behavioral approaches to comprehensively address multiple transdiagnostic factors such as executive functions, responsibility for daily tasks, and mental health may be a promising avenue to promote positive post-school outcomes in this population.
本纵向研究的目的是确定高中最后一年中可改变的因素，这些因素能够预测自闭症青少年高中毕业后一年的离校后结果。然后，我们探讨了高中阶段的抑郁症状是否介导了其他可改变因素与离校后结果之间的关联。32名自闭症青少年及其一名家长在青少年高中最后一年（T1）和高中毕业后一年（T2）完成了调查。在T1阶段测量的可改变因素包括社交沟通技能、执行功能、日常任务责任感和抑郁症状。T2阶段的青年成人结果测量包括生产力、社会幸福感和生活自主性的客观和主观指标。除社交沟通技能外，所有可改变因素均与青年成人结果显著相关。T1阶段的执行功能、日常任务责任感和抑郁症状共同预测了青年成人结果中40.2%的方差。只有抑郁症状解释了青年成人结果中显著的独特方差量。此外，抑郁症状介导了执行功能与青年成人结果之间的预测关联。研究结果表明，抑郁症状可能是自闭症高中生的关键干预目标。采用认知行为方法全面解决执行功能、日常任务责任感和心理健康等多种跨诊断因素，可能是促进该人群积极离校后结果的一条有前景的途径。
