# A Multisite RCT of a Daily Living Skills Intervention for Autistic Adolescents Prior to the Transition to Adulthood

> **NIH NIH R01** · CINCINNATI CHILDRENS HOSP MED CTR · 2024 · $690,880

## Abstract

Project Summary/Abstract: Daily living skills (DLS), which are the tasks (e.g., hygiene, cooking, laundry,
managing money) that individuals do to take care of themselves at home, school, work, and in the community,
are impaired in autistic adolescents without an intellectual disability (ID) such that their skills are 6-8 years
behind same-aged peers. Age appropriate DLS have been linked to achieving better adult outcomes in
employment, college, independent living, and overall quality of life. In the recent Lancet Commission on the
future of care and clinical treatment in ASD there was a call to action to address DLS in adolescence as a
potential intervention target to increase the likelihood of attaining positive adult outcomes. However, until our
team began developing and evaluating the Surviving and Thriving in the Real World (STRW) intervention,
there were no known comprehensive, evidence-based DLS interventions for autistic adolescents at this critical
developmental period. In two recent pilot randomized clinical trials (RCTs), STRW demonstrated statistically
significant and clinically meaningful gains in DLS (i.e., gains of 2-4 years of DLS over the course of a 14-week
intervention) compared to a control condition (i.e., PEERS social skills intervention). In our two pilot RCTs,
STRW was converted to telehealth due to COVID-19. There were equal DLS gains between in-person STRW
and STRW-telehealth (STRW-T) and there were numerous benefits to telehealth delivery. The next step in this
line of work is to assess the efficacy of STRW-T in a fully powered Phase 3 RCT compared to an attention
control condition (PEERS-telehealth; PEERS-T) and examine the impact of improved DLS on early adult
outcomes by following adolescents 6-months after high school graduation. We will enroll 192 autistic teens
without ID in the 11th/12th grades and randomize them to receive STRW-T (n = 96) or PEERS-T (n = 96).
Caregivers and adolescent participants will complete a comprehensive multi-method DLS battery (i.e.,
interview, survey, daily phone diaries, goal attainment scaling) at baseline, post-treatment, and 6-month follow-
up. Young adult outcomes in work, college, and quality of life will be assessed 6-months post-high school
graduation for all participants. The current proposal has the following aims: (1) examine the efficacy of STRW-
T on DLS compared to PEERS-T; (2) evaluate whether the improvement in DLS outcomes by STRW-T are
sustained at 6-month follow-up; (3) examine the effects of STRW-T intervention on outcomes in college, work,
and QoL after high school graduation compared to PEERS. We will also explore the mediating role of improved
DLS on young adult outcomes. If the aims of the proposed study are achieved, STRW-T would fill the gap in
the current evidence base for treating DLS in autistic adolescents and would be the first study to examine
whether a DLS intervention impacts work, college, and QoL outcomes after graduation from high school. Our
long ter...

## Key facts

- **NIH application ID:** 10770746
- **Project number:** 1R01HD113529-01
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Amie Marie Duncan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $690,880
- **Award type:** 1
- **Project period:** 2024-06-19 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10770746

## Citation

> US National Institutes of Health, RePORTER application 10770746, A Multisite RCT of a Daily Living Skills Intervention for Autistic Adolescents Prior to the Transition to Adulthood (1R01HD113529-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10770746. Licensed CC0.

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