# Improving Transition Outcomes for Youth with Autism Spectrum Disorder from within a Medicaid Accountable Care Organization

> **NIH NIH K18** · BOSTON MEDICAL CENTER · 2020 · $183,425

## Abstract

PROJECT SUMMARY
Despite an increasing number of American children with autism spectrum disorder (ASD), fragmentation
across child and adult service systems results in poor education, employment and health outcomes for
transition-age youth. Whereas much research is being conducted among young children with ASD, there has
been less work that addresses the topic of care transitions for older youth. The purpose of this K18 Career
Enhancement Award is to equip an experienced clinical trial investigator, Michael Silverstein, MD, MPH, with
new skills and knowledge in the area of ASD transition research, so that he can expand his research portfolio
in this direction. To date, Dr. Silverstein has conducted mental health services research among disparity
populations, primarily in the field of depression prevention. This K18 outlines a two-year plan, whereby Dr.
Silverstein will work with new mentors to augment his content and methodologic expertise, expand his
mentoring capacity in ASD transitions research, and conduct a randomized pilot study to optimize a problem-
solving based transition intervention that supports youth's autonomy, but addresses the variable functional
abilities of the ASD population by including other family members as intervention participants.
The premise of the K18 research plan is that successful transition to adulthood for the ASD population
depends on a mixture of systems- and family-level strategies. The proposed intervention, therefore, will be
embedded in a series of broader, systems-level transition strategies currently being deployed in a large
Medicaid accountable care organization. The primary aim of the pilot trial is to optimize a prototype problem
solving intervention model. Model refinements will focus on new components specific to youth with ASD and
on determining the optimal degree of parental involvement in the intervention for youth with varying functional
abilities. Concurrent qualitative work aims to generate hypotheses concerning testable intervention targets for
how problem solving strategies could impact ASD transition outcomes. To support this research, Dr.
Silverstein's K18 career development activities include structured mentor meetings that emphasize learning
intervention design for youth with ASD and becoming familiar with service systems in education, vocational
training and housing. Other activities include a 2-month internship at the Riverview School (which specializes
in children with ASD) to learn educational strategies that could be incorporated into intervention design; and
group mentoring experiences to develop the careers of junior investigators interested in studying ASD services
for transition-age youth. The K18 is designed to set the stage for a clinical trial of a new intervention model to
promote successful care transition and for a sustained shift in Dr. Silverstein's research focus.

## Key facts

- **NIH application ID:** 9961945
- **Project number:** 1K18MH120457-01A1
- **Recipient organization:** BOSTON MEDICAL CENTER
- **Principal Investigator:** Michael Silverstein
- **Activity code:** K18 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $183,425
- **Award type:** 1
- **Project period:** 2020-06-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9961945

## Citation

> US National Institutes of Health, RePORTER application 9961945, Improving Transition Outcomes for Youth with Autism Spectrum Disorder from within a Medicaid Accountable Care Organization (1K18MH120457-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9961945. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*