Promoting Readiness of Minors with Autism Spectrum Disorder: Evidence from a Randomized Controlled Trial

Youth with disabilities—particularly those receiving Supplemental Security Income (SSI)—face barriers to achieving education and employment outcomes at the individual, family, and systemic level that can undermine the foundation for their longer-term success. The transition from adolescence to adulthood can be particularly challenging for youth with intellectual and development disabilities such as autism spectrum disorder (ASD). These disabilities can have lifelong effects on youth’s cognition, emotional regulation, communication, and relationship skills that might make it difficult to pursue continued education, long-term employment, and independent living.

PROMISE—Promoting Readiness of Minors in SSI—was an initiative to address critical issues related to supporting youth with disabilities. It was a joint initiative of four U.S. federal agencies: the U.S. Department of Education, the Social Security Administration (SSA), the U.S. Department of Health and Human Services, and the U.S. Department of Labor. PROMISE focused on addressing issues related to youth with disabilities by funding and evaluating programs designed to facilitate a healthy transition to adulthood and set the stage for years of positive outcomes for youth. The initiative focused on youth ages 14 to 16 who were receiving SSI as well as their families. Six projects across 11 states implemented model demonstration projects that had to include the following components: (1) formal partnerships between state agencies (such as those providing services related to vocational rehabilitation, workforce development, and Medicaid), (2) case management, (3) benefits counseling and financial education for youth and their families, (4) career and work-based learning experiences for youth, and (5) parent training and information (U.S. Department of Education 2013a).

Under contract with SSA, Mathematica is conducting the national evaluation of the PROMISE initiative. The evaluation examines the way the projects were implemented, their impacts on youth and families, and how cost effective they were. The evaluation, based on a random assignment design, collected a wealth of information about the types of services youth with disabilities receive in the absence of PROMISE, how the PROMISE demonstration projects were implemented, and the impact of the PROMISE interventions. In this report, which was supported by Autism Speaks, we use the information collected for the PROMISE evaluation to examine specifically the experiences and outcomes of youth with ASD receiving SSI who enrolled in PROMISE.

We begin by describing the characteristics of youth with ASD receiving SSI who enrolled in PROMISE and show that they differed significantly from other youth receiving SSI in the evaluation. We then present findings on the services available to youth with ASD and their families under the status quo, based on our analyses of youth and families in the control group. We find that many youth with ASD received transition services even without the PROMISE projects, but we also found room for improvement in the specific types of services targeted by PROMISE (such as case management, employment-promoting services, benefits counseling, and financial education) and in their families’ receipt of support services. Our estimates of the impacts of PROMISE as of 18 months after youth enrolled in the program suggest that PROMISE had substantial impacts on the service receipt, job-related training, employment, and earnings of youth with ASD, but it had no impact on their education, total income, or use of SSA benefit programs. The impacts of PROMISE on the outcomes of youth with ASD were similar to those for youth with non-ASD impairments, except that youth with ASD experienced a smaller relative increase in their receipt of transition services because of PROMISE.