Abstract
Autistic individuals experience poor vocational outcomes internationally. Transition planning and interventions during adolescence may assist in improving outcomes in adulthood. Strength-based technology clubs show promise in improving outcomes for autistic adolescents by developing skills specific to the Information and Communication Technology industry, and fostering positive traits, such as self-determination. Although strength-based technology clubs have been examined with autistic adolescents, to date, no framework has been proposed to underpin their design and delivery. In this conceptual analysis, we propose a practical framework for delivering strength-based technology clubs for autistic adolescents. The framework builds on work from a previous systematic review of qualitative research and a realist evaluation study of technology clubs for autistic adolescents, combined with theoretical understandings from three health models. The new framework comprised the components of interests, value, autonomy, and requirements, forming the acronym IVAR. Interests refer to strategies drawing on adolescents' areas of interest. Value represents a culture of valuing autistic adolescents as individuals for their unique strengths and skills. Autonomy refers to providing opportunities for adolescents to make decisions, and Requirements refers to aspects of the social and physical environment. Practical recommendations of the framework are discussed, including design and delivery of future strength-based technology clubs, facilitator training, and design activities. The proposed IVAR framework may be useful in guiding the development of strength-based technology clubs. Future research is needed to validate the feasibility and efficacy of the IVAR framework in underpinning the delivery of strength-based technology clubs to autistic adolescents.
Community brief
Why is this topic important?
The shift from adolescence to adulthood can be challenging for young people on the autism spectrum, and opportunities for employment may be limited. Modern approaches to improving employment outcomes for autistic youth highlight the importance of adopting a strength-based framework, such as matching the strengths and interests of autistic young people to future career pathways. The strengths of many autistic individuals are considered beneficial for employment in the Information and Communication Technology (ICT) sector. Strength-based technology clubs provide opportunities for autistic young people to develop their technological and social skills, meet role models working in the ICT industry, and help them to find work experience.
What was the purpose of this article?
The purpose of this article was to develop a new framework for delivering strength-based technology clubs to autistic adolescents. The development of this framework was guided by the authors' earlier work in this area.
What do the authors conclude?
The authors proposed a new framework for delivering strength-based technology clubs to autistic adolescents. The framework contains four components, creating the acronym IVAR: Interests, Value, Autonomy, and Requirements. The component, Interests, refers to strategies that draw on adolescents' areas of interest, such as changing activities to include adolescents' focused interests. Value represented a culture of valuing autistic adolescents as individuals for their unique strengths and skills. Autonomy refers to providing opportunities for adolescents to make decisions during the program, and Requirements refers to the design of the social and physical environment.
What do the authors recommend for future research on this topic?
The authors recommend that future research should focus on exploring how practical and appropriate the IVAR framework is in supporting the delivery of strength-based technology clubs for autistic adolescents. The four IVAR components are potentially applicable to other areas of community focus to guide strength-based approaches more generally within autism research.
How will this analysis help autistic adults now and in the future?
This analysis and discussion will provide researchers, autistic individuals, and the community with practical examples of how service providers can apply IVAR to design and deliver strength-based technology programs for autistic adolescents.
The transition from adolescence to adulthood is widely recognized as bearing a range of challenges for autistic individuals, 1 who commonly experience poor vocational outcomes,2–5 reduced community participation, 6 limited peer relationships, 7 and low participation in postsecondary education. 8 In the Australian context, autistic individuals experience lower employment rates than people living with disability in general. 9
A 10-year prospective study of over 11,000 participants with disabilities in the United States of America indicated that more than half (53.4%) of autistic individuals had not been employed since graduating from secondary school, experiencing the lowest employment rate across all studied disability groups. 4 In particular, autistic individuals without intellectual disability are less likely to access vocational services and supports than their autistic peers with intellectual disability, 5 reflecting the disparity between available supports and actual needs of autistic individuals during this transition period.
The factors contributing to the low employment rates of autistic individuals internationally are complex and include both autism-related difficulties and environmental factors. Aspects relating to autism itself that pose challenges include incongruence between the social and communication expectations of employers and the individual on the spectrum,10,11 sensory environment mismatch presented by work environments such as open plan offices,12–14 workplace anxiety related to job performance and the fear of making mistakes, 13 and emotion regulation. 11
Recognized environmental barriers include the stigmatized attitudes of employers and colleagues, a lack of understanding of autism,10,15 unclear policies and expectations particularly with regards to the social expectations of the workplace, and limited supervisor support. 14 Although there are many opportunities to intervene and support autistic adults in the workplace, 16 planning for the transition to adulthood and employment should start during adolescence,4,17,18 building autistic adolescents' confidence and skills, understanding of workplace behaviors, and task expectations. 19
Contemporary approaches to improving employment outcomes for autistic youth emphasize the importance of adopting a strength-based framework, such as matching the strengths and interests of autistic individuals to future career pathways.4,17,20,21 Many of the commonly recognized strengths of autistic individuals, such as attention to detail and mathematical abilities, 22 are considered advantageous for employment in the Information and Communication Technology (ICT) sector. 23 The ICT sector has demonstrated the value of autistic employees by matching strengths to technology tasks through specialized employment programs that can be witnessed globally.24–26
Parents of autistic adolescents report that technology-based tasks are highly motivating for their children, 27 and autistic youth are more likely to enroll in science, technology, engineering, and mathematics (STEM) tertiary education pathways than the general population and people with other disabilities. 28 Given that many autistic youth are motivated to participate in technology-based tasks and potentially have natural strengths suited to technology-based jobs, researchers aiming to facilitate employment in the ICT sector have created strength-based technology clubs.21,29,30
Strength-based technology clubs provide opportunities for autistic adolescents to develop their technological skills, meet role models working in the ICT industry, and source opportunities for work experience.21,29 Although research has begun to document the delivery and outcomes of these programs in relation to employment,21,29,31 these clubs' benefits likely extend beyond improving vocational outcomes. For adolescents, participating in community activities is crucial in supporting their social, emotional, and physical development.32–34 For both typically developing and autistic adolescents, engaging in community activities is associated with forming a personal identity and sense of belonging,35–38 reducing loneliness and depression,39,40 and developing peer networks.38,41,42
Similarly, recent studies published by Chen et al.43–45 found that inclusive activity-based school clubs can support social participation of both autistic and non-autistic students, 43 and provide opportunities for relationship development and building a sense of community. 44 Although these inclusive clubs fostered an overall improvement in social participation, autistic students were more likely to interact with other autistic students than their non-autistic peers. 45 Strength-based clubs focused on the interests of adolescents present an opportunity for autistic adolescents to develop their technology skills and also provide opportunities to develop their social skills and positive traits.
Although published research has described several strength-based technology programs targeting autistic adolescents,3,27,29 to date, there has been no attempt to articulate an evidence-based framework underpinning the delivery of these programs. Currently, strength-based technology programs vary in their design and delivery, with some leveraging visual perceptual strengths, 27 whereas others focus on interest-based activities, 29 or prioritize technology skill development. 30
A technology club is separated from other technology-based interventions because it does not just use technology as the intervention delivery method but rather teaches autistic adolescents' technical skills. For example, previous strength-based technology clubs have taught computer coding languages, 46 3D design programs, 47 graphic design, and video game development. 48 Although many potential benefits of strength-based technology clubs have been suggested,47–49 there is limited quantitative data to support the claims.
Only two studies have been identified that provide quantitative data to support the outcomes of strength-based technology clubs.46,50 One study performed a 3-year longitudinal survey of 52 parents of autistic adolescents who had attended a strength-based technology club. 46 Parents responded to a questionnaire using a 10-point Likert scale, with the results indicating parent-reported improvement in adolescents' health and well-being, social relationships, confidence and self-esteem, and a sense of belonging. 46
Results were triangulated with open-ended questions from parents. 46 The limitations of the study include the untested psychometric properties of the measure, parent-reported measures only, and the lack of control group with randomized samples. The second study observed seven autistic children (ages 8–14 years old) participating in a robotics club once per week for 4 months. 5 The researchers collected video footage of each session, and multiple researchers coded to document collaborative behaviors. 50
They then compared the observation data with survey data from children and parents. Survey data asked questions about how enjoyable each session was and questions about collaborating with other students. 50 The results indicated that when students had more fun during the robotics class, they engaged in more collaborative behaviors and were more likely to share enjoyment. 50 The limitations of this study include the small sample size, the untested psychometric properties of the measure, and lack of a control group with randomized samples.
Although further quantitative testing is required, no current framework exists for the design and delivery of strength-based technology clubs. Other interventions, such as social skills group training, follow a standard pattern for their design and delivery allowing rigorous testing. 51
The absence of a framework, or understanding of these interventions' key components, has constrained our ability to develop and evaluate strength-based technology programs targeting the needs of autistic adolescents.
Given this need, we used the Medical Research Council (MRC) framework for developing and evaluating complex interventions 52 to guide the development of a standard approach for designing and delivering strength-based technology clubs to autistic adolescents. This process involved identifying the active ingredients through a systematic review of the literature 53 and a realist evaluation of three established strength-based technology clubs. 54
Active ingredients describe intervention components that cause change for participants. 52 Although the systematic review 53 and realist evaluation study 54 described the active ingredients of strength-based technology clubs targeting autistic adolescents, they did not articulate a comprehensive and practical framework underpinning the design and delivery of these programs.
In this article, we therefore aimed at synthesizing the systematic review, 53 and realist evaluation 54 findings, drawing from existing theory to propose a framework underpinning delivery of strength-based technology clubs to autistic adolescents. In doing so, this article briefly summarizes the results of the two previous studies,53,54 outlines existing theories relevant to this understanding, and finally proposes a new theoretical framework, including practical recommendations for its application.
Active Ingredients of Strength-Based Technology Clubs
A systematic review of qualitative literature identified nine studies that described strength-based technology clubs for autistic adolescents. 53 A meta-ethnographic synthesis of the identified studies revealed the core elements of technology clubs for autistic individuals as: mutual respect, demonstrating skills and interests. Although strength-based interventions have been proposed as an approach with the potential to improve the outcomes of autistic adolescents, 19 implementing these has been constrained by a lack of understanding of the core elements promoting outcomes.
This understanding of “how” these strength-based interventions work provides a foundational evidence-base, underpinning future intervention development and service delivery models. These ingredients are described in detail in Table 1.
Active Ingredients of Strength-Based Technology Clubs for Autistic Adolescents
Construction of a Theoretical Framework
In developing a practical framework to underpin future strength-based technology clubs for autistic adolescents, the authors conducted a review of existing theories and models relevant to adolescent health and development. Three health models emerged as most closely aligned with the active ingredients of strength-based technology clubs, articulated in Table 1: the PERMA (positive emotion, engagement, relationships, meaning and accomplishment) well-being model, 55 Self-determination Theory (SDT), 56 and the International Classification of Functioning, Disability and Health—Children and Youth Version (ICF-CY). 57
The PERMA model is used in positive psychology literature, 58 which is inherently aligned with a strength-based approach, and has been previously used with autistic populations.58,59 The SDT was selected due to its prevalence in the transition literature and predictive nature of adulthood outcomes.19,60–62 Finally, ICF-CY was chosen due to the researchers expertise in Occupational Therapy and its ability to describe the functioning of autistic individuals. 63 The ICF-CY specificity to autistic individuals and its international use across multiple health professions makes the model a strong choice.
Further, the ICF has been suggested as being able to bridge the gap between neurodiverse thinking and the biomedical model, describing autism holistically through the inclusion of environmental and biological factors. 64 It is likely that other competing theories could be used during this stage, and that there is overlap between theories and active ingredients. 52 To increase clarity, the central tenets of each model are described later with justification of how they are aligned with the most relevant active ingredients (Table 2). The subjective nature of this process and reliance on the specific discipline expertise of the research team is expected during this phase. 52
Alignment Between Active Ingredients of Strength-Based Technology Clubs and Relevant Theoretical Models
ICF-CY, International Classification of Functioning, Disability, and Health—Children and Youth Version; PERMA, positive emotion, engagement, positive relationships, meaning, and accomplishments; SDT, Self-determination Theory.
PERMA well-being model
The PERMA well-being model 55 is grounded in positive psychology and challenges the medical model by improving outcomes by building positive qualities rather than remediating deficits. 65 The strength-based approach seen in autism research aligns with positive psychology, with the PERMA model being previously applied in autism research. 58 The PERMA model proposes that there are five elements contributing to happiness and well-being: positive emotion, engagement, relationships, meaning, and accomplishment. 55
Positive emotion relates to what someone feels, for example, pleasure, joy, or satisfaction. Engagement refers to being completely absorbed by a task, where an individual's full attention is absorbed both cognitively and emotionally, experiencing a state of ‘flow.’ Relationships relate to initiating and maintaining positive relationships with others. Meaning refers to the feeling of a sense of belonging to something greater than oneself. Accomplishment refers to succeeding and feelings of mastery. 55
The PERMA model supports the active ingredients of interest-based activities and shared interests (see Table 2). The use of interest-based activities aligns with the PERMA model's engagement and positive emotion tenets, where autistic adolescents find activities aligning with their interests highly motivating and enjoyable. 54 The use of interest-based activities to increase motivation and engagement for autistic individuals is well supported.66–69
Shared interests align with the PERMA model's relationship component and can be harnessed in encouraging social interaction, 70 with autistic adolescents often forming friendships founded on shared interests. 54 Interests emerged as a cornerstone of the technology clubs, aligning with multiple elements of the PERMA model, including positive emotions, engagement, and positive relationships. Collectively, these findings highlight that a proposed framework underpinning strength-based technology clubs for autistic adolescents should leverage interests in promoting the well-being and positive psychological outcomes of autistic adolescents.
Self-determination theory
The utility of SDT 56 is well represented in disability literature, with higher levels of self-determination in people living with a disability associated with more positive outcomes in adulthood in independent living, tertiary education, community participation, life satisfaction, and employment.19,60–62 The SDT proposes that growing and achieving well-being across the life span is contingent on meeting three psychological needs: competence, autonomy, and relatedness. 56
Fulfilling competency needs depends on an individual achieving a desired effect or outcome. 71 Autonomy is met when an individual feels in control of their behaviour; relatedness is met through connecting with others and experiencing a sense of belonging. 72 The psychological needs outlined in SDT align with the active ingredients of the strength-based technology clubs for autistic adolescents.
The active ingredients of demonstrating skills, skill development goals, and strengths align with building competence. Demonstrating skills encourages technology clubs to provide opportunities for showcasing students' work, providing opportunities to demonstrate their competence and be acknowledged by their peers and mentors. Skill development goals highlight the importance of technology clubs focusing on building technology competencies rather than remediating specific characteristics of autism. Focusing on leveraging each autistic adolescent's strengths within the clubs promotes feelings of mastery and competence.
Within technology clubs, participants' need for autonomy are met through the active ingredients of individualized approach, activity choice, and mutual respect. An individualized approach encourages facilitators of technology clubs to align their instructional strategy with the needs of the person they are supporting, in preference to applying the same approach to every student, fostering adolescents' autonomy. 72 The active ingredient, activity choice, promotes adolescents' decision-making and sense of control, supporting adolescents to choose the type of activity they will participate in and how they will participate.
The active ingredient of mutual respect is aligned with the psychological need for autonomy and relatedness. Mutual respect is associated with participants feeling valued, liked, and respected by their facilitators, who act as role models rather than teachers or supervisors. Through working collaboratively with autistic adolescents, facilitators support autonomy while also developing relatedness. Clearly, strength-based technology clubs' active ingredients align with the psychology needs of competence, autonomy, and relatedness as outlined in SDT. A new framework to describe strength-based technology clubs for autistic adolescents should consider these psychological needs.
International classification of functioning, disability, and health—Children and youth version
The ICF-CY 57 views disability as resulting from individual functioning and environmental factors, blending the medical and social models of disability. 63 The development of the ICF Core Sets for autism spectrum disorder, 63 which provides a standardized framework for viewing functioning in autism specifically, has increased the utility of the ICF-CY in describing functioning and informing interventions in autism.
In applying the ICF-CY to autistic individuals aged 6–16 years old, autism experts highlighted the importance of the environment, specifically the “support and relationships” category, as one of the most relevant categories to describing functioning in autism. 63 Support and relationships relate to providing practical support, emotional support, and relationships with other people. 57 The importance of support and relationships aligns with the active ingredient of technology clubs being open only to autistic adolescents, where the shared experience of an autism diagnosis fostered a sense of belonging and feelings of safety, providing a context where they could be themselves. 54
Similarly, support and relations extend to the recommendation that facilitators remain consistent; their consistent attendance to the club and approach with autistic adolescents creates a supportive social environment. 54 The ICF-CY also considers the impact of the physical environment on functioning, including aspects of the built environment such as available rooms affecting sensory experiences, including noise and overcrowding. 54
Mismatch between the sensory environment and the sensory needs of the adolescents can lead to frustration and anxiety. 54 The ICF-CY highlights the dynamic interaction between the social and physical environment, which can be used to understand autistic adolescents' functioning within technology clubs.
Framework Components
We propose a new framework, combining the theoretical understandings drawn from the PERMA model, 55 SDT, 56 and ICF-CY, 57 as they relate to strength-based technology clubs for autistic adolescents (see Table 3), comprising four new components: interests, value, autonomy, and requirements, forming the acronym IVAR. The PERMA model reinforced the importance of leveraging autistic adolescents' “interests” in fostering positive emotions, engagement, and positive relationships.
New Strength-Based Technology Framework Components
The SDT further emphasizes developing adolescents' competence, encouraging autonomous behavior, and building relationships with students. The new framework components of “value” and “autonomy” represent the active ingredients of strength-based technology clubs drawn from SDT. Representing the concept of competence drawn from SDT, “value” at its core symbolizes valuing autistic adolescents by building upon their unique skills and strengths rather than focusing on deficits.
“Value” captures the active ingredients of demonstrating skills, skill development goals, and leveraging strengths. “Autonomy” points to the strategies that facilitators can employ in fostering the autonomy of autistic adolescents by achieving mutual respect, delivering an individualized approach, and providing between and within activity choice. Finally, the component of “requirements” incorporates the social and physical environmental factors as emphasized by ICF-CY (e.g., sensory experiences such as noise and overcrowding), considering their impact on the functioning of autistic adolescents.
Practice Recommendations
Underpinned by the newly developed IVAR strength-based framework, we developed practical recommendations and mapped them to the new framework using examples taken from the systematic review 53 and realist evaluation study 54 that informed the design and delivery of the strength-based technology clubs for autistic adolescents. We then provided our recommendations to the club for consultation and feedback. These practical recommendations are designed to inform facilitator training, design activities, and provide an overall framework for delivering strength-based technology clubs to autistic adolescents (see Table 4).
Application of Interest Value Autonomy Requirements Framework: Example Recommendations for Designing and Delivering Strength-Based Technology Clubs for Autistic Adolescents
IVAR, interests, value, autonomy, and requirements.
Future Research
Although strength-based technology clubs for autistic adolescents are present in the community, to date, no standardized evidence-based framework has been proposed to underpin their design and delivery. This has constrained both the delivery and evaluation of these programs, limiting understanding of the role of strength-based approaches in improving outcomes in autism. This article proposes the IVAR strength-based framework, developed to inform the design and delivery of these programs.
Future research should endeavor to build an evidence base for the new framework, examining the feasibility and acceptability of IVAR in underpinning strength-based technology programs for autistic adolescents. Although we developed the IVAR framework to underpin strength-based technology-based programs, it is acknowledged that not all autistic individuals have an affinity for this area. Future research should examine the utility of IVAR in other areas of autistic strength. The four IVAR components are likely applicable to other areas of community focus (e.g., community art clubs), and we hope they can guide strength-based approaches more generally within autism research.
Limitations
The methodology was guided by the MRC framework 52 for developing and evaluating complex interventions, and although the MRC framework provides a good overview of the development process, it lacks detailed instructions on theory development. We used existing health theories to gain greater insight into the active ingredients before producing the new framework. The selection of the health theories (i.e., PERMA model, SDT, and ICF-CY) was based upon their previous use in autistic populations, their relationship to positive adolescent development, and prominence in strength-based literature.
Even so, our experiences impacted the selection of health theories, limiting the replicability of the study. Further, the qualitative nature of aligning the active ingredients with pre-existing health theories is difficult to replicate and also dependent on the primary author's involvement in the systematic review 53 and realist evaluation. 54
Conclusion
This article proposes a new, practical framework for delivering strength-based technology clubs to autistic adolescents, developed via a rigorous process that involved drawing from the results of a literature review, realist evaluation, and understandings of relevant health models. The theoretical underpinnings of the new framework extended from tenets drawn from the PERMA model, SDT, and the ICF-CY approaches. The proposed framework contains four components creating the acronym IVAR: interests, value, autonomy, and requirements.
Interests represented strategies that leverage adolescents' areas of interest, such as modifying activities to include adolescents' focused interests. Value represented a culture of valuing autistic adolescents as individuals for their unique strengths and skills. Autonomy refers to providing opportunities for adolescents to make decisions during the program. Requirements referred to the design of the social and physical environment. This article provides practical recommendations of how a service provider can apply IVAR to design and deliver a strength-based technology program for autistic adolescents.
Footnotes
Author Disclosure Statement
The authors declare no conflict of interest related to this article. S.B. discloses that he has in the past 3 years acted as an author, consultant, or lecturer for Medice and Roche. He receives royalties for textbooks and diagnostic tools from Hogrefe, and Liber. S.B. is shareholder in SB Education/Psychological Consulting AB and NeuroSupportSolutions International AB.
Authorship Confirmation Statement
All authors conceptualized and wrote this article. All authors have reviewed and approved this article submission. The article has been submitted solely to Autism in Adulthood.
Funding Information
This study was financially supported by the Bankwest Curtin Economics Centre and the Ian Potter Foundation. The grants allowed the AASQA CoderDojo and Firetech Australia to be delivered free of charge to the client. The team would like to acknowledge the support of Ms Maya Hayden-Evans.