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Multi-level Influences in Use of Evidence-Based Clinical Language Assessment for Autistic Young Adults

Award Number: K23DC023649
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 05/01/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2031

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Multi-level Influences in Use of Evidence-Based Clinical Language Assessment for Autistic Young Adults - ABSTRACT In the United States, 1 in 31 youth receives an autism diagnosis. Many face poor adult communication and health outcomes, with language skills playing an important role. With a cost of autism-related care surpassing $461 billion and over 1.2 million autistic youth entering adulthood in the next decade, improving outcomes is necessary and urgent. A major obstacle is lack of effective care for the more than 60% of all autistic individuals with structural language (grammar) impairment, especially as they exit child- and school-based care systems. Multi-level factors negatively impact care for these individuals, from lack of appropriate assessment tools to implementation challenges in routine care settings. To better understand how to improve quality of care, this proposal will explore influences in the use of evidence-based clinical language assessment for autistic young adults. This mixed-methods sequential explanatory study has three phases of activity and is motivated by an established dissemination and implementation framework. The quantitative phase will assess autistic young adults and analyze measures. The qualitative phase will identify perspectives about use of assessment. The final phase will use qualitative feedback to interpret quantitative assessment data in more depth. This proposal has three aims: 1) Determine the classification accuracy and item-level properties of individual clinical language measures for autistic young adults with structural language impairment, 2) Identify multi-level perspectives about use of clinical language assessment in routine care settings, and 3) Assess partner priorities for evidence-based clinical language assessment for autistic young adults. Autistic young adults (N=115) will complete clinical language measures that are promising for screening this population. To provide a reference for classification accuracy, expert speech-language pathologists will review scores and judge language impairment. Data will be analyzed for classification accuracy and at the item level. Next, autistic young adults, caregivers, clinicians, and organizational leaders (N=24) will complete focus group interviews. Transcripts will be qualitatively analyzed to identify key themes. Last, a subset of participants from Aims 1 and 2 (N=12) will complete co-design workshops to interpret data and assess priorities for use of evidence-based assessment. Data will be analyzed descriptively and qualitatively, producing an agenda to guide future implementation. Training goals and mentored activities from an expert team will result in new knowledge and skills for psychometric validation, implementation science, and co-design. The long-term goal is to improve communication outcomes in autism by developing interventions to implement evidence-based clinical language assessment and services. In focusing on knowledge to support a longitudinal R01 proposal on language and communication in autism, including gold-standard validation and efficacy testing of assessment, this proposal responds to NIH NOT-DC-24024: Dissemination and Implementation Science for Research in Communication Disorders and NIDCD Theme 4: Translate and implement scientific advances into standard clinical care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $211,287 )
2026	2026	SAN DIEGO STATE UNIVERSITY FOUNDATION	5250 CAMPANILE DR	SAN DIEGO	CA	92182	SAN DIEGO	USA	Research Related to Deafness and Communication Disorders	000	1	4/27/2026	NEW	$211,287
														Subtotal = $211,287

Grand Total All Awards = $211,287

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Multi-level Influences in Use of Evidence-Based Clinical Language Assessment for Autistic Young Adults

Award Number: K23DC023649

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 05/01/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2031

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