2025, Vol. 5, Issue 2, Part A

Background and Objectives: Adolescence represents a crucial yet under-researched developmental stage for individuals with autism spectrum disorder (ASD), during which adaptive, social, and emotional challenges often intensify. While early intervention has been extensively studied, longitudinal evidence on the effectiveness of adolescent-focused rehabilitation remains limited. This study aimed to evaluate the effectiveness of structured, multi-component rehabilitation programs on adaptive functioning, social responsiveness, anxiety reduction, and transition-readiness among adolescents with ASD, and to identify the role of program intensity and caregiver involvement in moderating outcomes.
Methods: A total of 120 adolescents aged 12-18 years with clinically confirmed ASD were recruited from rehabilitation centers and inclusive schools. Participants were categorized into low-, moderate-, and high-intensity groups based on hours of intervention per week (< 5 h, 5-10 h, ≥ 10 h). Interventions included social-skills training, cognitive-behavioral therapy (CBT) modules, occupational therapy using sensory-integration principles, and structured physical-activity sessions. Standardized outcome measures included the Vineland Adaptive Behavior Scales-III (VABS-III), Social Responsiveness Scale-2 (SRS-2), Revised Children’s Anxiety and Depression Scale (RCADS), and transition-readiness checklists. Data were collected at baseline, 12 months, 24 months, and at 6-12 month post-program follow-up. Statistical analyses included repeated measures ANOVA, mixed-effects models, and logistic regression.
Results: Over 24 months, adolescents in the high-intensity group showed significantly greater adaptive functioning gains (+14.2 points on VABS-III) compared to moderate (+9.4) and low-intensity (+2.8) groups (F=28.93, p<0.001, η²=0.347). Social responsiveness improved with an 18.7-point reduction on the SRS-2 for high-intensity participants, moderated by caregiver involvement (P=0.006). Anxiety prevalence decreased from 68% at baseline to 31% overall, with CBT-integrated programs producing the strongest effects (p<0.001). Transition-readiness milestones were attained by 72% of high-intensity participants versus 48% and 21% in moderate and low groups, respectively (χ²=19.6, p<0.001).
Conclusion: The findings highlight adolescence as a second critical window for intervention in autism, demonstrating that high-intensity, multi-component rehabilitation programs with caregiver participation produce clinically meaningful and functional outcomes. These results underscore the need for integrated, school-embedded, and transition-oriented approaches, supported by policy and funding mechanisms to ensure scalability and equity.