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. Author manuscript; available in PMC: 2025 Aug 1.
Published in final edited form as: J Autism Dev Disord. 2023 Jun 3;54(8):2789–2801. doi: 10.1007/s10803-023-06022-6

Virtual Interview Training Among BIPOC Autistic Transition-Age Youth: A Secondary Analysis of an Initial Effectiveness RCT

Ed-Dee G Williams 1,2, Matthew J Smith 1
PMCID: PMC10759921  NIHMSID: NIHMS1949726  PMID: 37269499

Abstract

Purpose:

BIPOC autistic transition-aged youth (TAY) report lower rates of competitive employment compared to White autistic TAY and even greater deficits with social skills associated with positive job interviewing. A virtual job interviewing program was adapted to support and improve the job interviewing skills of autistic TAY.

Methods:

The current study evaluates the effectiveness of an efficacious virtual interview training program on the job interview skills, interview anxiety, and likeliness to be hired, for a subsample of 32 BIPOC autistic TAY, ages 17 to 26 years old from a previous randomized control trial of the program. Bivariate analyses were used to evaluate between-group differences at pre-test related to background characteristics, and whether VIT-TAY was associated with changes between pre-test and post-test measures of job interview skills. Additionally, a Firth logistic regression was conducted to examine the relationship between VIT-TAY and competitive integrative employment at 6 months, covarying for fluid cognition, having ever had a job interview, and baseline employment status.

Results:

Participants receiving pre-employment services (Pre-ETS) and virtual interview training had better job interview skills (Ϝ =12.7, ρ <.01; ηρ2 = .32), lower job interview anxiety (Ϝ = .3.96, ρ < .05; ηρ2 = .12), and a higher likeliness of receiving employment (Ϝ = 4.34, ρ <.05; ηρ2 =.13 at the 6-month follow up compared to participants that only had Pre-ETS.

Conclusion:

Findings from this study suggest that virtual interview training for TAY is effective for BIPOC autistic TAY in improving their interview skills to gain competitive employment and lower their job interview anxiety.

Keywords: Autism, Transition-Age, Employment Skills, BIPOC Youth, Interventions

Background

Autistic transition-age youth experience extensive unemployment (Lorenz et al., 2016; Roux et al., 2013; Shattuck et al., 2018). Studies have attributed much of the unemployment faced by autistic youth to be structural issues such as ableism, a lack of employment support programs, and common characteristics of autism, such as challenges with social communication (Chen et al., 2014; Hayward et al., 2019). Meanwhile, the rate of youth diagnosed with autism and transitioning into adulthood is rapidly increasing. Data suggests the rate of autism diagnosed in youth is now one in 47. Thus, over 800,000 autistic youth will be graduating high school over the next decade, with many of them looking to enter the workforce (Maenner et al., 2020). The high rate of unemployment for autistic individuals and the increased prevalence of autism demonstrates the importance of improved evidenced-based transition services, especially those that can help facilitate access to employment opportunities.

Notably, few studies have examined the employment outcomes associated with Black, Indigenous, and Persons of Color (BIPOC) autistic transition-age youth (Malone et al., 2022). However, the few studies that have examined this particular group have found that BIPOC autistic transition-age youth report average incomes lower than that of White autistic youth, are less likely to participate in transition services, are less likely to find competitive employment, and are more likely to live in poverty after high school (Eilenberg et al., 2019; Shattuck et al., 2018). These notable disparities in employment-related outcomes for BIPOC autistic transition-age youth call for a greater emphasis on the effectiveness of pre-employment transition services (Pre-ETS) to support their access to employment.

Although the employment-related outcomes of BIPOC autistic transition-age youth are under-studied, some research has identified racial and ethnic disparities between autistic transition-age youth related to employment outcomes. For example, Black autistic youth are more likely to experience life circumstances that increase their risk of depression and anxiety (Shaia et al., 2020; Stahmer et al., 2019; Yingling & Bell, 2019), which has been associated with poorer job interviews and employment outcomes. Additionally, studies have found that Black autistic youth tend to have greater challenges with their social communication skills, are less likely to have access to adequate transition services, and are more likely to attend lower-income schools that do not provide or have inadequate transitions services (Eilenberg et al., 2019). Zuckerman and colleagues (2014) found that Latino communities often report low levels of information about autism, available autism services, and hold a high level of stigma associated with mental illness that negatively impacts their help-seeking behavior (Zuckerman et al., 2014). Additionally, studies have reported that Black and Latino families often opted out of many autism services due to a lack of adequate cultural adaptation (Shaia et al., 2020; Zuckerman et al., 2014). For example, Angell et al. (2016) found that many Latino families reported difficulties adapting the services to match their familial preferences leading them to either modify or opt out of the service. Similarly, Burkett et al. (2015) found that Black families’ distrust of the healthcare system and perceived bias by health professionals led many Black families to avoid or modify their use of autism services. Findings from these studies highlight the unique needs of many BIPOC autistic youth and emphasize the field’s need to address this gap in services to improve BIPOC autistic youth’s employment outcomes.

Overall, these findings speak to the importance of examining the effectiveness of autism-related services and tools for BIPOC autistic individuals to ensure that they adequately address the unique needs of these individuals. Moreover, Kaiser and colleagues (2022) call for greater culturally-grounded models for autism services and, in particular, call for the examination of the effectiveness of current services for Black and other minoritized autistic individuals and their families. Thus, the current study is a direct response to this call, evaluating the initial effectiveness of an employment-focused intervention among BIPOC autistic youth.

Specifically, there has been a recent surge in technology-based interventions to support the needs of autistic transition-age youth and adults (for scoping review, see Kim et al., 2021). Although some of these interventions were associated with improved job interview skills using quasi-experimental designs (e.g., Burke et al., 2021), the study of Virtual Interview Training for Transition-Age Youth (VIT-TAY; an internet-delivered, job interview simulator with automated feedback and a virtual hiring manager) was the most rigorously evaluated using a randomized controlled trial (RCT) design and has been the only job interview intervention whose engagement has been associated with improved competitive employment (Smith et al., 2021). In addition, this study had a large enough subsample of BIPOC autistic youth to conduct secondary analyses to evaluate its initial effectiveness among these youth.

Notably, the VIT-TAY was designed to be a standalone intervention or an enhancement to more comprehensive services such as Pre-ETS. Specifically, Pre-ETS were established as a vital resource to support and improve the employment of youth with disabilities, given their overall low rates of employment and economic opportunities (Hayward et al., 2019; Roux et al., 2013). In 2014, the Workforce Innovation and Opportunity Act (WIOA) directed federal funds to expand Pre-ETS programming to provide these services to all transition-aged youth with disabilities. Additionally, the Individuals with Disabilities Education Act (IDEA) federally mandated the development and use of transition services by public schools to aid in the transition experience for autistic and dis/abled transition-age youth (IDEA, 2004). There are five primary domains of Pre-ETS that focus on workplace readiness training (e.g., job-seeking social skills), work-based learning experiences (e.g., internships), job exploration counseling, post-secondary education counseling, and self-advocacy to help prepare students with disabilities for the transition from secondary education to employment (Roux et al., 2020). Many programs have used a combination of community-based internships, mock employment trainings, as well as life-skill and independent trainings (Wehman, Chan et al., 2014; Wehman, Schall et al., 2020). However, even with directed federal funds and mandates to provide Pre-ETS to individuals that qualify, some studies have found that low-income and under-resourced schools, where many BIPOC autistic transition-age youth attend, often provide inadequate and very limited transition services (Baer et al., 2011; Eilenberg et al., 2019). Thus, the disparities in available high-quality Pre-ETS programs are likely associated with many differences in employment outcomes experienced by autistic BIPOC transition-age youth.

In this secondary data analysis, we evaluated whether VIT-TAY was initially effective, acceptable, and usable among a subsample of BIPOC autistic transition-age youth who participated in the aforementioned parent RCT of VIT-TAY. Specifically, we hypothesized that BIPOC autistic youth engaged in Pre-ETS with the addition of VIT-TAY would improve their job interview skills, and job interview anxiety as compared to BIPOC autistic youth engaged in Pre-ETS only. Additionally, we hypothesized that BIPOC autistic youth that engage with VIT-TAY would report greater rates of competitive integrative employment and lower rates of employment through informal means. We also hypothesized that BIPOC autistic youth would find VIT-TAY to be acceptable and usable.

Methods

Participants

This study is a secondary data analysis of n=32 BIPOC autistic transition-age youth (ages 17–26) who participated in an intent-to-treat randomized controlled trial that evaluated the initial effectiveness of Virtual Interview Training for Transition Age Youth (VIT-TAY). The RCT occurred at five Pre-ETS sites where participants were recruited and randomized. Participants were recruited from public, charter, and private high schools in urban, suburban, and rural communities in Michigan and Ohio via community outreach and conference presentations. Participants’ autism diagnosis was confirmed via the Social Responsiveness Scale (2nd edition) with a score of at least 60T (Constantino & Gruber, 2012) or confirmed through educational records. Primary inclusion criteria were: (1) having a 3rd-grade reading level or better (since VIT-TAY was designed at a 4th-grade reading level and 3rd-grade readers were able to successfully engage with it in a different study (Smith et al., 2021) via the Wide Range Achievement Test [5th edition] (Wilkinson & Robertson, 2017); (2) willingness to be recorded on video (given video-recorded role-plays were a secondary outcome); and (3) being engaged in Pre-ETS and job-seeking. Participants were excluded if they had uncorrected hearing or visual impairments that prevented them from using VIT-TAY. The University of Michigan Institutional Review Board approved the study protocol, and all participants provided informed consent (or assent with parental permission for minors). All 32 BIPOC participants in the primary RCT are included in this secondary analysis. No BIPOC participants were lost to attrition between pre- and post-test visits. By 6-month follow-up, nine of 32 participants (28.1%) were lost to attrition and teachers provided the participant’s employment outcomes.

Interventions

Pre-Employment Transition Services.

All five schools implemented the five core aspects of Pre-ETS as federally mandated by the Workforce Innovation and Opportunity Act (2014), including: (1) work-based learning experiences (e.g., volunteering, job shadowing, trial work experiences), (2) workplace readiness training (e.g., communication skills, job-seeking skills, soft skills), (3) job exploration counseling, (4) post-secondary education counseling, and (5) self-advocacy. Additional details can be found here (Smith et al., 2021).

Virtual Interview Training for Transition-Age Youth (VIT-TAY).

Developed by SIMmersion, LLC (www.simmersion.com), VIT-TAY is a computerized job interview simulator that facilitates the repeated practice of 10 job interview skills (e.g., conveying you are a hard worker or that you work well on a team) during simulated interviews with one of two virtual hiring managers (Figure 1). The skills were adapted from the job interview literature (Huffcutt, 2011) and with autism community review (Smith et al., 2020). Additionally, the skills were scaffolded across easy (four skills), medium (seven skills), and hard (10 skills) interviews. VIT-TAY includes four levels of automated feedback—real-time non-verbal cues, transcript-level feedback on responses during interview, summary-level feedback on 10 interview skills, and a numerical score from 0–100—and includes an e-learning curriculum introducing trainees to the 10 interview skills that will be scored (and other interview tips [e.g., what to wear]). There are 14 different jobs (e.g., cashier, food services, web developer) that informs the virtual interview experience. The design of VIT-TAY was reviewed iteratively by the autism community (n=13 White autistic youth; n=11 BIPOC autistic youth; n=13 White stakeholders; n=8 BIPOC stakeholders), a community advisory board (n=5 White stakeholders; one autistic youth; n=4 BIPOC stakeholders), and an external scientific review board (n=4 White scientists, n=1 BIPOC scientist). This feedback was integrated throughout the iterative design process (Smith et al., 2020).

Figure 1.

Figure 1.

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Virtual Interviewers Mr. Travis Bishop (a) and Ms. Rita Muniz (b)

Study Procedures

Participants were randomized (2:1) to engage in Pre-ETS with the addition of VIT-TAY (i.e., Pre-ETS + VIT-TAY) or Pre-ETS only. The uneven randomization was used to learn more about the intervention and implementation processes. The two study groups completed pre-test (two visits) and post-test (one visit) assessments at their schools in private rooms. During the first pre-test visit, participants provided consent and completed an employment history interview and a cognitive evaluation. During the second pre-test visit, participants completed a mood survey, a mock job interview role-play, and self-report measures. Using a random number generator, participants were randomly assigned to their study group after completing the second pre-test visit. We used allocation concealment via sealed envelopes to inform participants of their random assignment. In addition to completing the first and second pre-test visits, parents (or teachers) completed a behavioral assessment for each participant.

During their post-test visit, participants completed a second mock job interview role-play, and the same self-report measures as during the pre-test visits. A 6-month follow-up was conducted with the participants to obtain their employment outcomes. A reminder letter was sent to participants two weeks in advance of their 6-month follow-up. If participants were non-responsive for up to four weeks, their employment outcomes were obtained from parents (or teachers if parents were also non-responsive). Methods for research staff and teacher training procedures can be found here (Smith et al., 2021).

VIT-TAY Implementation Procedures

Teachers supervised 15 VIT-TAY sessions (approximately 45 minutes each). During Sessions 1–2, teachers oriented participants to the VIT-TAY e-learning curriculum, after which participants reviewed content related to 10 job interview skills and other tips on interviewing. During Session 3, teachers oriented participants on completing the VIT-TAY job application and navigating the virtual interview interface. During Sessions 4 through 15, participants engaged in virtual interviewing practice and feedback review. Teachers helped participants review their virtual interview transcripts and their performance assessment. Following guidance from prior studies of virtual interview training (Smith et al., 2021; Smith et al, 2020b), the study team recommended participants complete at least 15 virtual interviews. Additional details on VIT-TAY implementation can be found here (Smith et al., 2021). To monitor for potential adverse events, participants were encouraged to report any uncomfortable experiences during or after using VIT-TAY.

Study Measures

Background Characteristics

Demographic and Employment History.

Participants completed surveys during the pre-test that included basic questions about age, sex assigned at birth, prior employment, and job interview experiences.

Depressive Symptoms.

Depressive symptoms were measured using the self-report brief version of the Mood and Feelings Questionnaire (b-MFQ; Angold et al., 1995). The b-MFQ includes 13 items to assess feelings and behaviors over the past two weeks and has previously been validated to adequately measure depressive symptoms among autistic youth (Rai et al., 2018). The items were rated on a 3-point scale ranging from 0= “not true” to 2=“true,” with higher scores reflecting stronger depressive symptoms. Internal consistency was strong (α = .83).

Behavioral Challenges.

Behaviors were assessed by parents or teachers prior to randomization as trait-based mental health challenges using parent/teacher reports with the standardized child behavior checklist (CBCL) or an adult behavior checklist (ABCL) (Achenbach, 1997; Achenbach & Rescorla, 2001), which several studies have evaluated as a screener for autism (e.g., Deckers et al., 2020). The CBCL/ABCL rates 118 behaviors that represent internalizing (i.e., anxious/depressed, somatic complaints, and withdrawn (ABCL) or withdrawn/depressed (CBCL) and externalizing behaviors such as rule-breaking, aggressive behavior, and intrusive behavior. These behaviors are rated on a 3-point scale ranging from 0= “not true,” 1= “somewhat true,” and 2= “very true.” We used a standardized t-score, with higher scores reflecting stronger challenging behaviors. The internalizing and externalizing behavior domains had acceptable-to-good internal consistencies (α = .75 and α = .80, respectively).

Cognitive Ability.

Crystallized and fluid cognition was assessed using the National Institutes of Health (NIH) Toolbox Cognition Battery (Akshoomoff et al., 2013; Weintraub et al., 2013), which has been feasibly evaluated among autistic youth (Jones, Dallman et al., 2022; Solomon et al., 2021) and demonstrated acceptable reliability in our parent RCT (Smith et al., 2021). The battery included seven tests requiring approximately 60 minutes to complete on a computer. We used fully corrected T-scores with acceptable internal consistency to reflect: (1) accumulation of knowledge and skills (i.e., crystallized cognition [α = .77]) and (2) ability to think logically and solve problems (i.e., fluid cognition α = .71).

Study Outcomes

Employment.

At 6-month follow-up, participants completed a brief interview with unblinded research staff reflecting whether they obtained competitive employment or employment through informal means. Specifically, we defined employment as (1) a competitive and integrated job in the community that was paid at least minimum wage, not set aside for a person with a disability, nor obtained after completing an internship or volunteer position with that employer (1=yes, 0=no); (2) a job obtained through informal means such as after completing an internship or volunteer position with that employer, which would not call for a formal job interview and often tend to be non-competitive jobs (1=yes, 0=no); or (3) informal employment (i.e., cash under the table) (1=yes, 0=no). Nine participants or their parents were unable to provide this data, which was collected from teachers using the students’ educational records.

Job Interview Skills.

We conducted a single mock job interview role-play to assess job interview skills pre-test and post-test. We used a modified version of the Mock Interview Rating Scale (MIRS) adapted for autism (A-MIRS; Smith et al., 2014). Coders (blinded to group condition) reviewed videos of mock job interviews one time and then rated the participants’ “likeness to be hired” as a global rating of their overall job interview scale ranked from 1= “unlikely to be hired,” to 5= “very likely to be hired.” Coders then watched the videos a second time and rated 10 job interview skill items and one overall rapport item using a 7-point Likert scale. The overall rapport item measures the rapport established between participant and the interviewer. Higher scores reflected a smooth interaction where the participant was able to convey strong personal skills such as active listening, appropriate eye contact, friendliness, and expressiveness. Lower scores reflect disorganized conversation, poor eye contact, lack of friendliness, and inattentiveness. The 11 items were then summed for a total score.

Job Interview Anxiety.

The Measure of Job Interview Anxiety (MOJO-iAnxiety) was completed at pre- and post-test. The MOJO-iAnxiety consists of 10 items that were modified from the Personal Report of Job Interview Apprehension (McCroskey, 1970). The MOJO-iAnxiety uses a 3-point Likert-type scale ranging from 0= “not at all” to 2= “often.” We used a converted raw to standardized t-score. The initial psychometric properties of the MOJO-iAnxiety were recently established among n=85 autistic transition-age youth (Genova et al., 2023).

Acceptability and Usability.

VIT-TAY acceptability was measured using an adapted version of the self-reported Treatment Acceptability Rating Form (Reimers & Wacker, 1988). This form consisted of five items (e.g., “Virtual interviewing was enjoyable”) rated on a 5-point Likert-type scale (e.g., 1=Not at all true to 5=Very true) with higher raw scores reflecting stronger acceptability. VIT-TAY usability was measured using an adapted version of the self-reported System Usability Scale (Brooke, 1996). This form consisted of seven items (e.g., “I was able to use the virtual interview tool on my own”) rated on a 5-point Likert-type scale (e.g., 1=Not at all true to 5=Very true) with higher raw scores reflecting stronger usability.

Data Analysis

The study statistician (masked to group assignment) wrote the syntax to score and analyze the study variables. We used T-tests and Chi-Square analyses to evaluate the presence of between-group differences at pre-test related to background characteristics. Regarding effectiveness outcomes, we used repeated measures analysis of variance (RM-ANOVA) to evaluate whether VIT-TAY was associated with changes between pre-test and post-test measures of job interview skills (total score and single item ‘likeliness to be hired’) and self-reported job interview anxiety via the MOJO-iAnxiety. We tested for the presence of a significant group-by-time interaction effect and produced a partial eta-squared value to characterize the repeated measures’ effect size. We covaried for fluid cognition given its trend-level difference between groups at pre-test (χ2 = 1.8, p = .06) and that this type of cognition (e.g., process and integrate information, problem solve in the moment) might influence one’s ability to learn new skills (Ferrer et al., 2009). We also covaried for if the “participant ever had a job interview” given that it is reasonable to expect that prior interviewing experience may influence future interviewing experiences and outcomes. Then we used Chi-Square analyses to evaluate whether Pre-ETS + VIT-VAY, compared to Pre-ETS only, was associated with a higher rate of obtaining competitive and integrated employment by 6-month follow-up. We also used chi-square analyses to evaluate between-group differences in obtaining employment through informal means. Next, we conducted a Firth logistic regression (Firth, 1993) to examine the relationship between VIT-TAY and competitive integrative employment at 6 months while covarying for fluid cognition, having ever had a job interview, and baseline employment status. Lastly, we used descriptive statistics to evaluate VIT-TAY acceptability and usability as two initial implementation process outcomes among participants randomized to Pre-ETS + VIT-TAY.

Missing Data.

Following the intent-to-treat randomized controlled trial design, we used the expectation-maximization algorithm for data missing completely at random to conduct data imputation using the SPSS missing values analysis package. The maximum likelihood estimation method generates unbiased estimates and provides less biased parameter estimates than regression or mean imputation. The magnitude and direction of the effects did not differ. Thus, we proceeded with analyses using the full sample with imputed data to optimize power. Data were imputed for the SRS and ABCL (n=1 participant each), cognitive battery (n=3 participants), and job interview anxiety (one item for n=1 participant).

Community Involvement.

A community advisory board, including members of the autism community (n=1 autistic transition-age youth, n=1 parent/special education teacher, n=1 former president of the state board of education, n=2 transition services managers/directors, n=1 community employer, n=2 clinicians, n=1 special educator) reviewed and approved the research questions, study design, outcome measures, and implementation of the parent RCT.

Results

Demographic and Background Characteristics

Our between-group analyses revealed that the Pre-ETS+ VIT-TAY and Pre-ETS-only groups did not statistically differ with respect to age, sex-assigned-at-birth, and other remaining demographic and background characteristics (see Table 1), with the exception that the Pre-ETS-only group trended toward greater fluid cognition than the Pre-ETS + VIT-TAY group (p = 0.06).

Table 1.

Background Characteristics of Study Sample

Pre-ETS (n=10) Pre-ETS + VIT-TAY (n=22) Test StatisticX2 p (Two-Tailed)
% n % n
Age 20.3 (2.9) 20.1 (3.1) 0.3 .76
Biological sex (% male)
 Male 100.0% 10 77.3% 17 -- --
 Female 0.0 0 22.7% 5 -- --
Social responsiveness scale 2nd ed.; (M, SD) 63.9 (12.9) 63.45 (13.2) 0.1 .90
Race (%)
 Black/African American 80.0% 8 50% 11 -- --
 Latinx 0.0 0 27.3% 6 -- --
 Asian 0.0 0 9.1% 1 -- --
 American Indian/Alaska Native 0.0 0 4.5% 0 -- --
 More than one race 20.0% 2 9.1% 2 -- --
Current Grade (%)
 Sophomore 0.0% 0 9.1% 2 2.7 .42
 Junior 20.0% 2 9.1% 2
 Senior 10.0% 1 27.3% 6
 Transitional year 70.0% 7 54.5% 12
Parents highest level of education (%)
 High school graduate or less 0.0% 0.0 %
 Some college 28.6% 30.8%
 Associate degree 0.0% 7.7%
 Undergraduate degree 42.9% 30.8%
 Graduate degree 28.6% 30.8%
Co-occurring IDEA categorizations (%)
 Emotional disturbance 20.0% 2 13.6% 3 .21 .64
 Specific learning disability 10.0% 1 9.1% 2 .007 .93
 Intellectual disability 10.0% 1 22.7% 5 .73 .36
 Other health impairment 10.0% 1 22.7% 5 .73 .36
Cognitive Ability (M, SD)
 Fluid cognition 39.3 (14.0) 30.75 (11.2) 1.8 .06
 Crystalized cognition 41.2 (11.1) 44.5 (12.3) −0.7 .46
Mental Health
 Depressive symptoms 5.6 (4.3) 6.6 (4.5) −0.6 .27
 Internalizing behaviors 53.9 (10.2) 59.1 (11.5) −1.2 .22
 Externalizing behaviors 49.7 (12.8) 53.4 (11.6) −0.8 .40
Vocational History (%)
 Ever had a job interview 50.0% 5 22.7% 5 2.3 .12
 Ever employed in community 40.0% 4 27.3% 6 .51 .46
 Currently employed 10.0% 1 9.1% 2 .007 .92
 Interviewed for current job 100.0% 10 0.0% 0 3.0 .08
 Job Search Projection
  Currently or within 6 months 80.0% 54.6% 3.2 .17
  Beyond 6 months 20.0% 40.9%
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VIT-TAY Engagement and Performance

Participants completed a mean of 15.3 (SD=5.5) virtual interviews over a mean of 4.8 (SD=1.8; range 1 to 9) weeks. VIT-TAY interview scores had a mean of 76.0 (SD=10.2; range 47.2 to 91.9). Participants completed a mean of 220.9 (SD=94.7; range 41 to 422) minutes of virtual interviewing.

Effectiveness Outcomes

We found that the Pre-ETS + VIT-TAY group had a higher rate of competitive and integrated employment compared to the Pre-ETS-only group (27.3% vs. 0% = χ2 = 3.35, p <.05). Conversely, the Pre-ETS-only group had a higher rate of receiving employment through informal means compared to the Pre-ETS +VIT-TAY group (50.0% vs. 13.6% = χ2 = 4.84, p <.05). Additionally, we found a significant group-by-time interaction for the global rating of “likeliness to be hired” (F=3.44, p <.05), where Pre-ETS + VIT-TAY, as compared to Pre-ETS-only, were rated as having greater improvements in their “likeliness of being hired” between pre-test and post-test (ηp2=.11). Next, we found a significant group-by-time interaction for the job interview skill total score (F=12.71 p <.01) where Pre-ETS + VIT-TAY had greater increases in the job interview total score between pre-test and post-test as compared to Pre-ETS-only (ηp2 = .32). Then, we found a significant group-by-time interaction (F=3.96, p < .05), where Pre-VIT + VIT-TAY, as compared to Pre-ETS-only, reported a significant decrease in their job interview anxiety between pre-test and post-test (ηp2 = .13).

The Firth logistic regression (Wald χ2 = 3.70, p =.15) revealed a trend that the Pre-ETS + VIT-TAY group was more likely to obtain competitive employment than the Pre-ETS-only group (OR=13.11; p = .075; 95% confidence interval [CI]=.39, 434.89), while covarying for baseline employment (OR=16.52; p < .05; CI=.78, 346.34). Notably, fluid cognition and ever had a job interview were non-significant covariates and were removed from the final model to conserve statistical power.

Acceptability and Usability

The Pre-ETS + VIT-TAY group perceived VIT-TAY as having strong acceptability (M=20.6, SD=4.4; Max Possible=25) and strong usability (M=29.8, SD=4.9; Max Possible=35). Notably, one participant did not complete the usability scale.

Discussion

The current study evaluated whether VIT-TAY, an internet-delivered job interview simulator adapted to address the needs of autistic transition-age youth, was effective, acceptable, and usable among a subsample of BIPOC autistic transition-age youth. Although under-powered (an RCT of virtual interview training anticipating a ~25% employment difference among adults with serious mental illness required n=160 to obtain 80% power (Smith et al., 2019)), we observed that BIPOC autistic youth randomized to Pre-ETS with VIT-TAY, as compared to a Pre-ETS-only group, showed significant improvement in job interview skills and a “likeliness to be hired,” as well as a significant reduction in job interview anxiety. The observed changes in interview skills and interview anxiety are consistent with two recent community-based studies of virtual interview training at a community mental health agency and prison where the majority of participants were from BIPOC communities (Smith et al., 2020c).

The results also suggest the Pre-ETS + VIT-TAY group, as compared to the Pre-ETS-only group, may have a higher rate of competitive employment by 6-month follow-up. Specifically, the Chi-Square analysis revealed a significant difference, while the results of the Firth regression were trend level. Meanwhile, the Firth odds ratio was similar in magnitude to the significant odds ratio for the parent RCT that revealed using VIT-TAY was associated with greater competitive employment within a sample of 71 autistic transition-age youth (Smith et al., 2021). Moreover, the employment outcome results are consistent with prior studies in community settings where participants with virtual job interview training were more likely to obtain competitive employment than a services-as-usual group (Smith et al., 2021). Notably, the Pre-ETS-only group reported a significantly higher rate of obtaining employment through informal means. This is a novel finding within the virtual job interview training literature. Future research could further evaluate the pathway followed by autistic transition-age youth to obtain employment through informal means.

This study also found that BIPOC autistic youth reported VIT-TAY to be highly acceptable and usable, which is a critical component of successfully adopting and scaling an intervention (Elliott, 2017). These findings also speak to the VIT-TAY developmental process of intentionally recruiting BIPOC autistic participants and stakeholders who championed diversity and representation throughout the development of the intervention. Thus, the results of this evaluation have important implications for BIPOC autistic transition-age youth job interview experiences, the cultural adaptation of VIT-TAY, and the importance of considering the effectiveness (and acceptability and usability) of interventions for BIPOC autistic youth.

Job Interview Experiences for BIPOC Autistic Transition-Age Youth

Findings from this study provide important insight into the benefits of innovative transition services for BIPOC autistic youth’s employment outcomes, as well as the importance of evaluating services and intervention effectiveness among BIPOC youth. Studies have reported that BIPOC autistic youth tend to have greater difficulties with social communication and interactions, are less likely to take part in transition services, less likely to find competitive employment after high school, and are more likely to live in poverty after high school (Angell et al., 2016; Eilenberg et al., 2019). Given these established disparities, it is essential to consider tools that adequately address the unique needs of BIPOC autistic youth. The current study shares initial evidence that VIT-TAY could potentially help improve the job interview experience and employment outcomes for BIPOC autistic transition-aged youth through repeated practice of social interactions and interviewing skills that support positive job interview experiences. Our initial findings also suggest that VIT-TAY could potentially provide therapeutic support for BIPOC youth, which is observed in the decreased job interview anxiety of the participants using the tool.

Improved Employment Outcomes

A key finding in this study is that participants that used the VIT-TAY reported greater rates of competitive employment than the Pre-ETS-only group (27.3% vs. 0%), while the Pre-ETS-only group reported greater rates of employment through informal means. These findings are particularly important given that current research suggests that competitive integrated employment is a key factor in a person’s ability to support themselves financially and is associated with higher wages, long-term upward mobility, and improved quality of life (Parmenter, 2011; West, Wehman et al., 2005). Conversely, studies have found that non-competitive employment or under-employment is associated with lower wages, a greater risk of poverty, and overall poorer mental well-being (Allan et al., 2020; Wilkins, 2007). Given the increased risk for many BIPOC youth to experience adverse financial, mental, and physical outcomes during and after their transition years, these findings speak to VIT-TAY’s potential to aid in improving many of these negative outcomes for BIPOC autistic transition-age youth. Notably, the current study did not collect enough data to generate generalizable results with regard to the types of jobs obtained, hours worked, and wages earned by study participants in each group. Thus, future research is needed to evaluate whether the use of VIT-TAY might be associated with improving these aforementioned employment outcomes.

It is worth pointing out that while the use of VIT-TAY + Pre-ETS was significantly associated with improved employment outcomes, the overall rate of employment for BIPOC autistic youth was relatively low (27.3%). This low employment rate could be partially explained by the results of studies that have found that BIPOC autistic youth tend to experience many interpersonal and systemic barriers to accessing competitive employment after high school (Eilenberg et al., 2019). For example, Griffin and colleagues (2014) found that Black autistic youth were significantly less likely than White autistic youth to have engaged with transition services which could negatively impact their employment outcomes. However, most importantly when comparing the competitive employment rates of participants in the current study to national employment rates for autistic transition-aged youth we find that our rate of 27.3% is considerably higher than the national rate of competitive employment among transition-aged autistic youth is which is roughly 20% (Roux et al., 2013; Shattuck et al., 2018) supporting the effectiveness and usefulness of VIT-TAY + Pre-ETS for this population.

Examining VIT-TAY Acceptability, Usability, and Effectiveness for BIPOC Autistic Youth

The acceptability and usability results, along with data suggesting initial VIT-TAY effectiveness, suggest that this intervention may be a good fit for BIPOC autistic transition-age youth. This is particularly important given that many autism-focused interventions have not been effectively tailored for use by youth of diverse racial and ethnic identities. Specifically, participants in this study had a high mean acceptability rating of 20.6 (total possible score=25) and a high mean usability rating of 29.8 (total possible score of 35), which endorses VIT-TAY’s acceptance and usability among this population and supports the use of similar simulation-type interventions for BIPOC autistic transition-age youth.

Notably, the lack of transition services that specifically address the needs of BIPOC autistic youth demonstrates the importance of examining the effectiveness of available interventions for this population while also developing interventions specific to their needs. Recent discourse has highlighted the racial and ethnic disparities in autism research, especially in intervention development and evaluation (Jones, Nicolaidis et al., 2020; Shaia et al., 2020; West et al., 2016). For example, Kaiser and colleagues (2022), in a study that examined the implementation of a culturally specific parent training program, argued that autism-related research lacks culturally grounded intervention models, which often leave BIPOC autistic youth under-served and under-supported. Given the significant racial disparities in autism research and intervention science, this current study intentionally examined the effectiveness of VIT-TAY for BIPOC autistic transition-age youth. Though VIT-TAY was not developed to address the needs of BIPOC autistic youth specifically, its community-engaged development had strong representation from BIPOC autistic people and communities (though it lacked adequate review from BIPOC autism services scientists).

Hence, the findings from this study provide significant implications for the delivery of broader transition services. These preliminary findings provide initial evidence that VIT-TAY paired with Pre-ETS has the potential to significantly improve the types of programs delivered and Pre-ETS outcomes among BIPOC autistic transition-age youth. Though there are federal mandates to provide Pre-ETS to autistic youth, mandates tend to fall short of enforcing the adequacy of Pre-ETS, often leaving many lower-resourced schools with under-performing services. The findings from this study suggest that integrating VIT-TAY into standing Pre-ETS could improve interview skills and interview anxiety, which could aid in supporting the employment needs of BIPOC autistic transition-age youth who are often enrolled in low-resourced schools and programs.

The initial effectiveness (and acceptability and usability) of VIT-TAY for this population is an important first step to evaluate whether it is effective for BIPOC autistic youth, as well as considering ways to improve its cultural applicability, and improving key transition services for BIPOC autistic transition-aged youth. Nonetheless, additional research is still needed to not only examine the effectiveness of existing interventions but also to lead to the development of new and innovative interventions that are culturally grounded and specific to the needs of BIPOC autistic youth.

Limitations and Future Directions

The results of this study must be interpreted within the context of its limitations. First, this study is preliminary and was not fully powered to examine the effectiveness of the intervention among BIPOC autistic youth. However, the findings suggest the intervention’s potential and warrant additional research that will allow for a fully-powered examination. Notably, the pilot nature of the parent study and, by extension, the current analysis did not collect participant- and teacher-level details (e.g., dosage) around engagement with Pre-ETS. Thus, future VIT-TAY evaluations within Pre-ETS would benefit from collecting more details about participant-level Pre-ETS engagement. Second, though participants were recruited from public, charter, and private schools in rural, urban, and suburban communities, there is limited variation in participants. Therefore, the results cannot be generalized to larger BIPOC communities without greater representation in a future, fully-powered trial. Third, because of the small sample size, we chose to examine all participants of color (BIPOC) rather than any individual racial or ethnic group. Thus, the effectiveness of the intervention may be different for specific racial and ethnic groups, which must be considered by future studies. Future research also is needed to gain a deeper understanding of employment outcomes. In particular, the increased rate of Pre-ETS-only participants receiving employment through informal means. One potential explanation is that the use of the VIT-TAY could have provided an increased sense of confidence, leading participants from the intervention group to seek more competitive employment opportunities while participants from the control group were less frequently seeking competitive employment. However, future research is needed to examine this hypothesis further. Fourth, although participants were instructed to inform staff of any potential adverse events (e.g., headache, fatigue, boredom) during this minimal-risk study, the research team did not review the presence of specific side effects or potential adverse events at each intervention visit. Future research should monitor the presence of adverse events more formally.

Although the VIT-TAY developers had no role in the collection, processing, or analysis of study data (beyond the automated VIT-TAY engagement data), future studies focused on the independent replication of VIT-TAY are recommended. In addition, multiple biases may have been present in the current study that need to be addressed in future trials. For instance, local teachers were aware of random assignments, which could have biased how they supported students in the Pre-ETS-only group. To minimize this bias, future research could evaluate and attempt to covary for potential biases introduced by teachers in their lessons with students. Also, research staff who posed as hiring managers during the role-play sessions and conducted follow-up interviews were not masked to the study condition. Thus, bias may have been present in how the staff performed in the role play (though their videos were reviewed for performance fidelity), or detection bias may have been present when conducting the employment interview at follow-up. However, the employment interview does not collect any subjective data; hence, the threat of detection bias was minimal.

Conclusion

The results from this study demonstrate that Black, Indigenous, and Persons of Color (BIPOC) autistic transition-age youth who use virtual interview training in their special education pre-employment transition services reported significantly improved interview skills, lowered interview anxiety, and greater competitive employment within six months compared to participants engaged in typical pre-employment transition services. Given the overall low rates of employment and the lack of access to transition services for BIPOC autistic youth, the improvement in interview skills and increased employment outcomes are promising. Furthermore, the results demonstrate the importance of developing and examining transition and social skill interventions specifically for their effectiveness on BIPOC autistic youth outcomes, given their unique social context. The findings from this study call for a large-scale and fully powered validation trial of VIT-TAY for BIPOC autistic youth and specifically for an evaluation of VIT-TAY outcomes on individual racial and ethnic groups of autistic transition-age youth.

Table 2:

Estimated Mean Values (standard errors) for Effectiveness Outcomes

Pre-ETS (n=10) Pre-ETS + VIT-TAY (n=22) Effect Size F p (one-tailed)
Pre-test mean (SE) Post-test mean (SE) Pre-test mean (SE) Post-test mean (SE)
Likeliness to be hired 2.61 (.50) 2.38 (.55) 2.77 (.39) 3.60 (.43) .11 3.44 .002
Mock Interview Score 44.37 (4.06) 40.74 (4.11) 47.33 (3.20) 51.86 (3.23) .32 12.71 .001
Job Interview Anxiety 1.91 (.36) 2.09 (.40) 2.56 (.28) 1.83 (.31) .13 3.96 .02
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Acknowledgements

We would like to acknowledge that this study was supported by a grant to Dr. Matthew J. Smith from the National Institute of Mental Health (R34 MH111531). We would like to acknowledge our participants for their time completing the study and our school partners for allowing us onsite to work with their students and teachers, including the following: Ann Arbor Academy, Plainfield, MI; Autism Model School, Toledo, OH; Lincoln Park High School, Lincoln Park, MI; South Field High School, South Field, MI; Troy High School, Troy, MI.

Footnotes

Conflict of Interest Statement

The University of Michigan will receive royalties from SIMmersion LLC on the sales of the virtual interview training tool that was the focus of the parent randomized controlled trial. These royalties will be shared with Dr. Matthew Smith and the University Of Michigan School Of Social Work. Dr. Smith adhered to the University of Michigan’s Conflict Management Plan that was reviewed and approved by a University of Michigan Conflict of Interest Committee. No other authors have a conflict of interest.

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