A Qualitative, multitiered operational research model for teenagers and young adults with autism: Actionable insights from an Indian context

Authors : Chandran, Suhas; Shetty, Harshitha; Mathew, Anjali; Rao, Vanitha; Mysore, Ashok

Publication Year : November 2025

Abstract :

Abstract

Background: 

Teenagers and young adults (TYA) with autism spectrum disorder (ASD) in India face systemic barriers in education, employment, and healthcare, worsened by the lack of culturally tailored services.

Aim: 

This study aimed to design and validate a culturally sensitive assessment framework for TYA with ASD, incorporating expert and caregiver input to identify barriers and inform scalable interventions.

Methods: 

Using an operational research design, we integrated real-time interventions with a three-tiered assessment framework (clinical, home-based, and community evaluations). Forty-three participants aged ≥14 years were recruited via convenience sampling. Standardized tools (Vineland Adaptive Behavior Scale-2, DSM-5 Clinician-Rated Severity, Wechsler Abbreviated Scale of Intelligence-II) and structured interviews guided individualized interventions, including behavioral, pharmacological, and vocational strategies. Manual thematic analysis with inter-coder reliability provided qualitative insights.

Results: 

Significant psychiatric comorbidities were found in 82.9% of participants [e.g. Intellectual Disability, Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety], alongside high school dropout rates (31.7%) due to the behavioral and academic challenges, and limited vocational training access (17%). Gender disparities showed males with externalizing behaviors and females often underdiagnosed due to internalizing symptoms. Families reported financial strain, caregiver burnout, and social isolation, with siblings experiencing both neglect and support roles. Thematic analysis highlighted needs for family support networks, sexuality education, and vocational day centers, leading to targeted services launched in November 2024.

Conclusion: 

This study, one of India’s first to combine multidisciplinary assessments with real-time interventions, offers a replicable framework for scalable, family-centered ASD care. It underscores the need for adaptive policies and targeted interventions to address systemic barriers in education, mental health, and vocational integration for TYA with ASD.

https://journals.lww.com/indianjpsychiatry/fulltext/2025/11000/a_qualitative,_multitiered_operational_research.2.aspx?context=latestarticles