The goal of this fellowship is to prepare the applicant, Luther G. Kalb, for an academic research career focused on improving the treatment of mental health problems among individuals with an Autism Spectrum Disorder (ASD) and/or Intellectual Disability (ID). To that end, the proposed fellowship consists of two complementary components: 1) a research project examining mental health and service-related outcomes associated with the START (Systemic, Therapeutic, Assessment, and Resources & Treatment) program; and, 2) a training plan comprised of formal coursework, mentorship, and didactic as well as professional development activities. The Specific Aims of the research project are to conduct a prospective cohort study, using preexisting START data gathered from 200 individuals (ages 17 to 65 years) with an ASD and/or ID, to examine one year pre-post changes in: 1) the individuals' psychiatric symptoms (measured via the Aberrant Behavior Checklist; Aman, 1985); 2) caregivers' perceived support from and access to mental health care for their dependent (assessed via the Family Experiences Interview Schedule; Tessler & Gamache, 1993); and, 3) psychiatric hospitalization rates. This study marks the first formal scientific assessment of START, despite growing implementation throughout the US. One explanation for the proliferation of START across 7 states in the US, even in the face of limited evidence, is the lack of services available for the growing and aging ASD and/or ID population. Building evidence around START holds important implications to improving outcomes for this population who face numerous challenges once they graduate from the educational system. Evidence gathered from this study will also be critical to substantiate funding for a future randomized controlled trial of START. This project is supported by a strong interdisciplinary mentorship team with expertise in ASD/ID, health services research, health policy, and statistical methods, and will take place in a world class research department and institution. The proposed fellowship will also provide Mr. Kalb with the coursework, didactic opportunities, and professional relationships that he requires to progress to the next stage of his career as an independent researcher. Taken together, both the training plan, research project, and future career of Mr. Kalb aim to develop effective and targeted interventions for person with ASD (NICHD Scientific Vision, The Next Decade; Behavior and Cognition, Question 3) and increase the health and longevity of persons with ID and, based on this knowledge, develop better community- and population-based health care and living options for these individuals (NICHD Scientific Vision, The Next Decade; Population Dynamics, Question 2).