Autism Spectrum Disorder

Intellectual disabilities

Emotional disturbance

Specific learning disabilities

Populations:

Outcomes:

Increase in hours worked

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Vocational support approaches in autism spectrum disorder: A synthesis review of the literature

Authors:

Nieuwenhuijsen, K., Bos-Ransdrop, B., Uitterhoeve, L. L. J., Sprangers, M. A. G., & Verbeek, J. H. A. M.

Year Published:

2014

Publication:

Autism

Volume:

Number:

Pages:

1-11

Publisher:

Sage

Background:

Individuals with autism spectrum disorder have poor employment outcomes. Those who are employed typically work part time and in low skilled occupations.
The literature cites a number of challenges for individuals with ASD. It also suggest dissatisfaction with existing ASD vocational supports. The few studies that do exist suggest using models that support a person with ASD in the workplace. However little is known about the application of these supports.

Purpose:

This review of the literature takes a look at the overall state of the vocational support intervention literature related to autism spectrum disorder.

Setting:

This study is a systematic review. The included studies were undertaken in various locations and settings.

Sample:

The sample included 10 studies about employment support for adults and youth with autism spectrum disorder.

Data Collection:

A total of 22,878 studies were retrieved using databases comprised of Cochrane, Scholar's Portal, CINAHL,EMBASE, ERIC, Medline, PsycINFO, Google Scholar, Google, review of key ASD Association websites. All articles identified were reviewed using a 3 state retrieval and synthesis process including: initial screening, strict screening for inclusion or exclusion and data extraction and article review. A conceptual scheme was developed for cross comparison of studies whereby interventions and outcomes were reviewed, analyzed and categorized to a common theme.

Intervention:

There was no intervention. This is a synthesis based analysis of the literature. It is based on a larger systematic review of intervention studies.

Control:

There were no comparison or control conditions.

Findings:

The search led to 22,878 autism related intervention studies. After reviewed using a broad inclusion criteria, the number was reduced to 3974. Of the 3974, 501 targeted individuals 18 and over. These were reviewed for specific elements related to vocational intervention and outcome. In total 10 articles were identified. The following categories were found: supported employment comprising of community placement and jobcoaching (8 studies); technology-related applications including media and online use (2 studies).Of the 10 studies identified four focused on individuals with Asperger's Syndrome, and most include a substantial portion of more cognitively able adults with ASD. The literature focuses on using a supported employment approach with an emerging focus on technology related tools.

Conclusions:

The vocational literature is not substantial in this area. The existing literature must be reviewed with caution due to its low volume and research design issues. It does offer provisional guidance however, more research is needed.

URL:

http://www.autismalberta.ca/files/Vocational_Support_Approaches.pdf

Disabilities:

Outcomes:

Systematic reviews and meta-analysis

NIDILRR Funded:

Yes

Research Design:

Peer Reviewed:

Yes

Interview skills for adults with autism spectrum disorder: A pilot randomized controlled trial

Authors:

Mueser, K. T., Aalto, S., Becker, D. R., Ogden, J. S., Wolfe, R. S., Schiavo, D., ... & Xie, H.

Year Published:

2014

Publication:

Journal of Autism and Development Disorders

Volume:

Number:

Pages:

2290-2300

Publisher:

Springer Science + Business Media

Background:

Even among high functioning adults with autism spectrum disorder (ASD) employment outcomes vary widely. The social communication deficits of those with ASD can influence these outcomes. Thus, increasing job interview skills may serve to improve outcomes.

Purpose:

The purpose of this study was to examine the effectiveness of an interview skills curriculum (ISC) for young adults with ASD.

Setting:

The study was conducted in Tallahassee, Florida

Sample:

Participants were recruited from Florida State University Center for Autism and Related Disabilities (CARD). Twenty-eight adults with ASD between the ages of 18-36 took part in the study. All had a verbal IQ above 70 and possessed a high school diploma or GED. There were 27 males and one female.

Data Collection:

Mock interviews were scored using the Social Pragmatic Scale and linear regression was used to analyze variation in performance.

Intervention:

The experimental group was randomly assigned and received a 12 week ISC. Sessions were 90 minutes each and delivered in a group setting. The ISC is focused on improving social skills with an emphasis on those that are used in a job interview. Mock interviews were conducted before and after the ISC for both the experimental and control group.

Control:

Participants randomized to the control group did not participate in the ISC but were invited to participate in one at the conclusion of the study.

Findings:

The experimental group showed larger gains in social pragmatic skills on the final interview than did the control group.

Conclusions:

These findings support the effectiveness of a short term social skills program for individuals with ASD.

URL:

http://link.springer.com/article/10.1007%2Fs10803-014-2100-3#/page-1

Disabilities:

Outcomes:

Randomized Controlled Trials (RCTs)

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Predictors of employment and postsecondary education of youth with autism

Authors:

Moore, C. L.

Year Published:

2012

Publication:

Rehabilitation Counseling Bulletin

Volume:

Number:

Pages:

176-184

Publisher:

Sage

Background:

The increasing numbers of students diagnosed with autism spectrum disorders (ASD), exiting school an seeking Vocational Rehabilitation (VR) services has sparked interest in research of predictors of employment success.

Purpose:

The purpose of this study was to identify predictors or employment success for students with ASD who use VR services in transition from school to adulthood. Predictors included both demographic and specific VR service categories.

Setting:

This study included individuals with disabilities served by multiple vocational rehabilitation agencies in various settings.

Sample:

The study sample consisted of 2,913 youth and young adults who received VR services during the transition period from school to adulthood. Ages at application for services ranged from 16 to 26, and none were employed at application.

Data Collection:

Data collection for the RSA 911 data system is initiated at the time of application and ends at case closure. The system includes client demographic variables, service delivery variables, and outcome variables. Stepwise backward binary logistic regression was used to test the relationships between the predictors and the outcomes that were measured as categorical variables integrated employment and postsecondary education improvement.

Intervention:

Interventions were the following service categories used in the VR RSA 911 data set: Assessment, counseling and guidance, job readiness training, job search, job placement, on-the-job supports, college, miscellaneous training, and other services.

Control:

There was no control or comparison condition.

Findings:

The odds of achieving competitive employment were greater for youth who received job placement services. However, only 48% of youth with ASD received this service. In addition, postsecondary education was among the strongest predictors of better earnings, yet only 10% of youth received college services.

Conclusions:

The study's findings provide evidence that job placement services and college services can improve employment outcomes for youth with autism. They recommend that VR agencies offer those services to more youth with autism.

URL:

http://www.worksupport.com/kter/documents/pdf/Migliore2012.pdf

Disabilities:

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Observational

Peer Reviewed:

Yes

Job tips: A transition to employment program for individuals with autism spectrum disorders

Authors:

Taylor, J. l., McPheeters, M., Sathe, N.A., Dove, D., Veenstra-VanderWeele, J. & Warren, Z.

Year Published:

2013

Publication:

The Journal of Autism and Developmental Disorders

Volume:

Number:

Pages:

2472-2483

Publisher:

Springer

Background:

Shattuck et al. (2012) reported that youth with an ASD are uniquely at risk for negative post-school outcomes, as indicated by the fact that while only 55 % of those with an ASD are employed in the 6 years beyond high school, 86 % of those with a speech or language impairment, 94 % of those with a learning disability, and 69 % of those with an intellectual disability have found employment.

Purpose:

The current study evaluated the effectiveness of a treatment package comprised of a web-based interviewing skills program (JobTIPS) and virtual reality practice on responses to employment interview questions by adolescents with high functioning autism and Asperger‚ Disorder.

Setting:

The setting was a University Research Center.

Sample:

The study sample included 22 youth who were between the ages of 16‚Äì19 years old.

Data Collection:

An Interview Skills Rating Instrument was developed by researchers. The first scale was Response Content: A 10 item scale that measures the content of the participant's response to 10 interview questions. The second scale: Response Delivery: 20 items that measure behaviors related to greetings and farewells (handshakes, eye contact, verbal greeting, verbal expression of appreciation at end of interview), as well as the non-verbal behaviors (body positioning, facial expressions) that accompany verbal responses during the actual interview questioning period.

Intervention:

Internet based transition program

Control:

Services as usual

Findings:

The results of the study suggest that youth with ASD who completed the Job TIPS training program showed significant improvement in their job interviewing skills when compared to the control group. The program was more effective in teaching content rather than delivery skills. Participants were able to produce more appropriate verbal responses to interview questions following intervention, but the features that accompany those responses did not improve to the same degree.

Conclusions:

The findings demonstrate that a web-based training program can be effective as an intervention method to improve employment related interviewing skills for individuals with ASD.

URL:

http://link.springer.com/article/10.1007%2Fs10803-013-1800-4

Disabilities:

Populations:

Male

Outcomes:

NIDILRR Funded:

Research Design:

Quasi-experimental

Peer Reviewed:

Yes

A systematic review of vocational interventions for young adults with autism spectrum

Authors:

Test, D.W., Mazzotti, V.L., Mustian, A.L., Fowler, C.H., Kortering, L., & Kohler, P.

Year Published:

2012

Publication:

Pediatrics

Volume:

130

Number:

Pages:

531-538

Publisher:

American Academy of Pediatrics

Background:

Not much is known about effective vocational interventions to assist individuals with ASD. Yet, that population is rapidly growing. Programs and interventions to serve youth are not well understood. The lack of information impacts successful transition to work.

Purpose:

The purpose of this systematic review of the literature was to assess the effectiveness of vocational interventions for individuals with ASD who are 13 to 30 years old.

Setting:

The studies that were reviewed were undertaken in various locations and settings in the US, UK, Spain and Germany.

Sample:

Multiple databases and reference lists were searched to find relevant studies that were published between 1980 and 2011. Afterwards, each study was examined against an inclusion criteria developed by an expert panel. Data about sample, intervention characteristics, assessment techniques, and outcomes, were evaluated and an overall quality and strength of evidence rating was assigned to the included studies according to a specific criteria. The final sample consisted of 5 studies involving young adults with autism.

Data Collection:

Characteristics of study participants and interventions were summarized. Descriptive statistics were used to report study outcomes. No meta analysis was conducted.

Intervention:

The studies reviewed looked at a variety of vocational interventions which involved identifying and implementing work supports for young adults with ASD.

Control:

There were no comparison or control conditions.

Findings:

Only five studies, related to on the job supports and employment and vocational interventions were found. All of these received a poor quality rating by the reviewers which may be due to the fact that this is a new area of research. The studies included one non randomized trial that looked at the impact of supported employment versus sheltered work settings for 55 young adults with autism. A related study from the same researchers looked at the effect of supported employment versus sheltered work on the cognitive development of 44 young adults with autism. Two cohort studies and one cross sectional study reported on the influence of vocational interventions on independent living outcomes.

Conclusions:

There is very little evidence about vocational interventions for individuals with ASD. High quality research is needed. Supported employment may be a promising intervention however much more research is needed.

URL:

http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-0682

Disabilities:

Populations:

Outcomes:

Systematic reviews and meta-analysis

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Project ABLE (Autism: Building Links to Employment): A specialist employment service for young people and adults with an autism spectrum condition

Authors:

Lysaker P. H., Bond G., Davis L. W., Bryson G.J., & Bell, M.D.

Year Published:

2014

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

13-21

Publisher:

IOS Press

Background:

Individuals with Autism face high rates of unemployment due to a myriad of challenges. There have been some reports that participating in an employability program early on can improve work outcome for this group.

Purpose:

This study examined using a customized approach to either develop or improve employability skills of individuals with Autism.

Setting:

The settings included work experience sites across a wide range of community businesses.

Sample:

Participants included 27 students in special education, 15 young adults who were preparing to leave or who had recently left school and 30 who were 18 or older who were not in secondary education in Ireland. All but 4 of the participants were males. The cognitive profile varied among participants and included 27 individuals who had severe learning disability opposed to 14 who were high functioning. All were unemployed.

Data Collection:

An action research approach was used. Results were presented for each 3 groups of participants. The individualized approach was successful for 17 of the adult participants. By the end of year four 56% had secured full time and part time work. Among the special education group 27 people had the chance to participate in one to three work experiences. Eighteen required one to one ongoing support throughout the duration of the work placement. Some parents of the young adults in this group reported feeling less anxious about what would happen when the child left school. The mainstream group required work experience for short periods of time. A program spanning the entire school year was not possible due to difficulties associated with being released from school. During the engagement phase individuals completed a individual induction, an assessment, a vocational profile, and an action plan. The plan was reviewed and updated every six months.

Intervention:

The intervention was a Supported Employment Model in Northern Ireland. This model ensure correct level of support are in place for a person with disability, coworkers, management and families. The model include the following phases: engage; place, train, maintain and progress.
To develop employability and related skills participants chose from a range of interventions.

Control:

There was no control or comparison condition.

Findings:

The majority or 95% of the participants experience at least one work experience and 66% had two or more placements. Most individuals 47% worked in retail this was followed by job in administration (24%). Experiences lasted between six weeks to six months or more. The experiences took place across all types of businesses and included retail, business, catering and more. Some individuals also went on to secure employment. Feedback was solicited from participants through interviews and focus groups. They indicated a number of key areas improvement; the top two were better use of time and vocational skills.

Conclusions:

Work preparation and employability training at an early stage appears to help young people with autism spectrum condition in Ireland successfully transition from school to work. A Supported Employment Model assisted young people with autism spectrum condition prepare for and enter work.

URL:

https://www.qub.ac.uk/research-centres/CentreforBehaviourAnalysis/filestore/Filetoupload,503346,en.pdf

Disabilities:

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Mixed methods

Peer Reviewed:

Yes

Use of vocational rehabilitative services among adults with autism

Authors:

Leahy, M. J., Chan, F., Lui, J., Rosenthal, D., Tansey, T., Wehman, P., Kundu, M., Dutta, A., Anderson, C. A., Valle, R.D., Sherman, S., & Menz, F. E.

Year Published:

2009

Publication:

Lawer L., Brusilovskiy E., Salzer M.S., & Mandell, D. S.

Volume:

Number:

Pages:

487-494

Publisher:

Springer

Background:

Individuals with autism can have complex and significant impairments that hinder their ability to gain and maintain employment. The United States Vocational Rehabilitation (VR) System is set up to maximize the employment outcomes of individuals with disabilities by providing a variety of services. There is limited research on how existing services may assist individuals with autism with employment. Among those studies most do not report favorable results. More information is needed on how to improve access to services and enhance employment outcomes for individuals with autism.

Purpose:

The purpose of the study was to examine VR services for individuals with autism. More specific, the researchers examined if adults with ASD were more likely to be denied services as compared to adults with other impairments; costs of VR services for adults with autism as compared to adults with other impairments and whether individuals with autism achieved the goal of competitive employment at the time of case closure.

Setting:

This study included individuals with autism served by multiple vocational rehabilitation agencies in various settings.

Sample:

The dataset included 382,221 adults who were served by state vocational rehabilitation and had their cases closed in 2005 for reasons other than death or because they were determined not to need vocational rehabilitation services. There were 37 causes of disability in the dataset. The authors sorted them into the following categories: autism spectrum disorder (n=1,707); mental retardation (n=30,728); specific learning disabilities (n=33,155)and all others were combined into other impairments (n=316,471).

Data Collection:

Data on individuals receiving vocational rehabilitation services were obtained from the US Department of Education‚ Office of Special Education and Rehabilitative Services. This included demographic variables, impairment cause, types and cost of services paid for by the Rehabilitation Services Administration, reasons for closure, and competitive employment status. There were three dependent variables. The first indicating whether the case was closed because the rehabilitation service provider believed that the individual‚ disability was too significant to benefit from services. The second was the total dollar amount the state VR agency spent on services. The third was whether individuals
achieved competitive employment by the time of case closure. Bivariate associations between impairment cause and all other variables were estimated using means, medians and ANOVA for expenditure data, and frequencies and chi square tests for all other variables.

Intervention:

The intervention was various types of services provided by states' vocational rehabilitation agencies that led to competitive employment. This included services like: assessment and diagnosis, counseling, job search assistance, assistive technology,
and on-the-job training.

Control:

There was no control or comparison condition.

Findings:

The results revealed the following. First, relative to other individuals served by the vocational rehabilitation system, individuals with ASD were more likely to be denied services because it was believed that their disability was too severe for them to benefit from services. Second, among those who received services, people with ASD received a more expensive set of services than those with other impairments, although their service costs did not differ from individuals with mental retardation. And lastly, competitive employment rates among people with ASD did not differ from those with Specific Learning Disabilities or Mental Retardation, and were much higher than those of people with other impairments. Post hoc analyses seems to reveal that their employment is associated with on the job supports.

Conclusions:

Many individuals with autism can work. Individuals with autism and their families should seek out supports. Vocational rehabilitation should emphasize employment. Policy makers should examine ways to ensure individuals with autism have access to supports needed to make work a reality.

URL:

http://link.springer.com/article/10.1007%2Fs10803-008-0649-4#/page-1

Disabilities:

Populations:

Black / African American

White / Caucasian

Outcomes:

Return to work

NIDILRR Funded:

Not Reported

Research Design:

Observational

Peer Reviewed:

Yes

Supported employment for young adults with autism spectrum disorder: Preliminary data

Authors:

Wehman, P., Schall, C., McDonough, J., Molinelli, A. Riehle, E., Ham, W., & Thiss, W.

Year Published:

2012

Publication:

Research & Practice for Persons with Severe Disabilities

Volume:

Number:

Pages:

160-169

Publisher:

Tash Publishing

Background:

There is extremely limited information about using a supported employment approach to assist individuals with autism with gaining and maintaining employment in the community. Among the few studies that do exist, most are descriptive in nature. More research is needed.

Purpose:

This study took a close look at the work histories of individuals with ASD over a 23 month period of time. The purpose was to examine the effects of supported employment in assisting them with employment.

Setting:

The setting included a variety of different workplaces. This included: health care field, retail, recreational and educational field, food service and janitorial industry.

Sample:

Thirty three individuals with ASD were included in the study. Each was referred for supported employment services by a vocational rehabilitation counselor. The majority were white (76%) and males (76%). The average age of participants was 22 years old. Seventy percent of the individuals reported a secondary disability. All participants had received a high school diploma or equivalency diploma. Around 40% had some college. Over 90% had either no or short intermittent work histories. More than three fourths had high social interaction support needs. Notably close to a third or 13 individuals had participated in a extended work internship at a hospital that was modeled after the Project SEARCH approach.

Data Collection:

Employment specialist traced actual time spent either directly or indirectly working for the person with ASD across various types of supported employment interventions. This included developing a vocational profile about the person served, developing a job, job site training, and long term supports to enhance job retention. All data were stored in password protected database. The employment specialist's intervention time and participant outcomes were aggregated across the group of participants and over time.

Intervention:

The intervention was individualized supported employment services. This is an approach that supports one person at a time with gaining and maintaining work in a real job for real pay in the community.

Control:

There was no control. Due to the exploratory nature of the study no comparison group was used.

Findings:

Twenty seven or 82% of those served went to work in an entry level occupation. They earned between $7.25 and $10.50 per hour.Mean hours worked was 23 per week.The average intervention time for various interventions was as follows:completing a job seeker profile was about 9 hours; job development around 30 hours (notably some of the individuals went to work where they interned which reduced the hours needed to develop a job); job site training and support 107 hours; and long term support 27 hours.

Conclusions:

An individualized supported employment approach can assist individuals with ASD with gaining and maintaining employment. More research is needed.

URL:

http://rps.sagepub.com/content/37/3/160.full.pdf

Disabilities:

Populations:

Black / African American

White / Caucasian

Outcomes:

Full-time employment

Part-time employment

Wages

NIDILRR Funded:

Research Design:

Single group

Observational

Quasi-experimental

Peer Reviewed:

Yes

Project SEARCH for youth with autism spectrum disorders: Increasing competitive employment on transition from high school

Authors:

Wehman, P., Schall, C.M., McDonough, J., Kregel, J., Brooke, V., Molinelli., A., Ham, W., Graham, C. W., Riehle, J. E. Collins, H. T., & Thiss, W.

Year Published:

2013

Publication:

Journal of Positive Behavior Interventions.

Volume:

Number:

Pages:

144-155

Publisher:

Hammill Institute on Disabilities and Sage

Background:

Transition from school to work for youth with ASD is an ongoing problem for the public education system. Teachers also struggle with their attempts to match the strengths of a particular student to a job. Project SEARCH is a transition program for youth with disabilities. In this model students rotate through full day internships in businesses to gain work and related skills that may lead to an employment offer for some.Others have a positive work experience to highlight as they apply for jobs in their communities.Project SEARCH helps facilitate the transition from school to work.

Purpose:

The purpose of this study was to determine how a Project SEARCH approach would work for youth with ASD.

Setting:

The student internships took place in a large hospital.

Sample:

Two case studies were presented for two young men with ASD. A 19 year with autism and a 20 year old with Asperger Syndrome as well as severe scoliosis.

Data Collection:

The following data demographics, internship characteristics, job coach interventions was collected for each young man.

Intervention:

The intervention was Project SEARCH model along with some specific ASD supports.

Control:

There was no control or comparison condition.

Findings:

One young man participated in internships in the hospitals' radiation, engineering and infection control departments. His performance improved over time and he was offered a job in the infection control department working 20 hours and week and earning $9.14 an hour.The other young man participated in internships in the Coronary Care Unit, Biomedical Durable Equipment, and Intensive Care Unit (ICU). His abilities also improved during the internships. After completing the internships he was offered a job working 20 hours a week in the ICU earning $9.14 per hour.

Conclusions:

A Project SEARCH approach appears to be an effective way to assist youth with ASD with transition from school to work. This study was part of a larger study researching the use of Project SEARCH model to serve youth with ASD. The results from this larger study should help shed light on this topic.

URL:

http://pbi.sagepub.com/content/early/2012/10/11/1098300712459760

Disabilities:

Populations:

Male

Black / African American

White / Caucasian

Outcomes: