Tablet-based video modeling and prompting in the workplace for individuals with autism

Authors: 
Burke-Miller, J., Razzano, L. A., Grey, D. D., Blyler, C. R., & Cook, J. A.
Year Published: 
2013
Publication: 
Journal of Vocational Rehabilitation
Volume: 
38
Number: 
1
Pages: 
1-14
Publisher: 
IOS Press
Background: 

The number of adults with autism closed by Vocational Rehabilitation remains low. Employment rates for this group is the lowest for individuals with intellectual disabilities. For instance, the National Longitudinal Transition Study-2 reported that at two years post high school, only 28% of individuals with autism were employed (including competitive, supported, or sheltered employment).

Purpose: 

This article presents the findings from a preliminary study testing computer software across a range of employment settings for young adults with autism.

Setting: 

The study took place in a manufacturing and shipping warehouse in a Midwestern city.

Sample: 

The study sample included four young men ages 19 to 28, with autism spectrum disorder. One young man was Asian American and the other three were European American. All were unemployed; three lived with their parents; one lived in a community-based group home.

Data Collection: 

Participants were asked to complete a shipping task that involved an average of 73 steps. The percentage of task steps completed correctly was calculated by dividing the number of relevant completed steps by the sum of relevant completed and relevant not completed steps and multiplying by 100.

Intervention: 

A task analysis of the job was completed within the shipping department of the large manufacturing and shipping warehouse. The actual task was rental box shipping, which was reported as the most challenging of the shipping tasks due to the number of complex steps. A 13 minute, 10 second video was produced that depicted job responsibilities for the shipping tasks. This video had recorded voice overs to guide the user. The shipping task was then edited into 36 segments so that users could view portions of the task at a time. This video was loaded onto a software program called, VideoTote that was designed for an Android platform and made available to the study subjects on a Samsung Galaxy Tablet. The software was designed with universal design features.

Control: 

This study was a single subject design, the subjects were their own controls.

Findings: 

Results from this study suggest that the combination of video modeling during pre-employment training and on-the-job video prompting was helpful for individuals with autism when completing a complex shipping task.

Conclusions: 

The current study provides preliminary evidence that use of the tablet-based VideoTote software was an effective video modeling and prompting intervention for individuals with ASD in competitive employment. The results suggest that for some individuals with autism, job coaches likely will remain necessary.

URL: 
http://www.scholars.northwestern.edu/pubDetail.asp?t=pm&id=84873177849&
Disabilities: 
Autism Spectrum Disorder
Populations: 
Male
Asian
White / Caucasian
Transition-age youth (14 - 24)
Outcomes: 
Other
NIDILRR Funded: 
Yes
Research Design: 
Case reports
Peer Reviewed: 
Yes

Employment services as an early intervention for young people with mental illness

Authors: 
Brucker, D. L.
Year Published: 
2010
Publication: 
Early Intervention in Psychiatry
Volume: 
4
Number: 
4
Pages: 
237-335
Publisher: 
Blackwell Publishing Asia Pty Ltd
Background: 

The individual placement and support (IPS) approach to supported employment for people with severe mental illness is becoming widely accepted as an essential component of evidence-based psychosocial rehabilitation. A key feature of IPS is that employment services are closely integrated with public mental health services. This can be challenging to implement in developed countries where mental health and employment systems are typically segregated. The demonstrated success of integrated mental health and employment programs implies that this approach can enhance early intervention mental health services and recovery-oriented mental health services.

Purpose: 

This study examined the service characteristics and effectiveness of a segregated employment service assisting young clients with mental illness in New Zealand.

Setting: 

Workwise Employment Ltd in Christchurch, New Zealand is a supported employment service provider for people with mental illness, including substance misuse. Eligible participants were in receipt of either SB or IB due to a diagnosed mental health condition, often with concurrent family and social problems that exacerbated their situation. Four full-time employment specialists were supported by one administration position and one team leader. Employment specialists were not externally trained in IPS principles. However, in 2002 Workwise adopted these principles for internal training throughout its national network of disability employment services.

Sample: 

Employment outcomes were investigated for 49 young clients aged 16-25 years who entered the program between 1 July 2005 and 30 June 2007. These young clients represented 18% of the 270 clients assisted during this period. Data collection ceased on 4 April 2008. Eligible candidates were identified and referred by Work and Income staff from regular Work and Income seminars, and from individual income support reviews. Self-referrals were also permitted. Referrals were accepted if: (i) the person was in receipt of SB or IB for mental health or psychiatric reasons (including substance misuse); (ii)Work and Income approved the self-referral and (iii) it was clear people were volunteering for employment assistance. Clients were recommended to a particular employment service by the Work and Income staff. Clients could accept the initial referral or insist on choosing another of three alternative service providers.

Data Collection: 

The service had a comprehensive business information system that tracked all clients throughout the contract. Records of clients(n=49) aged 16–25 years were retrospectively examined. Data analysis was conducted by the team leader using Microsoft Excel 2003, guided by the outcome variables identified from published reports of comparable services. The comprehensive data management system enabled most variables of interest to be reported. Data quality was governed by the contract that required 100% accuracy and supporting evidence for all employment outcomes. All client records were reviewed monthly by an employment specialist, an administrator and by the team leader for the term of the contract. The records were also subject to regular internal review and intensive external auditing as a condition of the contract.

Intervention: 

The service assisted both youth and adults with severe mental illness to find and keep competitive employment. A retrospective case study method was used to examine service effectiveness with respect to employment outcomes attained by 49 clients aged 16–25 years over a 2-year period (2005–2007). These results were compared with recent national and international benchmarks.

Control: 

The condition was published outcomes from recent national and international benchmarks that were based on studies using Random Controlled Trials.

Findings: 

As a service segregated from public mental health services, there were no formal arrangements with local mental health teams, limiting coordination of services and reducing fidelity to evidence-based practices in supported employment. Despite an inability to collaborate closely with local community mental health services and a contract not specifically targeting youth, the service was high performing on a range of employment outcome variables.

Conclusions: 

Subject to some study design and benchmarking limitations, these results support the continuing use of evidence-based practices in supported employment and supported education as important early interventions for young people with mental illnesses.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/21043209
Disabilities: 
Autism Spectrum Disorder
Emotional disturbance
Populations: 
Transition-age youth (14 - 24)
Native Hawaiian / other Pacific Islander
White / Caucasian
Male & Female
Outcomes: 
Employment acquisition
Increase in tenure
Wages
NIDILRR Funded: 
No
Research Design: 
Case reports
Peer Reviewed: 
Yes

The quest for ordinary lives: The integrated post-school vocational functioning of fifty workers with significant disabilities

Authors: 
Browne, D. J. & Waghorn, G.
Year Published: 
2006
Publication: 
Research and Practice for Persons with Severe Disabilities
Volume: 
31
Number: 
2
Pages: 
93-121
Publisher: 
TASH Publishing
Background: 

More individuals with significant disabilities are entering and exiting schools and outliving their parents than ever before. As these individuals age, many are presenting more longitudinal, complicated, and expensive difficulties than their chronological age peers (Bittles and Glasson, 2004).

Purpose: 

The purposes of this study are to: (1) share information about the integrated vocational functioning of 50 adults with significant disabilities, (2( celebrate their vocational achievements, and (3) affirm the feasibility of integrated vocational functioning.

Setting: 

All participants were clients of Community Work Services, an employment services program in Madison Wisconsin.

Sample: 

The 50 participants were assisted into integrated jobs prior to 2005. The sample included individuals with a variety of disabilities, including autism, intellectual disabilities, and cerebral palsy. All were at least 15 years out of high school.

Data Collection: 

The data consisted of service records maintained by Community Work Services during the course of services. Additional information was collected from interviews with participants, family members, employers, and others.

Intervention: 

The intervention was community-integrated employment utilizing a job coach and long-term support.

Control: 

There was no comparison condition.

Findings: 

Job retention ranged from 2 months to 27 years and 6 months. Job changes occurred for a variety of reasons, but primarily to enhance opportunities and create better job matches. Work hours ranged from 6 to 30.5 hr/week, with an average of 20.15 hr/week. Hourly wages averaged $5.76, six cents above the prevailing minimum wage at the time of placement.

Conclusions: 

The study findings provide evidence for the feasibility of integrated employment for individuals with severe disabilities in need of long-term employment supports.

URL: 
https://pdfs.semanticscholar.org/3172/5be67b88b211fb2d73faa67d50824d704104.pdf
Disabilities: 
Autism Spectrum Disorder
Intellectual disabilities
Populations: 
Male & Female
Urban
Outcomes: 
Increase in tenure
Wages
NIDILRR Funded: 
No
Research Design: 
Case reports
Peer Reviewed: 
Yes

Difficulties with multitasking on return to work after TBI: A critical case study

Authors: 
Boycott, N., Schneider, J., & McMurran, M.
Year Published: 
2010
Publication: 
Work
Volume: 
36
Number: 
2
Pages: 
207-216
Publisher: 
IOS Press
Background: 

Cognitive functioning is a strong predictor of success at work. Every job requires a specific set of cognitive skills. Multitasking requires a person to switch between several concurrent tasks, requiring the application of a variety of cognitive strategies to succeed without errors. After a traumatic brain injury (TBI) a person may have problems processing cognitive information. This is one of the leading reasons for loss of work among individuals with mild TBI. People who return to work after injury have reported increased cognitive demand with associated stress. Occupational rehabilitation providers have noted organizational and planning of complex or multiple work tasks difficult for high functioning individuals post TBI. The difficulty seemed to not only stem from cognitive problems but also the ability to apply cognitive strategies on the spot or situations with increased cognitive load. While neuropsychological evaluations may prove useful in helping determine potential cognitive capacity to return to work, there are some limitations to its usefulness. Some believe that sampling work behaviors through observation or client and employer interview may be a much better way to obtain accurate evaluation of cognitive work demands for individuals who are attempting to return to work after TBI.

Purpose: 

The study examines the use of the Perceive, Recall, Plan, Perform@WORK:Questionnaire/interview with category rating response format, by an employer to determine information processing strategy application difficulties.

Setting: 

The study took place at a telemarketing company.

Sample: 

A thirty year old man who sustained a TBI nine months earlier. His Glascow coma score was 9/15 and he experienced post traumatic amnesia for 21 days post injury.

Data Collection: 

The participant's employer was interviewed by an occupational therapist using the PRPP@work questionnaire/interview format. The participant's case manager was also present to provide background information, and to corroborate interview data from other assessment sources like client observation and interview.

Intervention: 

A case study method using the PRPP at work questionnaire/interview format.

Control: 

There was no control or comparison condition.

Findings: 

The employer did not perceive that the employee with TBI, was adequately applying cognitive information strategies in any of the four areas (perceive, recall, perform, plan) to meet job requirements. The findings indicated specific areas of information processing strategy strengths and weaknesses during work performance as categorized by PRPP@WORK Employer Questionnaire/Interview.

Conclusions: 

More research is needed. A measure of mental effort should be included in future studies assessing a person's ability to apply cognitive information processing strategies in multitasking work environments. While it is not possible to generalize the findings to the broader population of individuals with TBI the findings contribute to targeting future research in the area of improving multitasking work behaviors. The PRPP@WORK may have potential to offer useful information about the capacity of a person to engage in complex information processing for multitasking work performance post TBI.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/20634614
Disabilities: 
Traumatic brain injury (TBI)
Populations: 
Male
White / Caucasian
Outcomes: 
Return to work
NIDILRR Funded: 
Not Reported
Research Design: 
Case reports
Peer Reviewed: 
Yes

Critical strategies for implementing supported employment

Authors: 
Bond, G. R., Becker, D.R., Drake, R.E., Rapp, C.A., Meisler, N., Lehman, A.F., Bell, M.D., & Blyler, C.R.
Year Published: 
2007
Publication: 
Journal of Vocational Rehabilitation
Volume: 
27
Number: 
1
Pages: 
13-20
Publisher: 
IOS Press
Background: 

Supported employment is considered to be "the most effective approach to increase work opportunities for people with severe mental illness [3–5]" (p. 13). However, access to Supported Employment services is difficult to obtain.

Purpose: 

The paper offers "a review of experiences by six states and the District of Columbia in disseminating an evidence-based practice, supported employment (SE). Each jurisdiction had unique strengths and barriers to overcome to effectively implement supported employment services for people with severe mental illness" (p. 13).

Setting: 

"Project leaders from the original six states and the District of Columbia" provided information as to how they were able to increase "access to high-quality SE services in their areas" (p. 13).

Sample: 

Maryland, South Carolina, District of Columbia, Oregon, Vermont, Kansas, Connecticut

Data Collection: 

Seven states (including the District of Columbia) reported unique aspects of implementing supported employment. The approach used was similar to that of a case study.

Intervention: 

Individual Placement and Support (IPS) is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice

Control: 

Control conditions varied across the studies. Conditions included Group skills training, enhanced vocational rehabilitation, psychosocial rehabilitation, diversified placement, train-place, sheltered workshop, brokered vocational rehabilitation, and traditional vocational services.

Findings: 

"Diverse strategies were used to augment implementation of supported employment services: a) Instituting state-level administrative procedures and reconfiguration of local staffing to enhance collaboration between mental health and vocational rehabilitation; b) Promoting SE services through the media, online training, and training by early adopters; c) Hiring benefits specialists; d) Teaching outcome-based supervision; and e) Building capacity for supported employment fidelity reviews" (p. 13).

Conclusions: 

"Dissemination of evidenced-based supported employment was enhanced when six states and the District of Columbia addressed special aspects. Supported employment implementation included different pathways to good employment outcomes" (p. 13).

URL: 
http://www.worksupport.com/kter/documents/pdf/CriticalStrategies.pdf
Disabilities: 
Emotional disturbance
Populations: 
Hispanic or Latino
Asian
Black / African American
White / Caucasian
Male & Female
Outcomes: 
Employment acquisition
NIDILRR Funded: 
Not Reported
Research Design: 
Case reports
Peer Reviewed: 
No