Reducing the need for personal supports among workers with autism using and iPod Touch as an assistive technology: Delayed randomized control trial | Knowledge Translation for Employment Research Center

Authors:	Gentry, T., Lau, S., Molinelli, A., Fallen, A., & Kriner, R.
Year Published	2014
Publication	Journal of Autism and Developmental Disorders
Volume	45
Number	3
Pages	668-684
Publisher	Springer Science+Business Media
Background	Adults with autism have typically not been considered suitable candidates for employment in the workforce. This is despite a multitude of information on employment of people with severe disabilities and published examples of how individuals with autism have successfully gained and maintained work in their communities using supported employment. People with autism remains underrepresented in supported employment programs. There is little research that focuses on analysis of differential efficacy between various employment modalities (ie. supported employment versus sheltered work).
Purpose	The purpose of the study was to determine if the use of an Apple iPod Touch, as trained by an occupational therapist, would significantly reduce the need for personal supports in performing job duties and building competence on the job. The examiners hypothesized that the group that received the device and training prior to employment would require fewer job coaching support hours than the other group who received it and training 12 weeks later.
Setting	The study took place in various types of work settings where each individual with ASD was employed.
Sample	The study sample included 50 individuals with ASD who were clients of the state's vocational rehabilitation program. Most were males (84%) and ranged in age from 18 to 60 years. Most lived at home (86%) and the majority or (68%) had conversant skills. Half were assigned to the "now" group. These are the people who received the AT and training prior to going to work. The remainder were assigned to the "delayed" group and received the same 12 weeks after their job placement.
Data Collection	An initial assessment was conducted using a demographic survey and CHART (Craig Handicap Assessment and Rating Technique) review. The job coach completed the Supports Intensity Scale Employment Subscale and the Employee Performance Evaluation Report (EPER) at pre-scheduled intervals. The EPER was used as a dependent measure of job performance. Data was collected on hours worked, job coach hours worked (only face to face or telephonic support), support needs and work performance across 24 weeks. The OT collected intervention data that included notes and hours. of AT training, follow along and more. Participants were also interviewed at the close of the study.
Control	The control was business as usual. The delayed group received job coach services.
Findings	Training in the use of a PDA reduced job coaching among all participants. However, starting sooner was more effective. The reduction in the job coach hours was great enough to set off the cost of the AT intervention which means a potential cost saving for state vocational rehabilitation.
Conclusions	The study support previous research into the use of mobile devices as vocational support aides. The HAAT model appears to be a sound one to provide this type of intervention. More research is needed as this type of AT continues to evolves. This study show that a mobile device can offer cost effective support and may improve employment outcomes for individuals with ASD. Research should also explore how devices may impact career development too. Research is also needed to develop applications and support users with varied abilities.
URL	http://www.ncbi.nlm.nih.gov/pubmed/25212414
Disabilities	Autism Spectrum Disorder
Populations	Male & Female
Outcomes	Other
NIDILRR Funded	Yes
Research Design	Randomized Controlled Trials (RCTs)
Peer Reviewed	Yes

Year Published

2014

Publication

Journal of Autism and Developmental Disorders

Volume

45

Number

3

Pages

668-684

Publisher

Springer Science+Business Media

Background

Adults with autism have typically not been considered suitable candidates for employment in the workforce. This is despite a multitude of information on employment of people with severe disabilities and published examples of how individuals with autism have successfully gained and maintained work in their communities using supported employment. People with autism remains underrepresented in supported employment programs. There is little research that focuses on analysis of differential efficacy between various employment modalities (ie. supported employment versus sheltered work).

Purpose

The purpose of the study was to determine if the use of an Apple iPod Touch, as trained by an occupational therapist, would significantly reduce the need for personal supports in performing job duties and building competence on the job. The examiners hypothesized that the group that received the device and training prior to employment would require fewer job coaching support hours than the other group who received it and training 12 weeks later.

Setting

The study took place in various types of work settings where each individual with ASD was employed.

Sample

The study sample included 50 individuals with ASD who were clients of the state's vocational rehabilitation program. Most were males (84%) and ranged in age from 18 to 60 years. Most lived at home (86%) and the majority or (68%) had conversant skills.
Half were assigned to the "now" group. These are the people who received the AT and training prior to going to work. The remainder were assigned to the "delayed" group and received the same 12 weeks after their job placement.

Data Collection

An initial assessment was conducted using a demographic survey and CHART (Craig Handicap Assessment and Rating Technique) review.
The job coach completed the Supports Intensity Scale Employment Subscale and the Employee Performance Evaluation Report (EPER) at pre-scheduled intervals. The EPER was used as a dependent measure of job performance. Data was collected on hours worked, job coach hours worked (only face to face or telephonic support), support needs and work performance across 24 weeks. The OT collected intervention data that included notes and hours. of AT training, follow along and more. Participants were also interviewed at the close of the study.

Control

The control was business as usual. The delayed group received job coach services.

Findings

Training in the use of a PDA reduced job coaching among all participants. However, starting sooner was more effective. The reduction in the job coach hours was great enough to set off the cost of the AT intervention which means a potential cost saving for state vocational rehabilitation.

Conclusions

The study support previous research into the use of mobile devices as vocational support aides. The HAAT model appears to be a sound one to provide this type of intervention. More research is needed as this type of AT continues to evolves. This study show that a mobile device can offer cost effective support and may improve employment outcomes for individuals with ASD. Research should also explore how devices may impact career development too. Research is also needed to develop applications and support users with varied abilities.

URL

http://www.ncbi.nlm.nih.gov/pubmed/25212414

Disabilities

Autism Spectrum Disorder

Populations

Male & Female

Outcomes

Other

NIDILRR Funded

Yes

Research Design

Randomized Controlled Trials (RCTs)

Peer Reviewed

Yes