Supported employment improves cognitive performance in adults with autism

Authors: García-Villamisar, D., Ross, D., & Wehman, P.
Year Published 2007
Publication Journal of Intellectual Disability Research
Volume 51
Number 2
Pages 142-150
Publisher Blackwell Publishing Ltd

Over the years there has been an increased interest in the vocational rehabilitation of adults with autism. Traditionally, individuals with severe or profound autism attend prevocational centers, sheltered workshops, or day activity enters. Supported employment provides an alternative. In this approach individuals with the most severe disabilities are assisted with gaining and maintaining employment in their communities. Characteristics of supported employment are: paid employment, integrated work setting, and ongoing supports. Services are provided by a job coach and are highly individualized and adaptable to the needs of the person with the disability needs and the employer who hires him.


The purpose of the study was to determine if supported employment could improve the cognitive performance of individuals with autism.
More specific, the researchers wanted to know what types of employment might have such benefits? Does supported employment also improve non-vocational outcomes?


Participants in the supported employment group worked in a variety of community workplaces. This included food services, retail, cattle raising, gardening, industrial laundry and more.


The sample included 44 adults with autism who were in an employment program in Spain. The mean educational attainment for the group was 5 years. The following selection criteria was used: participated in sheltered workshop, no prior supported work services, participation, no severe behavioural problems, acceptable professional and vocational abilities.

Data Collection

Participants memory and executive functions were evaluated at the beginning and at the end of the programme, using a series of neuropsychological tests from the Cambridge Neuropsychological Tests: Automated Battery (CANTAB). These tests were presented on a high-resolution touch-screen monitor under computer control. The battery included two control tasks: Big Circle/Little Circle (BLC), which assesses psychomotor speed, and Spatial Recognition Memory (SRM) and Span Tasks (SST). In addition, executive tasks were measured using: Intradimensional/Extradimensional (ID/ED) attentional set-shifting task; Spatial Working Memory Task; and Tower of
London Planning Task. Other tests included the Trail Making Test, Matching Familiar Figures Test and the Word Fluency Test.
Statistical analyses consisted of a t- test and a series of univariate analyses, comparing supported employment and non-supported employment groups on all demographic, clinical and neuropsychological measures. Between-group and intra-group differences on
neuropsychological variables were examined with repeated measures analysis of variance. All analyses were conducted using the SPSS statistical package 12.0.


The control group was individuals involved in employment or vocational activities in non-working settings.


The study found that adults with autism who work in competitive employment for an extended period of time show a greater rate of improvement in several cognitive variables. It also provided preliminary support for the view that competitive employment causes positive cognitive changes outside the work domain.


Supported employment(competitive work in the community)seems to have a positive impact on the cognitive performance of individuals with autism.

Disabilities Autism Spectrum Disorder
Populations Male & Female
Outcomes Employment acquisition | Return to work
Research Design Randomized Controlled Trials (RCTs)
Peer Reviewed Yes