Autism spectrum disorder (ASD) is a developmental disability that affects how people communicate and process information. People with ASD may have trouble expressing themselves verbally, responding to social cues, or adapting to changing situations. These challenges may make it difficult for youth with ASD to find and keep jobs in the community. Many youth with ASD may benefit from training in job-related social skills, as well as individualized on-the-job support from a job coach to help with behavioral or social challenges. In a recent NIDILRR-funded study, researchers looked at a comprehensive program called Project Search-ASD (PS-ASD), which was specifically designed to help youth with ASD build job skills and gain real-world work experience, combining vocational rehabilitation services with on-the-job supports and employer education. They wanted to find out if the youth participating in this program would have higher employment rates after completing the program compared with youth who did not participate, and whether those differences would hold up over 12 months. They also looked at changes over time in how much support the youth needed before and after participating in the program.
Researchers at the project on Vocational Rehabilitation Service Models for Individuals with Autism Spectrum Disorders (VCU ASD Career Links) enrolled 49 youth in a study between 2009 and 2013. The participating youth all had ASD, were 18-21 years old, and were starting their last year of high school. All of the participants could perform basic activities of daily living, such as feeding and dressing themselves, but had significant academic and support needs related to their ASD. Thirty-one participants were assigned to the PS-ASD program group, while 18 participants were assigned to a comparison group where they received only their regular special education services at school.
The youth in the PS-ASD group received the full PS-ASD program, where they participated in a nine-month internship conducted by special education teachers, university faculty, and staff at a local Vocational Rehabilitation (VR) agency. The participating youth rotated through three internships at a local hospital where they gained work experience while receiving individualized support from a job coach. They also received intensive instruction in social skills needed for the job setting such as interacting with coworkers and customers, accepting feedback, and managing frustration. The instruction was tailored to the learning needs of people with ASD and included hands-on demonstrations and role-playing, as well as positive reinforcement for adaptive behavior. The PS-ASD staff also educated employers and coworkers at the hospital about ASD and how the employers and coworkers could be supportive mentors for the youth interns. As part of the PS-ASD program, the youth also received supported employment (SE) services. SE is an evidence-based VR practice that provides job seekers with assistance in setting job goals and applying for jobs, job training, and continued on-the-job support. The youth received intensive support at first, and the support was reduced gradually over time.
The youth in the comparison group attended their regular high school where they received special education services according to their Individualized Education Plan (IEP). These services typically included academic supports, therapies, and limited vocational training. They also had access to the same VR services as the youth in the PS-ASD group, such as counseling and job coaching.
The researchers looked at how many of the participants in each group (PS-ASD or comparison) had a job when they graduated from high school, how many hours they were working, and how much they earned per hour. They also followed up with the participants again 3 months and 12 months after graduation to look again at employment rates, work hours, and wages. Finally, the researchers conducted interviews with the counselors and job coaches to measure how much one-on-one support each youth needed with employment-related activities at the beginning of the study and at each follow-up time point.
The researchers found that 74% of the youth in the PS-ASD group had part-time jobs when they graduated from high school, often at the same hospital where they interned. They found that 6% of the youth in the comparison group had jobs when they graduated. Three months after graduation, 90% of the youth in the PS-ASD group still had jobs, and by 12 months after graduation, 87% still had jobs. In contrast, 6% of the youth in the comparison group had jobs 3 months after graduation, and 12% had jobs 12 months after graduation.
Among the youth in both groups who had jobs, their wages and weekly hours were similar at first. However, over the 12 months after graduation, the employed youth in the PS-ASD group increased their work hours while the employed youth in the comparison group did not. In addition, both groups had similar needs for employment-related support at the beginning of the study. However, 12 months after graduation, the youth in the PS-ASD group had less need for employment-related supports than they did at the beginning of the study, but there was no change in support needs among the youth in the comparison group.
The authors noted that comprehensive programs like PS-ASD can lead to high employment rates for young people with ASD, even those with significant support needs. The internship experiences, which are a key part of the PS-ASD program, gave the youth opportunities to repeatedly practice important social skills needed to succeed on the job. With these supports, the youth who participated in PS-ASD not only obtained jobs, but retained them and increased their work hours and independence at work over the first 12 months after the program ended. Further, the employers learned to appreciate the value that these young employees with ASD added to their business. State education departments, VR agencies, and Medicaid waiver programs may want to consider internship programs like PS-ASD for youth with ASD that give young people the tools they need to successfully transition from high school to employment.
To Learn More
Research on Project SEARCH with ASD supports continues under a new NIDILRR-funded grant. Learn more about the project and watch webcasts at http://www.worksupport.com/school2work/
The Rehabilitation Research and Training Center on Evidence-Based Practice in Vocational Rehabilitation helps VR counselors, administrators, and educators to understand the importance of research in VR and how to integrate it into their practice to support job seekers with disabilities: http://www.research2vrpractice.org.
Project SEARCH programs are available in many communities in the US and internationally: http://www.projectsearch.us/
To Learn More About this Study
Wehman, P., Schall, C.M., McDonough, J., Graham, C., Brooke, V., Riehle, J.E., Brooke, A., Ham, W., Lau, S., Allen, J., and Avellone, L. (2017) Effects of an employer-based intervention on employment outcomes for youth with significant support needs due to autism. Autism, April 2017. The article is available from the NARIC collection under Accession Number J74348.