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Monday, September 24, 2012

Employment: A Case Study

The Ventura County Star looks at employment issues, focusing on a Camarillo man named Chris Valdez:
Valdez and his parents want more than the sheltered workshops of the past, as do most families in the new generation of autism.
"They want to be out in the community, doing volunteer work and hopefully get a job," said Fred Robinson, CEO of Arc of Ventura County, a nonprofit that has phased out its workshops.
"That's what we're trying to transition our services to reflect, and that's going to take time. It's going to be several years in the making."
Job specialists and advocates blame the high unemployment rates on a spotty transition between school and work, poor worker preparation and some employers' fear of autism.
Communication difficulties, behavioral issues and the tough labor market also are cited.
They also say it's time to speed up change.
With estimates showing as many as 500,000 on the autism spectrum will become adults in the next 10 years, a recent study published by the American Academy of Pediatrics showed they face heavy odds.
In the first six years after high school, 55 percent had held paid jobs, the lowest rate of any disabled group examined in the study. The authors found people with mental retardation were more likely to be employed, at nearly 70 percent
In another study, Julie Lounds Taylor and colleagues reviewed the literature on vocational programs.   As the abstract suggests, uncertainty prevails:
BACKGROUND AND OBJECTIVE: Many individuals with autism spectrum disorders (ASDs) are approaching adolescence and young adulthood; interventions to assist these individuals with vocational skills are not well understood. This study systematically reviewed evidence regarding vocational interventions for individuals with ASD between the ages of 13 and 30 years.

METHODS: The Medline, PsycINFO, and ERIC databases (1980–December 2011) and reference lists of included articles were searched. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes, and assigned overall quality and strength of evidence ratings based on predetermined criteria.

RESULTS: Five studies were identified; all were of poor quality and all focused on on-the-job supports as the employment/vocational intervention. Short-term studies reported that supported employment was associated with improvements in quality of life (1 study), ASD symptoms (1 study), and cognitive functioning (1 study). Three studies reported that interventions increased rates of employment for young adults with ASD.

CONCLUSIONS: Few studies have been conducted to assess vocational interventions for adolescents and young adults with ASD. As such, there is very little evidence available for specific vocational treatment approaches as individuals transition to adulthood. All studies of vocational approaches were of poor quality, which may reflect the recent emergence of this area of research. Individual studies suggest that vocational programs may increase employment success for some; however, our ability to understand the overall benefit of supported employment programs is limited given the existing research.