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Sunday, August 5, 2018

Autism and Employment: The Research

In The Politics of Autism, I discuss the employment of adults with autism and other disabilitiesMany posts have discussed programs to provide them with training and experience.

Melissa Scott and colleagues have an article at Autism titled "Factors Impacting Employment for People with Autism Spectrum Disorder: A Scoping Review."

The lay abstract:
Adults with Autism Spectrum Disorder (ASD) possess unique strengths and abilities. Despite increasing recognition of the potential contribution that individuals with ASD can make in the workplace, they continue to experience challenges in finding and maintaining a job. This review examined the factors relating to the employment of individuals with ASD. Database searches were conducted. Studies describing adults with ASD employed in competitive, supported or sheltered employment were included. A technique called content analysis was used to identify the strengths and abilities in the workplace of employees with ASD. Lastly, meaningful concepts relating to employment interventions were linked to the International Classification of Functioning, Disability and Health (ICF) Cores Sets for ASD (these are a way of categorising and describing how individuals with ASD function across the lifespan). The search identified 134 studies for inclusion. Of these studies, only 14 explored the strengths and abilities of individuals with ASD in the workplace including attention to detail, high quality of work and a strong sense of morality. Thirty-six studies evaluated employment interventions for adults with ASD, with a focus on modifying ASD characteristics for improved job performance, with little consideration of the impact of environmental factors on work participation. The ICF Core Sets for ASD were found to be a useful tool in holistically examining the employment literature. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with ASD and the critical need for interventions to target both personal and environmental factors if employment outcomes are to be improved.
From the article:
To date, ASD research has largely focussed on diagnosis and early intervention services for children, and as confirmed by the findings of the current review, a paucity of literature has focussed on examining the relative effectiveness of interventions in adulthood (Hedley et al., 2016; Howlin et al., 2015; Schall et al., 2015). Of the 134 employment studies identified for inclusion in this review, only 36 were intervention based. While these interventions studies had the stated collective purpose of improving employment outcomes, they were primarily impairment-focussed, targeting their interventions at intrinsic individual ASD characteristics, with little consideration of contextual influences. Interventions targeted ASD traits commonly associated with difficulties in finding and obtaining a job, such as executive functioning skills in relation to problem-solving, organisation, task management and behaviour regulation and social-communication skills required in interviews and workplace interactions (American Psychiatric Association, 2013; Hendricks, 2010; Müller et al., 2003). While many of these interventions were effective in increasing measured vocational and executive functioning skills, many participants continued to remain unemployed. The continuing high rates of unemployment among participants following these interventions suggest that impairment-focussed interventions alone are not sufficient in achieving and maintaining successful work-related outcomes for individuals with ASD (Ellenkamp et al., 2016). 
  • American Psychiatric Association (2013) Diagnostic andStatistical Manual of Mental Disorders. 5th ed. Text revision.Arlington, VA: American Psychiatric Publishing.
  • Ellenkamp J, Brouwers E, Embregts P, et al. (2016) Work environment-relatedf actors in obtaining and maintaining work in a competitive employment setting for employees with intellectual disabilities: a systematic review. Journal ofOccupational Rehabilitation 26: 56–69
  • Hedley D, Uljarevic M, Cameron L, et al. (2016) Employment programmes and interventions targeting adults with autismspectrum disorder: a systematic review. Autism 1: 13. 
  • Hendricks D (2010) Employment and adults with autism spectrum disorders: challenges and strategies for success.Journal of Vocational Rehabilitation 32: 125–134.
  • Howlin P, Arciuli J, Begeer S, et al. (2015) Research on adults with autism spectrum disorder: roundtable report. Journalof Intellectual & Developmental Disability 40: 388–393.
  • Müller E, Schuler A, Burton BA, et al. (2003) Meeting the vocational support needs of individuals with Asperger syndrome and other autsim spectrum disabilities. Journal of Vocational Rehabilitation 18: 163–175.
  • Schall CM, Wehman P, Brooke V, et al. (2015) Employment interventions for individuals with ASD: the relative efficacy of supported employment with or without prior project SEARCH training. Journal of Autism and Developmental Disorders 45: 3990–4001