Jobs 4 Autties

Do Job Programs for Autistic Adults Help?

 

By Amy Norton

NEW YORK | Mon Aug 27, 2012 2:41pm EDT

(Reuters Health) – Programs are out there to help young adults with autism find and keep a job. But no one yet knows whether they work, according to a study published Monday.

Combing the medical literature for evidence on the question, researchers were able to find only five studies. All were generally low-quality, the team reports in the journal Pediatrics.

“We did identify some small studies with promising results,” said lead researcher Julie Lounds Taylor, an assistant professor of pediatrics and special education at Vanderbilt University in Nashville, Tennessee.

But the studies were not well-designed enough to draw conclusions, according to Taylor.

“Even though there are vocational services out there, they haven’t been rigorously studied,” Taylor said.

She stressed, though, that the findings do not mean the programs don’t work – just that better studies are needed.

An autism researcher not involved in the new report agreed.

“I think this is more a critique of the research community, not the programs themselves,” said Paul Shattuck, an assistant professor at Washington University in St. Louis.

Why have there been so few studies, and no high-quality ones?

Both Taylor and Shattuck said that in autism, the research focus has historically been on children.

“But children with autism grow up,” Taylor pointed out. “We have startlingly little evidence on how to help adults.”In the U.S., it’s estimated that about one in 88 children has an autism spectrum disorder, or ASD.

That’s up 78 percent from a decade ago – which health officials attribute to better diagnosis as well as broader definitions of what constitutes an ASD.

ASDs are a group of developmental brain disorders that hinder a person’s ability to communicate and interact socially – ranging from the severe cases of “classic” autism to the relatively mild form called Asperger’s syndrome.

The five studies in the new review came from the U.S., UK, Spain and Germany. The U.S. study was the largest, looking at 1,700 autistic adults nationwide who took part in “vocational rehabilitation” services.

Most U.S. states have such services, which help people with disabilities – physical or mental – find a job and stay employed. That may include so-called on-the-job supports, when the agency works with an employer to get disabled workers the kind of training, accommodations or other forms of support they need.

Private organizations also offer people with autism help with finding and keeping a job. But the extent of what’s available to families varies widely depending on where they live, Taylor said.

The U.S. study in her review found that autistic adults who took part in vocational rehab were as successful in finding a job as people with other developmental disabilities.

Overall, 42 percent ended up “competitively” employed, compared with 39 percent of people with mental retardation, for example.

The other studies were smaller. A UK study of 30 young adults in a work program found that 19 got paying jobs, versus five of 20 young people not in the program. Of the 19 in the program with jobs 13 were still employed seven to eight years later.

But all of the studies had limits, Taylor’s team says. None of them, for instance, randomly assigned people to a vocational program or a comparison group; that type of study is considered the “gold standard” in proving that an intervention works.

Furthermore, a job program that helps one person with an ASD may not work for another person, Taylor pointed out.

“Adults with autism are a broad group,” she said. So studies should be done to see what types of services are best for different people.

Although the evidence is “thin” on work programs for people with autism, that doesn’t mean families should not try them, Shattuck said.

“We can’t say none of these things work.”

According to Shattuck, the progress that’s been made in understanding autism in recent years has come from the efforts of parents and advocacy groups. And “innovations” in work programs are coming from the community, too, he said.

As an example, Shattuck pointed to the drugstore chain Walgreens. The company redesigned the work process at some of its regional distribution centers to make it easier for all employees, and began hiring more and more people with autism or other disabilities. The idea came from a Walgreens executive whose son has autism.

Still, when it comes to higher education and jobs, young people with autism seem to be lagging even their peers with other types of developmental disabilities.

In a recent study, Shattuck found that of 680 young U.S. adults with an ASD, 35 percent had not gone to school or held a job since high school. That compared with one-quarter of young people with mental retardation, and only seven percent of those with speech or language impairments.

.http://www.reuters.com/article/2012/08/27/us-job-programs-autistic-idUSBRE87Q0Z820120827.

Many Youths with Autism Not Employed or In College 2 Years After High School .

National Institute of Mental Health
Science Update • July 20, 2012

Young adults with autism spectrum disorder (ASD) are less likely to have a job or be enrolled in any type of postsecondary education when compared to peers with a speech/learning impairment or learning disability, according to a study partially funded by NIMH. Published in the June issue ofPediatrics, the findings emphasize the need to improve transition planning for students with ASD before they leave high school.

Background

Past studies on post-high school activities of youths with ASD were limited by having relatively few participants, lacking adequate diversity in the study population, or studying a narrow set of outcomes. As a result, it was unclear if those studies gave accurate descriptions of the ASD youth population as a whole, and if so, how broadly any findings could be applied.

Using nationally representative data from the National Longitudinal Transition Study-2, Paul Shattuck, Ph.D., of Washington University, and colleagues assessed the activities of about 1,900 youths identified as having autism, speech/language impairment, learning disability, or mental retardation between the years 2007-2008. Data were provided by the youths’ parents or guardians or from the youths themselves if they were able to understand and answer the survey questions.

All participants had previously received special education services and were no longer in high school.

Results of the Study

Compared to youths in other disability categories, those with ASD were less likely to have a job after high school. Youths with ASD were also less likely to be enrolled in any type of schooling than youths with speech/learning impairment or learning disability, but more likely than youths with mental retardation.

In the first 2 years after leaving high school, youths with ASD were at significant risk of being completely disengaged, meaning to not be employed or in any postsecondary education.

The participation rates, with rounded percentages, are summarized in the table below:

 

 

Disability Category

Youth is involved in…

ASD

Speech/Learning
Impairment

Learning
Disability

Mental
Retardation

Any 2- or 4-year college*

35

51

40

18

Any paid employment

55

86

94

69

No education or
employment

35

7

3

2

*Additional data on youths’ participation in vocational or technical education showed a similar distribution.

Youths from low-income families were much more likely to become disengaged, regardless of the severity of their disability. More impaired youths were also at greater risk of disengagement.

Significance

The results indicate that young adults with ASD experience unique challenges in finding work or enrolling in appropriate educational opportunities after leaving high school. In a related paper, also partially supported by NIMH funding, Dr. Shattuck noted that “the evidence base on services for adults with ASD is inadequate for informing policy and program decisions to meet the needs of this growing population.”

In this context, the researchers emphasized the need to improve transition planning for youths with ASD or other special education needs as they prepare to leave high school.

What’s Next

According to the researchers, as more and more children are diagnosed with ASD, the demand for specialized adult services, jobs, and education will also continue to grow. Supporting targeted initiatives such as JobTIPS and further research on how to reduce or prevent disengagement will help inform efforts to better serve this population.

References

Shattuck PT, Narendorf SC, Cooper B, Sterzing PR, Wagner M, Taylor JL. Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder. Pediatrics. 2012 Jun;129(6):1042-9. Epub 2012 May 14. PubMed PMID: 22585766; PubMed Central PMCID: PMC3362908.

Shattuck PT, Roux AM, Hudson LE, Taylor JL, Maenner MJ, Trani JF. Services for adults with an autism spectrum disorder. Can J Psychiatry. 2012 May;57(5):284-91. PubMed PMID: 22546060.

Related funding: R01-MH086489

http://www.nimh.nih.gov/science-news/2012/many-youths-with-autism-not-employed-or-in-college-2-years-after-high-school.shtm


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