Placement of Young Adults with Autism Spectrum Disorder into Employment

Posted on March 03, 2011

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Many challenges face teachers and families who serve young adults with disabilities. The transition from school to adulthood is a challenge that is formidable and complex. Given diminished availability of adult services, young adults must be even better prepared than in past years to demonstrate independence and self-direction. The challenge is compounded exponentially when teachers and families are serving a young adult with Autism Spectrum Disorder (ASD). Individuals with ASD are often characterized by limited social skills and adaptability, deficits in attending to relevant stimuli, and non-responsiveness to instructions delivered by adults in authority roles. If accurate, these characteristics significantly limit young adults with ASD in obtaining and maintaining employment, where social skills, adaptability, alertness, and compliance are competencies expected to occur at high standards.

Even the process of identifying a preferred job can be daunting for a young adult with ASD. Some individuals with ASD have not achieved reading levels necessary to access and process information found in career education and job preference programs, such as www.UtahFutures.org. Reading-free assessments, such as line-drawing instruments (e.g., Reading-Free Vocational Interest Inventory-Revised) and video-based job preference instruments (www.yesjobsearch.com) may help the young adult with ASD to determine preferred employment.

At Utah State University, a new “booster-shot” effort has been developed to successfully place young adults with ASD into employment using research-based procedures (Hendricks & Wehman, 2009; Wehman, Smith, & Schall, 2009). To establish the infrastructure for the effort, a commitment must be established among all relevant stakeholders, including the transition teacher, parents and family, vocational rehabilitation counselor, district related-services specialists, volunteers, and others. The bottom line is that to achieve the most optimal outcome at graduation it may take more than the traditional process; considerably greater effort and coordination will be required of stakeholders and the young adult with ASD. Annual IEP meetings may serve as the minimum requirement, but the team may need to meet more frequently. If the burden seems extreme, the increased probability of success makes it well worth the effort.

The model is similar to the person-centered planning paradigm described by O’Brien (1997).  Much like O’Brien’s original conceptualization of person-centered planning as a community of practice, all stakeholders play active roles and check in periodically to show that they have carried out assignments leading to the goal.  However, it is distinct from person-centered planning in four ways. First, the focus is on achieving supported, and eventually, competitive employment as the best hedge against an adulthood hoping to rely on social services. When employment planning is well under way, other important adult life pathways, such as postsecondary education, recreation and leisure, and social opportunities, are explored. Second, from the outset, individual preference for employment guides job development, training, and placement activities. Assessment first identifies the individual’s preferences for employment, and second, the preferred job that is best matched to current skills. This may be a challenge as it makes the development of situational assessments and work experiences in the community an individualized process as well. Group or rotating work experiences, while helpful, may not be addressing the preferred job. Employment success increases in proportion to the match between the actual job and preferred job. Third, all activities related to achieving employment must show empirical evidence for efficacy (Wehman et al., 2009). Fourth, all activities are adapted given data collection on their effectiveness. Ineffective practices are scrapped, while  effective ones are maintained. As independence on a job grows, supports by an employment specialist (i.e. job coach) are systematically faded as natural supports are developed in the work environment. Implementation and monitoring steps are described below.

1. At least 4 years prior to exit from school (i.e., either high school graduation or at age 22 following in post-high school special education services), prosocial behavior and social skills are targeted. Behavior and social skill targets are identified from assessments, then goals are set, interventions are implemented, and progress is monitored. Given evidence of improved behavior, responsibility is gradually transferred to the young adult.

2. At least 2 years prior to exit from school, job preference and matching assessments are initiated. Preference assessments and information on specific careers are available at www.utahfutures.org and  www.yesjobsearch.com.

3. Given identification of strengths and weaknesses from a job matching assessment, two activities commence. First, weaknesses on preferred jobs are targeted for training or accommodation. Second, consistent with the Individuals with Disabilities Education Act (IDEA), the vocational rehabilitation counselor attends transition team meetings. The rehabilitation counselor can forecast job prospects, identify needed services, and provide advice to the youth and the transition team.

4. At about 1 year prior to exit from school, the transition teacher, parent, or vocational rehabilitation counselor contact individuals identified from the young adult’s social network (i.e., who you know and who they know) to get ideas about employment sites where the individual’s preferred/best matched job exists along with co-workers who will be available to provide ongoing supports. Given that eligibility is established and a rehabilitation case file is opened, the vocational rehabilitation counselor identifies long-term support services, such as those from a supported employment agency, and/or short-term services, such as vocational rehabilitation.

5. One job that is considered most preferred, best matched, and most supported is then designated for job development. Team members coordinate job development procedures (e.g., contacting employers, scheduling interviews, etc.).

6. Once job placement is secured, the transition team continues to communicate with each other. It is helpful if the employer and interested co-workers become active members of the transition team. The vocational rehabilitation counselor may contact the transition teacher if new skills need to be taught or if problem behaviors arise.

7. If special education services for the young adult are soon to expire, the team explores educational opportunities to support the employment for the individual with ASD (e.g., universal design courses at an applied technology college or community college). Additionally, training should be explored for employers and co-workers of the new employee.  Local university faculty or representatives from ASD support groups may be available to support employers and co-workers.

8. If long-term supported employment services are necessary, the transition teacher or vocational rehabilitation counselor make efforts to obtain a well-trained job coach. As the new employee becomes more proficient in carrying out job tasks, coaching supports are systematically faded until the employee performs them independently (Wehman & Moon, 1988).

9. Data are generated on job performance and are reviewed by the team at least once a month to identify adjustments in skill training or services required.

10. Concurrent with job placement, the team develops back-up plans in case the employee or employer becomes dissatisfied or a new direction is required.  Back-up plans keep stakeholders postured in a proactive way ready to implement alternatives.

One case is described here to illustrate how components of the model have been implemented. Grant is a 19-year-old youth with ASD who attends a local post-high school special education program. His teacher, Ms. Markovic, coordinates Grant’s Individualized Education Program with transition services. Grant’s parents, Mr. and Mrs. Oldham, are concerned about the future of their son and their family. Like many parents, they have multiple responsibilities and a limited budget. Grant, who was diagnosed with ASD at the age of two years, functions in the moderate range of intellectual disabilities. Strengths include visual and gross and fine-motor skills. Weaknesses include expressive language and social skills. Grant responds to others by verbalizing in one-to-four word phrases but does not initiate with others. Occasionally, he engages in loud outbursts when presented with high-demand tasks (yelling “I hate you!”). When he engages in outbursts, adults redirect him to the task.

The IEP team discussed Grant’s future, particularly his career prospects. The parents expressed concern about whether Grant would ever be responsible for himself. The team decided to focus on social and behavioral intervention, especially outbursts and asking for help when confronted with challenging tasks.

The Vocational Rehabilitation Counselor, Mr. Ramirez, opened a case file with the Oldhams. Mr. Ramirez worked with Grant on the job preference assessment. Grant’s mother filled out the job matching assessment. Grant’s highest preference and best-matched job was screen process printer. Although this job was the best-matched one, the job matching assessment revealed weaknesses in production rate and social skills. Ms. Markovic shared these results with the team.

A neighbor of the Oldham’s reported knowing the manager of a local graphics firm with screen process printing. Mr. Ramirez contacted the manager who indicated he needed someone to  “reclaim screens,” i.e., apply solutions and spray screens until they were clean using a power-washer. Ms. Markovic changed Grant’s post-high school schedule to accommodate 8 hours per week at the graphics firm for job training.

The local vocational rehabilitation agency hired a university student as a job coach. The job coach conducted situational assessments at the job site to determine how Grant performed tasks. After two sessions, verbal outbursts began occurring at the site. Ms. Markovic developed a behavior intervention to decrease outbursts and “replace” them with requests for a brief break (e.g., “break please”). Prior to intervention, outbursts occurred at the mean rate of 3.4 occurrences across eight, 2-hour sessions. The intervention called for replacing the outbursts by teaching socially and environmentally appropriate behaviors (e.g., asking for help or for a brief break). Procedures called for one bonus dollar to be awarded at home by the parents for zero outbursts at the end of each 2-hour session. Outbursts decreased to one occurrence in 12 sessions (0.08 occurrences per session).

The manager agreed to hire Grant at minimum wage for 8 hours per week, assuming short-term support from the job coach and continuation of the behavior intervention to decrease outbursts. The job coach collected data on three targets: (a) time (duration) required to wash screens, (b) steps of the cleaning task that were performed independently, and (c) number of verbal outbursts per session. Across 21 work sessions, Grant made progress, decreasing the time to clean a screen from 3 minutes to below the company standard (45 seconds per screen). Independence on cleaning steps was scored only if Grant performed a step without any assistance and within a time limit.  Any verbal, gestural, or other prompt from the job coach was scored as not independent. The job coach calculated independent steps divided by total steps times 100. Grant initially performed most steps with prompts (only 12% to 33% independent), but later performed steps independently (100% for five consecutive sessions). Job coach support is now being faded, and soon, the employer will assume full responsibility. Parents indicate they are very pleased. The employer is satisfied because a significant company need has been met and considers Grant “one of our people.”

Grant’s example illustrates how stakeholders can successfully achieve employment for a young adult with significant disabilities. The vocational rehabilitation counselor and post-high school teacher enlisted the active involvement of Grant and others in a goal-directed effort aimed at employment. Although cost and time intensive, the case exemplifies how successful employment can be attained for young adults with ASD through a well-organized and individualized process.

Authors: Robert L. Morgan, Jared C. Schultz, and Joel Johnson, Department of Special Education and Rehabilitation, Utah State University