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Chan DV, Doran JD. Mental health counseling is rated as most helpful by autistic adults: Service perspectives in adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1190-1202. [PMID: 37679948 PMCID: PMC10918044 DOI: 10.1177/13623613231197446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
LAY ABSTRACT The number of autistic adults is growing, but there are fewer services to support them in adulthood. Many autistic adults need some support services to lead successful adult lives. We know a lot about the services autistic adults use and some of the problems with using these services, but we do not know which services are most helpful to them and how the services they use relate to how they interact with their communities. Forty autistic adults took part in a study about service use and community participation. They completed surveys, interviews, and carried a global positioning system tracker. They answered questions about which services are most helpful in adulthood, things that make it hard to use services, and what services they needed. Most participants used two services in the past 2 years, most frequently mental health and employment services. Adults who were currently seeing a mental health counselor were more likely to be working full-time and visit more locations in the community compared to those who were not seeing a counselor. Mental health services were reported as the most helpful service they received as adults, followed by employment services. We often focus on the importance of employment services after high school, but our findings show a need for both mental health and employment services for autistic adults.
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Affiliation(s)
- Dara V Chan
- University of North Carolina at Chapel Hill, USA
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Davies J, Romualdez AM, Pellicano E, Remington A. Career progression for autistic people: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241236110. [PMID: 38477466 DOI: 10.1177/13623613241236110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
LAY ABSTRACT Lots of autistic people are unemployed. Even when they are employed, autistic people might be given fewer opportunities than non-autistic people to progress in their careers. For example, assumptions about autistic people's differences in social communication might mean they are not given as many promotions. Indeed, we know that many autistic people are in jobs lower than their abilities (known as 'underemployment'). We reviewed 33 studies that tell us something about career progression for autistic people. Our review found that lots of autistic people want to progress in their careers, but there are many barriers in their way. For example, when they told their employer about being autistic, some people were given fewer opportunities. Research has also shown that autistic people do not get enough support to progress and that gaps in their employment history can make it difficult to progress. Our review suggested that good employment support (e.g. mentors) might help autistic people to progress in their careers. However, not much research has evaluated employment support for autistic people, which means we do not know how useful it is. Future research should find the best support that allows autistic people to live and work in ways that are meaningful to them.
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Affiliation(s)
- Jade Davies
- Centre for Research in Autism and Education (CRAE), Department of Psychology and Human Development, IOE, UCL's Faculty of Education and Society, UK
| | - Anna Melissa Romualdez
- Centre for Research in Autism and Education (CRAE), Department of Psychology and Human Development, IOE, UCL's Faculty of Education and Society, UK
| | | | - Anna Remington
- Centre for Research in Autism and Education (CRAE), Department of Psychology and Human Development, IOE, UCL's Faculty of Education and Society, UK
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Solomon M, Hernandez JAY, Ruder S, Bothra S, Gonzales C, Kecskemeti K, Takarae Y. Commentary: The challenges and promises of competitively employing autistic adults in the United States. Autism Res 2023; 16:2054-2060. [PMID: 37668324 DOI: 10.1002/aur.3009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
Current United States statistics suggest that autistic individuals will experience high unemployment and underemployment rates throughout their lives. Furthermore, despite the passage of federal legislation to employ young autistic adults in competitive integrated settings, where they work alongside non-disabled workers and earn at least minimum wage, most individuals receiving state services still are placed in day programs or sheltered workshops. Since meaningful employment is the most important determinant of life satisfaction, this failure is a critical societal problem, exerting increasing pressure for systems change. But the news is not all bad. Private sector companies have increased their hiring of disabled workers, producing a growing base of expertise in the recruitment, on-boarding, training, and management of autistic employees. This has led to a growing recognition that autistic individuals can be ideal workers. Autism researchers have advanced the field by investigating these private industry programs as well as conducting efficacy trials of interventions and services that help autistic individuals in the workplace. However, gaps in knowledge persist stemming from the heterogeneity of autistic workers, limited knowledge about those not receiving state services, and a system of federal services that is fragmented, poorly coordinated, difficult to navigate, and over-taxed. Autism researchers can continue to improve outcomes of autistic workers through investigations of the fit between autistic workers, their preferences, and the characteristics of available jobs, and through effectiveness trails of promising employment interventions and services that promote systems change that help break down the barriers to better integration of existing state services and resources in the United States.
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Jo Ann Yon Hernandez
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Steve Ruder
- Center for Excellence in Developmental Disabilities, MIND Institute, University of California, Sacramento, California, USA
| | - Surina Bothra
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Catherine Gonzales
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Kali Kecskemeti
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Yukari Takarae
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
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Adams WE, Rogers ES, McKnight L, Lynde D. Examination of Adaptations to the Evidence Based Supported Employment Model: Individual Placement and Support. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01267-w. [PMID: 37162603 DOI: 10.1007/s10488-023-01267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/11/2023]
Abstract
Individual Placement and Support (IPS) is a long-standing and innovative employment service for individuals with mental illness with dozens of clinical trials demonstrating effectiveness. Little is known, however, about intentional adaptations to IPS, especially those outside of the context of research studies. Using an implementation science framework, we conducted an exploratory study to better understand the characteristics of stakeholder-reported adaptions to IPS, the impetus for their development, and perceived impacts. We conducted qualitative interviews to analyze and describe these adaptations. Numerous adaptations of IPS were found that address the needs of new and underserved populations both within and outside of the mental health field. Programs reported adapting IPS because of the dearth of other evidence-based employment services, to serve diverse populations in need, and based on financial incentives. Benefits of adaptations were weighed against impacts on fidelity. As evidence-based practices (EBPs) are adapted, developers of EBPs should determine how fidelity of a program or service can be assessed or preserved in light of adaptations. This is critical with the increase in different service delivery methods, new populations, new service recipient needs, and new settings in need of EBPs.
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Affiliation(s)
- Wallis E Adams
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
- Department of Sociology, California State University, East Bay, Hayward, USA
| | - E Sally Rogers
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Lauren McKnight
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
| | - David Lynde
- Independent Mental Health Consultant, Concord, NH, USA
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Walker-Bone K, Fraser SDS, Price C, Maguire N, Cooper C, Madan I, Ntani G, Linaker CL. A pilot trial investigating the feasibility of a future randomised controlled trial of Individualised Placement and Support for people unemployed with chronic pain recruiting in primary care. Prim Health Care Res Dev 2022; 23:e39. [PMID: 35866327 PMCID: PMC9309751 DOI: 10.1017/s1463423622000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/18/2022] [Accepted: 05/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND We investigated the feasibility of recruiting patients unemployed for more than 3 months with chronic pain using a range of methods in primary care in order to conduct a pilot trial of Individual Placement and Support (IPS) to improve quality of life outcomes for people with chronic pain. METHODS This research was informed by people with chronic pain. We assessed the feasibility of identification and recruitment of unemployed patients; the training and support needs of employment support workers to integrate with pain services; acceptability of randomisation, retention through follow-up and appropriate outcome measures for a definitive trial. Participants randomised to IPS received integrated support from an employment support worker and a pain occupational therapist to prepare for, and take up, a work placement. Those randomised to Treatment as Usual (TAU) received a bespoke workbook, delivered at an appointment with a research nurse not trained in vocational rehabilitation. RESULTS Using a range of approaches, recruitment through primary care was difficult and resource-intensive (1028 approached to recruit 37 eligible participants). Supplementing recruitment through pain services, another 13 people were recruited (total n = 50). Randomisation to both arms was acceptable: 22 were allocated to IPS and 28 to TAU. Recruited participants were generally not 'work ready', particularly if recruited through pain services. CONCLUSION A definitive randomised controlled trial is not currently feasible for recruiting through primary care in the UK. Although a trial recruiting through pain services might be possible, participants could be unrepresentative in levels of disability and associated health complexities. Retention of participants over 12 months proved challenging, and methods for reducing attrition are required. The intervention has been manualised.
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Affiliation(s)
- Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Simon DS Fraser
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Cathy Price
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
| | - Nick Maguire
- Department of Psychology, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Ira Madan
- Occupational Health Service, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- King’s College London Faculty of Life Sciences and Medicine, London, UK
| | - Georgia Ntani
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Cathy L Linaker
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
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Sharek D, Lally N, Brennan C, Higgins A. "These are people just like us who can work": Overcoming clinical resistance and shifting views in the implementation of Individual Placement and Support (IPS). ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:848-860. [PMID: 35793011 PMCID: PMC9393135 DOI: 10.1007/s10488-022-01204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/25/2022] [Indexed: 12/02/2022]
Abstract
Purpose Individual Placement and Support (IPS) is a recovery-based approach to support people with mental health difficulties back into employment. Embedding of IPS within the mental health Multi-Disciplinary Team (MDT) is a key component of IPS fidelity; however, few studies have examined how those involved with IPS implementation navigate this process. This article explores how IPS Employment Specialists (ES) and Occupational Therapist (OT) Managers integrated and embedded IPS within traditionally-oriented MDTs as part of a national reform program in the Republic of Ireland. Methods The study design was qualitative, descriptive with data collected through three focus groups with 17 IPS ESs and 11 OT Managers. Data were analyzed using thematic synthesis. Results Three key themes emerged from analysis. The first characterizes the context into which IPS landed, described as one marked by clinical resistance, doubt, and fear of risk. The second explores the strategies and factors that helped with the introduction of IPS into Irish mental health services. These included strategies, such as providing education and information about IPS and reassuring the MDT about IPS governance and IPS ES’ competencies. The evidenced-based nature of IPS and its attached accountabilities through IPS fidelity measures were perceived to be an important factor in its acceptance. The final theme encapsulates perceptions of how IPS impacted on the MDTs’ views of people with mental health difficulties. Findings suggest a shift in the ways in which MDTs view their clients. Initial fears about work capacity and risk shifted towards seeing people beyond the label of ‘service user’ and their diagnosis. Conclusions It is contended that IPS is an approach that allows practitioners to engage with real recovery-practice and may be one key to unlocking how a recovery approach can truly trickle down and embed itself within mental health service provision and support mental health system reform.
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Affiliation(s)
| | - Niamh Lally
- Centre for Social Innovation, Trinity Business School, Trinity College, Dublin, Ireland.
| | | | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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7
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Metcalfe JD, Drake RE. Participation in Individual Placement and Support in the Supported Employment Demonstration. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:521-529. [PMID: 34855098 DOI: 10.1007/s10488-021-01180-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
Individual placement and support (IPS) was the primary intervention in the United States Social Security Administration's supported employment demonstration (SED), a large randomized trial that sought to increase employment and reduce disability among those whose first application for disability benefits was denied. Researchers developed a measure of participation in IPS services to quantify participation among enrollees assigned to receive IPS. The IPS participation measure, which IPS teams completed monthly for individual clients, recorded clients assigned to IPS as being either out of contact with their IPS treatment teams or, if in contact, according to their employment status (employed or not employed) and receipt of IPS job search services (participating or not participating). The measure also recorded types of IPS activities and reasons for non-participation. IPS teams completed the IPS participation measure at a rate of approximately 95% each month. Between 27 and 35% of enrollees assigned to a treatment condition participated in IPS services each month during the first 24 months of measurement. The most common activities were applying for jobs and attending job interviews. Most of those out of contact were not responding to outreach efforts (58-72%). Those in contact but not participating despite being unemployed were typically either uninterested in employment (20-44%) or difficult to reach (10-16%). As IPS expands to serve new populations, it will be important to document and understand the links between individual characteristics, variance in participation patterns, and employment outcomes. Subsequent analyses of SED data will investigate these relationships among enrollees.
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Affiliation(s)
- Justin D Metcalfe
- Westat Inc, 85 Mechanic Street, Suite C3-1, Box4A, Lebanon, NH, 03766, USA.
| | - Robert E Drake
- Westat Inc, 85 Mechanic Street, Suite C3-1, Box4A, Lebanon, NH, 03766, USA
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Weld-Blundell I, Shields M, Devine A, Dickinson H, Kavanagh A, Marck C. Vocational Interventions to Improve Employment Participation of People with Psychosocial Disability, Autism and/or Intellectual Disability: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212083. [PMID: 34831840 PMCID: PMC8618542 DOI: 10.3390/ijerph182212083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
Objective: To systematically review interventions aimed at improving employment participation of people with psychosocial disability, autism, and intellectual disability. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Science, Scopus, CINAHL, ERIC, and ERC for studies published from 2010 to July 2020. Randomized controlled trials (RCTs) of interventions aimed at increasing participation in open/competitive or non-competitive employment were eligible for inclusion. We included studies with adults with psychosocial disability autism and/or intellectual disability. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias II Tool. Data were qualitatively synthesized. Our review was registered with PROSPERO (CRD42020219192). Results: We included 26 RCTs: 23 targeted people with psychosocial disabilities (n = 2465), 3 included people with autism (n = 214), and none included people with intellectual disability. Risk of bias was high in 8 studies, moderate for 18, and low for none. There was evidence for a beneficial effect of Individual Placement and Support compared to control conditions in 10/11 studies. Among young adults with autism, there was some evidence for the benefit of Project SEARCH and ASD supports on open employment. Discussion: Gaps in the availability of high-quality evidence remain, undermining comparability and investment decisions in vocational interventions. Future studies should focus on improving quality and consistent measurement, especially for interventions targeting people with autism and/or intellectual disability.
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Affiliation(s)
- Isabelle Weld-Blundell
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Marissa Shields
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Alexandra Devine
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
- Correspondence:
| | - Helen Dickinson
- School of Business, University of New South Wales, Canberra 2610, Australia;
| | - Anne Kavanagh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
| | - Claudia Marck
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia; (I.W.-B.); (M.S.); (A.K.); (C.M.)
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9
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A Scoping Review of the Contextual Factors Impacting Employment in Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00229-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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López B, Kargas N, Udell J, Rubín T, Burgess L, Dew D, McDonald I, O’Brien A, Templeton-Mepstead K. Evaluation of the ACE employment programme: helping employers to make tailored adjustments for their autistic employees. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-11-2019-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study was to explore the views of autistic people, carers and practitioners regarding the barriers autistic employees face at work (Study 1) and to use these views to inform the design of an employment programme for autistic employees without learning disabilities (Study 2).
Design/methodology/approach
In Study 1, 16 (20%) carers, 17 (21%) practitioners and 47 (59%) autistic adults who had been or were currently employed, answered a survey regarding barriers at work. Study 2 evaluates the efficacy of a set of profiling assessment tools (PA) developed to help employers make individually-tailored adjustments for their autistic employees by delivering an employment programme consisting of 15, 8-week work placements.
Findings
In Study 1, only 25% of autistic adults reported having had adjustments in the workplace and all groups reported this as the main barrier – alongside employers’ lack of understanding. Two sets of results demonstrate the efficacy of the PA tools in addressing this barrier. First, a comparative cost simulation revealed a cost-saving in terms of on-job support of £6.67 per participant per hour worked relative to published data from another programme. Second, 83% of autistic employees reported having had the right adjustments at work.
Research limitations/implications
This is an exploratory study that did not include a comparison group. Hence, it was not possible to evaluate the efficacy of the PA tools relative to a standard employment programme intervention, nor to assess cost reduction, which currently is only estimated from already available published data.
Practical implications
Overall the findings from these studies demonstrate that the time invested in the high-quality assessment of the profile of autistic employees results in saving costs over time and better outcomes.
Originality/value
The originality of the Autism Centre for Employment programme resides in that, unlike other programmes, it shifts the focus from helping autistic employees to helping their employers.
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Taylor J, Avellone L, Cimera R, Brooke V, Lambert A, Iwanaga K. Cost-benefit analyses of employment services for individuals with intellectual and developmental disabilities: A scoping review. JOURNAL OF VOCATIONAL REHABILITATION 2021. [DOI: 10.3233/jvr-201130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Understanding the cost-benefit of vocational rehabilitation services is critical to improve competitive integrated employment outcomes for individuals with intellectual and developmental disabilities (IDD). OBJECTIVE: The purpose of this scoping review was to analyze and synthesize micro and macroeconomic analyses of various types of vocational services which promote the employment outcomes of individuals with IDD. METHODS: This scoping review searched peer-reviewed and grey literature sources published between 2000 and 2020, examining both micro and macroeconomic analyses. RESULTS: A total of 26 studies met inclusion criteria. The majority of studies reported positive effects for the cost-benefit of integrated service approaches such as supported and customized employment. Conversely, our findings show no cost-benefit for sheltered workshops, and in some cases, negative effects. CONCLUSION: Limitations to the included studies as well as implications and recommendations for practice, policy, and future research are discussed.
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Affiliation(s)
- Joshua Taylor
- Rehabilitation Research & Training Center, Virginia Commonwealth University, Richmond, VA, USA
- School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Lauren Avellone
- Rehabilitation Research & Training Center, Virginia Commonwealth University, Richmond, VA, USA
- School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Rob Cimera
- College of Education, Health, and Human Services, Kent State University, Kent, OH, USA
| | - Valerie Brooke
- Rehabilitation Research & Training Center, Virginia Commonwealth University, Richmond, VA, USA
- School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Aliza Lambert
- Rehabilitation Research & Training Center, Virginia Commonwealth University, Richmond, VA, USA
- School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Kanako Iwanaga
- College of Health Professions, Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, USA
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Schall C, Wehman P, Avellone L, Taylor JP. Competitive Integrated Employment for Youth and Adults with Autism: Findings from a Scoping Review. Psychiatr Clin North Am 2020; 43:701-722. [PMID: 33127003 DOI: 10.1016/j.psc.2020.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A scoping review was conducted to map existing literature on effective interventions for competitive employment for individuals with autism spectrum disorder. Empirical database searches were conducted. A filter for level of methodological rigor was implemented. A total of 25 articles met inclusion criteria. Findings were categorized by level of evidence. Findings revealed strong empirical support for a transition-to-work program called Project SEARCH plus ASD Supports and traditional supported employment services. Receipt of specific vocational rehabilitation and transition services in high school were also identified as effective interventions. Recommendations per level of evidence are provided in more detail.
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Affiliation(s)
- Carol Schall
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA.
| | - Paul Wehman
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA; Department of Physical Medicine and Rehabilitation, Rehabilitation Research and Training Center, School of Medicine, Autism Center for Excellence, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
| | - Lauren Avellone
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
| | - Joshua P Taylor
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
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13
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Wehman P, Schall C, McDonough J, Sima A, Brooke A, Ham W, Whittenburg H, Brooke V, Avellone L, Riehle E. Competitive Employment for Transition-Aged Youth with Significant Impact from Autism: A Multi-site Randomized Clinical Trial. J Autism Dev Disord 2020; 50:1882-1897. [PMID: 30825082 DOI: 10.1007/s10803-019-03940-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study reports the results of a multi-site, parallel block randomized clinical trial to expand the previous findings regarding the implementation of Project SEARCH plus ASD Supports (PS + ASD) on employment outcomes upon graduation from high school. Participants were 156 individuals with significant impact from ASD between the ages of 18-21. There was a significant difference between treatment and control groups with 73.4% of the treatment group acquiring competitive employment at or above minimum wage by 1-year after graduation compared to 17% of the control group for whom data was provided. At 1-year, employed treatment group participants worked an average of 21.2 h per week (SD = 9) for a mean hourly wage of $9.61 per hour (SD = $1.55).Clinical Trial Registration: clinicaltrials.gov Identifier: NCT03560453.
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Affiliation(s)
- Paul Wehman
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.,Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Carol Schall
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA. .,School of Education, Virginia Commonwealth University, Richmond, VA, USA. .,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA.
| | - Jennifer McDonough
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Adam Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, USA
| | - Alissa Brooke
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Whitney Ham
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Holly Whittenburg
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA
| | - Valerie Brooke
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Lauren Avellone
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, Virginia Commonwealth University, Richmond, VA, USA.,School of Education, VCU Autism Center for Excellence, Virginia Commonwealth University, Box 842011, Richmond, VA, 23284-2011, USA
| | - Erin Riehle
- Division of Disability Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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14
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Schall C, Wehman P, Avellone L, Taylor JP. Competitive Integrated Employment for Youth and Adults with Autism: Findings from a Scoping Review. Child Adolesc Psychiatr Clin N Am 2020; 29:373-397. [PMID: 32169268 DOI: 10.1016/j.chc.2019.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A scoping review was conducted to map existing literature on effective interventions for competitive employment for individuals with autism spectrum disorder. Empirical database searches were conducted. A filter for level of methodological rigor was implemented. A total of 25 articles met inclusion criteria. Findings were categorized by level of evidence. Findings revealed strong empirical support for a transition-to-work program called Project SEARCH plus ASD Supports and traditional supported employment services. Receipt of specific vocational rehabilitation and transition services in high school were also identified as effective interventions. Recommendations per level of evidence are provided in more detail.
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Affiliation(s)
- Carol Schall
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA.
| | - Paul Wehman
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA; Department of Physical Medicine and Rehabilitation, Rehabilitation Research and Training Center, School of Medicine, Autism Center for Excellence, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
| | - Lauren Avellone
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
| | - Joshua P Taylor
- Department of Counseling and Special Education, Rehabilitation Research and Training Center, Autism Center for Excellence, School of Education, Virginia Commonwealth University, 1314 West Main Street, Box 842011, Richmond, VA 23284-2011, USA
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15
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Harrison J, Krieger MJ, Johnson HA. Review of Individual Placement and Support Employment Intervention for Persons with Substance Use Disorder. Subst Use Misuse 2020; 55:636-643. [PMID: 31782349 DOI: 10.1080/10826084.2019.1692035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Work is a critical part of recovery for many people with chronic health conditions, including Substance Use Disorders (SUD). Individual Placement and Support (IPS) is an evidence-based practice designed initially for adults with mental illness. Although the evidence for using IPS with individuals with severe mental illness is well documented, less is known about the efficacy of using IPS with consumers with substance use disorders, and the results have yet to be systematically evaluated and organized. Key components of zero exclusion, rapid competitive job search, and incorporation with treatment services as well as benefits are components that make IPS a strong practice to incorporate into substance abuse treatment. This study aims to evaluate and organize the evidence base of using IPS with adults with substance use disorders. Results: A systematic review was conducted of meta-analyses, reviews, and individual studies from 2000 through 2019, measuring the efficacy of IPS with individuals with SUD or comorbid SUD. Databases searched were Scopus, PubMed, and PsychInfo. Experimental and quasi-experimental studies are reviewed and critiqued for their application to a SUD population. Then, barriers and facilitators of IPS implementation with this population are discussed. Conclusions/Importance: There is a high evidence to support to application of IPS for persons with SUD, both singly and when combined with a mental health disorder. Barriers to IPS implementation including episodic treatment, risk of relapse, and housing or criminal justice instability make the IPS program a useful best practice to consider for this population.
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Affiliation(s)
- Jennifer Harrison
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
| | - Matthew J Krieger
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
| | - Hillary A Johnson
- School of Social Work, Western Michigan University, Kalamazoo, Michigan, USA
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16
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Roux AM, Garfield T, Shattuck PT. Employment policy and autism: Analysis of state Workforce Innovation and Opportunity Act (WIOA) implementation plans. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anne M. Roux
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Tamara Garfield
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Paul T. Shattuck
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
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17
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Bond GR, Drake RE, Pogue JA. Expanding Individual Placement and Support to Populations With Conditions and Disorders Other Than Serious Mental Illness. Psychiatr Serv 2019; 70:488-498. [PMID: 30813865 DOI: 10.1176/appi.ps.201800464] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A systematic review of studies of individual placement and support (IPS) for populations other than those with serious mental illness was conducted. METHODS The authors searched three electronic databases (PubMed, Web of Science, and Scopus) for studies of IPS and modified IPS. Eligibility criteria for the systematic review included randomized controlled trials with prospective data collection on competitive employment rate and at least 10 study participants from a well-defined population other than people with serious mental illness. Results were compiled for competitive employment rates, IPS fidelity, and other outcomes. RESULTS Three clinical groups other than people with serious mental illness have been studied: people with psychiatric disorders other than serious mental illness, people with substance use disorders, and people with musculoskeletal or neurological disorders. Nine controlled trials with a total of 2,902 participants included six trials with people who had psychiatric disorders other than serious mental illness, two with people who had substance use disorders, and one with people who had spinal cord injuries. In eight studies, results for competitive employment rates significantly favored IPS. Meta-analysis yielded an overall weighted odds ratio of 2.23 (95% confidence interval=1.53-3.24, p<.001). Findings for other employment outcomes also favored IPS, but findings on symptom reduction and quality of life were inconsistent. The strongest (and only replicated) findings were for veterans with posttraumatic stress disorder (PTSD). Methodological limitations included small samples, major modifications to IPS fidelity, and short follow-up periods. CONCLUSIONS IPS, often with modifications, is a promising employment intervention for several populations in addition to people with serious mental illnesses. The strongest evidence pertains to veterans with PTSD. IPS should be offered to these veterans. Research on other populations, including people with anxiety, depression, substance use disorder, musculoskeletal or neurological conditions, or pain syndromes, needs development, amplification, and replication.
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18
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Khayatzadeh-Mahani A, Wittevrongel K, Nicholas DB, Zwicker JD. Prioritizing barriers and solutions to improve employment for persons with developmental disabilities. Disabil Rehabil 2019; 42:2696-2706. [PMID: 30856355 DOI: 10.1080/09638288.2019.1570356] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Persons with a developmental disability have the lowest rate of labour force participation relative to other disabilities. The widening gap between the labour force participation of persons with versus without disability has been an enduring concern for many governments across the globe, which has led to policy initiatives such as labour market activation programs, welfare reforms, and equality laws. Despite these policies, persistently poor labour force participation rates for persons with developmental disabilities suggest that this population experiences pervasive barriers to participating in the labour force.Materials and methods: In this study, a two-phase qualitative research design was used to systematically identify, explore and prioritize barriers to employment for persons with developmental disabilities, potential policy solutions and criteria for evaluating future policy initiatives. Incorporating diverse stakeholder perspectives, a Nominal Group Technique and a modified Delphi technique were used to collect and analyze data.Results: Findings indicate that barriers to employment for persons with developmental disabilities are multi-factorial and policy solutions to address these barriers require stakeholder engagement and collaboration from multiple sectors.Conclusions: Individual, environmental and societal factors all impact employment outcomes for persons with developmental disabilities. Policy and decision makers need to address barriers to employment for persons with developmental disabilities more holistically by designing policies considering employers and the workplace, persons with developmental disabilities and the broader society. Findings call for cross-sectoral collaboration using a Whole of Government approach.Implications for RehabilitationPersons with a developmental disability face lower levels of labour force participation than any other disability group.Individual, environmental and societal factors all impact employment outcomes for persons with developmental disabilities.Decision and policy makers need to address barriers to employment for persons with developmental disabilities holistically through policies guiding employers and broader societal behaviour in addition to those aimed at the individuals (such as skill development or training).Due to multi-factorial nature of barriers to employment for persons with developmental disabilities, policy solutions are wide-ranging and fall under the responsibility of multiple sectors for implementation. This calls for cross-sectoral collaboration using a "Whole of Government" approach, with shared goals and integrated responses.
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Affiliation(s)
- Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Calgary, AB, Canada.,Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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19
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Scott M, Milbourn B, Falkmer M, Black M, Bӧlte S, Halladay A, Lerner M, Taylor JL, Girdler S. Factors impacting employment for people with autism spectrum disorder: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:869-901. [DOI: 10.1177/1362361318787789] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study is to holistically synthesise the extent and range of literature relating to the employment of individuals with autism spectrum disorder. Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with autism spectrum disorder employed in competitive, supported or sheltered employment were included. Content analysis was used to identify the strengths and abilities in the workplace of employees with autism spectrum disorder. Finally, meaningful concepts relating to employment interventions were extracted and linked to the International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder. The search identified 134 studies for inclusion with methodological quality ranging from limited to strong. Of these studies, only 36 evaluated employment interventions that were coded and linked to the International Classification of Functioning, Disability and Health, primarily focusing on modifying autism spectrum disorder characteristics for improved job performance, with little consideration of the impact of contextual factors on work participation. The International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder are a useful tool in holistically examining the employment literature for individuals with autism spectrum disorder. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with autism spectrum disorder and the critical need for interventions which target contextual factors if employment outcomes are to be improved.
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Affiliation(s)
- Melissa Scott
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Marita Falkmer
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Jönköping University, Sweden
| | - Melissa Black
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Sven Bӧlte
- Karolinska Institutet, Sweden
- Stockholm County Council, Sweden
| | | | | | - Julie Lounds Taylor
- Vanderbilt Kennedy Centre, USA
- Vanderbilt University, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, USA
| | - Sonya Girdler
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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20
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Manzoor M, Vimarlund V. Digital technologies for social inclusion of individuals with disabilities. HEALTH AND TECHNOLOGY 2018; 8:377-390. [PMID: 30416930 PMCID: PMC6208746 DOI: 10.1007/s12553-018-0239-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/27/2018] [Indexed: 12/22/2022]
Abstract
Information technology can be an important facilitator of social inclusion for people with disabilities into society. However, the goals specified in this area by organizations such as the European Commission have not yet been achieved in their totality. The aim of this paper is to explore which types of information communication technology-based applications and/or digital services have been suggested to facilitate the social integration of people who suffer from different types of disabilities. We performed a literature review that included studies published during a period of 6 years (2010–2016). The results show that, in the data we have had access to, no concrete patterns can be identified regarding the type of technology or technological trends that can be used to support the social integration of individuals with disabilities. This literature review is of relevance to the identification of further research areas and to the identification of issues which have to be considered in the context of the development and implementation of technological innovations that are aimed at promoting or facilitating social inclusion of individuals with disabilities.
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Affiliation(s)
- Mirfa Manzoor
- 1Department of Informatics, Jönköping International Business School, Jönköping University, Jönköping, Sweden
| | - Vivian Vimarlund
- 1Department of Informatics, Jönköping International Business School, Jönköping University, Jönköping, Sweden.,2Department of Computer Science, Linköping University, Linköping, Sweden
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21
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Ditchman NM, Miller JL, Easton AB. Vocational Rehabilitation Service Patterns: An Application of Social Network Analysis to Examine Employment Outcomes of Transition-Age Individuals With Autism. REHABILITATION COUNSELING BULLETIN 2017. [DOI: 10.1177/0034355217709455] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Young adults with autism spectrum disorder (ASD) face poor employment outcomes following transition from school to adult life. Social network analysis is a useful approach for examining service patterns associated with employment success for this population. An advantage of this approach is its focus on the interdependence of variables rather than individual predictors. This study applies network methodology to examine the relations between vocational rehabilitation services and young adults with ASD to predict employment status. Using the Rehabilitation Services Administration (RSA-911) data set, participants included 2,219 individuals with ASD between the ages of 16 and 24 served by the public vocational rehabilitation system and closed as either competitively employed or not employed. A two-mode network was constructed such that a relation was defined for each service an individual received. Results from a core-periphery analysis indicated that of the 22 services available, core services included assessment, counseling/guidance, job placement, on-the-job support, job search support, and transportation services. Follow-up analyses suggested that the greater number of these six core services an individual received, the better the employment outcome. Findings highlight that these services should be viewed as interconnected and suggest a set of six core services that may be particularly beneficial for this population.
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22
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Latimer E. Extending the Quality and Reach of IPS. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2017; 44:374-377. [PMID: 28361473 DOI: 10.1007/s10488-017-0801-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Eric Latimer
- Mental Health and Society Research Program, Douglas Hospital Research Centre, Perry 3C, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
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