Providing supportive transition services to individuals with autism spectrum disorder: Considerations for vocational rehabilitation professionals

Support in Daily Living for Young Adults with Neurodevelopmental Conditions in Sweden: A Qualitative Description of Current Practice

In Sweden, people living independently and requiring daily living support can access 'housing support', a form of practical, educational, and social support provided by the municipalities. About two-thirds of those receiving this support have neurodevelopmental conditions, primarily autism or ADHD. Many are young adults in the process of adapting to new roles and expectations in different life domains, including education, work, and accommodation. This study aimed to provide a qualitative description of support workers' views on current practice in housing support for young adults (aged 18 to 29) with neurodevelopmental conditions. Semi-structured telephone interviews were conducted with 34 housing support workers across 19 Swedish regions. An inductive qualitative content analysis approach was used. The interviews depicted a complex service, subject to organizational aspects (roles, responsibilities, availability, and allocation), the joint effort of key players (young adults, relatives, and support workers), and practical aspects of service provision (finding common ground for the work, and delivery of support). Some elements of the service were poorly designed for the target group. The support workers expressed a need for more knowledge about neurodevelopmental conditions, but also described new insights related to remote delivery of support. The results raise important questions about how housing support should be organized and delivered to strike the right balance between support and autonomy, meet specific needs, and ensure equal services across municipalities. Future research should adopt multiple perspectives and approaches, to help translate best practice and available evidence into a flexible and sustainable service.

View of the Work Community and Vocational Rehabilitation Services Among Adults With Autism Spectrum Disorder

Many adults diagnosed with autism spectrum disorder (ASD) face challenges in establishing and maintaining employment. These difficulties may be related to ASD symptomology or employer attitudes; however, vocational rehabilitation (VR) can provide employment-related resources. This study sought to understand how adults with ASD view their integration into workplace communities and VR services. Qualitative data were collected from 24 adults with ASD, and analysis identified themes surrounding the importance of workplace contributions, interesting work, and positive workplace relationships contributing to feeling integrated into the workplace community. Responses were also examined for perspectives on the role of VR in supporting workplace integration. Findings indicate the importance of attending to individual employment preferences and the need for long-term VR follow-along services to explore opportunities for employment growth. Implications and future recommendations for research and practice are also discussed.

A scoping literature review of transition-related research involving youth with autism spectrum disorder

BACKGROUND: Owing to steadily increasing rates of autism spectrum disorder (ASD) among children, youth, and adults, it is certain that growing numbers of these individuals will need transition and vocational rehabilitation (VR) services for many years to come. ASD research has focused on identifying employment barriers rather than on effective interventions to remove or reduce those barriers. Even so, some evidence has demonstrated support for the effectiveness of specific transition-related interventions. OBJECTIVE: The purpose of this article is to review the existing literature regarding transition and employment for youth with ASD. METHOD: We begin with an overview of the clinical characteristics of ASD and its incidence and prevalence in the U.S. Then, we examine vocational issues facing individuals with ASD. RESULTS: The remainder of the article focuses on transition and VR implications with specific emphases on (a) interdisciplinary transition planning, (b) postsecondary educational supports and services, and (c) employment interventions. CONCLUSION: ASD is a high-incidence disability that presents significant service delivery and advocacy needs for young people with ASD and their families. Evidence-based employment interventions are available to help young people with ASD make smooth transitions to adulthood in the settings of their choice.

Meaningful Transitions: Enhancing Clinician Roles in Transition Planning for Adolescents With Autism Spectrum Disorders

Purpose The purpose of this tutorial is to provide speech-language pathologists (SLPs) with foundational information that will assist them in transition planning for students with autism spectrum disorder (ASD) based on a review of current literature. SLPs must be knowledgeable of transition planning in order to assist students with ASD and their families with preparing for their future. An appreciation and awareness of pertinent assessments, functional goals, and factors associated with successful postsecondary outcomes are essential competencies that SLPs need when planning for the transition process. SLPs are ideal workforce development partners. They facilitate independence, communication, and interaction skills necessary for postsecondary and workplace success. Speech-language services are one of the most common special education services received by high school students with Individualized Education Programs. However, SLPs receive little preparation on the specifics or nuances of transition planning prior to working in the educational settings, despite the high incidence of speech-language services in secondary education. Method This tutorial reviews and synthesizes research findings related to assessment planning, goal-setting, and Individualized Education Program implementation for achieving meaningful postsecondary transitions for students with ASD. Additionally, it highlights some of the key postsecondary skillsets related to speech-language therapy services, including the development of self-determination, self-advocacy, social competence, and adaptive behaviors. Conclusion Greater focus on higher quality transition planning requires SLPs to develop high levels of knowledge and competencies in the transition planning process. This tutorial educates clinicians on the unique challenges faced by individuals with ASD and provides evidence-based strategies to help students and families successfully plan for and navigate postsecondary transitions.

Identifying Patterns of State Vocational Rehabilitation Performance in Serving Transition-Age Youth on the Autism Spectrum

Background

Transition-age youth on the autism spectrum (TAY-ASD) face many challenges when attempting to find and keep employment. Vocational rehabilitation (VR) is a key public source of support for employment for people with disabilities in the United States, and TAY-ASD increasingly use VR services. However, rates of VR service utilization and employment outcomes are known to vary dramatically across states for these youth, for reasons that are not fully understood.

Methods

This study aimed to examine a set of indicators for measuring the state VR performance in serving TAY-ASD, compared with youth with other disabilities, and to identify classes of homogenous patterns of state performance across these indicators. We used latent profile analysis (LPA) to model patterns of state performance in serving TAY-ASD.

Results

We identified five classes of states with unique patterns of performance across four key indicators (service receipt, early reach, timely services, and employment rates) and then matched states to each class based on their probability of inclusion. One class featured above average performance across all four indicators, and approximately one-fourth of states had a high probability of membership in this class.

Conclusions

Identification of states with patterns of more efficient and effective VR service delivery for TAY-ASD will help target efforts to learn how states are delivering, organizing, and coordinating VR services for these youth. The use of methods like LPA may also be beneficial for examining performance within other autism-related service systems in the United States and internationally.

Lay Summary

Background:: Achieving employment is an important milestone on the road to adulthood. Having a job is related to financial independence, health, and well-being but can also provide a sense of belonging and opportunities for inclusion. Transition-age youth on the autism spectrum (TAY-ASD) may find that getting and keeping a job is more difficult than it is for their peers with other types of disabilities. Vocational rehabilitation (VR) is a public source of support for employment for people with disabilities in the United States, and TAY-ASD are increasingly using VR services. However, whether youth receive VR services, and whether they gain employment following VR services, is highly dependent on which state they live in. We do not yet fully understand why state VR services vary so dramatically.About This Study:: New federal legislation, the Workforce Innovation and Opportunity Act, aims to reach students with disabilities with vocational services during secondary school (junior high and high school). Few studies exist to help us understand how well VR services are reaching students and what are the effects of these services. We tested new ways to measure VR services for TAY-ASD and also tested whether we could group states according to their results on these measurements. We wondered whether any groups of states performed better than other groups.We used the VR data for the 50 states and Washington DC to test the following four things: how often TAY-ASD received VR services if they were eligible for them; how often these youth applied for VR services during secondary school; how often their employment plan was finished on time; and how often they got a job after VR services. We compared youth on the autism spectrum with youth with other disabilities and found that they did about the same on these measures.What This Study Tells Us:: We identified five groups of states, which each had a unique pattern of how they performed on these measures. We named the groups-also called classes-according to their strengths. Class 1 had above average employment rates but below average performance on other measures. Class 2 had timely services, meaning that these states finished youth's employment plans on time, so that they could access services. Class 3 had both timely services and early reach to students, meaning that the students began services during secondary school. Class 4 had early reach to secondary students but low performance on other measures. Finally, Class 5 had above average performance on all measures. States in this class excelled at reaching students, developing employment plans quickly, enrolling students in services, and achieving employment by the time VR services ended. We then determined which states were most likely to belong in each class.This study gives us another way to think about how states are doing in delivering VR services to TAY-ASD. By studying states that have better overall performance, versus others, we can identify what states might be doing differently. Learning about how some states are adapting VR services for TAY-ASD and the innovations they are using is important information for other states who wish to improve their VR services. The methods we used may also be helpful for examining the performance of other autism-related service systems in the United States and internationally.