Employment and Vocational Skills Among Individuals

Authors: Lisa Walsh Sinéad Lydon Olive Healy

Publish Date: 2014/06/04

Volume: 1, Issue: 4, Pages: 266-275

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Abstract

Much research has been devoted to early intervention for individuals with autism spectrum disorder ASD with a lesser emphasis on research examining the outcomes for or support of these individuals as they reach employment age Historically employment opportunities for individuals with ASD have been limited The current literature review sought to investigate the existing predictors and impact of employment or vocational placements among persons with ASD Interventions described in the literature to teach individuals with ASD employment or vocational skills were also assessed A total of 26 studies were reviewed and results indicate that there is limited extant research on employment and vocational skills among individuals with ASD However it was found that employment positively impacted on the quality of life cognitive functioning and wellbeing of participants with ASD Predictors of employment were found to be a complex interplay of personal and external factors All interventional studies reported improvements in the vocational skills targeted although a limited range of skills have been taught across these studies The implications of these findings for individuals with ASD and future research in this area are discussedIn recent years the diagnosis of autism spectrum disorder ASD has become increasingly common with 1 in 68 children in the USA diagnosed with the disorder Centers for Disease Control and Prevention CDC 2014 Traditionally research and clinical focus has been on early intervention for individuals with ASD with a lack of emphasis on supporting adolescents or adults as they progress through life This is particularly problematic as research suggests that postsecondlevel employment opportunities for individuals with ASD are typically limited Hendricks and Wehman 2009 and among employmentaged adults with disabilities some of the lowest employment rates are reported for individuals on the autism spectrum Burke et al 2010The Individuals with Disabilities Education Act IDEA 2004 ensures that in the USA special education services are provided to youth with disabilities including autism Chiang et al 2013 Further IDEA specifies that appropriate postsecondary goals including further education or employment based upon students’ interests and strengths should be included in their individualized education plan IEP and that students should receive the support necessary to achieve these aims Chiang et al 2013 However research indicates that in reality approximately as few as 25  of individuals with ASD are employed Holwerda et al 2012 A recent study of 169 adults with highfunctioning ASD found that only about half of the participants were in paid employment 49  and many 36  were on social security benefits Barneveld et al 2014The limited employment opportunities available to those with ASD may be the result of the challenges associated with the disorder The impairments in social and communicative functioning associated with ASD can impact every aspect of adaptive functioning American Psychological Association 2000 Due to these deficits traditional training methods used by employers eg lengthy verbal instruction or the use of modeling are often counterproductive for individuals with ASD and may negatively impact their ability to secure employment Burke et al 2010 Further most workplaces require adherence to social norms and an understanding of social decorum which may also be problematic for those with ASD Vogeley et al 2013 Individuals on the spectrum may also have physical health problems behavioral issues and various comorbid diagnoses that may complicate their participation in employmentrelated activities Behavioral issues such as stereotyped motor movements and vocalizations insistence on maintaining routines or sameness and sensory difficulties are all associated with ASD Schall 2010 Persons with ASD also frequently present with comorbid disorders including gastrointestinal disorders intellectual disabilities epilepsy and anxiety among others eg Hofvander et al 2009 Lugnegård et al 2011 These challenges may create barriers to securing and maintaining employment for those diagnosed with ASDHowever in spite of the identified difficulties some individuals with ASD possess traits and attributes that are often highly desired by employers and should be viewed as strengths in the workplace Persons with ASD may have the ability to be highly focused in certain situations and possess excellent visual perception abilities Kellems and Morningstar 2012 Thorkil Sonne founder of the Specialist People Foundation and Specalisterne which employs individuals with ASD in Denmark seeks to transform the way society perceives autism from viewing it as a handicap to recognizing that it can become a competitive advantage Sonne 2009 While communication and repetitive behavior can be a barrier to employment for people on the autism spectrum Sonne 2009 emphasizes the value of employing those with ASD by describing the ability to focus on a given task exceptional persistency attention to detail and the tendency to thrive on routine as pertinent skills that any employer would valueHowever an adequate employment service including environmental accommodations and individualized support and skills training is necessary to aid individuals with ASD to join the workforce Currently the specific interventions that lead to positive employment outcomes for individuals with ASD are poorly understood and the lack of specific employmentrelated skills may prevent individuals with ASD from accessing available employment opportunities Existing employment options for people with disabilities described in the literature include sheltered employment supported employment and competitive employment Sheltered employment involves people with disabilities working below minimum wage together in a segregated setting designed to employ people with disabilities Gottlieb et al 2010 Supported employment represents an integrated model of employment where workers with disabilities are assisted throughout the employment process and work in communitybased settings Gottlieb et al 2010 Competitive employment involves people with disabilities working at an equivalent rate to those without disabilities and research illustrates that between 6 and 10  of individuals with ASD are competitively employed Wilczynski et al 2013 Although these employment options exist positions are limited and are typically directed toward individuals who are high functioning Sonne 2009The lack of employment opportunities for persons with ASD is further problematic given the positive impact of employment on quality of life QoL that has been frequently evidenced for typically developing persons Barneveld et al 2014 Research has shown that the three key domains of QoL common to all adults are residential living employment and socialization Graetz 2010 Further among typically developing persons employment has been related to a variety of other important outcomes a metaanalysis by McKee and colleagues 2005 indicated that across 52 studies employed individuals demonstrated greater mental health life satisfaction marital or family satisfaction and selfperceived physical health than those who were unemployed It has also been recognized that work is an important means of social inclusion and offers individuals often excluded from society such as those with disabilities a social outlet and a chance to contribute to society Carew et al 2010 Employment is also a necessary step toward economic selfsufficiency and hence greater inclusion in society Migliore et al 2014 With the considerable benefits of employment across many domains it is important that individuals with ASD have the opportunity to gain meaningful supported or competitive employmentThus given the positive outcomes associated with employment and the seeming dearth of employment opportunities for individuals with ASD the present literature review sought to critically examine the predictors and impact of employment for individuals with ASD and to evaluate the interventions described in the literature to teach employment and vocational skills

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