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People with Autism Achieving Career Success

Valerie Brooke, Jennifer McDonough, & Alissa Molinelli, VCU - RRTC. People with Autism Achieving Career Success . Research on ASD and Employment . Chronically Unemployed or Underemployed (Hendricks & Wehman, 2009, Cimera & Cowan, 2009)

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People with Autism Achieving Career Success

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  1. Valerie Brooke, Jennifer McDonough, & Alissa Molinelli, VCU - RRTC People with Autism Achieving Career Success

  2. Research on ASD and Employment • Chronically Unemployed or Underemployed (Hendricks & Wehman, 2009, Cimera & Cowan, 2009) • Frequently denied VR Services or deemed “too severely disabled to work” (Lawer & Brusilovskiy, 2005) • Received a more expensive set of services (Lawer & Brusilovskiy, 2005) • Require higher intensity of services and supported employment to achieve work (Schaller & Yang 2005) • Individuals with ASD can be successful and independent at work (Hillier, Fish, Cloppert & Beversdorf, 2007)

  3. Research on ASD, Employment and Behavior Challenges • Functional Behavior Assessment and the Implementation of Positive Behavior Supports CAN make a difference (Schall, 2010)

  4. Additional Supports for ASD • Social Interaction Support • Communication Skills • Behavioral support • Co-worker and Supervisor Support

  5. Our Study of Supported Employment for Individuals with ASD • Clinical application of supported employment through employment support division • Collected data on hours worked, wage, and support required to achieve independence • Community based, integrated jobs

  6. Participants • Total of 33 Individuals with ASD • 76% male • Average age 25 • Range of 18-50 • 76% Caucasian • 70% reported secondary disability • 83% reported to have high support needs • 91% no or short intermittent history of employment * Includes Project Search students (2009-10)

  7. Employment Outcomes • 27 out of 33 individuals placed (82%) • Average working hours per week is 22 • Range from 8 hours to 40 hours per week • Average hourly pay is $8.86. • Individuals hired in a number of fields: • Healthcare (14) • Retail (6) • Recreation (3) • Education (4) • Custodial (1) • Food Service (1)

  8. Task Notes

  9. Reminders

  10. Models to Increase Competitive Employment • Increase access to intensive support • Provide access to behavioral support • Explore ways to provide intensive internships or work experiences to identify • Preferred work conditions • Preferred tasks • Social Skill development • Communication Supports • Strengths

  11. Ms. Jennifer McDonough The Effect of Project SEARCH on Employment Outcomes for Transition Youth with ASD This project is funded by the Disability and Rehabilitation Research Project (DRRP) grant #H133B080027 from the National Institute on Disability and Rehabilitation Research (NIDRR).

  12. What we know about transition to adulthood for Students with ASD The transition of students with autism spectrum disorder (ASD) from school to adulthood is an increasing dilemma (Wehman, Smith and Schall, 2009).

  13. What the research says… • Shattuck (2010) examined patterns of service use among youth with ASD from the NLTS2 sample. Data on youth who exited high school. • 6% had competitive jobs, and • 21% had no employment or education experiences at all • 80% of these individuals were living with their parents, • 40% reported having no friends

  14. Method • Randomized clinical trial • Participants • Students in their last year of high school • 18 to 21 years old • Diagnosis on the Autism Spectrum • Treatment (Project SEARCH) and Control (Regular High School Program) groups equal on all functional and employment characteristics prior to participation (p > .05)

  15. Project SEARCH • Components of Project SEARCH • School-to-work transition program • Total immersion in the workplace • Classroom instruction 1.75 hours/day to address employment skills • Internships/Worksite Rotations

  16. Above and Beyond Project SEARCH • Additional supports above and beyond SEARCH • Behavioral Consultation with Behavior Analyst • Consistent Structure to Seemingly Unstructured Internships • Behaviorally Defining Idioms, Social Skills, and Work Expectations • Visual Supports to Increase Implementation of Strategies • Self Monitoring Checklists and Reinforcement Programs • Role-Playing and Practice for Required Social Skills • Ongoing Intensive Instruction and Monitoring of Student Success

  17. Preliminary Results

  18. The Future of this Research • New funding to expand this work • NIDRR Funded • Two replication sites with RCT • Northern Virginia • Tidewater

  19. Elizabeth • Strengths • Detail oriented • Hard working • Accurate • Fast paced

  20. Challenges • Noise level • Hard time with changes in schedule or when things don’t play out as expected (transportation, work tasks) • Appropriate use of hands when agitated • Interactions with co-workers • Unusual prosody

  21. Supports • Task Analysis in notes section IPOD • How to call job coach • New task for easy referral and access • Schedule for work day/ forewarning new schedule changes • Alarms • Keep working • Remind when call job coach if transportation has not arrived • Incredible 5 point scale for noise volume • Background of IPOD screen for subtle prompting • Visual Cue Cards • “I’m feeling sleepy…” • “I’m feeling sad…” • “I’m feeling frustrated…”

  22. Incredible 5 Point Scale

  23. Elizabeth’s Internships to Employment • Internships • Employee Wellness • Diabetes Treatment Center • Foundation • Employment • Employee Wellness/ Diabetes Treatment Center • Scanning in employee documents • Putting together TB masks • Assembling packets for employees • Compiling database for physician referrals • Library of Diabetes related research articles for employee use • Assist in event preparation: invites, decoration, etc.

  24. David • Strengths: • Organized • Organized • Organized • Detail Oriented • Attends to written rules

  25. Challenges • Silly • Loud • Extremely excitable • Motivated by food, special events, computer • Likes to be busy all the time • Unusual syntax (“Otis Spunkmeyer live in the cafeteria”) and prosody (robotic, deep radio voice) • Stealing from cafeteria

  26. Behavior Plan with Incentives Reviewed before & after each shift

  27. Food Dilemmas Game board to earn cafeteria time

  28. David’s Internships to Employment • Internships: • Employee Wellness • Med/Surg Floor • Main Pharmacy • Employment • Main Pharmacy • Pull outdated drugs • Organize (by date) all meds • Document meds that have been discarded • File filled prescriptions and chemo orders

  29. What works… • Enhanced community based assessment, planning, and training • Positive Behavioral Supports • Community Supports • PDA ‘s w/ training and supports • Providers who understand adults w/ ASD • Proactive support strategies • Educating employers and developing natural supports

  30. Questions? • Valerie Brooke • vbrooke@vcu.edu • Jennifer McDonough • jltodd@vcu.edu • Alissa Molinelli • admolinelli@vcu.edu • VCU – RRTC • 804-828-1851

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