Article Details

Research Database: Article Details

Citation:  Lawer, L., Brusilovskiy, E., Salzer, M.S., & Mandell, D.S. (2009). Use of vocational rehabilitative services among adults with autism. Journal of Autism and Developmental Disorders, 39 (3), 487-494.
Title:  Use of vocational rehabilitative services among adults with autism
Authors:  Lawer, L., Brusilovskiy, E., Salzer, M.S., & Mandell, D.S.
Year:  2009
Journal/Publication:  Journal of Autism and Developmental Disorders
Publisher:  Springer (Germany)
DOI:  https://doi.org/10.1007/s10803-008-0649-4
Full text:  https://link.springer.com/article/10.1007/s10803-008-0649-4    |   PDF   
Peer-reviewed?  Yes
NIDILRR-funded?  No

Structured abstract:

Background:  This study compared the experiences of individuals with autism spectrum disorders (ASD) in the United States vocational rehabilitation system with others who use this system. Individuals with ASD have markedly different vocational needs than individuals with other developmental disabilities (Mu ?ller et al. 2003). The uneven cognitive and social abilities associated with ASD results in a diverse set of vocational needs that are challenging to address with usual practices, create problems with employment stability, and result in isolated work opportunities. The lack of entitlements for individuals with ASD as they age out of the education system has contributed to a call to examine the utility of existing services and further expand adult services (Shattuck et al. 2007). The Expanding the Promise for Individuals with Autism Act of 2007, currently pending passage, would provide funding to states to expand supports for adults with ASD, including vocational services.
Purpose:  To examine the current vocational services available to adults with ASD in order to better understand their access to services, intensity of service provision and outcomes relative to other impairment groups using the national data reported by federally-funded vocational rehabilitation programs.
Setting:  The US Department of Education’s Office of Special Education and Rehabilitative Services (RSA data)
Study sample:  Subjects inclu- ded all 382,221 adults ages 18–65 served by this system whose cases were closed in 2005; 1,707 were diagnosed with ASD.
Intervention:  N/A
Control or comparison condition:  Impairment Causes: autism spectrum disorders, mental retardation, specific learning disabilities, and combined the other 34 causes. Demographic Variables: gender, race (categorized as Black, White and other), education at case closure (categorized as less than high school, high school graduate or GED, and more than high school), and age at case closure. Other Covariates of Interest: the number of months services were received, cost of services in $1,000 increments and an indicator of whether on-the-job supports were used.
Data collection and analysis:  First, bivariate associations between impairment cause and all other variables were estimated using means, medians and ANOVA for expenditure data, and frequencies and chi- square tests for all other variables. Logistic regression was used to examine the adjusted association between impairment cause and whether cases were closed because the disability was viewed as too significant to benefit from services. A two-part model was used to examine the adjusted association between impairment cause and total VR expenditures. First, logistic regression was employed to examine the adjusted association between impairment cause and whether any expenditure was incurred. Second, linear regression was used to examine the adjusted asso- ciation between impairment cause and total VR service expenditures for the 280,733 individuals with positive expenditures.
Findings:  Relative to other individuals served by the vocational rehabilitation system, individuals with ASD were more likely to be denied services because it was believed that their disability was too severe for them to benefit. Among those who receive services, people with ASD received a more expensive set of services than those with other impairments, although their service costs did not differ from individuals with mental retardation. Competitive employment rates among people with ASD did not differ from those with SLD or MR, and were much higher than those of people with other impairments. Post hoc analyses suggest that successful competitive employment for people with ASD and MR may depend on the presence of on-the-job supports, which include ‘‘job coaching, follow-up and follow-along, and job retention services.’’ The VR system appears as successful for people with ASD as for others. This result should inspire the belief that these individuals can participate in this valued social role. The results of this study suggest that adults with ASD who eventually receive supports do at least as well as persons with MR, and better than other disability groups, in achieving competitive employment. Our findings are also important in light of research indicating that supported employment through vocational rehabilitation programs may improve cognitive performance of adults with ASD (Garcia-Villamisar and Hughes 2007) and generally improves quality of life (Garcia-Villamisar et al. 2002). Combined, these findings suggest that people with ASD would likely benefit from this program and should be encouraged to participate. Of particular concern is the fact that individuals with ASD were more likely than other groups to be denied services because it was believed that their disability was too severe to benefit. This finding also hints at the possibility that some individuals with ASD may never explore the use of VR services because they (or their families) do not see it as a viable option or have been discouraged from seeking services. VR expenditures were much higher for individuals with ASD than for those with other impairments except people with MR. The VR system may not be structured to provide services to individuals with ASD in the most cost-efficient manner (Hillier et al. 2007).
Conclusions:  Adults with ASD were more likely than adults with other impairments to be denied services because they were considered too severely disabled. Among those served, adults with ASD received the most expensive set of services. They and adults with MR were most likely to be competitively employed at case closure. Post hoc analyses suggest that their employment was highly associated with on-the-job supports. The results suggest the importance of the VRS in serving adults with ASD.

Disabilities served:  Autism / ASD
Populations served:  Other
Interventions:  On-the-job training and support
Vocational rehabilitation
Outcomes:  Employment acquisition
Full-time employment
Part-time employment
Other