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A Systematic Review of Vocational Interventions for Young Adults With Autism Spectrum Disorders

Posted Aug 27 2012 7:49pm

Autism is more than something which concerns children. Autistics, like everyone, grow up. Some will find jobs, some could use supports to obtain jobs. At present, most do not gain employment. How can we as a society better support autistics in gaining employment? Well, that question is largely unanswerable. A paper out yesterday in Pediatrics A Systematic Review of Vocational Interventions for Young Adults With Autism Spectrum Disorders (full text is free), shows that there is little data on vocational services for adults.

The abstract is below, and the paper online, but a quick view of the study can be found in this Reuters article, quoting lead author Julie Lounds Taylor and Paul Shattuck , an autism researcher not involved with the study:

“Even though there are vocational services out there, they haven’t been rigorously studied,” Taylor said.

She stressed, though, that the findings do not mean the programs don’t work – just that better studies are needed.

An autism researcher not involved in the new report agreed.

“I think this is more a critique of the research community, not the programs themselves,” said Paul Shattuck, an assistant professor at Washington University in St. Louis.

Why have there been so few studies, and no high-quality ones?

Both Taylor and Shattuck said that in autism, the research focus has historically been on children.

“But children with autism grow up,” Taylor pointed out. “We have startlingly little evidence on how to help adults.”

Prof. Shattuck was, in my opinion, being polite. Autism parents such as myself will have a hard time finding someone to blame for this. We have dominated the discussion and advocacy efforts for some time and we have not called for better research on such critical areas as the effectiveness of adult supports.

BACKGROUND AND OBJECTIVE: Many individuals with autism spectrum disorders (ASDs) are approaching adolescence and young adulthood; interventions to assist these individuals with vocational skills are not well understood. This study systematically reviewed evidence regarding vocational interventions for individuals with ASD between the ages of 13 and 30 years.

METHODS: The Medline, PsycINFO, and ERIC databases (1980–December 2011) and reference lists of included articles were searched. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics, assessment techniques, and outcomes, and assigned overall quality and strength of evidence ratings based on predetermined criteria.

RESULTS: Five studies were identified; all were of poor quality and all focused on on-the-job supports as the employment/vocational intervention. Short-term studies reported that supported employment was associated with improvements in quality of life (1 study), ASD symptoms (1 study), and cognitive functioning (1 study). Three studies reported that interventions increased rates of employment for young adults with ASD.

CONCLUSIONS: Few studies have been conducted to assess vocational interventions for adolescents and young adults with ASD. As such, there is very little evidence available for specific vocational treatment approaches as individuals transition to adulthood. All studies of vocational approaches were of poor quality, which may reflect the recent emergence of this area of research. Individual studies suggest that vocational programs may increase employment success for some; however, our ability to understand the overall benefit of supported employment programs is limited given the existing research.

By Matt Carey

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