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Interventions for improving employment outcomes for persons with autism spectrum disorders: A systematic review update

Author

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  • Carlton J. Fong
  • Joshua Taylor
  • Aynura Berdyyeva
  • Amanda M. McClelland
  • Kathleen M. Murphy
  • John D. Westbrook

Abstract

Background The incidence of autism spectrum disorders (ASD) is on the rise. Currently, 1 in 59 children are identified with ASD in the United States. ASD refers to a range of neurological disorders that involve some degree of difficulty with communication and interpersonal relationships. The range of the spectrum for autism disorders is wide with those at the higher functioning end often able to lead relatively independent lives and complete academic programs even while demonstrating social awkwardness. Those at the lower functioning end of the autism spectrum often demonstrate physical limitations, may lack speech, and have the inability to relate socially with others. As persons with ASD age, options such as employment become increasingly important as a consideration for long‐term personal planning and quality of life. While many challenges exist for persons with ASD in obtaining and maintaining employment, some research shows that, with effective behavioral and social interventions, employment can occur. About 37% of individuals with ASD report having been employed for 12 months or more, 4 years after exiting high school. However, several studies show that individuals with ASD are more likely to lose their employment for behavioral and social interaction problems rather than their inability to perform assigned work tasks. Although Westbrook et al. (2012a, 2013, 2015) have reviewed the literature on interventions targeting employment for individuals with ASD, this review is outdated and does not account for recent developments in the field. Objectives The objective of this review is to determine the effectiveness of employment interventions in securing and maintaining employment for adults and transition‐age youth with ASD, updating two reviews by Westbrook et al. (2012a, 2013). Search Methods The comprehensive search strategy used to identify relevant studies included a review of 28 relevant electronic databases. Search terminology for each of the electronic databases was developed from available database thesauri. Appropriate synonyms were used to maximize the database search output. Several international databases were included among the 28 databases searched. In addition, the authors identified and reviewed gray literature through analysis of reference lists of relevant studies. Unpublished dissertations and theses were also identified through database searches. The programs of conferences held by associations and organizations relevant to ASD and employment were also searched. In sum, the search strategy replicated and expanded the prior search methods used by Westbrook et al. (2012a, 2013). Selection Criteria Selection criteria consisted of an intervention evaluation using a randomized controlled trial or quasi‐experimental design, an employment outcome, and a population of individuals with ASD. Data Collection and Analysis We updated the search from Westbrook et al., replicating and broadening the information retrieval processes. Our wide array of sources included electronic databases, gray literature, and conference and organization websites. Once all potentially relevant studies were located, pairs of coders evaluated the relevance of each title and abstract. Among the studies deemed potentially relevant, 278 were subjected to full‐text retrieval and screening by pairs of coders. Because many intervention studies did not include employment outcomes, only three studies met our inclusion criteria. Given the small number of included studies, meta‐analytic procedures were not used; rather, we opted to use more narrative and descriptive analysis to summarize the available evidence, including an assessment of risk of bias. Results The systematic review update identified three studies that evaluated employment outcomes for interventions for individuals with ASD. All three studies identified in the review suggest that vocation‐focused programs may have positive impacts on the employment outcomes for individuals with ASD. Wehman et al. indicated that participants in Project SEARCH had higher employment rates than control participants at both 9‐month and 1‐year follow‐up time points. Adding autism spectrum disorder supports, Project SEARCH in Wehman et al.'s study also demonstrated higher employment rates for treatment participants than control participants at postgraduation, 3‐month follow‐up, and 12‐month follow‐up. Smith et al. found that virtual reality job interview training was able to increase the number of job offers treatment participants received compared to control participants. Authors' Conclusions Given that prior reviews did not identify interventions with actual employment outcomes, the more recent emergence of evaluations of such programs is encouraging. This suggests that there is a growing body of evidence regarding interventions to enhance the employment outcomes for individuals with ASD but also greater need to conduct rigorous trials of vocation‐based interventions for individuals with ASD that measure employment outcomes.

Suggested Citation

  • Carlton J. Fong & Joshua Taylor & Aynura Berdyyeva & Amanda M. McClelland & Kathleen M. Murphy & John D. Westbrook, 2021. "Interventions for improving employment outcomes for persons with autism spectrum disorders: A systematic review update," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(3), September.
  • Handle: RePEc:wly:camsys:v:17:y:2021:i:3:n:e1185
    DOI: 10.1002/cl2.1185
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    References listed on IDEAS

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    1. John D. Westbrook & Frank H. Martin & Chad Nye & Carlton J. Fong, 2010. "PROTOCOL: Effectiveness of adult employment assistance services for persons with autism spectrum disorders," Campbell Systematic Reviews, John Wiley & Sons, vol. 6(1), pages 1-29.
    2. Andrew Jacob & Melissa Scott & Marita Falkmer & Torbjörn Falkmer, 2015. "The Costs and Benefits of Employing an Adult with Autism Spectrum Disorder: A Systematic Review," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-15, October.
    3. repec:mpr:mprres:7398 is not listed on IDEAS
    4. John D. Westbrook & Chad Nye & Carlton J. Fong & Judith T. Wan & Tara Cortopassi & Frank H. Martin, 2012. "Adult Employment Assistance Services for Persons with Autism Spectrum Disorders: Effects on Employment Outcomes," Campbell Systematic Reviews, John Wiley & Sons, vol. 8(1), pages 1-68.
    5. Erika Check Hayden, 2011. "Licence rules hinder work on rare disease," Nature, Nature, vol. 470(7334), pages 318-319, February.
    6. Melissa Scott & Marita Falkmer & Sonya Girdler & Torbjörn Falkmer, 2015. "Viewpoints on Factors for Successful Employment for Adults with Autism Spectrum Disorder," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-15, October.
    7. Laurent Mottron, 2011. "The power of autism," Nature, Nature, vol. 479(7371), pages 33-35, November.
    8. John D. Westbrook & Chad Nye & Oliver Wendt & Carlton J. Fong & Ann Williams & Tara Cortopassi, 2012. "PROTOCOL: Pre‐graduation Transition Services for Persons with Autism Spectrum Disorders: Effects on Employment Outcomes," Campbell Systematic Reviews, John Wiley & Sons, vol. 8(1), pages 1-31.
    9. John D. Westbrook & Chad Nye & Oliver Wendt & Carlton J. Fong & Ann Williams & Tara Cortopassi, 2012. "PROTOCOL: Pre‐graduation Transition Services for Persons with Autism Spectrum Disorders: Effects on Employment Outcomes," Campbell Systematic Reviews, John Wiley & Sons, vol. 8(1), pages 1-31.
    10. John D. Westbrook & Chad Nye & Carlton J. Fong & Judith T. Wan & Tara Cortopassi & Frank H. Martin, 2012. "Adult Employment Assistance Services for Persons with Autism Spectrum Disorders Effects on Employment Outcomes," Mathematica Policy Research Reports 73f39548485b440298851e260, Mathematica Policy Research.
    11. Timo Lorenz & Cora Frischling & Raphael Cuadros & Kathrin Heinitz, 2016. "Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-19, January.
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    2. Melissa Sharpe & Claire Hutchinson & June Alexander, 2022. "The Lived Experiences and Perspectives of People with Autism Spectrum Disorder in Mainstream Employment in Australia," Disabilities, MDPI, vol. 2(2), pages 1-14, March.

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