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

Department of Pediatrics, Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee 37203, USA.
PEDIATRICS (Impact Factor: 5.47). 08/2012; 130(3):531-8. DOI: 10.1542/peds.2012-0682
Source: PubMed

ABSTRACT

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.
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.
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.
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.

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Available from: Julie Lounds Taylor, Jun 29, 2015
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    • "These discouraging statistics suggest additional ramifications. There is a substantial discrepancy between the estimated costs associated with ASD, the evidence base for understanding what interventions can optimize employment, and the costs incurred (Taylor et al. 2012). For example, the costs related to the services for adults with autism are notably higher than their peers with other disabilities. "
    [Show abstract] [Hide abstract] ABSTRACT: With a disproportionately high unemployment rate, obtaining and maintaining employment is exceptionally difficult for individuals with autism spectrum disorders (ASD). Further, few individuals with ASD have been trained in the vocational skills needed to obtain gainful employment. The need to evaluate not only our current knowledge about the employment needs of individuals with ASD, but also to inquire about interventions, strategies, and supports in the workplace is pressing. The harsh reality of high unemployment rates for adults with ASD, and the consequently high cost of services, can be aided by examining the best practices for supporting employment. This review of the literature focuses on vocational training interventions targeted specifically to adolescents and adults with ASD. Twenty studies evaluating pre-employment, specific vocational skill training, and job retention interventions are discussed, trends in intervention characteristics are highlighted, and recommendations for future research are suggested.
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    • "Shattuck et al. (2012a, b) examined the research literature from 2000 to 2010 and found limited evidence regarding support services or interventions to improve adult outcomes. In another review, Taylor et al. (2012) identified only five studies in six publications (García-Villamisar et al. 2000; García-Villamisar and Hughes 2007; GarcíaVillamisar et al. 2002; Howlin et al. 2005; Lawer et al. 2009; Mawhood and Howlin 1999 ) that described a vocational intervention. All of these papers focused on ''on-thejob'' supports provided to individuals. "
    [Show abstract] [Hide abstract] ABSTRACT: This paper presents findings from a retrospective observational records review study that compares the outcomes associated with implementation of supported employment (SE) with and without prior Project SEARCH with ASD Supports (PS-ASD) on wages earned, time spent in intervention, and job retention. Results suggest that SE resulted in competitive employment for 45 adults with ASD. Twenty-five individuals received prior intervention through PS-ASD while the other 20 individuals received SE only. Individuals in this sample who received PS-ASD required fewer hours of intervention. Additionally, individuals in the PS-ASD group achieved a mean higher wage and had higher retention rates than their peers who received SE only. Further research with a larger sample is needed to confirm these findings.
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    • "K. Anderson, Liang, & Lord, 2013; Landa, Gross, Stuart, & Bauman, 2012; McGovern & Sigman, 2005), and recent work has begun to characterize the characteristics of individuals who lose their ASD diagnosis over time (often referred to as ''optimal outcomes ;'' D. K. Anderson et al., 2013; Fein et al., 2013). A number of effective psychosocial interventions have been developed and empirically validated to treat core and associated symptoms of ASD throughout the lifespan, including early behavioral intervention programs (Dawson et al., 2010; Warren et al., 2011), social skills training groups (Reichow, Steiner, & Volkmar, 2013), vocational intervention (Taylor et al., 2012), parent training programs (Kaminski, Valle, Filene, & Boyle, 2008; McConachie & Diggle, 2007; Virués- Ortega, Julio, & Pastor-Barriuso, 2013), and applied behavioral analysis (Lovaas, 1987; Virués-Ortega, 2010). "
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