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


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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    • ") 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; García- Villamisar 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. "
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    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.
    Full-text · Article · Mar 2015 · Journal of Autism and Developmental Disorders
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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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    ABSTRACT: This article suggests future directions for research aimed at improving our understanding of the etiology and pathophysiology of autism spectrum disorder (ASD) as well as pharmacologic and psychosocial interventions for ASD across the lifespan. The past few years have witnessed unprecedented transformations in the understanding of ASD neurobiology, genetics, early identification, and early intervention. However, recent increases in ASD prevalence estimates highlight the urgent need for continued efforts to translate novel ASD discoveries into effective interventions for all individuals with ASD. In this article we highlight promising areas for ongoing and new research expected to quicken the pace of scientific discovery and ultimately the translation of research findings into accessible and empirically supported interventions for those with ASD. We highlight emerging research in the following domains as particularly promising and pressing: (a) preclinical models, (b) experimental therapeutics, (c) early identification and intervention, (d) psychiatric comorbidities and the Research Domain Criteria initiative, (e) ecological momentary assessment, (f) neurotechnologies, and (g) the needs of adults with ASD. Increased research emphasis in these areas has the potential to hasten the translation of knowledge on the etiological mechanisms of ASD to psychosocial and biological interventions to reduce the burden of ASD on affected individuals and their families.
    Full-text · Article · Sep 2014 · Journal of Clinical Child & Adolescent Psychology
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    • "In conclusion, virtual reality training is an efficacious and highly accessible strategy for improving job interview skills among individuals with ASD. There is a major gap in services available to address vocational skills among adults with ASD after they transition out of high school (Taylor et al. 2012). This study presents preliminary evidence that the use of VR-JIT may be a feasible and efficacious tool to improve job interview skills for adults with ASD. "
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    ABSTRACT: Background: The community-based unemployment rate for adults with an autism spectrum disorder (ASD) ranges from 50-75%. Moreover, evidence-based services to support these adults in finding employment are sparse. The job interview is a common gateway to obtaining competitive community-based employment, but it can be a significant barrier for individuals with ASD to obtain employment. Improving job interview performance is a critical target for employment services and is especially important for individuals with ASD given their significant social deficits. Objectives: To test the feasibility and efficacy of the internet-based 'Virtual Reality Job Interview Training' (VR-JIT) program Methods: VR-JIT consists of up to 10 hours of simulated job interviews with a virtual human resource representative and didactic job interview education materials. In a randomized single-blind controlled trial, 26 adults with autism aged 18-31 years were randomized to VR-JIT (n=16) or to a treatment as usual (TAU) control condition (n=10). The primary outcome measures were improved performance on standardized job interview role-plays and a measure of job interview self-confidence. Within the VR-JIT condition, change in trial performance over time was examined as a process measure. Results: Regarding feasibility, participants attended 90% of VR-JIT training sessions and reported that the training was easy-to-use, helpful, and enjoyable. They also reported that training increased their confidence and prepared them for future interviews. Regarding efficacy, participants in the VR-JIT condition had greater improvement in standardized role-plays than TAU participants (p=.046). A similar pattern was observed with regards to self-confidence at the trend level (p=.060). We also found a log linear increase in the training scores for the simulated job interview trials over time (R-Squared=.83). Conclusions: The current study was a novel attempt to demonstrate changes in vocational skills through virtual reality training using an internet-based platform that can be widely used by families, support groups, and service providers. The findings provide preliminary evidence that VR-JIT is both feasible and efficacious for adults with ASD.
    Full-text · Conference Paper · May 2014
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