Examining Vocational Services for Adults with

Autism

Kevin StoddartBarbara MuskatWendy RobertsMargaret SpoelstraSarah Duhaime Isabel Smith

Cynthia Carroll

Tom Jackman

David NicholasLonnie ZwaigenbaumMargaret ClarkeHerb EmeryLaura GhaliPat Mirenda

Karen Kalynchuk

Peter Gerhardt - USA

Funding is gratefully acknowledged from Autism Speaks.

ObjectivesTo explore the vocational experiences of adults with ASD

To identify barriers and facilitators to vocational outcomes

Methods

Survey of Vocational Resources: n=94 (12)

Key Informant Interviews: n=160 (27)• Individuals with ASD: 45 (9)• Parents/Caregivers: 60 (10)• Services Providers: 36 (7)

•Employers: 19 (1)

Delphi Consultation

Municipality

Population

Rural Under 10,000

Small Urban 10,000 - 99,999

Large Urban 100,000+

Response to the Survey by Size of Municipality

Service Municipality Size  # of

Respondents % of RespondentsRural 1 8.3Small Urban 5 41.7Urban 6 50.0

Total 12 100.0

% o

f R

esp

ondents

# of Individuals with ASD Served by Respondent

Organizations

Individuals with ASD Served in a Year

# o

f R

esp

on

den

ts

N=8

Services Provided by Respondent Organizations

N=11

2

2

2

3

3

3

4

4

7

8

9

10

Serv

ices P

rovid

ed

Response Percentage

Org

an

izati

on

Typ

e

Response Percentage

Respondents by Organization Type

1

1

3

3

3

8

9

N=12

“Other” Organization Types

Non-profit, advocacy, information service

Employment support

Provide occupational education

Non-profit society contracted with Work BC to provide employment services

Provide employment support for competitive employment

Help people obtain employment

Non-profit organization facilitating post-secondary inclusion for people with developmental disabilitiesCorporation providing services to adults with significant intellectual and functional disabilitiesEmployment program for people who are transitioning from high school to post-secondary or workplace - young adults with special learning needs

Service Planning and Evaluation: How well are vocational services of the organization planned and evaluated?

Organizational Capacity: How well is the organization able to meet the vocational needs of persons with ASD (within its resource capacity)?

Enhancing Systems Capacity: How well does the organization support broader systems of adult services?

Community Capacity: How well does the region or municipality meet the vocational needs of individuals with ASD?

Service Planning and Evaluation Enhancing Systems Capacity

Average Agreement with Statements by Domain: BC

Organizational Capacity Community Capacity

0%

10%

20%

30%

40%

50%

60%

Agree Neutral Disagree Do not

know

Not

applicable

Service Planning and Evaluation

Enhancing Systems Capacity

Average Agreement with Statements by DomainNational

Organizational Capacity

Community Capacity

Male: 69%; Female: 31% 18-25 yrs: 54%; 26-40 yrs: 32% 41-65 yrs:14%; 65+ yrs: 0%

Urban: 80%; Rural: 20%Autism 26%; PDD-NOS 15%; Aspergers 59%

English - 1st language: 84%; Other language: 18%

No supportive family members: 4%1-5 supportive family members: 83%6-11 supportive family members: 6%>11 supportive family members: 8%

Canada Wide Demographics – Persons with ASD

Individuals represented in the data

Under $20,000 / year 94%

$20,000 to $39,000 / year 3%

$40,000 to $59,000 / year 0%

$60,000 to $79,000 / year 0%

$80,000 to $99,000 / year 3%

$100,000 + / year 0%

Inco

me C

anada-

Wid

eFamilies represented in the data

Under $20,000 / year 7%

$20,000 to $39,000 / year 11%

$40,000 to $59,000 / year 14%

$60,000 to $79,000 / year 17%

$80,000 to $99,000 / year 3%

$100,000 + / year 48%

PRELIMINARY QUALITATIVE FINDINGS: INTERVIEWS

“I haven’t had a chance to figure out what my vocation is. My life hasn’t let me up to this point.”

“The problem is I can do the job well, but I get anxious on the job because I’m comparing myself to other people and I’m analyzing. I don’t… do the job like other people. I see the power dynamics and the way it treats people and it gets to me you know. Because I’m passionate about the job and I don’t like it when other people are not passionate about their jobs. It’s horrible, I hate it.”

Psychological/Emotional/Mental ChallengesEMOTIONAL/PSYCHOLOGICAL CHALLENGES:• anxiety, mental health issues• lack of confidence• self-esteem

FOCUS/CONCENTRATION:• “he can’t think about doing four things

at once…he can focus on one”• study for hours see patterns, but

can't remember

ENVIRONMENTAL/PROCESSING:• sensory issues• verbal details • time insufficient to process tasks or

emotions/situations

SOCIAL/RELATIONAL:• colleagues/supervisors • others not direct• too honest

• blunt communication misinterpreted• eye contact• difficulty with strangers

Physical/Biological Issues (e.g., sleep, attention)

Logistical Issues (e.g., travel/transportation)Disclosure of ASDMarket Issues (e.g., few jobs, difficulty competing)

Job Structures/Demands (e.g., tasks too great, “not enough time to recuperate”, “You can’t have meaningless rules that muddle up my mind.”)

Relationship Formation with Employer familiarity with supervisor employer has an understanding of ASD and

supports employee

External Navigator/Advocate employer open to support person during

orientation follow up between job coach and employer individualized and regular support employer letting job coach attend to crisis intervention to both individual with ASD and employer

Strategies and Skill Development help with social skills time to accomplish task/time to process emotions visual triggers to facilitate memory retrieval scripted role play clarity of tasks and processes (tasks broken down)

Elements of Workplace Success…

Stability of Employment

remuneration/incentivesconsistency of job experienceemployer open to work environment adjustments

‘effective’, sensitive non-patronizing support person/agency

optimizing successrecognition for the value of contribution

Workplace Environment

positions offer good fit with the skills/aptitudes of the individualconsistent with interestcommensurate with skills and strengths

individuals are permitted to work from their skills and strengths, rather than from limitations or avoiding weaknesses

balance in reaching to skills while generally avoiding areas of challenge

Workplace Environment (cont’d)

person-centered – oriented for successclear, achievable job expectations attention to detailactive communication including “checking in”

opportunity for skill developmentawareness of potential sensory concernscalm atmospheremutual understanding and respect for involvement and support (balanced support/two-way support)

Workplace Preparednesssupportive involvement of HR or management

some knowledge about autism and autism in the workplace

open communication between HR/employer and employee

openness to having a job coachjob coach communication with internal mentor

feedback mechanisms

Helpful Employee Attributes

willingness to engage in training (job skills, work-related social skills) before work begins

engage with support person in developing greater awareness of strengths and challenges including building strengths and dealing with challenges

consideration of benefits and risks of disclosure of ASD and concurrent disorders

openness to dialogue with support worker as needed including after assistance is decreased over time

Job Coach Roles

assessment – understanding of what individual is looking for and workplace capabilities

training employee: job skills and social skills development

before employment commencement employer/HR: support HR or management if

necessary with tools and info needed for workplace training or HR training in autism and autism in the workplace

job fit – understanding what employer is looking for

comprehensive support - nuanced knowledge of individual’s sensitivities and concurrent issues

proactive strategies to help employee optimize workplace experience and mitigate challenges

Job Coach Roles (cont’d)

liaison - careful, respectful, open communication with HR/management and other resources, if needed

way finding - assistance in navigating employment and, as needed, other appropriate vocational activities (e.g. volunteer positions while looking for work)

problem-solving – strategy development for needs and issues as they arise

navigation – awareness of and access to funding resources and placement opportunities

support network development – nurturing persons available to employee including family, friends, others

advocacy – connection with community in finding positions, raising awareness, seeking proactive vocational opportunities

Skills & Aptitudes of Job Coach

understanding employee background and needs knowledge of the workplace including the details of

workday positive, encouraging and goal focused attitude motivating – for the employee to succeed through

differential use of self respectful sense of humour (focused yet relaxed) approachability – ease of access, friendliness, and

availability willingness to actively engage in training to

continually develop understanding of ASD and the workplace

eagerness to adopt evidence-based principles – continually working toward refined goals, as appropriate

Ability to Mentor

demonstrate respect, positive regard & encouragement

teach (e.g. small talk, appropriate conversation, prioritizing tasks) and provide opportunity for practice

offer a scaffolding of support, then step back, with possibility of reinsertion as needed

balance – ability to determine and resist over-involvement, yet learn with the individual with ASD

prepare for and implement transition plan to decrease direct support and set up other mentorship with co-worker, HR, management

Skills & Aptitudes of Job Coach (cont’d)

engagement with other workplace staff when appropriate depending on employer/employee priorities and desires

open, respectful communication with HR and management re: concerns, successes, etc.

acknowledgement of success and focus on strengths while working on challenges

confidence with humility and openness to learning

Role of ParentsSubstantial role in

seeking service in some cases, liaising with service

“[I] dreamt just before [he] left high school, I dreamt he died, because it’s like you die as a human being in terms of the services that are available or programs or anything.”

“The parents are always the people driving it, because they’re the people who have to live with it, I guess”

“It involves so much creativity and imagination and courage as a family to look at how can I integrate my child into the community we live in”

Systems Issuesoverall lack of adult-focused services

varying transition support

issues for families in poverty or isolated populations

support organizations - confusing as to what each agency offers and who is eligible for programs

lack of balance - more job preparation services than job placement and retention services

Debate - incentives (wage subsidies) to employers- support vs. valued (market) contribution

Relational/Structural Interface:MAKING IT WORK…

Structural/Programmatic Issues•Service availability

•Service access•Information navigation

•Coordination

Tailored Individual Support

•Job preparation – job skills, life skills•Job access – fit•Job retention support

Community/Workplace Capacity•Organizational/employer capacity

enhancement•Workplace accommodations (e.g., sensory, environmental, challenge

management)•Associated supports (e.g., mental health,

housing, transportation, etc.)

Family Navigationand Support

•Honoring family role•Augmenting/easing family role

ACCESSENGAGEMENT

RETENTION

Some Emerging ThemesGeneral organizational enthusiasm for the work being done

Individuals with ASD and parents’ perception of insufficient services, difficulty in finding appropriate services, and/or services not appropriate to needs

Parents ‘pick up the slack’ in seeking/navigating services

Lack of community capacity

Range of issues negatively impacting vocational outcome

Non-vocational skills and other considerations impact vocational opportunity (e.g. transportation, social skills)

Some beneficial elements of services identified, yet substantial areas for development

Questions:

1. To what extent do these findings reflect the issues here in BC?

2. How do you see moving forward in addressing these issues?

nicholas@ucalgary.ca

Thank you