Supported Employment

1. Supported Employment How can we make it work for individuals on the ASD continuum?

2. Part I: SE Overview From: Work and Disability: Issues and Strategies in Career Development and Job Placement, by Edna Mora Szymanski and Randall M. Parker

3. Supported Employment Beliefs • Competitive employment allows people with disabilities to earn wages and receive benefits • Greater independence • Increased access to the community • Productive work that has meaning enhances self esteem and dignity for the individual • Employment facilitates the development of new friendships and social networks • Employment enhances the opportunities for individuals with disabilities to be free from government subsidies.

4. Core Features of SE Competitive Employment with wages typical of the community Integrated settings: Workers with disabilities are included alongside other employees Employment of workers with the most severe disabilities Provision of ongoing supports

5. Efficacy of Supported Employment • Average annual cost of SE is often less than alternative services • SE participants are tax-paying citizens • Savings in government paid subsidies • Early studies suggested that most SE participants, when employed, earn too much to qualify for subsidies • More recent studies indicate that the savings are more moderate—reduced reliance on subsidies is indicated

6. Models of SE • Group models— • For people judged “not appropriate” for individual placements • Thought to need “intense daily supports that never fade” • Criticized for inherent limits on integration within the workplace • Enclave (congregated/dispersed) • Mobile Crew (contractual services)

7. Models of SE, Cont. • Individual Models— • Primary Provider: Responsible for assessment, job development, placement, training, and on-going support • Physical integration is ensured • Provider is responsible for ensuring that social integration is also present • Facilitator/Consultant • Emphasizes natural, on-site supports, training of co-workers, etc. • Shifts emphasis from direct support to facilitation of supports from others

8. Service Delivery • Assessment • Job assessment (or analysis) • ID duties and responsibilities (direct and indirect) • Abilities, skills, experiences need by the job holder (job specific skills and related skills) • Individual assessment (an on-going process) • Strengths, limitations, support systems • General profile of the individual • Vocational evaluations, psychological tests, etc.

9. Service Delivery, cont. • Job Development and Marketing • ID potential jobs • Refine available options • Expand the number and type of jobs available • Create opportunities for mobility and advancement • “Person first” approach (Most common) • “Job first” approach

10. Service Delivery, cont. • Job Development and Marketing, cont. • Traditional Models • “Beg, place, pray” • Hat in hand (“Please hire the handicapped”) • SE Participants are the only customer • Business Responsive Models • Shifting from a social service model (“hire this person out of the goodness of your heart”) to a business model (“hire this person because he or she is a good fit, and both you and the individual will benefit”) • Uses marketing and sales techniques from the corporate world

11. Post-Placement Training • Employer driven: Should reflect both short and long term needs of the individual • Basic skills training (literacy skills, etc. related to the job) • Coaching (usually provided by a supervisor or manager) • Mentoring (a new employee is matched with a more senior employee for formal and informal training) • Apprenticeship (relies heavily on hands-on acquisition of skills through demonstration, modeling, and practice)

12. Ongoing Supports Intended to enhance the long-term maintenance of skills that are critical to the job and to enhance the flexibility of the supported employee in adapting to changes

13. Part II SE and persons who have Autism Spectrum Disorders

14. Where we are Individuals with ASD are among those within the disability community least likely to be employed (Dew & Alan, 2007; Cameto, et al., 2003); According to Cameto, et al., (2003), only 15 percent of persons with autism are employed.

15. Where we are, cont. • “Many of those adults with ASD who do have employment are forced to change their job (within and outside organizations) frequently as well as taking on roles far beneath their ability levels. This is not a sensible use of any individual's skills and has a direct, negative consequence for the employee as well as for the employer.” http://www.opposingviews.com/i/employment-benefits-people-with-autism

16. Where we are, cont. "We…also looked at indicators of depression and anxiety in our survey. Rates of these were higher than we would have expected in a non-ASD group, and similar to rates reported in other research studies.” .” http://www.opposingviews.com/i/employment-benefits-people-with-autism

17. Factors affecting employment • A number of external factors, from market trends to employer discrimination, can impact employment outcomes (Hernandez, et al., 2006) • Researchers have also identified a number of characteristics of the current vocational rehabilitation service delivery system that present barriers to successful employment outcomes for persons with ASD. The Institute on Rehabilitation Issues on ASD (Dew & Alan, 2007)

18. Issues within the VR system VR counselors' involvement with public schools often does not begin until the student with ASD is about to graduate. Few VR counselors have training or experience in working with people with ASD. Vocational rehabilitation services are oriented around seeking successful closure as efficiently, effectively, and quickly as possible. A consumer with ASD, however, often needs long-term support without which employment placements would be lost.

19. Issues within the provider system • There is a severe shortage of agencies that provide specialized services for adults with ASD. • Few supported employment job coaches have the specialized knowledge and skills needed to effectively support persons with ASD in employment settings. • Research information describing best practices for facilitating the employment of persons with ASD is extremely limited.

20. So, what do we need to do? • Research, though limited, indicates that workplace adjustments can make a huge difference to both the employee, members of their team and their employers. • These should all be considered on an individual basis but might include: • a quiet place to go at lunchtime, • clear rules about when and how to respond to phone calls and emails, • changes to the ambient lighting or temperature in an individual's office space.

21. Recommendations • Dahl and Arici (2008) recommend the following: • a sophisticated understanding of autism; • ongoing employment assessment, job • development and training within community settings; • Systematic application of the principles found in the science of applied behavior analysis; • Comprehensive post-placement consultation, collaboration, and support in work environments

22. Summary and Conclusions García-Villamisar and Hughes found that adults with ASD who were employed had improved cognitive functioning when compared to adults who were not working. Journal of Intellectual Disability Research Volume 51 Issue 2, Pages 142 - 150, 2006 It is less expensive to provide employment assistance than to continue reliance on government subsidies

23. Summary and Conclusions, cont Advocates and persons who have autism and autism spectrum disorders should continue to lobby for changes in the Vocational Rehabilitation system and to advocate for increased supported employment options. Adequate and acceptable employment is truly a win-win for society and for the people we support.