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Supporting Individuals with Autism Spectrum Disorders: Quality Employment Practices

The Institute Brief, Issue No. 25

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Originally published: 12/2008

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THE ICI PROFESSIONAL DEVELOPMENT SERIES December 2008

By Alan Kurtz and Melanie Jordan

“If you have met one person with autism, you have met one person with autism.”

—Stephen Shore

Introduction

It has been known for decades that individuals with autism spectrum disorders (ASD), including those with significant impairment or who have behaviors that others find challenging, can work when they are given appropriate supports (Smith, Belcher, & Juhrs, 1995). It is also clear that individuals with ASD can benefit from employment. Benefits include improved emotional state, greater financial gain, decreased anxiety, greater self-esteem, and greater independence (Mawhood & Howlin, 1999; Hurlbutt & Chalmers, 2004). Nonetheless, employment outcomes for individuals with ASD have traditionally been poor (Bilstedt, Gilberg, & Gilberg, 2005; Howlin, Goode, Hutton, & Rutter, 2004). Even those who do find work are often underemployed or do not hold onto jobs for a long period of time (Mawhood & Howlin, 1999). 

It is a mistake to assume that these historically poor employment outcomes for individuals with ASD mean that most cannot work. People with ASD can work when employment staff help them find the right job match and when appropriate and individualized supports are built in. It is important to recognize that each person with ASD is unique. Even those who share a common specific diagnosis (such as Asperger syndrome, autism, or PDD-NOS) differ dramatically from one another in their skills, interests, motivation, ability to communicate, behavior, and social ability. In itself, the knowledge that an individual has an ASD diagnosis is of little use to a professional helping the person find and keep a satisfying job. Instead, the employment specialist must develop a thorough understanding of the individual’s unique characteristics, learning style, strengths, and, most importantly, interests (Duffy, Opperman, Smith, & Shore, 2007).  

What are autism spectrum disorders, or ASD?

Achieving a Good Job Match: Considerations For Placement Planning and Assessment

It is imperative to match the job to the unique set of strengths, interests, and passions that the person with ASD brings to the situation. 

It is not essential that a job initially be a perfect match with the person’s skills. For example, a person with ASD might find a job (s)he is interested in but not have all the necessary skills to perform the job independently. Persons with ASD can learn new skills throughout their lives. Additionally, the skills that a person can independently demonstrate currently tells us little about what that person can do with appropriate supports. The discrepancies between the demands of the job and the person’s existing skills must be assessed so that those discrepancies might be reduced through teaching or accommodation. Assessment needs to be a dynamic process that looks at how a person performs in response to various supports over time.

An important aspect of determining appropriate supports is assessing the individual with ASD’s learning style. For example, many—but not all—individuals with ASD are visual learners and respond well to visual prompts. Many do well with picture or written cues. Others may respond well to a combination of visual and verbal prompts. Asking a person with ASD to imitate a task performed by a co-worker may be the best strategy in some cases. Another common strategy is to provide the employee with an example of a completed product. Often parents, family members, former teachers and others who know a person well have a good understanding of a person’s learning style.

It is also important to assess the work environment to determine the match between the communication, sensory, social, and organizational demands of the job and the needs of the individual with ASD. Again, the match between the demands of the environment and the needs of the individual does not have to be perfect. It is possible to introduce accommodations and instruction that will help create a better fit between the employee with ASD and the environment. 

After some potentially good job matches for an individual with ASD, based on his or her unique skills and interests, have been identified, it is important to examine in more detail the communication, sensory, social, and organizational demands of the job. In each of these four categories, the following sections will address: 

What Should Be Assessed?

Who Can Help?

Communication Demands

Almost all working people must communicate with others—co-workers, supervisors, and customers—at some time. There may be topics related to specific aspects of the job that the person needs to communicate. This can be difficult for persons with ASD. As many as 50% of persons with autism never develop functional speech (Lord and Paul, 1997). Moreover, a great deal of social communication occurs on a job site. Even persons with ASD who do develop speech may have difficulty with the social aspects of language (Prizant, Wetherby, & Schuler, 2000). Many have difficulty understanding the meaning of what others are saying – both through their spoken words and their expressions and body language. Some may get stuck on a particular topic or not know when it is appropriate to stop, start, or interrupt. The inability to communicate effectively can make it difficult for a person with ASD to fit in.

Employment specialists can help individuals with ASD find jobs that are a good match for their communication skills or style of communication. 

In some cases, there may a big discrepancy between the communication demands of the job and the skills the person with ASD currently possesses. Instead of ruling out the job, some of the following strategies and solutions might be considered:

Sensory Demands 

It has become increasingly clear that most individuals with ASD experience some sensory processing differences (Leekam, Nieto, Libby, Wing & Gould, 2007). Some individuals may be hypersensitive to certain sounds, sights, smells, tastes, textures, or touch. A particular noise or feeling might produce the same kind of response that fingernails on a blackboard produce in most of us. Some also may crave certain types of sensory feedback. For example, many individuals with ASD need some kind of movement (rocking or swinging) or deep pressure (from a hug or a heavy blanket) in order to remain calm and focused. 

A good sensory job match is one in which a person is not overwhelmed by stimuli (s)he cannot tolerate and one in which (s)he is getting the kind of feedback needed to stay focused on his or her job. Muller et. al (2003) contend that many individuals with ASD do well in a tranquil and calm workplace. Similarly, Quirk, Zeph, & Uchida (2007) suggest that employment specialists may need to work with the employer to create an environment free from unnecessary distracters.

Often employment specialists can help employers design some fairly simple modifications to the sensory characteristics of the workplace: 

Other strategies and solutions to help a person moderate sensory issues include:

Websites with Augmentative and Alternative Communication (AAC) Devices:

Low-Tech Devices

AAC Example

Lucinda can communicate most job-related information through signs, gestures, and through the use of a picture schedule. She has difficulty communicating socially with co-workers, however, during lunch breaks and at other times. Her employment specialist has brought in a speech therapist who is helping to design an AAC system that will allow Lucinda to participate in lunchtime conversations. The system will have a voice output that Lucinda can access by pushing buttons with pictures on them. The initial goal is to give her a means of exchanging greetings, sharing information, and telling stories.

Social Demands 

Social difficulties are often the biggest obstacle faced by individuals with ASD in a work environment. As one person with Asperger syndrome explains, “It is not that we do not work hard, or have problems with being prompt, not being on time, or unwilling, because we are not that at all. It is that we are not very good at dealing with people in social situations” (Hurlbutt and Chalmers, 2004, p.94).

Hagner and Cooney (2005) report that good job matches for persons with ASD are often ones in which there is a great deal of tolerance for individual differences. Gilbride, Vandergloot, Golden & Stensrud (2006) have developed a survey tool that can be used to assess an employer’s openness or tolerance (see reference section). Employees with ASD also may do well in situations in which co-workers are willing to learn how to initiate interaction with them and how to provide clear and direct feedback to them about social expectations. There are some individuals who may do best in situations where a great deal of social interaction is not required. 

However, it is important to remember that individuals with ASD may often want to interact but simply have difficulty with the mechanics of social interaction. In those cases, employment staff may have to provide some customized supports. Employment staff should become familiar with the workplace culture in order to help the worker with ASD understand what is acceptable, unacceptable, and expected. Clear, straightforward, positive explanations to the worker can then be provided and facilitated on an ongoing basis by all involved. Also keep in mind that stronger workplace cultures tend to be more welcoming. Hagner’s (2000) book titled “Coffee Breaks and Birthday Cakes” can be a useful tool in analyzing workplace culture (see reference section).

There are a number of strategies and solutions that have been used to support positive social interaction at job sites. These include the use of: 

Employment specialists working with individuals with ASD must also look at the bigger picture when analyzing problems.  Sometimes minor changes in routine or a change in personnel at work can be very difficult for a person to handle.

Difficulties with Workplace Social Interaction:

Social Stories™ describe situations, skills, or concepts in terms of relevant social cues, perspectives, and common responses in a specifically defined style and format. The goal of a Social Story™ is to share accurate social information in a patient and reassuring manner that is easily understood by its audience. Following is an example of a social story that could be used in a fast food restaurant:

I usually keep four hamburgers on the grill at work. Sometimes more customers come into the restaurant than usual. During those times I may need to put more hamburgers on the grill. My supervisor usually lets me know when I need to do this. If I need more help during those times I can ask my supervisor or one of the other employees: “Can you give me some help?” It is all right to ask for more help when I need it.

For more information, go to www.thegraycenter.org

Organizational Demands—Ensuring Adequate Structure, Routine and Predictability 

One of the most common needs among employees with ASD is to know what is going to happen and when. For many, the stress of not knowing if or when something is going to happen can cause overwhelming anxiety. Jeff, for example, quit his job when the employer changed the schedule without talking to him first. Many workers with ASD require some kind of visual organizer with pictures, video, written words, or symbols. This is true even for those who seem to have their routine or schedule memorized. 

Many individuals with ASD are visual learners. It often helps to be able to see what is expected of them. Even those who are able to tell others verbally or in writing what their schedule is often benefit from seeing it visually. 

Good job matches for individuals with ASD are often ones in which there is a high degree of structure, predictability, and routine. (Note, however, that structure and routine is not necessarily the same as boring and tedious.) A good job environment match in this case is often one in which responsibilities and schedules are spelled out in great detail. Additionally, employees are notified well in advance when there will be changes in the routine.

Employment staff can help employers provide customized supports for workers who might need extra attention around predictability and routine. As previously stated, the use of visual schedules and calendars are among supports that have been found most effective. For many people, the introduction of a concrete, visual schedule may make the difference between success and failure at a job. Other strategies and solutions include: 

Employment Specialist Role in Supporting the Job

Once the job is carefully developed, employment staff need to pay close attention to ongoing details and progress. Since situations can develop and change quickly, staff need to be aware of surrounding circumstances and to be proactive in anticipating and preventing problems. Some key aspects of this role include:

Visual Organizers and Schedules

Types of Visual Schedules

Symbols Used with Visual Schedules

Websites with Examples of Visual Organizers:

Low-tech organizers

www.spectronicsinoz.com/product.asp?product=17625#commfolder

High-tech organizers

www.abilityhub.com/cognitive/index.htm

Personal Digital Assistants and Software

www.ablelinktech.com/

Job Development Strategies  

Many individuals with ASD have characteristics that could make them attractive to potential employers, including punctuality, attention to detail, consistency, reliability, or good visual-spatial or mechanical skills.  Whatever skills the person possesses, it is important to emphasize the strengths and the contributions (s)he could make to the business.

There are certain job development strategies that may be particularly useful and productive to prioritize when job searching with and for job seekers with ASD.

Application Strategies and Accommodations 

Differences in communication and social interaction styles among individuals with ASD can make some of the up-front job search activities such as interviews and applications difficult. Some job seekers struggle with the big picture and may not understand what the employer is looking for or how much detail to provide. A number of large corporations now require prospective employees to take computer-based personality assessments. These can be especially hard for individuals with ASD.

One common strategy is to practice interviews in advance. There are a number of other solutions to these issues involving accommodations to the application/interview process. These include:

Getting the Job Seeker Involved

Use creative and customized strategies to keep the job seeker involved and engaged in planning and job search activities. Incorporate AAC, photographs, story writing, or other expressive alternatives. Tasks that job seekers can contribute include:

Situational Assessment as Job Try-out: A Central Strategy for Persons with Limited Communication

The reality for many people with ASD is that the typical hiring criteria are going to exclude them from getting the job. Why not offer the employer an opportunity to fully evaluate the individual’s ability to do the job tasks by allowing him/her to try the job out for a few hours, a day, or even a couple of days, at no obligation to the employer? This also gives the individual the chance to understand the job and to make an informed decision about whether (s)he wants to work there. The job try-out should be portrayed as a reasonable accommodation of the normal hiring process, under the American with Disabilities Act (ADA), in order that the applicant gets equal consideration. The following are important guidelines for using situational assessment in this way:

Conclusion

Over the past few years, much attention and research has focused on persons with ASD. There are reasons to be optimistic that employment outcomes for this population can and will continue to improve:

Individuals with ASD can work, but we need to match them with jobs that build on their strengths and interests.  At the same time, we need to carefully consider the demands of particular jobs, the physical and social environments, and how we might provide instruction or accommodations that will make success possible.  This requires precise support and planning, collaboration, creative strategizing, and, most importantly, an intimate understanding of the person with ASD as a unique individual. This takes time, perseverance, and commitment, but it works! 

References / Resources

Bellini, S. (2006). Building social relationships: A systematic approach to teaching social interaction skills to children and adolescents with autism spectrum disorders and other social difficulties.  Shawnee Mission, KS:  Autism Asperger Publishing Co.

Billstedt, E., Gillberg, C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism & Developmental Disorders, 35(3), 351-360.

Duffy, T., Oppermann, R., Smith, M.R. & Shore, S. (2007).  Supporting successful employment. In D. Dew & G. Alan (Eds.), Rehabilitation of individuals with autism spectrum disorders (Institute on Rehabilitation Issues Monograph No. 32) (89-118). Washington, DC: The George Washington University, Center for Rehabilitation Counseling Research and Education.

Emmons, P.G. & Anderson, L.M. (2005). Understanding sensory dysfunction: learning, development and sensory dysfunction in autism spectrum disorders, ADHD, learning disabilities and bipolar disorder. London:  Jessica Kingsley Publishers.

Fast, Y. et al. (2004). Employment for Individuals with Asperger syndrome: Stories and Strategies. London. Jessica Kingsley Publishers Ltd.

Gilbride, D., Vandergoot, D., Golden, K., Stensrud, R. (2006). Development and Validation of  the Employer Openness Survey.  Rehabilitation and Counseling Bulletin, 49(2), 81-89.

Grandin, T., Duffy, K. (2004). Developing Talents: Careers for Individuals with Asperger syndrome and High-Functioning Autism. Shawnee Mission, KS:  Autism Asperger Publishing Co.   

Hagner D. & Cooney, B.F. (2005).  “I do that for everybody”: Supervising employees with autism. Focus on Autism and Other Developmental Disabilities, 20(2), 91-97.

Hagner D. (2000) Coffee Breaks and Birthday Cakes: Evaluating Workplace Cultures To Develop Natural Supports for Persons with Disabilities. St. Augustine, FL. Training Resource Network, Inc.

Henn, J. & Henn, M. (2005).  Defying the odds: You can’t put a square peg in a round hole no matter how hard you try.  Journal of Vocational Rehabilitation, 22, 120-130.

Hoff, D., Gandolfo, C., Gold, M., & Jordan, M. (2000).  Demystifying job development:  Field based approaches to job development for persons with disabilities.  St. Augustine, FL: Training Resource Network.

Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcomes for children with autism. Journal of Child Psychology & Psychiatry, 45(2), 212-229.

Hurlbutt, K. & Chalmers, L. (2004).  Employment and adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 19(4), 215-222.

Lattimore, L. P., Parsons, M. B., & Reid, D. H. (2002). A prework assessment of task preferences among adults with autism beginning a supported job. Journal of Applied Behavior Analysis, 35(2), 85.

Leekam, S. R., Nieto, C., Libby, S. J., Wing, L., & Gould, J. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of Autism and Developmental Disorders, 37(5), 894-910.

Lord, C., & Paul, R. (1997). Language and communication in autism. In D. Cohen & F. R. Volkmar (Eds.), Handbook of autism and pervasive developmental disorders. New York: John Wiley and Sons.

Mawhood, L., & Howlin, P. (1999). The outcome of a supported employment scheme for high-functioning adults with autism or Asperger syndrome. Autism, 3(3), 229-254.

Muller, E., Schuler, A., Burton, B., & Yates, G. (2003). Meeting the vocational support needs of individuals with Asperger syndrome and other autism spectrum disabilities. Journal of Vocational Rehabilitation, 18, 163-175. 

Meyer, R. N. (2001). Asperger syndrome employment workbook. London: Jessica Kingsley Publishers, Ltd.

Olney, M. (2000). Working with autism and other social-communication disorders. Journal of Rehabilitation, 66(4), 51–56.

Quirk, C., Zeph, L., & Uchida, D. (2007).  Accessing the vocational rehabilitation system.  In D. Dew & G. Alan (Eds.), Rehabilitation of individuals with autism spectrum disorders (Institute on Rehabilitation Issues Monograph No. 32) (55-58). Washington, DC: The George Washington University, Center for Rehabilitation Counseling Research and Education. 

Romoser, M. (2007).  Mal-employment in autism.  Focus on Autism and Other Developmental Disabilities, 15(4), 246-247.

Smith, M. D., Belcher, R., & Juhrs, P. (1998). Guide to successful employment of individuals with autism. Baltimore: Brookes.

Wetherby, A. M., Prizant, B. M., & Schuler, A. L. (2000). Understanding the nature of communication and language impairments in autism. In autism spectrum disorders: A transactional developmental perspective. (pp. 109-141). Baltimore, MD, US: Paul H Brookes Publishing.

Worksheet

Ten Preliminary Questions to Ask About Employment Supports for an Individual with ASD

These questions below are designed to help employment specialists and individuals with ASD think about the kind of job they might want and the kind of supports they might need to be successful. As you begin the job development process you may not be able to answer all these questions. However, you should be able to answer most of them by the time the person with ASD is ready to begin a job.

  1. What are some of his or her strengths? What makes this person unique?
  2. How might this person benefit from having a job?
  3. List some of the obstacles that you think may get in the way of him or her becoming employed.
  4. What are some of the communication issues he or she deals with? How might these issues interfere with job performance? What kinds of support might he or she need to communicate socially? To communicate job-related information?
  5. Has this person reported any problems with touch, sounds, smells or things that he or she sees? Does he or she ever overreact to some sensations such as light touch, certain tastes or smells, particular noises, etc.? Does he or she crave any sensations such as deep pressure from hugs or heavy blankets? Does he or she have any repetitive movements such as rocking? Does anyone who knows the person well notice any issues? Is there anything that helps when the person reacts negatively to a sensation?
  6. Are there social or behavioral issues that might get in the way of succeeding at a job? Are there any particular kinds of environment that might help this person be more successful? What kinds of supports or instruction would you need to think about providing to the person? To co-workers and employers?
  7. Does the person need help in organizing the work or schedule? Has there been anything that has worked in the past in helping this person understand his or her schedule or in understanding what will come next?
  8. What kinds of things increase his or her anxiety? What helps? What kinds of supports for anxiety issues would be necessary for the person on a job? Are there any kinds of work environments that would probably help this person experience less anxiety?
  9. What personal, organizational, neighborhood, or family networks can you access to help this person find a job?
  10. Does the person need help in applying for jobs or in participating in interviews? 

New Manual!

Teaching Networking Skills: Paving a Way to Jobs and Careers

Easy-to-use curriculum enables employment staff to teach job seekers how to network. Download the pdf for free at...

www.communityinclusion.org/article.php?article_id=251

Contact the ICI Publications Office to order a hard copy three-ring binder of the curriculum.

About the Authors

Alan Kurtz is a research associate at the Center for Community Inclusion and Disability Studies (CCIDS) at the University of Maine in Orono.

Melanie Jordan is a training associate at the Institute for Community Inclusion (ICI) at the University of Massachusetts Boston.

Acknowledgements

Special thanks to Cecilia Gandolfo, Janet May, Janine Collins, Gayla Dwyer, and David Hagner for their input and editorial assistance. This publication was funded by a grant from the Rehabilitation Services Administration of the U.S. Department of Education (grant #H264BO50009). The opinions contained in this publication are those of the grantees and do not necessarily reflect those of the U.S. Department of Education.

For more information, contact:

Publications Office
Institute for Community Inclusion
UMass Boston
100 Morrissey Boulevard
Boston, Massachusetts 02125
617-287-4300 (voice); 617-287-4350 (TTY)
ici@umb.edu

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