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Vocational Rehabilitation Services Received by Youth with Autism: Are they Associated with an Employment Outcome?

Research to Practice Brief

By:

Originally published: 12/2010

Institute for Community Inclusion
University of Massachusetts Boston
Issue 48
December 2010

Introduction

While youth with autism represent a small percentage of all vocational rehabilitation (VR) closures, the number who closed out of VR more than tripled between 2003 and 2008 (see Institute for Community Inclusion Data Note 26). As increasing numbers of youth with autism are accessing VR services, it is important to understand how they are using these services and the relationship of these services to outcomes and costs.

The purpose of this brief is to:

Description of Sample

The current analysis considered youth with autism who had a VR closure into employment (Status 26) or a VR closure after services were provided, but without an employment outcome (Status 28), during FY2008. “Transition-age youth” are defined as people between the ages of 16 and 26 who applied for VR services. These individuals were identified as having autism based on VR counselor indications of primary and secondary disability in the RSA-911 case record data (n=3,323). As comparison groups, transition-age youth with intellectual disabilities (ID) (n=22,748) and other disabilities (n=100,182) were also considered.

Findings

Youth with autism were more likely than youth in other groups to have received assessment, job placement, and on-the-job supports.

Table 1 on page 2 shows the percentage of transition-age youth from the three subgroups who received various services through VR. Data are sorted by percentage of people with autism receiving these services.

A larger percentage of youth with autism received assessment, job placement, and on-the-job supports than the other two subgroups. They received significantly fewer college services and occupational/vocational training than the subgroup of other disability types, but slightly more than the subgroup with ID. Youth with autism received fewer maintenance services than other groups.

Receipt of job placement, on-the-job supports, job search, and on-the-job training services were associated with an employment outcome.

Table 2 on page 2 shows the percentages of youth with autism who achieved an employment outcome (status 26) according to VR service.

Youth who received job-specific training, supports, and preparation were more likely to achieve an employment outcome. With the exception of college services, youth who received any of the other services were more likely to achieve an employment outcome, especially job placement. Of the people who exited VR into employment, 79.7% received job-placement services.

For a detailed definition of each of the VR services presented, please see Table 3.

Conclusion

Youth with autism were more likely to receive services that involve direct engagement in finding a job than other disability groups, including job-placement and job-search services, and services that involve workplace supports. Receipt of these services also had a significant positive relationship to achieving an employment outcome. These findings are consistent with the underlying philosophy of rapid placement and supports inherent in Supported Employment and Individual Placement and Support models of service delivery. The data also suggest that youth with autism may move into job search and job placement services more rapidly when compared to other groups.

The more general services of assessment and rehabilitation counseling and guidance are the services most frequently received. The high percentage of youth receiving these services may be a reflection of which services VR provides first after an individual's Individualized Plan for Employment (IPE) is completed. The VR service flow would, after the provision of assessment and counseling services, progress to more employment-specific services.

Further exploration into the relationships between specific services provided and employment outcomes would help determine which efforts are most fruitful in obtaining a desirable outcome. The data suggest that there is value to rapid engagement in job-specific outreach and supports. However, it is difficult to distinguish between levels of support needed and other personal factors that influence progression through the individual employment plan and ultimately lead to job success. Research that assesses rapid engagement in direct placement supports through random assignment will help to determine which services provided are most effective in achieving positive outcomes. Another question that needs to be addressed is the extent to which the client elects or influences which services he or she receives.

Implications for Supports

Rapid job placement and a philosophy of place-then-train are fundamental to the Supported Employment model. These data suggest some support for engaging an individual directly in the job search as quickly as possible, focusing on a rapid career-planning or discovery process. The Supported Employment Fidelity Scale, for example, includes the criterion that first face-to-face employer contact about a competitive job occurs within 30 days (Becker et al, 2008).

Reference

Becker, D. R., Swanson, S., Bond, G. R., & Merrens, M. R. (2008). Evidence-based supported employment fidelity review manual. Dartmouth Psychiatric Research Center.

Smith, F. & Lugas, J., (2010). Vocational Rehabilitation (VR) Employment Outcomes for Transition-age Youth with Autism,and Other Disabilities. DataNote Series, Data Note XXVI. Boston, MA: Institute for Community Inclusion.

Table 1. Percentage of Transition-Age Youth Who Received Services (by Service Type)
Type of Service Percent of total who received service
Autism ID Other Disability Total
Assessment 70.50 66.90 63.30 64.20
Rehabilitation counseling & guidance 63.10 58.40 65.10 63.80
Job placement 47.80 44.30 33.50 35.80
On-the-job supports 44.80 39.80 15.20 20.40
Job search 34.20 33.20 27.70 28.90
Other services 24.70 27.30 28.00 27.80
Transportation services 23.30 23.80 29.40 28.20
Diagnosis and treatment 22.60 21.60 35.10 32.40
Job readiness training 22.00 26.60 16.50 18.50
Information/referral 19.50 15.00 17.40 17.00
Misc. training 15.60 14.90 13.30 13.70
College services 9.60 3.00 25.70 21.20
Occupational/vocational training 9.00 7.70 15.50 14.00
Maintenance 7.60 10.80 16.20 15.00
On-the-job training 6.70 6.30 3.50 4.10
Disability related training 2.60 2.20 2.30 2.30
Basic academic/literacy training 2.10 2.20 2.70 2.60



Table 2. Percentage of Transition-Age Youth Who Achieved an Employment Outcome (by Receipt of Service Status)
Type of Service Percent of those who received service that achieved outcome Percent of those who did not receive service that achieved outcome Difference
Job placement 79.7 47.7 32.0*
On-the-job supports 77.5 51.2 26.3*
Job search 75.8 56.4 19.4*
On-the-job training 79.4 61.8 17.6*
Rehabilitation counseling & guidance 67.0 56.0 11.0*
College services 54.1 63.9 -9.8*
Basic academic/literacy training 72.5 62.8 9.7
Misc. training 70.5 61.6 8.9*
Disability related training 71.3 62.8 8.5
Job readiness training 68.7 61.4 7.3*
Other services 67.4 61.6 5.8*
Maintenance 67.1 62.7 4.4
Assessment 64.2 60.2 4.0*
Occupational/vocational training 66.6 62.6 4.0
Rehab technology 66.2 62.9 3.3
Information/referral 65.5 62.4 3.1
Transportation services 65.0 62.4 2.6
Diagnosis and treatment 64.3 62.6 1.7

* p < 0.05



Table 3: Brief Description of Service
Service Definition
Assessment Actions performed to determine VR eligibility and scope of services included in an IPE.
Rehabilitation counseling & guidance Therapeutic counseling and guidance services necessary for an employment outcome.
Job placement Referral to a specific job resulting in an interview but not necessarily employment.
On-the-job supports Services provided when an individual is placed in employment in order to stabilize placement and job retention.
Job search Assisting an individual in searching for a job (e.g., resume preparation, identifying appropriate jobs).
Other services All other VR services that can't be recorded elsewhere.
Transportation services Travel and related expenses necessary for an individual to participate in VR services (including training in the use of public transportation).
Diagnosis and treatment Medical services to treat impairment (e.g., dentistry, physical therapy, mental health services, etc.).
Job readiness training Training to prepare for a work setting, including discussion of punctuality and appropriate work behavior.
Information/referral Provided to people needing services from other agencies that aren't available through VR.
Misc. training Any training not otherwise listed, including GED or high-school training.
College services Full- or part-time academic training above high-school level leading to a degree.
Occupational/vocational training Training provided to prepare students for gainful employment.
Maintenance Monetary support for expenses that are in excess of an individual's normal expenses but are needed as part of VR services (e.g., cost of uniforms).
On-the-job training Training in specific job skills by a prospective employer.
Disability related training Training in disability-related augmentative skills such as Braille, orientation and mobility, and speech reading.
Basic academic/literacy training Training provided to remediate basic academic skills necessary for a job in the competitive labor market.

RESEARCH TO PRACTICE

Issue No. 48
December 2010

This issue of Research to Practice is funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services (award #R40MC16396).

Recommended citation for this brief: Lugas, J., Timmons, J. & Smith, F.A. (2010). Vocational Rehabilitation Services Received by Youth with Autism: Are they Associated with an Employment Outcome? Research to Practice Brief, Issue No. 48. Boston, MA: Institute for Community Inclusion, University of Massachusetts Boston.

For more information, contact

John Butterworth, Institute for Community Inclusion, UMass Boston
john.butterworth@umb.edu

This publication will be made available in alternate formats upon request.

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