Research to Practice Brief
Institute for Community Inclusion
University of Massachusetts Boston 
Issue 48
December 2010
Vocational Rehabilitation Services Received by Youth with Autism: Are they Associated with an Employment Outcome?
Jaime Lugas, Jaimie Timmons, and Frank A. Smith

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:
•	Determine differences in services received by youth with autism compared to youth with other disabilities.
•	Identify services that are most closely associated with an employment outcome for youth with autism.
•	Establish if large percentages of the group are receiving these successful services.

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. 
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 

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). 
ICI’s National Report on Employment Services and Outcomes
ICI’s National Report on Employment Services and Outcomes is now available. The book provides national and state level statistics spanning a twenty-year period. Its sources include several data sets that address the status of employment and economic self-sufficiency for individuals with ID/DD.

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.

www.communityinclusion.org  
www.facebook.com/communityinclusion

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