Evidence-Based Pathways to Competitive Employment for Youth and Young Adults with ASD

Transcription

1 Evidence-Based Pathways to Competitive Employment for Youth and Young Adults with ASD Carol Schall, Ph.D. Virginia Commonwealth University

2 This Presentation is Based Upon the Following Research Schall, C. M., Wehman, P., & McDonough, J. (2012). Transition from school to work for students with ASD; Understanding the process and achieving better outcomes. Pediatric Clinics of North America. 29, Wehman, P., Schall, C., McDonough, J., Molinelli, A., et al. (2014). Project SEARCH for youth with autism spectrum disorders: Increasing competitive employment on transition from high school. Journal of Positive Behavior Intervention, 15,

3 This Presentation is Based Upon the Following Research Wehman, P., Schall, C., Carr, S., Targett, P., West, M., & Cifu, G., (2014). Transition from school to adulthood for youth with ASD: What we know and what we need to know. Journal of Disability Policy Studies, 25, 30-40; DOI: / Schall, C. M., Wehman, P., Brooke, V., Graham, C., McDonough, J., Brooke, A., Ham, W., Rounds, R., Lau, S., Allen, J. (2015). Employment interventions for individuals with ASD: The relative efficacy of supported employment with or without prior Project SEARCH training. Journal of Autism and Developmental Disorders. 45: DOI: /s

4 This Presentation is Based Upon the Following Research Wehman, P. H., Schall, C. M., McDonough, J., Kregel, J., et al. (2014). Competitive employment for youth with Autism Spectrum Disorders: Early results from a randomized clinical trial. Journal of Autism and Developmental Disorders, 44, DOI /s x. Ham, W., McDonough, J., Molinelli, A., Schall, C., & Wehman, P. (2014). Employment Supports for Young Adults with ASD: Two Case Studies. Journal of Vocational Rehabilitation. DOI: /JVR Wehman, P., Brooke, V., Brooke, A. M., Ham W., Schall, C., et al. (2016). Employment for adults with autism spectrum disorders: A retrospective review of a customized employment approach. Research in Developmental Disabilities. DOI: /j.ridd Wehman, P., Schall, C., McDonough, J., Graham, C., et al. (2016). Effects of an employer based intervention on employment outcomes for youth with significant support needs due to autism. Autism: DOI: /

5 Research on High School Findings (Wehman, Schall, Carr, et al., 2014) * Youth with Significant ASD have untapped potential * Youth with ASD are not challenged in high school * More non-vocational, non-academic than academic or vocational credits * Youth with ASD do not work during high school * Working during high school is one of the most significant predictors of work after high school * We are not preparing youth with ASD for adult life

6 What are the current outcomes for young adults with ASD? * Unemployed and underemployed at higher levels than others with disabilities * Low rates of independent living -- Most individuals with ASD continue to live at home with their parents * Low incidence of friendships and relationships

7 High School Curriculum

8 High School Curriculum

9 Non-Academic/Non-Vocational

10 Findings and Policy Recommendations * Youth with Significant ASD have untapped potential * Youth with ASD are not challenged in high school * Youth with ASD do not consider college or Post Secondary Education * Youth with ASD do not work during high school * Improve High School Curriculum * Promote Post-Secondary Education * Promote inclusion and employment in high school * Provide Systematic Instruction to Increase Functional Literacy, Independence, and Self- Determination

11 Future Directions for Policy & Practices in Autism Education v Improve High School Curriculum and Services v Improve Access to Internships and Employment During High School v Promote Postsecondary Education and Dual Enrollment v Promote Inclusion and Provide Social Skill Instruction v Provide Systemic Instruction to Increase Functional Literacy, Independence, and Self-Determination

12 Key to Changing High School ASSESSMENT

13 Goal of Education at various ages * Preschool * Learn to manage self in group of children * Learn to learn * Kindergarten * Learn to listen to authority * Learn to regulate personal behavior * Develop motivation to learn * Elementary School * Learn basic academics (reading, writing, mathematics, science, history, etc.) * Learn personal strengths and preferences All of these curricula are similar across students 13

14 Goal of Education at various ages * Middle School * Prepare for High School * Begin to narrow choices related to future * High School * Prepare for university * Select desired career path * Prepare for career Education becomes individualized based upon the student s strengths, preferences, and interests 14

15 I m really bad and nearly failed my physics class Maybe I should be a physicist Said no one ever! 15

16 Biggest question we should strive to answer in our assessment * What should we teach this individual/student to help him/her achieve her/his goals and dreams? 16

17 An assessment that might help you do that The Community Based Functional Skills Assessment (CSA) It is FREE and available on the internet here: documents/finalcommunityasses sment pdf 17

18 Purpose of the assessment * Assess functional skills from a person-centered point of view 1. Designed to help parents and professionals assess the current skill levels and ability of individuals with ASD beginning at age 12 and continuing into adulthood in order to develop a comprehensive plan 2. Assist teams in identifying areas of instructional priority 3. Identify the level according to A. Life Aware B. Life Explorer C. Life Seeker Post Secondary 18

19 What does it assess * Skills and abilities in eight domains Career Path and Employment Self-Determination and Advocacy Health and Safety Peer Relationships, Socialization, and Social Communication Community Participation and Personal Finance Transportation Leisure and Recreation Home Living Skills 19

20 How does it assess these Skills * 4 Ways: 1. Home Observation (Alternative = Home Survey) 2. Recreation/Leisure Observation 3. Work/Education Observation 4. Interview 20

21 Pathways to Employment (Wehman, Targett, Schall, & Carr, 2014) Internships Supported Education Employment Supported Employment Customized Employment

22 The Supported Education Model

23 Going to College: A great way to grow up

24 Why Attend College? I would like to participate in this program because I think it will help me get a better job. It will give me something else to do besides watching TV and maybe I can make some friends.

25 What is ACE-IT in College? v Inclusive: on-campus, 30 month certificate program for students with intellectual disabilities v Employment Driven: all activities designed to explore career interests, build career skills & secure employment in the community v Student Centered: individualized supports provided through education & job coaches, along with mentors v Collaboration: school divisions, agency personnel & campus departments v Comprehensive Transition Program Status (CTP)

26 Certificate Requirements v30-24 credits over 5 semester vwork with education coaches vcampus & community employment vvolunteer hours & campus activities vone credit internship semester

27 *You may not need a college experience to do a job, but you may need a college experience to get a job.

28 Employment Driven vdesired outcome is competitive employment in student s interest area based on courses & experiences at VCU. vcurriculum includes: Career exploration Campus part-time employment during the school year Internships during the final semester

29 Employment after Graduation v 100%: Current competitive integrated employment outcome rate after graduation for ACE-IT in College vcurrently starting job development for internship students

30 Competitive Employment Placements v VCU s School of Education Dean s Office v American Family Fitness v Health Diagnostics Laboratory v Memorial Regional Hospital v Altria Theater v Chenault Veterinary Hospital v Amazon

31 Internships through Project SEARCH Plus ASD Supports An internship is an opportunity offered by an employer to potential employees, called interns, to work at a firm for a fixed, limited period of time. Interns are usually undergraduates or students, and most internships last for any length of time between one week and 12 months.

32 Internship Key Points * Paid or unpaid? * NOT volunteering * Working in a real job with support * Has onsite mentor * Is there for educational purpose * DOES NOT replace a paid employee * May not actually do a whole job, but purpose is to learn job skills and behaviors

33 Employment Outcomes In Community Based Integrated Employment Percent Employed Baseline Graduation 3 M ont hs 12 Months Data Collection Point N = 54 Treatment = 31 Control = 18 Tr eat men t Co nt ro l

34 Support Intensity Tr eat men t Co nt ro l 6 5 Baseline Graduation 3 M ont hs 12 Months

35 Supported Employment Supported Employment refers to service provisions where people with disabilities, are assisted with obtaining and maintaining community-based, integrated employment with support from a job coach and/or the use of person-centered approaches.

36 Phases of Intervention * Job Seeker Profile: * Person-centered planning, Interviews, Observations, Review of informal and formal assessment records, Community-based and situational assessments, Stated goal versus experience * Job Development * Job shadowing, Touring a company, Talking to employers, Pursing assistive technology, Developing a resume, Conducting a job analysis, Applying and interviewing for jobs

37 Phases of Intervention * Job Site Training: 100% to 20.1% of Support Time on Job * Direct instruction of job skills, Soft skill training, Transportation training, Family supports and any service or supports needed to achieve and maintain employment * Long Term Supports: 20% or less of Support Time on Job * Monitoring work performance, job satisfaction, Integration into the work culture, Support training with coworkers and employer, and Career advancement

38 Supported Employment * Part Time Spa Assistant * Sort, Wash, Dry Laundry * Fold Laundry * Stock drink stations * Stock bathroom * Load & Empty dishwasher * Employed for over a year * Long term employment supports provided by job coach plus natural supports on the job.

39 Additional Training for Job Coaches * Understand ASD * Learn EBPs * Behavior Support and Access to Regular Consultation * Reinforcement * Systematic Instruction * Data Based Decision Making * Visual Supports * Antecedent Interventions * Functions of Behavior * Understand Business * Work not School * Building trust * Understand business needs * Provide training to coworkers and supervisors * Building relationships * Understanding the work culture * Assessing the environment for Match

40 Customized Employment Customized Employment is a flexible process designed to meet the needs of the job candidate with a disability and the employer and can take such forms as task reassignment, job carving, and job sharing, leading to a new or modified job description

41 Findings * Individuals with ASD can work in Competitive Integrated Employment with supports * The majority of individuals worked part time. * Individuals with ASD earned a wage commensurate with their peers in similar positions

42 Findings * Supported Employment is a critical support across the spectrum * The vast majority of these students required limited support long term (approximately 1 hour a week)

43 Findings * Positive Behavior Supports are an essential way to address the social skill differences and behavior challenges of youth with ASD * Employment may be therapeutic for Individuals with ASD in independence, social awareness, social cognition and social communication

44 Areas Where Support is Required Work Skills * Following break & lunch Schedule * Following task list & transitioning independently * Initiating Tasks * Interactions with public and coworkers * Staying on task at work Behavioral Skills * Handling frustration * Recognizing private vs. public conversation topics * Accepting Correction * Break time * Professional Behaviors

45 Specifics How do we accomplish this? What are the supports?

46 Alarms on ipod or Cell Phone

47 Following Task List & Transitioning Independently * Visual schedule: pictures or written * PDA schedule * Voice reminders on PDA * Decision Tree

48 Visual Schedules

49 Decision Tree

50 Task Initiation * Circular web schedule * List of tasks which is numbered daily

51 Self Monitoring Checklists and Reinforcement Programs * Teach the person to monitor and collect data on their own behavior

52 Thank you for your attention! Carol Schall, Ph.D. Virginia Commonwealth University