FINDING WORK THAT FITS WITH ASD

Transcription

1 FINDING WORK THAT FITS WITH ASD Frank O Cnnr Auckland 23 July, frank.cnnr@insteplimited.cm There is great cncern within the autism wrld abut the un- and under-emplyment f peple n the spectrum Many peple with autism have cnsiderable skills and knwledge, but find it very hard t wrk, t be independent and thus cntribute t sciety There is interest frm wuld-be-emplyees and emplyers, prfessinals and families in hw t get adults n the spectrum int wrk, and keep them there We ll explre sme strategies that seem t wrk (r nt) fr adults n the spectrum t find and keep wrk they want t d Health Fundatin 1

2 FINDING WORK THAT FITS 1 There is great cncern... 2 Cnsiderable skills and knwledge 3 Hw t get int wrk, and stay 4 Emplyer strategies that seem t wrk (r nt) The un-and underemplyment figures are discuraging, sitting abve 80% arund the wrld There is limited large-scale empirical research int the wrking lives f adults wh have an autism spectrum disrder with n c-ccurring intellectual disability Baldwin et al (2014) Health Fundatin 2

3 Emplyment results are Even fr individuals wh are cnsidered t be higher functining, emplyment results are appalling. Adults: experience underemplyment switch jbs frequently have difficulty adjusting t new jb settings make less mney than their cunterparts are much less likely t be emplyed than: typically develping peers individuals with less severe language disrders individuals with learning disabilities Even fr thse individuals wh have pstsecndary educatinal experience, emplyment difficulties are cmmn Hendricks, D. (2010) Emplyment and adults with autism spectrum disrders: Challenges and strategies fr success. Jurnal f Vcatinal Rehabilitatin, 32 (2), 127 Sme studies estimate that 50-75% f adults with ASD are unemplyed Other ppular media reprts are much higher The reasns matter mre than the numbers Few glbal facts 22,878 autism-related interventin studies 3974 articles identifying an ASD interventin 501 studies targeted participants 18+ years f age 10 studies evaluated vcatin-related interventins in ASD Nichlas, D.B., Attridge, M., Zwaigenbaum, L. & Clarke, M. (2015) Vcatinal supprt appraches in autism spectrum disrder: A synthesis review f the literature. Autism, 19 (2), Health Fundatin 3

4 Fewer lcal facts A study f 130 Australian adults at the high-functining end f the spectrum Mst in scientific, technical, and infrmatin-based jbs Sme in educatin, healthcare wrk, hspitality, retail, gardening 54% needed help t find a jb 72% nt currently receiving any ASD specific supprt in their wrkplaces 66% wuld like mre supprt Baldwin, S., Cstley, D. & Warren, A. (2014) Emplyment activities and experiences f adults with high-functining autism and Asperger s disrder. Jurnal f Autism and Develpmental Disrders, 44, Cncerns abut ver-educatin 86% pst-schl qualificatins cf. 57% in general Australian ppulatin 45% verqualified fr their psitin cf. ANZSCO Summing up Adults with ASD ften experience difficulty securing and maintaining wrk perids f unemplyment are cmmn, as is underemplyment, r wrking belw ne s skills level few specialist supprt systems mst individuals relied heavily n the supprt f their families in finding jbs 5.1.c, NZASD Guidelines, 2008 Health Fundatin 4

5 Many facets affect this utcme, and smething can be dne abut sme - at least smetimes If we separate what we can change frm what we can t, then we can lk fr where it will help mst Fcus n the bstacles The cuntless permutatins and cmbinatins f scial interactins, language, learning, sensry, and behavir deficits and excesses fund in these individuals, in cmbinatin with their wide range f abilities, develpmental levels, islated skills, and unique persnalities make autism an especially baffling disability Simpsn, R.L. (2001) ABA and students with autism spectrum disrders: Issues and cnsideratins fr effective practice. Fcus n Autism and Other Develpmental Disabilities 16 (2), p69 Health Fundatin 5

6 Wuldn t yu avid taking the risk t If yu were fearful f a difficult wrking situatin, as either wuld-be emplyee and emplyer? Or n respnses t bstacles Highly individual vcatinal needs Scial difficulties Impaired executive functining Behaviural difficulties High distress and anxiety Cmrbidities such as depressin, anxiety, epilepsy Hendricks, D. (2010) Emplyment and adults with autism spectrum disrders: Challenges and strategies fr success. Jurnal f Vcatinal Rehabilitatin 32, Obstacles t emplyment Cmmunicatin and scial difficulties with supervisrs and c-wrkers, including difficulty understanding directins, inability t read between the lines and read facial expressins and tne f vice, asking t many questins, and cmmunicating in an inapprpriate manner Scial impairment which may include inapprpriate hygiene and grming skills, difficulty fllwing scial rules, inability t understand affect, wrking alne, and acting inapprpriately Cgnitive functining including impairments t executive functining; prblems with attentin, mtr planning, respnse shifting, and wrking memry; acclimatising t new jb rutines and settings; and fr peple with Asperger syndrme, prblems with rganisatin and prblem-slving Behaviural difficulties which may include tantrums, aggressin, self-injury, prperty destructin, ritualistic behaviurs, r pica, the experience f anxiety and stress relating t fitting int a new wrld, and sensitivity t wrkplace nise and ther sensry stimuli Cmrbid with psychiatric symptms which may include anxiety, depressin, biplar disrder, and epilepsy Ministry f Health. (2012) Guideline Supplementary Paper (t the New Zealand autism spectrum disrder guideline). Wellingtn: Ministry f Health. p14. Health Fundatin 6

7 FINDING WORK THAT FITS 1 There is great cncern... 2 Cnsiderable skills and knwledge 3 Hw t get int wrk, and stay 4 Emplyer strategies that seem t wrk (r nt) A situatin and cmplicatin There is capacity fr gd wrk in many adults n the spectrum Matching bth task and cntext t the dynamics f the persn (and his r her piece f spectrum) is smething many emplyers are nt at all sure f In my experience, many f thse in wrk-finding brkerage rles aren t s cnfident either Health Fundatin 7

8 Successes reprted 1 Jb placement, especially supprted emplyment and cmmunity placement 2 Supervisin and c-wrkers 3 On-the-jb training and caching 4 Wrk place mdificatins, media and technlgy helping tls 5 Lng-term supprt Hendricks, D. (2010) Emplyment and adults with autism spectrum disrders: Challenges and strategies fr success. Jurnal f Vcatinal Rehabilitatin, 32 (2), 127 Supprts fr success Jb placement t be individualised and based n the persn s strengths, interests and task preferences t ensure a jb match... jb tasks and wrk envirnment shuld be cnsidered (eg, predictable schedule, defined tasks, require minimal scial skills, allw adequate time, avid excessive sensry stimulatin) Supervisrs and c-wrkers need t be tlerant, flexible, receptive and aware f a persn with ASD s characteristics and supprt needs and assist in scial interactins On-the-jb prvisins, including training targeting jb tasks, acclimatisatin t the jb site and scial integratin, as well as develping cmmunicatin and interpersnal skills, management f inapprpriate behaviur, and cping with stress. A jb cach may be identified t assist in training, slwly lessening supprt Wrk place mdificatins including addressing distracting envirnmental stimuli, and prviding a cnsistent schedule f wrk tasks Lng-term supprt including natural supprts (eg, identify supervisrs and c-wrkers t take n supprt as the jb cach s rle diminishes) and external supprts (eg, fllw-up and clse mnitring, assisting with issues utside f wrk, intrductin t scial grups, and individual cunselling t develp cping strategies) Ministry f Health (2012) Guideline Supplementary Paper (t the New Zealand autism spectrum disrder guideline). Wellingtn: Ministry f Health. p15 Risk is rarely evenly spread Yuth frm lwer incme families and thse with greater functinal impairments particularly at risk fr pr emplyment utcmes Shattuck, P.T., Narendrf, S.C., Cper, B., Sterzing, P., Wagner, M., & Lunds, J. (2012). Pstsecndary educatin and emplyment amng yuth with an autism spectrum disrder. Pediatrics. 129 (6) p1048 Health Fundatin 8

9 A quiz n assets r liabilities Punctuality Cnscientiusness Lyalty Attentin t detail Perfectinism Independence Enjyment f repetitive tasks Careful attentin t wrk area discmfrt with lack f structure Unique wrk rutines Preference fr n interruptins Stress reactins t deadlines Difficulties with team wrk Anxiety abut perfrmance Reluctance t ask fr help r supprt Lw awareness f danger t self r thers Difficulty with time management Strng reactins t changes in wrk Mtivatinal issues regarding tasks f n persnal interest Difficulty with writing reprts NZASD Guideline p Assisting less able peple Even peple with severe autism r c-mrbid intellectual disability can becme engaged in meaningful wrk Specialist schemes fr assisting less able peple with ASD t get int wrk have recrded success Fr many peple with an intellectual disability, real wrk in real emplyment settings is preferable by far t vcatinal and day services NZASD Guideline p171 Peple with an intellectual disability wh receive relevant wrk experience as part f their schl-based transitin planning are mre likely t maintain cmpetitive jbs Health Fundatin 9

10 FINDING WORK THAT FITS 1 There is great cncern... 2 Cnsiderable skills and knwledge 3 Hw t get int wrk, and stay 4 Emplyer strategies that seem t wrk (r nt) We can reduce risk by aviding the mismatch between capability and practicality fr wuld-be emplyees Health Fundatin 10

11 Preparatin cunts Fr a persn with ASD, whatever their ability level, becming a wrker is mre likely t be achieved with careful attentin t preparatin and planning NZASD Guideline Supprt needs include Assistance in finding a jb Learning hw t d the jb Assistance with cmpleting the jb Addressing wrk-related issues Addressing nn-wrkrelated issues Transprtatin NZASD Guideline Hw hard is jb seeking? Fr each questin, chse ne f: Never Rarely Often Always 1 D yu understand cmplex jb applicatin materials? 2 D yu think well n yur feet in an interview? 3 D yu quickly adjust t new prcedures and rutines? 4 D yu remember and fllw verbal instructins? 5 D yu respnd pleasantly and flexibly t unexpected situatins? 6 D yu cpe with planning and juggling several tasks at nce? 7 D yu cmmunicate effectively with all f yur c-wrkers? 8 D yu interact scially in a way that is cmfrtable fr everyne? 9 D yu have t d unusual things t manage sensry sensitivities? Health Fundatin 11

12 What wrks ften has smething t d with stuff we can d smething abut The diversity f the spectrum means many intellectual, sensry and scial differences Expressing an individual's set f these takes effrt, but they can be put cnstructively, as capacities fr useful wrk Health Fundatin 12

13 Remember wh s in charge! research suggests that the respnsibility fr making it wrk in an emplyment setting tends t rest n the persn with ASD, rather than the emplyer NZASD Guidelines, 2008 We cand a lt Cnstructive respnses t urban myths Prvide sund infrmatin and reassurance Gd help in preparing and maintaining the emplyment relatinship Fr bth parties, and their helpers Accmmdate arund wrk that almst fits What this persn is likely t be gd What this emplyer is likely t knw, learn, d Cmmunicate the match f the persn t the psitin Help bth parties talk, flex and accmmdate Health Fundatin 13

14 Invlving specialist emplyment services Increases chances f psitive wrk utcmes finding wrk maintaining wrk having gd wrking relatinships NZASD Guidelines, 2008 See als Recmmendatin B - Ministry f Health (2012) Guideline Supplementary Paper p15 Assciated with imprved attitudes f emplyers twards peple with ASD Emplyers mre willing t be supprtive and adapt circumstances t suit the persn cncerned Emplyers mre likely t rate the emplyee s effectiveness at their jb (rather than t wrk in an established way and t adapt t the rganisatin) Frm emplyees wh succeed Adults with ASD interviewed abut emplyment: Significant difficulty in the wrkplace due t insufficient knwledge Sught autism awareness training fr emplyers and c-wrkers t: Understand wh I am Knw why I behave in a certain way Sphie Nesbitt (2000) Health Fundatin 14

15 FINDING WORK THAT FITS 1 There is great cncern... 2 Cnsiderable skills and knwledge 3 Hw t get int wrk, and stay 4 Emplyer strategies that seem t wrk (r nt) What can emplyers d? Regardless f any useful individual supprts, ne thing is clear: emplyers need t be mre understanding and accmmdating Autistic wrkers are wired differently and thus experience things differently Many like rutine and structured tasks r infrmatin can aid wrk perfrmance Sme emplyers have demnstrated that making changes t the wrk setting instead f accmmdating individual wrkers prcessing, sensry and scial differences benefits all f their emplyees Campbell Teague, Autism and Emplyment: A Reflectin n the Pr Statistics Health Fundatin 15

16 Make a cmpelling case Emplyers need t knw that it makes gd business sense t emply: peple wh are reliable, punctual and lyal peple wh have gd attentin t detail and cncentratin levels peple wh have excellent prblem slving skills and can be analytical, resurceful and creative What gd emplyer wuldn t want an emplyee with thse skills? making a few small adjustments smene with autism can make a lyal and hardwrking emplyee a huge pl f untapped talent ut there We must make it clear that peple with autism can wrk and want t wrk they just need t be given the supprt and pprtunities Lrd David Freud, UK Minister fr Welfare Refrm, Natinal Autistic Sciety Parliamentary Receptin, 20 March 2012 Dn t frget emplyers can adapt t challenges fund in thers at wrk scial interactins deficits and excesses wide range f abilities develpmental levels islated skills unique persnalities Health Fundatin 16

17 Research n best practice Individuals cntrlling their wn vcatinal destinies thrugh self-determinatin, facilitated by persn-centred planning, and a career-based apprach Emplyment specialists acting as facilitatrs, nt experts Taking accunt f emplyers as well as individuals needs Using natural supprts and supplementing jbs in ways that are typical fr each setting Using intentinal strategies t enhance scial integratin Supprting self-emplyment Pst r fllw-up supprt Ensuring that peple with severe disabilities can access supprted emplyment Quality utcmes result when services adpt a principlesand values-led apprach t supprted emplyment NZASD Guideline after Ridley, J., Hunter, S. and Infusin C-perative. (2005) G Fr It! : Supprting Peple with Learning Disabilities and/r Autistic Spectrum Disrder in Emplyment. Edinburgh: Scttish Executive Scial Research Which can we affect? Many attributes f an autism friendly envirnment help everyne t d their wrk better Such as clear gal setting, r a wrk place which isn t t bright r t lud Health Fundatin 17

18 Assisting emplyers 1 Jb mdificatin maintain a cnsistent schedule and jb duties keep the scial demands f the jb manageable and practicable prvide rganisers t help structure and keep track f wrk add activities t reduce r eliminate unstructured time NZASD Guideline p172 Benefits fr ther wrkers t Assisting wrk directin 2 Supervisin be direct and specific when giving directins verify that cmmunicatins are crrectly understd assist the emplyee in learning scial rules and interpreting scial cues encuntered n the jb explain and help the emplyees deal with changes n the jb NZASD Guideline p171 Treat everyne like this? Health Fundatin 18

19 Assisting wrkmate strategies 3 C-wrker relatinships and scial interactins encurage c-wrkers t initiate interactins ensure that ne r tw cwrkers play a rle in helping t give jb-related suggestins and keep an eye ut fr the emplyee NZASD Guideline p171 Include everyne else t Assisting help-seeking 4 Supprt services prvide a sense f familiarity and reassurance until the emplyee and cmpany staff get t knw ne anther transfer relatinships and supprts t cmpany emplyees check in and remain n-call in case prblems arise maintain a liaisn rle fr nn-wrk issues that affect the jb NZASD Guideline p171 Health Fundatin 19

20 Then the minr adjustments fr smene with autism are less daunting Mre levers n jb success Rle f wrkplace peers Scial netwrks Wrkplace and scial plicies Ways successful emplyment prgrams benefit businesses and cmmunities Strengths and benefits peple n the autism spectrum cntribute t wrkplaces and sciety Shattuck, P.T. and Rux, A.M. (2015) Cmmentary n emplyment supprts research. Autism 19 (2) Health Fundatin 20

21 The things that help mst Supprtive emplyment is a specific mechanism that is reprted t Facilitate finding a jb Teach individuals with ASD hw t apply and interview fr a psitin Liaise between an individual with ASD and his r her c-wrkers r supervisr Deal with crisis situatins that may arise [ ] t supprt verall vcatinal success Ntins f vcatinal fit, preparedness, and supprt, as needed, appear t be reflective f vcatinal success fr individuals with ASD and their emplyers Jb caches integral t: Finding emplyment fr the individual Prviding needed supprt in the wrk envirnment Clse cntact allwed fr Explring apprpriate jb pprtunities Matching the skills and abilities f a specific emplyee with a suitable jb Develping individual s understanding f the scial aspects f wrk settings Big investment f time and effrt necessary fr bth parties Nichlas, D.B., Attridge, M., Zwaigenbaum, L. & Clarke, M. (2015) Vcatinal supprt appraches in autism spectrum disrder: A synthesis review f the literature. Autism, 19 (2), Wrkplace adaptatins wrk Many wrkers n the spectrum (and many ther wrkers) benefit frm clearly defined wrk tasks May require rearranging actual jb scpe / duties r the way a jb is perfrmed Activity schedules, based n jb analysis, can assign tasks t be dne t certain times r wrk cnditins Using sme frm f wrk rganizers helps structure and keep track f wrk Examples: flwcharts, ticksheets, srting bxes, ntebks, labels and whitebard run charts Health Fundatin 21

22 Mre changes that wrk Identify ptential distractins and ways t lessen their impact in each relevant wrk area Assess nise level, interruptins, crwding, lighting, and mvement Keep individual s needs in mind Prviding a cnsistent schedule fr cmpletin f wrk tasks increases jb predictability These reduce wrry and stress and need fr recmmunicatin Dwn time culd include taking a walk r playing cmputer games Emplyers wh dn t knw dn t emply Biggest difference in awareness and understanding f the disrder Nesbitt, S. (2000) Why and why nt? Factrs impacting emplyment fr individuals with Asperger syndrme, Autism 4 (4), Fcused n ptential negative behaviurs ratherthan the persn s capabilities Didn t knw f r appreciate emplyment supprts that culd be prvided Health Fundatin 22

23 Keep explring Health Fundatin 23