Dr. Paul Wehman, VCU Dr. Carol Schall, VCU

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Transcription:

Dr. Paul Wehman, VCU Dr. Carol Schall, VCU

2

There is a lessening of many core symptoms in adolescence and adulthood (Schall & McDonough, 2010) Chronically Unemployed or Underemployed (Hendricks & Wehman, 2009, Cimera & Cowan, 2009) Frequently denied VR Services or deemed too severely disabled to work (Lawer & Brusilovskiy, 2005) Received a more expensive set of services (Lawer & Brusilovskiy, 2005)

Achieve independent work at same rate as others with disabilities (Lawer & Brusilovskiy, 2005) Require higher intensity of services and supported employment to achieve work (Schaller & Yang 2005) Employers report being able to supervise employees with ASD (Hangner & Cooney, 2005) Individuals with ASD can be successful and independent at work (Hillier, Fish, Cloppert & Beversdorf, 2007)

Functional Behavior Assessment and the Implementation of Positive Behavior Supports CAN make a difference (Schall, 2010)

Dr. Paul Wehman

facilitates competitive work in integrated work settings for individuals with the most severe disabilities (i.e. psychiatric, mental retardation, learning disabilities, traumatic brain injury) for whom competitive employment has not traditionally occurred, and who, because of the nature and severity of their disability, need ongoing support services in order to perform their job. Supported employment provides assistance such as job coaches, transportation, assistive technology, specialized job training, and individually tailored supervision.

Clinical application of supported employment through employment support division Collected data on hours worked, wage, and support required to achieve independence Community based, integrated jobs

Total of 33 Individuals with ASD 76% male Average age 25 Range of 19-59 76% Caucasian 70% reported secondary disability 91% no or short intermittent history of employment * Includes Project Search students (2009-10)

27 out of 33 individuals placed (82%) Average working hours per week is 22:53 Range from 8 hours to 40 hours per week Average hourly pay is $8.86. Individuals hired in a number of fields: Healthcare Retail Recreation Education Custodial Food Service

Job seeker profile development: average of 9 hours Job development: average of 29 hours Job site training: average of 107 hours Long term supports: Average of 27 hours (ongoing based on length of employment) *intervention time rounded to nearest whole hour.

Percent intervention hours per week. Stabilization begins around week 15 - when hours drop and begin to consistently stay below 20%.

Higher Intensity of supports to independence Use of behavioral supports Use of Visual supports through ipod

National Institute on Disability and Rehabilitation Research (NIDRR) VCU Rehabilitation Research & Training Center Research related to Vocational Rehabilitation Models for Individuals with ASD Partners: Virginia Department of Rehabilitative Services (DRS) Henrico County Public Schools The Faison School for Autism Bon Secours Richmond Health System Cincinnati Children s Hospital

Purpose of the study: Conduct evidence-based research on vocational rehabilitation service models for individuals with Autism Spectrum Disorders Examine the impact of intensive community-based work experiences on the employment outcomes of young adults with ASD Project Search Randomized Controlled Trial

Senior year transition program In large business microcosm community Hospital Large bank center Government center Classroom time, 1 hour in am, 45 minutes in pm Rest of day internships in business 3 rotations across year, ~10 wks each

Single point contracts and contacts Interns, not volunteers Create need in business Talk about potential employment at every evaluation Work on match between intern and internship

Rehabilitative Services Provides job coaching School Provides teacher and instructional assistant Family Provides information and receives support during transition University Provides consultation in best practice and behavior support

Demographic Treatment Control N 14 10 Gender 79% Male 75% Male Age 19.5 18.9 Race 0.42 African American 0.39 African American Diagnosis 0.58 Caucasian 0..50 Autism 0.21 PDD-NOS 0.28 Aspergers Disorder 0.61 Caucasian 0.4 Autism 0.3 PDD-NOS 0.2 Aspergers Disorder

Statistic Treatment Group Control Group Employment Status Upon Graduation Employment Status at 3 Months Post Graduation Employment Status at 1 Year Post Graduation Average Hours Worked Per Week 100% Employed 0% Employed 100% Employed 0% Employed 92% Employed 0% Employed 22.85 0 Wage $9.51 0

Positive Behavior Support Intensive, Structured Instruction Comprehensible Environments Routines Parent Support Focus on Strengths Focus on communication and social Skills

Strengths Excellent work ethic Able to understand concepts Challenges: Difficulty with accepting criticism Cursing Episodes of intense anger outbursts

Intensive Social Skills Training Accepting Criticism Supports: Check in and check out on emotions/feelings Think Sheet Level Plan

Internships: Cardiac Care Unit Employee Wellness Ricoh/Print Shop Employment: Ricoh/Print Shop Mail delivery Metering mail Copying/binding

Strengths: Engaging personality Strives to please his employer Challenges Tactile Stimulated Invades personal space Cursing Problem Solving when an issue arises

Professional work habits Body positioning Building professional friendships Supports: Visual aids Role play

Internships: Radiology Engineering Infection Control Employment Infection Control Maintain Infection Control carts Remove supplies, wipe down, return materials to drawers Restock and charge departments for supplies

Strengths: ORGANIZED ORGANIZED ORGANIZED Challenges: Motivated by food & computer games Speech volume

Behavior plan with incentives Reviewed before & after each shift Visual cue Incredible 5 point scale

Game board to earn cafeteria time

Internships: Employee Wellness Med/Surg Floor Main Pharmacy Employment Main Pharmacy Pull outdated drugs Organize (by date) all meds Document meds that have been discarded File filled prescriptions and chemo orders

People with ASD CAN WORK in community based employment with support People with ASD can achieve independence at work It may take more intensive supports and more time to achieve independence