Autism and transition to work: a thematic analysis of service user experiences

Introduction This study investigates the experiences of individuals with autism spectrum conditions (ASC) as they experienced transition into employment in the UK. The high prevalence of ASC has led to increased social and economic pressures (Gerhardt & Lainer, 2010), with the estimated yearly cost to the UK for each individual at £90,000 (Knapp, Romeo & Beecham, 2007). Employment may help to reduce economic pressures, benefit individuals and society (Howlin, Alcock & Burkin, 2005). Individual gains in cognitive functioning (García-Villamisar & Hughes, 2007), quality of life and self-esteem (Eggleton et al., 1999) may be experienced. However, individuals with ASC tend to find transitioning to employment difficult, due to implicit characteristics associated with the condition (Berney, 2004). Transitions represent challenges to individuals’ social identity and self-concept, require behaviour change and may contribute to distress (Liddle, Carlson & McKenna, 2004). These factors may be exacerbated in individuals with ASC due to their difficulties with social and behaviour change processes (American Psychiatric Association [APA], 2010). Transition and employment support strategies have been shown to facilitate successful employment for individuals with ASC (Howlin et al., 2005). The National Institute for Health and Clinical Excellence ([NICE], 2012) propose how best to support people with ASC, based on the synthesis of available evidence. However, the evidence lacks in consideration of individuals’ experiences and psychological theories of support and transition. Considering these perspectives may facilitate service users to influence effective service provision, through disseminating their views and experiences of transition to work by means of a rigorous qualitative study. Method This study investigates the experiences of 10 participants with ASC during their transition to employment settings in the UK and aims to provide them with a platform to express their experiences and views of this process. An inductive thematic analysis methodology (Braun & Clarke, 2006) is used to explore semantic information obtained from retrospective interviews relating to the experiences of transition to work and identify frequent and salient themes within the data (Buetow, 2010). Results Analysis identified three main themes that were particularly salient and frequent for the interviewed participants: Diagnosis; comprised of subthemes ‘Access to support’, ‘Identifying with ASC’, ‘Other-understanding’ and ‘Delay in diagnosis’. Barriers to transition; comprised of ‘Socio-economics’, ‘Physical accessibility’ and ‘ASC characteristics’. Transition support; comprised of ‘Emotional needs’, ‘Clear guidance and honest feedback’, ‘Practical support’ and ‘Social integration’. Discussion Thematic analysis facilitated investigation into the experiences of 10 participants with ASC as they transitioned to work. Participants’ difficulties and needs were reflected in the existing evidence base and aims of current legislation and guidance, but short-comings in the delivery of these were also highlighted. In addition, a unique insight into both the positive and negative emotional impact of transition to work for individuals with ASC was obtained. Psychological models of support and transition are considered in relation to the experiences of transition and associated challenges to self-concept. Potential support measures for more effective and less distressing transition to work are discussed

Baseline characteristics of dual-axis cervical accelerometry signals

Dual-axis swallowing accelerometry is a promising noninvasive tool for the assessment of difficulties during deglutition. The resting and anaerobic characteristics of these signals, however, are still unknown. This paper presents a study of baseline characteristics (stationarity, spectral features, and information content) of dual-axis cervical vibrations. In addition, modeling of a data acquisition system was performed to annul any undesired instrumentation effects. Two independent data collection procedures were conducted to fulfil the goals of the study. For baseline characterization, data were acquired from 50 healthy adult subjects. To model the data acquisition (DAQ) system, ten recordings were obtained while the system was exposed to random small vibrations. The inverse filtering approach removed extraneous effects introduced by the DAQ system. Approximately half of the filtered signals were stationary in nature. All signals exhibited a level of statistical dependence between the two axes. Also, there were very low frequency oscillations present in these signals that may be attributable to vasomotion of blood vessels near the thyroid cartilage, blood flow, and respiration. Demographic variables such as age and gender did not statistically influence baseline information-theoretic signal characteristics. However, participant age did affect the baseline spectral characteristics. These findings are important to the further development of diagnostic devices based on dual-axis swallowing vibration signals. © 2010 Biomedical Engineering Society