Purpose:  The purpose of this review is to examine the effects of vocational support programs versus the absence of vocational support programs on employment rates, social skills, and quality of life of transition-aged youth diagnosed with autism spectrum disorders and related diagnoses.
Methods:  The CINAHL, Cochrane Collection Plus, Medline, PubMed, and UpToDate databases were searched for articles pertaining to our purpose statement.  Four reviewers analyzed the articles for results and extracted data regarding sample characteristics, treatment characteristics, assessment tools, and outcomes.
Results:  Nine studies were included, all of which related to the effects of vocational support programs on individuals with ASD and related diagnoses.
Conclusion:  Across the board, data strongly suggested that vocational support interventions increased employment rates, improved social skills, and enhanced quality of life for individuals with ASD and related diagnoses

Kester, Angel

Martin, Addie T.

McRory, Ivey M.

Williams, Marybeth

English

Digital Commons

Cedarville UniversityDigitalCommons@CedarvilleThe Research and Scholarship Symposium The 2015 SymposiumApr 1st, 11:00 AM - 2:00 PMThe Effects of Vocational Support Programs onIndividuals with Autism Spectrum DisordersAngel KesterCedarville University, akester@cedarville.eduAddie T. MartinCedarville University, addietmartin@cedarville.eduIvey M. McRoryCedarville University, iveymcrory@cedarville.eduMarybeth WilliamsCedarville University, marybethwilliams@cedarville.eduFollow this and additional works at: http://digitalcommons.cedarville.edu/research_scholarship_symposiumPart of the Mental Disorders Commons, Nursing Commons, and the Vocational RehabilitationCounseling CommonsThis Poster is brought to you for free and open access byDigitalCommons@Cedarville, a service of the Centennial Library. It hasbeen accepted for inclusion in The Research and Scholarship Symposiumby an authorized administrator of DigitalCommons@Cedarville. For moreinformation, please contact digitalcommons@cedarville.edu.Kester, Angel; Martin, Addie T.; McRory, Ivey M.; and Williams, Marybeth, "The Effects of Vocational Support Programs onIndividuals with Autism Spectrum Disorders" (2015). The Research and Scholarship Symposium. 25.http://digitalcommons.cedarville.edu/research_scholarship_symposium/2015/poster_presentations/25Effects of Vocational Support Programs on Individuals with Autism Spectrum DisordersAngel Kester, Addie Martin, Ivey McRory, & Marybeth WilliamsCedarville UniversityPATIENT CARE ISSUE● Autism spectrum disorders (ASD): “A serious neurodevelopmental disorder that impairs a child's ability to communicate and interact with others” [13]● Vocational support programs:  programs intended “to maximize employment outcomes by providing services such as assessment and diagnosis, counseling, job search assistance, assistive technology, and on-the-job training” [12] ● 1 out of every 68 children in the United States is diagnosed with ASD every year and the rates are only increasing [2]● 50-75% of adults with ASD are unemployed, but have the desire and ability to be employed [7][8]● Youth with ASD are transitioning into adulthood with a lack of employment, inadequate social skills, and a diminished quality of life [3][8][9]Question: In transition-age youth with autism spectrum disorders and related diagnoses, how do vocational support programs versus the absence of these programs effect employment rates, social skills, and quality of life?P: Transition-age youth with autism spectrum disorders and related diagnosesI: Vocational support programsC: Absence of vocational support programsO: Employment rates, social skills, and quality of lifeEVIDENCE-BASED PRACTICE QUESTIONDatabases searched: Cochrane Collection Plus, CINAHL, Medline, PubMed, UpToDateKey words: Vocational rehabilitation, supported employment, autism spectrum disorders, intellectual disabilities, vocational services, developmental disorders, transitional services, ASD, and employment ratesInclusion criteria: Articles pertaining to the use of vocational support programs in transition-age youth with ASD and related diagnoses; articles analyzing vocational support program effects on the outcomes of employment rates, social skills, and quality of lifeExclusion criteria: Articles analyzing different interventions, age groups, or outcomes other than those identified for this reviewNumber of articles: Twenty-four articles were initially found, nine articles were critiqued and included in this reviewMETHODSREGISTERED NURSE INTERVIEWAn RN at Achieve, a program that helps ASD diagnosed individuals transition into adulthood, noted the following impacts of vocational support programs [1][15]:Employment Rates● Participants were capable of transitioning into business in the community (e.g. food service, custodial, etc.)● Participants showed more productivity and increased work ethic after participation in the programSocial Skills● Some learned to interact with peers and supervisors- talking through conflicts rather than throwing tantrumsQuality of Life● Felt productive in society by working for and earning their own paycheck● Enjoyed going to their jobs and performing their assigned tasks● Required medication amounts decreased during program hours[1] Achieve: Find yourself here. (2013). Retrieved from:  http://www.achieveny.org/who-we-are/  [2]   Baio, J. (2014). Prevalence of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2010. Morbidity and Mortality Weekly Report, 63(SS02), 1-21. Retrieved from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w [3]   Bolman, W. M. (2008). Brief report: 25-year follow-up of a high-functioning autistic child. Journal of Autism and Developmental Disorders, 38, 181-183. doi: 10.3233/JVR-2010-0502[4]   Burgess, A. F. & Gutstein, S. E. (2007). Quality of life for people with autism: Raising the standard for evaluating successful outcomes. Child and Adolescent Mental Health, 12(2), 80-86. doi: 10.1111/j.1475-3588.2006.00432.x[5]   Carter, E., Austin, D., & Trainor, A. A. (2011). Factors associated with the early work experiences of adolescents with severe disabilities. Intellectual and Developmental Disabilities, 49(4), 233-247. doi: 10.1352/1934-9556-49.4.233  LOE 6[6]   Cimera, R., Burgess, S., & Wiley, A. (2013). Does providing transition services early enable students with ASD to achieve better vocational outcomes as adults? Research and Practice for Persons with Severe Disabilities, 38(2), 88-93. doi: 10.1177/1540796914534633  LOE 6[7]   Dutta, A., Gervey, R. Chan, F., Chou, C., & Ditchman, N. (2008). Vocational rehabilitation services and employment outcomes for people with disabilities: A United States study. Journal of Occupational Rehabilitation, 18, 326-334. doi: 10.1007/s10926-008-9154-z  LOE 2[8]   Hillier, A., Campbell, H., Mastriani, K., Izzo, M. V., Kool-Tucker, A. K., Cherry, L., & Beversdorf, D. Q. (2007a). Two-year evaluation of a vocational support program for adults on the autism spectrum. Career Development and Transition for Exceptional Individuals, 30(35), 35-47. doi:10.1177/08857288070300010501 LOE 3[9]   Hillier, A., Fish, T., Cloppert, P., & Beversdorf, D. Q. (2007b). Outcomes of a social and vocational skills support group for adolescents and young adults on the autism spectrum. Focus on Autism and Other Developmental Disabilities, 22(2), 107-115. doi: 10.1177/10883576070220020201  LOE 2[10] Howlin, P., Goode, S., Hutton, X., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45, 212-229. doi: 10.1111/j.1469-7610.2004.00215.x  LOE 6[11] Lavelle, T. A., Weinstein, M. C., Newhouse, J. P., Munir, K., Kuhlthau, K. A., & Prosser, L. A. (2014). Economic burden of childhood autism spectrum disorders. Pediatrics, 133(3), 520-529. doi: 10.1542/peds.2013-0763d  LOE 6[12] Lawer, L., Brusilovskiy, E., Salzer, M. S., & Mandell, D. S. (2009). Use of vocational rehabilitative services among adults with autism. Journal of Autism and Developmental Disorders, 39, 487-489. doi: 10.1007/s10803-008-0649-4  LOE 6[13] Mayo Clinic Staff. (2014). Diseases and conditions: Autism spectrum disorder. Retrieved from http://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/basics/definition/con-20021148[14] Morisse, F., Vandemaele, E., Claes, C., Claes, L., & Vandevelde, S. (2013). Quality of life in persons with intellectual disabilities and mental health problems: An explorative study. The Scientific World Journal, 2013(491918), 1-8. doi: 10.1155/2013/491918[15] (Roberta, RN at Achieve, personal communication, Nov 13, 2014)[16] Taylor, J. L., McPheeters, M., Sathe, N., Dove, D., Veenstra-VanderWeele, J., & Warren, Z. (2012). A systematic review of vocational interventions for young adults with autism spectrum disorder. Pediatrics, 130(3), 531-538. doi: 10.1542/peds.2012-0682  LOE 1[17] Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, L. Q.,…Goode, C.J. (2001). The IOWA model of evidence-based practice to promote quality care. Critical Care Nursing Clinics of North America, 13(4), 500.[18] Wehman, P., Chan, F., Ditchman, N., & Kang, H. (2014). Effect of supported employment on vocational rehabilitation outcomes of transition-age youth with intellectual and developmental disabilities: A case control study. Intellectual and Developmental Disabilities, 52(4), 296-310. doi: 10.1352/1934-9556-52.4.296  LOE 4[19] Wehman, P., Lau, S., Molinelli, A., Brooke, V., Thompson, K., Moore, C., & West, M. (2012). Supported employment for young adults with autism spectrum disorder: Preliminary data. Research and Practice for Persons with Severe Disabilities, 37(3), 160-169. doi: 10.2511/027494812804153606  LOE 3REFERENCESEmployment Rates:● Employment rates for recipients of supported employment were consistently higher than those without supported employment [18]● After vocational rehabilitation, the employment rate of the participants was 62% [8]● Implementing vocational rehabilitation early yielded an employment rate of 69.1% compared to the late implementation employment rate of 52.2% [6]Social Skills:● Individuals with ASD lack social skills but still want to socialize and interact with others[7]● After participation in vocational rehabilitation, individuals had an increased awareness of other peoples’ thoughts and feelings resulting in some friendships [9]● These increased social skills were key factors which allowed these individuals to gain and maintain employment [9]Quality of Life:● Supported employees with ASD can and do become more independent in performing competitive employment tasks [19]● Parents reported that their child gained social interests and positive outlooks of their own situations, enhancing their quality of life [9]● Vocational support programs have a positive impact on their participants because they allow the participants to feel accepted within a group, have the opportunity to meet people with similar diagnoses, and participants are able to discuss challenging issues they may face [9]SYNTHESIS OF EVIDENCERoberta, RN from Achieve in Binghamton, NY [1][15]ACKNOWLEDGEMENTS● Additional research is needed in this area of healthcare● Nurses should be further educated and made more aware of vocational support programs● Nurses should encourage clients with ASD to participate in vocational support programs● Nurses should educate patients diagnosed with ASD and their parents about available resourcesEVIDENCE-BASED PRACTICE RECOMMENDATIONS● Lack of research on sustained outcomes of vocational support programs● Inability to do exhaustive, up to date research due to limited resources relating to area of study● Limited generalizability to US population due to use of research conducted in various countriesLIMITATIONSRESULTSEmployment ratesSocial skills Quality of lifeCarter, Austin, & Trainor (2011) X XDutta, Gervey, Chan, Chou, Ditchman (2008) XCimera, Burgess, & Wiley (2013) X XHillier et al. (2007a) X X XHillier, Fish, Cloppert, & Beversdorf (2007b) X XLawer, Brusilovskiy, Salzer, & Mandell (2009) XTaylor et al. (2012) X X XWehman, Chan, Ditchman, & Kang (2012) XWehman et al. (2012) X X Xo Also known as, vocational rehabilitation and supported employment

The Effects of Vocational Support Programs on Individuals with Autism Spectrum Disorders

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The Effects of Vocational Support Programs on Individuals with Autism Spectrum Disorders

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