Adults Living with Autism Spectrum Disorder

Autism and Employment

Introduction

Autism Spectrum Disorder (ASD) is a life-long disorder related to brain development that has impacts on the different ways through which people socialize and perceive others, bringing about problems in communication and social interactions. Repetitive and limited behaviour patterns are also characteristic of the condition. There, exist discrepancy in ASD literature which suggests that the longest life-cycle phase, adulthood, is not receiving adequate attention. Adults with ASD tend to remain reliant on families and support services.

Independent living is a basic human right (United Nations, 2006). However, independence is relative to each individual. There are many ways to live independently, including earning your own money, moving out and getting your own space, or completing daily tasks by yourself. Although many published studies help promote services and policies to support children with ASD, little has been done for adults with ASD. Individuals with ASD should have the same rights and entitlements enjoyed by the rest of society. Individuals with ASD have the ability and desire to work, but they are faced with several barriers. Employment enables adults with and without disabilities to earn an income to support themselves and pursue their interests (Hendricks, 2010). The loss of social support and services for young people with autism after school leaves young adults and their families in a challenging situation. For the most part cases, these young adults end up reliant on their parents. This essay will explore the challenges faced by adults with ASD in gaining employment and the strategies for successful employment with employment while using hypothetical case examples to illustrate these issues.

Employment

Employment is a major milestone to enabling all young people to transit to adulthood. Paid employment is a key area that can provide a better quality of life for adults with autism. It however, tends to be difficult for autistic individuals to find regular and paid employment. Only 15% of individuals with ASD are in paid employment in the UK (National Autistic Society, 2007), and access to full-time work is disappointingly low. Chen (2015) reports that early adult outcome studies had demonstrated a poor employment situation for individuals with ASD. Rutter et al. (1967) found that out of 63 individuals who received their diagnosis of autism during 1950 to 1958, and they found that only three individuals had paid jobs when they became adults. More recently, the HSE New Directions (2012) report uncovered that only 7% of adults with ASD obtained supported employment in mainstream work environments. Research overwhelmingly demonstrates disappointing employment outcomes for this group. The vast majority are unemployed, and underemployment is common for those with gainful employment (Hendricks 2010). Studies illustrate that people with autism are inadequately paid with very limited weekly working hours. Howlin et al. (2004) followed 68 individuals from an average age of 7 to 29 years, and they found that only two were working on full salary when they entered adulthood (Chen, 2015).

Evidence from the research and lived experiences shows that jobs and employment are a huge issue for people on the autism spectrum (Solomon, 2020). Employers are often keen to offer volunteer or job experience but unwilling to take that further and pay people with autism. Even for those autistic individuals who are employed, the majority have only part-time jobs or do work for which they are overqualified. Hayward, McVilly and Stokes (2019), advance different explanations for this; one is that there are only low expectations placed on disabled adults, which in effect, destroys their self-confidence. The other factor is that autistic people are forced to compete for positions with other fully upright people, which tends to be difficult, especially for the autistic individuals whose social communication skills are hampered. Hampered communication skills puts them at a disadvantage during interviews and even makes successful engagement with other co-workers difficult. The other issue is that the majority of workplace programs developed for disabled individuals were not developed with autism in mind, but for people who are intellectually and physically disabled. Current research suggests that social deficits are a significant barrier to successful employment for people with ASD (Hendricks, 2010). Challenging behaviors are another major obstacle for successful employment among individuals with ASD (Chien 2015; Hendricks 2010). If a person with ASD displays challenging behavior or has additional disabilities, they face additional barriers to obtaining mainstream employment. Individuals with ASD may encounter high stress and anxiety levels in the workplace, interfering with performance, while social interactions are also often challenging. Hendrick (2009) found that Parents reported anxiety as a major obstacle due to their child’s fear of the unfamiliar and navigating social interactions along with mental and physical health issues significantly interfering with their ability for positive employment outcomes.

Another area that was raised frequently was the unwillingness of many businesses to hire adults with ASD, as they are concerned about the increase in supervision costs and a decrease in productivity (Soloman, 2020).

Assistance provided through the provision of transition schemes and supported employment is often necessary for job success. Growing research indicates supports related to job placement are the most impactful for successful employment (Soloman, 2020). Hendricks (2010) found modifications to job tasks, work environment, adjustments to communication exchanges, assistance with social interaction, visual supports will likely be required. Also, knowledge of the disorder and job supports are important prerequisites for employing individuals with ASD. Providing a consistent schedule for completion of work tasks has increased job predictability, along with work tasks being clearly defined and in areas with the least distractions

Above all, it is vital to ensure an appropriate job match by identifying suitable jobs to the individual’s academic and educational background, social skills, and abilities. Employment opportunities for individuals with ASD may differ based on their strengths and abilities and may be under one of the three types of employment: competitive, supported, and sheltered (Autism Society, 2019).

From looking through the lens of behavior analysis, most challenging behaviors have clear antecedents; these may include sensory overload and unexpected schedule changes. Therefore these challenging behaviors can be minimized by adjusting to the work environment, as mentioned above.

Early-initiated services provide a longer time for individual preparation and navigation, and young adults with ASD can become more skilled and employable for employment after exiting the school system (Autism Speaks 2012).

There is also sufficient evidence to support the potential benefits to employers and companies when they hire individuals with ASD as individuals with adults can have exceptional talents. The New Directions Report (2012) also recommends that if people across the ASD spectrum are to be supported into mainstream employment, person-centered health supports need to be provided to assist them in accessing education and employment opportunities. Employers should be included in this process and provided with the required supports and training to recruit, employ and retain people with ASD.

Case Study

I will base my case study on a hypothetical client, a young adult called Freddie. He has ASD and mild learning difficulties and has transitioned from a home environment to residential care. The local disability vocational service provider has made connections in the local community to help the client gain work experience and find a job; however, a few issues occurred along the way. Currently, he lives with his elderly parents and depends on them financially.

After finishing school, the local service provider linked Freddie with local originations; however, they felt Freddie was not good for their organization. It was recommended that Freddie should attend an adult activities center. That was a very disappointing outcome for Freddie and his family. A year later, Freddie was referred to a supported employment program for an assessment. They found that Freddie has many employable qualities like high concentration levels, performs repetitive actions with high-quality outcomes, and has excellent attention to detail.

Freddie does struggle with social interaction and communicating with other people. He also prefers calm environments and following the same routine every day. Scott et al. (2017) found that adults with ASD have a high tolerance for repetitive tasks, concentrate for an extended period, and perform well in jobs that require a high degree of accuracy in visual perception.

This supported employment program involves identifying and facilitating job supports specifically tailored towards assisting individuals to gain and maintain employment. Generally, these services include having on-the-job support, such as negotiating work hours, modeling positive social interactions, monitoring job performance to ensure Freddie meets the employer standards, and providing additional support where needed.

Freddie attended workshops and courses to help prepare him for mainstream work environments by supporting him in developing his social and communication skills and training him in workplace protocol and life skills, for example, supporting him to manage any challenging behaviours when he gets overstimulated.

His transition into mainstream employment was managed effectively. He was provided with short work placements in various settings so he could decide which one best suited him. Freddie enjoyed the cafe environment, but the high-stress environment and unpredictable schedule caused Freddie to have several meltdowns throughout the day. However, environments with high levels of stress and stimuli are often not suitable for people with ASD and may trigger challenging behaviors. Freddie enjoyed the repetitive process of making creative coffees. Unfortunately, Freddie's challenges initially are all too common for people on the autism spectrum in the world of employment.

Task analysis was one of the strategies used with Freddie, and this involves the breaking down of a complex skill into smaller, manageable parts (Cooper et al., 2020). This procedure was deemed appropriate for teaching Freddie the skill of coffee making. Video modeling was also used where Freddie learned coffee making by watching a recorded video of someone performing the skill. The environment was modified for Freddie because he had his own work space, regular breaks, and access to assisted communication through an iPad. These Visual aids were implemented to help Freddie to process information quickly and easily, and this will inevitably increase his confidence

Conclusion

It is worth noting that Independence is a broad, individualized concept. What constitutes independence for one adult with ASD may not be the same for another. A person with ASD can be employed and live independently as an adult. However, not all individuals achieve the same level of independence. As Hendricks (2010) discussed, social and communication issues, Challenging behaviors, anxiety and stress are core obstacles that are continuing to hinder the successful employment of adults with autism while acknowledging the possible benefits to employers of hiring people with autism, such as reliability, low absenteeism, attention to detail, completing work that other employees do not like due to the repetitive nature of the task.

It's also important that individuals with ASD are matched to jobs that suit their skill set and that necessary skills are identified and taught to participate in the work environment fully. Limited access to employment has distressing effects on adults with ASD and their families as it prevents them from living independent life. Work provides people with ASD with meaningful identity and a pathway to social inclusion. A common thread throughout the literature was the challenges associated with social communication for adults with ASD when securing employment. Therefore, new policies regarding the funding of ASD-related services, including day and residential transition programs and supported employment, need to be established to encourage employers to hire adults with ASD (Solomon, 2020).

Hendricks (2010) highlighted the factors which lead to improving employment outcomes for adults with ASD and states that meaningful integrated employment should be an option for all individuals with ASD who wish to work as employment provides a medium that leads to improvement in one’s quality of life. In addition, we as professionals working with adolescents with ASD need to think about how to encourage their employability best and teach these individuals work-related skills. Individuals with ASD can gain employment with the right support. As mentioned above, many modifications can be made to encourage the successful employment of individuals with ASD. Considering individual characteristics, including strengths, weaknesses, and specific interests can lead to appropriate job placement. When coupled with proper support, this careful match between the individual and the environment can result in successful and ongoing employment for individuals with ASD.

Further exploration of developing skills to access paid employment is a worthwhile area to teach for individuals with ASD as it would certainly have the power to improve quality of life. Solomon (2020) describes how the effects of employment extend far beyond someone’s bank balance; they extend to relationships, social status, identity, goals, and even self-worth. However, unfortunately for many with ASD, access to employment is exceptionally limited. It is clear from the literature that there is a demand for suitable adult services and support, especially employment-related services, for individuals with ASD. Cuadros (2016) states that individuals with autism, employers, and support workers alike should be encouraged to focus on strengths and solutions instead of deficits.

References

Autism Speaks. (2012, July 25). Why a transition plan? Retrieved June 16, 2021, from https://www.autismspeaks.org/family-services/toolkits/transition-tool-kit/why-transition-plan

Chen, J.L., Leader, G., Sung, C. et al. (2015). Trends in Employment for Individuals with Autism Spectrum Disorder: a Review of the Research Literature. Rev J Autism Dev Disord 2, 115–127 (2015). https://doi.org/10.1007/s40489-014-0041-6

Hayward, S.M., McVilly, K.R. and Stokes, M.A., 2019. Autism and employment: What works. Research in Autism Spectrum Disorders, 60, pp.48-58.

Health Service Executive (2012) New Directions. Review of HSE Day Services and Implementation Plan 2012 – 2016. Personal Support Services for Adults withdirections.html

Lorenz, T., Frischling, C., Cuadros, R., & Heinitz, K. (2016). Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment. PloS one, 11(1), e0147040. https://doi.org/10.1371/journal.pone.0147040

Solomon, C., 2020. Autism and Employment: Implications for Employers and Adults with ASD. Journal of Autism & Developmental Disorders, 50(11).

Cooper, J.O., Heron, T.E. and Heward, W.L. (2020)Applied Behavior Analysis,3rd edn.,International Edition: Pearson Education Limited.

Hendricks, D. (2010). Employment and adults with autism spectrum disorders: Challenges and strategies for success. Journal of Vocational Rehabilitation 32, pp. 125-134.

Scott, M., Jacob, A., Hendrie, D., Parsons, R., Girdler, S., Falkmer, T. and Falkmer, M. (2017) 'Employers' perception of the costs and the benefits of hiring individuals with autism spectrum disorder in open employment in Australia.', PLoS ONE, 12(5), pp. e0177607 [Online]. Available at: https://doaj.org/article/6f73f04837664f55aeee63d4776f8607? (Accessed: 10 December 2021).

Howlin, Patricia & Goode, Susan & Hutton, Jane & Rutter, Michael. (2004). Adult Outcome for Children with Autism. Journal of child psychology and psychiatry, and allied disciplines. 45. 212-29. 10.1111/j.1469-7610.2004.00215.x.

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