Measuring Work Adjustment in Adolescents with ASD

Background: Adults with ASD often have poor outcomes including difficulty gaining and keeping employment. Research shows the current employment rate for young adults with ASD is 35% (Roux et al. 2013). Because employment is a pivotal experience that typically leads to better daily living skills (Taylor et al., 2015) and higher quality of life (Klinger et al., 2015), it is important to develop instruments that assess individuals’ workplace readiness skills to identify individualized intervention goals. A common brief (i.e., 15 minutes) Vocational Rehabilitation assessment measure is the Becker Work Adjustment Profile (BWAP). The BWAP is composed of four subscales: Work Habits, Interpersonal Relations, Cognitive Skills, and Work Performance. It has been validated for persons with a wide variety of physical, developmental, and psychiatric disabilities but has not been previously validated with adults on the autism spectrum.

Objectives: The goal of this study was to examine the validity of the BWAP for adults with ASD. Specifically, we examined the relation between the BWAP and other measures associated with employment outcomes in adults with ASD: ASD symptom severity, intellectual functioning, and executive functioning.

Methods: Participants were 42 adolescents with ASD (14-19 years of age, M = 16 years,10 months) who participated in an employment and college readiness intervention. Measures were collected during a baseline assessment prior to beginning the intervention. All participants had their diagnosis confirmed by the ADOS-2, and all had intellectual functioning within the average range on the Wechsler Abbreviated Scale of Intelligence-II (WASI-II; range: 85-135; M=104). Parents completed the BWAP, the Social Responsiveness Scale-2 (SRS-2), and the Behavior Rating Inventory of Executive Functioning Adult Version (BRIEF-A). Teachers also completed the BWAP.

Results: Parent and teacher BWAP total scores were highly correlated (r=.65, p<.001) supporting convergent validity across raters. Multiple regression analyses were conducted to investigate the relation of each BWAP subscale to ASD symptom severity (SRS-2), intellectual functioning (WASI-II), and executive functioning (BRIEF-Global Executive Composite). For parent completed BWAP, Work Habits and Work Performance were significantly predicted by the BRIEF-GEC (β=-.71, p<.001 and β=-.78, p<.001, respectively). BWAP Interpersonal Relations was predicted by SRS-2 (β=-.37, p=.02) and BRIEF-GEC (β=-.32, p=.04). Finally, BWAP Cognitive Skills was predicted by WASI-II (β=+.48, p=.001) and SRS-2 (β=-.44, p=.001). Similar results were seen for the teacher completed BWAP.

Conclusions: Each of the subscales of the BWAP was strongly related to measures of functioning in adolescents with ASD. BWAP Interpersonal Relations was strongly related to autism symptom severity, BWAP Cognitive Skill was strongly related to intellectual functioning, and BWAP Work Habits and Work Performance was strongly related to executive functioning. These results suggest that the BWAP provides a relatively brief measure of employment skills that capture the range of interpersonal, intellectual functioning, and executive functioning difficulties experienced by adults with ASD in work settings. Research examining the utility of this measure in documenting intervention effectiveness is ongoing.