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Factors Impacting Employment for People with Autism Spectrum Disorder: A Scoping Review

Oral Presentation
Thursday, May 10, 2018: 10:30 AM
Willem Burger Hal (de Doelen ICC Rotterdam)
M. T. Scott1, B. T. Milbourn2, M. Falkmer3, S. Bolte4, A. Halladay5, M. D. Lerner6, J. L. Taylor7 and S. J. Girdler2, (1)School of Occupational Therapy and Social Work, Curtin University, Perth, Australia, (2)School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia, (3)Curtin University, Bentley, Australia, (4)Center for Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden, (5)Autism Science Foundation, New York, NY, (6)Psychology, Stony Brook University, Stony Brook, NY, (7)Vanderbilt Kennedy Center, Nashville, TN
Background:

Adults with Autism Spectrum Disorder (ASD) demonstrate not only difficulties, but possess unique strengths and abilities which can be harnessed in the work environment often performing well in jobs requiring systematic information processing, precision and repetition. However, despite increasing recognition of the potential contribution that individuals with ASD can make in the workplace, they continue to experience challenges in finding and maintaining employment. Given that employment research in ASD is progressing there is a need to synthesize research to enable an understanding of those factors impacting employment, and a description of the targets and effectiveness of various intervention approaches. This scoping review examined the extent and range of literature relating to the employment of individuals with ASD.

Objectives:

The primary objectives of this review were to: 1) comprehensively review employment literature relating to ASD and employment; 2) explore measures used in evaluating employment outcomes; 3) identify the strengths and abilities of individuals with ASD in the workplace; 4) classify and link ASD employment interventions to the International Classification of Functioning, Disability and Health (ICF) Core Sets for ASD; and 5) summarise the targets and outcomes of employment interventions.

Methods:

Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with ASD in competitive, supported or sheltered employment, the role of vocational support, or the evaluation of employment interventions were included. Data were extracted in relation to author, year of publication, country, design, participants, outcome measures and nature stage of employment. Quality of the evidence was assessed. Content analysis of results identified the strengths and abilities of employees with ASD in the workplace. Lastly, meaningful concepts relating to the evaluation of employment interventions were extracted and linked to International Classification of Functioning, Disability and Health (ICF) Core Sets for ASD.

Results:

The search identified 3,701 references, of which 117 were include for review. Methodological quality of the articles ranged from limited to strong. Of the 117 articles, only 14 explored the strengths and abilities of individuals with ASD in the workplace including attention to detail, high quality of work, strong sense of morality and precise technical abilities. Thirty-two studies evaluated employment interventions for adults with ASD, primarily focusing on modifying autism-related characteristics such as social interaction, communication skills and executive functioning for improved performance in acquiring a job. While environmental factors such as technology, employer and co-worker support and job coaches were utilised in facilitating work participation, these were never the focus of interventions.

Conclusions: The ICF Core Sets for ASD enabled a holistic review of the employment literature relating to individuals with ASD. While employment interventions targeting intrinsic personal factors of adults with ASD are beneficial in improving work-related outcomes, there has been limited consideration of the role that environmental factors may play in the workplace. This review highlighted the need for the development of more holistic approaches, which consider the influence of both personal and environmental factors in improving the employment outcomes of people with ASD.