Employment Outcomes of Vocational Rehabilitation Clients With Autism Spectrum Disorders

Abstract

Research has consistently documented poor employment outcomes for young adults with autism spectrum disorder (ASD). Vocational rehabilitation (VR) services provide substantial federal and state commitments to individuals with disabilities to obtain and maintain employment. To date, little research has examined the relationship between VR services and employment outcomes of clients with ASD. The purpose of this descriptive study was to better understand employment outcomes of individuals with ASD. Data spanning 10 years from the Rehabilitation Services Administration (RSA) 911 database were analyzed to identify characteristics of VR clients with ASD and the services they received. The percent of individuals who achieved competitive employment averaged 37% across the 10 years. Those who achieved an employment outcome participated in twice as many services as those who did not achieve an employment outcome.

Keywords

employment vocational rehabilitation autism spectrum disorder adult services

The Rehabilitation Act was passed in 1973 to “ . . . empower individuals with disabilities to maximize employment, economic self-sufficiency, independence and inclusion and integration into society, and to ensure that the federal government plays a leadership role in promoting employment of individuals with disabilities” (29 U.S.C. §701). Since 1973, millions of individuals with disabilities have received vocational rehabilitation (VR) services designed to help them achieve and retain employment. Other legislative mandates have also addressed employment-related issues for individuals with disabilities of all ages (e.g., School-to-Work Opportunities Act of 1994; Workforce Innovation and Opportunity Act of 2014).

Research has consistently documented poor employment for young adults with autism spectrum disorder (ASD; Hendricks & Wehman, 2009; Taylor & Seltzer, 2011). The National Longitudinal Transition Study–2 (NLTS2) found that at the time of interview, 45.2% of youth with autism had a paid job outside the home compared with 71% of same-age peers in the general population (Sanford et al., 2011). Taylor and Seltzer (2011) found 18% (n = 12) of the 66 individuals with ASD were employed either with or without supports.

To date, little research has investigated the relationship between VR services and employment outcomes of clients with ASD by analyzing VR data. Since 1990, when ASD was first federally recognized as a disability category, only three studies analyzed VR data on individuals with ASD (Burgess & Cimera, 2014; Cimera, Burgess, & Wiley, 2013; Schaller & Yang, 2005) and one focused on developmental disabilities (DD), including ASD (Wehman, Chan, Ditchman, & Kang, 2014). Burgess and Cimera (2014) analyzed Rehabilitation Services Administration (RSA) data from 2002 to 2011 and found that while the number of ASD clients increased, their employment outcomes—percent achieving employment closure, wages earned, and hours worked—did not improve over that time. Those with ASD were significantly more likely than the general VR population to achieve employment closure; however, the latter worked more hours and earned higher wages on average. Cimera et al. (2013) analyzed RSA data from 2006 to 2009 and found young adults with ASD who received transition services at age 14 were significantly more likely to achieve employment than those who received transition services at age 16. Schaller and Yang (2005) analyzed RSA data for 2001 and found clients with ASD had significantly higher closure rates in supported employment (SE) than in competitive employment. Clients’ average weekly earnings were significantly higher in competitive employment, but the average cost of VR services were significantly higher (slightly more than double) for SE cases. Furthermore, 80% of those in competitive employment and 76% of those in SE were Caucasian. Wehman et al. (2014) examined employment outcomes of youth with intellectual and developmental disabilities (e.g., ASD) who received SE services within VR for 2009. Their findings indicated SE was an effective service for achieving employment outcomes for individuals with significant disabilities.

Although previous research has analyzed RSA data to study VR outcomes for individuals with ASD, the connection between client characteristics (e.g., demographics), the specific types of VR services, and case outcomes remains sparse. Cimera and Cowan (2009) examined the cost of services and outcomes of VR clients with ASD. They found the average cost of services was $3,213, second highest only to individuals with sensory impairments. The 40.8% of individuals with ASD who were employed at case closure “worked far fewer hours (18.65) and earned lower wages (mean = $146.65) per week than most groups studied” (p. 294). Examining one federal fiscal year ([FFY], 2011) of RSA-911 data, Chen, Sung, and Pi (2015) found those aged 18 and younger received six services—assessment, college or university training, occupational/vocational training, miscellaneous training, information and referral services, and other services—significantly more than those aged 25 and older. Furthermore, individuals with ASD ages 25 and older received five services—diagnosis and treatment of impairment, job search assistance, job placement assistance, on-the-job training support, and transportation services—significantly more than those aged 18 and younger.

The purpose of the present study was to better understand employment outcomes of individuals with ASD by analyzing 10 years of RSA data for client characteristics and services received. We examined three a priori research questions regarding VR clients with ASD: (a) What are their demographic and service characteristics; (b) What are their case outcomes; and (c) What are their differences in service and case employment outcomes over time?

Method

Data Collection

The data source for this study was the RSA-911 database, a federal data collection on VR services and clients from VR agencies in all 50 states and the U.S. Territories and Entities. For this analysis, we examined data from the 50 states and District of Columbia and excluded Territories and Entities with different political and economic structures. We obtained RSA-911 data from fiscal years 2003 to 2012. These data were mailed to the authors in text data (.txt) format on CD-ROMs.

Defining Variables

RSA provided a data-variable dictionary, the RSA-911Reporting Manual (2008), listing all variables and their operational definitions for the annual 911 data set. The variables we used in this analysis were defined according to the RSA-911 Reporting Manual (see Tables 1 and 2). We also created two variables—time with VR and improved education level (see Table 1).

Table 1.

Variable Definitions.

Variable	Variable definition from the RSA reporting manual
Gender	Coded as female, male, or asterisk (*) indicating information is not available
Ethnicity	Coded as White, Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, Hispanic or Latino
Primary disability	An individual’s primary physical or mental impairment that causes or results in a substantial impediment to employment and was designated by a four-digit code in the data set. The “first two digits designate the impairment (sensory, physical or mental), and the last two digits indicate the cause or source of the impairment” (Reporting Manual, 2008, p. 11). We used cases with primary impairment codes of (a) communication impairments, expressive/receptive (09), (b) cognitive impairments (17), (c) psychosocial impairments, defined as interpersonal and behavioral impairments, difficulty coping (18), and (d) other mental impairments (19) paired with a cause of autism (08)
Individualized education program (IEP)	Indicates whether the individual ever received services under an IEP in accordance with the provisions of the Individuals With Disabilities Education Act (IDEA). Coded as Yes, No, or an asterisk (*) indicating information is not available
Education attainment at application	The level of education the individual has attained at the time of application to VR. The coding categories were (a) no formal schooling, (b) elementary education (Grades 1–8), (c) secondary education, no high school diploma (Grades 9–12), (d) special education certificate of completion/diploma or in attendance, (e) high school graduate or equivalency certificate (regular education students), (f) postsecondary education, no degree, (g) associate degree or vocational/technical certificate, (h) bachelor’s degree, (i) master’s degree or higher
Employment status at application	Two-digit code which best describes the employment status of the individual at application. Coded as (a) employment without supports in integrated setting, (b) extended employment, (c) self-employment (except BEP), (d) state agency–managed business enterprise program (BEP), (e) homemaker, (f) unpaid family worker, (g) employment with supports in integrated setting, (h) not employed: student in secondary education, (i) not employed: all other students, (j) not employed: trainee, intern, or volunteer, (k) not employed: other
Education attainment at closure	Referred to the level of education the individual had attained when the service record was closed. The reporting categories are the same as those listed for education attained at application
Employment status at closure	Employment status of the individual at case closure in one of the following categories: (a) employment without supports in integrated setting, (b) extended employment, (c) self-employment (except BEP), (d) state agency–managed BEP, (e) homemaker, (f) unpaid family worker, (g) employment with supports in integrated setting
Competitive employment	Referred to employment in an integrated setting, self-employment, or a state-managed BEP that is performed on a full-time or part-time basis for which an individual is compensated at or above the minimum wage; coded as competitively employed or not competitively employed
Type of closure	Indicates when in the VR case process an individual exited the program, e.g., exiting with an employment outcome or exiting without an employment outcome
Reason for closure	Indicates the reason for closing the service case of an individual, e.g., achieved employment outcome, unable to locate or contact, refused services, death, failure to cooperate, other
Time with vocational rehabilitation	For this analysis, this variable was created by subtracting the year the individual’s case was closed from the year the case was opened and estimates the length of time an individual received services from VR
Improved education level	For this analysis, this variable was created by subtracting achieved education level at closure from the achieved education level at application and estimates how many individuals advanced their education level while receiving VR services

Note. RSA = rehabilitation services administration; VR = vocational rehabilitation.

Table 2.

Definitions of the 22 VR Services for Clients.

Service	Service definition from the RSA reporting manual
Assessment	Services and activities to determine an individual’s eligibility for VR services, to assign individual to a priority category of a state VR agency that operates under an order of selection, and/or to determine the nature and scope of VR services to be included in the IPE (Individualized Plan for Employment)
VR counseling and guidance	Discrete therapeutic counseling and guidance services that are necessary for an individual with a disability to achieve an employment outcome. This service is distinct from the general counseling and guidance relationship that exists between the counselor and individual during the entire rehabilitation process
Diagnosis and treatment	Corrective surgery or therapeutic treatment that is likely, within a reasonable period of time, to correct or modify substantially a physical or mental impairment that constitutes a substantial impediment to employment; diagnosis and treatment for mental and emotional disorders by qualified personnel who meet state licensure laws; other medical or medically related rehabilitation services
Job placement assistance	A referral to a specific job resulting in an interview, whether or not the individual obtained the job
On the job supports	Support services provided to an individual who has been placed in employment to stabilize the placement and enhance job retention. Such services include job coaching, follow-up and follow-along, and job retention services
Job search assistance	Job search activities support and assist a consumer in searching for an appropriate job. Job search assistance may include help in resume preparation, identifying appropriate job opportunities, developing interview skills, and making contacts with companies on behalf of the consumer
Other services	Use this category for all other VR services that cannot be recorded elsewhere (e.g., occupational licenses, tools and equipment, initial stocks and supplies). Medical care for acute conditions arising during rehabilitation and constituting a barrier to the achievement of an employment outcome is also included in this category
Transportation services	Transportation, including adequate training in the use of public transportation vehicles and systems, means travel and related expenses that are necessary to enable an applicant or eligible individual to participate in a VR service
Job readiness training	Training to prepare an individual for the world of work (e.g., appropriate work behaviors, getting to work on time, appropriate dress and grooming, increasing productivity)
Miscellaneous training	Any training not recorded in one of the other categories listed, including GED or high school training leading to a diploma
Information and referral services	Information and referral services are provided to individuals who need services from other agencies (through cooperative agreements) not available through the VR program
On the job training	Training in specific job skills by a prospective employer. Generally, the individual is paid during this training and will remain in the same or similar job upon successful completion. Also include apprenticeship-training programs conducted or sponsored by an employer, a group of employers, or a joint apprenticeship committee representing both employers and a union
Occupational/vocational training	Occupational, vocational, or job-skill training provided by a community college and/or business, vocational/trade, or technical school to prepare students for gainful employment in a recognized occupation, not leading to an academic degree or certification
College or university training	Full-time or part-time academic training above the high school level leading to a degree (associate, baccalaureate, graduate, or professional), a certificate or other recognized educational credential. Such training may be provided by a 4-year college or university, community college, junior college, or technical college
Maintenance	Maintenance means monetary support provided for those expenses such as food, shelter, and clothing that are in excess of the normal expenses of the individual, and that are necessitated by the individual’s participation in an assessment for determining eligibility and VR needs or while receiving services under an IPE
Disability-related augmentative skills training	Disability-related augmentative skills training includes but is not limited to orientation and mobility; rehabilitation teaching; training in the use of low vision aids; Braille; speech reading; sign language; and cognitive training/retraining
Basic academic remedial or literacy training	Literacy training or training provided to remediate basic academic skills that are needed to function on the job in the competitive labor market
Rehabilitation technology	Rehabilitation technology means the systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation
Personal attendant services	Personal attendant services are those personal services that an attendant performs for an individual with a disability such as bathing, feeding, dressing, providing mobility and transportation, and so on
Technical assistance services	Technical assistance and other consultation services provided to conduct market analyses, to develop business plans, and to provide resources to individuals in the pursuit of self-employment, telecommuting, and small business operation outcomes
Reader services	Reader services are for individuals who cannot read print because of blindness of other disability. Reader services include, in addition to reading aloud, transcription of printed information into Braille or sound recordings if the individual requests such transcription. Reader services are generally for individuals who are blind or deaf-blind, but may also include individuals unable to read because of serious neurological disorders, specific learning disabilities, or other physical or mental impairments
Interpreter services	Interpreter services are sign language or oral interpretation services for individuals who are deaf or hard of hearing and tactile interpretation services for individuals who are deaf-blind. Specially trained individuals perform sign language or oral interpretation. Also include her real-time captioning services for persons who are deaf or hard of hearing. Do not include language interpretation in this category, but in “other services”

Note. VR = vocational rehabilitation; RSA = rehabilitation services administration.

Data Analysis

Only clients coded with ASD as their primary disability were included in the statistical analyses. We organized the RSA data for each fiscal year in SPSS statistical software v.21 (IBM-SPSS, 2013) for Windows and screened these data for keystroke errors and missing values. Descriptive statistics were run for demographics—ethnicity, gender, highest level of education attained at client’s application, individual education program (IEP) status, and employment at application and case closure (Table 3). Statistical tests were conducted using t tests and chi-square tests of independence to empirically ascertain differences in employment outcomes among VR clients with ASD based on gender, ethnicity, IEP status, improved education, and total services received (Tables 4 to 8). A priori statistical significance was set at p < .05.

Table 3.

Demographics of VR Clients With ASD.

Demographic Characteristics	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012
Number of total VR cases	643,994	647,596	609,501	609,367	592,422	609,625	580,295	602,814	581,258	571,975
Number of ASD cases	1,541	2,012	2,422	3,127	3,901	4,865	5,867	7,059	8,482	10,347
Percent of ASD cases/total VR cases	0.24%	0.31%	0.40%	0.51%	0.66%	0.80%	1.01%	1.17%	1.46%	1.81%
Males	81%	81%	83%	81%	81%	84%	83%	84%	84%	84%
Ethnicity
White	84%	85%	85%	85%	87%	87%	87%	87%	87%	88%
Black	11%	12%	12%	12%	11%	11%	10%	10%	10%	10%
Hispanic/Latino	4%	3%	4%	4%	3%	4%	4%	5%	6%	5%
Asian	3%	2%	2%	3%	3%	2%	2%	3%	3%	2%
American Indian/Alaska Native	1%	1%	1%	1%	1%	1%	1%	1%	1%	1%
Hawaiian/Pacific Islander	0%	0%	1%	1%	1%	1%	1%	1%	1%	0%
Individual education program (IEP)	60%	66%	68%	71%	71%	71%	72%	73%	73%	73%
Education level at application
Less than high school	41%	43%	43%	38%	39%	34%	38%	36%	34%	33%
High school completion	43%	39%	38%	41%	40%	42%	41%	40%	41%	41%
Special education	26%	25%	25%	22%	21%	20%	20%	20%	18%	17%
Postsecondary education training
No degree	8%	10%	11%	12%	11%	13%	11%	12%	13%	14%
AA degree vocational/technical	4%	5%	4%	5%	5%	5%	4%	5%	5%	6%
Bachelor’s degree	3%	3%	3%	3%	4%	4%	3%	3%	4%	4%
Master’s degree or higher	<1%	<1%	<1%	1%	<1%	1%	1%	1%	1%	1%
Employment at application to VR	13%	14%	14%	13%	12%	13%	11%	10%	9%	9%

Note. Percentages rounded to the nearest whole number. VR = vocational rehabilitation; ASD = autism spectrum disorder; AA = associate degree.

Table 4.

Percent of Clients With ASD Receiving VR Services.

VR Service Category	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012
Assessment	64%	66%	65%	65%	63%	64%	63%	61%	59%	58%
VR counseling	48%	51%	49%	53%	52%	53%	52%	55%	50%	54%
Diagnosis and treatment of impairment	35%	35%	37%	38%	42%	41%	38%	39%	37%	37%
Job placement assistance	30%	31%	31%	32%	33%	33%	31%	31%	30%	32%
On the job supports	29%	29%	30%	31%	30%	29%	26%	23%	24%	26%
Job search assistance	26%	23%	24%	24%	25%	24%	22%	20%	20%	23%
Other services	17%	15%	18%	20%	18%	18%	19%	18%	18%	16%
Transportation services	13%	14%	16%	15%	17%	17%	16%	15%	16%	16%
Job readiness training	13%	13%	14%	14%	14%	15%	14%	15%	15%	16%
Miscellaneous training	11%	10%	10%	11%	11%	10%	11%	10%	11%	9%
Info and referral services	10%	11%	13%	14%	15%	18%	19%	19%	17%	18%
On the job training	7%	7%	7%	5%	4%	4%	4%	4%	4%	4%
Occupational vocational training	6%	5%	6%	6%	6%	6%	5%	5%	5%	5%
University training	4%	6%	5%	6%	6%	6%	6%	7%	8%	7%
Maintenance	4%	5%	5%	6%	6%	5%	6%	5%	6%	7%
Disability-related augmentative skills training	2%	2%	3%	2%	2%	2%	2%	2%	1%	1%
Basic academic training	1%	2%	2%	2%	1%	1%	1%	1%	1%	1%
Rehabilitation technology	1%	1%	1%	1%	1%	1%	1%	2%	2%	2%
Personal attendant services	1%	<1%	<1%	1%	<1%	<1%	<1%	<1%	<1%	<1%
Technical assistance services	1%	1%	1%	1%	1%	2%	0%	0%	0%	0%
Reader services	0%	<1%	0%	<1%	<1%	<1%	<1%	<1%	<1%	0%
Interpreter services	0%	<1%	<1%	<1%	<1%	<1%	<1%	<1%	<1%	<1%
Participated in VR for 3 years or less	88%	88%	87%	86%	86%	86%	87%	87%	86%	84%
Improved education level	28%	29%	30%	33%	30%	32%	31%	32%	32%	32%

Note. ASD = autism spectrum disorder VR = vocational rehabilitation.

Table 5.

Rates of VR Case Closure Type (%) by Year.

Closure type	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012
1. Exited as applicant	5	4	4	4	4	4	5	5	5	5
2. Exited during/after trial work	2	2	1	1	2	1	2	2	2	2
3. Exited with an employment outcome^a	41	42	41	42	42	41	36	33	34	37
4. Competitive employment rate	39	39	40	41	41	39	35	32	33	36
5. Exited without an employment outcome after services	25	26	25	24	24	23	25	28	28	26
6. Exited without an employment outcome after IPE, before VR services	1	1	1	1	1	1	2	2	3	3
7. Exited order of selection wait list	1	1	1	1	1	0	1	0	0	1
8. Exited without an employment outcome after eligibility, before IPE	25	25	27	27	27	28	29	30	28	26

Note. VR = vocational rehabilitation; IPE = individual plan for employment. ^aConsidered the only “successful” VR closure.

Table 6.

Achieved Employment Outcome by Gender Chi-Square.

Year	Male (n, %)	Female (n, %)	Chi-square	p
2003	540, 86	90, 14	13.96	<.0001*
2004	712, 85	131, 16	13.33	<.0001*
2005	839, 85	150, 15	5.51	.019*
2006	1,088, 83	224, 17	4.92	.027*
2007	1,358, 83	284, 17	7.33	.007*
2008	1,707, 85	291, 15	3.39	.047*
2009	1,808, 85	325, 15	4.06	.045*
2010	2,020, 87	310, 13	17.83	<.0001*
2011	2,479, 86	415, 14	14.03	<.0001*
2012	3,280, 85	568, 15	7.58	.006*

Note. *Statistically significant at p < .05.

Table 7.

Achieved Employment Outcome by Ethnicity Chi-Square.

Year	White (n, %)	Non-White (n, %)	Chi-square	p
2003	540, 86	89, 14	2.94	.086
2004	732, 87	111, 13	5.12	.024*
2005	870, 88	119, 12	12.66	<.0001*
2006	1,170, 89	142, 11	26.43	<.0001*
2007	1,440, 88	202, 12	3.11	.078
2008	1,780, 89	218, 11	13.21	<.0001*
2009	1,917, 90	216, 10	19.60	<.0001*
2010	2,063, 89	267, 12	9.57	.002*
2011	2,594, 90	300, 10	20.37	<.0001*
2012	3,448, 90	399, 10	13.71	<.0001*

Note. *Statistically significant at p < .05.

Table 8.

Achieved Employment Outcome by IEP Status Chi-Square.

Year	IEP (n, %)	Non-IEP (n, %)	Chi-square	p
2003	364, 58	266, 42	2.43	.119
2004	551, 65	292, 35	0.21	.644
2005	678, 69	311, 31	0.59	.441
2006	903, 69	409, 31	6.31	.012*
2007	1,156, 70	486, 30	0.44	.505
2008	1,419, 71	579, 29	0.00	.926
2009	1,499, 70	634, 30	3.96	.046*
2010	1,647, 71	683, 29	13.22	<.0001*
2011	2,059, 71	835, 29	7.35	.007*
2012	2,776, 72	1,072, 28	6.17	.013*

Note. IEP = individual education program.

Statistically significant at p < .05.

Results

Clients with ASD (n = 49,623) constituted less than 1% of the 6,048,847 total client cases in VR across all states and D.C. from Fiscal Years 2003 to 2012. We found less than 1% of all data missing for clients with ASD. Cases with any missing data were excluded from further statistical analyses. Results are organized by research question.

What are the Demographic and Service Characteristics of VR Clients With ASD?

Table 3 shows the percentage of cases with ASD in six demographic characteristics (a) gender, (b) ethnicity, (c) IEP status, (d) education attainment at the time of application, (e) employment at application, and (f) employment at closure. The majority of clients with ASD were male, ranged from 81% in 2003 to 84% in 2012. The majority of clients identified as White ranged from 84% in 2003 to 88% in 2012. The percent of clients identified as Black ranged from 11% to 12% until 2009 when the percentage dropped and remained at 10% through 2012. The percent identified as Hispanic/Latino ranged from 3% in 2004 to 6% in 2011. Clients identified as Asian ranged between 2% and 3% across the decade. Combined, less than 2% of clients identified as American Indian/Alaska Native or Hawaiian/Pacific Islander.

Clients with ASD who had less than a high school education ranged from 41% in 2003 to 33% in 2012, with a high of 43% in 2004 and 2005. The majority of clients who received VR services were recorded in the database as regular high school students who graduated or received an equivalency certificate; this group ranged from a high of 43% in 2003 to 41% in 2012, with a low of 38% in 2005. An additional 26% in 2003 to 17% in 2012 of the cases were recorded as having received a special education certificate of completion, diploma, or being in attendance. This classification included individuals who were still in school and receiving special education services, those who received special education services and earned a certificate of completion or high school diploma, and those who received special education services but did not receive a certificate or diploma. Clients with ASD who had some postsecondary education or training without earning a degree ranged from 8% in 2003 to 14% in 2012. Those with an associate degree or vocational technical certificate ranged from 4% to 6%. Those with a bachelor’s degree ranged from 3% to 4%, and those with a master’s degree or higher ranged from less than 1% to 1%. Clients who were employed at the time of VR application ranged from 9% to 14%.

Table 4 shows the percent of VR clients with ASD who received services across all 10 years. On average, 63% of these clients received an assessment to determine their eligibility for VR services and an average of 52% received VR counseling. On average, 38% received a service related to diagnosis and treatment of impairment, and 23% to 31% received job-related services such as job placement assistance (31%), on-the-job supports (28%), and/or job search assistance (23%). Across the decade, on average, fewer than 20% of these clients were reported as receiving other services (e.g., occupational licenses, tools and equipment, initial stocks and supplies; 18%), transportation services (16%), and job readiness training (14%), and information and referral services (15%) and miscellaneous training (e.g., GED or high school training leading to a diploma).

Across the decade, on average, fewer than 10% of clients with ASD received occupational vocational training (6%), university training (6%), on-the-job training (5%), and maintenance services (5%). Furthermore, 2% or fewer were reported as receiving disability-related augmentative skills training (2%), basic academic training (1%), rehabilitation technology (1%), and personal attendant services (1%), and technical assistance service, reader, or interpreter services were reported for less than an average of 1% of the clients with ASD. On average, 87% of these clients participated in VR for 3 years or less. Yearly, approximately one third of the VR clients with ASD improved their education level at least one reporting level (e.g., not having high school diploma to having a high school diploma).

What Are the Outcomes of VR Clients With ASD?

Only an exit with an employment outcome is considered a successful case closure by VR (RSA, 2008). Although the number of cases of clients with ASD steadily increased from 1,541 in 2003 to 10,347 in 2012, successful case closure rate did not, averaging 37.5%, with a low of 33% in 2010 to a high of 42% in years 2004, 2006, and 2007 (Table 5). On average, a quarter (25%) of those who sought VR services exited without employment after receiving services, ranging from a low of 23% in 2008 to a high of 28% in 2010 and 2011. Still other clients with ASD exited VR before receiving services (e.g., at application, after eligibility determination), a low of 32% in 2004 to a high of 39% in 2010 (Table 5). The percent of individuals who achieved competitive employment averaged 37%, fluctuating from 39% to 41% through 2008 before declining to a low of 32% in 2010 and then increasing to 36% in 2012.

What Are the Differences in Employment Service and Case Outcomes Among VR Clients With ASD Over Time?

Across all 10 years, a total of 31,004 of the 49,623 (i.e., 62%) cases of clients with ASD did not achieve an employment outcome. These clients were mostly male (78% to 83%), White (83% to 87%), who had an IEP (62% to 75%), and had at least a high school diploma at the time of their application for VR services (54% to 59%).

To examine who achieved an employment outcome and whether differences were statistically significant, we conducted chi-square tests of independence between the discrete outcome variable, achieved employment outcome (yes/no), and each of four dichotomous predictor variables: (a) gender (male/female), (b) ethnicity (White/non-White), (c) IEP status (yes/no), and (d) improved education (yes/no). In all 10 years, male clients with ASD were significantly more likely than female clients with ASD to achieve an employment outcome (see Table 6). In 8 of 10 years, White clients with ASD were significantly more likely than non-White clients with ASD to achieve an employment outcome (see Table 7). In 5 of the 10 years, clients with ASD who had an IEP were significantly more likely to achieve an employment outcome (see Table 8). In 9 of 10 years, clients who increased their education level from application to exit were significantly more likely to achieve an employment outcome (see Table 9).

Table 9.

Achieved Employment Outcome by Improved Education Chi-Square.

Year	Improved education (n, %)	No improved education (n, %)	Chi-square	p
2003	429, 68	201, 32	7.43	.006*
2004	258, 31	582, 64	3.23	.075
2005	665, 67	324, 33	8.02	.005*
2006	836, 64	472, 36	12.14	<.0001*
2007	1,047, 64	595, 36	44.12	<.0001*
2008	1,239, 62	758, 38	46.02	<.0001*
2009	1,322, 62	810, 38	69.63	<.0001*
2010	1,483, 64	846, 36	21.17	<.0001*
2011	1,797, 62	1,097, 38	57.59	<.0001*
2012	2,332, 61	1,516, 39	119.43	<.0001*

Note. *Statistically significant at p < .05.

To further understand the empirical relationship between VR services and case outcomes for clients with ASD, t tests were conducted. As shown in Table 10, clients with ASD who achieved an employment outcome, consistently across the decade, had utilized a significantly greater number of VR services (4.5 to 4.9) than clients who did not achieve an employment outcome (2.1 to 2.3). Even after correcting for unequal variances (i.e., Levene’s test) between the two groups, the differences between them were statistically significant (p < .001).

Table 10.

Service Total Difference in Employed (E) and Non-Employed (NE) Outcomes.

Year	M (E)	SD (E)	M (NE)	SD (NE)	df	t	t ^a	p
2003	4.46	2.35	2.11	1.95	1,539	−21.40	−20.71	<.001
2004	4.42	2.29	2.15	1.88	2,010	−24.28	−23.53	<.001
2005	4.63	2.38	2.23	2.95	2,420	−26.51	−25.81	<.001
2006	4.62	2.28	2.28	2.02	3,125	−30.21	−29.63	<.001
2007	4.67	2.35	2.27	2.12	3,899	−33.29	−32.75	<.001
2008	4.73	2.36	2.28	2.13	4,863	−37.60	−36.93	<.001
2009	4.77	2.36	2.25	2.09	5,865	−42.25	−40.90	<.001
2010	4.85	2.29	2.26	2.06	7,057	−47.96	−46.26	<.001
2011	4.89	2.28	2.14	2.07	8,480	−55.96	−54.31	<.001
2012	4.71	2.23	2.20	2.00	10,345	−59.11	−57.49	<.001

Adjusted with Levene’s test for unequal variances

Discussion

The purpose of this study was to examine characteristics of VR clients with ASD and the services they received to better understand their employment outcomes. Significance tests were conducted only on select variables to determine bivariate statistical differences to facilitate description of the population, not to establish a relationship between a dependent variable and independent variables (see Shadish, Cook, & Campbell, 2002). No causal inferences can be drawn. Results of the present study are important given the sparseness of published studies on employment outcomes of VR clients with ASD by analyzing multiple years of VR data. By examining 10 years of RSA-911, this study provides a more comprehensive picture of employment outcomes and services used by VR clients with an ASD. The discussion is organized by research question, followed by recommendations for future research and implications for practitioners.

What are the Demographic and Service Characteristics of VR Clients With ASD?

The number of VR clients with ASD increased by 571% across the decade, whereas the total number of all VR clients decreased by 10%. There were small increases in the percentages of male clients and White clients with ASD and small or no increases in female clients and non-White clients with ASD. These demographic findings are consistent with what is known about the connection between ASD identification, ethnicity, and gender. The male-to-female ratio found in this data set is similar to other reported findings (Chakrabarti & Fombonne, 2001; Werling & Geschwind, 2013). For years 2003 and 2004, the ratio in this RSA data set mirrors this proportion at 4:1 with an increase to 5:1 in the remaining years. Increase in the VR ASD population is also consistent with the Center for Disease Control’s noted increase in the prevalence of ASD in the general population (Baio, 2014). Reasons for this increase vary, from improved screening to possible over-identification or misidentification (Miller et al., 2013).

There was an increase in the percentage of VR clients with ASD who received some postsecondary education or training, which corresponds to a decrease in the percentage of ASD clients with less than a secondary education. Among young adults with ASD in the general population, the rates of postsecondary education did not improve statistically from late 1990s to late 2000s (Newman, Wagner, Cameto, Knokey, & Shaver, 2010). Unfortunately, a national estimate of postsecondary education attainment for older adults with ASD is unknown (Haley, 2011).

Relative to patterns of services, an average of 57% of the VR clients with ASD received assessment and/or VR counseling, and about 40% received diagnosis/treatment across the decade. These were the three most frequently used services, which were not surprising given an assessment is required to determine eligibility for services. In addition, VR counseling—defined as discrete therapeutic counseling and guidance services needed to achieve employment—is necessary to assist VR clients in finding employment options, and diagnosis and treatment directly addresses a client’s barriers to employment. However, none of the remaining 19 services were used by more than 33% of clients. Since ASD manifests so uniquely across the population (Attwood, 2007), a higher percentage of these other services utilized by clients might have been expected. Difficulties such as social skills, communication, executive functioning, and anxiety can pose significant barriers for individuals with ASD requiring specific supports to address them (Alverson, Lindstrom, & Hirano, 2015). It is possible that challenges with communication, social skills, and executive functioning were barriers preventing these VR clients from taking advantage of the full range of services available to them. Muller, Schuler, Burton, and Yates (2003) found individuals with ASD experienced several major obstacles to successful employment “(a) mastering the job application process, (b) acclimating to new job routines, (c) communication, and (d) navigating social interactions with supervisors and co-workers” (p 167). Within each major theme, these researchers identified minor themes affecting employment, such as “difficulties contacting potential employers by phone, difficulty reading between the lines, and taking too long to learn new tasks” (Muller et al., 2003, p. 167). These themes appear to describe the services available to clients from VR (e.g., job readiness training focused on building communication skills).

What are the Outcomes of VR Clients With ASD?

To understand employment outcomes in this context, one must first understand the various ways in which the RSA defines an employment outcome which include several categories such as “homemaker” and “unpaid family worker” (RSA, 2008, p. 32). This differs from the RSA definition of competitive employment, which is more restrictive—employment in an integrated setting, self-employment, and state-managed Business Enterprise Programs (RSA, 2008). Of the 49,623 cases with ASD, 36% (n = 17,922) achieved a competitive employment outcome. Research has consistently documented unemployment or underemployment of individuals with ASD (Frith, 2004; Hurlbutt & Chalmers, 2004). Recent reports estimate only 6% to 11% of adults with ASD are competitively employed (Cedurland, Hagberg, Billstedt, Gillberg, & Gillberg, 2008; Taylor & Seltzer, 2011). Shattuck et al. (2012) found 55.1% of individuals with ASD, ages 19 to 23 at data collection, had engaged in any paid work since leaving high school. Findings from this study are consistent with the wide range of employment findings.

Whereas the total number of VR clients with ASD increased from 2003 to 2012, the rates of closure with an employment outcome did not. Year-to-year fluctuations in the VR employment rates can be attributed to two other types of case closures that represented the largest groups of clients each year, those who exited without an employment outcome after (a) VR services and (b) being found eligible for services, but before development of the individual plan for employment (IPE). The consistent, substantial number of clients with these types of case closures can be accounted for, in part, by the reasons clients did not achieve an employment outcome. The four most frequently cited reasons that clients with ASD exited VR without an employment outcome accounted for 76% to 88% of cases (a) refused services/further services, (b) all other reasons, (c) unable to locate or contact, and (d) failure to cooperate. These reasons could be directly related to the common cluster of ASD challenges related to communication, social skills, and executive functioning, which could potentially be mitigated through expanded utilization of other VR services not commonly used.

What Are the Differences in Employment Service and Case Outcomes Among VR Clients With ASD Over Time?

In each year, VR clients with ASD who achieved an employment outcome had utilized a statistically significantly (p < .001) greater number of services, twice as many as clients who did not achieve an employment outcome. Common services utilized by the clients who achieved an employment outcome were (a) diagnosis and treatment of impairment, (b) job placement assistance, and (c) on the job supports. To further understand the empirical relationship between individual factors and VR case closure outcomes, client characteristics (i.e., predictor variables) were tested for statistical differences across two case outcomes—achieving or not achieving employment outcome at closure (i.e., criterion variable). Of the four predictors (gender, ethnicity, IEP status, and improvement in educational attainment from application to closure) across the decade, gender consistently had the strongest effect. Being male was the best predictor of whether a client with ASD would achieve an employment outcome at case closure, followed by ethnicity and improvement in educational attainment. This finding is not surprising given the economic and employment data in the general population with regard to the disparities between males and females (United States Department of Labor, 2014) combined with the fact that many more males are identified with ASD than are females (Attwood, 2007).

Recommendations for Future Research

We conducted a descriptive study to begin to understand the characteristics of VR clients with ASD as a population, the VR services they received, and their employment outcomes. From this beginning point, the field can pose research questions to discover and explain contributing factors, test hypotheses, and craft interventions that are likely to result in positive outcomes.

A multitude of important research questions can be addressed with further analyses of the RSA data. For example, how do the VR outcomes and services of other subpopulations compare with the outcomes and services of clients with ASD over multiple years? What are the relationships between the reasons clients with ASD did not achieve employment at case closure (e.g., refused services, failure to cooperate) and the types of services they received (and did not receive) while also accounting for differences across clients’ state economic conditions (e.g., unemployment rates of individuals with disabilities, predominant state industries or employers). Answering these research questions may also require further contextualization, such as surveying VR counselors, clients, clients’ coworkers, work supervisors, and others to more fully understand the individualized reasons for clients not achieving an employment outcome, such as inadequacy of workplace supports or mismatch between client skill-set and job requirements. Research could also directly address the financial costs and impact of VR services on case outcomes of clients with ASD, asking, what is the relationship of the changing national and state policies and fiscal expenditures on VR services and case outcomes of clients with ASD? This would entail analyzing the dollar cost of VR services, public assistance (e.g., Social Security Disability Insurance [SSDI], Temporary Assistance for Needy Families [TANF]), and number of hours worked and weekly average salary at case closure.

Implications for Practice

In light of the findings from this analysis, there are two important implications for practice. First, given that, across the 10 years examined in this analysis, 62% of the cases of clients with ASD did not achieve an employment outcome, it is imperative that those working with individuals with ASD (e.g., educators of transition age youth and adult services providers) maximize the individuals’ preparation for employment. Although VR is charged with helping individuals overcome barriers to employment, Individuals With Disabilities Education Act of 2004 (IDEA) charges educators with preparing young adults with disabilities for employment (C.F.R. §300.1(a)). Previous research (Benz, Lindstrom, & Yovanoff, 2000; Rabren, Dunn, & Chambers, 2002) has established the importance of having paid work experiences while in high school. For practitioners working with individuals who experience ASD and who do not receive IDEA services in school, the Workforce Innovation Opportunities Act of 2014 provides for the provision of pre-employment transition services to youth ages 14 to 24, including job exploration counseling, work-based learning experiences, and workplace readiness training.

Second, with the 571% increase in the number of individuals with ASD seeking services through VR, it is critical that those tasked with helping individuals get a job (e.g., VR counselors, job developers), as well as employers and natural supports understand the characteristics of ASD and how they manifest in individuals (Alverson et al., 2015). Valle et al. (2014) found specialized VR case loads to be an effective strategy for supporting individuals with ASD. Although VR counselors may not have a single-focused caseload, developing expertise in ASD may be beneficial. To help VR counselors understand the unique needs of their clients with ASD, they need training beyond describing of stereotypical characteristics of ASD. Furthermore, individuals with ASD should be comfortable explaining and describing how ASD affects them. Educators, families, and support personnel can help individuals with ASD understand and talk about their strengths and support needs.

Limitations

These findings should be considered within the following limitations. A limitation of using an extant data set is the lack of control over variables definitions, data collection, and entry. This limitation is evident in two ways. First, the RSA data set we received lacked an age variable, which did not allow for disaggregating a variety of key questions (e.g., average age of clients, closure rates—there may be different employment rates between older and younger clients). Second, the level of education variable for those who received special education services combined three distinct categories, individuals who (a) were still in school, (b) earned a certificate of completion or diploma, or (c) exited high school without receiving a certificate or diploma. It is important to note, this analysis represents only those individuals with ASD who sought VR services; these individuals may be significantly different from individuals with ASD who did not seek services.

Conclusion

By examining the characteristics of VR clients with ASD and the services they received, we have a better understanding of the employment outcomes of this fast-growing population. The RSA’s annual collection of these data from every state provides a snapshot of one segment of this population—those who sought VR services. Analyzing these data over a long period of time provides insights to avenues for further research related to improving service provision through interventions targeted to this population, improving the overall system, and developing service policies. This research provides a starting point to understanding the employment outcomes for individuals with ASD who seek services through VR.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

References

Alverson

C. Y.

Lindstrom

L. E.

Hirano

(2015). High school to college: Transition experiences of young adults with autism. Focus on Autism and Other Developmental Disorders. Advance online publication. doi:10.1177/1088357615611880

Attwood

(2007). The complete guide to Asperger’s syndrome. London, England: Jessica Kingsley.

Baio

(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 Surveillance Summaries, 63, 1–24.

Benz

M. R.

Lindstrom

Yovanoff

(2000). Improving graduation and employment outcomes of students with disabilities: Predictive factors and student perspectives. Exceptional Children, 66, 509–541.

Burgess

Cimera

R. E.

(2014). Employment outcomes of transition-aged adults with autism spectrum disorders: A state of the states report. American Journal on Intellectual and Developmental Disabilities, 119, 64–83. doi:10.1352/1944-7558-119.1.64

Cedurland

Hagberg

Billstedt

Gillberg

I. C.

Gillberg

(2008). Asperger syndrome and autism: A comparative longitudinal follow-up study more than 5 years after original diagnosis. Journal of Autism and Developmental Disorders, 38, 72–85.

Chakrabarti

Fombonne

(2001). Pervasive developmental disorders in preschool children. Journal of American Medical Association, 285, 3093–3099.

Chen

J. L.

Sung

Sukyeong

. (2015). Vocational rehabilitation service patterns and outcomes for individuals with autism of different ages. Journal of Autism and Developmental Disorders, 45, 3015-3029.

Cimera

Burgess

Wiley

(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, 88–93.

10.

Cimera

Cowan

R. J.

(2009). The costs of services and employment outcomes achieved by adults with autism in the U.S. Autism, 13, 285–302. doi:10.1177/1362361309103791

11.

Frith

(2004). Emmanuel Miller lecture: Confusions and controversies about Asperger syndrome. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 672–686.

12.

Haley

D. C.

(2011). Asperger’s in higher education: A peer support group to raise self determination. Retrieved from UMI Dissertation Publishing (1501375).

13.

Hendricks

Wehman

(2009). Transition from school to adulthood for youth with autism spectrum disorders: Review and recommendations. Focus on Autism and Other Developmental Disabilities, 24, 77–88.

14.

Hurlbutt

Chalmers

(2004). Employment and adults with Asperger syndrome. Focus on Autism and Other Developmental Disabilities, 19, 215–222.

15.

Miller

J. S.

Bilder

Farley

Coon

Pinborough-Zimmerman

Jenson

Rice

C. E.

Fombonne

Pingree

C.B.

Ritvo

A.-R.

McMahon

W.M.

(2013). Autism spectrum disorder reclassification: A second look at the 1980s Utah/UCLA autism epidemiologic study. Journal of Autism and Developmenal Disorders, 43, 200-210.

16.

Muller

Schuler

Burton

B. A.

Yates

G. B.

(2003). Meeting the vocational support needs of individuals with Asperger Syndrome and other autism spectrum disabilities. Journal of Vocational Rehabilitation, 18, 163–175.

17.

Newman

Wagner

Cameto

Knokey

A. M.

Shaver

(2010). Comparisons across time of the outcomes of youth with disabilities up to 4 years after high school. A report of findings from the National Longitudinal Transition Study (NLTS) and the National Longitudinal Transition Study-2 (NLTS-2) (NCSER 2010–3008). Menlo Park, CA: SRI International.

18.

Rabren

Dunn

Chambers

(2002). Predictors of post-high school employment among young adults with disabilities. Career Development for Exceptional Individuals, 25, 25–40.

19.

Rehabilitation Act of 1973, 29 U.S.C. § 701 et seq.

20.

RSA 911 Reporting Manual. (2008). Reporting manual for the case service report (RSA-911). State-Federal Program for Vocational Rehabilitation. Washington, DC: U.S. Department of Education Office of Special Education and Rehabilitative Services Rehabilitation Services Administration.

21.

Sanford

Newman

Wagner

Cameto

Knokey

A. M.

Shaver

(2011). The post-high school outcomes of young adults with disabilities up to 6 years after high school. Key findings from the National Longitudinal Transition Study-2 (NLTS2) (NCSER 2011–3004). Menlo Park, CA: SRI International.

22.

Schaller

Yang

N. K.

(2005). Competitive employment for people with autism. Rehabilitation Counseling Bulletin, 49, 4–16.

23.

Shadish

W. D.

Cook

W. D.

Campbell

D. T.

(2002). Experimental and quasi-experimental designs for generalized causal inference. Boston, MA: Houghton Mifflin.

24.

Shattuck

Narendorf

Cooper

Sterzing

Wagner

Taylor

(2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129, 1042–1049. doi:10.1542/peds.2011-2864

25.

Taylor

J. L.

Seltzer

M. M.

(2011). Employment and post-secondary educational activities for young adults with autism spectrum disorders during the transition to adulthood. Journal of Autism and Developmental Disorders, 41, 566–574. doi:10.1007/S10803-010-1070-3

26.

United States Department of Labor. (2014). Persons with a disability: Labor force characteristics—2013. Bureau of Labor Statistics News Release, June 11, 2014. Retrieved from http://www.bls.gov/cps

27.

Valle

R. D.

Leahy

M. J.

Sherman

Anderson

C. A.

Tansey

Schoen

(2014). Promising best practices that lead to employment in vocational rehabilitation: Findings from a four-state multiple case study. Journal of Vocational Rehabilitation, 41, 99–113. doi:10.3233/JVR-140708

28.

Wehman

Chan

Ditchman

Kang

H.-J.

(2014). Effect of supported employment on vocational outcomes of transition-age youth with intellectual and developmental disabilities. Intellectual and Developmental Disabilities, 52, 296–310. doi:10.1352/1934-9556-52.4.296

29.

Werling

D. M.

Geschwind

D. H.

(2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26, 146–153. doi:10.1097/WCO.0b013e32835ee548