Supporting a 23-Year-Old Male with Autism Spectrum Disorder in Employment
For a 23-year-old male with autism who struggles to obtain or maintain employment, a comprehensive vocational rehabilitation approach that includes supported employment with job coaching is strongly recommended as the most effective intervention strategy.
Assessment and Planning
Initial Evaluation
- Conduct a comprehensive neurobehavioral evaluation including:
- Assessment of cognitive strengths and weaknesses
- Evaluation of working memory and processing speed (commonly affected in ASD)
- Assessment of communication abilities and language skills
- Evaluation of fine and gross motor skills
- Assessment of adaptive functioning
- Screening for co-occurring conditions (anxiety, depression)
Identify Employment Barriers
- Common barriers may include:
- Social communication difficulties
- Challenges with executive functioning (planning, organizing)
- Sensory sensitivities in workplace environments
- Difficulty with transitions or changes in routine
- Limited work experience or employment history
Vocational Intervention Strategies
Supported Employment
- Supported employment has been identified as the most productive approach for individuals with ASD 1
- Key components include:
- Job development tailored to individual strengths and interests
- Job coaching with on-site support
- Ongoing support to maintain employment
- Gradual fading of supports as independence increases
Job-Based Social Skills Training
- Implement structured social skills training focused specifically on workplace interactions
- The Job-Based Social Skills (JOBSS) curriculum has shown significant improvement in social cognition and 45% employment rate post-intervention 2
- Focus on teaching:
- Interview skills
- Workplace communication
- Understanding workplace culture and unwritten rules
- Problem-solving in workplace situations
Communication Accommodations
- For individuals with working memory and processing speed deficits:
- Speak slowly and clearly without infantilizing
- Use repetition and attention questions to ensure information is encoded
- Keep directives to a reasonable length
- Use visual schedules, planners, and timers 3
Augmentative Communication Support
- For individuals with limited verbal abilities, consider augmentative/alternative communication devices 3
- Implement visual supports and structured communication systems in the workplace
Family Involvement and Support
Family involvement is essential for effective treatment outcomes 4
Engage family members in:
- Setting employment goals and priorities
- Supporting skill generalization outside of formal training
- Providing consistent reinforcement of workplace skills
- Assisting with transportation and other logistical needs
Provide education to family members about:
- Behavioral management techniques
- Strategies to promote independence
- Available community resources and services
Community Resources and Services
Vocational Rehabilitation Services
- Connect with state vocational rehabilitation agencies that can provide:
- Career assessment and counseling
- Job training and education
- Job placement assistance
- Assistive technology evaluation and provision
Specialized Employment Programs
- Project Search-ASD (PS-ASD) has demonstrated effectiveness in teaching work-related skills 5
- Community-based employment programs with job coaching have shown positive outcomes 6
Occupational Therapy
- Occupational therapists can provide valuable support in:
- Assessment of vocational abilities
- Job development and adaptation
- Training in job-specific skills
- Ongoing support in the workplace 1
Potential Pitfalls and Considerations
- Avoid focusing solely on job placement without ongoing support - Continued job coaching is often necessary for long-term success
- Don't overlook sensory issues in the workplace - Environmental modifications may be necessary
- Be cautious about job-skill mismatch - Multiple trial sessions in work environments help identify appropriate "fit" 7
- Consider cultural and family factors that may affect participation in vocational programs 3
- Don't delay intervention - Early and intensive intervention yields better outcomes 4
Long-Term Support
- Maintain an active role in long-term planning and support 3
- Recognize that service utilization may be sporadic and needs will change over time
- For adults with ASD, vocational training and thoughtful planning for independence/self-sufficiency is particularly important 3
- Monitor for co-occurring conditions (anxiety, depression) that may affect employment success
By implementing these comprehensive vocational support strategies, a 23-year-old with autism can significantly improve his chances of obtaining and maintaining meaningful employment, which will positively impact his quality of life, independence, and overall well-being.