Final Week 2

Question 1

ASD and Employment Assumptions

Answer 1

ASD quality of life measurements comparable to NTs
Job satisfaction correlates with life satisfaction
Self efficiency correlates with work outcome
ASD individuals are capable of employment and want to work
Advantages of ASD employment: a chance to do what they want, social components, and money (not as significant)

Question 2

Employment Numbers

Answer 2

Canada: 300,000 adults working with ASD
Worldwide: 50-60 million adults have ASD
Many people employed aren’t officially diagnosed/don’t know they’re autistic

Question 3

Employment Numbers Studies

Answer 3

Scott (2015) labour force participation rates:
•Neurotypicals: 83%, Those with any disabilities: 54%, ASD: 34%
Howarda (DSM 4):
•25% of ASD were employed
Roux:
•ASD: least likely to be employed out of all special ed
•ID 4x, emotional disturbance 7x, learning disability 12x, and speech/language impairment 7x
The National Longitudinal Transition Study:
•45.2% of youth with ASD had paid job (71% normals)

Question 4

Possible Employment Outcomes

Answer 4

Unemployed (no job)
Underemployed (employed but doesn’t meet skill sets)
Malemployed (wrong job)

Question 5

Barriers to Employment

Answer 5

People with ASD need:
•Family support
•Agencies available (life coaches)
•Community (employers wanting to take the risk)
•Workplace (keeping them on the job)
Benefits: social, economic (Ganz: average lifetime cost: $3,200,000 – adult care and lost productivity)

Question 6

Internal Challenges with ASD and Employment

Answer 6

Finding work, interviews, On-the-job skills, behaviours, social skills, and comorbidities

Question 7

Finding Work

Answer 7

• Navigating want-adds (craigslist)

* Executive functioning needed for: writing resumes, sending to employers, following up (ToM)

Question 8

Job Interview

Answer 8

• Presentation (hygiene, dress)
• On time (executive functioning)
• Open ended questions/thinking on your feet
• Social graces: eye contact, smile, firm hand shake, etc

Question 9

On-the-job Skills

Answer 9

• Executive functioning skills (knowing how to ask for direction)
• Balancing/prioritizing workload (knowing where to start)
• Complex sets of instruction
• Expectation of generalization (floor specialist at mcdonalds)

Question 10

Behaviours

Answer 10

Hendricks: behaviours are more problematic to employers than job-task related issues because of their: 
•Inflexible routines (floor specialist)
•Ritualistic behaviours
•Tantrums/aggression 
•Sensory issues

Question 11

Social Skills

Answer 11

Hendricks: one of the most significant barriers to successful employment
•Rude/no filter
•Poor social communication
•Poor negotiation skills/challenge with compromise
•Failure to understand instructions

Question 12

Comorbidities

Answer 12

When they want to start work, mental health issues can come up: anxiety, depression, ADHD, and ID

Question 13

External Challenges

Answer 13

Workplace protocols, disability attitudes

Question 14

Workplace protocols

Answer 14

Tardiness protocol, overtime, health and safety, rules, honesty (assessment making him an alcoholic)

Question 15

Disability attitudes

Answer 15

• Employer understanding?

* Fixed way of doing business (not willing to adapt)

Question 16

Types of Jobs

Answer 16

ASD Friendly:
•Pattern recognition/repetitive 
•Income not tied to production/sales
•Less emphasis on deadlines/rushing 
ASD Challenging:
•Income tied to social skills (sales) needing ToM
•Reliant on generalization 
•Reliant on deadlines/rushing

Question 17

Types of Employment

Answer 17

Competitive employment, self-employment, supported employment, customized employment, social enterprise

Question 18

Competitive Employment

Answer 18

• ‘Regular’ job

* Doesn’t necessarily require support (but can)

Question 19

Self-Employment

Answer 19

• Start-ups
• Contract work
• Ex: art work, programming websites

Question 20

Supported Employment

Answer 20

UN: person with disabilities has the right to work on an equal basis with others
•Supported employment: paid work in integrated work settings with support for individuals with disabilities
*Phases: assessment, job finding/analysis/matching/ redesign, intro to workplace, training on the job, support outside the workplace and ongoing support

Question 21

Customized Employment

Answer 21

Provides a set of services prior to employment designed to fit the employer and job seeker’s needs
•Goal: avoid barriers created by job descriptions through voluntary negotiations

Question 22

Social Enterprise

Answer 22

Non-Prof organization that generates income while promoting positive social, cultural, and environmental outcomes (may or may not be payed)

Question 23

Making a Case for ASD in the Workplace

Answer 23

• Employers: learn about ASD and how it brings positivity and new skill sets to workplace
• ASD ratings: less flexible, pay more attention to detail, complete work on time, and have better work ethic

Question 24

Anderson: A Systematic Review of Interventions for Adults with ASD to Promote Employment

Answer 24

• ABA
• Behavioural Skills Training (prompting, reinforcement, feedback) showed strong impacts
• Video-Based Intervention (VBI): an emerging intervention showing potential

Question 25

Baker: Supported Employment, Comprehensive Cognitive Enhancement, and Social Skills Intervention (SUCCESS)

Answer 25

* Cognitive/social challenges lead to poor employment outcomes * Taught skills (executive functioning, social) lead to more than doubled employment rates

Question 26

Specialisterne

Answer 26

Danish for "the specialists" •Danish company (2008) •Specialist People Foundation (2009): goal to employ 1,000,000 people with ASD globally (not achieved yet) •Partnered with SAP (software company) to help get 1% (65,000) of their goal workforce (2013) •Testsite in Vancouver

Question 27

Other Employers

Answer 27

Israeli Army (unit 9900 deciphering satellite images), Microsoft, Walgreens, Focus Professionals, Meticulon

Question 28

Adults Who Missed Diagnosis

Answer 28

Kanner (1943): "autistic disturbances of affective contact" •First wave up to 75 years old that were never diagnosed DSM-III (1980): first generation to have title of autism (IA) •Second wave all over 38 years old DSM-IV (1994): Intro to Aspergers •Third wave now 24 years old

Question 29

ASD in Adulthood Assumptions

Answer 29

Prior versions of DSM/ICD •More likely to be intellectually delayed, male, and has lower incidence rates Current •should be 1/68, M-F ratio should be less than 5-1, cognitive functioning should be above ID level

Question 30

Brugha: Epidemiology of ASD in Adults in England

Answer 30

•Stratified random sampling with questionnaire (20 questions) •ADOS-4: 618/7,461 had probable scores •Incidence rates: approx 1% •Significant demographic findings: *Male: 18/1,000 Female 2/1,000 *More likely to be single and less likely to own real estate

Question 31

Lai & Baron-Cohen

Answer 31

Average male has more ASD symptoms than average female

Question 32

Challenges with ASD Adult Assessment

Answer 32

* Parents may not be able to provide developmental history * Normative behaviours change overtime (Kanner's version of play different than current play) * More isolation lead to less social comparison * Lifelong social pressures may lead to more camouflage behaviours (trained eye contact) * ASD symptoms can be overshadowed by co-occuring conditions (epilepsy) * May be triggered by setback phenomenon

Question 33

Late vs Early Diagnosis

Answer 33

Early: more likely to get accurate support, accommodations, and acceptance of ASD Late: diagnostic confusion and missed opportunities leading to: •High rates of co-occuring mental challenges •Increased cost of social challenges •Higher likelihood of health conditions (epilepsy)