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Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 1
FINDING WORK
THAT FITS WITH ASD
Frank O’Connor
Auckland – 23 July, 2015
+64 21 386-911 [email protected]
There is great concern within the autism world about the un- and under-employment of people on the spectrum
Many people with autism have considerable skills and knowledge, but find it very hard to work, to be independent and thus contribute to society
There is interest – from would-be-employees and employers, professionals and families – in how to get adults on the spectrum into work, and keep them there
We’ll explore some strategies that seem to work (or not) for adults on the spectrum to find and keep work they want to do
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 2
FINDING WORK THAT FITS
1 There is great concern ...
2 Considerable skills and knowledge
3 How to get into work, and stay
4 Employer strategies that seem to work (or not)
The un- and underemployment
figures are discouraging, sitting
above 80% around the world
“There is limited large-scale empirical research into the working lives of adults who have an autism spectrum disorder with no co-occurring intellectual disability”
Baldwin et al (2014)
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 3
“Employment results are …”
“Even for individuals who are considered to be higher functioning, employment results are appalling. Adults:o experience underemployment
o switch jobs frequently
o have difficulty adjusting to new job settings
o make less money than their counterparts
o are much less l ikely to be employed than:� typically developing peers
� individuals with less severe language disorders
� individuals with learning disabilities”
“Even for those individuals who have postsecondary educational experience, employment difficulties are common”
Hendricks, D. (2010) Employment and adults with autism spectrum
disorders: Challenges and strategies for success. Journal of Vocational
Rehabilitation, 32 (2), 127
o Some studies estimate that 50-75% of adults with ASD are unemployed� Other popular media reports are
much higherThe reasons matter more
than the numbers
Few global facts
22,878 autism-related intervention studies
o 3974 articles identifying an ASD intervention
o 501 studies targeted participants 18+ years of age
o 10 studies evaluated vocation-related interventions in ASD
Nicholas, D.B., Attridge, M., Zwaigenbaum, L. & Clarke, M. (2015)
Vocational support approaches in autism spectrum disorder: A synthesis
review of the literature. Autism, 19 (2), 235-245
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 4
Fewer local facts
A study of 130 Australian adults at the high-functioning end of the spectrumo Most in scientific, technical, and
information-based jobs
o Some in education, healthcare work, hospitality, retail, gardening
54% needed help to find a job
72% not currently receiving any ASD specific support in their workplaceso 66% would like more support
Baldwin, S., Costley, D. & Warren, A. (2014) Employment activities and
experiences of adults with high-functioning autism and Asperger’s disorder. Journal of Autism and Developmental Disorders, 44,
2440-2449
Concerns about over-educationo 86% post-school qualifications cf.
57% in general Australian population
o 45% overqualified for their position cf. ANZSCO
Summing up
Adults with ASD often experience difficulty securing and maintaining work
… periods of unemployment are common, as is ‘under-employment’, or working below one’s skills level
… few specialist support systems
… most individuals relied heavily on the support of their families in finding jobs
§5.1.c, NZASD Guidelines, 2008
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 5
Many facets affect this outcome,
and something can be done
about some - at least sometimes
If we separate what we can change from what we
can’t, then we can look for where it will help most
Focus on the obstacles
“The countless permutations and combinations of social interactions, language, learning, sensory, and behavior deficits and excesses found in these individuals, in combination with their wide range of abilities, developmental levels, isolated skills, and unique personalities make autism an especially baffling disability”
Simpson, R.L. (2001) ABA and students with autism spectrum disorders:
Issues and considerations for effective practice. Focus on Autism and Other
Developmental Disabilities 16 (2), p69
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 6
Wouldn’t you avoid taking the risk
too …
If you were fearful of a difficult working situation, as
either would-be employee and employer?
Or on responses to obstacles
• Highly individual vocational
needs
• Social difficulties
• Impaired executive functioning
• Behavioural difficulties
• High distress and anxiety
• Comorbidities such as
depression, anxiety, epilepsy
Hendricks, D. (2010) Employment
and adults with autism spectrum
disorders: Challenges and strategies for
success. Journal of Vocational
Rehabilitation 32, 125-134
Obstacles to employmento Communication and social difficulties with supervisors
and co-workers, including difficulty understanding directions, inability to ‘read between the lines’ and read facial expressions and tone of voice, asking too
many questions, and communicating in an inappropriate manner
o Social impairment which may include inappropriate hygiene and grooming skills, difficulty following social rules, inability to understand affect, working alone, and acting inappropriately
o Cognitive functioning including impairments to executive functioning; problems with attention, motor planning, response shifting, and working memory; acclimatising to new job routines and settings; and for people with Asperger syndrome, problems with organisation and problem-solving
o Behavioural difficulties which may include tantrums, aggression, self-injury, property destruction, ritualistic behaviours, or pica, the experience of anxiety and stress relating to fitting into a new world, and sensitivity to workplace noise and other sensory stimuli
o Comorbid with psychiatric symptoms which may include anxiety, depression, bipolar disorder, and epilepsy
Ministry of Health. (2012) Guideline Supplementary Paper (to the New Zealand autism spectrum disorder guideline).
Wellington: Ministry of Health. p14.
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 7
FINDING WORK THAT FITS
1 There is great concern ...
2 Considerable skills and knowledge
3 How to get into work, and stay
4 Employer strategies that seem to work (or not)
A situation and complication
There is capacity for good work in many adults
on the spectrum
o Matching both task and context to the dynamics
of the person (and his or her piece of spectrum) is
something many employers are not at all sure of
o In my experience, many of those in work-finding
brokerage roles aren’t so confident either
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 8
Successes reported
1 Job placement, especially
supported employment and
community placement
2 Supervision and co-workers
3 On-the-job training and coaching
4 Work place modifications, media
and technology helping tools
5 Long-term supportHendricks, D. (2010) Employment and
adults with autism spectrum disorders: Challenges
and strategies for success. Journal of Vocational
Rehabilitation, 32 (2), 127
Supports for successo Job placement to be individualised and based on the
person’s strengths, interests and task preferences to ensure a job match ... job tasks and work environment should be considered (eg, predictable schedule,
defined tasks, require minimal social skills, allow adequate time, avoid excessive sensory stimulation)
o Supervisors and co-workers need to be tolerant, flexible, receptive and aware of a person with ASD’s characteristics and support needs and assist in social interactions
o On-the-job provisions, including training targeting job tasks, acclimatisation to the job site and social integration, as well as developing communication and interpersonal skills, management of inappropriate behaviour, and coping with stress. A job coach may be identified to assist in training, slowly lessening support
o Work place modifications including addressing distracting environmental stimuli, and providing a consistent schedule of work tasks
o Long-term support including natural supports (eg, identify supervisors and co-workers to take on support as the job coach’s role diminishes) and external supports (eg, follow-up and close monitoring, assisting with issues outside of work, introduction to social groups, and individual counselling to develop coping strategies)
Ministry of Health (2012) Guideline Supplementary Paper (to the New Zealand autism spectrum disorder guideline).
Wellington: Ministry of Health. p15
Risk is rarely evenly spread
Shattuck, P.T., Narendorf, S.C., Cooper, B., Sterzing, P.,
Wagner, M., & Lounds, J. (2012). Postsecondary
education and employment among youth with an
autism spectrum disorder. Pediatrics. 129 (6) p1048
“Youth from lower income
families and those with
greater functional
impairments …
particularly at risk for
poor employment
outcomes”
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 9
A quiz on assets or liabilities
Punctuality
Conscientiousness
Loyalty
Attention to detail
Perfectionism
Independence
Enjoyment of repetitive tasks
Careful attention to work area
… discomfort with lack of structure
Unique work routines
Preference for no interruptions
Stress reactions to deadlines
Difficulties with team work
Anxiety about performance
Reluctance to ask for help or support
Low awareness of danger to self or others
Difficulty with time management
Strong reactions to changes in work
Motivational issues regarding tasks of no personal interest
Difficulty with writing reports
NZASD Guideline p170-171
Assisting less able people
Even people with severe autism or co-morbid intellectual disability can become engaged in meaningful work
Specialist schemes for assisting less able people with ASD to get into work have recorded success
For many people with an intellectual disability, real work in real employment settings is preferable by far to vocational and day services
NZASD Guideline p171
People with an intellectual disability who receive relevant work experience as part of their school-based transition planning are more likely to maintain competitive jobs
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 10
FINDING WORK THAT FITS
1 There is great concern ...
2 Considerable skills and knowledge
3 How to get into work, and stay
4 Employer strategies that seem to work (or not)
We can reduce risk
… by avoiding the mismatch between capability and
practicality for would-be employees
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 11
Preparation counts
For a person with ASD,
whatever their ability
level, becoming a worker
is more likely to be
achieved with careful
attention to preparation
and planningNZASD Guideline
Support needs include
o Assistance in finding a job
o Learning how to do the job
o Assistance with completing
the job
o Addressing work-related
issues
o Addressing non-work-
related issues
o Transportation
NZASD Guideline
How hard is job seeking?
For each question, choose one of: Never… Rarely… Often… Always
1 Do you understand complex job application materials?
2 Do you ‘think well on your feet’ in an interview?
3 Do you quickly adjust to new procedures and routines?
4 Do you remember and follow verbal instructions?
5 Do you respond pleasantly and flexibly to unexpected situations?
6 Do you cope with planning and juggling several tasks at once?
7 Do you communicate effectively with all of your co-workers?
8 Do you interact socially in a way that is comfortable for everyone?
9 Do you have to do unusual things to manage sensory sensitivities?
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 12
What works often has something to
do with stuff we can do
something about
The diversity of the spectrum
means many intellectual,
sensory and social differences
Expressing an individual's set of these takes effort,
but they can be put constructively, as capacities
for useful work
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 13
Remember who’s in charge!
… research suggests that
the responsibility for
‘making it work’ in an
employment setting
tends to rest on the
person with ASD, rather
than the employerNZASD Guidelines, 2008
We can do a lot
Constructive responses to
urban myths
o Provide sound information
and reassurance
Good help in preparing and
maintaining the
employment relationship
o For both parties, and their
helpers
Accommodate around work
that almost fits
o What this person is likely
to be good
o What this employer is
likely to know, learn, do
Communicate the match of
the person to the position
o Help both parties talk, flex
and accommodate
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 14
Involving specialist
employment servicesIncreases chances of
positive work outcomes finding work
o maintaining work
o having good working relationships
NZASD Guidelines, 2008
See also Recommendation
5.1.13.B - Ministry of Health (2012) Guideline Supplementary
Paper p15
Associated with improved attitudes of employers towards people with ASD
o Employers more willing to be supportive and adapt circumstances to suit the person concerned
o Employers more likely to rate the employee’s effectiveness at their job (rather than to work in an established way and to adapt to the organisation)
From employees who succeed
Adults with ASD interviewed
about employment:
o Significant difficulty in the
workplace due to
insufficient knowledge
o Sought autism awareness
training for employers and
co-workers to:
� Understand who I am
� Know why I behave in a
certain way
Sophie Nesbitt (2000)
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 15
FINDING WORK THAT FITS
1 There is great concern ...
2 Considerable skills and knowledge
3 How to get into work, and stay
4 Employer strategies that seem to work (or not)
What can employers do?
“Regardless of any useful individual supports, one thing is clear: employers need to be more understanding and accommodatingo Autistic workers are wired differently and thus experience
things differently
o Many like routine and structured tasks or information can aid work performance
Some employers have demonstrated that making changes to the work setting – instead of accommodating individual workers’ processing, sensory and social differences – benefits all of their employees”
Campbell Teague, Autism and Employment: A Reflection on the Poor Statistics www.ariconference.com/enews/adults/adult_enews_vol11
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 16
Make a compelling case
“Employers need to know that it makes good business sense to employ: o people who are reliable,
punctual and loyal
o people who have good attention to detail and concentration levels
o people who have excellent problem solving skills and can be analytical, resourceful and creative
What good employer wouldn’t want an employee with those skills?
o … making a few small adjustments … someone with autism can make a loyal and hardworking employee
o … a huge pool of untapped talent out there …
We must make it clear that people with autism can work and want to work … they just need to be given the support and opportunities”
Lord David Freud, UK Minister for Welfare Reform, National Autistic Society Parliamentary Reception, 20
March 2012
Don’t forget employers …
… can adapt to challenges
found in others at work
o social interactions
o deficits and excesses
o wide range of abilities
o developmental levels
o isolated skills
o unique personalities
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 17
Research on best practice
Individuals controlling their own vocational destinies through self-determination, facilitated by person-centred planning, and a career-based approach
Employment specialists acting as facilitators, not experts
Taking account of employers’ as well as individuals’ needs
Using ‘natural supports’ and supplementing jobs in ways that are ‘typical’ for each setting
Using intentional strategies to enhance social integration
…
Supporting self-employment
Post or follow-up support
Ensuring that people with severe disabilities can access supported employment
Quality outcomes result when services adopt a principles-and values-led approach to supported employment
NZASD Guideline after Ridley, J., Hunter, S. and Infusion Co-operative.
(2005) “Go For It!”: Supporting People with Learning Disabilities and/or Autistic
Spectrum Disorder in Employment. Edinburgh: Scottish Executive Social
Research
Which can we affect?
Many attributes of an ‘autism
friendly’ environment help
everyone to do their work better
Such as clear goal setting, or a work place which
isn’t too bright or too loud
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 18
Assisting employers
1 Job modification o maintain a consistent
schedule and job duties
o keep the social demands of the job manageable and practicable
o provide organisers to help structure and keep track of work
o add activities to reduce or eliminate unstructured time
NZASD Guideline p172
Benefits for other workers too
Assisting work direction
2 Supervisiono be direct and specific when
giving directions
o verify that communications are correctly understood
o assist the employee in learning social rules and interpreting social cues encountered on the job
o explain and help the employees deal with changes on the job
NZASD Guideline p171
Treat everyone like this?
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 19
Assisting workmate strategies
3 Co-worker relationships and social interactions
o encourage co-workers to initiate interactions
o ensure that one or two co-workers play a role in helping to give job-related suggestions and ‘keep an eye out’ for the employee
NZASD Guideline p171
Include everyone else
too
Assisting help-seeking
4 Support serviceso provide a sense of
familiarity and reassurance until the employee and company staff get to know one another
o transfer relationships and supports to company employees
o check in and remain on-call in case problems arise
o maintain a liaison role for non-work issues that affect the job
NZASD Guideline p171
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 20
Then the minor adjustments for
someone with autism are less
daunting
More levers on job success
o Role of workplace peers
o Social networks
o Workplace and social policies
o Ways successful employment programs benefit businesses and communities
o Strengths and benefits people on the autism spectrum contribute to workplaces and society
Shattuck, P.T. and Roux, A.M. (2015) Commentary on
employment supports research.Autism 19 (2) 246–247
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 21
The things that help most
Supportive employment is a specific mechanism that is reported to o Facilitate finding a job
o Teach individuals with ASD how to apply and interview for a position
o Liaise between an individual with ASD and his or her co-workers or supervisor
o Deal with crisis situations that may arise […] to support overall vocational success
Notions of vocational “fit,” preparedness, and support, as needed, appear to be reflective of vocational success for individuals with ASD and their employers
Job coaches integral to:o Finding employment for the individual
o Providing needed support in the work environment
Close contact allowed foro Exploring appropriate job opportunities
o Matching the skills and abilities of a specific employee with a suitable job
o Developing individual’s understanding of the social aspects of work settings� Big investment of time and effort
necessary for both parties
Nicholas, D.B., Attridge, M., Zwaigenbaum, L. & Clarke, M. (2015) Vocational support
approaches in autism spectrum disorder: A synthesis review of the literature. Autism, 19 (2), 235-245
Workplace adaptations work
Many workers on the spectrum (and many other workers) benefit from clearly defined work tasks
o May require rearranging actual job scope / duties or the way a job is
performed
o Activity schedules, based on job analysis, can
assign tasks to be done to certain times or work conditions
o Using some form of work
organizers helps structure and keep track of work
� Examples: flowcharts, tick-
sheets, sorting boxes, notebooks, labels and
whiteboard run charts
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 22
More changes that work
Identify potential
distractions and ways to
lessen their impact in
each relevant work area
o Assess noise level,
interruptions, crowding,
lighting, and movement
o Keep individual’s needs
in mind
Providing a consistent
schedule for completion
of work tasks increases
job predictability
o These reduce worry and
stress and need for re-
communication
o ‘Down time’ could
include taking a walk or
playing computer games
Employers who don’t know
don’t employ
Biggest difference in
awareness and
understanding of the
disorderNesbitt, S. (2000) Why and
why not? Factors impacting
employment for individuals
with Asperger syndrome,
Autism 4 (4), 357–369
Focused on potential
negative behaviours
rather than the person’s
capabilities
Didn’t know of or
appreciate employment
supports that could be
provided
Altogether Autism 2015 - Finding work that
fits with ASD
(c) 2015 Frank O'Connor for Instep and Mental
Health Foundation 23
Keep exploring