Research Update: What have we learned about Vocational Rehabilitation and Autism?
By Anne Roux, MPH
January 11, 2019
Vocational services are essential for transition-age youth on the autism spectrum who often have difficulty finding and keeping employment. These youths may experience a dramatic decline in supports and services after high school. Vocational Rehabilitation (VR) is a key source of public assistance for people with disabilities who are seeking employment, including youth and adults with autism. Local VR counselors determine eligibility for VR services and help decide which services are most appropriate. Individuals eligible for VR may receive services related to exploring possible careers, assistance locating jobs, and short or long term supports in the workplace.
During federal fiscal years (FFY) 2014-2016, over 51,000 transition-age youth with autism exited VR services – roughly, 19,000 per year. Some youth are employed when they leave VR, but others are not successful in finding and keeping a job.
Transition-age youth with autism currently comprise about 40% of all youth with developmental disabilities who use VR services (ages 14-24).
Students with disabilities can now receive Pre-Employment Transition Services (Pre-ETS) through collaboration between schools and VR. In future years, we will have data to help us understand whether Pre-ETS is making a difference for youth on the autism spectrum.
Our VR Research
Over the last several years, we have been studying how Vocational Rehabilitation services work for youth and adults on the autism spectrum. We started by producing the National Autism Indicators Report: Vocational Rehabilitation. Read this report to learn how VR works, the types of VR services people with autism receive, and what their outcomes are.
One thing we discovered is that states differ in how they provide VR services. For example, some states do not have enough funds to serve everyone who is eligible for VR services, so they prioritize who receives services. We wanted to learn more about how often transition-age youth with autism receive VR services across states and other differences in their VR experience across states. We were interested in four things:
Service receipt: How often did youth with autism received VR services after they were found eligible for them?
Early reach: How often did youth began VR services during secondary school?
Timeliness: How often did youth have timely development of an individual plan for employment (IPE)?
Employment rate: How often did youth became employed following VR services?
What we know so far
VR outcomes for TAY-ASD vary dramatically by state across key indicators. We analyzed VR data for transition-age youth with autism who exited VR in FFY 2014-2016. Across these years, some states served fewer than 100 youth with autism in VR (New Mexico, North Dakota, Wyoming, and the District of Columbia). Other states served more than 2000 youth with autism (California, New York, and Ohio). We found that states varied widely across our four key indicators:
Service receipt – In New Jersey and Tennessee, 51% of youth with autism received VR services after being found eligible, compared to 89% in Pennsylvania – a 38 percentage point difference across states.
Early reach – In Montana and New Jersey, 10-11% of youth with autism began their VR services during secondary school, compared to 77% in Oklahoma – a 67 percentage point difference across states.
Timely services – In Iowa, 23% of youth with autism had timely development of an individualized plan for employment, compared to 84% in California– a 61 percentage point difference across states. The employment plan must be developed before youth can begin VR services.
Employment – In the District of Columbia, only 29% of youth with autism were employed when VR services ended, while 37-39% were employed in Mississippi and New Mexico, compared to 76% in the state of Washington – a 47 percentage point difference across states.
Some states experienced much higher rates of success. At least 70% of youth with autism had jobs following VR services in four states: Alabama, Nebraska, South Dakota, Washington. Clearly, the state you live in plays a role in your access to vocational services, which services you receive, and the likelihood of becoming employed.
Experts have ideas about which state-level factors are influencing VR vocational services and outcomes of transition-age youth with autism. We conducted several rounds of interviews with experts on employment for people with autism. We categorized their input into five categories of state-level factors that might be associated with VR outcomes for those with autism. We focused on identifying factors that can be changed and identified five themes: 1) state capacity to provide VR services and job opportunities, 2) efficient and effective VR processes, 3) innovation, 4) inter-agency efforts, and 5) staff training and competency.
Experts also identified four types of innovation which may be helping outcomes of youth with autism in some states: 1) use of demonstration projects and innovative programs to improve outcomes, 2) creation of unique supports to meet the needs of service users with autism, 3) use of specialty caseloads and autism specialists, and 4) use of assessment tools/methods tailored to challenges of people with autism.
We can identify groups of states with similar performance on indicators of VR service delivery to TAY-ASD. Most studies of “high-performing” states rely upon single indicators, such as the employment rate following VR services. This approach is too simplistic. Instead, we pioneered an analysis which helped us identify unique patterns of state performance on our four key indicators. State performance tended to fall into one of five groups: (1) above average employment rates, (2) timely services, (3) timely services and early reach, (4) early reach, and (5) above average performance across indicators (timely services and early reach with above average service receipt and employment). This last group was considered “higher-performing” across indicators.
The states that were most likely to belong in the higher-performing group (above average performance across indicators) were: Alabama, Alaska, California, Delaware, Michigan, Oklahoma, Pennsylvania, South Carolina, South Dakota, Vermont, and Wyoming.
States are addressing autism differently in their state VR employment plans. We analyzed state plans for implementing the Workforce Innovation and Opportunity Act (WIOA) – the legislation which governs VR services. Our preliminary findings indicate that 19 states identified people on the autism spectrum as a group that is underserved by VR. This study will identify states with comprehensive and/or innovative plans for reaching TAY-ASD with VR services.
What we need to learn
Now that we know that people with autism do encounter differences in VR services across states, we need to understand why some states are higher performing than others. Are they delivering different types of services or programs? Are they adapting existing services to better serve those on the spectrum? How are states deciding what types of autism-related programs to fund? This type of information will help us to measure and monitor VR activities and the degree to which they are helping improve employment for people with autism.
Study Citations and links
Roux, A. M., Rast, J. E., & Shattuck, P. T. (2018). State-level variation in Vocational Rehabilitation service use and related outcomes among transition-age youth on the autism spectrum. Journal of Autism and Developmental Disorders. doi: 10.1007/s10803-018-3793-5
Roux AM, Anderson KA, Rast JE, Nord D, Shattuck PT. (2018). Vocational Rehabilitation experiences of transition-age youth with autism spectrum disorder across states: Prioritizing modifiable factors for research. Journal of Vocational Rehabilitation. 10.3233/JVR-180976
Roux AM, Rast JE, Nye-Lengerman K, Purtle J, Lello A, Shattuck PT. (2018). Identifying patterns of state Vocational Rehabilitation performance in serving transition-age youth on the autism spectrum. Autism in Adulthood. 10.1089/aut.2018.0018
Who funded this research?
This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under UJ2MC31073: Maternal and Child Health-Autism Transitions Research Project. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
This project was also supported by funding from the Organization for Autism Research (OAR), Inc. Applied Research Grant, under the title “Association of state-level factors with vocational outcomes for transition-age youth with autism.”
Our forthcoming state WIOA plan study was supported by funding from the Autism Science Foundation via an Accelerator Grant, under the title “Leveraging new federal law to improve employment outcomes for youth with autism.”
Anne Roux, MPH is a nationally renowned autism researcher, author and family advocate. She leads the production of our National Autism Indicators Report series and other publications.