Lessons for Policy and Practice from Diverse Approaches to Autistic Employment

• In Event: Novel Approaches to Supporting Employment for Individuals with Disabilities

Abstract

Background: Autistic adults experience high rates of joblessness and underemployment. Sustained, competitive employment may be especially important for autistic adults with co-occurring mental health disabilities. Both traditional state-run vocational rehabilitation services and newer employer- and family-led initiatives have attempted to address employment disparities among autistic adults. Understanding how to promote sustained employment, career progression, and support for co-occurring mental health disabilities is essential to developing national strategies.

Research Questions: We aim to (1) identify strategies that may benefit autistic adults with co-occurring mental health conditions, and (2) develop specific recommendations that facilitate existing employment programs in supporting autistic adults in achieving sustained employment and career development.

Methods: We use previously collected online survey data from 611 autistic adults, and interviews with 104 autistic adults, family members, service providers, and employers. Quantitative data were analyzed in two stages: a preliminary analysis of the full sample, which helped shape initial codes for qualitative analysis, and a second detailed analysis focusing on respondents who reported past participation in vocational rehabilitation or structured employment programs for autistic adults (N=46).
Qualitative data were analyzed using an inductive thematic coding approach. Three team members coded excerpts and created memos to identify themes. The full team met regularly to discuss and refine emerging themes.

Results: 83% of survey respondents reported co-occurring depression (64%) and/or anxiety (77%); 58% reported both conditions. Participants with one of these conditions were more likely to report feeling isolated from coworkers made challenging to get/sustain employment. Participants who reported co-occurring anxiety were more likely to report bullying made it challenging to get/sustain employment, and participants with co-occurring depression were more likely to say feeling misunderstood by coworkers created work challenges. Of respondents who participated in employment programs, the largest share (40%) reported it was operated by a government agency. Specific program offerings varied widely, but only 5 participants (11%) reported the program they attended provided anxiety management training. 
Relatedly, interview themes included anxiety and depression prevalence, and trauma from previous negative employment experiences among autistic adults. Interviewees emphasized how autistic employees’ mental health can be negatively impacted when they are infantilized or treated as though hiring them is an act of charity. 

Conclusions: Our data highlight the importance of supporting mental health among autistic adults receiving employment services. However, findings suggest mental health is under-considered within vocational programs. Given wide program variation and differences in how states manage vocational rehabilitation, efforts to streamline employment programs are an important step to ensure that autistic adults have access to sustained, competitive employment. These efforts should include greater emphasis on mental health support, and increased education of employers, supervisors, and coworkers, whose attitudes and behavior can significantly impact autistic people’s workplace experiences.

Authors

• Ian Moura, Brandeis University
  Presenting Author

• Jennifer Wicks, Brandeis University
  Non-Presenting Co-Author

• Spenser Wright, University of Colorado Denver
  Non-Presenting Co-Author

• Joanne Nicholson, Brandeis University
  Non-Presenting Co-Author