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Introduction

The past decade has seen a general consensus regarding an increase in the prevalence of autism and related disorders (ASD) and, subsequently, steadily growing numbers of adolescent and young adults on the autism spectrum. With this increase has come an increased demand for appropriate services for adults with ASD in the post-school years. Unfortunately the employment, day, community, and residential needs of these individuals continue to far exceed the available resources leaving a generation of individuals with autism and their families in a programmatic, financial, and personal limbo (e.g., Parish, Thomas, Rose, Kilany, & Shattuck, 2012; Perkins & Berkman, 2012).

The resulting poor outcomes for adults with ASD, while not unexpected, are also not easily addressed. Among the contributing factors are poorly implemented transition services intended to guide individuals from school to adult life; a general lack of societal understanding as to the potential for adults with ASD to be employed, active, and contributing members of their; a near total absence of coordination between the educational, behavioral, mental health, vocational rehabilitation, and the adult intellectual/developmental disabilities systems; an absence of qualified staff to work with older learners; and the shift from an entitlement services (i.e., IDEA) to nonentitlement services made available as a function of available funds.

Note that none of these challenges focus on the individual challenges of living with autism. Rather, the potential of individuals with ASD to become employed and engaged adults seems limited more by the failure of the systems charged with supporting them than by the challenges associated with their being on the spectrum. Not surprisingly, the economic cost of these systemic inadequacies is rather far reaching. As Ganz (2007) notes “Autism is a very expensive disorder costing our society upwards of $35 billion in direct (both medical and nonmedical) and indirect costs to care for all individuals diagnosed each year over their lifetimes” (p. 343). Absent a concerted effort on behalf of all stakeholders (i.e., parents, professionals, employers, society at large) to correct these inadequacies, the costs can only be expected to grow in the coming years.

Despite recognition of the complex and lifelong needs of adolescents and adults with autism, the development of appropriate and effective services continues to lag far behind those currently available for persons with less severe disabilities. This disparity between the potential for an integrated and productive life and the lack to services to achieve this potential represents an ongoing challenge to parents, professionals, and adults with autism.

Employment and Related Services

Vocational settings for individuals with developmental disabilities, including individuals with a diagnosis of ASD, are diverse; ranging from segregated day programs to competitive employment without supports. Unfortunately, there is no specific government program or agency that is designed to exclusively meet the needs of individuals with ASD. Adolescents transitioning into the adult vocational world need to choose from a variety of public and private programs designed for individuals with a range of developmental disabilities. The decision on which program to choose is made based on the needs of the individual, his or her transitioning and vocational goals, the nature of his or her disability, the economic resources available, and eligibility requirements amongst the various options (McDonough & Revell, 2010). Currently, possible placements include day habilitation settings, sheltered workshops, supported employment programs, and competitive employment without support.

Many individuals with developmental disabilities are placed in vocational and employment settings through programs that are funded through state run Vocational Rehabilitation agencies (Wehman, Inge, Revell, & Brooke, 2007). Vocational Rehabilitation programs often provide an array of services and supports including assessment of eligibility, vocational counseling, guidance and referral services, vocational on the job training, and supported employment. As part of their services, Vocational Rehabilitation agencies will develop an Individualized Plan of Employment (IPE) for each eligible individual. IPEs outline the support services that are needed in order for the individual to achieve his or her personalized goal (McDonough & Revell, 2010). Research suggests that traditional Vocational Rehabilitation programs may not appropriately meet the needs of individuals with ASD. Out of 382,221 individuals who received services through vocational rehabilitation programs whose cases were closed in 2005, 4.3 % of individuals with ASD had a case closed to their disability being determined to be too severe to benefit from services as compared to only 2.0 % of individuals with cognitive impairment and 0.4 % of individuals with specific learning disability (Lawler, Brusilovskiy, Salzer, & Mandell, 2009). Despite this finding, Vocational Rehabilitation programs are showing an increase in the number of cases they are receiving with individuals with a primary diagnosis of ASD. It has been found that cases involving individuals with ASD cost more in supports than cases with individuals with other developmental disabilities. Employment outcomes are found to be mixed. Out of all disabilities, individuals with ASD had the third highest rate of successful employment post Vocational Rehabilitation services (only individuals with a diagnosis of sensory impairment or learning disability were found to achieve more successful outcomes), however individuals on the spectrum are found to work fewer hours and earn lower wages than nearly all other disability groups (Cimera & Cowan, 2009).

Segregated day settings, such as day habilitation and pre-vocational programs, continue to be the most popular setting for individuals with developmental disabilities. In 2004, state disability agencies reported a 3:1 ratio of individuals in segregated settings as compared to supported employment settings (Wehman et al., 2007). Day habilitation settings are “community-based programs that provide long term personal and social development opportunities within a structured environment for individuals with developmental disabilities who are unable to function independently in social, recreational or employment settings. Services are available on an hourly or daily basis and may include daily living skills instruction, basic education, recreational and social activities, exercises to improve coordination and other forms of developmental support which help participants develop and maintain the functional skills that are required for community involvement, self advocacy, self care and employment” (Day habilitation, n.d.). Although theoretically designed to lead toward less restrictive vocational settings, day habilitation programs are often inconsistent with independence and community inclusion. In fact, in 2001 the Rehabilitation Service Administration (RSA) of the US Department of Education stated that positive employment outcomes will only be considered those that are within integrated settings (Wehman et al., 2007).

Sheltered employment programs/sheltered workshops are another vocational option for individuals with developmental disabilities. Sheltered employment refers to “employment provided under special conditions (e.g. in a special workshop or at home) for handicapped persons who, because of the nature and severity of their disability, are either totally unable to carry out a job under ordinary competitive conditions or are able to do so only for a very short period of time” (Sheltered employment, n.d.). Individuals in sheltered workshops can either be paid or not paid for their work, which often includes a variety of activities including sorting, collating, assembly and disassembly tasks set up in contracts with local businesses. Although not an integrated setting, the RSA allows the use of Vocational Rehabilitation monies to fund sheltered employment programs as long as the service is being provided on a time-limited basis in preparation for integrated employment (Wehman et al., 2007).

Initiated in the United States in the 1980s, based upon the 1986 amendment to the Rehabilitation Act in Title VI Part C, supported employment programs were created to enable individuals with disabilities to obtain paid, community-based employment with the addition of necessary supports directly in the job site (Mawhood & Howlin, 1999). Supported employment programs are in accordance with RSA requirements stating that positive outcomes are those where jobs are in integrated settings; “Integrated setting” being defined as a setting typically found in the community where the individual has interaction with people without disabilities, other than those individuals providing supportive services (Wehman et al., 2007). Within supported employment programs, an employment specialist or job coach provides individualized training to the person with a developmental disability. Providing stability and predictability in an independent work environment is the mission of the supported employment paradigm. True supported employment has three main characteristics: paid employment, an integrated work setting, and ongoing support (Garcia-Villamisar & Hughes, 2007).

Outcomes of supportive employment programs seem to be superior to outcomes of sheltered employment and day habilitation settings. Specifically, research has shown greater financial gain for participants, greater social integration, increased worker satisfaction, and savings related to service cost (Mawhood & Howlin, 1999). Ridgeway and Rapp (1998), as cited in Wehman et al. (2007), indicate key employment interventions for effective supported employment. Specifically identified as important elements of supported employment are workplace accommodations, job coaching, supportive counseling, off-site assistance, on-site assistance, support groups linked to community supports, ongoing assessment of support needs after securing a job and ongoing assessment of the job site environment making accommodations as necessary. Bond (2004) outlined six evidence-based principles for successful supported employment, specifically (1) eligibility for the program is based on individual choice, (2) supportive employment is integrated with other services and treatments, (3) the goal of the program is focused on competitive employment, (4) job searching and placement is rapid, (5) job finding is individualized to participant preference, and (6) supports are ongoing and continuous. Programs adhering to these principles showed greater employment outcomes as compared to programs that did not adhere to best practice supportive employment principles.

Mawhood and Howlin (1999) conducted a study to compare employment outcomes of individuals with ASD within a supported employment program to the outcomes of individuals with ASD within nonspecialist day programs. Thirty participants were included in the study, all with a diagnosis of ASD, IQs of 70 or above, able to travel independently and without comorbid psychiatric conditions. Participants within the supported employment group were assessed for their level of functioning and past employment history. Employment specialists were then responsible for indentifying an appropriate integrated job site and providing guidance to the worker on a full-time basis for the first 2–4 weeks of the program. Employment specialists were also responsible for ensuring that the participant could cope with the social and occupational requirements of the job, educating employers about autism and the focus of supportive employment, and advising coworkers and supervisors on how to deal with problems. The amount of support was faded to weekly visits within the second month and then further faded to occasional visits by the fourth month. Planned meetings continued on a regular basis and the employment specialist was made available at all times in case of an emergency. Results indicated that two-third of participants in the supported employment program obtained competitive jobs as compared to only one-quarter of participants in the control group. Of the supported employment participants who obtained competitive employment, over 80 % of the jobs were in administration or computing. Only one of the jobs in the control group was at this level. Regarding participant satisfaction, high levels of dissatisfaction were reported from control group participants while participants in the supported employment group reported high levels of satisfaction.

In another outcome study, Howlin, Alcock, and Burkin (2005) investigated the efficacy of a supported employment program for individuals with ASD in the UK over an 8-year period. Within the first year of the program, eight individuals were enrolled in paid employment. By the eighth year, paid employment was obtained for 192 cases with 70 % of jobs meeting the UK Department for Work and Pensions job criterion of 16+ h per week, sustained for over 13 weeks. Most individuals surveyed were satisfied with their jobs and the pay they received. Almost all individuals reported that the supported employment program was extremely helpful in allowing them to succeed. One problem was that many individuals reported that they did not make friendships in the job site and only seven individuals reported that they met up with coworkers socially after work hours.

Schaller and Yang (2005) reviewed the case closure data for 815 individuals with autism who received services through Vocational Rehabilitation programs in 2001. 55.2 % of individuals had received services to obtain competitive employment and 44.8 % had received supported employment services. Results indicated that individuals who had received supported employment had significantly greater successful closure rates than individuals who had only received competitive employment services. The authors hypothesize that this difference is attributed to the core feature of supported employment which is to provide on the job supports in order to enhance job retention. Although a portion of individuals with autism were able to obtain competitive jobs, without supports they were less likely to retain those jobs over time. In the opposite direction, it was found that individuals who received supported employment earned significantly less wages and worked significantly less hours than individuals who only received competitive employment services. The authors offered two hypotheses for this finding. First, it could be that the range of jobs available for individuals who require supported employment naturally pay less and require less hours than jobs that would be more appropriate for independent workers. Second, it could be that individuals who qualified for supported employment programs needed to earn less pay per year in order to retain Supplemental Security Income (SSI). It is likely that individuals who were appropriate for independent competitive employment were not eligible for SSI support.

Garcia-Villamisar, Wehman, and Diaz Navarro (2002) tracked the outcomes of 55 individuals with autism who were either receiving sheltered workshop or supported employment services. Results indicated a positive relationship between supported employment and improved quality of life; with quality of life being defined by environmental control, community involvement and perception of personal change. In comparison, the quality of life of individuals receiving sheltered workshop services did not change.

Hillier et al. (2007) studied the outcomes of nine individuals with ASD who received supported employment within community-based settings over a 2-year period. Overall, employment levels increased by 78 %. Seven out of nine individuals who were placed in jobs held their first positions for an average of 12.5 months. On average it took 4.5 months to find correct placements based on participant vocational interests, previous experience, and aptitude for particular jobs.

In addition to successfully promoting job placement and retention, supported employment programs have been found to result in increased job satisfaction among individuals with autism (Hillier et al., 2007), increased knowledge of autism among community employers (Howlin et al., 2005), and improvements in standardized test scores related to nonverbal intelligence as compared to individuals in noncompetitive vocational day programs (Garcia-Villamisar & Hughes, 2007). Despite all the evidence showing the benefits of supported employment programs for individuals with ASD, the majority of adults on the spectrum continue to be unemployed, work only to a limited degree or work only within sheltered settings (Lattimore, Parsons, & Reid, 2008).

There is also an economic benefit to supported employment programs beyond the direct benefit to participants. It has been found that supported employment programs cost less per individual in the long run than sheltered workshops or day habilitation programs. Cimera (2008) investigated the financial costs of four adult service agencies providing both supported and sheltered employment services to individuals with cognitive impairments. Results indicated that the cumulative cost of services per individual were significantly higher for individuals served in supported employment settings ($6,618.76 per employment cycle) as compared to individuals served in sheltered workshop settings ($19,388.04 per employment cycle). These numbers indicate that for every one sheltered employee being served, nearly three individuals can be served in community-based supported employment settings. Looking at the trend in cost over time, Cimera (2008) found that supported employment programs showed an initial increase in cost over the first three fiscal quarters followed by a decreasing trend over future quarters. Sheltered workshops, on the other hand, showed an increasing trend in costs over all fiscal quarters.

For individuals whose behaviors or skills prevent them from participating in full time, community-based supported employment, there are some variations to supported employment that might be appropriate alternatives. Lattimore et al. (2008) discuss a procedure whereby individuals with ASD were taught to master skills necessary in community-based jobs through simulated activities within nonintegrated settings. Three supported workers with ASD were introduced to work tasks within simulated teaching sessions that took place within an adult day program setting. Learned skills were then generalized to the job site once mastered. Positive findings were noted even when equipment and materials used in the simulated sessions were not identical to those which would be encountered in the job site. The authors point out that although simulated training is a concept that is well researched in the general behavioral literature, it is a concept that is unfortunately not included within recommended practices for supported employment. Another variation of traditional supported employment is enclave employment. Enclave employment is when individuals attend a community-based job site as a group and are supervised together by one or more than one employment specialist. In enclave employment models, the employment specialists might fade out their influence, however are always present to provide assistance to individuals and the group as needed.

Another variation to the traditional, job coach/employment specialist model of supported employment is using natural supports in place of or in addition to paid job coaches. Some vocational professionals suggest that the presence of paid job coaches impedes the social integration of individuals with disabilities in the employment setting. Using natural supports inherent in the natural environment, in place of job coaches, might alleviate this problem (Unger, Parent, Gibson, Kane-Johnston, & Kregel, 1998). Natural supports refer to resources that are inherent to the job site such as coworkers, supervisors, friends, family members, and community volunteers. Of 385 supported employment agencies surveyed, 328 or 85.2 % indicated that their agency used natural supports in the delivery of their services. 93.3 % of agencies reported that natural supports were used in the job training; however, only 66.1 % indicated that they used natural supports for participant assessment and only 78.3 % used them for job development. Coworkers were the most often reported natural support used (West, Kregel, Hernandez, & Hock, 1997).

Although individuals with ASD are still often unemployed, underemployed or attending non-integrated vocational or pre-vocational settings, the field is gradually moving away from this model in favor of empirically-based supported employment. Wehman et al. (2007) offers the following five suggestions for increasing the availability of supported employment programs which lead to independent competitive employment: (1) the opportunity to obtain paid work before graduating from state education funded school programs, (2) the presumption of employability which will lead to the imposition of time limits on adult day programs, (3) the availability of work vouchers which will increase funding for placement outside of day programs, (4) self-determination training, and (5) expanding the utilization of Medicaid dollars to support community-based job placements and supports.

Challenges to Effective Employment Programming

There are a number of barriers that complicate the process of helping individuals with ASD find and maintain employment. Several of the most significant are underdeveloped preparation programs (e.g., educational, transition), challenges in finding and keeping appropriate numbers of qualified staff, negative societal attitudes, a lack of coordination with the business community, and economic challenges. An overview of these issues is provided below.

Underdeveloped Preparation Programming

As is the case with persons of all abilities, the degree to which persons with an ASD complete tasks effectively will be in large part a function of instruction, both prior to and after acquiring employment. Given the challenges that persons with ASDs often face in acquiring effective task completion and employee-relevant social skills, a strong case can be made for providing instruction in these domains early in the individual’s educational career. In a description of their adult services program, McClanahan, MacDuff, and Krantz (1999) noted that less than half of the funding used for their children’s program was effective in maintaining appropriate adult programs, an outcome they attributed to adults receiving science-based education throughout childhood and adolescence. In addition to instruction in core areas of academics, these individuals were taught a number of skills that prepare them to succeed in a variety of environments, including requesting assistance, saying “please” and “thank you,” controlling stereotypic movements, and utilizing tools facilitating independent task completion such as photographic or text-based activity schedules (McClanahan et al., 1999). Similar evidence-based educational programs for persons with ASD have also included instruction in skills that will eventually facilitate maintaining employment (e.g., effective social interaction, problem behavior reduction, independent completion of personal daily living skills; Handleman & Harris, 2006). Unfortunately, well designed and implemented science-based education is not yet a hallmark of public schooling despite the short- and long-term benefits of doing so (for reviews, see Eikeseth, 2009; Green, 2011). Thus, most individuals with ASD are reaching the transition stage without the benefit of such programming, complicating the task of utilizing multiple skill sets that many jobs require (e.g., job-specific skills, negotiating social and self-management requirements). This issue is likely the most significant regarding effective preparation for vocational and independent living opportunities.

An additional challenge in the preparation process is the difficulty that many students face in transition from special education to adult-based services. Many students do not experience a seamless transition from the entitlement-based special education system to the less-funded adult services world (Certo et al., 2003). Families are often unprepared to utilize a service system that typically yields fewer supports than they were accustomed to within special education. And although some individuals with ASD are able to successfully transition, most are faced with significant obstacles in multiple areas, even those individuals considered to be more skilled (Hendricks & Wehman, 2009). Obstacles include misperceptions about the nature and needs of persons with ASD and the need for intensive social skill and behavior management intervention. While attention to the transition process appears to be increasing, intervention and assessment methods facilitating effective transitioning have been slow to emerge, with research efforts focused primarily on younger ASD populations (Hendricks & Wehman, 2009). Empirically evaluated transition assessment tools offering a survey of employment-related skills, behavioral barriers, and interests are needed to facilitate effective transition processes.

Staffing Challenges

As outlined in the Current Service Models of this chapter, staff who effectively assist individuals with ASD directly are often crucial to meaningful employment experiences. However, there are a number of challenges to effectively staffing vocational programs for individuals who require it. These challenges are many, and mirror the difficulties encountered in service provision for adults with developmental disabilities. First, finding qualified staff has been a significant problem for a number of years (Hewitt & Larson, 2007; Larson, Hewitt, & Anderson, 1999). Direct support work is often viewed as an unskilled labor by educators and policy makers, contributing to few available career paths and related educational programs (Hewitt & Larson, 2007). Additionally, direct service positions are often low paying, to the degree of constituting poverty-level wages, in some cases (Hewitt & Larson, 2007). Training staff to implement appropriate supports in employment settings is another difficulty. While a number of studies have illustrated a range of effective staff training techniques (e.g., Reid, Parsons, Lattimore, Towery, & Reade, 2005), the implementation of such techniques is unusual as standard practice. Further, the position of direct staff is often multifaceted, encompassing responsibilities that extend far beyond the circumscribed duties of the job description (e.g., relationship building, communication, counseling; Hewitt & Larson, 2007). Thus, training individuals to handle all responsibilities that may come along with their position may be a challenge that is not adequately addressed. Given the many difficulties associated with direct support work, it is not surprising that staff turnover rates are high. This has long been an unfortunate hallmark of vocational and day services for adults with developmental disabilities. Estimates of turnover rates in employment settings have ranged from 33 to 86 % (Larson, Hewitt, & Knobloch, 2005); the Department of Health and Human Services (1994) estimated the rate at 46 % from 1998 to 2003.

These issues highlight the multifaceted nature of staffing-related challenges. Addressing this problem will therefore require multifaceted solutions. Hewitt and Larson (2007) review a number of them, including recognizing the profession of direct support as a primary labor market requiring skilled workers, creating programs to increase awareness of direct support career opportunities among educators, modification of employment selection strategies (e.g., utilization of realistic job previews), implementing effective programs to reduce employee stress and develop peer support, and implementation of competency-based training.

Societal Attitudes

Historically, persons with an ASD have been portrayed in media as presenting with a characteristic profile of challenges (e.g., Raymond Babbit in the movie Rain Man), with few strengths that might facilitate success in an employment setting. Much research has described the presence and negative impact of stigma—stereotypes, prejudice, and subsequent discrimination—on persons with mental and developmental disabilities (for reviews, see Corrigan & O’Shaughnessy, 2007; Werner, Corrigan, Ditchman, & Sokol, 2012). Despite legislation preventing discrimination for persons with “mental disabilities,” there is significant evidence that negative employer attitudes have served as a barrier for employment (Scheid, 2005), with assumptions primarily being that such persons would perform at an inferior level which would adversely affect business productivity. There have been reports of similar attitudes among employers for persons with developmental disabilities (Morgan & Alexander, 2005). Research on stigma for persons with ASD is relatively scant, though initial findings suggest that for one particular ASD—Asperger’s Disorder—the label itself does not evoke reactions consistent with stigma, though contact with negative social behaviors does (Butler & Gillis, 2011). While further study related to stigma and employment barriers for persons with ASD is needed, it is likely that persons with an ASD have been negatively affected regarding employment opportunities, similar to other populations of individuals with disabilities.

Research on the reduction of stigma has highlighted the importance of interaction with disabled populations, such as persons with chronic mental illness (e.g., Corrigan, Edwards, Green, Diwan, & Penn, 2001). A number of employers have reported positive experiences in employing individuals with ASDs (Hagner & Cooney, 2005; Hillier et al., 2007). Specific benefits reported have included trustworthiness, high quality work performance, low absenteeism, and attention to job detail (Hagner & Cooney, 2005). There is also some evidence that for persons with developmental disabilities, employers may go well beyond ADA requirements in providing supports after receiving effective assistance from employment support professionals (Unger, 2002). Thus, it is likely that with application of supports and other programmatic elements found to lead to successful employment experiences, negative attitudes and stigma related to ASD will dissipate, facilitating increased employment opportunities.

Lack of Coordination with the Business Community

Despite legislation and policy initiatives supporting employment opportunities for persons with ASDs, there is often a “ground-level” lack of coordination between the general business community and those supporting individuals with ASD that may slow the employment process. Relations campaigns for persons with developmental disabilities have often utilized disability-centric terminology (e.g., “Hire the Handicapped”) that appeals to advocacy agencies but may miss the mark with employers concerned primarily with operational or revenue objectives (Luecking, 2008). Luecking (2011) points out that traditional efforts to help obtain employment have overlooked such primary employer objectives, instead emphasizing employer awareness and recruitment initiatives regarding hiring persons with developmental disabilities. Not surprisingly, surveys of employers reflect that they perceive disability employment personnel as naïve about or unfamiliar with business practices (Luecking, 2008). Other contributors to a lack of effective coordination between disability employment service providers and employers include terminology differences and different success metrics used by each group. These differences are not surprising given the differing missions, organizational structure, and financial priorities of these groups (Gerhardt & Holmes, 2005).

Measures can be taken to increase coordination and communication between the business and advocacy communities. For example, Gerhardt and Holmes describe the Business Advisory Council (BAC)—a group than can help ASD service providers better understand the needs, language, and culture of for-profit businesses. Specific functions include providing training on how to effectively interact with business community members, providing assistance in developing employer-friendly informational materials, and identifying areas of potential job development (Gerhardt & Holmes, 2005). The coordination process can also consist of helping employers recognize opportunities to meet their labor needs, to examine their work processes, and even to change the nature of their work environments through competitive employment (i.e., “Demand-Side” activities, Luecking, 2011). Luecking (2011) describes a case in which one potential employee’s strengths and preferences were matched to unaddressed needs within a retail clothing store that were negatively affecting business (e.g., matching clothing sizes to size tabs on hangers, organizing the stock room), leading to the creation of a mutually beneficial position. Given the accumulating evidence that employers’ experiences in hiring persons with an ASD are generally positive, better coordination and engagement with the business community could lead to significantly increased employment opportunities for this population.

Economic Challenges

Lastly, there are “macro” level difficulties impeding employment opportunities for persons with ASDs, factors that are unfortunately very difficult to address for those involved in the field of autism and developmental disabilities. In particular, recent economic difficulties have resulted in widespread challenges in employment, including the loss of jobs and cuts to a number of public funding agencies. Persons with disabilities have been differentially affected by the recent economic recession (Butterworth et al., 2011), and economic challenges appear to have contributed to recent declines in supported employment services (Rogan & Rinne, 2011). Under such circumstances, efforts to help employers create mutually beneficial employment positions through “demand side” activities may be particularly helpful, potentially allowing employers to address organizational needs that might increase revenue, as well as creating stable opportunities for persons with ASD.

Discussion

Despite the best efforts of parents, educators, and adult service providers the employment outcomes for adults on the autism spectrum continue to be, at best, disappointing. This despite that fact the studies, and day to day experience, have repeatedly demonstrated the employability of these individuals when provided with proper training, support, and follow-up. So while, historically, much of our intervention effort has gone into changing the behavior of individuals with autism, perhaps it is time to alter that focus a bit and expand our sphere of intervention to include the behavior of families, professionals, and systems. In other words, if we are to more effectively and appropriately meet the needs of adults with ASD some significant changes to current systems of planning and intervention would appear to be necessary (e.g. Gerhardt & Lainer, 2011). While the federal and state authorization of additional funding for adult employment services is critical, this appears unlikely in the near term. This, however, does not mean we are without potential interventions, despite a challenging budgetary environment. Among the systemic interventions are:

  • Proactive and effective coordination between the educational, vocational rehabilitation, adult developmental disabilities service systems along with the individual and their family needs to take place. In a desirable world this would take the form of a series of meetings dedicated to the programming needs of specific individuals throughout the transition process. However, given the current fiscal realities a system whereby a single, annual coordination meeting between all parties on a school wide basis would be desirable, affordable, and potentially help shift outcomes in a slightly more positive direction.

  • Adult outcomes tend to indicate that transition plans developed under IDEA for individuals with ASD fail to comply with the transition requirements of IDEA (2004) such that individuals with autism are generally not provided with the skills necessary to successfully move from school to post-secondary education, integrated employment (including supported employment), adult services, independent living, or community participation (emphasis added). Not only does this need to change but the fiscal resources necessary to support such change are, potentially, available, under IDEA.

  • Within the developmental disabilities adult system more effective strategies of staff recruitment, training, and retention (e.g. Reid, Parsons, & Green, 1989) need to be developed and implemented on a consistent basis to ensure both better trained staff and more consistent programs and supports for adults with ASD.

  • While continuing the necessary focus on biomedical, genetic, and/or etiological research, an addition emphasis on research addressing “quality-of-life” and related intervention variables for adults with ASD needs to be actively implemented and the results disseminated in such a way to accessible to both families and professional staff.

  • Efforts need to be undertaken to shift at least some of the focus of current public awareness efforts away from emphasizing the deficits and challenges associated with living with ASD to include attention to the strengths and competencies of individuals on the spectrum and the benefits of their active inclusion in adult life in the community (Gerhardt & Lainer, 2011).

Adults with ASD deserve the same opportunities and options that those of us not on the spectrum, more often than not, take for granted. This would include the opportunity for a real job, a home in the community, people in their life for whom they care and who, in turn, care for them, to be free from abuse and neglect, to have access to healthcare, leisure and, if desired, a community of faith, and to be treated with dignity and respect. None of this should be considered beyond the scope of our current capabilities.