Research Review

In 2016 OAR awarded an applied grant to researchers Anne Roux, M.P.H., M.A., and Paul Shattuck, Ph.D., both from the Life Course Outcomes Program at A.J. Drexel Autism Institute, Drexel University. They used the grant to study state-level variation in vocational rehabilitation services and employment outcomes for transition-age youth with autism.

Their goals were to:

• Investigate the underlying the differences in rates of vocational services and outcomes for transition-age youth with autism.
• Begin identifying effective practices in state policies and programs related to vocational rehabilitation.

Transition-age youth with autism face many challenges as they attempt to find and keep a job — more challenges than many of their peers with other types of disabilities face. While some do find jobs on their own or with support from family members, others turn to services like vocational rehabilitation for assistance.

While vocational rehabilitation services are federally funded and legislated through the Workforce Innovation and Opportunity Act (WIOA), state agencies are the ones who govern the implementation at the local level. Recently reauthorized, WIOA now places greater focus on delivering early vocational preparation. The goal is to reach students with disabilities during secondary school years through pre-employment transition services. Students who need more intensive supports are then referred to traditional vocational rehabilitation services.

Overall, vocational rehabilitation outcomes for transition-age youth with autism haven’t changed much over the past decade — except in a handful of states. Roux and Dr. Shattuck are interested in trying to understand this phenomenon — why people accessing and using vocational rehabilitation services in some states are so much more successful compared to people in other states.

They hoped to find the answers to three primary questions through their OAR-funded study:

1. How much do vocational rehabilitation services and outcomes vary from state to state for youth with autism?
2. What factors might be driving these big differences across states?
3. Did some groups of states perform better than others in serving transition-age youth with autism? Those states could inform others about how to better provide services that are effective.

This is what they found:

1. They confirmed a high degree of state-level variation across key indicators that told them about the reach of vocational rehabilitation services to transition-age youth with autism, and whether these services are resulting in employment. It is concerning that high levels of variation seem to have persisted for about a decade. The good news is that some states are clearly doing better than others, and researchers can learn from their successes.
2. They identified five thematic groups of factors that could be contributing to differences seen across states:

• Capacity
• Efficient and effective vocational rehabilitation processes
• Innovation
• Inter-agency efforts
• Staff training and competency

Within each of these themes, they pinpointed factors that are high priorities for research. For example, “efficient and effective vocational rehabilitation processes” might include factors about access to services, such as how easy it is to navigate the process of applying for services, or whether people with autism who do not have intellectual disability are able to obtain services in their state. This is important because it tells them where to focus their research and gives them clues about what questions to ask when they take a closer look at what states are doing to serve youth with autism.

3. They also determined that it is possible to group states according to their similarities in performance in serving transition-age youth with autism. Previous studies about employment of people with autism and other developmental disorders rank-ordered states using only the percentage of people employed. Roux and Dr. Shattuck grouped states using their performance across these indicators:

• Youth began vocational rehabilitation services during secondary school.
• The employment plan was completed on time.
• Youth actually received vocational rehabilitation services.
• They got a job at the end of these services.

While this information does not tell the researchers everything they would like to know about employment for transition-age youth with autism, it does give them critical information for the next steps of their investigation.
The study also provided these take-away points for job-seekers with autism, their family members/guardians, and people who advocate for improvements to vocational rehabilitation services:

1. Where you live matters. Some states have better outcomes than others in terms of:

• The percentage of transition-age youth with autism who receive vocational rehabilitation services
• Providing services while the youth are still in high school
• Whether they experience timely development of a plan for employment services,
• The percentage who achieve employment at exit

For example, in West Virginia and Massachusetts, transition-age youth with autism are more likely to receive vocational rehabilitation services while in high school. They are more likely to experience timely development of a plan for employment services in Montana and Arkansas. In Washington and Iowa, these youth are more likely to be employed when they leave vocational rehabilitation. Transition-age youth with autism in Pennsylvania and California are likely to experience all of the above and are more likely to receive vocational rehabilitation services in general. The researchers plan to publish the complete report in a peer-reviewed journal later this year.

2. Your state vocational rehabilitation agency may be performing better on some outcomes but not as well on others. For example, your state may have above average rates of employment for transition-age youth with autism who received vocational rehabilitation services, but below average ability to reach youth early. The information in Roux and Dr. Shattuck’s studies provides more nuanced information about patterns of strengths and weaknesses for each state. This information could be used to guide discussions about progress and improvements in your state.

3. Experts believe there are many practices and policies that could be contributing to state-level differences in vocational rehabilitation outcomes for transition-age youth with autism, and many of these factors are possible to impact through systems change.

The researchers are continuing their investigation. They want to know what high-performing states are doing differently to achieve better results. For example, they learned that several states were testing new vocational rehabilitation services that might specifically support the social skills of people with autism on the job site.

Ultimately, they note, learning about what is working in some states will provide powerful ideas for crafting standards and guidance about vocational services for transition-age youth with autism.