The Effect of Brief Training on Attitudes and Interactions of Co-Workers with Autism | Organization for Autism Research

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While the philosophy of community based employment is to promote community integration and the social skills of persons with disabilities, studies suggest that there is minimal interaction between persons with disabilities in the workplace and their non-disabled co-workers and that when interaction does occur it may be limited and non-social in nature (Belcher & Smith, 1994; McDermott, Martin, & Butkus, 1999; Chadsey-Rusch, Gonzalez, Tines & Johnson, 1989; Parent, Kregel, Metezler & Teardzik, 1992; Test & Wood, 1996; Wehman & Kregel, 1995). Conversely, research also demonstrates that non-disabled co-workers can serve as important resources for persons with disabilities in the workplace. The very proximity of non-disabled employees to their co-workers with disabilities presents the opportunity for them to act as supports for the individual with a disability’s successful employment (Hagner, Butterworth, & Keith, 1995; Patton, de la Garza, & Harmon, 1997; Luft, & Rubin, 1999; Rusch, Johnson & Hughes, 1990).

The concept of “natural supports” is most often related to the utilization of co-workers, supervisors and other non-disabled work personnel to act in similar roles as do job coaches for their co-workers with disabilities (Wehman, 2001). Research suggests that workers without disabilities are less likely to advocate for co-workers with disabilities, as the disability becomes more severe. Supported employment agencies are less likely to accept persons with very severe disabilities, such as autism, due to the need for continuing support for these individuals (Datlow-Smith & Belcher, 1994; Ohtake & Chadsey, 1999; Revel, Wehman, Kregel, West, & Rayfield, (1994).

Persons with severe disabilities could be further excluded from supported employment services, and subsequently the workforce, because their needs for on-the-job support may be greater than co-workers or supervisors abilities to successfully manage (West, 1992). Since it’s inception, the natural support model has been designed to help facilitate successful employment outcomes for individuals with severe disabilities (Wehman, 2001). The opposite may be the case for persons with very severe disabilities, according to Wehman, Revell, and Kregal (1997). They assert that since 1988 there has been very little progress made toward including the very severely disabled and subsequently difficult to place/train individuals in supported employment. According to Wehman, Revell, and Kregal, persons with disabilities such as severe cognitive limitations, autism, cerebral palsy and dual diagnosis have been notably left out of supported employment initiatives due to their significant needs for ongoing support. It is this social aspect of work, and with natural supports as work support in particular, that individuals with autism spectrum disorders may have the most difficulty.

Historically, individuals with autism have experienced numerous difficulties in accessing appropriate supported employment services in their communities (Datlow-Smith & Belcher, 1994; Keel, Mesibov & Woods, 1997). This results in a situation in which most supported employment organizations are unable or ill-equipped to provide for the specialized training or long-term supports required for successful employment of persons with autism (Datlow-Smith & Belcher 1994; Keel, Mesibov & Woods, 1997).


Current Study

Based on the literature, it was hypothesized by the researcher that two significant social barriers exist for persons with autism in their endeavors to secure supported or competitive employment that are not routinely addressed as part of job training; successfully interacting with co-workers and using the needed ongoing supports available through “natural supports.” This study endeavored to explore these barriers in three ways. First, the researcher studied the interaction between employees and their co-workers with autism. Second the study sought to determine if specific autism related training could better facilitate these interactions. Through measuring this co-worker attitudes toward individuals with autism the study endeavored to explore if individuals without developmental disabilities in the workplace can be motivated toward improved attitudes toward their co-workers with autism through the provision of training and education on the specifics of autism. The study also endeavored to identify specific factors of the individuals without disabilities that may have affected their perceived level of interaction with persons with autism.



The study occurred over a 12 month time period. During this investigation, two key research questions were addressed: (a) Did training/education increase the observed interactions of employees with their co-workers with autism; and (b) Did training/education influence the reported attitudes of the employees toward their co-workers with autism. In contrast to programs that target the individuals with autism, this study focused on providing a training and educational workshop for the co-workers and examined how this training impacted their interactions and attitudes involving their fellow employees with autism.

In regards to the first research question, co-workers of individuals with autism were observationally measured on a pre-post basis with respect to their level of observed interaction with their co-workers with autism. To address the second research question, the co-workers completed a pre and post-training questionnaire with respect to their reported attitude toward their fellow employees with autism. All co-workers employed in worksites randomly assigned to the experimental group participated in a training/education workshop, while the co-workers in the control group only participated in the pre-post assessment, receiving training only after data collection was completed.



Co-workers of Individuals with Autism

Co-workers of individuals with autism were drawn from various community worksites that employ persons with autism and PDD-NOS using the community based supported employment model. In order to be eligible for inclusion in the study, volunteers had to work in a close physical proximity to supported employees with autism. This close physical proximity had to allow the employee the opportunity to interact with the person with autism in some on-going way, such as through training, sharing of work, interrelated work or shared breaks and lunches. These workers were either full or part-time with regard to their employment status and represented multiple employment levels and job titles. The co-workers at the selected sites who meet these criteria were invited to participate in this study through a letter of information as well as through the job coach working at their place of employment. Each co-worker was given a brief questionnaire pertaining to their knowledge and previous experience with individuals with autism.

Persons with Pervasive Developmental Disorders

A total of eight persons with autism participated in this study. These individuals met the diagnostic criteria for autism, or Pervasive Developmental Disorder – Not Otherwise Specific (PDD-NOS) as defined by the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). Participants with autism ranged in age from 20 to 38 years, with an average age of 25 years. All individuals with autism participating in the study had a history of showing moderate/severe deficits in communication and social skills. Individuals who exhibited high levels of disruptive behaviors such as severe self-injurious behavior or physical aggression were excluded from this investigation. Each individual with autism was employed in a community work setting with a minimum of four co-workers volunteering to participate in the study.

Once volunteers were identified at various jobsites, the sites were randomly assigned to either the control or experimental group. The individuals with autism and/or their family or guardian were administered the Scales of Independent Behavior – Revised as a means of measuring independent functioning of the individual. Co-workers of individuals with autism were observed in conjunction with the job coach and ranked on the Co-Worker Involvement Index (Revised) on all nine items. This measure was administered to both the control and experimental groups as part of the baseline determination. All subjects were next administered the Attitude Toward Autism measure. The Attitude Toward Autism measure was used in the determination of a pre-treatment baseline.

After baseline measurement, the researcher conducting the training/treatment coordinated with job coaches and supervisors/managers in order to schedule the training for those subjects in the experimental group. Training sessions consisted of both a commercially available natural supports training program entitled Training For Work Supports as well as specific training relating to characteristics of persons with autism spectrum disorders. These training sessions were scheduled with supervisors/managers so that subjects received training in the workplace during regularly scheduled shifts.

Upon completion of the baseline evaluations/observations and/or subsequent application of the training program treatment a time interval of approximately three weeks was observed. This time interval was based upon a test-retest reliability for the Co-Worker Involvement Index (Revised) in which a correlation of .90 was shown when comparing test and re-test administration of the index on the same subjects with a three week interval. After the three-week time interval had elapsed from the administration of the training program, the subjects were again observed and measured using the Co-Worker Involvement Index (Revised), again being observed by a compatriot who was naive with regard to whether they were observing the control or experimental group and whether or not training had yet occurred.



Three standardized measures were used in this study: (a) the Co-Worker Involvement Index (Revised), (b) the Attitudes Toward Autism Survey and (c) the Scales of Independent Behavior – Revised. Non-developmentally disabled co-workers of individuals with autism were administered the Co-Worker Involvement Index (Revised) and the Attitudes Toward Autism Survey. Individuals with autism who work alongside non-developmentally disabled co-workers were administered the Scales of Independent Behavior-Revised (SIB-R), in order to provide information about the severity of their developmental disability.


Training/Education of Non-Developmentally Disabled Co-Workers

In order to minimize variance in the administration of training, natural supports training consisted of administration of the commercially available natural supports training program entitled Training for Success: Facilitating Natural Supports in the Workplace for Persons with Disabilities. This pre-established training program produced by Training Resources Network (1999), consists of a training video and workbook designed to introduce non-developmentally disabled employees to the concept of natural supports and how to serve as natural supports for individuals with disabilities in the workplace. The workbook and training video focus on the use of task analysis, behavioral prompting, reinforcement and error correction. The video and workbook are used in conjunction with one another and provide instruction on each topic with accompanying examples of a job analysis, behaviorally based cues and rewards and corrections. Following each section is a sample scenario presented on the video with a prompt to pause and work through the scenario in the workbook. These scenarios were worked as a group prior to returning to the video training for demonstrated and recommended solutions.

The training specific to autism was based upon curriculum from Kentucky Autism Training Center’s Autism Awareness Training, designed to provide a basic overview of autism and autism spectrum disorders to a general population of individuals.

Following all data collection the employment sites having been randomly placed into the control group will be offered the training, though no data will be collected as part of this training. This is believed to be the most ethical procedure for this study and will still allow co-workers of individuals with autism the opportunity to learn more about their co-worker with autism and possibly become a better source of natural support in the workplace.


Results and Discussion

An analysis of the data indicated that neither training protocol had a statistically significant impact on the behavior of co-workers and, thereby, the social inclusion of employees with autism. One possible consideration as to lack of significant findings in this study may be related to the social skills of the individuals with autism in the workplace. Though a lack of awareness or markedly decreased social skills are a hallmark of the diagnosis of autism spectrum disorders, it is possible that these individuals with autism possessed a level of social skills that endeared them to their co-worker and thus increased co-worker attitudes/interactions. Autism is a spectrum disorder in which the various diagnostic criteria can occur in a very wide range of presentations and severities. At one end of the ‘spectrum’ are individuals for whom autism is more severe with significant deficits in many areas while at the other extreme are individual’s who possess the diagnostic criteria but for whom these deficits are less severe. Although two individuals may both hold the diagnosis of autism, one may be non-verbal and another very verbal with an advanced vocabulary but with limited initiation and/or ability to sustain communication.

Another consideration is that employers who hire individuals with autism may already possess more favorable attitudes toward individuals with disabilities and thus training may have little effect on increasing these already favorable attitudes. In working with a supported employment provider or vocational rehabilitation agency, the employer will be aware of the fact that the employees hired under such a program are individuals with disabilities. Regardless if they are aware of the specific diagnosis the very fact that these employers are willing to hire individuals with known severe disabilities may suggest a tolerance for many of the issues that could accompany such an employee and thus an increased score on an attitudinal survey with regard to the hiring of individuals with autism, even if they remain uninformed of the specifics of autism.

Though this study did not specifically seek to assess the attitudes or interactions of supervisors, managers or executives in the businesses participating, it is possible that the attitudes of the organizational leaders were an influence on those of the employees surveyed. An employment site in which supervisors demonstrate a strong commitment to hiring individuals with disabilities may well result in a workplace culture in which tolerance for employees with disabilities is reinforced. A possible direction of future research may be to assess the attitudes of individuals holding supervisory or managerial positions to determine the effect attitudes of these key personnel on those of subordinate employees.

The fact that all employers participating in this study have hired an individual with autism to perform some aspect of work in their organization may place these jobsites in an already biased position, they are willing to try working with individual’s with severe disabilities. Therefore there is something already different about these employment sites. This difference may be a more open nature, a commitment to diversity or other qualities that may result in elevated attitudes and interactions with co-workers with disabilities irrespective of training.

The very fact that these sites employ persons with autism may mean that they already possess more positive attitudes and increased interactions than would employees of organizations who do not or have not yet hired persons with autism. The control group would ideally be made up of employees at jobsites where no individuals with severe disabilities have yet been hired. A significant change in measured attitudes from this group as a result of training may point to a possible effect upon the work culture that would initiate, influence or increase the hiring of persons with disabilities.

If management is open to the hiring of individuals with autism then it is possible that other individuals with disabilities, either currently or previously, have been employed by these worksites. It is possible that these previous or current experiences may have an impact on current attitudes and/or interactions with employees with autism and the willingness of employers to consider participating in this project. If an employer has previous experience working with co-workers with disabilities then that experience may transfer into changes in how these workers interact with co-workers with disabilities. An employee who has worked with someone with a disability may find that their ability to interact with the co-worker is improved and their expectations of social interactions are more realistic and consistent with the individual’s capacities. For these reasons it is possible that previous experience working with individuals with disabilities could result in an increase in co-worker attitudes and/or interactions with employees with autism. The current study did not include this variable, but such prior experience should be measured in future research in this area.



The findings of this study suggest that presentation of a brief training may not be an effective means of facilitating a change in attitudes and/or interactions of employees with their co-workers with autism. It is recommended that future research in this area focus on the use of other training models that are longer, more intense or experiential rather than academic in approach. It is noted that the brief training program used in this study was primarily an overview of the diagnostic features of autism and various deficits in communication, social skills and sensory issues that accompany this diagnosis. Future research in this area is encouraged to include more practical information regarding how employees can better interact with their co-workers with autism or how they can teach more acceptable social skills in the workplace.



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