The Effectiveness of Advancing Employment of Individuals with Autism and Intellectual Disabilities

It is commonly understood that young adults with autism and intellectual disabilities (ID) struggle to find and maintain successful employment. Although a large percentage of high school students with autism and ID work toward a goal of establishing paid employment after high school, approximately only half of these individuals actually end up employed. Individuals with autism and ID that do find employment usually experience a number of challenges from low pay for lower level work, social struggles, and financial hardship.

Gilson and Carter note that there is an increase in Postsecondary Education (PSE) programs available for advancing employment of individuals with autism and ID through job coaching and training, particularly academic and vocational training of college students. Such programs, according to Gilson and Carter, include job shadowing, coursework, and opportunities for internships and networking in promoting employment skills and social interactions between the individual and their employers and co-workers. Gilson and Carter describe the use of job coaching strategies, such as task analysis, prompting, fading, verbal instruction, and demonstration to teach job skills to individuals with autism and ID. However, Gilson and Carter note that another important element is the role of a job coach in teaching individuals to socially adapt and develop interpersonal skills in the workplace environment.

One challenge the authors point out is that the close proximity of a job coach to their student can negatively impact the individual’s ability to integrate and form interpersonal relationships. Although the authors discuss the importance of the job coach to assist the student and provide support, they point out that eventually the supports will need to be faded and at that time it is important that the job coach is able to fade proximity to the learner while still being able to effectively give feedback. In other words, how can job coaches effectively provide instruction and give feedback to individuals with autism and ID while providing more distance or greater proximity to the learner in order to increase the individual’s independence and provide them greater opportunities to socially integrate in their workplace environment?

Covert audio coaching (CAC) is described in this study as an instrument that allows the coach to give audio cues and feedback, discreetly and instantaneously to students through a bug-in-ear device and it also allows for further proximity between the learner and the job coach. Gilson and Carter note that several studies have reported that this has been an effective method for improving vocational skills for individuals with autism and ID but that there have not been any previous studies done on the use of CAC to improve social skills. The authors sought to find if college students with autism or ID would increase their social interactions in their work environment through the use of the social coaching method and if the increase would be the result of an increase or decrease of interacting with the job coach. The authors also wanted to know if the individuals would maintain their engagement to task behaviors as proximity to the job coach was faded.

Finally, the authors also sought out to learn the view of college students with autism and ID, job coaches, and co-workers in regards to feasibility and acceptability of the use of this type of job coaching method. Three college students with who were enrolled in a PSE program from a mid-size, private university were selected for Gilson and Carter’s pilot study. Each of the participants had a cognitive impairment. The participants met requirements for the 2-year comprehensive transition program (CTP) through age and diagnosis; 18-26 years old and diagnosed with autism or ID (determined by their high school special education classification). Participants also had to want to gain greater independence and want to receive transition services, have the ability to communicate, had received a minimum of 1 year internship experience, either completed high school with a high school diploma but without meeting college admissions criteria or completed high school but without a high school diploma, and also display socially adaptive behaviors and responsiveness when left unattended. The 3 participants, Braxton, Jeremy, and Noah, were assigned a job coach and completed an unpaid internship each semester. Internships were based on vocational interests of the students. Job coaches were chosen based on interest, client need, and scheduling availability. It is important to note that although all three of the female job coaches were in special education but only one had prior experience as a job coach. For the first few weeks, the job coaches attended their student’s entire shifts and then they began to fade supports as the students began to complete their tasks independently.

Gilson and Carter’s study was conducted at each of the individual student’s internship sites; a grocery store, a preschool, and a health clinic. Each of the participants worked at their internship sites a total of 4-8 hours per week. A multiple-probe, single-case experimental design across participants was used to determine the impact of the job coaching method on the behaviors of social interaction and task engagement. Data was collected for 30 minutes, twice a week at the internship sites and baseline data was taken for a minimum of five sessions before tiers were introduced. During baseline, prompts and feedback were given by the job coach (from approx. 10 feet) for task independence, not just social cues.