Purpose of Review We review original research about services for adults on the autism spectrum published from January 2013 through December 2018. The main aim is to characterize the topical and methodological aspects of research about services. We review research on services related to employment, living in the community, and social participation. We compare our results with those from a similar review published in 2012 to assess progress and identify where new directions in research about services for adults with autism are needed. Recent Findings We found the evidence base about services for adults on the autism spectrum remains very small and highly variable in aims and methods. There is wide variability in methods used to define sampling frames and recruit participants. Most studies focus on employment. Almost no studies examine the overall ecosystem of services serving autistic adults. Few studies use a conceptual framework for understanding access to, or improvement of, services. Summary The small size of the extant research coupled with inconsistent quality prevents the accumulation of new knowledge in ways that would significantly inform the improvement of systems of care for the growing population of adults on the autism spectrum.

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BACKGROUND: The problem of persistently low rates of employment and earnings for people with autism is well established. In the U.S., the 2014 Workforce Innovation and Opportunity Act (WIOA) updated the legal framework for the federal Vocational Rehabilitation (VR) program which assists people with disabilities to find and maintain employment. OBJECTIVE: This study examined whether and how the needs of transition-age youth and adults with autism are addressed in state WIOA plans. METHODS: We analyzed WIOA documents for all states plus the District of Columbia using content analysis. RESULTS: Of the 51 state plans, 44 contained references to autism, and 19 explicitly identified autism as a disability group that is underserved by the state VR agency. Even among states that clearly defined autism as underserved, only 10 provided comprehensive plans which defined goals and strategies to address the vocational needs of this group. We discuss major themes related to VR service delivery for people with autism identified within the state plans. CONCLUSIONS: This study identifies state policy aimed at facilitating employment for people with autism and contributes to efforts to discover why individuals with autism in some states have better employment outcomes than in others.

Families of children with ASD face significant financial challenges due to their child's complex service needs and frequent out-of-pocket expenditures for community services and health care. This report describes financial hardship among families of children with ASD (ages 3-17 years) and their participation in safety net programs.

The purpose of this report is to catalogue indicators of mental health and mental health care to highlight areas of needed improvement in practice and policy. Mental health care is an urgent priority and this report documents barriers that individuals and families face when trying to access mental health care. Good health and wellbeing require effective interventions and supportive policy to ensure that mental health needs of autistic children and adults are effectively addressed.