Identifying Patterns of State Vocational Rehabilitation Performance in Serving Transition-Age Youth on the Autism Spectrum

Abstract

Background: Transition-age youth on the autism spectrum (TAY-ASD) face many challenges when attempting to find and keep employment. Vocational rehabilitation (VR) is a key public source of support for employment for people with disabilities in the United States, and TAY-ASD increasingly use VR services. However, rates of VR service utilization and employment outcomes are known to vary dramatically across states for these youth, for reasons that are not fully understood.Methods: This study aimed to examine a set of indicators for measuring the state VR performance in serving TAY-ASD, compared with youth with other disabilities, and to identify classes of homogenous patterns of state performance across these indicators. We used latent profile analysis (LPA) to model patterns of state performance in serving TAY-ASD. Results: We identified five classes of states with unique patterns of performance across four key indicators (service receipt, early reach, timely services, and employment rates) and then matched states to each class based on their probability of inclusion. One class featured above average performance across all four indicators, and approximately one-fourth of states had a high probability of membership in this class. Conclusions: Identification of states with patterns of more efficient and effective VR service delivery for TAY-ASD will help target efforts to learn how states are delivering, organizing, and coordinating VR services for these youth. The use of methods like LPA may also be beneficial for examining performance within other autism-related service systems in the United States and internationally.

Accelerating research on treatment and services for transition age youth and adults on the autism spectrum

“…Adults with autism, on the other hand, find it extremely difficult to access appropriate services (GAO, 2017) and available services often dramatically decrease as they transition to adulthood. This extreme shift is often referred to as the “service cliff” (Roux et al, 2015). Existing services for adults frequently only enroll those with more significant needs such as intellectual disability, psychiatric disorders, or medical problems (Lorenc et al, 2017).…”

Employment policy and autism: Analysis of state Workforce Innovation and Opportunity Act (WIOA) implementation plans

“…In federal fiscal year (FFY) 2015 nearly 18,000 VR cases of youth and adults with ASD closed -doubling the 9,000 cases closed in FFY 2010 (Roux, Rast, Anderson, & Shattuck, 2016). Nationally, about 50-60% of transition-age youth (TAY) and adults on the autism spectrum attain employment following VR services (Kaya et al, 2016;Roux et al, 2016;Roux, Rast, & Shattuck, 2018), most working part-time at low wages (Roux et al, 2016), and often earning less than their peers with other types of disabilities (Burgess & Cimera, 2014).…”

“…Dramatic differences exist across states in distribution of VR service use and related outcomes for people with ASD (Burgess & Cimera, 2014;Migliore, Butterworth, & Zalewska, 2014;Roux, Rast, & Shattuck, 2018). Analysis of VR data for FFY 2014-2016 revealed 30 to 60 percentage point spreads across states for service receipt, early reach, timely services, and employment at VR exit among transition-age youth with ASD (TAY-ASD) who were eligible for VR services (Roux, Rast, Nye-Lengerman, et al, 2018).…”

“…Dramatic differences exist across states in distribution of VR service use and related outcomes for people with ASD (Burgess & Cimera, 2014;Migliore, Butterworth, & Zalewska, 2014;Roux, Rast, & Shattuck, 2018). Analysis of VR data for FFY 2014-2016 revealed 30 to 60 percentage point spreads across states for service receipt, early reach, timely services, and employment at VR exit among transition-age youth with ASD (TAY-ASD) who were eligible for VR services (Roux, Rast, Nye-Lengerman, et al, 2018). State-level variation in VR outcomes for those with ASD is not adequately explained by models that consider demographics and impairment characteristics of service users (Kaya et al, 2016), or by models that also include state unemployment rates or funds a state might have available for social services (Roux, Rast, & Shattuck, 2018).…”

The Transition to the Adult Health Care System Among Youths With Autism Spectrum Disorder

“…5 However, little research has explicitly explored the change in service usage as children with ASD transition out of the pediatric healthcare system. 6 In addition, the transition from the pediatric healthcare system often coincides with an exit from the educational system (i.e. leaving high school), where many children may receive everyday physical and mental health services.…”