Employing people with autism

April 3

The Centers for Disease Control and Prevention reported last week that one in every 68 U.S. children has autism. Paul Wehman, a teacher and researcher at Virginia Commonwealth University, argues that we must begin to plan for their futures as adults.

Sean was born at Bon Secours St. Mary's Hospital in Richmond, Va., and spent many weeks of his young life in the hospital's pediatric intensive care unit. Today, 20 years later, he is a handsome young man with a brilliant smile, and he is back in the same pediatric intensive care unit. Now, however, he is serving a 10-week internship stocking nursing stations, sanitizing supplies and verifying patient information on charts.

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Sean has autism and is participating in a research study through Virginia Commonwealth University. His co-workers say he has changed the way they interact with patients, families and one another.

The Centers for Disease Control and Prevention reported a 30 percent increase in the rate of autism over the past two years. The rise is likely due to changes in the way autism is recognized and diagnosed, rather than to a dramatic jump in the condition itself. But as more children living with autism are diagnosed – and as they grow older – we need to be ready to take the next step with them, including finding them work. I have seen, empirically and anecdotally, for more than 20 years that people living with autism are smart, hardworking, well-liked and valuable members of society who can contribute in meaningful ways.

At VCU, we have partnered for five years with the Virginia Department for Aging and Rehabilitative Services, school districts and hospitals to place high school seniors with autism in nine-month internships in lieu of their final year of school.

The program is based on Project SEARCH, a nationwide, one-year, high school transition program that provides skills training and work experience for young adults aged 18 to 22 who have intellectual and developmental disabilities. We apply the model to students with autism. This is not being done anywhere else in the country.

Students report to a host hospital, where they spend the majority of their day in unpaid internships matched to their skills and interests. The school system provides a teacher and paraprofessional, while VCU provides job coaches who help students learn their responsibilities and provide training for the hosts. VCU also provides site coordinators and positive behavior specialists to work with each site.

The interns complete three 10- to 12-week rotations in a variety of areas, such as ambulatory surgery, coronary care and materials management. They do everything from sterilizing instruments and wrapping surgical trays to pulling soiled linen and stocking supplies.

In 2009, using this model, we began a randomized clinical trial with 14 families to evaluate whether a nine-month internship can lead to employment for people with severe autism. Seven students were placed in internships and seven stayed in their traditional high schools. By the end of the year, all seven interns were offered jobs with the hospital.

We continued the program through 2012 with increasing numbers of participants and found that 88 percent of our student interns were employed upon graduation. In that same time, only one student from the control group (no internship) found a job after graduation. Nationally, 86 percent of students with autism graduate high school without employment.

The students in the internships became increasingly independent at work. This was especially interesting to us because most students in both groups had at first shown significant behavioral and medical problems associated with autism spectrum disorders. They required extraordinary support, including one-on-one aides, prior to entering the study. Usually, students with behavioral challenges are among the most difficult to transition to employment.

Our results, however, show that as employees, these former interns average 22 to 23 hours of work per week and earn $9.22 per hour – 24 percent more than the minimum wage in Virginia. And they are valuable contributors to their hospitals.

We are working with several school districts and hospitals to replicate our programs. We will know these results in June, but some of the interns in this group have already been hired.

We work with hospitals because jobs are available there, but results likely can be achieved on university campuses, in municipal governments or any place with a chance for employment.

People who live with autism can be a difficult group to work with, but our work shows they are willing and able to contribute.

Paul Wehman is a professor of physical medicine and rehabilitation with joint appointments in the departments of Rehabilitation Counseling and Special Education and Disability Policy at Virginia Commonwealth University.

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Lenny Bernstein | April 2