Autism Transition Handbook

From Autism Transition Handbook

Revision as of 19:38, 15 May 2012

Acknowledgement: The sections on Finding and Ensuring Success on the Job are reprinted here with the kind permission of the Organization for Autism Research, from their publication, Life Journey Through Autism: A Guide for Transition to Adulthood.  This excellent resource is available for download at the Organization for Autism Research's website at www.researchautism.org. 

Transition to Work

Whether a job provides financial support, personal fulfillment, social opportunities, or some combination of these, it is a very important component of adult life. In fact, what one does for a living is often regarded as a defining feature of that person and his role in society. Finding the right employment match for a student with ASD may be challenging, but the rewards can also be great in terms of personal satisfaction in a job well done and as an active, participating, well-regarded member of society.

IDEA Federal special education law requires that school districts help students with disabilities make the transition from school to work and life as an adult. Although IDEA mandates services and programs while your young adult is in school, there are no federally mandated programs or services for individuals once they leave the school system. This means that your adolescent will need to make the most of this transition period to develop his life skills and prepare for entering the work force.

Broad Timeline for Middle School and High School

When is it the Right Time to Begin Exploring Employment Opportunities?

It is never too early to begin planning for the school to employment transition. Part of this planning process involves exploring career guides and resources to provide a better idea available careers.Also, there are a number of pre-requisite skills that are important for individuals with ASD to acquire as early as possible depending on the future job of interest. Having these early pre-requisite skills, specifically strong functional skills and social skills, can help ensure that your young adult is in a position to pursue meaningful employment.

Functional skills include a broad area of skills needed in order to be successful or “function” to meet the demands of everyday life, and are critical components to ensuring on the job success. Examples include self-help skills (e.g., bathing, teeth brushing, dressing, toileting skills), functional academics such as being able to read or understand safety skills, math skills that involve using money, counting change, and reading receipts, making budgets, and making sure that these skills are generalized, or can be used across multiple environments. In addition, it is also important to consider what functional skills are needed to pursue a career in field your son or daughter may want to work. For example, if your son or daughter is especially interested in working in a library, it is important to have more specified, functional knowledge of how to work within a library.

Social skills are another set of key skills that need to be developed at a young age to ensure your young-adult can be employed in meaningful contexts. Important social skills to have in employment settings vary depending on job demands, but often include the ability to initiate and respond to greetings, being able to request and ask for breaks and help, avoiding violations of others’ personal space, and refraining from disruptive behaviors.

See Also:
Devereux's Adolescent Skills Assessment Worksheet: This resource provides a number of different skills important for assessing pre-vocational readiness.

Since the needs of individuals with autism spectrum are so different, there is no one way to plan for and find meaningful employment. However, the outline below provides some general steps parents should consider based on the age of their young adult. The following information was adapted from the Organization for Autism Reserach's publication, Life Journey Through Autism: A Guide for Transition to Adulthood, and the Pennsylvania’s Department of Health’s Document, Transition to Adult Living in Pennsylvania.

What Jobs are Available for Individuals with Autism?

The employment available for an individual with ASD reflects the breadth of the entire job market. Generally, a job may belong to any of three categories that vary in the amount of support they offer the worker with a disability. Ranging from least to most supportive, these categories are Competitive employment, Supported employment, and Secured or segregated employment although neither is mutually exclusive, and an individual may find employment in more than one category.

What is the Best Way to Search for a Job?

Look to see what employment options are currently available in your area. Networking among friends, colleagues, and acquaintances will often be your best job search strategy. Once opportunities are identified, find out what kinds of skills your young adult will need to be successful in those environments. Then, identify what supports your young adult might require to do this job. This exercise can be done in advance of an actual job search to start your thinking about these topics. Think “Job carving.” The charts in Appendix: Job Ideas offer more lists and details of possible jobs that both low functioning and higher functioning individuals on the spectrum may enjoy based on their interests and thinking styles.

Job Match
When searching for jobs for your young adult with ASD, it is important to consider the match between your son and a particular job’s social, navigation, and production requirements. This “job match” is the extent to which a particular job meets an individual’s needs in terms of challenge, interest, comfort, camaraderie, status, hours, pay, and benefits. Generally, as people move through the job market over time, they get closer and closer to an ideal job match. Individuals on the spectrum may not be as motivated by money as their neurotypical coworkers are. So, for the majority of individuals with autism, their motivation to work will be directly related to the extent to which they enjoy the work they are being asked to do. A good match is of critical importance in these cases. When considering things that contribute to job match, they can be classified into physical and social components.

See Also:

The Range of Possible Jobs for Individuals with Autism

The Institute for Community Inclusion's real work stories Career one stop offers a variety of online worksheets to help people identify their work skills, abilities, and interests.  American Academy of Pediatrics report on Postsecondary Education and Employment Among Youth With an Autism Spectrum Disorder

Pennsylvania Career Services

Team PA CareerLink provides employment and training information and services to assist people in getting a job, and to promote lifelong learning. More information and the link to career opportunities can be found at https://www.cwds.state.pa.us.

Delaware Career Services

For further assistance with identifying job interests, job searching, resume building, basic computer workshops, and creating an email account, you can visit any of the locations of the Division of Employment and Training at the following locations.

To search for a job, you can go to the Delaware Job Link.

What is an Internship?

In addition to these types of employment, an internship may also help your young adult learn more about the workforce. Internships are temporary positions where emphasis is placed on training and developing on the job skills. Internships exist in a variety of settings including but not limited to hospitals, small businesses, law firms, laboratories, and libraries. Internships can either be paid, Un-paid, or partially paid (e.g., with a stipend), and can be either full-time or part-time. The on the job supervision and training characteristic of an internship may help many individuals with ASD attain the support they need to be successful later on in the job market.

Finding an Internship

Just as there are many ways to find a job, there are many different ways to find an internship. One way to find an internship, if your son or daughter is still in high school, is through their high school’s vocational program. Many high schools have vocational programs that seek to provide their students with professional experience and training through internships. To help your son or daughter to obtain an internship through their school, contact a school employee involved with the vocational program, such as the school vocational coordinator, school counselor, school psychologist, or transition specialist.

Another way to help your son or daughter find an internship is by contacting local businesses and asking if they would be interested in having an intern. Prior to contacting a particular business, it is important to learn as much information about the business as possible including if the business has a mission or vision statement, different resources and supports available to employees, and types of jobs and job requirements. It is also important to consider the type of role your son or daughter would have in the company, and how their strengths, abilities, and interests match that specific business. When contacting businesses, it is often best to speak to one of the mangers or owners of the business, and explain that you are interested in helping your son or daughter find an internship. Though many businesses may not specifically have an internship program, some businesses may be willing to work with you to create a role for your son or daughter in their company. Note that internships created in this manner tend to be un-paid. 

What Steps Have Employers Made to Create Jobs for Individuals with Autism?   

Many businesses are making an increased effort to incorporate programs for employing individuals with autism. Though not specific to Pennsylvania, Project Search through the Cincinnati Children’s medical hospital developed a model to provide internships to individuals with autism at their hospital. A group of individuals with autism was chosen to complete an internship at the hospital with both a classroom and hands-on component. During the internship, interns received on the job training and support to learn specific jobs including pulling and organizing charts, materials assembly, and patient transport.

Though this project is not currently in Pennsylvania, a number of nationally recognized businesses have taken steps to create jobs for individuals with disabilities.  Some of these employers include Walgreens, Bank of America Card Center, Safeway, Lowes, AMC Theatres, Best Buy,  and Marriot/Bridges.   

See Also :

A list of internships provided by The American Association of People with Disabilities

What Steps Help Ensure Success on the Job?

Personal Disclosure
When considering a possible job or employment in general, it is important to consider when and if your young adult will disclose that he has ASD. If he has had assistance securing the job and is being provided with job coaching, the primary question becomes not should one disclose, but rather what information is relevant for disclosure and to whom? Remember, in all cases, disclosure is a personal choice, and there is no law obligating anyone to disclose that they have a disability. However, to be eligible for accommodations under ADA, some level of disclosure will be necessary. The Appendix on When (and if) To Disclose provides more information on timing options for disclosure, helping you to think through the positives and negatives about disclosing at various stages in the job search process. There is no one correct answer for when to disclose; however, once disclosed, that information legally must be kept confidential by the employer.

Accommodations on the Job

The ADA requires employers to make reasonable accommodations to persons with a disability in the workforce if i would not impose “undue hardship” on the operation of the employer’s buisness. Reasonable accommodations may include, but are not limited to:
• Making existing facilities used by employees readily accessible to and usable by persons with disabilities
• Job restructuring or modifying work schedules
• Acquiring or modifying equipment or devices; adjusting/modifying examinations, training materials, or policies; and providing qualified readers or interpreters
• Additional training periods or instruction for developing job-related competencies.
For a more complete list of reasonable accommodations specific to autism,  see the Appendix on Job Accommodations.

See also: The Job Accommodation Network

Educating Employers and Coworkers
Should your young adult decide to disclose, both employers and coworkers need to be educated about ASDs so that they can offer support when necessary. They will need to be trained on how to best work with your young adult. As part of the transition process, the transition team can establish what information will be necessary to teach future employers and coworkers about autism, and your young adult in particular. Be sure to emphasize areas where he will need help, along with his particular strengths.

Workplace-Specific Social Skills
Although social skills may not be necessary for your young adult to perform the actual job, they may be needed to help him or her keep the job or be more socially included at work. The social skills demanded vary from place to place, but there are basic skills that every employee should know. The following sections provide an overview of the areas where your young adult with ASD may need assistance or training to perform the job.

• Personal Presentation
• Communication Skills
• Social Behaviors

Government Employment Support

Social Security Programs

Ticket to Work Program
The Ticket to Work program is a program from the Social Security Administration for those who receive SSDI or SSI due to a disability, providing beneficiaries with more choices for receiving employment services. Under the Ticket to Work program, the Social Security Administration (SSA) gives tickets to eligible beneficiaries who may assign those tickets to an Employment Network (EN) of their choice to obtain employment services, vocational rehabilitation services, or other support services necessary to achieve a vocational (work) goal. To determine the EN in your region contact Maximus at 1-866-968-7842  (1-866-YOURTICKET) or 1-866-833-2967 TTY (1-866-TDD 2 WORK) or at their website www.tickettowork.com.  To link directly to ENs in PA, click here.  ENs, if they accept the ticket, will coordinate and provide appropriate services to help the beneficiary find and maintain employment.  One can receive extended health care coverage, protection from Continuing Medical Reviews while "Ticket" is in use, more money, and reinstatement of benefits if you can no longer work. Find more information about the Ticket to Work program refer to  www.yourtickettowork.com or www.ssa.gov/work. You may also contact your local OVR District office, or call 1-800-257-4232.

For a list of Ticket to Work Employment Networks, refer to the Ticket to Work website at Ticket to Work Directory

See Also:

Latest "TEN" (Training and Employment Notice) on Ticket to Work changes at http://wdr.doleta.gov/directives/attach/TEN/TEN6-11.pdf.

Work Incentives Planning and Assistance (WIPA) Program
The WIPA program is a program from SSA that helps address the need for effective benefits planning and allows individuals with disabilities to remain employed without the loss of medical benefits (i.e Medicaid). Work Incentives include, but are not limited, the Plan to Achieve Self- Support (PASS), Trial work periods (TWP) and theImpairment Related Work Expenses (IRWE) .   SSA Work Incentives are available to all beneficiaries regardless of the source of their employment services. For more information on WIPA see
http://www.socialsecurity.gov/work/WIPA/html.

Continued Medicaid Eligibility:

Part of the Social Security Act also provides protection for individuals that want to work and maintain their Medicaid eligibility. In order to qualify for continuing Medicaid coverage, a person must either:

A. Have been eligible for an SSI cash payment for at least 1 month
or
B. Still meet the disability requirement
    Still meet all other non-disability SSI requirements
    Still need Medicaid benefits to continue working
    and have total earnings that are insufficient to replace SSI, Medicaid, and publicly funded attendant care services. Total earnings are determined based on a specific state threshold  (In 2011, the total earning threshold in PA is $29,410).

Working for the Federal Government

Schedule A is a hiring authority available to federal agencies to promote the hiring of individuals with disabilities without competing the job. Agencies can use schedule A to avoid the often lengthy hiring process. For tips on how to apply for Schedule A jobs click here.

Project SEARCH

Project SEARCH is an employer-based internship program that provides young adults with disabilities on-the-job training through real work experiences. Competitive employment in an integrated setting is the goal of a Project SEARCH internship. The Project SEARCH model was developed at the Cincinnati Children's Hospital and can now be found at many locations across the US. For more information see projectsearch.us.

Project SEARCH in Pennsylvania

In Pennsylvania, Project SEARCH locations include Children's Hospital of Philadelphia, Bryn Mawr Rehab Hospital, and Good Shepherd Rehabilitation.

Project SEARCH in Delaware

In Delaware, Project SEARCH is currently located at Christiana Care and is looking to expand to other locations. For a recent news story on Project Search in Delaware click here.

Pennsylvania Employment Resources/Job Support

Department of Labor and Industry - Office of Vocational Rehabilitation OVR is a Pennsylvania Agency that provides services that enable an individual to become employable.  They provide services such as diagnostic, vocational evaluations, vocational counseling, training, placement assistance, assistive technology and support services.  To determine eligibility, the vocational rehabilitation counselor will ask the following:

• Does your son or daughter have a mental or physical disability that creates a substantial impediment to employment?
• Is there a reasonable expectation that he/she will succeed in employment with the accommodations provided through OVR? 

To find out more information about OVR's Individualized Placement Services and to meet with an OVR counselor who can help you select an employment goal and develop a comprehensive strategy so that you can find the type of job that meets your needs, please refer to their website on OVR Individualized Employment Services.   Office of Vocational Rehabilitation, Department of Labor and Industry, Special Programs, 1313 Labor and Industry Building, Harrisburg, PA 17120.  Or contact a local office.

If you are interested in a comprehensive report on the Office of Vocational Rehabilitation's activities, refer to the draft 2011 FEDERAL FISCAL YEAR UPDATE, March 2010.

Pennsylvania Career Link, Commonwealth Workforce Development System (CWDS) may be used for career assistance (finding a job, looking for a better job, improving job skills) or seeking vocational rehabilitation services.  CWDS enables individuals to search for job openings, create a résumé, apply for jobs online, research career information or request vocational rehabilitation services.

Department of Education - Bureau of Career and Technical Education  provides individuals with opportunities throughout their lifetimes to develop, in conjunction with other education and training programs, the knowledge and skills needed to keep Pennsylvania’s workforce competitive. Bureau of Career and Technical Education, 333 Market Street, Harrisburg, PA 17126.

Delaware Employment Resources/Job Support

Delaware Department of Labor: Division of Vocational Rehabilitation assists individuals who are capable of being employed, but have barriers to meeting that goal. The basic questions that would be asked to determine eligibility are

- Is the person capable of being employed (with assistance)?
- Does the person have a physical or mental impairment that substantially limits a major life activity?

Referrals are made to DVR two years prior to completing high school.

Early Start to Supported Employment

Delaware's Early Start to Supported Employment Program assists in creating a seamless transition for students needing supported employment services for job success. Early Start to Supported Employment is a collaborative program sponsored by the Delaware Division of Vocational Rehabilitation, the Delaware Division of Developmental Disabilities Services, the Delaware Department of Education and Local School Districts. The goal of ESSE is for the student to have paid employment with post-school supports in place before the student leaves school. The program is available for students who are eligible for DVR and DDDS. The process begins two years prior to exiting high school. More information can be found on the Delaware Department of Education website. See also the following documents:
ESSE Parent Handbook
ESSE Initial Review Forms
ESSE Parent Consent Form
ESSE Anticipation of Participation Form

SSI and Working

A person who qualifies for SSI or SSDI, will automatically qualify for Vocational Rehabilitation services if he/she has the desire to become employed. Under the Ticket to Work Program, a person can receive free Vocational Rehabilitation services and still receive SSI for a nine month "trial work period" with no limits on earnings, and then for 36 months thereafter provided earnings each month are not over $1,000.

In Delaware, the Work Incentive Planning and Assistance (WIPA) offers free services to Social Security Disability Beneficiaries in the state of Delaware from age 14 up. Work related benefits include Medicaid/Medicare, Food Stamps, Housing and rental assistance, unemployment, workers compensation, and Veterans benefits. Services are provided by a Community Work Incentive Coordinator (CWIC). There are offices in all three counties. For more information, and contact numbers see http://dvr.delawareworks.com/wipa.php

Services Available

Services provided by Delaware Division of Vocational Rehabilitation include assessment, counseling, referral, skills training, job placement, and supported employment.

Job coaches may be provided to help an individual learn a new job and maintain employment. The job coach will spend time with the individual at their place of employment during the training stage. After the individual is trained and feels comfortable at the job site, the job coach fades his/her presence but checks in frequently with the person to make sure everything is going well.

Office Locations

The Department of Vocational Rehabilitation has 5 Office Locations in Delaware.

Delaware POW&R Program POW&R, which is funded by the Delaware Division of Developmental Disabilities, the Division of Vocational Rehabilitation, and Autism Delaware, is a unique community-based program, with full-time staff members dedicated to helping adults with autism spectrum disorders find and be successful at employment, volunteer activities and recreation.

POW&R staff members assist adults with autism and their families to create a plan and budget based on individual choices -- this includes transition planning. Services are provided wherever the person chooses to reside, socialize, recreate, or work.

Eligibility is based on the following criteria:

• Applicant is at least 18 years of age and has an autism spectrum disorder.
  
• Funding is available to provide a significant service.
  
• Funding may be either public or private.
  
• Determination that POW&R can provide a service that meets and supports the applicant’s goals safely and effectively in the community.
  
• Following completion of admissions requirements, a letter of acceptance has been offered to the applicant by Autism Delaware/POW&R.
  

This is a collaborative program with families to find community resources to make sure that participant preferences can be obtained. This includes finding jobs, volunteer opportunities, etc. Admission decisions are made by a committee of Autism Delaware and POW&R. To apply, go to the Autism Delaware/POW&R website at Autism Delaware.

Waivers for Employment and Employment Related Services

In September 2011 the Centers for Medicaid and Medicare Services released a bulletin which is intended to provide guidance on waiver supports available to increase employment opportunities for individuals with disabilities. Each state has the flexibility to design its own service definitions and modify CMS core service definitions, although many rely on CMS language for their waiver core service definitions. These new guidelines cover the following:

• Highlights the importance of competitive work for people with and without disabilities and CMS’s goal to promote integrated employment options through the waiver program
• Acknowledges best and promising practices in employment support, including self direction and peer support options for employment support
• Clarifies that Ticket to Work Outcome and Milestone payments are not in conflict with payment for Medicaid services rendered because both Ticket to Work and Milestone payments are made for an outcome, not service delivery
• Adds a new core service definition- by splitting what had previously been supported employment into two definitions- individual and small group supported employment
• Includes a new service definition for career planning, that may be separate or rolled into the other employment related service definitions
• Emphasizes the critical role of person centered planning in achieving employment outcomes
• Modifies both the prevocational services and supported employment definitions to clarify that volunteer work and other activities that are not paid, integrated community employment are appropriately described in pre-vocational, not supported employment services
• Explains that pre-vocational services are not an end point, but a time limited (although no specific limit is given) service for the purpose of helping someone obtain competitive employment

Click here to read the bulletin.

For more information on services covered see the following: Waiver Funded Services for Transitioning to Work

Resources

Transition to Work Resources

Transition to Work Providers

References

The Current State of Services for Adults with Autism (2009). Gerhardt (Ed.)  Organization for Autism Research. 

Transition to Adult Living in Pennsylvania (2010). Pennsylvania Department of Health. 

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