Predictors of Employment Status Among Adults With Autism Spectrum Disorder

PURPOSE: In the United States, adults with autism spectrum disorder (ASD) experience high rates of unemployment in relation to adults with other disabilities (Shattuck et al., 2012) and the general population. Underemployment in this population is also common and characterized by poor wages, part-time hours, and low-level jobs that are often mismatched with employee qualifications. Despite the challenges associated with employment and the known benefits of work (e.g., better quality of life), only a small body of literature has examined the employment experiences and the predictors of employment status (employed vs. unemployed) in the ASD population. The purpose of this study was to examine the employment characteristics and histories of both employed and unemployed adults with ASD and the factors that contributed to their employment status. This study added to the existing literature by examining new variables hypothesized to affect employment status (e.g., disability disclosure, work imbalance) and by including a standardized measure of perceived job imbalance (Short Effort–Reward Imbalance [ERI] Questionnaire; Siegrist, Li, & Montano, 2013).

In 2011, the American Occupational Therapy Association (AOTA) identified working with adults with ASD as an emerging niche area of occupational therapy practice. Because the occupation of work is a primary aspiration for many adults with ASD, occupational therapists have a key role to play in both pre-employment skills training and on-the-job support schemes. To better understand how to assist adults with ASD throughout the employment process, this study provides occupational therapists with a greater understanding of factors that impact employment status.

DESIGN: This cross-sectional study used an online survey, the ASD Employment Questionnaire (ASDEQ), to collect data on both employed and unemployed adults with ASD living in the United States. Participants were recruited from agencies serving adults listed in the Autism Speaks Resource Guide. The research advertisement specified the inclusion criteria for the study: age 18 yr or older and previous diagnosis with Asperger disorder.

METHOD: The author, an assistant professor of public health, and four occupational therapy students developed the ASDEQ and piloted it prior to use. The ASDEQ contains three sections: Participant Characteristics, Employment Characteristics, and Employment History. The Short ERI Scale was also included in the online survey. Independent t tests and chi-square tests were used to examine differences between employed and unemployed participants. Multivariate logistic regression analyses were used to examine predictors of employment status.

RESULTS: Of the 254 adults with ASD who participated in this study, 61.42% were employed and 38.58% were unemployed at the time of survey completion. Over half of the participants reported job imbalance on the Short ERI Scale, and the vast majority did not receive any job assistance from a support professional (77.56%). Participants who disclosed their ASD diagnosis to their employer were more than three times as likely to be employed than those who did not disclose. Education level was also a significant predictor of employment status.

CONCLUSION: In this study, disability disclosure was a strong indicator of employment status. Further studies examining the processes and outcomes of disability disclosure in the ASD population are warranted. Although this study is not fully generalizable, it is recommended that occupational therapists review the potential benefits and risks of disclosure with their clients during employment-related interventions.

References

Siegrist, J., Li, J., & Montano, D. (2013). Psychometric properties of the Effort–Reward Imbalance Questionnaire. Department of Medical Sociology, Faculty of Medicine, Düsseldorf University, Germany. Retrieved from http://www.uniklinik-duesseldorf.de/fileadmin/Datenpool/einrichtungen/institut_fuer_medizinische_soziologie_id54/ERI/PsychometricProperties.pdf

Shattuck, P. T. Narendorf, S. C., Cooper, B., Sterzing, P. R., Wagner, M., & Taylor, J. L. (2012). Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics, 129, 1042–1049. https://doi.org/10.1542/peds.2011-2864