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UNITED STATES DEPARTMENT OF LABOR

Competitive employment for youth with autism spectrum disorders: Early results from a randomized clinical trial (Wehman et al., 2014)

Review Guidelines

Causal Evidence Guidelines

Absence of conflict of interest.

Citation

Wehman, P. H., Schall, C. M., McDonough, J., Kregel, J., Brooke, V., Molinelli, A., Ham, W., Graham, C. W., Riehle, J. E., Collins, H. T., & Thiss, W. (2014). Competitive employment for youth with autism spectrum disorders: Early results from a randomized clinical trial. Journal of Autism and Developmental Disorders, 44(3), 487-500. https://doi.org/10.1007/s10803-013-1892-x

Highlights

  • The study's objective was to examine the impact of Project SEARCH plus Autism Spectrum Disorder (ASD) Supports on employment outcomes. 
  • The study was a randomized controlled trial. Using interview data, the authors conducted statistical tests to compare the outcomes of treatment and control group members at the end of the school year and at one year after study enrollment. 
  • The study found that Project SEARCH plus ASD Supports was significantly associated with higher rates of employment.   
  • This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to Project SEARCH plus ASD Supports; other factors are likely to have contributed. 

Intervention Examined

Project SEARCH plus Autism Spectrum Disorder Supports (PS+ASD)

Features of the Intervention

Project SEARCH was a transition-to-work internship program that applied a supported employment approach to help young adults with developmental disabilities gain vocational skills. Project SEARCH was not originally designed to support individuals with ASD. Project SEARCH plus ASD Supports provided customized supports to address common ASD-related barriers to employment, such as instruction at the internship sites using applied behavior analysis, an autism/behavioral specialist to provide support and consultation at the internship sites, and staff training related to Project SEARCH plus ASD Supports. The program provided participants with three 10- to 12-week unpaid internships during the final year of high school based on their goals and vocational assessments. In addition to working at the business, students learned about social communication behaviors, job skills, and received support from job coaches and instructional assistants. 

Features of the Study

The study used a randomized controlled trial to examine the impact of Project SEARCH plus ASD Supports on employment outcomes after high school. The study was conducted in two Virginia public special education programs.  Eligible participants were high school students in their last year of high school, who were at least 18 years old, had a diagnosis and/or educational eligibility of ASD, and were determined to have an appropriate level of independence and support needs for the program. Of the 44 eligible students, the authors randomly assigned 24 to the treatment group and 20 to the control group. Participants in the treatment group spent their final year of high school participating in Project SEARCH plus ASD Supports. Participants in the control group received services and support as outlined in their Individualized Education Plans.  

The analysis sample consisted of 24 students in the treatment group and 20 students in the control group. The treatment group was primarily male (75%), had higher proportions of White (58%) and African American students (42%), with an average age of 19.96 years. The largest proportion of the treatment sample had an autism diagnosis (63%), followed by Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS; 25%). The control group was primarily male (68%), had equal proportions of White (47%) and African American students (47%), with an average age of 19.13 years. The majority of the treatment sample had an autism diagnosis (81%). The authors collected data using interviews at three time points: at baseline, at the end of the school year, and one year after study enrollment. The authors used statistical tests to compare employment outcomes between treatment and control group members. 

Findings

Employment

  • The study found a significant relationship between Project SEARCH plus ASD Supports and higher employment rates at the end of the school year and one year after study enrollment. 

Considerations for Interpreting the Findings

Although the study was a randomized controlled trial, the study had high attrition. The authors noted that the baseline composition of the treatment and comparison groups significantly varied by age. However, the authors did not control for this variable in the analysis. This preexisting difference between the groups—and not Project SEARCH plus ASD Supports—could explain the observed differences in outcomes. 

Causal Evidence Rating

The quality of causal evidence presented in this report is low because it was based on an RCT with high attrition, and the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to Project SEARCH plus ASD Supports; other factors are likely to have contributed.  

Reviewed by CLEAR

March 2024

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