Vocational rehabilitation experiences of transition-age youth with autism spectrum disorder across states: Prioritizing modifiable factors for research

Abstract

BACKGROUND: Tremendous state-level variation exists in the Vocational Rehabilitation (VR) service experiences of transition-age youth with autism spectrum disorder (TAY-ASD). Individual-level factors alone have not adequately explained differences in VR service utilization and employment outcomes for these youth, and the socio-demographic and economic state-level factors examined to date are largely non-modifiable. OBJECTIVE: This study aimed to identify and prioritize modifiable state-level policies and practices that may affect VR service utilization and outcomes of TAY-ASD. METHODS: We used a modified, two-round Delphi approach with 12 subject matter experts within this mixed methods study. RESULTS: Twenty-three factors of VR service use and outcomes were rated in the top half of importance scores – most of which were also in the top half of modifiability scores. These factors were organized into five themes regarding capacity, efficient and effective VR processes, innovation, inter-agency efforts, and staff training and competency. All participants agreed that these themes captured the main types of factors that might be driving state-level variability in VR outcomes. CONCLUSIONS: This study identified key themes and modifiable factors for investigation within next-step research. Studying these themes and factors may enable researchers to learn from what is working in some states to enhance employment outcomes for TAY-ASD.

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