New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 5: Living in the community
Part 5
common, as is ‘under-employment’, or working
below one’s skills level 25 26 262 347 362 363 . A systematic
review of outcomes in adult life of more able
people with ASD concluded that few specialist
support systems existed for adults with ASD,
and that most individuals relied heavily on
the support of their families in finding jobs 352 .
Anecdotal evidence suggests that this conclusion
is applicable to New Zealand. Furthermore,
research into, and systematic reviews of,
the employment options and experiences of
people with an intellectual disability (many
of whom may also have ASD) found similarly
disappointing results and unsatisfactory
experiences 350 .
To become a worker is a normal life goal. For
a person with ASD, whatever their ability
level, becoming a worker is more likely to be
achieved with careful attention to preparation
and planning 262 346 347 349 352 362-367 (Recommendations
5.1.2 and 5.1.8). The support needs of people with
disabilities, including ASD, fall into six broad
areas: assistance in finding a job (recruitment),
learning how to do the job, obtaining assistance
with completing the job, addressing work-related
issues, addressing non-work-related issues and
transportation 368 (Recommendation 5.1.9). People
with an intellectual disability who receive
relevant work experience as part of their schoolbased
transition planning are more likely to
maintain competitive jobs 350 . However research
suggests that the responsibility for ‘making it
work’ in an employment setting tends to rest on
the person with ASD, rather than the employer 369 .
While advice especially designed for use by
people with ASD exists 347 , strategies are typically
targeted towards specialist employment services
for people with ASD 349 362-364 368 370 .
Positive work outcomes (eg, increased chances
of finding work, maintaining work and having
good working relationships) for people
with ASD (including those with co-morbid
intellectual disability) are more likely when
specialist employment services are involved 349
350 365-368 371
(Recommendation 5.1.10). Involvement
of specialist employment services has also been
associated with improved attitudes of employers
towards people with ASD, in that they are
more likely to rate the employee’s effectiveness
at their job, rather than their ability to work
in an established way and to adapt to the
organisation, and more likely to be willing to be
supportive and adapt circumstances to suit the
person concerned 369 .
Features of best practice identified in a review
of intellectual disability and ASD supported
employment literature 349 include:
• individuals controlling their own vocational
destinies through self-determination,
facilitated by person-centred planning, and a
career-based approach
• employment specialists acting as facilitators,
not experts
• taking account of employers’ as well as
individuals’ needs
• using ‘natural supports’ and supplementing
jobs in ways that are ‘typical’ for each setting
• using intentional strategies to enhance social
integration
• supporting self-employment
• post or follow-up support
• ensuring that people with severe disabilities
can access supported employment
• quality outcomes result when services adopt
a principles- and values-led approach to
supported employment 349 (Recommendation
5.1.11).
Additional strategies recommended for use by
specialist employment services are:
• careful vocational assessment and job
matching
• use of case management and job coaching
• clear explanation of duties, responsibilities,
expectations and rules ahead of time
• undertaking task analysis (breaking complex
tasks down into small logical components)
to develop written and/or pictorial prompts
and instructions
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New Zealand Autism Spectrum Disorder Guideline