Supported employment improves cognitive performance in adults with Autism.

Garcia-Villamisar D & C Hughes.

Journal of Intellectual Disability Research. 2007; 51 (Part 2): 142-150.

Question: Did taking part in a supported employment program improve the thinking, planning, and memory skills of people with autism and low educational attainment?

Background: People with autism have talents and skills but also have deficits in attention, memory, and planning and decision-making skills. These difficulties hinder their ability to obtain and hold jobs that are in keeping with their intelligence and talents. As well, many people with autism who have limited education could be employed if efforts were made to help them find and keep jobs. Finding the right “fit” for people with autism could provide them with economic security and the dignity inherent in making their own contribution in the world. Job support programs have been found to be helpful in this process (see Howlin).

Design: Pre-post study with wait list control.

Setting: A community in Spain.

Participants: In this study, the participants were 44 adults with autism and low level educational attainment who were assigned a job coach from a supported employment scheme. They were placed in mainly service sector or agricultural jobs in their community and were paid standard trainee wages. The average length of stay in the program was 30 months. A wait list control group took part in other vocational activities.

Intervention: Jobs in food service, retail outlets, gardening, an industrial laundry, and farm work were found for adults with autism and low educational achievement. Each worker as assigned a job coach who helped them learn skills necessary to hold down a job.

Main Outcome Measures: Various tests of memory, planning, decision-making, and attention.

Main Results: Those who had attended the supported employment program showed significantly better performance on more than half of the tests of learning ability, particularly those related to planning and decision-making (executive function). The wait list group showed no improvement in cognitive ability over the study period.

Conclusions: Participants in a supported employment scheme made greater improvements on measures of general intelligence and planning and decision-making compared to a wait list control group. The wait list group did not show any improvements in these skills over time.