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Davies J, Romualdez AM, Malyan D, Heasman B, Livesey A, Walker A, Pellicano E, Remington A. Autistic Adults' Priorities for Future Autism Employment Research: Perspectives from the United Kingdom. AUTISM IN ADULTHOOD 2024; 6:72-85. [PMID: 38435326 PMCID: PMC10902279 DOI: 10.1089/aut.2022.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background A growing body of research has sought to understand autistic people's research priorities. Several of these studies have identified employment as a key research priority. Yet, there have been a few attempts to identify specific, actionable priorities within this area. Methods Using an online survey, we asked 197 autistic people in the United Kingdom about their priorities for future autism-employment research. Results Participants spoke of their challenges in gaining and sustaining meaningful employment and called for researchers to conduct research that results in direct improvements to employment experiences. Regarding their research priorities, participants indicated a need for research covering all aspects of the employment lifecycle from accessing employment to transitioning out of employment. Importantly, participants also discussed how such research should be conducted: with autistic people as co-researchers and ensuring a diverse range of autistic people are listened to. Conclusion While much existing autism-employment research appears to align with the priorities outlined in this study, seemingly minimal attention has been paid to later stages of the work lifecycle (e.g., progressing into more senior job roles or transitioning out of work). By identifying disparities between autistic people's priorities and the research being conducted, we can support autistic people to drive the research agenda and ensure autism-employment research positively impacts the community it aims to serve.
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Affiliation(s)
- Jade Davies
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Anna Melissa Romualdez
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Danae Malyan
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Brett Heasman
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Adam Livesey
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Amy Walker
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
- Neurodiversity Works, London, United Kingdom
| | - Elizabeth Pellicano
- Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Anna Remington
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
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2
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Espelöer J, Proft J, Falter-Wagner CM, Vogeley K. Alarmingly large unemployment gap despite of above-average education in adults with ASD without intellectual disability in Germany: a cross-sectional study. Eur Arch Psychiatry Clin Neurosci 2022; 273:731-738. [PMID: 35567615 PMCID: PMC10085916 DOI: 10.1007/s00406-022-01424-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/22/2022] [Indexed: 12/28/2022]
Abstract
For individuals with autism spectrum disorder (ASD), both getting access to as well as staying in the labor market are very challenging. However, the detailed educational, vocational, and employment characteristics of persons with ASD without intellectual disabilities are not yet studied. We conducted a retrospective study on a sample of 232 clinically late-diagnosed adults with ASD without intellectual disabilities. Data were compared to the general German population obtained from the public database of the German Federal Employment Agency. Results showed that the majority of persons with ASD graduated from high school and obtained a university entrance qualification (ASD: 50.4%; general population: 32.5%). Also, lower rates of basic secondary education were found in the ASD sample (ASD: 16.5%, general population: 29.6%). Significantly less individuals with ASD completed vocational training (40.1%) in comparison to the German population (56.3%). Despite the above-average level of education, the unemployment rate of the sample substantially exceeds that of the general population by the factor 5 (ASD: 25.2%; general population: 5.2%). Periods of unwanted unemployment of persons with ASD lasted on average 23 months with interpersonal problems being the main reason for contract termination. A higher level of educational qualification does not protect against a higher risk of unemployment for individuals with ASD presumably due to autism-specific interpersonal difficulties. Data emphasize the necessity to develop and spread both specific employment support activities for individuals with ASD as well as adequate awareness raising strategies. Funded by a public grant of the "Landschaftsverband Rheinland (LVR)".
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Affiliation(s)
- Julia Espelöer
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany.
| | - Julia Proft
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
| | | | - Kai Vogeley
- Department of Psychiatry, University Hospital Cologne, Kerpener Strasse 62, 50924, Cologne, Germany
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3
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How Well Environmental Design Is and Can Be Suited to People with Autism Spectrum Disorder (ASD): A Natural Language Processing Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095037. [PMID: 35564436 PMCID: PMC9103321 DOI: 10.3390/ijerph19095037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 12/04/2022]
Abstract
The quality of life of people diagnosed as having Autistic Spectrum Disorder (ASD) is essential for increasing their self-reliance and reducing their communication problems in order to allow them to work, take care of themselves, and develop a capacity to intercommunicate with their surroundings. Their need to organize their day-to-day and workplace surroundings has been addressed in the literature via long-term intervention programs aimed to imbue people with ASD with interpersonal communication capabilities. Yet, there is still a gap in the literature regarding new design methods aimed at creating a safe and friendly environment adapted to the needs of people with ASD. Therefore, this study has two objectives: (1) to shed light on the existing factors and methods related to workplaces designed to be friendly to people with ASD, specifically adults, through a natural language processing (NLP) analysis of existing scientific papers in the field of architecture and design; and (2) to explore the factors that might assist in improving the design and architecture of adaptive spaces for people with ASD by analyzing a corpus of experts' documents. The study findings and their implications are analyzed and discussed.
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4
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Daedelow LS, Beck A, Romund L, Mascarell-Maricic L, Dziobek I, Romanczuk-Seiferth N, Wüstenberg T, Heinz A. Neural correlates of RDoC-specific cognitive processes in a high-functional autistic patient: a statistically validated case report. J Neural Transm (Vienna) 2021; 128:845-859. [PMID: 34003357 PMCID: PMC8205905 DOI: 10.1007/s00702-021-02352-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/08/2021] [Indexed: 11/29/2022]
Abstract
The level of functioning of individuals with autism spectrum disorder (ASD) varies widely. To better understand the neurobiological mechanism associated with high-functioning ASD, we studied the rare case of a female patient with an exceptional professional career in the highly competitive academic field of Mathematics. According to the Research Domain Criteria (RDoC) approach, which proposes to describe the basic dimensions of functioning by integrating different levels of information, we conducted four fMRI experiments targeting the (1) social processes domain (Theory of mind (ToM) and face matching), (2) positive valence domain (reward processing), and (3) cognitive domain (N-back). Patient’s data were compared to data of 14 healthy controls (HC). Additionally, we assessed the subjective experience of our case during the experiments. The patient showed increased response times during face matching and achieved a higher total gain in the Reward task, whereas her performance in N-back and ToM was similar to HC. Her brain function differed mainly in the positive valence and cognitive domains. During reward processing, she showed reduced activity in a left-hemispheric frontal network and cortical midline structures but increased connectivity within this network. During the working memory task patients’ brain activity and connectivity in left-hemispheric temporo-frontal regions were elevated. In the ToM task, activity in posterior cingulate cortex and temporo-parietal junction was reduced. We suggest that the high level of functioning in our patient is rather related to the effects in brain connectivity than to local cortical information processing and that subjective report provides a fruitful framework for interpretation.
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Affiliation(s)
- Laura S Daedelow
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Anne Beck
- Health and Medical University Potsdam, Potsdam, Germany
| | - Lydia Romund
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lea Mascarell-Maricic
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Berlin, Germany.,Department of Psychology, Humboldt-University of Berlin, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany. .,Department of Clinical Psychology and Psychotherapy, Psychological Institute, Ruprecht-Karls-University Heidelberg, Hauptstr. 47-51, 69117, Heidelberg, Germany.
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
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5
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How Do Adults with Autism Spectrum Disorder Participate in the Labor Market? A German Multi-center Survey. J Autism Dev Disord 2021; 52:1066-1076. [PMID: 33864556 PMCID: PMC8854283 DOI: 10.1007/s10803-021-05008-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 12/03/2022]
Abstract
International studies show disadvantages for adults with autism spectrum disorder (ASD) in the labor market. Data about their participation in the German labor market are scarce. The aim of this study was to examine the integration of adults with ASD in the German labor market in terms of education, employment and type of occupation by means of a cross-sectional-study, using a postal questionnaire. Findings show above average levels of education for adults with ASD compared to the general population of Germany and simultaneously, below average rates of employment and high rates of financial dependency. That indicates a poor integration of adults with ASD in the German labor market and emphasizes the need for vocational support policies for adults with ASD.
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Health Services Use and Costs in Individuals with Autism Spectrum Disorder in Germany: Results from a Survey in ASD Outpatient Clinics. J Autism Dev Disord 2021; 52:540-552. [PMID: 33728496 PMCID: PMC8813793 DOI: 10.1007/s10803-021-04955-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 11/18/2022]
Abstract
Autism spectrum disorders (ASD) are associated with high services use, but European data on costs are scarce. Utilisation and annual costs of 385 individuals with ASD (aged 4–67 years; 18.2% females; 37.4% IQ < 85) from German outpatient clinics were assessed. Average annual costs per person were 3287 EUR, with psychiatric inpatient care (19.8%), pharmacotherapy (11.1%), and occupational therapy (11.1%) being the largest cost components. Females incurred higher costs than males (4864 EUR vs. 2936 EUR). In a regression model, female sex (Cost Ratio: 1.65), lower IQ (1.90), and Asperger syndrome (1.54) were associated with higher costs. In conclusion, ASD-related health costs are comparable to those of schizophrenia, thus underlining its public health relevance. Higher costs in females demand further research.
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Scott M, Falkmer M, Kuzminski R, Falkmer T, Girdler S. Process evaluation of an autism-specific workplace tool for employers. Scand J Occup Ther 2020; 29:686-698. [PMID: 32955966 DOI: 10.1080/11038128.2020.1820571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Limited studies exist exploring employers' capacity in hiring and supporting employees on the autism spectrum, and even fewer have considered interventions targeting employers' skills and knowledge in enhancing employment opportunities. In response to this need, the Integrated Employment Success Tool (IESTTM) was developed and its effectiveness established in a randomized controlled trial (RCT). Furthermore, a process evaluation was conducted to determine the usability and implementation of the IESTTM. AIMS/OBJECTIVES The process evaluation was conducted to determine employers' perceived usability, implementation, and perceived barriers and facilitators in using the IESTTM. MATERIAL AND METHODS Employers (N = 29) provided their feedback via an online questionnaire. Of these, 11 participants were interviewed, further exploring their experiences. Data were analysed via descriptive statistics and thematic analysis. RESULTS While employers' frequency and usage of the IESTTM varied across workplaces, it was predominantly used to increase employers' knowledge of autism and implement workplace strategies. A major barrier was the paper-based format of the intervention, with more than 60% of employers indicating the need for an online version. CONCLUSIONS AND SIGNIFICANCE The process evaluation was a critical step in understanding why the IESTTM was effective, and how it could be further optimized for prospective employers.
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Affiliation(s)
- Melissa Scott
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Marita Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia.,School of Education and Communication, CHILD programme, Institute of Disability Research, Jönköping University, Jönköping, Sweden
| | - Rebecca Kuzminski
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Torbjörn Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia.,Rehabilitation Medicine, Department of Medicine and Health Science (IMH), Linköping University, Linköping, Sweden
| | - Sonya Girdler
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
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8
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Lallukka T, Mittendorfer-Rutz E, Ervasti J, Alexanderson K, Virtanen M. Unemployment Trajectories and the Early Risk of Disability Pension among Young People with and without Autism Spectrum Disorder: A Nationwide Study in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072486. [PMID: 32260520 PMCID: PMC7177271 DOI: 10.3390/ijerph17072486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/02/2020] [Indexed: 12/20/2022]
Abstract
Depression and anxiety are associated with unemployment and disability pension, while autism spectrum disorder (ASD) is less studied. We aimed to first identify unemployment trajectories among young adults with and without ASD, and then to examine their social determinants. Finally, we used the trajectories as determinants for subsequent disability pension. We used a population-based cohort, including 814 people who were 19–35 years old, not on disability pension, and who had their ASD diagnosis between 2001 and 2009. A matched reference population included 22,013 people with no record of mental disorders. Unemployment follow-up was the inclusion year and four years after. Disability pension follow-up started after the unemployment follow-up and continued through 2013. We identified three distinctive trajectories of unemployment during the follow-up: (1) low, then sharply increasing (9%,) (2) low (reference, 67%), and (3) high then slowly decreasing (24%). People with ASD had higher odds of belonging belong to the trajectory groups 1 (OR 2.53, 95% CI 2.02–3.18) and 3 (OR 3.60, 95% CI 3.08–4.19). However, the mean number of unemployment days was relatively low in all groups. A disability pension was a rare event in the cohort, although memberships to groups 1 and 3 were associated with the risk of a future disability pension. More knowledge is needed about factors facilitating participation in paid employment among people with ASD.
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Affiliation(s)
- Tea Lallukka
- Department of Public Health, University of Helsinki, P.O.B. 20, 00014 Helsinki, Finland
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (E.M.-R.); (K.A.); (M.V.)
- Finnish Institute of Occupational Health, Work Ability and Working Careers, P.O.B. 18, 00032 Helsinki, Finland;
- Correspondence:
| | - Ellenor Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (E.M.-R.); (K.A.); (M.V.)
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Work Ability and Working Careers, P.O.B. 18, 00032 Helsinki, Finland;
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (E.M.-R.); (K.A.); (M.V.)
| | - Marianna Virtanen
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (E.M.-R.); (K.A.); (M.V.)
- School of Educational Sciences and Psychology, University of Eastern Finland, P.O.B. 111, 80101 Joensuu, Finland
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Drimalla H, Scheffer T, Landwehr N, Baskow I, Roepke S, Behnia B, Dziobek I. Towards the automatic detection of social biomarkers in autism spectrum disorder: introducing the simulated interaction task (SIT). NPJ Digit Med 2020; 3:25. [PMID: 32140568 PMCID: PMC7048784 DOI: 10.1038/s41746-020-0227-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/17/2020] [Indexed: 12/28/2022] Open
Abstract
Social interaction deficits are evident in many psychiatric conditions and specifically in autism spectrum disorder (ASD), but hard to assess objectively. We present a digital tool to automatically quantify biomarkers of social interaction deficits: the simulated interaction task (SIT), which entails a standardized 7-min simulated dialog via video and the automated analysis of facial expressions, gaze behavior, and voice characteristics. In a study with 37 adults with ASD without intellectual disability and 43 healthy controls, we show the potential of the tool as a diagnostic instrument and for better description of ASD-associated social phenotypes. Using machine-learning tools, we detected individuals with ASD with an accuracy of 73%, sensitivity of 67%, and specificity of 79%, based on their facial expressions and vocal characteristics alone. Especially reduced social smiling and facial mimicry as well as a higher voice fundamental frequency and harmony-to-noise-ratio were characteristic for individuals with ASD. The time-effective and cost-effective computer-based analysis outperformed a majority vote and performed equal to clinical expert ratings.
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Affiliation(s)
- Hanna Drimalla
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Prof.-Dr.-Helmert-Str. 2-3, 14482 Potsdam, Germany
| | - Tobias Scheffer
- Institute of Computer Science, University of Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
| | - Niels Landwehr
- Institute of Computer Science, University of Potsdam, Am Neuen Palais 10, 14469 Potsdam, Germany
- Leibniz Institute for Agricultural Engineering and Bioeconomy, Max-Eyth-Allee 100, 14469 Potsdam, Germany
| | - Irina Baskow
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Stefan Roepke
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Behnoush Behnia
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Isabel Dziobek
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
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10
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Goldfarb Y, Gal E, Golan O. A Conflict of Interests: A Motivational Perspective on Special Interests and Employment Success of Adults with ASD. J Autism Dev Disord 2019; 49:3915-3923. [PMID: 31177369 DOI: 10.1007/s10803-019-04098-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A course of action often suggested in an attempt to improve employment outcomes of adults with autism spectrum disorder, is to match between special interests and job opportunities. In this commentary, we propose that the match may be more complicated than it seems, possibly overseeing more pressing employment needs that should be answered such as: the job's characteristics, labor market demands, and stress resulting from job expectations. Self determination theory of motivation is suggested as a lens through which the association between special interests and a paying job can be examined, highlighting important considerations that hold the potential to increase employment success. Recommendations for new research directions and vocational rehabilitation practice are discussed.
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Affiliation(s)
- Yael Goldfarb
- Department of Occupational Therapy, University of Haifa, Haifa, Israel.
| | - Eynat Gal
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Ofer Golan
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
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11
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Lipinski S, Blanke ES, Suenkel U, Dziobek I. Outpatient Psychotherapy for Adults with High-Functioning Autism Spectrum Condition: Utilization, Treatment Satisfaction, and Preferred Modifications. J Autism Dev Disord 2019; 49:1154-1168. [PMID: 30415320 DOI: 10.1007/s10803-018-3797-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Many adults with autism spectrum condition (ASC) desire outpatient psychotherapy (PT). This study compared reasons for seeking PT, experiences with PT, and modifications preferred with respect to PT of individuals with ASC to non-autistic individuals with depression (MDD). Furthermore, factors predictive for treatment satisfaction were identified in individuals with ASC. A total of 262 adults with ASC without intellectual impairment and 304 non-autistic controls with MDD were surveyed. In this pilot study both groups predominantly sought treatment for depressiveness. A low level of expertise with autism was the main reason for being declined by therapists and a contributing factor to the overall treatment dissatisfaction of patients with ASC. ASC patients desire adjustments such as written communication, and clearly structured sessions.
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Affiliation(s)
- Silke Lipinski
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany.
| | - Elisabeth S Blanke
- Lebenswissenschaftliche Fakultät, Institut für Psychologie, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Ulrike Suenkel
- Hertie Institute for Clinical Brain Research (HIH), Center of Neurology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
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12
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Vincent A, Da Fonseca D, Baumstarck K, Charvin I, Alcaraz-Mor R, Lehucher-Michel MP. The quality of life and the future of young adults with Asperger syndrome. Disabil Rehabil 2019; 42:1987-1994. [PMID: 30669888 DOI: 10.1080/09638288.2018.1544297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This pilot study describes the socio-professional development and quality of life of young adults with Asperger syndrome in France.Methods: Those young adults, between 18 and 30 years old, receiving care in a child psychiatry department for autistic spectrum disorder, were requested to respond to the Ad Hoc, World Health Organization Quality Of Life - Bref and Copenhagen psychosocial questionnaires regarding their socio-professional background and feelings about their future.Results: Of the 79 eligible subjects, 24 were selected to participate in our study. Their average age at the time of the pilot study was 22.2 years (standard deviation 3.4 years), and their average age when they were diagnosed was 17.5 years (standard deviation 3.7 years.). There were 54% who reported a psychiatric comorbidity anxiety disorder. Half stated they had completed secondary school and benefitted from being professionally employed. During this study, only six were employed, while the others remained financially dependent on their parents. The group's quality of life self-assessment scores were significantly lower compared to the French general population in overall psychology (43.6 versus 68.7) and social relationships (48.9 versus 76.5). However, the study's participants perceived work as an important means to their personal development. Hence, in order to cope with their difficulties, they hoped to benefit from customized support adapted to their autistic disorder and for their workplace colleagues to be better informed about Asperger syndrome.Conclusions: Our results are in line with international data. Additional studies need to be done in order to determine socio-professional integration factors and, in particular, the integration of potential contributions by occupational health departments with those social and medical teams supporting these young adults.Implications for rehabilitationYoung adults with Asperger syndrome benefit from the support of their family in determining their professional goals.Support may be required to enhance social and communicative abilities to help integration.Employees would benefit from information on the syndrome and how best to support.
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Affiliation(s)
- Alix Vincent
- Department of Medicine and Occupational Health, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - David Da Fonseca
- Adolescent Psychiatry Service, Assistance Publique Hopitaux de Marseille, Marseille, France.,University Pole of Psychiatry, Marseille, France
| | - Karine Baumstarck
- Aix-Marseille Univ, Timone Hospital, Medicine and Occupational Health Department, Marseille, France
| | - Isabelle Charvin
- Adolescent Psychiatry Service, Assistance Publique Hopitaux de Marseille, Marseille, France
| | - Rafael Alcaraz-Mor
- Department of Medicine and Occupational Health, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix-Marseille Univ, Timone Hospital, Medicine and Occupational Health Department, Marseille, France
| | - Marie-Pascale Lehucher-Michel
- Department of Medicine and Occupational Health, Assistance Publique Hopitaux de Marseille, Marseille, France.,Aix-Marseille Univ, Timone Hospital, Medicine and Occupational Health Department, Marseille, France
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13
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Principles for Successful Employment Integration of People with HF-ASD. AUTISM IN ADULTHOOD 2019. [DOI: 10.1007/978-3-030-28833-4_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Scott M, Milbourn B, Falkmer M, Black M, Bӧlte S, Halladay A, Lerner M, Taylor JL, Girdler S. Factors impacting employment for people with autism spectrum disorder: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:869-901. [DOI: 10.1177/1362361318787789] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study is to holistically synthesise the extent and range of literature relating to the employment of individuals with autism spectrum disorder. Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with autism spectrum disorder employed in competitive, supported or sheltered employment were included. Content analysis was used to identify the strengths and abilities in the workplace of employees with autism spectrum disorder. Finally, meaningful concepts relating to employment interventions were extracted and linked to the International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder. The search identified 134 studies for inclusion with methodological quality ranging from limited to strong. Of these studies, only 36 evaluated employment interventions that were coded and linked to the International Classification of Functioning, Disability and Health, primarily focusing on modifying autism spectrum disorder characteristics for improved job performance, with little consideration of the impact of contextual factors on work participation. The International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder are a useful tool in holistically examining the employment literature for individuals with autism spectrum disorder. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with autism spectrum disorder and the critical need for interventions which target contextual factors if employment outcomes are to be improved.
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Affiliation(s)
- Melissa Scott
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Marita Falkmer
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Jönköping University, Sweden
| | - Melissa Black
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Sven Bӧlte
- Karolinska Institutet, Sweden
- Stockholm County Council, Sweden
| | | | | | - Julie Lounds Taylor
- Vanderbilt Kennedy Centre, USA
- Vanderbilt University, USA
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, USA
| | - Sonya Girdler
- Curtin University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Work-Related Communication Barriers for Individuals with Autism: A Pilot Qualitative Study. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2018. [DOI: 10.1017/jrc.2018.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study identified situations where communication was a barrier to employment for adults with autism spectrum disorders (ASD). Informant interviewees were six college graduates with ASD who have been employed for one year. Following the qualitative inductive analysis, five communication-related themes emerged: (1) job interviewing success, (2) negotiating co-worker interactions, (3) supervisory interactions, instruction, and feedback, (4) handling customer intercommunication, and (5) communication-oriented coping strategies. Participants were relatively more successful in communication coping strategies and supervisory interaction compared to difficulties with job interviewing and co-worker interactions. Vocational rehabilitation counsellors assisting clients with ASD should prioritize job interview communication skills and social skill education specific to appropriate interactions with co-workers and supervisors utilizing role play, social skill training, and job coaching.
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Education and employment status of adults with autism spectrum disorders in Germany - a cross-sectional-survey. BMC Psychiatry 2018; 18:75. [PMID: 29580218 PMCID: PMC5870494 DOI: 10.1186/s12888-018-1645-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 03/02/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Adults with autism spectrum disorders (ASD) experience challenges in participating in the labour market and struggle to achieve and maintain appropriate professional positions, possibly due to impairments of communication and social interaction. Studies have shown high rates of unemployment as well as evidence of inadequate employment. As knowledge on the participation in the German labour market is scarce, the aim of our study was to examine employment status, type of occupation and inadequate employment in a sample of clinically mostly late-diagnosed and most likely not intellectually disabled adults with ASD in Germany. METHODS We conducted a cross-sectional-survey in clinically mostly late-diagnosed adults with ASD. Employment status, type of occupation, and the level of formal education and training were examined through a postal questionnaire. Inadequate employment regarding participants' current and longest practised occupation was assessed by transforming participants' information into skill levels of the "Classification of Occupations 2010" of the German Federal Employment Agency, and comparing these with participants' level of formal education and training. RESULTS The response rate was 43.2% (N = 185 of N = 428 potential participants). 94.6% were first-time diagnosed when being 18 years of age or older. 56.8% held a general university entrance-level qualification and 24.9% had obtained a Masters' or diploma degree as their highest vocational qualification. 94.1% had been employed at some time. Of these, 68.4% reported being currently employed, 13.5% being currently unemployed and 17.0% being retired for health reasons. Regarding the longest-practised and the current occupation, the highest proportion of participants was found in the occupational area "health and social sector, teaching and education" (22.4% and 23.3%, respectively). With respect to inadequate employment, 22.1% were found to be overeducated in relation to their longest-practised occupation and 31.3% in relation to their current occupation. This is significantly higher than the percentage of overeducation in the general population. CONCLUSIONS Despite largely high formal qualifications, the clinically mostly late-diagnosed adults with ASD represented in our sample are disadvantaged regarding their participation in the German labour market, especially with respect to rates of unemployment, early retirement and overeducation. Employment support programs should be developed to improve employment outcomes.
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17
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An Evaluation of a Social Skills Intervention for Adults with Autism Spectrum Disorder and Intellectual Disabilities preparing for Employment in Ireland: A Pilot Study. J Autism Dev Disord 2017; 48:1727-1741. [DOI: 10.1007/s10803-017-3441-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Building Employer Capacity to Support Meaningful Employment for Persons with Developmental Disabilities: A Grounded Theory Study of Employment Support Perspectives. J Autism Dev Disord 2017; 47:3510-3519. [DOI: 10.1007/s10803-017-3267-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Rashid M, Hodgetts S, Nicholas D. Building Employers’ Capacity to Support Vocational Opportunities for Adults with Developmental Disabilities. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0105-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Bachmann CJ, Gerste B, Hoffmann F. Diagnoses of autism spectrum disorders in Germany: Time trends in administrative prevalence and diagnostic stability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 22:283-290. [PMID: 29671642 DOI: 10.1177/1362361316673977] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
For Germany, no data on trends in autism spectrum disorder diagnoses are available. The primary aim of this study was to establish the time trends in the administrative prevalence of autism spectrum disorder diagnoses. The second aim was to assess the stability of autism spectrum disorder diagnoses over time. We analysed administrative outpatient data (2006-2012) from a nationwide health insurance fund and calculated the prevalence of autism spectrum disorder diagnoses for each year, stratified by age and sex. Additionally, we studied a cohort with a first-time diagnosis of autism spectrum disorder in 2007 through 2012, investigating the percentage of retained autism spectrum disorder diagnoses. From 2006 to 2012, the prevalence of autism spectrum disorder diagnoses in 0- to 24-year-olds increased from 0.22% to 0.38%. In insurees with a first-time autism spectrum disorder diagnosis in 2007, this diagnosis was carried on in all years through 2012 in 33.0% (The International Classification of Diseases, Tenth Revision diagnoses: F84.0/F84.1/F84.5) and 11.2% (F84.8/F84.9), respectively. In Germany, like in other countries, there has been an increase in the administrative prevalence of autism spectrum disorder diagnoses. Yet, prevalences are still lower than in some other Western countries. The marked percentage of autism spectrum disorder diagnoses which were not retained could indicate a significant portion of autism spectrum disorder misdiagnoses, which might contribute to rising autism spectrum disorder prevalences.
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Affiliation(s)
| | | | - Falk Hoffmann
- 3 Carl von Ossietzky University of Oldenburg, Germany
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21
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Hedley D, Uljarević M, Cameron L, Halder S, Richdale A, Dissanayake C. Employment programmes and interventions targeting adults with autism spectrum disorder: A systematic review of the literature. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:929-941. [DOI: 10.1177/1362361316661855] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Individuals with autism spectrum disorder face significant challenges entering the workforce; yet research in this area is limited and the issues are poorly understood. In this systematic review, empirical peer-reviewed studies on employment programmes, interventions and employment-related outcomes in individuals with autism spectrum disorder over 18 years with and without intellectual disability were identified and evaluated. The review was prefaced by a summary of previous systematic reviews in the area. Web of Science, Medline, PsychINFO, ERIC and Scopus databases were systematically searched through to October 2015. From 32,829 records identified in the initial search, 10 review and 50 empirical articles, comprising N = 58,134 individuals with autism spectrum disorder, were included in the review. Selected articles were organised into the following themes: employment experiences, employment as a primary outcome, development of workplace skills, non-employment-related outcomes, assessment instruments, employer-focused and economic impact. Empirical studies were limited by poor participant characterisation, small sample size and/or a lack of randomisation and use of appropriate controls. Poor conceptualisation and measurement of outcomes significantly limited study quality and interpretation. Future research will require a multidisciplinary and multifaceted approach to explore employment outcomes on the individual, the family system, co-workers and the employer, along with the impact of individual differences on outcome.
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Affiliation(s)
- Darren Hedley
- Olga Tennison Autism Research Centre, La Trobe University, Australia
| | - Mirko Uljarević
- Olga Tennison Autism Research Centre, La Trobe University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Lauren Cameron
- Olga Tennison Autism Research Centre, La Trobe University, Australia
| | | | - Amanda Richdale
- Olga Tennison Autism Research Centre, La Trobe University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Scott M, Falkmer M, Girdler S, Falkmer T. Viewpoints on Factors for Successful Employment for Adults with Autism Spectrum Disorder. PLoS One 2015; 10:e0139281. [PMID: 26462234 PMCID: PMC4603894 DOI: 10.1371/journal.pone.0139281] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/09/2015] [Indexed: 12/04/2022] Open
Abstract
This article explores the key factors for successful employment from the viewpoints of adults with autism spectrum disorder (ASD) and employers. Two groups of individuals participated in this study, 40 adults with ASD and 35 employers. Q method was used to understand and contrast the viewpoints of the two groups. Data were analysed using by-person varimax rotation factor analysis. Results showed that although both groups appear committed to the employment process, the difference in their understanding regarding the type of workplace support required, job expectations and productivity requirements continues to hinder successful employment. These results highlight the need to facilitate communication between employees and employers to ensure a clear understanding of the needs of both groups are met. The use of an ASD-specific workplace tool may assist in facilitating the necessary communication between these two groups.
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Affiliation(s)
- Melissa Scott
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Marita Falkmer
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- School of Education and Communication, CHILD programme, Institute of Disability Research, Jönköping University, Jönköping, Jönköping County, Sweden
| | - Sonya Girdler
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Torbjörn Falkmer
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia
- Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
- Rehabilitation Medicine, Department of Medicine and Health Science (IMH), Faculty of Health Sciences, Linköping University, Linköping, Östergötland County, Sweden
- * E-mail:
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Neely BH, Hunter ST. In a Discussion on Invisible Disabilities, Let Us Not Lose Sight of Employees on the Autism Spectrum. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2015. [DOI: 10.1111/iops.12148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Trends in Employment for Individuals with Autism Spectrum Disorder: a Review of the Research Literature. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2014. [DOI: 10.1007/s40489-014-0041-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Koelkebeck K, Riedel A, Ohrmann P, Biscaldi M, Tebartz van Elst L. [High-functioning autism spectrum disorders in adulthood]. DER NERVENARZT 2014; 85:891-902. [PMID: 24969950 DOI: 10.1007/s00115-014-4050-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The prevalence of autism spectrum disorders in the general population is approximately 1 %. Some individuals with high-functioning autism graduate from regular schools without autism having been diagnosed and problems only occur when the demands for social competence increase. Then patients often present with secondary psychiatric symptoms, such as depression, anxiety or interpersonal problems. At this time, typical autistic features, such as social interaction deficits, restricted interests and stereotypic behavior can be camouflaged by high compensatory skills, particularly in highly intelligent patients. Therefore, missed or wrong diagnoses are frequent. Interviews, questionnaires and neuropsychological tests might be used to support the diagnosis. In cases where there is evidence for a secondary cause of autistic symptoms, somatic disorders should be excluded. Pharmacological treatment should be symptom-oriented. Individualized psychotherapeutic approaches are becoming increasingly more available; however, pragmatic solutions often need to be deployed.
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Affiliation(s)
- K Koelkebeck
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A9, 48149, Münster, Deutschland,
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Employment and Vocational Skills Among Individuals with Autism Spectrum Disorder: Predictors, Impact, and Interventions. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2014. [DOI: 10.1007/s40489-014-0024-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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27
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Kirchner JC, Dziobek I. Toward the Successful Employment of Adults with Autism: A First Analysis of Special Interests and Factors Deemed Important for Vocational Performance. Scand J Child Adolesc Psychiatr Psychol 2014. [DOI: 10.21307/sjcapp-2014-011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Schmitt A, Falkai P. Selected topics of the DGPPN Congress 2012. Eur Arch Psychiatry Clin Neurosci 2013; 263 Suppl 2:S121-2. [PMID: 24091602 DOI: 10.1007/s00406-013-0457-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Schmitt
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nußbaumstr. 7, 80336, Munich, Germany,
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