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The effect of business internships model and employment on enhancing the independence of young adults with significant impact from Autism (Schall et. al, 2020)

Absence of conflict of interest.

Citation

Schall, C., Sima, A. P., Avellone, L., Wehman, P., McDonough, J., & Brown, A. (2020). The effect of business internships model and employment on enhancing the independence of young adults with significant impact from Autism. Intellectual and Developmental Disabilities, 58(4), 301-313. https://doi.org/10.1352/1934-9556-58.4.301

Highlights

  • The study's objective was to examine the impact of Project SEARCH plus Autism Spectrum Disorder Supports (PS+ASD) on employment and health outcomes. 
  • The study was a randomized controlled trial. Using interview data, the authors compared the outcomes of treatment and control participants before and after they participated in the intervention. 
  • The study found that PS+ASD participants were significantly more likely to be employed at graduation and a year after graduation than control group participants. 
  • This study receives a moderate evidence rating. This means we are somewhat confident that the estimated effects are attributable to PS+ASD, but other factors might also have contributed. 

Intervention Examined

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

Features of the Intervention

Project SEARCH plus Autism Spectrum Disorders Supports (PS+ASD) was an alternative to high school, where participants attended 35 hours of community-based employment training (CBET) each week and had three internships. The internships would change every 10-12 weeks. The target population was adults (ages 18-21) who had a diagnosis or educational eligibility label of ASD; attended a local public school; were able to do self-care activities like eating, going to the bathroom, and moving from place to place; and were eligible for funding through the state Vocational Rehabilitation (VR) offices.

Features of the Study

The study was a randomized controlled trial. Four hospitals in Virginia within a 100-mile radius partnered with a school district and local VR offices for participant recruitment and data collection. Of the 156 eligible participants, the authors randomly assigned 81 individuals to the treatment group and 75 individuals to the control group. Participants in the treatment group attended PS+AD for the school year. The control group remained in high school for the school year and received services identified in their individualized education program (IEP). Over half of the sample was White (57%) and primarily male (76%), with an average age of 19.6 years. Interviewers used the Supports Intensity Scale-Adult (SIS-A) to collect information on employment, behavioral support needs, home living, community life, life-long learning, health and safety, social, and supplemental protection, and advocacy. Data were collected at baseline (beginning of the school year, between August and October), graduation (end of school year between June and August), and a year after graduation. Using statistical tests, the authors compared the outcomes of treatment and control participants before and after they participated in the intervention.

Findings

Employment

  • The study found a positive statistically significant relationship for participating in PS+ASD, where treatment participants were more likely to be employed at graduation, and a year after graduation, compared to the control group. 

Health

  • The authors did not find any significant effect of participating in PS+AD and improved behavioral support needs

Considerations for Interpreting the Findings

Although this study was a randomized controlled trial, the study had high attrition in the control group throughout the study. Additionally, 20 control participants migrated to the treatment condition. These participants were not included in the analysis. Therefore, the study is not eligible for a high evidence rating. However, the authors did account for preexisting differences between the groups before program participation.

Causal Evidence Rating

The quality of causal evidence presented in this report is moderate because it was a randomized controlled trial with high attrition, but the authors ensured that the groups being compared were similar before the intervention. This means we are somewhat confident that the estimated effects are attributable to PS+ASD, but other factors might have also contributed.  

Reviewed by CLEAR

January 2024