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Running head: EMPLOYMENT TRANSITION PROGRAM

Evidence Synthesis of an Employment Transition Program for Individuals with Autism


Kristin Caroza and Mallory Viveros
Touro University Nevada

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Research Question
Does work training programs help improve social communication skills of adolescents
with autism spectrum disorder?
APA Reference
Strickland, D., Coles, C., & Southern, L. (2013). JobTIPS: A Transition to Employment Program
for Individuals with Autism Spectrum Disorders. Journal of Autism & Developmental
Disorders, 43(10), 2472-2483. doi: 10.1007/s10803-013-1800-4
How Does This Study Relate to Your Research Question?
This study asserts that most individuals within the autism spectrum disorder (ASD) have
issues with job attainment due to their deficits in social skills. In particular, Strickland, Coles,
and Southern (2013) explain that one of the main hurdles is the interview process in order to
obtain employment. This study relates to the research question because it looks at the
effectiveness of JobTIPS, a transition to employment program among individuals with ASD.
JobTIPS is a specific program that aims to help individuals with ASD in developing interviewing
skills in order to communicate effectively to future employers.
What is the Purpose of the Study?
The purpose of the study is to examine the most effective way to provide job training
support to late adolescent children with autism. Strickland, Coles, and Southern (2013), wanted
to see how effective JobTIPS, an online interview skills training program would be in helping
youth improve their interpersonal and interviewing skills. Researchers hypothesized that
participants would improve in two specific areas: making eye contact and verbalization.

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What are the Research Questions or Hypotheses?
Strickland, Coles, and Southern (2013) hypothesized that youth who participated in the
intervention program (JobTIPS) would demonstrate improved skills, both skills that involved the
content of their interactions with job interviewers and the way in which this content is
delivered.
Does the Literature Review Justify the Need for this Study?
The literature review justifies the need for this study because it discusses the growing
population of youth diagnosed with ASD, and the increased need for job placement for this
population. The literature indicates that adults with ASD work far less hours per week than adults
with other disabilities (Cimera & Cowman, 2009). The literature review attribute this to the great
difficulty individuals with autism have engaging in social interaction with others. Therefore,
there is a need to find a training program that works best at improving this populations
interviewing skills by focusing on social skills.
What is the Study Design or Type of study? What is the Level of Evidence?
This study type used in this article is a randomized controlled trial, with a Level 1 of
evidence.
How many Participants? How were the Participants Recruited and Selected?
There were twenty-two male participants with high functioning ASD or Aspergers
Disorder. Eleven youth were in the control group, and eleven youth in the intervention/treatment
group. Participants were recruited through flyers that were distributed throughout two large
autism treatment centers and through letters that were mailed to other agencies for adolescents
with ASD. This study also enabled inclusion criteria that required each participant to be between

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the ages of 16-19 years and was diagnosed with a high functioning autism or Aspergers
Disorder.
How were Participants Assigned to Groups?
Participants were randomly assigned to either the treatment group or the controlled
group. The participants and their family were not made aware of which group they belonged to
until after the first interview was conducted. Randomization of the participants took place once
all twenty-two participants provided consent to be involved in the research study.
How are the Participants Described?
All of the participants in this study were male and between the ages of 16-19 years. Most
of the participants in this study completed at least 11 years of school. Race or ethnicity varied
between the control and intervention group. Within the control group, 27.3% were AfricanAmerican, 63.6% were Caucasian, and 9.1% was biracial. While in the intervention group,
18.2% were African-American, 72.7% were Caucasian, and 9.1% were reported as Other as their
ethnicity. Within each of the control and intervention groups, 7 out of 11 participants were on
medication.
What are the Variables?
Demographic variables among the control and intervention groups were compared, and
researchers found no significant difference. The demographic variables examined were the
gender and race of participants, and use of psychoactive medications if applicable. Seven out of
eleven participants in each group were actively using psychoactive medication, all participants
were males, and the race representation was equal in each group. The demographic variable were
measured using the Analysis of Variance and Chi Square in order to compare the intervention and
control groups.

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What Measures were used?
In order to measure the improvement of the social skills of the participants, this study
used the Interview Skills Rating Instrument and the Social Responsiveness Scale. The Interview
Skills Rating Instrument looks at the content of the participant's responses to interview questions
as well as the behaviors in which the statements were delivered. This included non-verbal social
cues such as body positioning or facial cues. The Social Responsive scale is a 65 item
questionnaire that measures items that relate to social awareness, social cognition, social
communication, social motivation, and autistic mannerisms.
What is the Intervention?
The intervention in this study involved was a training intervention aimed at
demonstrating realistic interview scenarios for the participants. JobTIPS was the multi-media
program that was used to help participants with ASD figure out what jobs they were interested
in, how to get the job, and how to keep the job. The program used videos to demonstrate real life
interviews, handouts to help with role play of an interview, and printable scripts. The goal was to
improve social skills among the intervention group in order to help them with the interview
process and ultimately land a job.
What Statistical Analyses were used?
This study examined the participants by using Analysis of Variance for continuous
measures and Chi Square for ordinal variables for the demographic variables. For the Interview
Rating Scale Reliability, they used a Pearson Product Moment procedure for each sub-scale to
look at the effectiveness of the intervention.

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What are the Findings?
Overall the findings of the study indicate that web-based programming designed to help
youth with ASD learn interview skills is an effective training method to help improve
employment related interview skills among this population. Results show that participants were
able to improve in the area of content more so than the delivery of their responses. This is an
area that can be further examined in future research. The JobTIPS program makes training
available on the individuals home computer via a virtual reality and incorporates practicing the
interviews skills with a trained therapist in order for them to receive feedback. The study found
the combination of computer and real-life practice to be most beneficial.
Do these Findings Support the Hypothesis?
These findings support the hypothesis that adolescents with ASD who have completed the
JobTIPS training program would improve significantly in social skills for a job interview
compared to a control group who did not receive any training. This study noted that although
both of the content and the behaviors during the delivery of the content improved, this
intervention was more effective for the content skills.
How do the Findings Relate to Previous Research as Described in the Literature Review?
The research in the literature review found programs using technology, video modeling,
and virtual worlds to be beneficial in training job interview skills with individuals with ASD. The
previous research shows video-modeling as a great tool to demonstrate behaviors ideal for job
interviews. The program used in the treatment group used technology that also provides videomodels of appropriate behaviors during an interview session.

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Does the Author State any Clinical Implications for the Findings?
The implications for practice in which Strickland, Coles, and Southern (2013) discussed
were that most individuals with ASD struggled with considering the perspective of the
interviewer. For example, when asking an individual about teamwork, most employers desire
employees who can work well with others. Individuals with ASD would have a difficult time in
crafting a response with this assumption. With this found information, it is important to rehearse
and repeat the appropriate responses to questions that would most often be asked in a job
interview.
What are the Limitations that the Author Identifies?
There are a few limitations in this study including: gender, motivation of participants, and
length of study. All twenty-two participants were males, therefore a general statement could only
be made applicable to males with ASD leaving out the entire female population. The motivation
of the participants is another limitation because all willingly signed-up for the study and may
have had more of a positive outlook than other individuals with ASD who cannot seem to land a
job. Lastly, the short length of the study is cause for limitations because it does not allow the
researchers to take note of observable effects over time. These limitations can be addressed in
further research conducted with female participants, with a different method of recruitments, and
studied over a longer period of time to allow for long term effects.
Does the Author Discuss Implications for Future Research?
In this study Strickland, Coles, and Southern (2013) discuss that although JobTIPS has a
short term effect on the social skills of the participants, further research is needed to evaluate
how well it is attained after a long period of time. Furthermore, this article also would like to see
how individuals with ASD respond to more novel situations after using the JobTIPS program,

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such as a real job interview. It questions whether or not the participants would be able to adjust
their responses and behaviors to answer different types of questions outside of the topics
discussed in the JobTIPS program.
What would you Say About the Sample size? Do You Think it is Adequate?
The sample size is fairly small and lacks an equal balance of gender. There are only
eleven participants in each group, thus making the sample sizes even smaller. To have an
adequate sample size researchers should double to the amount of participants using the same
amount of male and female participants. It is hard to make a general statement when only eleven
individuals have benefited from the JobTIPS program.
If the Researcher did not find a Significant Difference between the Groups, is it Possible
that this is Due to a Type II error? If so, Why Do You Think So?
The JobTIPS program found a significant difference between the control and treatment
group. Therefore, there was not type II error.
Is There a Control or Comparison group? If so, is the Control or Comparison Group
Comparable to the Experimental Group on Key Features?
The study involves a control and treatment group. The treatment group received access to
the JobTIPS program and instructional handouts to assist with the use of the program. The
program was to be used by the treatment group as often as possible prior to their second
interview session. The controlled group did not receive any assistance or training to support their
preparation for the next interview session. However, both groups did receive information
describing the job position they were interviewing for.

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Are Those Administering the Outcome Measures Blind to Group Assignment?
The standardized interview simulation was administered by a human resources
professional that was blind to the group assignments. This interview took place in an office
setting in which participants permitted the experiment to be observed and recorded.
Are the Participants Blind to Group Assignment?
The twenty-two participants all participated in the initial interview process without
knowing which group they belonged to. After the interview was over the participants and their
caregivers were informed if they were in the treatment or controlled group. The participants in
the controlled group were then given all the information and handouts necessary for accessing
JobTIPS before their second interview. The interviewer was blind to which group the participants
belonged to in order to prevent any biased opinion about the potential improvements of
interviewing skills.
Does the Researcher Account for Drop-Outs in the Study? Could Drop-Outs Have
Influenced the Outcomes?
This study did not indicate whether or not there were any drop-outs in this study.
However, if there were any drop-outs in this study, it could influence outcomes. For example, if
there were drop-outs in the treatment group, it would only leave individuals who were more
motivated to get a job. Therefore, it would indicate higher improvement in scores of
interviewing skills compared to if there were no drop-outs.
Does the Researcher Report Reliability and Validity of the Outcome Measures? Are there
Questions about the Outcome Measures Chosen?
The study used four different raters to determine the participants use of social:
awareness, cognition, communication, and motivation. Two reports were filled out pre-

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intervention and the last two were completed post-intervention. In order to maintain reliability
the researchers made summary scores for both the pre-intervention interviews and the postintervention interviews, and these two scores were compared resulting in a mean change
variable. The mean change variable for the control and treatment group were compared side by
side, therefore a significant difference in improvement in interview skills among the treatment
groups was easily determined.
What Confounding Factors Could Contribute to or Influence the Study Outcomes?
A confounding factor that could influence the study outcomes is the fact that this study
required participants to have regular access to a computer and the internet. This may affect the
study because individuals who have regular access to a computer would be able to understand
material from the JobTIPS program compared to those who do not know how to use a computer.
This may indicate that individuals who have more resources in general perform better.
What are the Major Strengths of the Study?
One strength of this study was its focus on both content and delivery of interview
responses. Both areas resulted in improvement, yet content showed far greater improvement
than delivery skills. This allowed researchers to take note of the effectiveness of JobTIPS in
improving participants ability to provide verbal responses to interview questions. Although
participants improved in their delivery, there is still room for further improvement in their
body language, eye contact, and facial expressions. Further research can be conducted to seek
programs that will help further improve the delivery of responses as well.
A second strength is the use of a control group. Although all twenty-two participants
willingly signed-up for the study, not all of them received the treatment. Motivation to improve
and work on interview skills is a common factor for all participants, but comparing the two

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groups allowed researchers to determine the JobTIPS treatment as the cause of improvement.
Lastly. The use of pre-intervention and post-intervention ratings is a major strength to the study
because it provides a comparison of the participants interview skills over time. Conducting a
before and after treatment test quantifies the level and rate of improvement in both content and
delivery of responses to interview questions and scenarios.
What are the Major Weaknesses of the Study?
One of the major weaknesses of this study was that the demographic of the participants
was not diverse as most of them were Caucasian. The percentage of Caucasian participants in
the control group was 63.6% while there was 72.7% in the intervention group. It is important to
get a representative sample in a study in order to generalize the information that was obtained.
Secondly, although this study required the participants to be high functioning, autism covers a
wide spectrum of behaviors, sensory deficits, and cognitive ability. This study did not compare
these characteristics of the participants in the control and treatment group. It is possible that
these differences among the group could affect the outcome of the study.
Lastly, this study could be improved by looking at how individuals performed in real job
interviews. The aim of this study is to improve the social skills of adolescents with ASD for job
attainment. However, this study only looks at the improvement of skills within a controlled
experimental environment. Although this environment decreases the bias and extraneous
variables of the study, it creates limitations on how an individual would perform in an actual
interview.
How Would You Use this Article as a Therapist?
As therapists we would use this article to support our decision to incorporate virtual
environments and web-based programs in our intervention plan when working with individuals

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in their late adolescent years with ASD and Aspergers Disorder. The goals of our intervention
would be to help youth with ASD and Aspergers Disorder transition from high school to
adulthood by incorporating job training practices. Alongside teaching job skills, it is greatly
important to focus on the social aspect of landing a job, which is most difficult for this
population. The article supports the use of interviewing skills as a focus of treatment because it
helps the individual figure out what job interests they have, and helps them succeed in the initial
step of getting a job, the interview process.
The article can be used to help plan activities that require clients to verbalize responses to
common interview questions, and help them express their feelings of personal strengths and
weaknesses. The article identifies body language, eye contact, and posture as areas that need
improvement for participants in both the control and treatments group. This information can be
used in practice as well because we could create more activities that involve role-playing and
feedback, so the clients can see the differences in appropriate and inappropriate delivery.
How does this Article Support or Not Support Participation in Occupation and the Field of
Occupational Therapy?
This study emphasizes that more than half of young adults with Autism are unemployed
after graduating high school. This is often because individuals with Autism have deficits in
social skills that are needed to obtain a job. This article supports participation in occupation
because it provides a new resource for individuals within the spectrum. Strickland, Coles, and
Southern (2013) discuss that one of the reasons why young adults with ASD are struggling to
obtain a job is the lack of services to support skills training. JobTIPS is a program that is easily
accessed through the internet that serves to help individuals with disabilities to learn skills that
are necessary for employment. Part of occupational therapy addresses work and employment

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because it provides individuals with many aspects of financial attainment and a sense of wellbeing. Although occupational therapists would not make programs like JobTIPS a central aspect
of an intervention for adolescents with ASD, it is an excellent supplementary tool.

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References
Cimera, R. E., & Cowan, R. J. (2009). The costs of services and employment outcomes achieved
by adults with autism in the US. Autism, 13(3), 285302.
Strickland, D., Coles, C., & Southern, L. (2013). JobTIPS: A Transition to Employment Program
for Individuals with Autism Spectrum Disorders. Journal of Autism & Developmental
Disorders, 43(10), 2472-2483. doi: 10.1007/s10803-013-1800-4

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