Category: Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Neurodegenerative Disease (e.g. MS, Parkinson's disease)
Objective :
Customized employment (CE) strategies show promise for improving competitive, integrated employment outcomes in persons with complex disabilities. The ACCESS-Vets intervention protocolizes the CE process and has the potential to optimize employment outcomes. Objectives 1) develop and refine training, treatment and study protocols to test the ACCESS intervention; 2) examine the feasibility and acceptability of ACCESS in an iterative open trial; and 3) examine the feasibility, acceptability and preliminary efficacy of ACCESS relative to usual care.
Design :
Randomized pre-test post-test experimental control group design.
Setting : Community-based intervention
Participants (or Animals, Specimens, Cadavers) :
Individuals with Autism Spectrum Disorders (ASD) diagnosis aged 22+. Open Trial (N=10); RCT (N=30).
Interventions :
ACCESS intervention protocolizes the CE process for application with adults with ASD to optimize functional and employment outcomes in this population while reducing related societal impacts and costs.
Main Outcome Measure(s) : Competitive, integrated employment; self-determination and QoL.
Results : The Phase I open trial is complete and has presented the research team with important data about the real-world challenges surrounding employment for adults with ASD. Phase 2(Spring 2019) will provide the comparison between usual care and intervention. A total of 13 individuals (10 males and 3 females) consented to participate in the study and completed the baseline assessments. All but one individual, who did not meet eligibility requirements, were enrolled in the study. Initial (baseline) feasibility benchmarks were achieved. Findings from the open trial suggest the need for a revised recruitment strategy and an extended timeframe for the intervention. Thorough screening of practitioners and assessing participants’ work motivation may reduce attrition.
Conclusions :
Given early evidence regarding the promise of customized interventions, ACCESS has the potential to yield far-reaching benefits for adults with complex disabilities.
Tammy Jorgensen-Smith
– Associate Professor, University of South Florida, Tampa, Florida
Christina Dillahunt-Aspillaga
– Associate Professor; Research Affiliate, USF - RMHC, Veterans Affairs, James A. Haley Hospital Rehabilitation Outcomes Research Center, Tampa, FloridaDeveney Ching
– Doctoral Student; Research Assistant, University of South Florida, Department of Child& Family Studies, Rehabilitation & Mental Health Counseling Program, Tampa, Florida