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|Effective Program: VCU-RRTC|
VCU: Rehabilitation Research and Training Center
VCU is a public research university with an enrollment of over 32,000 students, the largest university in Virginia. Ranked as a Carnegie 1 research institution, VCU is among the top 60 colleges and universities for funded research in the country. The VCU-RRTC is housed with the VCU School of Education and linked with the Schools of Medicine and Allied Health, the School of Business and the VCU Center for Rehabilitation Science and Engineering (CERSE), which is a large interdisciplinary research group. This organization has an abundance of research, business, educational, and rehabilitation resources. The VCU-RRTC has been in existence since 1983 under the direction of Dr. Paul Wehman.
1314 West Main Street
The VCU-RRTC is a multifaceted organization with a multidisciplinary staff of national experts in the area of employment and services to people with disabilities. Some of the projects and programs housed within the Center are listed in the table below.
An individual with ASD must first go through the Virginia Department of Rehabilitative Services (VA DRS) and become a client of their services. Then individuals are referred to VCU-RRTC by their VA DRS counselor for job supports. The VA DRS counselor then purchases services from VCU. Services can include situational assessment, job development, job site training, and stabilization.
The critical first step is for the employment specialist to complete a jobseeker profile and assessment based on a variety of interviews and observations in the community. After a profile is complete, the individual leads a job search and practices interviewing with assistance from his or her employment specialist. Once on a job, the individual and the employment specialist work on the actual job tasks and work with a supervisor to do any modifications. The employment specialist helps identify any natural supports and provides positive behavioral supports to the individual. When an individual is stable in the workplace, the employment specialist works with the individual to fade the employment specialist's direct intensive instruction and support employment services.
As with all high performing supported employment programs, fading employment specialist support services is done gradually as the individual demonstrates independence. VCU-RRTC continues to provide long-term supports even after an individual with ASD is successfully "closed" for employment services by VA DRS. Long-term supports often include an individual's employment specialist training employers and coworkers especially when there are changes in the staffing, training on new job tasks, and assessing satisfaction of the individual and the employer.
A recent study (Wehman et al, In press) conducted by VCU-RRTC charted the progress of 33 individuals with ASD in the supported employment program from October 1, 2009 to August 31, 2011. These selecting findings show the effectiveness of VCU-RRTC.
Outcome Paper: Wehman, P. Lau, S., Molinelli, A., Brooke, V., Thompson, K., West, M., & Moore, C. (In Press) Supported employment for young adults with autism spectrum disorder: Preliminary data. Research and Practice for Person with Severe Disabilities.
What makes VCU-RRTC successful in helping people with ASD find work?
A key to VCU-RRTC's success is that it is housed amongst so many other expert autism programs. While staff receive training on working with individuals with autism on the job site, they also have access to onsite autism expert technical assistance on an on-going basis.
Additionally, our success is achieved through the use of a supported employment model and skilled employment specialists who are able to provide a high level of social supports and compensatory training strategies for skill acquisition. Specifically, employment specialists support individuals through the development of a job seeker profile and assessment, guiding the job development and career search, conducting job site training, and designing long-term supports to promote job retention. The multitude and variance of specific methods and strategies used in each case to execute these key steps of the supported employment model accurately reflect an emphasis on a highly individualized approach.
Aiden is a 19-year-old young man with Autism. He is serious minded, though charismatic. He enjoys structure, following rules, and staying busy with work. He possesses many innate qualities that make him a strong worker. Occasionally Aiden initiates conversation with others, though he frequently talks to himself quietly repeating words, phrases, or songs. He does not have many social experiences and requires a lot of support in this area.
Aiden's first internship was with the Radiology Department and the Emergency Room. He was responsible for stocking linens in cabinets, cleaning and erasing x-ray cassettes, and occasionally cleaning and turning over patient rooms. Each of these tasks was routine, and structured, which seemed to be ideal characteristics of employment for Aiden. The challenges that he faced at work, and where his job coach provided the most support, was in regards to his social behaviors. Aiden is tactilely stimulated, and he has a tendency to invade personal space and rub or touch the person with whom he is interacting. In the workplace this is unacceptable and made his coworkers feel uncomfortable. Aiden's job coach worked with him on appropriately positioning his body and keeping his hands to himself. Aiden and his job coach used visual aids and role playing scenarios to clearly define for him the types of space and contact that are appropriate. Aiden also learned that he could not use curse words at work. No touching, giving personal space, and using appropriate language were defined for Aiden as "professional." When he gets too close to people, they ask him to "be professional" and this reminds him to back up, while also being a non-embarrassing way to address his behavior in the workplace. Despite the social challenges that Aiden faced he demonstrated his skills as a dedicated worker who takes his job seriously and consistently works to high quality.
Aiden's second internship was in the Engineering Department. He expressed interest working with his hands to fix things and being "one of the guys." His job coach and teachers thought he would also benefit from working closely with a male role model who could help teach him how to respect women in the workplace while being respectful and "cool." In this department the employees worked in teams of at least 2, for Aiden, who still needed support with his social interactions, this would provide a safe and supportive atmosphere. During this internship experience Aiden became independent installing light bulbs and vacuuming the air ducts in the hospital.
Aiden's first and second internships provided his job coach with a lot of insight into his interests and strengths at work. Aiden enjoys repetitive tasks and cleaning, he is dedicated to following rules, has strong orienting abilities, and does well working independently and staying busy. Knowing this, his job coach met with the head of the Infection Control Department to create an internship, which would benefit the needs of the department, while capitalizing on Aiden's positive work traits. Aiden became responsible for cleaning, and stocking isolation carts (which hold warning signs, gowns, gloves, and masks for nurses and visitors to wear when entering patient rooms) throughout the entire hospital, totaling 75 carts. The job coach and manager worked to get Aiden his own cart to hold cleaning supplies, and the signs that he needed to stock. Aiden mastered the sanitizing of isolation carts quickly, but initially he had difficulty remembering how to stock the carts. His job coach created a checklist for him. This checklist was laminated and Aiden was able to write on it to determine how many supplies he needed to restock. This checklist helped Aiden become independent on his job. Now that Aiden was working independently he had trouble getting to lunch and leaving work on time. Since Aiden has trouble telling time, his job coach helped him set alarms on his cell phone, which was a quick, simple solution.
Aiden's Infection Control internship was very appreciated by staff throughout the hospital and the importance of his position was recognized. The day that he graduated from Project Search he was offered a position working in the Infection Control department. He works 20 hours a week, earns $9.14 per hour, and takes specialized transportation to and from work. As an employee, in addition to sanitizing and stocking the isolation carts, he is also responsible for cleaning, refilling, and replacing batteries in the 45-50 free standing hand-sanitizing machines throughout the hospital. When he replaces hand sanitizer in a machine he needs to record the date that it was done, since writing neatly is a challenge Aiden's job coach obtained a rubber stamp for him so that he could simply stamp the date onto the chart. As far as his work tasks, he continues to thrive. He now has an iPod Touch where he keeps his checklist and reminder alarms.
Aiden's greatest challenge continues to come from inappropriate social interactions like invading personal space, touching coworkers, and problem solving when faced with confrontation. He has difficulty with sensitivity and cannot easily put himself in another person's shoes. In one particular incident a patient and a visitor confronted Aiden, because they felt uncomfortable by the way he was looking at them and they felt uncomfortable. When confronted Aiden felt offended. He did not back down from the conflict, and when he finished speaking with them he cursed to himself as he walked away. He was not able to reason and understand where they were coming from, and he was very angry and embarrassed. In order to address these social challenges Aiden's job coach created a card with visual aids, which Aiden keeps on his supply cart. It clearly lists steps to follow in case of conflict, such as "no cursing" and illustrates appropriate personal space. These tools coupled with frequent reminders, role-playing, and support from his family have helped Aiden cope with his challenges, and be a highly valued "professional."
Costs of Program
The budget varies yearly based on the number of referrals received from the Virginia Department of Rehabilitative Services. However, approximately 95 percent of VCU-RRTC's budget comes from VR payments and 5 percent is comprised of federal grants and contracts.
Necessary for Successful Replication