The influence of race and ethnicity on Vocational Rehabilitation service utilization and

outcomes of transition-age young adults with autism

Anne M. Roux, MPH ; Jessica E. Rast, MPH; Kristy A. Anderson, MSW; Tamara Garfield, MA; Paul T Shattuck, PhD

Background Methods 3. Employment Predictor Models (ORs)

In the U.S., efforts to address the employment-related needs of youth and adults on the Research questions. This studied explored the questions: 1) Does the percentage of eligible VR applicants who go on to
Statistically Significant
autism spectrum are a matter of national importance given the growth of this population and receive services vary by race/ethnicity across YA-ASD and YA-Other?, 2) Does the prevalence of receipt of key types of White Black Hispanic
the relative lack of improvement in outcomes over time. The Vocational Rehabilitation (VR) VR services differ by race/ethnicity for YA-ASD?, 3) Does the rate of successful employment (following VR services) differ
(p<.01)
program annually closes cases for approximately 19,000 transition-age youth and young by race/ethnicity for YA-ASD? Male
adults with autism spectrum disorder (YA-ASD) who apply for services – about 14,000 of
.77 .66 .71
whom receive services. Disparities in who receives VR services, and who achieves Analysis. We analyzed VR service utilization and employment outcomes for 22,846 young adults on the autism spectrum Age 1.05 1.07 .98
employment, are understudied in the ASD population. who had a VR case that closed in FFY 2014-2016. We pooled three years of data to ensure a sample size adequate for
examining disparities. We used binary analyses and multivariable logistic regressions to examine the association of race SSI at application
and ethnicity with VR service use and outcomes. .55 .55 .56

Purpose Most significant disability

1. Prevalence of VR service receipt by race/ethnicity .83 1.21 .79
This study used VR data from federal fiscal years (FFY) 2014-2016 to explore whether race
and ethnicity predict VR service receipt and employment outcomes among YA-ASD. Assessment .61 .73 .80
VR Counseling 1.22 .99 1.31

Data and Sample On-the-Job Supports

5.36 .6.86 7.31
*** Job Placement
Data. Data for this study came from the U.S. Department of Education Rehabilitation Service
Administration (RSA-911) which contains administrative records for every person who applies
2.68 3.86 2.98
for VR services. We focused on two administrative services (Assessment, VR Counseling) ***
and three job-related services (On-the-Job Supports, Job Placement, Job Search). Job Search 1.45 1.53 .86
Sample. We analyzed data for young adults (19-24 years) with autism (YA-ASD, n=22,846).
We compared prevalence of VR service receipt for YA-ASD to their same age peers with any
disability other than autism (YA-Other, n=207,736) for purposes of contextualization. However, overall, YA-ASD were significantly more likely to receive VR services than youth with
Summary and Discussion
other disabilities (p<.001).
Findings.
2. Average number of VR services and types of services received differed by race/ethnicity. Question 1: The percentage of eligible VR applicants who received services varied significantly by race/ethnicity.

Black young adults with ASD received an average of
one or more fewer services than YA-ASD who were
Hispanic or White.
Black and Hispanic YA-ASD experienced significant differences in the VR services they received
compared to White YA-ASD when controlling for other factors.
Question 2: The prevalence and likelihood of receiving key VR services differed by race/ethnicity. Black and
Hispanic YA-ASD were both less likely to receive job placement assistance, compared to White YA-ASD. Black
YA-ASD were less like to receive job search services, while Hispanic YA-ASD were more likely to receive job
search services. Hispanic YA-ASD were less likely to receive VR assessment.

Question 3: A significantly smaller (p,.01) percentage of Black (54%) and Hispanic (57%) YA-ASD were employed
Administrative services: at VR exit compared to White YA-ASD (61%). When controlling for covariates (sex, age, receipt of public benefits,
and receipt of specific VR services), race and ethnicity were not significant predictors of employment in an overall
model including all YA-ASD (not shown).

Discussion.
We found significant differences in prevalence of VR service receipt and in the average number of VR services
received by race/ethnicity. This difference is important because receiving key VR services, and higher numbers of
Job-related services: different VR services, have been associated with positive employment outcomes.
**
Even though significantly fewer Black and Hispanic YA-ASD were employed at VR exit compared to White YA-
ASD, race/ethnicity did not predict employment in an overall model of all YA-ASD who received VR services.
However, differences in predictors of employment were noted in subgroup models for White, Black, and Hispanic
YA-ASD. In particular, Hispanic YA-ASD who received job search services were less likely to achieve employment
at VR exit, when controlling for demographics and other types of services received. However, they were also more
likely to receive job search services compared to other services. Black and Hispanic YA-ASD were more likely to
achieve employment if they received on-the-job supports and job placement, but they were less likely to receive
job placement (compared to other services) and no more likely to receive on-the-job supports. The reasons
Statistically underlying significant differences in VR service receipt by subgroup merits further investigation.
significant at p<.01

This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under UJ2MC31073: Autism Transitions Research Project. This information or content
and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.