* The majority of individuals aged 21–30 do not have any paid work. Those that do work, work in facility settings rather than community settings. 
* While there have been recent efforts to adopt public policy aimed at increasing community-based employment participation. 
* These efforts need to be bolstered and adopted across all states. 
* Transition and job placement services should focus on community-based employment as a priority over facility-based work.

Majority of Individuals Aged 21–30 Do Not Have Any Paid Work:

* Adults with DS were the closest group to approaching this previously reported percent of community-based employment with about 16% in paid community employment for the years 2011–2013. 
* The study replicated previous findings indicating a downward trend of participation in paid community employment among individuals with developmental disabilities. 
Individuals who made choices in their daily routine: 
 *What to do with free time, choosing a daily schedule
 * What to buy with spending money
 *Those who made more short-term choices had greater odds to be employed in the community.

Study Sample - ID, ASD. DS

In a study Butterworth et al. (2015) reported 19% of all individuals receiving services from state developmental disability agencies were in integrated community employment in 2013, a percentage that had dropped from 25% in 2001. 



Bridgewater College

The three research groups: 
* Autism 
* Intellectual disabilities 
* Down Syndrome 


Comparisons- ASD ,  ID, DS.


Bush, K. L., & Tassé, M. J. (2017). Employment and choice-making for adults with intellectual disability, autism, and down syndrome. Research in Developmental Disabilities, 65, 23–34. https://doi.org/10.1016/j.ridd.2017.04.004

References

* short-term choice-making was strongly associated with employment. This is an area that could be targeted for intervention, with studies investigating the directionality of choice-making and employment. 

* Employment as a dependent variable of adult outcome, instead of one component of a global outcome variable. 

* The field needs to better understand barriers and facilitators to employment and explore different factors that may account for the wide variability of employment rates in adults with developmental disabilities beyond simple demographic variables.

* Employment and choice-making are critical to understanding successful independent living and community inclusion

Choice-making- ID, ASD and DS- employment

The differences in employment trends between adults with ASD, DS, and ID. 

* There was a research study conducted on individuals with down syndrome, autism spectrum disorder and intellectual disabilities.
 *  Individuals with down syndrome were the youngest, followed by individuals with DS, then individuals with ID. 
 * Individuals with DS were expected to be younger than individuals with ID, as individuals with DS have a slightly reduced life expectancy.

Age- ASD, ID, DS

* Individuals with ASD were the most impaired. 
* The NCI Adult Consumer Survey population represents: 
      adults receiving services from state developmental disability systems 
      and a diagnosis of ASD alone is not always sufficient to receive state 
       funded DD services. 
* The subset of individuals in this dataset with ASD may represent 
        * a population of individuals with comorbid diagnoses 
        * More complex service needs
         * Beyond that of an individual with only an ASD diagnosis.

NCI Adult Consumer Survey population represents adults receiving services from state developmental disability systems and a diagnosis of ASD:

* Individuals with DS were still significantly more likely to be employed in a community paid job than individuals with ID or individuals with ASD. 

* Inherent differences within diagnostic groups that accounts for variability in employment status, regardless of differences in cognitive and behavioral functioning. 

* The relationship between choice making and employment is important, only partially because of its intervention implications. It is a skill that can be targeted for intervention and potentially expanded.

Community Paid Job than Individuals With ID or Individuals With ASD:

* Approximately 70% of individuals with ASD have at least one comorbid mental illness and 40% have two or more (Simonoff et al., 2008). 

* Adults with comorbid ASD and ID are at greater risk for behavior problems than individuals with ID: 
*  Griffith et al. (2010) found that children with ASD had significantly more behavior problems than either children with DS or children with ID. 
 *  Esbensen et al. (2008) found that adults with DS had fewer behavior problems and less externalizing problem behaviors compared with adults with ID alone. 
  *  Tassé et al. (2016) reported a similar trend in their sample of adults with DS, reporting a lower prevalence rate of co-occurrence of mental and behavioral health issues than a comparable group of adults with idiopathic ID.  

Note: This study was in the article that I read.

behavior support needs- severity of intellectual disability.

Three disability groups: 
*Lower severity levels of ID were associated with increased probability of paid community employment.
 * ID severity level also had the highest effect sizes for employment status compared to all other independent variables.

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