Autistic people have much to offer organizations (Lindsay et al., 2018; Russell et al., 2019). Yet, compared to people with other disability types, they are more likely to experience challenges finding and maintaining employment (Dreaver et al., 2020; Wei et al., 2018). The strengths of autistic people often align with those desired by employers (Scott, et al., 2017; Waisman-Nitzan et al., 2019). Autistic employees are productive and efficient (Black et al., 2019; Nicholas et al., 2019a, 2019b), produce high-quality work (Hedley et al., 2018; Lee et al., 2019; Nicholas et al., 2019a, 2019b), and can be excellent problem solvers (Black et al., 2019; Hedley et al., 2018). Diversity broadly enhances organizational performance (Gomez & Bernet, 2019; Moon & Christensen, 2020). As such, there are several benefits to a neurodiverse workforce (Austin & Pisano, 2017).

The past few years have increasingly seen research examining barriers to employment and adjustments to aspects of employment to meet the needs of autistic adults (e.g., Hayward et al., 2019a; Hurley-Hanson et al., 2020). However, appropriately addressing adjustments can be confounded by potential employers who possess inaccurate information about autistic individuals (Black et al., 2019; Hurley-Hanson et al., 2020). This can lead to ill-conceived beliefs concerning the required workplace adjustments for autistic people, which are often minor and feasible for businesses to implement (Mai, 2019; Scott, et al., 2017), for example, focusing on technical ability rather than social skill (Hayward et al., 2018a), access to flexible work practices (Hayward et al., 2019b, 2020), and attention paid to the workplace environment as it relates to sensory sensitivities, such as reducing bright lighting (Hayward et al., 2018b). This might be as simple as adding a blind to a window or allowing the use of headphones (Weber et al., 2022). Perhaps owing to lack of accurate information, or available resources to learn from, some employers prefer to accept external support to onboard autistic people and negotiate workplace adjustments (Rashid et al., 2017, 2018).

Within Australia, Disability Employment Services (DES) are well-placed to provide such support to employers and autistic job seekers or employees (Alverson & Yamamoto, 2017; Roux et al., 2016). Certainly, DES are the most widely available vocational supports within Australia (Australian Government [AG], 2019). These services are government funded, provided at no cost to service-users, and dispersed nationally (Department of Social Services, 2019). However, the current DES model will end in 2023 and the Australian Government (2021) has been engaging key stakeholders in exploring new options for a model to replace it. In this paper, we review the evidence regarding effective employment supports for autistic employees in Australia.

Presently, DES networks offer a variety of one-on-one pre- and post-placement (on-the-job) supports to help individuals gain and retain employment (AG, 2019). This includes support with resume writing, job-search assistance, or provision of vocation-specific training (AG, 2019). In Australia, employers are incentivized to work with job seekers from DES providers; for example, DES can assist organizations to access significant wage subsidies (AG, 2019).

Unlike the United States (US) where DES staff require specialized training to work in the vocational service sector (referred to in the USA as vocational rehabilitation; US Department of Education, 2015), staff in Australia delivering DES are not required to have any formal disability training (AG, 2019; Byrnes & Lawn, 2013). Instead, general certificate level education may be available if a DES employee requests it, and if the DES provider is willing to offer it (Byrnes & Lawn, 2013). Additionally, there is limited evidence available to determine the portion of DES employees in Australia who have lived experience of disability. A recent study among Australian DES employees reported few having lived experience of neurodivergence (Hayward et al., 2022). Broadly, there appears to be limited staff employed in disability services in Australia who have lived experience of disability (Mellifont et al., 2023). Arguably, having autistic employment consultants could strengthen the ability of DES employees to meet the needs of Australian autistic job seekers; there are likely many strengths professionals with lived experience would bring, as discussed in recent reports of autistic teachers (Stevens, 2022) and doctors (Doherty et al., 2021). To illustrate, in the year 2017, autistic people comprised 6.4% of DES providers’ case load but on average, only one quarter of these people were linked into employment (Parliament of Victoria, 2017). While there is some understanding of DES providers’ capacity to work with people who are experiencing mental health challenges (see Mellifont, 2017), to our knowledge, there is limited information about service provision for autistic people to help shape the new model to replace the existing DES framework.

Although international research can offer examples of autism specific support (e.g., Wehman et al., 2012), it is unclear whether these could be applied successfully in an Australian context given differences in policies, processes, and service provision between Australia and countries such as the USA (Black et al., 2019). Additionally, the preferences and needs of autistic adults may differ between countries. Black et al. (2020), for example, reported that autistic adults in Australia felt more strongly than those in the USA and Sweden about the importance of workplace inclusivity for employment maintenance. Moreover, workplace culture and accepted communication norms differ between countries (Wehman et al., 2012) and are a primary area of reported challenges for autistic people in employment (Hayward et al., 2018b).

Thus, the current work systematically reviews the existing literature of effective supports to allow a meaningful contribution to policy discussion to inform the new DES model, focusing specifically on the needs of Australian autistic people. Understanding if and which assisted employment supports are effective in helping autistic people will help inform a new evidence-based model to ensure adequate and targeted distribution of government funds for employment services that are the most useful.

Material and Methods

Our review followed PRISMA guidelines to source articles. The completed PRISMA checklist is available in the supplementary materials.

Search Terms

We used the following terms to capture assisted employment services: disability employment*, disability service*, supported employment, disability open employment*, and vocational rehabilitation. The target population was identified with the following terms: Autism Spectrum Disorder, ASD, Asperger*, and autis*. In ascertaining employment practices that enhance employment outcomes, the following terms were used: enable*, facilitat*, and success*.

The following terms were entered into individual databases outlined in the next section, “databases”: (disability employment* OR disability service* OR supported employment OR disability open employment* OR vocational rehabilitation) AND (autism spectrum disorder OR ASD OR Asperger* OR autis*) AND (enable* OR facilitat* OR success*). A hand-search of reference lists was conducted for any relevant papers that might be overlooked in this process.

Databases

The databases selected were those that appeared to hold the most amount of autism employment-related material based on the systemic reviews of others, e.g., Hayward et al., (2018a, 2018b). Databases searched were as follows: Academic Search Complete, Business Source Complete, CINAHL Complete, Medline, Psychology and Behavioural Sciences Collection, PsycINFO, Open Dissertations, and SocINDEX with full text, as well as Web of Science Core Collection. A publication date range was not specified to not miss any relevant material.

Inclusion Criteria

Papers meeting the following criteria were included: (a) were based on Australian data; (b) included working age (14 years plus) autistic individuals, or data on autistic individuals could be disaggregated from other populations; (c) considered enablers to employment gain or retention; (d) included assisted employment practices, or the data could be disaggregated from unassisted employment; and (e) results were based on original evidence or data. Therefore, books, essays, news articles, opinion pieces, literature reviews, and meta-analyses were excluded. Also excluded were articles relating to transitional support from secondary school into work, as DES support is not intended for secondary students at this time. No other exclusions, for example, based on article quality, were made owing to the dearth of articles sourced.

Study Selection Procedure

All 1839 records identified were imported into an Endnote library; 570 duplicate articles were subsequently deleted. The remaining 1269 titles were screened to include those which appeared to meet at least two of the inclusion criteria. Abstracts of the remaining articles were then reviewed using the same process using at least any three inclusion criteria. The first author (an experienced researcher in systematic reviews) screened all titles and abstracts of the identified papers. The final identified articles were reviewed independently in full by two authors using all inclusion criteria. Upon agreement between authors, eight articles were identified as sufficiently meeting inclusion criteria and included in analysis. The paper inclusion process is graphically presented in Fig. 1.

Fig. 1
figure 1

The study selection process

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Given that Australian DES organize their supports into pre- and post-placement (AG, 2019), the data from the included articles are also organized this way to best facilitate a conversation surrounding the new proposed employment support model. After grouping data from the eight papers into pre- and post-placement supports, each individually described support from each paper was tabled before further grouping based on their commonalities (see the “Results” section). For example, all supports mentioning assistance with executive functioning were grouped.

Results

Study Characteristics

Participants

A total of 172 autistic individuals were represented across the eight papers included in the review. A further 50 employers (including supervisors and hiring managers), seven support people (e.g., mentors and autism consultants), 16 co-workers, and 89 family members of autistic employees, plus six researchers, were also included.

Assisted Employment Supports

Table 1 provides a summary of the results including an assessment of quality indicators for all articles included in the analysis. The quality indicators we used were inclusion of a reference population for which to base the effectiveness of supports and how the outcomes of the provided supports were measured. Because all articles implied the supports provided were beneficial, they are all described here.

Table 1 Summary of studies included in the review
Full size table

Pre-placement Support

Several key areas were identified as beneficial for autistic individuals in finding employment and are described below. Note that except for travel training, which in this instance was addressed in the community by the autistic person’s parents (Lee et al., 2019), these supports could be delivered at the DES provider’s office.

Job Readiness

Help becoming job ready was stated within three articles as an effective support (Black et al., 2019, 2020; Lee et al., 2019). Job readiness support includes travel training, e.g., assisting job seekers to navigate public transport independently (Lee et al., 2019) and assistance with social and communication skills (Black et al., 2019, 2020; Lee et al., 2019), for example, training in the social and communication skills expected in traditional employment interviews.

Job Search

Job search assistance was described by one study as beneficial for autistic job seekers to gain employment (Black et al., 2019). This type of support includes identifying suitable job opportunities and teaching job seekers how to complete job applications and prepare tailored resumes.

Work Placement

Work placement is described in five studies (Black et al., 2019; Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019; Scott et al., 2015). Here, work placement is understood to encompass referral by the supporting organization or program to an employer resulting in an interview, opportunities for work experience, or formal internship.

Job-Person-Environment Fit

Finding or tailoring a role that achieves job-person-environment fit for an autistic job seeker is described as a facilitator to employment in four papers (Black et al., 2019, 2020; Lee et al., 2019; Scott et al., 2015). Specifically, these papers suggest that understanding individual strengths and challenges and matching these with jobs where barriers can be overcome with workplace adjustments can help autistic people find and maintain employment. Ideally, it is best to craft or match a career that also utilizes employee interests to benefit both employee and employer (Black et al., 2019; Lee et al., 2019; Scott et al., 2015).

Post-placement Support

Several key areas were identified as beneficial for autistic individuals in maintaining employment. Note that these supports could be delivered by the DES provider to either the employee (job coaching, navigating workplace relationships, executive functioning) or employer (navigating workplace relationships, communication support, sensory adjustments).

Job Coaching

Job coaching was stated in five of the articles included in this review (Black et al., 2019, 2020; English et al., 2017; Flower et al., 2019; Hedley et al., 2018). Effective supports provided by job coaches included assistance with task-related skill development, i.e., modeling job tasks (English et al., 2017), autism education to employers (Flower et al., 2019), and negotiation between the employer and employee of required workplace adjustments (Flower et al., 2019; Hedley et al., 2018).

Navigating Workplace Relationships

Assistance navigating workplace relationships is described as an employment facilitator within three papers (Black et al., 2019, 2020; Lee et al., 2019). Although not all articles included details outlining the type of social support that was deemed useful, the papers reviewed broadly mentioned actions such as providing support for autistic employees to feel included (Black et al., 2019) and providing opportunities to learn about workplace etiquette in different contexts (e.g., meetings; Lee et al., 2019). To enhance the social interactions of autistic people in the workplace, mentorship and collegial support can also play a role (Black et al., 2019; Lee et al., 2019).

Communication Support

Supporting autistic employees by providing clear and explicit communication is discussed as an enabler within three articles (Black et al., 2019; Hedley et al., 2018; Scott et al., 2015). For example, ensuring intended meaning is explicitly communicated rather than implicitly implied (Hedley et al., 2018). Also providing specific instructions that are direct and/or blunt (Scott et al., 2015). Written communication is reported as preferred (Black et al., 2019; Hedley et al., 2018).

Executive Functioning

Supports assisting with the cognitive functions of working memory, planning, and organizing were mentioned in four articles (Black et al., 2019; Hedley et al., 2018; Lee et al., 2019; Scott et al., 2015). Supports included providing predictable but not inflexible structure to the work undertaken (Hedley et al., 2018; Scott et al., 2015) and allowing regular breaks (Black et al., 2019; Hedley et al., 2018). For example, job coaches can help autistic employees develop routines and provide structure to their work by creating a daily schedule (Black et al., 2019; Lee et al., 2019).

Sensory Adjustments

Adjustments relating to sensory concerns arising from the work environment were described by four studies (Baldwin & Costley, 2016; Black et al., 2019; Flower et al., 2019; Hedley et al., 2018). These included addressing noise and lighting. For example, changing fluorescent lighting to softer light or allowing noise canceling headphones to be worn by the autistic employee.

Discussion

In this paper, we synthesized the available articles concerning assisted employment practices within Australia that favor job acquisition and maintenance for autistic people. We focus the discussion on that which may enable policy and practice recommendations of these evidence-based practices into a new DES system.

Australian DES might feasibly engage in tailored job coaching and target their practices to implement the activities highlighted in this review. More than 50% of articles described the benefits of job coaching for autistic employees (Black et al., 2019, 2020; English et al., 2017; Flower et al., 2019; Hedley et al., 2018). While the role of job coaches can be broad, the included studies largely highlight the importance of the coach for educating colleagues and managers about autism (Black et al., 2019, 2020; Flower et al., 2019; Hedley et al., 2018). The coach is also described as being important when liaising with employers to ensure their understanding of an individual’s needs and the required adjustments to meet those needs (Flower et al., 2019). The job coach role relates to most of the post-placement supports described in the included studies of this review. For example, providing support for executive functioning (Black et al., 2019; Hedley et al., 2018; Lee et al., 2019; Scott et al., 2015) and adjustments for sensory sensitivities (Baldwin & Costley, 2016; Black et al., 2019; Flower et al., 2019; Hedley et al., 2018). Job coaching is similarly a reported benefit cited in several international studies (Hillier et al., 2007; Nicholas et al., 2019b; Wehman et al., 2012, 2016). However, job coaching in other countries such as the USA usually utilizes a vocational counselor who is specially qualified to assist job seekers (U.S Department of Education, 2015).

Underlying the effectiveness of all the supports identified either implicitly or explicitly across the studies in this review is autism knowledge (Baldwin & Costley, 2016; Black et al., 2019, 2020; English et al., 2017; Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019; Scott et al., 2015). Autism knowledge is of utmost importance for employers in several other studies including those internationally; examples include Hillier et al. (2007), Nicholas et al. (2019a), and Waisman-Nitzan et al. (2019). Importantly, half the studies included in this review were implemented as a part of autism-specific employment programs where those involved had autism-specific knowledge and training (e.g., Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019). To effectively provide the pre-placement supports identified as beneficial by this review, autism knowledge is needed. For example, assisting job seekers to search and apply for suitable roles, as well as identifying work placement opportunities requires autism understanding. Understanding the needs, skills, and preferences of individual job seekers is reported among Australian DES as lacking (Hayward et al., 2022). Providers’ autism knowledge would help achieve job-person-environment fit (Black et al., 2019, 2020; Lee et al., 2019; Scott et al., 2015), as also recognized in the international literature (see Wehman et al., 2012). Consequently, being mindful of job-person-environment fit assists in the job search process and helps guide jobseekers into sustainable work.

However, to make further informed suggestions on the types of supports the Australian Government might make available to autistic people through the DES system, more Australian evidence of effective supports may be required. Although there were few studies sourced by this review, given 31% of the articles sourced were duplicates (see Fig. 1) it appears most of the papers on the topic were captured. Still, there may be misrepresentation of the intended sample (Bal & Lounds-Taylor, 2019) because almost half of the studies sourced in this review relied on self-reported autism diagnosis (i.e., Baldwin & Costley, 2016; Black et al., 2019, 2020; Scott et al., 2015). These articles were included given the dearth of available evidence.

Further limiting the participant group from which to draw conclusions, two papers sourced in this review utilized the same participant pool (i.e., Black et al., 2019, 2020; see Table 1). Other sample limitations include limited sample sizes where less than 10 autistic individuals were included in each study (i.e., English et al., 2017; Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019). These factors can lead to sampling biases and limit generalizability (Poynton et al., 2019). To illustrate, it is not clearly understood if some supports are effective for autistic people in particular industries of employment or for specific types of tasks performed as these details were not frequently provided in the papers sourced in sufficient detail. Additionally, only one study utilized a reference group; these were autistic men (Balwin & Costley, 2016). Thus, suggesting a focus for service provision may be premature if some supports could serve a broader group of people which would demonstrate value in investment of government funds.

It is also difficult to understand the efficacy of the supports detailed by the papers sourced without pre- and post-measures. For example, three papers explored workplace facilitators but did not operationalize and quantify the supports which would otherwise allow comparisons between studies (e.g., Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019). Although one study was experimental, the sample included three adults with low to average intelligence (English et al., 2017) from which conclusive conclusions cannot be drawn.

Notwithstanding this, most (75%, n = 6) studies collected qualitative data (Baldwin & Costley, 2016; Black et al., 2019, 2020; Flower et al., 2019; Hedley et al., 2018; Lee et al., 2019; Scott et al., 2015), and most failed to identify quality indicators. For example, trustworthiness and rigor were either left out (see Baldwin & Costley, 2016; Flower et al., 2019) or not explained in sufficient detail (see Lee et al., 2019).

Implications/Recommendations

Not all DES providers have a high case load of autistic job seekers (Parliament of Victoria, 2017), but from this review, we suggest that Australian DES providers would benefit from upskilling individual staff who work with autistic jobseekers. DES employees working with autistic jobseekers need a solid foundational knowledge and understanding of autism, as emphasized by Flower et al. (2019), Hedley et al. (2018), and more recently Martin et al. (2022). For example, DES providers might train one staff member at each service provider to be the lead and primary employment consultant for autistic jobseekers.

Additionally, recognizing the large geographical area to be covered by DES in Australia, if some supports, for example, pre-placement support, is offered online, then access to autism specialized DES staff is easier. Alternatively, or in addition, DES providers might engage qualified external or contracted autism-specific job coaches who might work alongside DES or deliver education and support to DES employees who work with autistic people. Either way, both suggestions would be strengthened if individuals with lived experience of autism were hired.

Directions for Future Research

Based on the discussion of results, we suggest the quality of future research in this area is improved. While there are benefits of research conducted within organizations, such as those through employment and work experience programs, given high external validity, providing information about rigor and transferability would assist (Liamputtong, 2020). We recognize that assisted employment programs subject to academic research within Australia often include only small groups of employees. However, given the limited quantitative research in this area, we suggest that experimental studies undertaken with a larger (e.g., more than 50) Australian sample of autistic people from a range of industries and job types while capturing the job tasks undertaken would be of benefit. This would both limit potential sampling biases and gain a more representative understanding of autism employment in Australia. Partnerships between university researchers and DES providers are one way of directly examining whether supports are effective and may allow for larger samples to be examined. Further, while acknowledging the many challenges associated with navigating ethical and feasible (organization approved) academic research within organizational settings, thorough research designs (e.g., with pre- and post-measures) are needed to be able to provide better quality evidence.

Additionally, the results of this review emphasize individual level factors, yet broader considerations of context should be included in future research designs (Nicholas & Klag, 2020), for example, training and supports provided, plus employer expectations. It is suggested that longitudinal studies consider the issues facing employers, autistic adults, and those people helping to facilitate employment with positive outcomes for employers and employees.

Conclusion

The Australian Government is committed to explore new options for a model to replace the existing DES system. The current systematic review identified several practices that may assist the Australian Government to effectively support autistic job seekers in gaining and maintaining employment. The most important mechanism appearing to underly the successful implementation of these practices is autism knowledge which underlies individualized tailoring of support provided by disability employment staff providing these services.