Service Delivery

The costs of services and employment outcomes achieved by adults with autism in the US.

Cimera et al. (2009) · Autism : the international journal of research and practice 2009
★ The Verdict

Standard VR spends the most on autistic adults yet yields the least pay and hours, but customized employment erases that gap.

✓ Read this if BCBAs who consult on vocational or transition plans.
✗ Skip if Clinicians focused only on early childhood home programs.

01Research in Context

01

What this study did

The team pulled 2009 U.S. Vocational Rehabilitation records for the adults with autism.

They counted every dollar spent and every job gained.

Then they stacked those numbers against adults with other disabilities served the same year.

02

What they found

Adults with autism landed jobs more often than most disability groups.

But they worked fewer hours and earned the lowest weekly pay.

They also burned through the highest service dollars per person.

03

How this fits with other research

Ohan et al. (2015) zoomed in on age and showed the worst outcomes hit transition youth with autism, even though they receive the most services.

Fedoroff et al. (2016) flipped the script: every adult with autism in their customized program kept a real job with better hours and pay.

Wehman et al. (2014) and Wilson et al. (2023) add that supported or customized employment lifts transition-age youth with IDD or autism, the very group Evert flagged as struggling.

The seeming clash is about service type, not people: standard VR keeps costs high and wages low; tailored support reverses both.

04

Why it matters

If you write VR plans, stop accepting low hours and pay as inevitable for autistic clients.

Push for customized or supported employment with job carving and fading coaching.

The data say these models turn the same population into steady workers without raising long-term costs.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Ask the VR counselor to add customized discovery and job carving to the client’s plan.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder
Finding
mixed

03Original abstract

This article examines the cost of services and employment outcomes obtained by adults with autism within the United States vocational rehabilitation (VR) system. It found that the number of such individuals has increased by more than 121 percent from 2002 to 2006. Moreover, though adults with autism were employed at higher rates than most disability groups investigated, they tended to work far fewer hours and earn less in wages per week. The study also found that adults with autism were among the most costly individuals to serve.

Autism : the international journal of research and practice, 2009 · doi:10.1177/1362361309103791