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Tang, J. S. Y., Chen, N. T. M., Falkmer, M., Bӧlte, S. & Girdler, S. (2019). A systematic review and meta-analysis of social emotional computer based interventions for autistic individuals using the serious game framework. Research in Autism Spectrum Disorders, 66, Article ID 101412.
Open this publication in new window or tab >>A systematic review and meta-analysis of social emotional computer based interventions for autistic individuals using the serious game framework
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2019 (English)In: Research in Autism Spectrum Disorders, ISSN 1750-9467, E-ISSN 1878-0237, Vol. 66, article id 101412Article, review/survey (Refereed) Published
Abstract [en]

Background and aim: Adopting the elements of the Serious Game framework has been hypothesised as a strategy to promote the efficacy of social emotional computer-based interventions (CBI) for autistic individuals. This systematic review aimed to review the application of Serious Game principles in current social emotional CBI targeting autistic individuals and evaluate the effect of these principles in remediating social emotional outcomes via meta-analysis.

Methods: Database searches identified 34 studies evaluating social emotional CBI with 17 controlled efficacy studies included in meta-regressions analyses. Narrative synthesis summarised the attributes of each CBI based on the five Serious Game principles; motivating storyline, goal directed learning, rewards and feedback, increasing levels of difficulty and individualisation.

Results: Based on the scores of the Serious Game assessment tool we developed, findings revealed on average a limited (45%) integration of Serious Game design principles in social emotional CBI for autistic individuals. Main findings from the meta-regressions of 17 controlled efficacy studies revealed a moderating effect of Serious Game design principles on the distant generalisation of social emotional skills and transferability of outcomes among autistic individuals. No significant moderating effects of Serious Game was found for close generalisation and maintenance outcomes.

Conclusion: Overall, findings suggest that the Serious Game design framework has utility in guiding the development of social emotional CBI which improve the social emotional skills of autistic individuals. 

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Autism, Innovative technology, Serious games, Social skills
National Category
Psychology Interaction Technologies
Identifiers
urn:nbn:se:hj:diva-45476 (URN)10.1016/j.rasd.2019.101412 (DOI)000480668200011 ()2-s2.0-85068220128 (Scopus ID);HLKCHILDIS (Local ID);HLKCHILDIS (Archive number);HLKCHILDIS (OAI)
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-09-30Bibliographically approved
Arnold, S. R. C., Foley, K.-R., Hwang, Y. I., Richdale, A. L., Uljarevic, M., Lawson, L. P., . . . Trollor, J. N. (2019). Cohort profile: The Australian Longitudinal Study of Adults with Autism. BMJ Open, 9(12), Article ID e030798.
Open this publication in new window or tab >>Cohort profile: The Australian Longitudinal Study of Adults with Autism
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 12, article id e030798Article in journal (Refereed) Published
Abstract [en]

PURPOSE: There is a significant knowledge gap regarding the lives of adults on the autism spectrum. Some literature suggests significant health and mental health inequalities for autistic adults, yet there is a lack of comprehensive longitudinal studies exploring risk factors. Further, most research does not include the perspective of autistic adults in its conduct or design. Here, we describe the baseline characteristics and inclusive research approach of a nationwide longitudinal study. ​

PARTICIPANTS: The Autism Cooperative Research Centre for Living with Autism's Australian Longitudinal Study of Adults with Autism (ALSAA) is a questionnaire-based longitudinal study of autistic adults (25+ years old) with follow-up at 2-year intervals. Autistic advisors were involved in each stage of research apart from data analysis. Three questionnaires were developed: self-report, informant report (ie, proxy report) and carers (ie, carer experiences and characteristics). ​

FINDINGS TO DATE: An inclusive research protocol was developed and agreed with autistic advisors. Baseline data were collected from 295 autistic adults (M=41.8 years, SD=12.0) including 42 informant responses, 146 comparison participants and 102 carers. The majority of autistic participants (90%) had been diagnosed in adulthood (M=35.3 years, SD=15.1). When compared with controls, autistic adults scored higher on self-report measures of current depression and anxiety. Participant comments informed ongoing data gathering. Participants commented on questionnaire length, difficulty with literal interpretation of forced response items and expressed gratitude for research in this area.

​FUTURE PLANS: A large comprehensive dataset relating to autistic adults and their carers has been gathered, creating a good platform for longitudinal follow-up repeat surveys and collaborative research. Several outputs are in development, with focus on health service barriers and usage, caregivers, impact of diagnosis in adulthood, further scale validations, longitudinal analyses of loneliness, suicidal ideation, mental illness risk factors and other areas. Baseline data confirm poorer mental health of autistic adults. The ALSAA demonstrates a working approach to inclusive research.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
adult; autism; longitudinal
National Category
Psychiatry
Identifiers
urn:nbn:se:hj:diva-46763 (URN)10.1136/bmjopen-2019-030798 (DOI)31806608 (PubMedID)2-s2.0-85076155615 (Scopus ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Local ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Archive number)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2019-11-04 Created: 2019-11-04 Last updated: 2020-01-02Bibliographically approved
Tang, J. S., Falkmer, M., Chen, N. T., Bölte, S. & Girdler, S. (2019). Designing a Serious Game for Youth with ASD: Perspectives from End-Users and Professionals. Journal of autism and developmental disorders, 49(3), 978-995
Open this publication in new window or tab >>Designing a Serious Game for Youth with ASD: Perspectives from End-Users and Professionals
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2019 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 49, no 3, p. 978-995Article in journal (Refereed) Published
Abstract [en]

Recent years have seen an emergence of social emotional computer games for individuals with Autism Spectrum Disorder (ASD). These games are heterogeneous in design with few underpinned by theoretically informed approaches to computer-based interventions. Guided by the serious game framework outlined by Whyte et al. (Journal of Autism and Developmental Disorders 45(12):1-12, 2014), this study aimed to identify the key motivating and learning features for serious games targeting emotion recognition skills from the perspectives of 11 youth with ASD and 11 experienced professionals. Results demonstrated that youth emphasised the motivating aspects of game design, while the professionals stressed embedding elements facilitating the generalisation of acquired skills. Both complementary and differing views provide suggestions for the application of serious game principles in a potential serious game.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Adolescent, Autism spectrum disorder, Computer, Educational game, Technology
National Category
Interaction Technologies
Identifiers
urn:nbn:se:hj:diva-42023 (URN)10.1007/s10803-018-3801-9 (DOI)000459794700013 ()30377883 (PubMedID)2-s2.0-85055981758 (Scopus ID);HLKCHLDIS (Local ID);HLKCHLDIS (Archive number);HLKCHLDIS (OAI)
Available from: 2018-11-13 Created: 2018-11-13 Last updated: 2020-01-20Bibliographically approved
Black, M. H., Vaz, S., Parsons, R., Falkmer, T., Tang, J. S. Y., Morris, S., . . . Falkmer, M. (2019). Disembedding performance and eye gaze behavior of adolescents with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 66, Article ID 101417.
Open this publication in new window or tab >>Disembedding performance and eye gaze behavior of adolescents with Autism Spectrum Disorder
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2019 (English)In: Research in Autism Spectrum Disorders, ISSN 1750-9467, E-ISSN 1878-0237, Vol. 66, article id 101417Article in journal (Refereed) Published
Abstract [en]

Background: Atypical visual perception in individuals with Autism Spectrum Disorders (ASD) may contribute to superiority in disembedding tasks. Gaze behavior has provided some insights in to mechanisms underlying this purported superiority in children, however evidence is limited and requires additional investigation.

Method: The performance and gaze behavior of 27 adolescents with ASD and 27 matched typically developing (TD) peers were examined during the Figure Ground Subtest of the Test of Visual Perception Skills-third edition (TVPS-3).

Results: Compared to their TD counterparts, adolescents with ASD were no different in accuracy, however, had a longer response time. Differences in gaze behavior were also observed, characterized by adolescents with ASD spending less time viewing the incorrect and target figures, and spending a greater proportion of time viewing irrelevant areas of the stimuli compared to TD adolescents.

Conclusions: Results suggest that while altered visual perception was observed, this did not contribute to superiority in disembedding tasks in adolescents with ASD. Future research is required to elucidate conditions under which altered visual perception may contribute to behavioral superiority. 

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Enhanced perceptual functioning, Eye tracking, Local bias, Weak central coherence
National Category
Pediatrics Psychology
Identifiers
urn:nbn:se:hj:diva-45475 (URN)10.1016/j.rasd.2019.101417 (DOI)000480668200008 ()2-s2.0-85068396586 (Scopus ID);HHJCHILDIS,HLKCHILDIS (Local ID);HHJCHILDIS,HLKCHILDIS (Archive number);HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2019-08-07 Created: 2019-08-07 Last updated: 2019-09-30Bibliographically approved
Scott, M., Milbourn, B. T., Falkmer, M., Black, M. H., Bölte, S., Halladay, A. K., . . . Girdler, S. J. (2019). Factors impacting employment for people with autism spectrum disorder: A scoping review. Autism, 23(4), 869-901
Open this publication in new window or tab >>Factors impacting employment for people with autism spectrum disorder: A scoping review
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2019 (English)In: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 23, no 4, p. 869-901Article, review/survey (Refereed) Published
Abstract [en]

The aim of this study is to holistically synthesise the extent and range of literature relating to the employment of individuals with autism spectrum disorder. Database searches of Medline, CINAHL, PsychINFO, Scopus, ERIC, Web of Science and EMBASE were conducted. Studies describing adults with autism spectrum disorder employed in competitive, supported or sheltered employment were included. Content analysis was used to identify the strengths and abilities in the workplace of employees with autism spectrum disorder. Finally, meaningful concepts relating to employment interventions were extracted and linked to the International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder. The search identified 134 studies for inclusion with methodological quality ranging from limited to strong. Of these studies, only 36 evaluated employment interventions that were coded and linked to the International Classification of Functioning, Disability and Health, primarily focusing on modifying autism spectrum disorder characteristics for improved job performance, with little consideration of the impact of contextual factors on work participation. The International Classification of Functioning, Disability and Health Core Sets for autism spectrum disorder are a useful tool in holistically examining the employment literature for individuals with autism spectrum disorder. This review highlighted the key role that environmental factors play as barriers and facilitators in the employment of people with autism spectrum disorder and the critical need for interventions which target contextual factors if employment outcomes are to be improved. 

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
adult, intervention, strengths-based, vocational rehabilitation, work environment
National Category
Work Sciences Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-41511 (URN)10.1177/1362361318787789 (DOI)000470858200007 ()30073870 (PubMedID)2-s2.0-85052370363 (Scopus ID);HHJCHILDIS,HLKCHILDIS (Local ID);HHJCHILDIS,HLKCHILDIS (Archive number);HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2018-09-19 Created: 2018-09-19 Last updated: 2020-01-20Bibliographically approved
Afsharnejad, B., Falkmer, M., Black, M. H., Alach, T., Lenhard, F., Fridell, A., . . . Girdler, S. (2019). KONTAKT© for Australian adolescents on the autism spectrum: Protocol of a randomized control trial. Trials, 20(1), Article ID 687.
Open this publication in new window or tab >>KONTAKT© for Australian adolescents on the autism spectrum: Protocol of a randomized control trial
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2019 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, no 1, article id 687Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes.

METHOD/DESIGN:

With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs.

DISCUSSION:

The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.

TRIAL REGISTRATION:

Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Adolescents, Autism spectrum disorder, KONTAKT, Social skills, Training, adolescent, anxiety, Article, Australian, autism, child, clinical effectiveness, clinical outcome, controlled study, cooking, cost effectiveness analysis, emotion, face, female, gaze, gender, Goal Attainment Scale, health care cost, human, intelligence quotient, interview, loneliness, major clinical study, male, parent, peer group, performance, quality of life, randomized controlled trial, rating scale, school child, self concept, social interaction, social skills group training
National Category
Pediatrics
Identifiers
urn:nbn:se:hj:diva-47210 (URN)10.1186/s13063-019-3721-9 (DOI)000506884900006 ()31815642 (PubMedID)2-s2.0-85076298440 (Scopus ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Local ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Archive number)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-29Bibliographically approved
Kuzminski, R., Netto, J., Wilson, J., Falkmer, T., Chamberlain, A. & Falkmer, M. (2019). Linking knowledge and attitudes: Determining neurotypical knowledge about and attitudes towards autism. PLoS ONE, 14(7), Article ID e0220197.
Open this publication in new window or tab >>Linking knowledge and attitudes: Determining neurotypical knowledge about and attitudes towards autism
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2019 (English)In: PLoS ONE, E-ISSN 1932-6203, Vol. 14, no 7, article id e0220197Article in journal (Refereed) Published
Abstract [en]

"Why are neurotypicals so pig-ignorant about autism?" an autistic person wrote on the Curtin Autism Research Group's on-line portal as a response to a call for research questions. Coproduced with an autistic researcher, knowledge about and attitudes towards autism were analysed from 1,054 completed surveys, representing the Australian neurotypical adult population. The majority, 81.5% of participants had a high level of knowledge and 81.3% of participants had a strong positive attitude towards autism. Neither age, nor education level had an impact on attitudes. However, attitudes were influenced by knowledge about 'Societal Views and Ideas'; 'What it Could be Like to Have Autism'; and the demographic variables 'Knowing and having spent time around someone with autism'; and gender (women having more positive attitudes than men). Thus, targeted interventions, geared more towards men than women, to increase knowledge about autism could further improve attitudes and increase acceptance of the autistic community.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Neurology
Identifiers
urn:nbn:se:hj:diva-45536 (URN)10.1371/journal.pone.0220197 (DOI)000484977900067 ()31344074 (PubMedID)2-s2.0-85069963650 (Scopus ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Local ID)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (Archive number)GOA HHJ 2019,GOA HLK 2019;HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2019-08-12 Created: 2019-08-12 Last updated: 2020-01-20Bibliographically approved
Rogerson, J. M., Falkmer, M., Cuomo, B. M., Falkmer, T., Whitehouse, A. J., Granich, J. & Vaz, S. (2019). Parental experiences using the Therapy Outcomes by You (TOBY) application to deliver early intervention to their child with autism. Developmental Neurorehabilitation, 22(4), 219-227
Open this publication in new window or tab >>Parental experiences using the Therapy Outcomes by You (TOBY) application to deliver early intervention to their child with autism
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2019 (English)In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 22, no 4, p. 219-227Article in journal (Refereed) Published
Abstract [en]

PURPOSEAs computer-based interventions become commonplace for parents of children with neurodevelopmental disorders, this study sought to understand the experience of using a parent-delivered supplementary early intervention therapy for children with autism spectrum disorder grounded in a variety of behavioral, sensory, developmental, and relationship-based approaches and delivered via a tablet device.

METHODSParental experiences using the 'Therapy Outcomes by You' (TOBY) application were collected through semi-structured interviews with 17 parents.

RESULTSParents reported TOBY facilitated parent-child engagement, provided ideas for therapeutic activities, created feelings of empowerment, and positively impacted their child's development. Barriers to use included preparation time, execution of the intervention, and individual strengths and weaknesses of their child.

CONCLUSIONThe overall parental experience of TOBY was positive when use of the application aligned with parental proficiency, opportunities for use, and importantly, the needs of the child.

Place, publisher, year, edition, pages
Informa Healthcare, 2019
Keywords
App; iPad; intervention; technology; treatment
National Category
Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-38909 (URN)10.1080/17518423.2018.1440259 (DOI)000463811300001 ()29485349 (PubMedID)2-s2.0-85042914082 (Scopus ID);HHJCHILDIS,HLKCHILDIS (Local ID);HHJCHILDIS,HLKCHILDIS (Archive number);HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2020-01-20Bibliographically approved
Black, M. H., Mahdi, S., Milbourn, B., Thompson, C., D'Angelo, A., Ström, E., . . . Bölte, S. (2019). Perspectives of key stakeholders on employment of autistic adults across the United States, Australia and Sweden. Autism Research, 12(11), 1648-1662
Open this publication in new window or tab >>Perspectives of key stakeholders on employment of autistic adults across the United States, Australia and Sweden
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2019 (English)In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806, Vol. 12, no 11, p. 1648-1662Article in journal (Refereed) Published
Abstract [en]

Despite efforts to improve employment outcomes for autistic individuals, internationally their employment rates remain low. There is a need to better understand the factors influencing successful employment for autistic adults in the labor market from the perspectives of multiple keystakeholders. This study represents the second in a series of papers conducted as part of an International Society for Autism Research policy brief aimed at improving employment outcomes for autistic individuals. A community consultation methodology using focus groups, forums, and interviews was applied with autistic individuals (n = 19), family members (n = 18), service providers (n = 21), employers (n = 11), researchers (n = 5), and advocacy group representatives (n = 5) in Australia, Sweden, and the United States, aiming to identify the factors perceived to determine gaining and maintaining employment for autistic individuals. Directed content analysis, guided by the International Classification of Functioning, Disability and Health (ICF), was conducted to investigate the key factors influencing employment outcomes for autistic individuals. Meaningful verbal concepts, or units of text with common themes, were also derived from the qualitative data and then linked and compared to the ICF Autism Spectrum Disorder (ASD) Core-sets. Across countries, activity and participation and environmental factor categories of the ICF were the most associated with employment outcomes. Results suggest that removal of environmental barriers and enhancing environmental facilitators may assist to remediate ASD-related difficulties in the workplace.

LAY SUMMARY: This study sought to understand the perspectives of autistic individuals and key stakeholders on factors influencing if autistic adults get and keep jobs. Across Australia, Sweden, and the UnitedStates, focus groups and interviews were conducted to understand international perspectives on what helps and hinders getting and keeping a job for autistic individuals. The environment, including supports, relationships, attitudes, and services, were perceived to be the most important for workplace success. Intervention targeting barriers and facilitators in the workplace environment may support autistic adults to be successful in the labor market.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ICF; autism; cross-cultural; employment
National Category
Other Health Sciences Work Sciences
Identifiers
urn:nbn:se:hj:diva-44344 (URN)10.1002/aur.2167 (DOI)000474180800001 ()31276308 (PubMedID)2-s2.0-85068532718 (Scopus ID);HHJCHILDIS,HLKCHILDIS (Local ID);HHJCHILDIS,HLKCHILDIS (Archive number);HHJCHILDIS,HLKCHILDIS (OAI)
Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2019-12-18Bibliographically approved
Dreaver, J., Thompson, C., Girdler, S., Adolfsson, M., Black, M. H. & Falkmer, M. (2019). Success Factors Enabling Employment for Adults on the Autism Spectrum from Employers' Perspective. Journal of autism and developmental disorders
Open this publication in new window or tab >>Success Factors Enabling Employment for Adults on the Autism Spectrum from Employers' Perspective
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2019 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432Article in journal (Refereed) Epub ahead of print
Abstract [en]

Employment outcomes for individuals with autism spectrum disorder (ASD) are poor and there is limited understanding on how best to support individuals with ASD in the workplace. Stakeholders involved in the employment of adults with ASD, including employers and employment service providers have unique insights into the factors influencing employment for this population. Organisational and individual factors facilitating successful employment for adults with ASD across Australia and Sweden were explored, including the supports and strategies underpinning employment success from an employers' perspective. Three themes including Knowledge and Understanding of ASD, Work Environment and Job Match emerged, suggesting that a holistic approach was key to supporting success, with employer knowledge and understanding of ASD underpinning their ability to facilitate employment.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Autism, Competitive employment, Employment outcomes, Vocational support
National Category
Work Sciences
Identifiers
urn:nbn:se:hj:diva-43360 (URN)10.1007/s10803-019-03923-3 (DOI)30771130 (PubMedID)2-s2.0-85061587562 (Scopus ID);HLKCHILDIS (Local ID);HLKCHILDIS (Archive number);HLKCHILDIS (OAI)
Available from: 2019-03-21 Created: 2019-03-21 Last updated: 2019-03-21
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7275-3472

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