Career assessment for a young person with Autism Spectrum Disorder (ASD) in Hong Kong - Findings and reflection

Received: 27-Apr-2018 Accepted Date: Jun 09, 2018; Published: 14-Jun-2018

Citation: Wong S. Career assessment for a young person with Autism Spectrum Disorder (ASD) in Hong Kong - Findings and reflection. J Child Adolesc Psych. 2018;2(2):3-5.

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Abstract

The difficulties encountered by persons with ASD in employment and the need for both career assessment and transition planning service are well documented. A young person with ASD was given both quantitative and qualitative assessment tools. As revealed, both the occupational card sort and the instrument for value clarification were the most helpful among the tools adopted while the results of career interests exploration using both SDS-5R and Fabry and Bertinetti’s (2014) Career Interpersonal Identity Type Assessment could be misleading for clients with ASD, especially in case of high score in Social type. The findings highlight the importance of a comprehensive assessment using both quantitative and qualitative instruments in multiple domains, including exploration for strengths and talents.

Keywords

Autism Spectrum Disorder; Career assessment; Values; Chinese; Hong Kong

Introduction

Autism spectrum disorder (ASD) is a complex, life-long neurodevelopmental disability characterized by neurological abnormalities in sensory, motor, and integrative functions resulting in a wide array of impairments in social relatedness, communication, inflexibility, restricted patterns of interest, and misinterpretation of social cues [1]. Due to their disabilities, persons with ASD encounter various problems in finding and keeping employment [2-5]; hence, transition planning is crucial for students with ASD to secure gainful employment [6].

The term “career assessment” is usually interchanged with “transition assessment” [7], which is defined as “a planned, continuous process of obtaining, organizing, and using information to assist individuals with disabilities of all ages and their families in making critical transitions in students’ lives both successful and satisfying.” [7], Career assessment is a critical component of transitional planning [8,9]. Unfortunately, studies on career assessment tools for young persons with ASD are rare [10,11] and healthcare or social services are deficient incoherent, integrated systems to help youth with ASD in transition planning [1]. In Hong Kong, the literature on career assessment targeting on ASD clients is lacking, especially case study. To fill the gap, a field test has been conducted to examine various instruments in a case aiming at gaining insight on career assessment practice.

Humphrey

Humphrey came from an intact family with parents and a younger brother. His father is a self-employed electric technician and his mother is a housewife. He was diagnosed as suffering from Asperger (now ASD in DSM-V) in his young age. Fortunately, with strong support from both his mother and maternal aunt (a social worker), he managed to learn how to keep eye contacts and “communicate” with his schoolmates, peers, and teachers. Despite the need for changing schools resulting from his typical autistic behaviors, he eventually enrolled in a higher diploma program in social work in a self-financed institution in Hong Kong. Although he has completed all the coursework within two years, he failed to meet the graduation requirement due to his unsatisfactory performance in both the concurrent and block fieldwork placement as a result of his inability to develop a working relationship with his clients, colleagues, center-in-charge, and fieldwork supervisors. Consequently, he had to repeat his fieldwork practicum causing him to feel a strong sense of frustration.

Career assessment for smooth school-to-work transition

It is well documented that multiple types and levels of assessments should be used in transition planning [9]. Hence, both quantitative and qualitative tools will be adopted in the present study—the former, such as John Holland’s Self-Directed Search Form R, 5^th Edition (SDS-5R) and Super’s Work Value Inventory (WVI), were adopted to measure his both career interests and work values, while the latter, including vocational card sort and [12] Career Interpersonal Identity Type Assessment, were used to identify both career themes and interest. Feedback from Humphrey on his perception regarding the effectiveness and usefulness of the tools was also gathered.

Self-Directed Search is a very popular quantitative career assessment tool for interest because it is linked directly to Holland’s career theory. It is assumed that interest is crucial for career development because of the association between interests and job satisfaction and achievement. Unfortunately, interests and satisfaction can be linked through other mediating factors, including values, abilities, and so on. What is more, the distribution of career interests in the population does not match the world of work in reality. The most obvious example is the high percentage of artistic interests among secondary students but the low numbers of the artistic jobs in the market. Perhaps more importantly, there is a lack of predictive validity of interests [13]. Modeled on Kelly’s and Holland’s theories, Career Interpersonal Identity Type Assessment is a qualitative method to measure interest based on the influences of past and present interpersonal relationships. Due to being new, a rare study has been found to discuss the strengths and drawbacks of the instrument. The present study finds its potential problem in assessing people with ASD (please refer to the following findings and discussion). Considering that work values are one of the crucial determinants of career choice, Super’s Work Values Inventory can be included as part of a formal assessment process to facilitate career decision making. Unfortunately, weaknesses in internal consistency are reported in Wong and Yuen’s study [14]. Card sorts are non-standardized assessments commonly used in career counselling to help clients explore various aspects of them. The advantages include clients’ active engagement, the immediacy of results, flexibility, being inexpensive and so on, whereas the disadvantages are lack of research proving reliability or validity, results being unpredictable and being judged by clients as non-scientific due to being not high tech [15].

Findings

The total scores of SDS-5R were reported as Realistic 18, Investigative 14, Artistic 6, Social 32, Enterprising 28, and Conventional 15 respectively indicating a Holland code of SER. The highest score in Social type for a young person with ASD is most likely misleading and can be explained by his academic training in social work. It is speculated that he might not get a high score in Social type before his receiving social work training. However, he frankly admitted that a Social type of occupation, such as social worker, teacher, and so on, is a “Mission Impossible”. Perhaps, if he met a professional career counselor two years ago, he was surely advised NOT to choose social work as his major of study. This is a common error in transition assessment as put forwards by [6] the failure to consider student challenges in core areas associated with ASD, especially social skills.

Career Interpersonal Identity Type Assessment, [12] Humphrey successfully paired 8 out of 12 listed persons who have had a strong influence on him and then converted the occupations of these 8 persons into the primary code of Holland’s six types. The results are Social 3, Realistic 2, Investigative 2, and Enterprising 1. Although his Holland code (SER) is similar to those of the findings of the Career Interpersonal Identity Assessment, the findings can be again misleading for a client with ASD. However, Humphrey reflected that significant others around him during his childhood and adolescence belonged to Social Type and helped him overcome part of his deficits in social communication and interaction. Therefore, he had once thought that he belonged to this type of persons when studying social work. The findings of the present case may suggest that a person’s career interests and identity can be influenced by the past and present interpersonal relationships but this person may neglect the fact that other factors, such as abilities and competencies, are more important for people with ASD in career decision making.

Humphrey scored highest in 3 subscales in WVI (Independence 1), Altruism 14, and Creativity 14 and lowest in Security 6, Supervisory Relationship 9, Associates 9, Achievement 9, and Aesthetic 9. The test results indicate that a youngster with ASD strives for leading an independent life and creating new ideas or initiatives for a new life. The relatively low score in Security subscale may probably reflect his dissatisfaction with the present social structure, while the importance of Supervisory Relationship and Associates being underscored demonstrates his social handicaps. His low score in Achievement again indicates his lack of self-confidence in achieving something under physical restrictions. As revealed, among the four assessment methods, the values inventory helped him reflect most. It is confirmed that independence is very important to him, even more, important than helping others. He wants to help others but the altruistic acts must be under his leadership and control. The test helps him become aware of his strong needs for independence.

The themes being discovered in the vocational card sort exercise include Independent living based on his own ability to work on data (occupations: data scientist, credit analyst, investment analyst), pursuit of knowledge (occupations: anthropologist, economist, geologist, physicist), jobs that do not require to work with people (occupations: librarian, curator, factory manager, camp warden), and craftsmanship (occupations: construction worker, decoration worker, construction supervisor). Humphrey enjoyed doing the vocational card sort very much and gained insight from the exercise. He understands the work values behind each occupation and confirms that he will give up Social occupations although he will go on his social work fieldwork placement just to complete his postsecondary study. At the same time, he comes up with two plans to make a living in the future. Firstly, he would follow his father’s path as a freelance electric technician or decoration worker (so as to avoid occupations required to work with people). He had started to attend relevant courses and learn from his fathers and friends. Secondly, he would engage in investment in the stock market because he has a good track record of earning money from analyzing listed company information. Hence, he can lead an independent life without giving burdens to his family or others.

Discussion

The fact that Humphrey had high social scoring in both interest assessments is indeed surprising since research consistently depicts their social deficits, including face processing difficulties, low ability in expressing empathy and emotion regulation, and problems in social interaction [16]. Coupled with handicaps in theory of mind and the decline in self-related memory, persons with ASD should have problems in representing the contents of their own and other’s minds. The decline is suspected to be associated with a deficit in memory reconstruction and source monitoring [17]. Impairments in memory for information relating to the self-have a negative impact on social functioning [18]. The ability of people with ASD to overcome their social deficits can be explained by their adaptive capacity or compensatory effort.

This adaptive capacity, including rote memory, is particularly evident in the high functioning groups. In addition, the cognitive performances of persons with ASD are much better in adulthood than in childhood. That means they can overcome difficulties since childhood through the learning process [19]. Ullman and Pullman’s [20] echo that declarative memory (e.g. consciously mastering the steps involved; memorizing stock phrases and sentences) helps persons with ASD compensate for social handicaps by memorizing scripts for facing different challenges in social settings.

Although Humphrey has never received any formal social skills training, his mother and aunt (a registered social worker) has been offering strong support to him and continuously taught him to relate to others, including maintaining eye contact, explaining how his behaviors hurt others (such as revealing a fat girl’s weight loudly in the class), teaching him how to avoid conflict, and so on. Furthermore, he made improvement by observing and imitating others. Most often, he learned by committing mistakes and avoiding the same mistakes again. Even though he failed to show empathy, he still gained a friendship with several classmates in secondary and postsecondary schools. Of course, the micro-skills learned in the social work courses helped him a lot. Belonging to high-functioning ASD group, Humphrey exhibits adaptive capacity, greater cognitive compensation, and improvement in both learning abilities and declarative memory when he is growing up. Together with a strong familial support, he demonstrates his improving capabilities in overcoming parts of his social deficits.

Thompson et al. [21] interviewed 19 parents of young people with ASD and identified three major themes relating to their children’s transition to adulthood [1]. To be understood, [2] To understand the world, and [3] To succeed. These themes can be applied to this case too. On one hand, Humphrey needs to be understood by society in general and prospective employers in particular. He needs understanding and equal opportunities, instead of prejudice. On the other hand, he needs to understand the world, especially which work environment fits him best. More importantly, he needs to explore his own strengths, unfold his own potential, build his selfconfidence, and achieve success eventually. The cruel fact is that out of 4,300 autistic adults aged below 64, only 32.6% were employed in Hong Kong in 2014 and more than 66% of the employers in Hong Kong admitted that they had little or no knowledge of the syndrome or ways to cope with it [22]. Through “understanding the world” and understanding himself, Humphrey decided to give up a social-type occupation and seek a non-social one. Following his father’s path as a freelance electric technician or decoration worker seemingly is the most realistic option for him and he considers being financially independent as a success to him.

Conclusion

The findings highlight the importance of using both quantitative and qualitative methods in career assessment [23]. Based on Humphrey’s verbal report, both Super’s Work Values Inventory and vocational card sort help him the most since he can explore his values and know what is more important to him. In other words, career assessment should include instruments for values clarification. In addition, the results of the interest assessment, including SDS-5R and Career Interpersonal Identity Type Assessment, can be misleading for clients with ASD. Career counsellors should be cautious when the highest scores are related to Social type among clients with ASD. The high social scores may be due to their being in high-functioning ASD group, adaptive capacity, greater cognitive compensation, and improvement in both learning abilities and declarative memory. For a more comprehensive assessment, instruments/ tools measuring skills, competencies, personality traits, and other domains, should be included. Focus on exploring their strengths is particularly important since they are well-known to have special talents or skills [24]. The present case, Humphrey, was found to be sensitive to numerical figures and attentive to listed company information. Whether he can match with jobs that can utilize this kind of talents should be further investigated.

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