The effects of employment on the mental health and executive functions of adults with autism spectrum disorder (ASD)

Recent government initiatives have addressed employment opportunities for adults with autism spectrum disorder (ASD). Employment for adults with ASD is now of legislative, clinical and financial concern. Supported employment has been shown to improve the economy and increase social networks and well-being for adults with ASD. This is pertinent considering adults with ASD report poor mental health and demonstrate an uneven profile of executive functioning skills. In the present thesis, three studies address the effects of employment on mental health and executive functions in adults with ASD. Study One shows adults with ASD report higher levels of anxiety, lower levels of well-being and lower levels of satisfaction with life compared to adults without ASD. Also, unlike adults without ASD, levels of anxiety remain high for adults with ASD whether employed or unemployed. Study Two shows no significant differences in group performance on executive function tasks post-employment compared to pre-employment and no adult with ASD demonstrates consistent meaningful improvement on executive function tasks post-employment compared to pre-employment. Also, adults with ASD report similar depression, anxiety, satisfaction with life and well-being scores pre- and post-employment. This demonstrates the heterogeneity within autism and suggests a certain profile of an adult with ASD may exist in autism and employment services e.g. fewer self-reported mental health problems than other adults with ASD. Study Three shows social support predicts an increase in job satisfaction and a decrease in anxiety for employed adults with ASD. The findings are discussed in relation to: co-occurring intellectual disability and clinical disorders; the use of measures and types of reports; task complexity and the range of executive function tasks; the focus on group rather than individual differences; the role of anxiety; neurodiversity; and the legislative, clinical and financial impact of employment as a means of social inclusion for adults with ASD.