Hardly any adults with autism are receiving supports to help them find or keep a job, new research shows, and even among the few who do, the services are often far too short-term.

Some 1.98 million working-age individuals on the spectrum — or almost 99% — accessed no employment supports through Medicaid or vocational rehabilitation between 2008 and 2016, according to findings published this month in the journal The Milbank Quarterly.

Researchers combed data from the Centers for Medicare and Medicaid Services and the U.S. Department of Education’s Rehabilitation Services Administration, which administers the vocational rehabilitation program, to assess usage of employment services among those with autism ages 14 to 64. They found that just shy of 22,700 working-age individuals with autism were served in 2016, a number that the study authors described as “alarmingly low.”

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“It is difficult for me to wrap my brain around exactly how few people are receiving public employment services,” said Anne Roux, a research scientist at Drexel University’s A.J. Drexel Autism Institute who led the study.

During the time period studied, vocational rehabilitation provided employment services to eight times as many people with autism as Medicaid. Likewise, spending on Medicaid employment services dropped almost 30% while it grew nearly 400% for vocational rehabilitation, according to the findings.

That’s notable, the researchers said, since vocational rehabilitation supports are much more short-term in nature.

“Public spending, as a whole, is going toward short-term employment services, even though many autistic people are likely to need some level of flexible, longer-term supports across the working years,” Roux said.

The consequences of limited access to employment services go well beyond the ability to earn a paycheck, the study notes, since employment is often an indicator of health and well-being.

Major policy changes are needed to improve employment services for those with autism, the researchers said.

“Without substantial changes in the funding and provision of employment supports for this population, the effects of unemployment and its related economic and health sequelae may compound as an estimated one million youth on the autism spectrum reach the age of 18 years old over the next decade,” the study authors wrote in their findings.

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