Employment Outcomes Among Foster Youth with Autism Spectrum Disorder and Other Developmental Diagnoses

Background and Purpose:  Previous research on employment outcomes for youth aging out of the child welfare system has found that foster youth are less likely to be employed and earn lower wages on average than comparable low-income children outside of the child welfare system.  This pattern has been found in several states including Illinois, South Carolina, North Carolina, California, and Minnesota.  None of the previous research on employment outcomes has sought to identify the relationship between specific developmental conditions and employment outcomes.  The purpose of this study is to fill this gap in the literature by comparing rates of employment and wages among transition aged youth with and without developmental diagnoses including autism spectrum disorder (ASD). 

Methods:  The study uses linked administrative data from three state agencies in Illinois.  The study population includes 1,247 youth that reached age 18 in the child welfare system between July 1, 2009 and September 30, 2010.  Linked Medicaid claims were used to identify 39 youth with ASD based on claims with ICD-9-CM diagnosis codes 299.0, 299.8, or 299.9.  Youth with ASD represented 3.1% of the study population.  Another 74 youth or 5.9% had another developmental diagnosis (DD).  The remaining 1,134 youth did not have ASD or another developmental diagnosis.  A maximum of 8 quarters of wage report data was available beginning with the quarter of the youth’s 21^st birthday.  Generalized estimating equations were used to identify the population-average effect of demographic and child welfare related factors on the log-odds of employment and average quarterly wages.  

Results: During four quarters of their 21^st year, less than half of all youth who reached age 18 while in the child welfare system were ever working.  Just 26% of youth with ASD had ever worked over this four-quarter period compared with 30% of youth with other DD and 45% of youth without ASD or other DD (p<0.002).  After controlling for demographic and child welfare factors, there was no significant difference in the odds of employment after age 21 among youth with ASD compared with youth without ASD or other DD (Odds Ratio (OR) 0.75, p<0.46).  There was a significant difference in the odds among youth with other DD.  Youth with other DD had half the odds of employment than youth without ASD or DD (OR 0.50, p<0.007).  A similar pattern was found with respect to the level of quarterly earnings.  Like previous research, the study finds that living in a congregate setting is associated with a lower odds of employment (OR 0.59, p<0.0001) and average quarterly earnings $244 less than youth living in a foster home setting (related or unrelated) at age 18 (p<0.001).

Conclusions and Implications:  

Transition aged youth with ASD and other DD have poorer employment outcomes when compared with youth without these conditions.  Surprisingly, youth with recent claims for other developmental diagnoses faired significantly worse when compared to youth without ASD or other DD.  These findings demonstrate heterogeneity in the employment outcomes of youth exiting the child welfare system by developmental diagnoses.