To receive the schedule of upcoming programs, author discussions, book festivals and more. Booktv every sunday on cspan2 or anytime online at booktv. Org. Television for serious readers. Im doctor marjorie solomon, a professor of psychiatry in the department of psychiatry and Behavioral Sciences at Uc Davis School of medicine. Im also the associate director of Uc Davis Mind Institute located in sacramento, california. Mind institute is a Collaborative InternationalResearch Center committed to our awareness, understanding and treatment of the challenges associated with neurodevelopmental conditions. Today worker the talking to dr. Lewis mara who said archaeologist and member of one of the founding families of the mine. Welcome doctor. Thank you. And michael bernick, michal is an attorney with International Law firm of duane morris llc. Is also a fellow of the Milken Institute and former director f Californias Department of labor. Welcome, michael. Thank you, marjorie. Our conversation will be focused on adults with autism, adhd, and other learning differences. Particularly those with intellectual disability. Many of these adults are unemployed and they face a huge challenge after transition from high school when they have few cosecondary options and also few job options. These doctors are two experts in this area and actually have written a book on the subject called the autism full employment act. So lets start first by learning a little more about each one of you. Can you please our dishes up until so bit about how a cardiologist deals with autism . Thank addressing the white background i was born in italy and moved to the United States to my from another six years old. Not piquing the english language but quickly and peer group and send it come with director school in the bay area and then to medical school in houston, came to sacramento in the 70s to do my cardiology training. Ive been on the faculty for about five years and then started a Surgical Program for one of the local hospitals openheart surgery programs, and practiced medicine for 20 years. In 2000 i took your your sabbatical and was involved and proved to be involved with starting the mine institute with some other families and after that advertiser medicine completely and for 15 15 yeai had the privilege of working as a fulltime senior policy consultant in the California Senate working on a variety of Health Issues that included disabilities. For the past four years ive been working on various special projects that are related to education and community development. Esther story of my life. Michael, would you tell us about yourself. Was ive been involved in the employment field now for almost 40 years. And started actually the Job Training Group back in, actually the late 70s. And became involved in the autism committed in the early 90s, in 1999 with my son william was diagnosed at the time larger people with autism, they might know something about. Of course you cant mention autism without people say i have a niece, nephew, neighbors, so its much more prevalent now. But over the past 20 years lou and i have worked together on specific employment programs. Our focus is on developing programs to get people into jobs, people in Autism Community and related because autism [inaudible] a lot of other conditions. So we come to this as people have tried to work on, design, work as volunteers with individuals over the past 20 years. Lets get you to share your views. This employment issue, how big a problem is it today in terms of employment for autistic adults and those who have intellectual and Developmental Disability in particular . Its very interesting, marjorie. The employment rates for adults with autism and other developmental differences havent really changed since the early 1990s. We have developed this sort of infrastructure of training and placement after, especially after passage of the americans with disabilities act, but the employment rates havent really changed. A lot else has changed but employment rates have been stubborn, stubbornly low at roughly a less than a third in jobs that are anything more than say ten hours a week, so even parttime jobs. So the employment rates remain very, very limited. Even after many other elements of the autism world have change changed. Dr. Vismara, are you going to take the question . Its huge. Absolutely theres no doubt that in california individuals with autism, the unemployment or underemployment is well over 90 . And this problem has been further accentuated just by the sheer number of individuals who now have been diagnosed with being on the autism spectrum disorders. Its also a huge problem because theres a tremendous amount of talent and tremendous amount of potential that is currently being underused, add we really, really need to try to identify that and correct this issue. Theres also some great opportunity. Speaking a little bit more to that, to the opportunity, its a very big ship to turn around, as i think michael was speaking about before. What are some of the solutions that you two would propose to change this massive problem and make it a better situation . First of all, to recognize the problem, to know that there is unemployment, underemployment, and also recognize the fact that individuals with intellectual Development Disability are part of equity and diversity. Recognizing the problem is certainly a key aspect. The next thing we need to do is to come up with very basic solutions and hard to address this, in my opinion, early really focusing on the fact that as we go through life will need a job, home and a friend come really starting in secondary post secondary education and really identifying specific strategies that will engage individuals in meaningful work so its early identification here its providing support and then transitioning support to real jobs. You agree with that . The book doesnt have one big strategy. It doesnt have one big hedgehog. It has a variety of strategies, and thats what we found in our efforts over the past two decades. Part of those strategies have to do with increasing employment in private sector. Theres a lot of activity going on in terms of the past decade or so, Work Programs, other private sector initiatives. But the numbers, the numbers of adults involved in these programs remain very, very modest. Autism of work, very prominent, major firms in the United States still has fewer than a thousand individuals enrolled. So the numbers remain modest. Part of it is increasing again and a private sector i think we need a lot more activity within University Settings and nonprofits that are not under the same market pressures of private firms, and the book talks about that. We talk about state and local governments who often lecture private employers about hiring, but do very limited themselves. In the book sets out a number of strategies concerning those who are more severely impacted because as lou said, we see a place in the labor market for everyone. Thats a very fascinating and interesting point of view that one size doesnt fit all. Ive heard a lot about the push to competitive integrated employment. Can you talk a little bit more specifically about what you see the role of competitive integrated employment is in the landscape of opportunities for these adult . We certainly believe competitive integrated employment is really key factor and its very aspirational and we really believe thats an Important Role to strive for all individuals. Individuals that have an array of challenges, abilities and, frankly, disability. But whether competitive integrated employment is an appropriate setting for all individuals something that again still needs to be determined. My own personal feelings is individuals have the appropriate educational, Vocational Training and support, hopefully they will be able to achieve that but whether thats realistic for some individuals i think remains to be determined. Certainly individuals need choices and need an array of settings so they can optimize their potential and hopefully competitive and a cradle employment can provide that. One of the things ive heard a lot is that people with autism have unique strengths and unique challenges. Some people even say the autism challenge advanced and i think at this in your book. Can you speak more about that . Autism is associated with certain tech skills but thats misleading. Thats probably maybe ten, 15 of of our community at most. I think we need to approach it from a talent event. Thats the best way to expand employment but those talents are going to be in a range of skills, not particularly intact. Also another range of values that people bring. Theres a recent study of the walgreens distribution center. Theyve made a real effort at walgreens to increase employment of workers with the elemental differences in their distribution centers. What they find and what the study emphasizes are other traits of loyalty, of reduced absenteeism, im just a positive upbeat nature for the job. So theres some skills but it think there are a lot of other values that our Community Brings to the workplace that are important. I completely agree with what mike just said about an array of issues. Again, our son who is now 28 years of age, mark, is overcome with lots of challenges, needs a lot of support. But one of the issues or one of the strengths that he has is consistency. Once mark learned how to do something, he is very consistent. He enjoys that. So the ability to have a consistent structured environment is certainly an important aspect, and again i believe a lot of these soft skills which is certainly a great experience with, marjorie, are certainly very, very important to develop. And they can serve as role models for all employers and all businesses. Thank you. I agree i think the way the Research Literature is exactly what youre both suggesting that people with autism do make very loyal, punctual, responsible, reliable workers who sometimes dont mind doing tasks that other people might find routine because they enjoy the aspects of the job or just the predictability of the job. I also think some people feel that the social, the fact that they may not be as social or socially skilled and may hang back a bit is also an advantage. I think, marjorie, the social aspect is very interesting in that we found during the pandemic that i am very involved, and lewis with a group called the Adult Autism Group of northern california. Its a volunteer group. Many of our members were laid off or furloughed during the pandemic and have nowhere to go, and they constantly talked about how they missed having someplace to go every day. Our members actually prefer, and in no that is certainly true of my son, prefer the structure of the job, having someplace to go to. So i think the workplace itself and having a workplace to go to is far from being less important for the Autism Community, is more important. And have to say that they do echo you and agree with you entirely just about the role of work and the middle health of people with all known to governmental and other conditions. If you had in the single most important factor in probably having some light setasides for adults its ability to have meaningful work. So agreed to there. So we talk a lot about people with autism and big problems. How does a company go about building and autism Friendly Workplace . Marjorie, there are a lot of good examples of companies are developing programs. Again the autism at work, and we actually have a model thats developed that works well, unlike other areas of the social sciences and other areas of employment. Actually know it works in these are models that have three key elements. One, they focus as we discussed on skills, on the strengths of people. They sell the program as a challenge advantage. Its not social welfare. Two, these are programs that have a range of support. They recognize the challenges, so there are job coaches and there are mentors and mind managers are coached and brought into the process. And three, which i think is a most important is the impact and changes in workplace culture. That is, trying to develop a culture of of greater patients, flexibility, buyin from all elements, all sort of levels of the company. And this is a model used by microsoft and sap and Jpmorgan Chase and others firms, but its distinguished by its intentionality. And again its emphasis on retention, not just hiring. We started to talk about this a bit but, you know, what about adults with autism or more seriously impacted by autism . We know that in some of these autism at Work Companies you have really amazingly talented people that kind of fit that description you mentioned of the tech wizard but what about people who may have more limited language, people who have intellectual disability . Whats the best strategy in regards to employing them . Well, unfortunately, i dont think theres any best strategy, and i can speak from personal experience. As mentioned our son mark who was diagnosed with autism when he was 18 months of age, received Early Intervention, therapy which again was quite limited but again we were very privileged to have access to an array of interventions for mark, and those Early Intervention there was significant improvement. Nevertheless, mark essentially has very limited language, has some language but his expressive line which is very limited and significant intellectual impairment, has seizures in the past, has had behaviors. So hes overcoming a lot, lots and lots of challenges. Nevertheless, we have been able to provide an array of opportunities. So i think one of the most important aspects for individuals with severe developmental or overcoming significant challenges is to have an array of opportunities to be flexible enough, and weve been blessed, or ive been blessed that my wife, wendy, who is an occupational therapist, and it really worked with mark in terms of developing practical skills. Mark lives in his own home and he supported living service, has been living with support staff on his own since he was 18. And we feel that the ability to basically to able, promote independent is one of the best ways that families can support their children of any age and again mark falls into that. Wendy started working with mark at a young age when you send his own home in terms of promoting independence come in terms of taking care of his own home, helping with meal preparations. We also started when mark was in school, and again in terms of trying to blend very basic Academic Skills with practical experience. So i believe that starting in school with individuals as soon as possible, at a very young age in terms of promoting independence, promoting activities. One of the things that we have found or helpful with marcus first of all to engage him, to get into them specific taso provide specific outcomes that are helpful in promoting those skills. Its also important to provide not only Early Education but to relate that education to vocational outcomes that can be meaningful and to be sure that our transitional programs that lead to real life experience, the lead to employment opportunity, at that there is support that follow the students and are specific to some type of meaningful activities and support. Dr. Vismara, you know, ive known as a founding father of the mind for a long time now. When it comes to attitudes and up limit opportunities for children and adults with autism change since institute was founded more than 20 years ago . Thats a great question, marjorie, and i wish that i could say that yes, there is been an explosion and theres been tremendous improvement in both vocational and Employment Opportunities. But one of the reasons why, again i was privileged to coauthor the book with michael bernick, and hes one who reay spearheaded this project, is the data speak for themselves and when were still dealing with underemployment and unemployment that range from 8090 , i believe there has been an improvement in the sense that theres been greater recognition and there are a lot of people who started to work on this issue, but a think were really at the tip of the iceberg. And part of it is the fact that we are now really in an era in which many of the individuals like mark when the autism epidemic started in the early 90s, now individuals are aging out. We are also aging out as parents. So i think were really at the leading costs of this issue to provide the cost employment and training opportunities for individuals. A lot of work to be done spur i think thats well said, marjorie. It is the case where theres a lot more focus, a lot more tension, a lot more activity, a lot of the Work Programs and other initiatives in private the result of parents within these firms or family members within these firms wishing them. But the Unemployment Rate i can have been stubbornly low. They have not increased significantly. Over the past 30 years and that, as lucid thats why in the post and an economy there are opportunities. But we need it strange of range of strategies within a committee working in mutual support and terms of other utilizing the government structure. And really taking advantage of the programs, the funding that is being sent out now. Marjorie, let me add one more thing. As mike was talking it occurred to me that theres a certain analogy, practice similarity, in terms of where we are now with employment issues and where we were 20 some years ago with research and early identification that led to families and lou and others that were involved. Back in the early 90s, much of the Early Intervention research was actually being done around kitchen tables. It was being done in coffee shops. And one of the impetus of starting the mind institute was the fact that we really needed to take that passion and really put it into an infrastructure and into a real academic setting. And again we were so fortunate, so privileged to work with researchers such as yourself that made the reality, the passion and hopes and aspirations of parents, and the really transitioned into researchers and experts that have led to two amazing, amazing outcomes with the mind and others in terms of really finding potential causes and Early Intervention. I think that potential we are at the same place now with a lot of the issues, services and support for adults. Right now so much of that as mike indicated is being done by parents, and were certainly hopeful and i was one of the major emphasis of mikes vision in writing the book, that we could somehow serve as a small nudge in the right direction of taking that vision and putting it into infrastructure. It certainly involve academic institutions, state and local governments and business. We are hopeful that book could provide some guidance and almost a challenge in terms of why we need infrastructure to provide employment. When i delve into this issue it is, is an incredible, incredible challenge, an incredible nobrainer that we need to be able to provide jobs for all these people that are falling off the autism cliff. But once really struck me is how complicated and difficult all the system issues are in terms of getting the government actors, department of, unit, department of rehab, department of labor and all the different state agencies in every state to lineup and march in the same direction to provide an agreedupon set of services. I know, mike, you started down that road in your last answer, and i guess the book does a good job of putting it forward, your views on that. Could you just for our audience tell us a a bit more what youe there . It is a combination of strategy, a part of it is continuing to develop these programs, specific, intentional programs, placement and retention in private companies, and particularly, marjorie, theres a new sub industry that im very positive on. These are groups like in the great, started by individuals, largely family members who come out in the private sector, they are highly entrepreneurial and their focus, there are focused on placement and retention. I think in some ways as lou and i have often discussed theres probably still too much going on in terms of discussing the issue and in planning. They have real focus on placement and retention for individuals. And so we need that. And we need the participation of again nonprofits and universities under the same market pressures. And again, theres a workplace culture. Marjorie, i keep coming back to that. Lou and i often discussed it, which is there are real challenges. Those workplaces ive worked for for my son and others, im also serve as a volunteer job coach of Adult Research for workplaces that have these autism friendly elements that have very little to do with the usual elements associate with autism Friendly Workplaces. That is, lighting, sounds, so forth, but much more to do with the true autism friendly which has to do with a culture. Again, patience, flexibility, willingness to give people the time to learn and buy an from all levels of the company. I want to ask you if its possible that now were in a postpandemic era and also an era when issues of diversity equity and inclusion have risen to the forefront of the minds of many americans, are we in a particularly good time to introduce a really big changes into the way we view people with autism in the workforce . Again, as you mentioned, the issues of equity and diversity and inclusion are so important. They are not only important for individuals with Developmental Disabilities but its important for all this. Because when when we bring diversity into our lives, it not only improves our lives, and empowers us, but it also engages us into new ideas. And i certainly believe that in this postpandemic world that individuals with development of disability can be part of the economic recovery. Let me give you a specific example that more and i, that mike and i were privileged to participate. Prior to covid, mike was able to secure a California Workforce Development board a small grant, and as result of that grant over sixmonth period of time, we were able to place 17 young adults with autism with an array of intellectual challenges, some were relatively high functioning but others like our son mark were severely limited. We found that those individuals who are able to work in a senior assisted living facility, five different living assistant facility was remarkable express. Not only with the extra productive but was really, really empowering and engaging was how individuals that were there with developmental challenges really bonded and really interacted the rest of the senior residence. Theres going to be a huge need for those types of services not only an assisted living facilities but in others as well, and we really are very helpful that in the postpandemic, that individuals will be part of the economic recovery and overcome the labor shortage, not only in assisted living facilities but every restaurant that i i go and haa sign of labor workforce needed. And we really believe that it would be appropriate Vocational Training and support individuals will be able to contribute. Marjorie, there are i think to elements of postpandemic economy that make it particularly promising. New one, of course, is frankly changing on steroids. The amount of spending by the administration is proposing hundreds of billions of new spending in the developmental systems, including employment, in home and community services. So the challenge for all of us for practical expense will be how to spend the money most effectively. And number two, is lucid, the job world has changed and we look at shortages in certain fields. We are beginning to see it already. And those at shortages create opportunity. So this combination i think makes it a good time to reconsider how we can spend the funding effectively, what have we learned over the past 30 years, what are the effective programs at the local level, and what jobs are good fits . Some of them in restaurants and other places may be. For many in our community they may not be but there are other opportunities. So this post pandemic condos provide opportunities. We have releasing really seen over the past 20 years. If i am an employer, why should i hire an individual whos on the autism spectrum . Again, the issue of equity and diversity is so important. Many companies are now focusing on socalled sdgs come social environmental government issues, and that is certainly improves the culture, it improves innovation, it improves morale. But again the importance come what is most important factors are the businesses that are inclusive and that have included individuals with intellectual and Development Disabilities really not only improve their culture but improve productivity. So the most important thing is that its good for morale, its good for business, and is good for the bottom line. And with the appropriate support and training of individuals intellectual develop disabilities, are excellent employees. I like to take a step back and just ask you both, and weve alluded to this, too, but think about in more specifics. What about postsecondary options for adults with neurodevelopmental conditions . There are limited options, but actually uc davis just received a grant from department of education called the tipton grant to start a College Program with a pipeline to work for individuals with intellectual disability. What kind of activity do you see in the space and he believe this is important for employment in the future . Kudos and congratulation. I know youve been an International Leader on educational issues, particularly soft skills on how social training can transition into life skills that are so crucial to independence and successful employment, so first of all, thank you. Thank you. Its huge. Yet i feel though is the next step, an important challenge, is how to link Postsecondary Education the secondary education. So that there are seamless transitions. Right now there are significant funding streams that are intended for independence. They include a regional center. They include a department of rehab. They include special education, they include others. I am hopeful that in the very, very near future that we will be able to provide links and have your thoughts in terms of how we can engage some of the Research Entities second to mind so weak they can also be heitkamp again and programs in which all these funding sources, curriculum and strategies, i really person centered so that they can occur to successful integrated employment. This area of transition is becoming more important, not less, given the demographics that we are looking at 50,000 or so a year turning 18. So called falling off the click where we are very structured services up through k12. This is in in a way theres t of activity, good news. Colleges are creating both four year colleges and are to be recalled system are creating more and more structure, intentional programs to both help people get through and to get into the labor market but are a lot of other options also in terms of vocational programs. In sacramento we have a system which is a program that helps people transition through a type of emphasis on land and crafts. Theres a variety of what we urge parents, the people i i , families i work with, is to be very active, look at these options. Theres a lot out there and if your client, if theres a department of rehab, a number of these options include financial aid. So its really important that families take the initiative in terms of looking at the options. Because these options are increasing both college and noncollege. What can the family do if a family has a child thats in their late teens, what can you do to put the cells in the best position to have a good vocational outcome for their child . What do you recommend . A few thoughts come to mind. Again, for my personal experience. First of all, to really start thinking about independence for the child or for the young adult. And the sooner that we can promote independence, the better. Number two, look at networks to reach out to other families, to look at jobs come to look at again educational entities within secondary and Postsecondary Education. Number three, to do as Much Research as possible online and again through various networks. But right now there is, there unfortunately are no simple answers. Its a work in progress with we have outlined some of these recommendations in our book in terms of how to promote employment so i guess one of the things i would say is by our book and find out what we have to say. But we also would love to partner with other entities, both locally and throughout california. And again the book does outline some of the ways that folks can get involved in this project. Huge, huge need. We are at the cutting edge of it and we hope that our book will be a small step in the right direction. We have a job club in the sense which is our adult autism. So we meet on a monthly basis at a number of us volunteered or so people usually come to our job club, usually they are bewildered by the job market or they heard about autism at work. Their daughters or sons are finishing high school or turning 18, and we say really three things. One, do not do it alone. You not try to do it alone. You want to be active but you want, as lou says, theres Government Agencies out there, nonprofits, of the workforce areas and you want to Seek Partnership with them. Two, everyone else tells you not to be a helicopter parent. We say you ought to be a helicopter parent. You want to try to get as much. What we know about the job market is so much of it is networking and contacts, and you want to get involved in ginger contacts of knowledge and abilities as much as you can. And three, reach out to participate, as lou says, in this job clubs. Get together with other people in the community. In some ways all three of these are connected to the fact that dont try to do it alone. Mike already discussed this but in terms of being advocates, it is crucial to reach out not only to your friends and colleagues, but elected officials, even at the school board level, the city council, the state level. Because very often these individuals who are elected or appointed offices have an impact on policy, they have an effect on funding and an impact on outcome. And again that was one of the main reasons or the main reason why in early 2000 i retired from medicine and had the privilege of working as a fulltime policy consultant in the California Legislature pick because it is important that we take the research that you and others are doing and make it into system changes at a variety of levels that then enable systems to be scalable, to be expandable and sustainable. And so advocacy is really important. Gentlemen, this is an amazingly fascinating and wideranging conversation. In conclusion here, i would jt like to ask you both what you were doing to take the lessons you learn from writing your book and put them into action. What are the next steps . Its been a wonderful experience just reaching out to you and other individuals in terms of being able to discuss our book and the employment. So just reaching out to a variety of contacts and bringing new individuals and hopefully expanding our network has been really important. One of the specific issues that mike and i are doing is actually starting a Pilot Project where the vision would be to integrate some of our advocacy in the book and put into practice. And again part of that is Vocational Training and how to integrate the various assistant there were exploring the idea of working with regional centers, the department of, the department of development and services and also working with community colleges. Because again we feel that Higher Education plays an Important Role. So the idea would be to start Pilot Projects in which there could be a collaboration among these various entities in terms of actually started with Vocational Education the leads to employment and then leads to sustained employment on an ongoing basis. So the idea in thinking through some of the surge put them into practice is the next up we are exploring. Lou and i are working on focuses over the next two years, placing at least a thousand adults here in california in a series of pilots throughout the state, for the five pilot programs can placing a thousand individuals in learning more through their experiences on what is most effective, both in terms of hiring and retention. Its interesting, some of the other issues we discussed in the book like direct support professionals, job coaches and job counselors, marjorie, includes improving both training and wages, already moving forward here in california with additional American Rescue act funds. And so i think were seeing that. We are very interested in the area of adults who are more severely impacted. Lou and i are looking at a pilot also in that area. So thats exactly it. The book is a first step. For us we are now focusing on implementing elements of these strategies. Another goal that we have as the next step is how to link not only the various support entities, but how to link them to employment, how to link them to education, and how to link them to nonprofits. And thats why all of the profits from the book are being donated to Pride Industries. Because Pride Industries that is based here in the greater sacramento area now provides Employment Opportunities for 3500 3500 individuals with Developmental Disability throughout the United States. We feel that by being able to take some of the work that pride is doing, and its on the ground, its in specific areas of employment, and how to link that to education, how link that to Vocational Training will be an important step in achieving the goal that might mention of employment of over a thousand individuals with development of disability over the next several years. Thank you both so much. For spending time with us today. And again i want to thank doctor Louis Vismara whos a cardiologist and when the Founding Fathers of the mind institute, and mr. Michael bernick who is an attorney with the International Law firm of Duane Morris Llp and a former director of californias Employment Development department. Its been really great to talk to both of you. Thank you. Thank you. Thank you very much. Its been a pleasure and privilege, as a great to see you again, marjorie. 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