Browsing by Author "Narendorf, Sarah C."
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Item Attitudes and Intentions of Social Work and Law Students toward Each Other and Practice Together: A Quantitative Study(2019-05) Webb, Ann Elizabeth; Cheung, Monit; Narendorf, Sarah C.; Pritzker, Suzanne; Heppard, Janet M.This exploratory, cross-sectional, quantitative analysis examines the views of students of law and of social work, toward their own and the other profession, and their intentions regarding future collaboration. Three research questions were explored: (1) The perceptions of social work students and law students with respect to each profession, (2) Student attitudes regarding the collaborative value added by each profession, and (3) Factors predicting planned future involvement in collaborative practice following graduation. The findings reveal that (1) student views across both groups are similar, but a significant interaction effect between area of study (law/social work) and profession being rated precludes a definitive conclusion; (2) law students rate the collaborative value of lawyers significantly higher than do social work students, but no significant differences between the groups were noted regarding collaborative value of social workers, or based on prior experience; and (3) for both groups, there is a significant association between area of study and intentions to practice, with social work students more likely than law students to report future collaborative intent; there is no significant association between prior experience and future intent; as a logistic regression model, although area of study, interprofessional perceptions, collaborative beliefs, and prior experience predict intent to practice, only area of study is significant, with social work students having twice the odds of expressing a future collaborative intent than do law students. This study provides baseline data for students at the beginning of their academic careers, forming the foundation for future research into these concepts.Item Attitudes and Needs Related to the Adoption of Evidence-based Practices Among Mental Health Professionals in Puerto Rico(2022-08) Giraldo-Santiago, Natalia; Gearing, Robin Edward; Orengo-Aguayo, Rosaura; Narendorf, Sarah C.Empirically supported interventions are warranted to achieve desired clinical outcomes and improve service delivery. Thus, efforts to identify, adopt, and implement Evidence-Based Practices (EBPs) are underway in Puerto Rico due to the growing prevalence of mental health and substance use disorders. The current study sought to investigate the needs and attitudes towards EBPs among a sample of Puerto Rican mental health professionals. Methods: An anonymous survey was distributed to social workers, psychologists, and professional counselors in Puerto Rico (n = 237). Using structural equation modeling, four dimensions of attitudes towards EBPs (requirement, appeal, openness, and divergence) were regressed on various individual and organizational factors. Results: Greater organizational support and graduating from a private institution predicted greater divergence from research, while being trained on EBPs and married predicted less divergence. Female participants and those working in rural settings were more open to using new interventions. Exposure to EBPs in college and older age predicted less interest in the intuitive appeal of an intervention. Meanwhile, more years of experience predicted greater interest in the appeal of an intervention. No differences in attitudes toward EBPs were found by professional discipline or those working in clinical, community, and school settings. Conclusions: This is one of few studies looking at socio-demographic and organizational factors shaping specific dimensions of attitudes towards EBPs among Latino mental health professionals. Recommendations to address needs in the adoption and implementation of EBPs among Latino professionals are highlighted.Item Breast Cancer Treatment-Completion: Can an Integrative Medicine Center Play a Role?(2021-05) Wagner, Richard W.; Narendorf, Sarah C.; Torres, Isabel; Cohen, LorenzoIntroduction: The survival of women with breast cancer depends on treatment-completion. We explored factors that promote treatment-completion and reduce aromatase inhibitor (AI) medication switching. We evaluated the effect of any Integrative Medicine (IM) clinic use on those outcomes. Methods: Means, frequencies, modified Poisson regression analysis, and propensity score analysis were used to examine three samples of women with hormone receptor-positive breast cancer treated with taxane chemotherapy or hormone therapy between 1/1/2009-12/31/2019 at MD Anderson Cancer Center. Treatment-completion was defined as a relative dose-intensity(RDI) of ≥85% for chemotherapy, or ≥54 months with a hormone therapy prescription; AI switching was also assessed. Sample: There were 508, 3764, and 2253 women in the chemotherapy, hormone therapy, and AI switching samples, respectively. Results: We found that 53.1% of patients completed chemotherapy, 64.3% of patients completed hormone therapy, and 68.8% of patients took just one AI medication. Less pain (RR, 0.97; 95%CI, 0.95 to 0.98; p<0.001) and SF-12 PCS (RR 1.03; 95%CI: 1.02 to 1.05; p<0.001) were associated with increase probability of hormone therapy treatment-completion in bivariate analysis. Differences between IM clinic users and non-users were not statistically significant among the samples. Discussion: Many women did not complete treatment. Two quality-of-life measures were related to hormone therapy treatment-completion. Treatment-completion of IM clinic users were not different from non-users. Some predictors of treatment-completion are changeable and warrant a central focus during treatment. Future research should include more IM treatments (e.g., 8 acupuncture treatments) for the inclusion criteria.Item Capping Back: A Grounded Theory on African American Adolescent Males and Emotional Self Protection(2015-05) Lachapelle, Alicia Renee; Robbins, Susan P.; Brown, C. Brené; Narendorf, Sarah C.This qualitative study sought to generate a theory grounded in data to conceptualize the main concern of African American male adolescents about their educational experiences and how they resolve this main concern. There has been a proliferation of studies that attempted to address variables that are essential to the academic success of African American male adolescents. However, few of these studies have addressed the main concern that these adolescents have regarding their own educational experiences. To discover the main concern of African American male adolescents and its resolution, adjusted conversational interviewing was used. A purposive sample consisted of 17 African American male adolescents. A theoretical sample consisted of 8 adults who were either African American male college students, parents of African American male adolescents or youth program workers. A grounded theory analysis of the interviews revealed that the main concern was to protect self-worth and the freedom to explore authenticity when experiencing emotional vulnerability. Participants resolved this main concern by connecting with loved ones, friends, and supportive adults. The main concern and its resolution resulted in the development of the theory, Capping Back: A grounded theory on African American adolescent males’ emotional self-protection. Capping Back illustrates how participants, upon experiencing emotional vulnerability, are prompted to protect their self-worth and/or their freedom to develop authenticity. The subsequent protective responses are influenced by relationships with loved ones, friends and supportive adults. This theory holds practice and policy implications for Social Workers as well as educators who work with African American male adolescents.Item Children's Perception of Violence: A Thematic Analysis of Student Essays(2015-05) Gummelt, Virginia; Cheung, Monit; Pritzker, Suzanne; Narendorf, Sarah C.Exposure to violence which affects approximately three out of every five children in America is clearly a threat to the health and well-being of society. Previous research on youth exposure to violence has focused primarily on the implications for victims or the treatment of the offenders. While some research has concentrated on the lived experience of the children who are subjected to violence, it has generally been defined within a specific domain such as domestic violence or bullying. By understanding children’s perspective on the violence experienced within their everyday life, professionals can design comprehensive prevention and intervention programs that better target children who have been exposed to violence. Using the secondary data available from the “Do the Write Thing” (DtWT) Challenge, this research project explored significant issues of violence as experienced and perceived by children in 13 middle schools from 9 districts in Region V of Texas. The DtWT Challenge is an initiative of the National Campaign to Stop Violence in which participating students engage in classroom discussions about violence and then write essays addressing the issues. Descriptive statistics were used to analyze significant issues that are related to exposure to violence after controlling for demographic differences. Qualitative data in the form of the submitted written essays were coded, and categorized to identify major themes of how children describe their experience of violence and assign meaning to violence. Results indicate that students wrote more about bullying than other forms of violence, and they more likely identified their role as a witness than victim or perpetrator. Protective factors were described proportionally more by students in schools identified as Economically Disadvantaged or Minority Schools. Several themes within three domains (cognitive, social, and moral) arose including defining violence in terms of bullying, violence as a universal experience, and complex emotions related to violence.Item Contextualizing the Mental Health of Transgender, Genderqueer and Non-binary Communities Through Intersectionality and Gender Minority Stress and Resilience Frameworks(2022-05-07) Keo, Bec Sokha; Narendorf, Sarah C.; Ali, Samira B.; Dettlaff, Alan J.This dissertation examines the mental health context of transgender women, transgender men, genderqueer, and non-binary individuals (TGNB collectively) through the lens of Intersectionality Theory (Combahee River Collective, 1971; Crenshaw, 1989; Crenshaw 2017) and the Gender Minority Stress and Resilience Model (Testa et. al., 2015). Through three independent studies, this dissertation critically reviews the Gender Minority Stress and Resilience Model; compares experiences multi-domain gender affirmation and mental health between transgender and GQNB groups; and applies an intersectional approach to the examination of mental health among BIPOC transgender and GQNB groups. The overall findings of this dissertation suggest that pre-existing TGNB mental health research has been shaped by white supremacy. In addition, this dissertation confirms previous research findings which demonstrate differential mental health experiences among genderqueer and non-binary individuals compared to transgender women and transgender men. The differential mental health outcomes are explained, in part by differences in interpersonal and structural gender affirmation between groups. In addition to multi-domain gender affirmation, the mental health of BIPOC (i.e. Black, Indigenous, People of Color) TGNB individuals is directly impacted by racist and anti-TGNB discrimination. Finally, this dissertation highlights the need for intersectional approaches to the mental health research of multiply minoritized groups such as BIPOC TGNB communities.Item DEVELOPING A MEASURE OF RACIAL EQUITY: THE ‘AWARE BELIEFS’ SCALE FOR SCHOOLS(2021-05) Minott, Kenya; Pritzker, Suzanne; Gist, Conra D.; Williams Jennings, Sheara; Narendorf, Sarah C.Structural racism persists in our schools and continues to create barriers to achieving racial equity in education. Organizational change efforts are needed to confront these barriers at the school level. These efforts should focus on two problems: 1) the existence of the “culture of Whiteness” in schools, and 2) the academic and emotional harm it poses to Black children. These experiences speak to an underlying set of beliefs about race held by individuals within the organization. School social workers who apply an anti-racism lens can confront structural barriers and offer innovative strategies for assessing organizational change by targeting beliefs about racial equity among their colleagues in school settings. The Assessing Workplace Attitudes toward Racial Equity Beliefs (AWARE-b) scale is designed to assess individual beliefs about racial equity in school settings. This study operationalizes the concept of racial equity work and proposes beliefs about racial equity as a construct that can be measured using the AWARE-b scale. The recommended steps for scale development, item pool generation, expert panel feedback, pilot testing, and analyses of items were used in this study. The pilot sample (n=140) included adults ages eighteen and older and school personnel, including teachers and non-teachers, who currently work in a P-12 school campus setting in the state of Texas. The items were evaluated using an exploratory analysis known as principal axis factoring. There was good factor structure, internal reliability, and construct validity for sixteen items (α = .93) indicating racial equity beliefs as the underlying construct. Limitations and recommendations for future study of the AWARE-b scale, along with the implications for school leaders and school social workers are discussed.Item Development and Piloting of a Treatment Foster Care Program for Older Youth with Psychiatric Problems(Child and Adolescent Psychiatry and Mental Health, 06/26/15) McMillen, J. Curtis; Narendorf, Sarah C.; Robinson, Debra R.; Havlicek, Judy; Fedoravicius, Nicole; Bertram, Julie E.; McNelly, DavidBackground: Older youth in out-of-home care often live in restrictive settings and face psychiatric issues without sufficient family support. This paper reports on the development and piloting of a manualized treatment foster care program designed to step down older youth with high psychiatric needs from residential programs to treatment foster care homes. Methods: A team of researchers and agency partners set out to develop a treatment foster care model for older youth based on Multi-dimensional Treatment Foster Care (MTFC). After matching youth by mental health condition and determining for whom randomization would be allowed, 14 youth were randomized to treatment as usual or a treatment foster home intervention. Stakeholders were interviewed qualitatively at multiple time points. Quantitative measures assessed mental health symptoms, days in locked facilities, employment and educational outcomes. Results: Development efforts led to substantial variations from the MTFC model and a new model, Treatment Foster Care for Older Youth was piloted. Feasibility monitoring suggested that it was difficult, but possible to recruit and randomize youth from and out of residential homes and that foster parents could be recruited to serve them. Qualitative data pointed to some qualified clinical successes. Stakeholders viewed two team roles – that of psychiatric nurse and skills coaches – very highly. However, results also suggested that foster parents and some staff did not tolerate the intervention well and struggled to address the emotion dysregulation issues of the young people they served. Quantitative data demonstrated that the intervention was not keeping youth out of locked facilities. Conclusions: The intervention needed further refinement prior to a broader trial. Intervention development work continued until components were developed to help address emotion regulation problems among fostered youth. Psychiatric nurses and skills coaches who work with youth in community settings hold promise as important supports for older youth with psychiatric needs.Item Effectiveness Of Life Story Book On Depression And Meaning In Life For Mentally Alert Residents Of Nursing Homes(2019-12) Chrisman, Theresa C.; Rubin, Allen; Narendorf, Sarah C.; Brohard, CherylAlmost 50% of nursing home (NH) residents have a diagnosis of depression. Meaning in life (MIL) has been shown to be a protective factor against depression. Life Story Book (LSB) is a reminiscence intervention designed to provide a person with the opportunity to review their past and capture their history, stories, and photographs into a book. LSB has had significant effects on depression and psychological well-being for persons with dementia, but there is a gap in the literature for mentally alert NH residents. For this 9-week study, a quasi-experimental switching replication design was employed with two comparable NHs (NH-A and NH-B) and 21 mentally alert residents. The GDS-12R and the MLQ were used to measure depression and MIL respectively. Participants from NH-A (n =11) and NH-B (n = 10) had a mean age of 75 (SD =11.34). Many had some college or technical training (42.9%). Most were female (81%) and widowed (52%). Over half were non-Hispanic white (52%) and 33% were African American. The majority were Protestant (76.2%) and had been a resident for one-two years (57%). A comparison of the two groups using a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ, F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η2 = .35. Although the results were statistically nonsignificant, the effect size was moderate. In light of the small sample size (N= 21), low statistical power, and meaningful effect size, replicating the study with a larger sample size is advisable.Item Exploring Contextual Factors of Youth Homelessness and Sexual Risk Behaviors: A Qualitative Study(Perspectives on Sexual and Reproductive Health, 11/17/15) Santa Maria, Diane M.; Narendorf, Sarah C.; Ha, Yoonsook; Bezette-Flores, NoelCONTEXT: HIV disproportionately affects homeless youth, and interventions to date have had minimal success in reducing sexual risk behaviors in this population. Few qualitative studies have been conducted to provide insight into the influence of homelessness‐related factors on sexual risk behaviors. METHODS: A qualitative study with a quantitative component was conducted with a nonprobability sample of 64 homeless youth aged 14–24; participants were recruited from a variety of venues in Houston between October 2013 and March 2014. Thirteen focus group discussions were conducted; thematic analysis was used to identify themes related to HIV risk. RESULTS: Participants were predominantly black (75%), sheltered (67%) and aged 18 or older (77%). Youth discussed how the circumstances of their homelessness and the struggle to meet their immediate needs led to behaviors and experiences that put them at risk for HIV. Three themes emerged: Homeless youth frequently engage in risky sexual behavior, sometimes as a way to cope with stress; they often trade sex, either voluntarily or involuntarily, for such necessities as money or a place to sleep; and many experienced childhood sexual victimization or have been victimized since becoming homeless. Youth also described how stress, stigma and self‐reliance contributed to their involvement in HIV risk behaviors. CONCLUSIONS: HIV prevention methods that target stress and stigma while respecting youths’ self‐reliance may help reduce sexual risk behaviors. Further research is needed to determine suitable behavioral change techniques to address these potentially modifiable factors.Item Exploring the Bidirectional Relationship between Early Adolescent Coping Style and Internalizing Symptoms(2023-06-14) Mytelka, Caitlyn Louise; Narendorf, Sarah C.; Boyd, Reiko K.; Acquati, Chiara; Baumler, Elizabeth; Temple, JeffRising rates of depression and anxiety among youth represent a significant public health issue with the potential to negatively influence the wellbeing of adolescents and young adults. Early adolescence is a critical developmental period to equip youth with skills to enhance wellbeing and lower risks of internalizing symptoms throughout adolescence. A nuanced understanding of mechanisms, such as coping, among early adolescents is needed to augment prevention and treatment efforts and address the needs of all adolescents. This dissertation study identified relationships between early adolescent active and avoidant coping styles and internalizing symptoms cross-sectionally and over one year using multilevel modeling, with a specific focus on exploring differences by subgroup. This secondary data analysis utilized a longitudinal dataset of a cluster, randomized trial of a preventive intervention from 12 racially/ethnically diverse middle schools in a large public-school district (N=1273, 49% female). The results of the study highlight and further support that coping is a potential mechanism for impacting symptoms of depression and anxiety before and after the onset of symptoms in early adolescence. Symptoms of anxiety and depression affected the type and frequency of coping skills that students employed one year later, indicating that symptoms could precede maladaptive coping in some situations. Reciprocal relationships over time between active coping and depressive symptoms as well as avoidant coping and anxiety symptoms were identified. There were also differences in how gender affected the relationships between types of coping and internalizing symptoms, which should be considered in practice and in future research. Findings suggest implications for future longitudinal research to examine the trajectory of these relationships throughout adolescence in addition to implications for enhancing coping psychoeducation for early adolescents within prevention and intervention programs and models.Item Intergroup Threat and Minority Student Suspension Risk: The Relation of School District Outcomes with Community Factors.(2021-05) Minter, Anthony Hall; Robbins, Susan P.; Pritzker, Suzanne; Narendorf, Sarah C.; Chin, Wynne W.Students of color experience disproportionate risk of suspension due to racial-ethnic bias in school disciplinary decision making. The present study employees Partial Least Squares Path Modeling to investigate suspension disproportions through the lens of Integrated Threat Theory (ITT). The study finds significant mediation relations between community- and district-level indicative of inter-group threat. Results demonstrate the effects of community structure on school district disciplinary outcomes. Results also support the identification of school district structures with the ITT constructs of symbolic and realistic threat. Results are applied to identify opportunities for research, policy, and school social work practice.Item Knowledge of and Attitudes toward Behavioral Health Services among Older Youth in the Foster Care System(Child and Adolescent Social Work Journal, 11/06/10) Munson, Michelle R.; Narendorf, Sarah C.; McMillen, J. CurtisThis study examined knowledge of and attitudes toward services among 268 17-year olds with psychiatric diagnoses preparing to exit foster care. A structured interview assessed knowledge of services with vignette scenarios and attitudes with a standardized scale. Descriptive statistics described the extent of knowledge and attitudes among this population and regression analyses examined predictors of these dimensions of literacy. Most youth suggested a help source, but responses often lacked specificity. Gender and depression were the strongest predictors of knowledge and attitudes, respectively. Knowing which aspects of literacy are low, and for whom, can inform education efforts to improve access to care in adulthood.Item Knowledge of Social Work Roles on Interdisciplinary Primary Care Teams: An Advanced Mixed Methods Study(2018-05) Bakos-Block, Christine River; Robbins, Susan P.; Narendorf, Sarah C.; Hart, John M.Driven by the Patient Protection and Affordable Care Act (ACA, 2016), new programs like Healthcare Transformation Initiatives are being adopted by healthcare systems in the United States to improve patient health outcomes. Social workers are uniquely suited to address the psychosocial needs that often get overlooked in primary care. This study used an advanced mixed methods, qualitative + qualitative + quantitative design to understand the roles fo the social worker on the integrated primary care team and how knowledge of social work roles is related to interdisciplinary collaboration. A scale developed in the qualitative part of the second phase of this study was used to quantitatively measure knowledge of social work roles. This study identified a positive relationship between increased knowledge of social work roles and interdisciplinary collaboration. This study also found that as knowledge of social work roles increased, satisfaction with collaboration increased. These findings establish the importance of role knowledge on interdisciplinary collaboration. Additionally, as social work roles are diverse and often defined by setting, this study promotes the need for further research regarding the various functions of social workers in primary care. It further suggests that social work is in a unique position to make its mark on integrated primary care and further redefine its role on interdisciplinary healthcare teams.Item Likelihood of Using Mental Health Services among Asians and Latinos in the U.S.: An Acculturative Approach(2020-05) Lopez, Angelica A.; Monserud, Maria A.; Anderson, Kathryn F.; Narendorf, Sarah C.Prior research indicates that because of acculturation, racial minorities’ use of mental health services increases with each subsequent generation. Yet little is known about how refining generational categories to include the 1.5 and 2.5 generations affects the association between acculturation and the perceived need for mental health resources. Using the National Latino and Asian American Study, the present study examined the interplay between generation status, acculturation, socioeconomic status (SES), and perceived need to seek mental health services among Asians (N = 2,095) and Latinos (N = 2,554) in the United States. The findings indicate that the interrelationships between these factors may be different for Asians and Latinos and that it is crucial to use more refined generational categories in intergenerational health mobility research. Specifically, the 1.5, 2.5 and third generations are associated with an increase in perception of needing to seek mental health resources among Asians. Furthermore, the findings highlight the importance of taking into consideration the implications of several acculturation measures on the association between generation status and the perception of mental health services. In particular, English proficiency accounts for the impact of generation status partially among Asians and completely among Latinos. Lastly, this study demonstrates that not only various acculturation measures, but also some SES factors (i.e., education and employment) might make a difference in the effect of generation status on access to mental health services.Item Mental Health Service Use among Adolescents with an Autism Spectrum Disorder(Psychiatric Services, 2011-08) Narendorf, Sarah C.; Shattuck, Paul T.; Sterzing, Paul R.Objective: This study examined prevalence and correlates of mental health service use among adolescents with an autism spectrum disorder (ASD). Methods: Data from the National Longitudinal Transition Study-2 (NLTS2) was used to examine mental health service use among youth with an ASD (n=920). Nationally representative estimates generalize to students enrolled in the special education autism category. Regression models examined the association of predisposing, enabling, and need factors with service use overall then with receiving these services at school. Results: Overall, 46% had used a mental health service in the past year. Of those that received a service, 49% had received it at school. Need variables were the strongest correlates of service use. African American youths, and youths from lower income families were more likely to receive school-based services. Conclusion: The school plays a key role in providing services, especially for vulnerable populations. Focused attention on these youths is needed to ensure continuity of care as they leave high school.Item Perspectives on Psychotropic Medication Treatment Among Young Adults Formerly Served in Public Systems of Care: A Thematic and Narrative Analysis(Journal of the Society for Social Work Research, 01/26/15) Narendorf, Sarah C.; Munson, Michelle R.; Floersch, JerryThis study examines the perspectives of psychotropic medications held by young adults with mood disorder diagnoses. This article presents an analysis of qualitative interviews with 52 young adults who had been involved with public systems of care during adolescence and had used psychiatric medications. A concatenated analytic approach was used. First, we used a thematic analysis across cases, then a narrative analysis within selected cases. Two main themes emerged from the thematic analysis that captured aspects of the experience of taking medication. First, young adults described the effects of the medications and how they thought the medications were working. They described the impact on their moods, thinking, bodies, and functioning, and the ways in which these effects related to their lives. Second, the process of taking medications emerged as an important aspect of the medication treatment experience, including the trial-and-error nature of treatment and interactions with psychiatrists. The narrative analysis within cases identified that some youth created a medication narrative composed of three elements: why medications were needed, what medications do, and participants’ outlook on future medication use. These narratives are helpful in understanding prior patterns of service use and are instructive in framing young people’s future intentions to use medications. Findings support the importance of eliciting the perspectives of young adults about their treatment and ensuring that services are designed and delivered in developmentally appropriate ways tailored to this group.Item Pioneering the Psychiatric Nurse Role in Foster Care(Archives of Psychiatric Nursing, 10/11/13) Bertram, Julie E.; Narendorf, Sarah C.; McMillen, J. CurtisOlder youth served in the foster care system have elevated rates of mental health disorders and are high users of mental health services, yet concerns have been raised about the quality of this care. This paper describes the details of a psychiatric nurse’s work within a multidisciplinary team to address gaps in care for older youth with psychiatric disorders. We describe the process, outcomes, and lessons learned in developing and piloting a psychiatric nurse intervention for older youth in the foster care system as part of a multidimensional treatment foster care program. Our experiences support further work to develop a role for nursing to improve the quality of mental health treatment in foster care.Item Post High School Service Use for Youth with Autism Spectrum Disorders(Archives of Pediatric and Adolescent Medicine, 02/07/11) Shattuck, Paul T.; Wagner, Mary; Narendorf, Sarah C.Objectives: To produce nationally representative population estimates of rates of service use among young adults with an autism spectrum disorder during their first few years after leaving high school and to examine correlates of use. Design : Nationally representative telephone survey from April 2007 to February 2008. Setting: United States. Participants: Parents and guardians of young adults with autism spectrum disorders aged 19 to 23 years. Main Exposure: Autism spectrum disorder. Main Outcome Measures: Use of the following services in the prior 2 years or since leaving high school: mental health services, medical evaluation and assessment, speech therapy, and case management. Results: Rates of service use ranged from 9.1% for speech therapy to 41.9% for case management; 39.1% of youths with an autism spectrum disorder represented by the survey received no services. The adjusted odds of no services were higher among African American participants and those with low incomes. The adjusted odds of case management were lower among youths with high functional skills and those with low incomes.Item Postsecondary Employment Experiences among Young Adults with an Autism Spectrum Disorder(Journal of the American Academy of Child and Adolescent Psychiatry, 07/31/13) Roux, Anne M.; Shattuck, Paul T.; Cooper, Benjamin P.; Anderson, Kristy A.; Wagner, Mary; Narendorf, Sarah C.Objective: We examined postsecondary employment experiences of young adults with an autism spectrum disorder (ASD) and compared these outcomes with those of young adults with different disabilities. Method: Data were from Wave 5 of the National Longitudinal Transition Study 2 (NLTS2), a nationally representative survey of young adults who had received special education services during high school. We examined the prevalence of ever having had—and currently having—a paid job at 21–25 years of age. We analyzed rates of full employment, wages earned, number of jobs held since high school, and job types. Results: About half (53.4%) of young adults with an ASD had ever worked for pay outside the home since leaving high school, the lowest rate among disability groups. Young adults with an ASD earned an average of $8.10 per hour, significantly lower than average wages for young adults in the comparison groups, and held jobs that clustered within fewer occupational types. Odds of ever having had a paid job were higher for those who were older, from higher-income households, and with better conversational abilities or functional skills. Conclusions: Findings of worse employment outcomes for young adults with an ASD suggest this population is experiencing particular difficulty in successfully transitioning into employment. Research is needed to determine strategies for improving outcomes as these young adults transition into adulthood.