500,000 teens with autism will become adults in next 10...

When Olivia Shanks landed in the hospital, it changed her life.

She didn’t arrive as a patient, though — she came to work. The 21-year-old, who has high-functioning autism, has struggled to get places on time. Some basic workplace tasks stressed her out. Dependence on others dinged her self-confidence.

Her work in Memorial Hermann Southwest Hospital’s food-services department came via one of Houston’s nonprofit groups providing job training and support for a population that’s exploding but finds few opportunities to live as fully as possible.

“I basically learned everything here. I didn’t know how to organize silverware,” said Shanks, who also learned about teamwork and following a schedule. “Even though I’m still not good at it, I’ve gotten less scatterbrained with time management or pressure.”

The climb of autism diagnoses is alarming. This year, the Centers for Disease Control and Prevention upped its estimate to 1 in 59 U.S. births — twice the 2004 rate of 1 in 125. National advocacy group Autism Speaks estimates 500,000 teens with autism will reach adulthood over the next 10 years.

Yet nearly half of 25-year-olds with the disorder have never held a paying job, according to Autism Speaks. Ninety percent of adults with autism are unemployed or underemployed.

About the workers in this story Most of the young adults in this story have high-functioning autism, or what was called Asperger syndrome until the sub-type was folded into the single diagnosis of autism spectrum disorder in 2013. The descriptions “high functioning” and “low functioning” aren’t clinical but in lay terms describe how severely one is affected. “Aspies” have difficulty with social interactions and a restricted range of interests and/or repetitive behaviors. Motor development may be delayed, leading to clumsiness or uncoordinated movements. Compared with people affected by other forms of ASD, however, those with high-functioning autism do not have significant language delay or cognitive impairment. Some demonstrate precocious vocabulary, often in a highly specialized field of interest. Frequently they live and work independently, with varying degrees of support. Sources: The Autism Society; Autism Speaks Autism and employment in the U.S. Striking numbers: More than half of young adults with autism (58 percent, according to one study) remain unemployed and not enrolled in higher education in the two years after high school. This is a lower rate than that of young adults with a learning disability, intellectual disability or speech-language impairment. Low hire rates and pay: Of the nearly 18,000 Americans with autism who used state-funded vocational rehabilitation programs in 2014, only 60 percent left the program with a job. Of these, 80 percent worked part time at a median weekly rate of $160, putting them well below the poverty level. Sources: Autism Speaks; Drexel University

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Some are too impacted to work once they age out of school-based vocational services by 22. But many who could work face depression and isolation, idle on their parents’ couch, financially dependent on them, government or community organizations. Research shows job activities that encourage independence reduce symptoms and increase daily living skills.

Autism spectrum disorder is a complex developmental disability. Symptoms typically appear in early childhood and inhibit communication and interaction to varying degrees. Though some of the increase in incidences can be attributed to better diagnosis, the cause remains unknown. There is no cure.

Stereotypes run along a spectrum of their own. On one end, there’s the savant of the 1988 film “Rain Man,” which the autism community disavows as inaccurate or oversimplified. On the other is the “tech nerd” who reads computer code as easily as “Dick and Jane” but is missing the chip to get jokes around the office. These perceptions make it difficult to get and keep meaningful work.

October marks the 30th anniversary of National Disability Employment Awareness Month, highlighting job needs and contributions of the disabled. Houston’s autism-focused groups promote workplace inclusion. They collaborate with employers and tout the untapped potential of those whose traits include reliability, loyalty and focus.

The business world is beginning to see the benefits.

Maximizing ability

Shanks was 19 before she got an autism diagnosis. Out of high school and out of a routine, she was sitting at home in River Oaks uncertain about her future. But that began to change thanks to Houston nonprofit Social Motion Skills.

The organization offers T3 (Transition, Training, Taxpaying), a program that pairs a job coach with young adults with autism and similar special needs. The workers are eventually weaned off the coach, who stays in touch as issues arise.

T3 partners are: Memorial Hermann Southwest Hospital; Aspire Accessories, a gift shop where artisans learn light manufacturing, retail and customer service; Clear Lake Infiniti, where clients hone interpersonal skills as customers drop off cars for service; FedEx’s ground hub in Cypress; and Michael E. DeBakey VA Medical Center.

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Workers are either permanent employees or interns. Both arrangements expose them to direct deposit, banking and paying taxes.

The intern model is low risk: Memorial Hermann, for example, adds to its pool of 275 volunteers while Social Motion Skills pays its interns minimum wage (tuition to the nonprofit to participate covers the job coach’s salary).

In the kitchen and cafeteria, job coach Rachel Pasternak worked on sociability with Shanks and two others for six weeks this spring. The goal is “to get them secure enough in themselves to apply for a job — and get it.”

Shanks did: Her experience in a hospital setting helped her land a position, with benefits, as a patient transporter at DeBakey VA Medical Center.

Her mother, Stephanie Shanks, said the internship encouraged Olivia to be a self-starter. “She’s well on her way to independence,” Stephanie said.

At Memorial Hermann, Shanks and her peers got no special treatment, said Elana Hoffman, who oversees the volunteers.

“At first, they were nervous that we were there, but now the staff looks around and notices when we’re not,” said Stacy Anderson, Social Motion Skills’ transition director.

At FedEx’s ground hub in Cypress, 13 Social Motion Skills clients unload trailers.

“This is working out very well. For some of these kids, this is their first job, and they don’t know really what to expect,” senior manager Brady Bates said. With their job coach on hand, they learn the job via a steady, repetitive workflow with few interruptions.

“FedEx believes in diversity and inclusion,” Gulf Coast District managing director Clay Roach said. “(This) is a way to not only invest in our community, but afford these kids an opportunity at a real career.”

In an op-ed piece for the Houston Business Journal, “Your next great employee might have Autism,” Social Motion Skills founder and executive director Wendy Dawson said both employee and employer benefit — when the job is the right fit.

“Roles that require sorting products, performing data entry, or filing draw on the unique strengths of autistic workers, who are usually extremely detail-oriented and procedure-driven,” Dawson wrote. “While a non-autistic person might resent the repetitive nature of such tasks, many autistic people truly enjoy this sort of work. Moreover, supervisors can count on them to show up on time and to be loyal employees.”

Building their own

The Monarch School and Institute, a private special-needs facility in west Houston, teaches children and adults with autism and neurological disabilities. Its Life Academy serves as a “practice center” for home-living and personal skills and employment.

One goal is lessening rigid thinking. “A lot of our learners may see a coworker not following the rules 100 percent, and that may frustrate them,” coordinator Samantha Sanchez said. “We provide our students with tools that they need to stay regulated.”

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Historically, employers have voiced concerns: “I don’t think we know how to handle someone like that. What if there’s bullying? Can this individual stand up for themselves?”

Mark Foley defies history. The general manager at MOD Pizza’s west Galleria location has hired several of Monarch’s 15 to 20 off-campus “learners” and holds them accountable like any of his staff. He noted one didn’t work out because he made excuses for slow or poor performance. “Everyone at MOD is special,” Foley said. “Check the disability at the door.”

Still, Monarch showed him the need for accommodations, including shorter or fewer shifts. Those are worth the tradeoff for handling tasks most other employees don’t like. Aaron Glick assembles pizza boxes “faster and better than anyone,” Foley said. “The (rest of the) employees love it because they hate folding boxes.”

Sanchez cited a bigger benefit.

“The dependence on (government) assistance is going to have a huge financial impact,” Sanchez said. “When people say things like, ‘It takes so much energy to train them. Is it even worth it?’ It is absolutely worth it.”

Employees with disabilities, including autism, aren’t a drain on business, said Joe Bontke of the Equal Employment Opportunity Commission’s local office. Accommodations save much more than they cost by reducing turnover and down time, he said.

Businesses with $1 million or less in gross receipts or 30 or fewer employees qualify for a tax write-off for making accommodations. That “sweetens the pot,” Bontke acknowledged, but the employers he’s worked with found “the benefit comes from the understanding that it’s just good for business. They didn’t champion the dollar amount.”

MOD Pizza is 32-year-old Glick’s first job. His two shifts a week include busing tables and refilling silverware containers. “I’ve been a help to the company, doing what I can do,” he said.

Foley teared up thinking about grateful parents who tell him they fear what will happen to their adult children once they’re gone. “I have to make this work,” he said softly.

On Monarch’s campus, Hannah Hess, 26, spent the summer organizing the new library. For the aspiring writer, earning $10 an hour surrounded by books was ideal.

“I love being called a bibliophile, not a bookworm because that just sounds gross,” Hess said. Like many with autism, she spoke fervently about her interests but avoided eye contact. Then her phone buzzed. “Ugh, cantankerous phone,” she said. “I love the word ‘cantankerous.’ I’m developing my vocabulary.”

Hess’ phone is Bess. Her tablet is Ned. “I name my devices. Don’t judge me,” she said before turning back to checking out books.

Masters of technology

Nicholas, 19, whipped through screens of light fixtures to choose for a house he was digitally assembling. He studies video-game level design at nonPareil Institute’s Houston facility, which requested its crew members not be fully identified. The institute is a technology-training nonprofit.

Nicholas has communication challenges. “I need to put lights in the bathroom,” he announced without looking up. Asked what his favorite thing is to add to the scene, he didn’t answer. Prompted, he said, “trees on the grass.”

The institute produces games and apps for iOS and Android, along with print and electronic comic books.

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“Nonpareil” means “no equal.” The institute harnesses the technology interest common in people with autism. Founded in Plano by Gary Moore and another father who saw a limited future for their own sons, it aims to provide self-sufficiency and a sense of purpose.

“Crew,” as trainees are called, pay tuition to attend. Some also work at nonPareil part time as lab assistants or instructors. Most of the 74 enrolled in Houston are high functioning; a few even hold a degree in computer science.

Code instructor Chris McCrimmons uses his project-management background to get “crew” to break down tasks and review trends — “What was blocking us?” Members respond to the process-driven format, he said.

NonPareil strives to break a defeating job cycle of adults with autism. “They get a part-time job, they’re there a couple of months and start to have issues,” Moore said. Classes address team-building and connecting with others, concepts vital to success in the workplace.

This year staff composed of former crew worked on Trade ’Em, an app that lets users store, use or trade gift cards. Current crew served as testers. The results led Amarillo-based Trade ’Em CEO Kristopher Barnings to “show that they are being underutilized.” Next year, Barnings’ support will be to the tune of $210,000 a month.

Christian Hitz, 26, who has autism, relocated from Plano to work full time as a nonPareil art instructor. If it wasn’t for the teaching job he’d probably be bored working in a warehouse. “This is more fun, more entertaining,” Hitz said. “It’s a relaxed job opportunity.”

In the Houston business world, he is both contributing and being fulfilled.

Suzanne Garofalo has a 12-year-old son with autism and ADHD. She writes stories about programs and experiences of people with disabilities for the Houston Chronicle. Email her at suzanne.garofalo@chron.com.