Virtual Reality Job Interview Training and 6-Month Vocational Outcomes for Young Adults with Autism Spectrum Disorder

Background: Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them.

Objectives: To evaluate the acceptability, efficacy, and vocational outcomes for young adults with ASD who completed a virtual reality job interview training (VR-JIT) program compared to a treatment-as-usual (TAU) control group.

Methods: We conducted a randomized controlled trial with 16 participants randomly assigned to the VR-JIT treatment group and 10 participants randomized to a treatment-as-usual (TAU) group. The primary outcome measures were: 1)  blindly rated video-recorded job interview role-plays (with professional actors) that assessed interview skill level as pre-test and post-test measures and 2) self-reported interviewing self-confidence. Acceptability measures included session attendance, total minutes spent using the intervention, and a self-report regarding VR-JIT's ease-of-use and perceived helpfulness at improving interview skills.  Vocational outcomes at 6-month follow-up were determined by surveying: 1) if the study participants completed interviews for a competitive position (employed or volunteer), 2) accepted a competitive position, and 3)the number of weeks participants sought a competitive position. We used descriptive statistics to report the acceptability data for VR-JIT. We used repeated measures analysis of variance to assess if the VR-JIT group demonstrated improved interviewing skills between the pre-test and post-test interview role-plays. We used logistic regression to evaluate if training with VR-JIT was associated with a greater odds of attaining a competitive position (job or volunteer).

Results: Participants attended 90% of the lab-based training sessions, and more than 90% of participants reported that VR-JIT was easy-to-use, enjoyable, and prepared them for real-life interviews.  VR-JIT participants had greater improvement during live standardized job interview role-play performances than the control group (p<0.05) and had greater improvement in interviewing self-confidence at the trend level (p=0.06).  Eighty-eight percent of participants (23 of 26) completed the 6-month follow-up survey.  Logistic regression indicated that the VR-JIT group, compared to the TAU group, had greater odds of attaining a competitive position (OR 7.82, p<0.05). Exploratory correlations revealed that, among VR-JIT participants, improvement in role-play performance between pre-test and post-test was correlated with completing more interviews at 6-month follow-up (r= 0.55, p<.05). 

Conclusions: Vocational training in the community is a critical issue within the ASD community and this study provides initial evidence that VR-JIT may be a helpful intervention for young adults with ASD searching for a job or competitive volunteer work. Future directions include evaluating the community-based effectiveness of VR-JIT as well as modifying for VR-JIT for adolescents with ASD who are preparing to pursue employment.