Journal of Vocational Rehabilitation 49 (2018) 309–325 DOI:10.3233/JVR-180976 IOS Press 309 Vocational rehabilitation experiences of transition-age youth with autism spectrum disorder across states: Prioritizing modifiable factors for research Anne M. Roux a,∗ , Kristy A. Anderson a , Jessica E. Rast a , Derek Nord b and Paul T. Shattuck a a A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA b Indiana Institute on Disability and Community, Indiana University, Bloomington, IN, USA Revised/Accepted December 2017 Abstract. BACKGROUND: Tremendous state-level variation exists in the Vocational Rehabilitation (VR) service experiences of transition-age youth with autism spectrum disorder (TAY-ASD). Individual-level factors alone have not adequately explained differences in VR service utilization and employment outcomes for these youth, and the socio-demographic and economic state-level factors examined to date are largely non-modifiable. OBJECTIVE: This study aimed to identify and prioritize modifiable state-level policies and practices that may affect VR service utilization and outcomesof TAY-ASD. METHODS: We used a modified, two-round Delphi approach with 12 subject matter experts within this mixed methods study. RESULTS: Twenty-three factors of VR service use and outcomes were rated in the top half of importance scores – most of which were also in the top half of modifiability scores. These factors were organized into five themes regarding capacity, efficient and effective VR processes, innovation, inter-agency efforts, and staff training and competency. All participants agreed that these themes captured the main types of factors that might be driving state-level variability in VR outcomes. CONCLUSIONS: This study identified key themes and modifiable factors for investigation within next-step research. Studying these themes and factors may enable researchers to learn from what is working in some states to enhance employment outcomes for TAY-ASD. Keywords: Vocational rehabilitation (VR), transition-age youth (TAY), autism spectrum disorder (ASD), state systems, transition 1. Background About half of transition-age youth with autism spectrum disorder (TAY-ASD) in the U.S., 53–58% across population-based studies, will work between ∗ Address for correspondence: Anne M. Roux, A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA 19104, USA. Tel.: +1 267 788 9762; Fax: +1 215 571 3187; E-mail: amr376@drexel.edu. high school and their early 20 s – a rate of employ- ment that is much lower than that of their peers with other types of disabilities (Roux et al., 2013; Roux, Shattuck, Rast, Rava, & Anderson, 2015; Shattuck et al., 2012). Growing numbers of transition-age youth (TAY) and adults with autism are found eligible for help from state-administered Vocational Rehabilita- tion (VR) agencies to find and maintain employment (Burgess & Cimera, 2014; Smith & Lugas, 2010). The 1052-2263/18/$35.00 © 2018 – IOS Press and the authors. All rights reserved