The efficacy of technology use by people with intellectual disability: A single-subject design meta-analysis.

Authors: 
West, M. & Anderson, J.
Year Published: 
2008
Publication: 
Journal of Special Education Technology
Volume: 
23
Number: 
3
Pages: 
21-30
Publisher: 
The Council for Exceptional Children
Background: 

The design of products should be usable by all people without the need for adaptation or specialized design for those with disabilities. This has been referred to as the Principle of Universal Design. It is assumed that if technology is designed to benefit all people, then individuals with intellectual disabilities will also benefit. Technology can impact the functional limitations and provide accommodations that will allow individuals with cognitive or intellectual disabilities to function in their daily environments. The Arc conducted a survey in 1995 that showed individuals with intellectual disabilities who needed technology but did not use it was greater than the number of respondents who had and used technology.

Purpose: 

The authors used a meta-analysis of single subject design studies to determine if people with intellectual disabilities benefit from technology. Specifically, they were interested in determining if the principles of universal design benefit those with intellectual disabilities.

Setting: 

This study is a systematic review. The included studies were undertaken in various locations and settings. Settings included special education, residential setting, employment (1.8% of the studies), community settings, computer lab, multiple settings, and "other."

Sample: 

The sample consisted of 81 single-subject design studies that involved a total of 281 participants with intellectual and developmental disability. Participants ranged in age from 2 to 68 years. There were 169 males and 106 females with missing date for six participants.

Data Collection: 

The authors conducted an extensive search for articles published in peer-reviewed journals on the use of technology by people with intellectual disabilities from 1977 to 2003. They identified a total of 411 articles that were then coded and keywords identified such as inclusion, employment, education, recreation/leisure, and so forth. They also evaluated the degree to which the principle of universal design was discussed or identified as part of the features of the study. Of this number 275 articles were databased. The remaining were opinion or position statements. Of this number 251 were quantitative (group design, single-subject, literature reviews.) Of the quantitative studies, 81 implemented a single-subject design. These were the articles used in the meta-analysis. Each of the studies were examined for treatment efficacy.PND and PZD scores were calculated for each unique treatment phase and its preceding baseline identified in the cases. Data were summarized and reported in tabular and graphic formats. To examine the effect of individual characteristics and universal design features, separate ANOVAs were conducted with PND scores as dependent variables. The reliability of PND scores was assessed by using two independent raters. Reliability was calculated by dividing the number of agreements by the number of agreements plus disagreements, multiplied by 100 reaching 90% agreement.

Intervention: 

Use of assistive technology such as computer, augmentative communication device, switches, video device, electronic technology, computer-assisted electronics, palmtop computer-audio vibrator, voice-recognition software, optic sensors, etc.

Control: 

Of these 81 articles, two-thirds were multiple-baseline design (n=54), 15% were ABAB reversal design (n=12), 10% used an AB design (n=8), and the remaining used some other design. Each of the studies were examined for treatment efficacy.

Findings: 

Forty percent of the articles had at least one universal design feature identified, and 60% used a device for which no UD feature was identified. Participants in the group incorporating UD features had an average PND score of 86% and those in the group not addressing UD features had an average PND score of 75%. Significant differences on PND scores emerged by level of severity of intellectual disability. Using ANOVA and post hoc analyses indicated differences between cases in which (a) participants had mild intellectual disabilities and cases in which participants had moderate or severe intellectual impairment, (b) cases in which participants had moderate intellectual disabilities and profound intellectual disability, and (c) cases in which participants had severe impairment and profound intellectual disability. No significant differences were found in PND scores by gender.

Conclusions: 

The authors concluded that additional research is needed on the efficacy of a wider range of technology devices with people with intellectual disability. Over 55% of the participants were evaluated with technology that fell into three types: computers, augmentative communication devices, and auditory prompting devices. If the next highest type of technology were added, video devices and switches, more than 70% of the participants were accounted for. In addition, three quarters of the participants were evaluated in segregated settings. The authors conclude that we know too little about the impact of technology on community-based settings. In addition, there were limited studies for employment meaning that the authors combined this area with other studies looking at independent living and leisure because there were not enough to be looked at separately. They conclude that it is evident "that we know very little about technology use and employment issues for people with intellectual disability in real employment settings."

URL: 
http://eric.ed.gov/?id=EJ861032
Populations: 
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Influence of least restrictive environment and community based training on integrated employment outcomes for transitioning students with severe disabilities.

Authors: 
Wickizer, T. M., Campbell, K., Krupski, A., & Stark, K.
Year Published: 
2004
Publication: 
Journal of Vocational Rehabilitation
Volume: 
21
Number: 
3
Pages: 
149-156
Publisher: 
IOS Press
Background: 

In light of the data supporting the education of individuals with severe disabilities in natural contexts, it stands to reason that programs would no longer provide training in contexts other than those that result insurable employment opportunities. However, this continue to occur. Even with mandated transition planning integrated employment outcomes are not improving for students with severe disabilities. Many of these students will then enter the public welfare system and/or segregated adult programs.

Purpose: 

The purpose of this study was to identify variables that are correlated with successful integrated employment outcomes for transitioning students with severe disabilities.

Setting: 

The setting included 20 different schools sites within 12 school districts in a county in California.

Sample: 

The sample included 104 students with severe disabilities, ages 18-22, who had exited school without diploma. Close to half (48%) of the participants had an IQ that placed them in the profound (25%) or severe (23%) category. The majority of the participants were white (53%), followed by Hispanic (28%), Asian (13%),African American (4%) and Pacific (2%). Around 53% of the students were males. Around 80% of the participants lived at home; the others lived in group homes.

Data Collection: 

The specific variables measured in this study included: the influence of duration of community-based training (CBT) that included on-the-job training, on the-job training as a subset of CBT, the least restrictive environment (LRE), or the degree of integration with non-disabled peers during the school day, demographics(gender, ethnicity, home setting, behavior problems, physical disability and mental ability) as measured by
intelligence quotient (I.Q.).Data was collected by structured interview with teachers and administrators, record review and on site observations. Correlations were used to examine predictive relationships between the independent variables and the dependent variable of post-school integrated employment. Cross tabulations and chi-square analysis of correlated variables were then used to identify significance of specific variables on employment outcome.

Intervention: 

The intervention was community based training. This included on the job training and physical integration with non disabled peers.

Control: 

There was no comparison or control group

Findings: 

These data indicate significant interactions between community based training (r = 0.387, p < 0.001), degree of integration with typical peers (r = 0.360, p < 0.001), andon-the-job training (r = 0.305, p = 0.001) and employment outcome. There were also strong intercorrelations among the three variables of CBT, degree of integration or LRE and on-the-job training.Transitioning students who received CBT and on the job training had a 69% integrated employment rate after leaving school.

Conclusions: 

The combinations of least restrictive environments,CBT/on-the-job training, and innovative teacher advocacy are potent predictors of post school employment for students with severe disabilities, regardless of intellectual functioning.

URL: 
http://www.kcdsg.org/files/content/Cheryl%20Jorgensen_Influence%20of%20LRE%20on%20Outcomes.pdf
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Vocational rehabilitation services and employment outcomes for people with disabilities: A United States study

Authors: 
Employment outcomes of transition-aged adults with autism spectrum disorder: A state of the states report
Year Published: 
2008
Publication: 
Journal of Occupational Rehabilitation
Volume: 
18
Number: 
4
Pages: 
326-334
Publisher: 
Springer Science+Business Media, LLC
Background: 

Work is fundamental to the physical and psychological well-being of all people. The United States state-federal vocational rehabilitation programs spend more than $2.5 billion annually. Understanding the factors and service patterns that contribute to successful employment outcomes will help enhance services.

Purpose: 

The purpose of the study is to identify key factors associated with successful employment outcomes for people with sensory/communicative, physical, and mental impairments in the United States.

Setting: 

This study included individuals with disabilities served by multiple vocational rehabilitation agencies in various settings.

Sample: 

Data for this study were extracted from the fiscal year 2005 RSA-911 Case Service Report. The sample includes 5,000 clients from each disability group (sensory/communicative, physical, and mental impairments) whose cases were closed as either rehabilitated or not rehabilitated.

Data Collection: 

Data extracted from the RSA-911 data were analyzed using Statistical Package for the Social Sciences (SPSS). Logistic regression analysis was used to examine the association among demographic characteristics, provision of cash or medical benefits, VR service patterns, and employment outcomes. (p. 328)

Intervention: 

Assessment, diagnosis and treatment of impairments, vocational rehabilitation counseling and guidance, college or university training, occupational/vocational training, on-the-job training, basic academic remedial or literacy training, job readiness training, job search assistance, job placement assistance, on-the-job supports, transportation, maintenance, rehabilitation technology, reader services, interpreter services, personal attendant services, information and referral, and other services.

Control: 

Comparison of cases that were closed rehabilitated to those that were closed not rehabilitated.

Findings: 

Individuals with sensory/communicative impairments had the highest employment rate (75%) compared to 56% for the physical impairments group and 55% for those with mental impairments. Job placement, on-the-job support, maintenance, and other services were identified as significant predictors of employment success.

Conclusions: 

This study provides some empirical support documenting the association between vocational rehabilitation services and employment outcomes of people with disabilities. (p. 326)

URL: 
https://www.researchgate.net/publication/23449787_Vocational_Rehabilitation_Services_and_Employment_Outcomes_for_People_with_Disabilities_A_United_States_Study
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

The quest for ordinary lives: The integrated post-school vocational functioning of fifty workers with significant disabilities

Authors: 
Browne, D. J. & Waghorn, G.
Year Published: 
2006
Publication: 
Research and Practice for Persons with Severe Disabilities
Volume: 
31
Number: 
2
Pages: 
93-121
Publisher: 
TASH Publishing
Background: 

More individuals with significant disabilities are entering and exiting schools and outliving their parents than ever before. As these individuals age, many are presenting more longitudinal, complicated, and expensive difficulties than their chronological age peers (Bittles and Glasson, 2004).

Purpose: 

The purposes of this study are to: (1) share information about the integrated vocational functioning of 50 adults with significant disabilities, (2( celebrate their vocational achievements, and (3) affirm the feasibility of integrated vocational functioning.

Setting: 

All participants were clients of Community Work Services, an employment services program in Madison Wisconsin.

Sample: 

The 50 participants were assisted into integrated jobs prior to 2005. The sample included individuals with a variety of disabilities, including autism, intellectual disabilities, and cerebral palsy. All were at least 15 years out of high school.

Data Collection: 

The data consisted of service records maintained by Community Work Services during the course of services. Additional information was collected from interviews with participants, family members, employers, and others.

Intervention: 

The intervention was community-integrated employment utilizing a job coach and long-term support.

Control: 

There was no comparison condition.

Findings: 

Job retention ranged from 2 months to 27 years and 6 months. Job changes occurred for a variety of reasons, but primarily to enhance opportunities and create better job matches. Work hours ranged from 6 to 30.5 hr/week, with an average of 20.15 hr/week. Hourly wages averaged $5.76, six cents above the prevailing minimum wage at the time of placement.

Conclusions: 

The study findings provide evidence for the feasibility of integrated employment for individuals with severe disabilities in need of long-term employment supports.

URL: 
https://pdfs.semanticscholar.org/3172/5be67b88b211fb2d73faa67d50824d704104.pdf
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

The viability of self employment for individuals with disabilities in the United States: A synthesis of empirical-research literature

Authors: 
Yao-Jen Chang, Hung-Huan Liu, Shu-Min Peng, Tsen-Yung Wang
Year Published: 
2011
Publication: 
Journal of Vocational Rehabilitation
Volume: 
35
Number: 
2
Pages: 
117-127
Publisher: 
IOS Press
Background: 

The lack of employment opportunities and stable employment for individuals with disabilities continues to pose personal and social difficulties and challenges. Individuals with disabilities experience persistently higher poverty rates. Very little is known about individuals with disability in self employment as compared to the more extensive research literature on individuals with a disability who work for someone else.

Purpose: 

Paper reports on a review, analysis, and synthesis the findings of empirical-research studies on self-employment of individuals with disabilities in the United States. Paper addresses the question: "How viable is self employment for individuals with disabilities in the U.S."

Setting: 

This study is a systematic review. The included studies were undertaken in various locations and settings.

Sample: 

The data search used five large data bases: Academic Search Premier, ERIC, PsycINFO, Sociological Abstracts, and Business Source Premier/Econ-Lit. The database search used the terms self employment, entrepreneurship and micro enterprise as synonymous terms in the search. Results were sorted to identify U.S. empirical literature. Twelve studies met the selection criteria.

Data Collection: 

Coding of selected studies comprised the following steps: First author completed multiple readings noting, for example, research questions, research design, data collection and measurement, and research findings, and limitations. Second and third author evaluated first and second authors evaluated first authors coding for accuracy. Full interobserver accuracy (100%) was established before proceeding to the synthesis of selected studies.

Intervention: 

The study adopted a two part definition of self employed worker:
a) Self employed in own not incorporated business workers. This includes people who worked for profit or fees in their own unincorporated business, professional practice, or trade or who operated a farm.
b) Self employed in own incorporated business workers.

Control: 

There were no comparison or control conditions.

Findings: 

In recent years, approximately 12% of working individuals with disabilities have earned an income from self-employment. The national Vocational Rehabilitation closure rates in self employment have remained around 2-3% since the late 1980s (although the rate varies considerably from state to state). The reasons individuals with disabilities pursue self employment are diverse and vary in complexity. Individuals can derive a range of benefits and challenges in self employment. Primary benefit is financial. Other potential benefits involve having a more of a decision making role in their own lives, and personal control and autonomy. Primary challenge in self employment is the access to adequate capital and financing for funding a business, extending beyond individual and family resources. Support in self employment has typically meant relying on a patchwork of resources.

Conclusions: 

In the 21st century, self employment can be a catalyst for expanding work opportunities and improving outcomes for individuals with disabilities. Tentative indications that Individuals with disabilities can succeed in self employment under certain conditions involve a number of stakeholders. State and federal agencies could expand their support of self employment for individuals with disabilities through the establishment of micro finance development funds outside the VR system.

URL: 
http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr559
Outcomes: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services

Authors: 
Bond, G. R. & Drake, R.
Year Published: 
2000
Publication: 
Rehabilitation Counseling Bulletin
Volume: 
44
Number: 
1
Pages: 
10-21
Publisher: 
Rehabilitation Counseling Bulletin
Background: 

Since the 1950‚ rehabilitation research has been try to find out which variables influence or predict successful employment outcomes for rehabilitation clients. The rationale behind such an investigation is that if we understand the determinants of successful outcomes, we can intervene to increase the likelihood of success for vocational rehabilitation (VR) clients. Consequently, research on the prediction of rehabilitation outcomes has been extensive, including examinations of numerous demographic, psychological, social, and service variables for a wide variety of client populations. The VR process consists of three service phases: (a) referral, (b) diagnostic evaluation and rehabilitation planning, and (c) service provision, all of which lead to some type of vocational outcome at case closure. Despite the fact that rehabilitation outcomes have been extensively researched, very few studies have attempted to assess the predictability of outcomes from variable sets that reflect the multiple phases of the VR service process while controlling for the effects of disability. Ideally, a comprehensive, quantitative investigation of rehabilitation outcomes should include, at minimum, the following data elements: (a) personal history information collected using the application for services form (referral phase), (b) diagnostic information summarized in a functional limitations profile (evaluation and planning phase), and (c) specific rehabilitation services provided to clients as stipulated in the rehabilitation plan. Despite efforts not one single investigation of the prediction of vocational outcomes has been reported in the rehabilitation literature that used data from all three phases of the VR process.This study was the first.

Purpose: 

The purpose of the study was to quantify the major phases of the VR service process, using large samples of clients that enabled control for the influence of disability and statistical analysis of all variables simultaneously, thereby quantifying the VR service system. The research questions were: How much variance in employment outcomes can be explained by three sets of predictor variables that represent the three major phases of the VR service process? Which variables made the largest contributions to the explanation of employment outcomes? The study assessed vocational outcome at closure in two ways (a) Competitively employed clients were compared to clients who were not working, and (b) weekly salary was analyzed for the competitively employed clients.

Setting: 

This study included individuals with disabilities served by the state of Arkansas' vocational rehabilitation agency in various settings.

Sample: 

Participants in this study were 25 predominantly Caucasian (n=18, 72%) females (n=19, 76%) between 18 and 64 years of age.

Data Collection: 

Four sets of variables: personal history, functional limitations, rehabilitation services and employment outcomes were measured. The Scale of Social Disadvantage, was developed to predict competitive employment for VR clients from information collected on the application form. The FAI, a behaviorally anchored, counselor rated tool was used to measure a client's functional limitations and key environmental factors that are relevant to VR service planning. Three categories of rehabilitation service variables were used. Two discrete services were job placement and personal adjustment training. Three aggregate service variables were vocational training, restoration, and maintenance. Two global measures of service intensity were time in rehabilitation and total service costs. Various service variables were excluded from the analysis like counseling, diagnosis, support and transportation. Two criteria related to employment success, competitive employment versus not working. Weekly salary for competitive employment were used. Clients closed in other work statuses (i.e.. workshop, student, homemaker etc.) were excluded from the analysis.
Hierarchical multiple regression analysis was used to assess predictive relationships between the variable representing the 3 phases of VR services and the two employment outcomes. The first set only included the SDD total score. The second set included the SSD score and six FAI factor scales. The third set consisted of the SDD score, the six FAI scales, and the seven rehabilitation service variables. The three sets of variables were used to predict the employment outcomes (competitive employment and weekly wages).

Intervention: 

The intervention was various vocational rehabilitation service types and intensity levels.

Control: 

There was a comparison condition. The study compared outcomes across disability groups.

Findings: 

The combination of personal history items in the Scale of Social Disadvantage predicted competitive employment and salary at closure. Job placement services was by far the greatest contributing factor to achieving competitive employment. The authors expected that Functional Assessment Inventory factors would also predict employment outcomes for VR clients. However, this investigation did not uphold this finding. There was a minimal relationship between functional limitations and employment outcomes.

Conclusions: 

The study supported the following conclusions: 1) competitive employment is more predictable and thus more susceptible to improvement than salary at closure; 2) personal history information constitutes a quantitative basis for calculating an estimate of client case difficulty; 3) job placement services, the most important determiner of competitive employment, should receive greater emphasis in VR counselor education programs; and 4) functional limitations should continue to be evaluated by counselors in conjunction with the VR client diagnostic and service planning phase. The results should be used to improve counselor training and service delivery.

URL: 
http://rcb.sagepub.com/content/44/1/10.full.pdf
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A collaborative follow-up study on transition service utilization and post-school outcomes

Authors: 
Baer, R. M., Flexer, R. M., Beck, S., Amstutz, N., Hoffman, L., Brothers, J., Stelzer, D., & Zechman, C.
Year Published: 
2003
Publication: 
Career Development for Exceptional Individuals
Volume: 
26
Number: 
1
Pages: 
7-25
Publisher: 
Sage
Background: 

In spite of nearly 20 years of research on postschool outcomes, local schools rarely use these data to drive their improvement efforts. A number of school-based activities have been shown to improve post-school employment, such as employment experiences and community-based learning; however, in many schools these activities have not been adopted.

Purpose: 

The purpose of this study was to examine characteristics related to transition service utilization and postsecondary outcomes, and identify program- and student-related variables that best predicted full-time employment.

Setting: 

Settings were multiple school systems in Ohio.

Sample: 

The study sample consisted of 140 randomly selected former special education students who had exited school in either 1997 or 2000. Dropouts were excluded because they could not be tracked. The sample was 59% male, with the majority having educational diagnosis of either learning disability (49%) or intellectual disability (28%); however, most disability diagnoses were in the sample.

Data Collection: 

Data for the study were collected through two main sources: School records and a postschool survey. The survey collected information regarding employment, postsecondary education, independence, and other areas of adult life. Bivariate correlations were run between student-related variables, program-related variables, and postschool outcomes. A logistic regression model was developed to predict work and postsecondary education outcomes from student characteristics and secondary participation.

Intervention: 

The interventions that were assessed included those that have been found in prior research to be associated with post school employment: Work experiences while in school, inclusion in the general academic program, and participation in vocational or work/study programs.

Control: 

The comparison condition in the study was not having received the interventions.

Findings: 

Related to employment, the logistic regression analysis showed that vocational education, work study participation, attending a rural school, and having a learning disability were the best predictors of full-time employment after school exit. Participation in work/study and vocational education each increased the likelihood of employment two-fold. However, other school-based vocational services, such as job shadowing, career fairs, in-school jobs, etc. were not predictive of post-school employment.

Conclusions: 

Work/study and vocational education may be significantly correlated with postschool outcomes because they screen out students with more severe disabilities, but also may have been due to work/ study and vocational programs being more comprehensive and better integrated into the general curriculum than other school-based services. The finding that other work-related school programs were not correlated with positive postschool outcomes may have been because they were uncoordinated with the student area of study.

URL: 
http://cde.sagepub.com/content/26/1/7.refs?patientinform-links=yes&legid=spcde;26/1/7
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes