Case reports

Outcomes:

Full-time employment

Part-time employment

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Project SEARCH for youth with autism spectrum disorders: Increasing competitive employment on transition from high school

Authors:

Wehman, P., Schall, C.M., McDonough, J., Kregel, J., Brooke, V., Molinelli., A., Ham, W., Graham, C. W., Riehle, J. E. Collins, H. T., & Thiss, W.

Year Published:

2013

Publication:

Journal of Positive Behavior Interventions.

Volume:

Number:

Pages:

144-155

Publisher:

Hammill Institute on Disabilities and Sage

Background:

Transition from school to work for youth with ASD is an ongoing problem for the public education system. Teachers also struggle with their attempts to match the strengths of a particular student to a job. Project SEARCH is a transition program for youth with disabilities. In this model students rotate through full day internships in businesses to gain work and related skills that may lead to an employment offer for some.Others have a positive work experience to highlight as they apply for jobs in their communities.Project SEARCH helps facilitate the transition from school to work.

Purpose:

The purpose of this study was to determine how a Project SEARCH approach would work for youth with ASD.

Setting:

The student internships took place in a large hospital.

Sample:

Two case studies were presented for two young men with ASD. A 19 year with autism and a 20 year old with Asperger Syndrome as well as severe scoliosis.

Data Collection:

The following data demographics, internship characteristics, job coach interventions was collected for each young man.

Intervention:

The intervention was Project SEARCH model along with some specific ASD supports.

Control:

There was no control or comparison condition.

Findings:

One young man participated in internships in the hospitals' radiation, engineering and infection control departments. His performance improved over time and he was offered a job in the infection control department working 20 hours and week and earning $9.14 an hour.The other young man participated in internships in the Coronary Care Unit, Biomedical Durable Equipment, and Intensive Care Unit (ICU). His abilities also improved during the internships. After completing the internships he was offered a job working 20 hours a week in the ICU earning $9.14 per hour.

Conclusions:

A Project SEARCH approach appears to be an effective way to assist youth with ASD with transition from school to work. This study was part of a larger study researching the use of Project SEARCH model to serve youth with ASD. The results from this larger study should help shed light on this topic.

URL:

http://pbi.sagepub.com/content/early/2012/10/11/1098300712459760

Disabilities:

Transition-age youth (14 - 24)

Populations:

Male

Black / African American

White / Caucasian

Outcomes:

Traumatic brain injury (TBI)

Increase in hours worked

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Return to work for individuals with TBI and a history of substance abuse.

Authors:

Wehmeyer, M. L., Palmer, S. B., Smith, S. J., Davies, D., & Stock, S.

Year Published:

2000

Publication:

NeuroRehabilitation

Volume:

Number:

Pages:

71-77

Publisher:

IOS Press

Background:

Substance abuse can be a problem for any person. However, it is more prevalent among individuals with disabilities than society in general. Individuals with substance abuse problems often have trouble gaining and maintaining work. Among those disability groups demonstrating a prevalence of substance abuse are individuals who survive traumatic brain injury (TBI).When individuals have a dual diagnosis of substance abuse and disability like TBI the treatment of both conditions becomes more complex. This may increase the possibility of medical complications and heighten the the symptoms of the disability for the person. It can also decrease the effectiveness of interventions designed to assist a person with employment post TBI. Research that specifically examines strategies or models that enhance employment rates of persons with TBI and substance problems is scant. Supported Employment is one return to work strategy for individuals with severe TBI and substance abuse problems

Purpose:

The purpose of this paper is to describe how substance abuse can be addressed within the context of a vocational rehabilitation program that provides supported employment services to individuals with severe TBI and substance abuse problems.

Setting:

The setting was a place of employment in Virginia.

Sample:

A case study illustrate how a man with a long history of substance abuse and a TBI gained and maintained work using a supported employment approach.

Data Collection:

Information was collected from the employment specialist who worked with individual described in the case study through face to face interview. In addition, case file information including daily notes were reviewed.

Intervention:

The individualized model of supported employment. In this approach a vocational rehabilitation professional known as an employment specialist or job coach analyzes the jobseeker's personal vocational strengths and
support needs; meets with employer's to develop jobs; provides on the job support to help the new hire learn the job and offers ongoing follow up services and case management throughout the person's job tenure.

Control:

There was no control or comparison condition.

Findings:

The individual described in the case study remained employed for over one year at the time of publication. The employment specialist took on a variety of roles in response to his needs. Roles included: providing feedback and encouragement, on the job site new skills training including designing and implementing compensatory strategies, ongoing support and case management.Employment specialists will need training and ongoing education to effectively support individuals with TBI and substance abuse histories. Lack of transportation remains a barrier to work and impacts the ability to get to substance abuse treatment (ie. AA meetings). Repeated efforts may be needed to assist individuals with successfully returning to work. Furthermore, many programs do not serve individuals with active substance abuse, so these people do not get help.

Conclusions:

Substance abuse further complicates TBI and return to work. Supported employment providers need to provide a mix of services that are career oriented and unique to a person‚ specific needs and circumstances.Individualized support should include assisting a person with issues outside of work, particularly those that may negatively impact employment or substance abuse treatment.

URL:

https://www.ncbi.nlm.nih.gov/pubmed/11455083

Disabilities:

Populations:

Male

Outcomes:

Return to work

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

Telework and employees with disabilities: Accommodations and funding options.

Authors:

Westerlund, D., Granucci, E. A., Gamache, P., & Clark, H. B.

Year Published:

2005

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

115-122

Publisher:

IOS Press

Background:

Telework or telecommuting are alternative work arrangements that employers are using to meet the changing needs in of the workforce. Some typical telecommuting occupations include: sales representatives, claims adjusters, computer programmers, and customer service representatives.Telecommuting allows organizations to be better meet business needs including more flexibility in meeting the changing expectations of employees. It also increases the labor pool by allowing companies to pursue the non-traditional employee, such as disabled people, retired individuals, older workers, and part-time employees and does not restrict employers or employees to geographical locations. Research is needed about how telework can serve as an accommodation for employees with disabilities.

Purpose:

The paper reviewed the literature on telework as an accommodation for individuals with disabilities.This included an examination of the barriers to telework and funding options. Two case studies were presented to illustrate how telework could be used as an accommodation to facilitate return to work of three individuals.

Setting:

The interventions (telework) took place in the employees homes.

Sample:

A total of 40 students participated in the study. Sixteen students were assigned to the control group and 24 were in the treatment group. The two groups were equivalent on a number of demographic variables including gender, race, medical diagnosis, and Individualized Education Plan category. There was a significant difference between the ages of the treatment and control groups. The age range for both was between 18 and 21.5 years old.

Data Collection:

Case study information came from a key informant. Participants were referred to this organization by the state vocational rehabilitation agency for telework skills training and job placement.

Intervention:

The intervention examined in this study was telework. In this paper the term telework was as working at home during business hours one or more days a week, using a combination of computing and communications technology to stay productive and connected to the office and client.

Control:

Case study information came from a key informant. Participants were referred to this organization by the state vocational rehabilitation agency for telework skills training and job placement.

Findings:

The woman in the first case study received training on teleworking and computer skills. Afterwards she went to work for a non profit at 20 hours a week. Initially, she typed and edited reports. Eventually she received more hours to manage a database and mailings. She has worked for 14 years.In the second case study a husband and wife teleworker. The husband was was hired by a non profit to work 20 hours a week as a customer service representative to handle calls during traditional business hours. Nine months later his wife was employed by the same organization doing the same type of work.The jobs also the team to maintain health and manage fatigue.

Conclusions:

Telework provides another work option for individuals with disabilities. However, it is not a panacea. More research is needed on how to increase this work option for individuals with disabilities whose interest, life situation and work personality match this work arrangement.

URL:

http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00301

Disabilities:

Orthopedic impairments

Populations:

Outcomes:

Return to work

NIDILRR Funded:

Yes

Research Design:

Specific learning disabilities

Peer Reviewed:

Yes

Effects of peer mentors on work-related performance of adolescents with behavioral and/or learning disabilities.

Authors:

White, J., & Weiner, J.

Year Published:

2006

Publication:

Journal of Positive Behavior Interventions.

Volume:

Number:

Pages:

244-251

Publisher:

Hammill Institute on Disabilities.

Background:

The transition to adulthood can be challenging for all youth; this is especially true for many young people with disabilities. They often experience high levels of school dropout, unemployment, economic hardship and instability, and social isolation. Over the years policies of special education programming (e.g., Individualized Education Programs, Individual Transition Plans) have been developed to increase employment competence and outcomes for young people with disabilities. However, these policies have not translated into effective practices.Research has been evolving on how to use person-centered planning and positive behavioral support principles and strategies to improve post secondary outcomes particularly in employment settings. A peer-mentor instructional and coaching role for youth with disabilities in school-based technical or vocational training programs may be an effective. This approach may be used to build on young people interests and strengths, tailor supports, and improve successful learning of work-related curriculum skills. They could also provide a cost-effective way of preparing youth for the task and social expectations of the workplace.

Purpose:

The purpose of this study was to examine the role of peer mentors in a school-based cosmetology vocational training salon in increasing the work-related skills of youth with specific learning disabilities (SLDs) and severe emotional disturbances (SEDs).

Setting:

The setting for the study was a vocational training program in cosmetology at a technical center. There secondary and adult students learn how to perform a variety of salon services (ie. haircuts, hair styling, nail care etc...), using manikins and school and community patrons.

Sample:

Four female students between the ages of 16 to 18 participated in the study. Each had a diagnosis of severe emotional disturbance or severe learning disability. Each student had expressed a desire in pursuing a career in cosmetology during person centered planning.

Data Collection:

Each participant had a targeted work related tasks to learn. The first had roller setting and combing out. The second had combing out and roller setting. Roller setting was judged based on a predetermined criteria. Combing out was observed and afterwards the task was judged on predetermined factors. The other two participants, the third and fourth received training on comfort inquires and suggestive statements. Work tasks were selected where specific comfort inquiries (i.e.. Is the water to hot?) and suggestive statements (using hair styling products) were appropriate. The mentor and experimenter determined 1 to 3 minimal opportunities to make comfort inquiries and 1 to 2 minimal suggestion statements for each type of service. Observers were trained on all behaviors or products to an interrater reliability of 85% or more by observing other students in the program.
Each participant completed a circle of support form during baseline and at the end of the study. Both participants and mentors completed a questionnaire to gauge their views about the peer mentoring role.

Intervention:

The intervention involved vocational training in a beauty salon and peer mentoring. Four advanced students in the cosmetology program served as peer mentors. These students were selected based on task proficiencies and personal attributes (patient, good listener, willingness to participate etc...) associated with successful mentors. Mentors participated in a 30 to 45 minute training that covered instructional methods. Specifically they were taught how to help the students learn work related skills using behavioral rehearsal demonstrating targeted tasks and delivering descriptive praise and corrective feedback. Each mentor introduced the intervention, explained and or modeled the behavior, allowed the student to perform the behavior and then provided descriptive praise and corrective feedback. If the participant failed to demonstrate the correct behavior after 3 trials, the mentor would model the behavior again. The peer mentor was in close proximity of the participant during the first 3 sessions. The experimenter observed the sessions, giving the mentor feedback. Once data revealed that the first behavior was stable, the next intervention began. A multiple baseline design across behaviors was used to analyze the treatment effects of the peer mentor training. Each participant was paired with a mentor. Afterwards each received training from the peer mentor on one behavior after baseline stability was achieved. The first target behavior was told to the mentor immediately prior to training and intervention. The second behavior was not revealed until sufficient data had been collected on the first behavior. The peer mentor was trained and instructed to intervene on the second behavior while continuing intervention on the first behavior. The condition changes were determined through visual inspection of the graphic data to ensure that the data for the first targeted behavior were stable and no trend was evident on the second behavior in the expected direction of the next condition.

Control:

There was no control or comparison condition.

Findings:

Conclusions:

Peer mentors can trained to teach individuals with disabilities who have difficulties learning verbal and nonverbal tasks. This appears to be an effective and acceptable way to assist student performance in a vocational training setting. It also appears to be help young people feel more comfortable in such settings. More research is needed to learn more about using peer mentors in vocational training settings and using coworkers as natural supports in employment settings.

URL:

http://pbi.sagepub.com/content/8/4/244.abstract

Disabilities:

Populations:

Female

Transition-age youth (14 - 24)

Outcomes:

NIDILRR Funded:

Not Reported

Research Design:

Peer Reviewed:

Yes

Employment supports for young adults with autism spectrum disorder: Two case studies

Authors:

Hart, T., Dijkers, M., Whyte, J., Braden, C., Trott, C. T., & Fraser, R.

Year Published:

2014

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

117-124

Publisher:

IOS Press

Background:

Many young adults with autism spectrum disorder (ASD) face trouble transitioning from school to employment. Project SEARCH and ASD Supports have helped young adults with ASD transition successfully to employment. This paper presents two cases of successful transition through those programs.

Purpose:

The purpose of this article is to present two cases of young adults with ASD and describe the supports they received through project SEARCH.

Setting:

The setting included businesses where the two young adults worked.

Sample:

The sample included two young adults with ASD; one female and one male.

Data Collection:

The case histories reviewed described the various types of supports the young adults used at work.

Intervention:

The interventions were various types of supports that the individuals received on the job.

Control:

There was no control or comparison condition.

Findings:

Kristin worked in a Mother Infant Unit of a hospital and despite being able to complete her job tasks had many struggles. During her second month of work she would refuse to work, return from breaks late, and throw things across the room when she became upset. Kristin‚ behavior resulted in her being at risk of termination from her position. Through a Positive Behavior Support plan that was a collaboration of her job coach, supervisor, co-workers, and family she was able to become a productive employee.

Darnell is a 23 year old with ASD and works as a pharmacy assistant in a hospital. He is a valuable asset to his unit but has his struggles. He has refused to follow instructions, thrown medications on the floor, and fist pumped. Through a Positive Behavior Support plan he was able to cut down on the undesired behavior and continues to be successful in his position.

Conclusions:

These cases demonstrate the positive impact of supported employment for individuals with ASD.

URL:

http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr677

Disabilities:

Populations:

Transition-age youth (14 - 24)

Outcomes:

NIDILRR Funded:

Yes

Research Design:

Peer Reviewed:

Yes

When prolonged exposure fails: Adding an imagery-based cognitive restructuring component in the treatment of industrial accident victims suffering from PTSD

Authors:

Hagner, D., Cloutier, H., Arakelian, C., & Brucker, D.

Year Published:

2003

Publication:

Cognitive and Behavioral Practice

Volume:

Number:

Pages:

333-346

Publisher:

Association for Advancement of Behavior

Background:

Accidents within the workplace affect a large number of individuals each year. The most frequently studied traumas have involved victims of combat,physical and sexual assault, natural disaster, and motor vehicle accidents. (p.333)

Purpose:

The purpose of this study is to examine the efficacy of adding an imagery-based, cognitive restructuring component to the treatment of two victims of work-related injuries suffering from PTSD who failed to improve from prolonged exposure alone.

Setting:

The study took place in individual treatment sessions provided by the senior author.

Sample:

This article reviews 2 case studies of individuals receiving Imagery Rescripting and Reprocessing Therapy (IRRT) in addition to Prolonged Exposure (PE).

Data Collection:

The BDI, IES, State-Trait Anxiety Scale, and the WMS-R Digit Span Subtest were administered at pre and post-treatment, and again at 1-month, 3-month, and 6 month follow-ups. SUDS ratings were recorded throughout each treatment session as well as at intake, post treatment, and each of the follow-ups.

Intervention:

The intervention was Imagery Rescripting and Reprocessing Therapy (IRRT) and Prolonged Exposure (PE).

Control:

There was no control or comparison condition.

Findings:

Imagery Rescripting and Reprocessing Therapy appeared to facilitate and foster a significant cognitive shift, which resulted in successful emotional processing and an immediate alleviation of PTSD symptoms. (p.343)

Conclusions:

Prolonged exposure is more likely to be an effective PTSD treatment when fear is the primary emotion and avoidance is the primary coping strategy. An imagery based cognitive-restructuring treatment (IRRT) is likely to be an effective PTSD treatment when non-fear emotions are primary.

URL:

http://www.sciencedirect.com/science/article/pii/S1077722903800512

Disabilities:

Emotional disturbance

Populations:

Outcomes:

NIDILRR Funded:

Research Design:

Peer Reviewed:

Yes

The Apple iPod Touch as a vocational support aid for adults with autism: Three case studies

Authors:

Gersons,B. P. R., Carlier,I. V. E., Lamberts, R. D., & van der Kolk, B. A.

Year Published:

2012

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

75-85

Publisher:

Journal of Vocational Rehabilitation

Background:

Personal digital assistants (PDAs) offer task management and organizational features that may be utilized to help people with autism spectrum disorder (ASD) function more successfully in the workplace. However, most of the focus in autism research is on the identification, assessment and treatment of children; few studies examine interventions and outcomes in adulthood. As a result, evidence-based programs of workplace support are limited.

Purpose:

The purpose of the study was to determine if supported employment could improve the cognitive performance of individuals with autism. More specific, the researchers wanted to know what types of employment might have such benefits? Does supported employment also improve non-vocational outcomes?

Setting:

The setting included three employment sites in 3 different businesses.

Sample:

The three people profiled were adults with autism spectrum disorder who were participants in a 4 year randomized trial examining the use of these devices as job coaching aids in the workplace. The participants were: a 21-year-old man working as a daytime custodian in a fast food restaurant, a woman aged 60 years responsible for processing incoming mail at an office, and a 20-year-old female non-reading hospital worker,

Data Collection:

Data was maintained for each study participant on average hours worked per week, average job coach direct verbal/gestural supervision hours per week, and average job coach indirect monitoring hours per week. Date was also maintained on software applications used.

Intervention:

Onboard iPod Touch task organization applications were used to set up work schedules with audible task prompts and reminder alarms. The Notes application was used to provide additional task guidance, and the PDAs video camera was used to record short videos guiding the mail clerk around various stations in her work environment. Other apps utilized included Simply Being, providing relaxation and meditation coaching; VoCal, a verbal reminder application; iCal, for creating a color coded alternating-day calendar; StoryKit for creating picture-prompting task lists; and iReward for positive performance feedback, the latter three added for the non-reader hospital worker.

Control:

There was no control or comparison condition.

Findings:

Participants wore the portable PDAs, clipped to a belt or with a lanyard around their neck, as vocational supports throughout their workday for a period of six months, resulting in improved functional performance and reduced behavioral challenges

Conclusions:

PDAs should be considered as an assistive technology for use with people with cognitive-behavioral conditions. The partnership of an Occupational therapist familiar with task analysis, PDAs and applications and an employment specialist onsite at the job site can facilitate successful individualized strategies for vocational support using PDAs.

URL:

http://worksupport.com/documents/apple_ipod_touch.pdf

Disabilities:

Populations:

Outcomes:

Increase in hours worked

NIDILRR Funded:

Yes

Research Design:

Peer Reviewed:

Yes

Changes in the quality of autistic people's life that work in supported and sheltered employment. A 5-year follow-up study

Authors:

Gates, L. B., Klein, S. W., Akabas, S. H., Myers, R., Schawager, M., & Kaelin-Kee, J.

Year Published:

2002

Publication:

Journal of Vocational Rehabilitation

Volume:

Number:

Pages:

309-312

Publisher:

IOS Press

Background:

There is growing consensus that quality of life should dominate policies and services for individuals with autism. Supported employment is one service that enables individuals with autism with obtaining and maintaining meaningful community employment. It is important for professionals to understand how individuals with autism enjoy and benefit from various experiences.

Purpose:

The study evaluated the changes in the quality of life of adults with autism who worked in the community via supported employment versus those who were in sheltered work.

Setting:

Individuals in the supported employment group worked in a variety of community jobs that were primarily in the service sector.

Sample:

Fifty five adults with autism, who live in Spain and Germany, participated in the study. Twenty six individuals in sheltered work (18 males and 8 females) were matched to 25 individuals (21 males and 4 females) in a supported work. The mean age for both groups was around 21 years. The average IQ for members in both groups was about equal at about 53.

Data Collection:

Data was collected through interviews with individuals with autism and their family, caretakers, and therapists using the Quality of Life Survey. The survey included 18 questions that were grouped in three categories: a) Environmental Control (EC), b) Community Involvement (CI), and Perception of Personal Change (PC). Each person with autism was interviewed in 1996 and again in 2000. If the individual with autism was not able to verbally communicate, the job coach was interviewed.

Intervention:

The intervention was sheltered work or supported employment. Sheltered work was as piece work performed in segregated programs with only disabled co-workers. Supported employment was working in a community job 15 to 30 hours per week for competitive wages. Job coaches provided various types of services to supported workers including on the job site training and ongoing follow-along.

Control:

A group individuals with autism who participated in sheltered work was compared with supported employment group.

Findings:

In 1996, at the start of the study, there was no difference between the sheltered and the supported work groups on total Quality of Life scores.
In 2000, the sheltered work group showed less quality of life than the supported work group in total score. The sheltered work group did not change its quality of life level between 1996 and 2000. The supported employment group improved its global quality of life.

Conclusions:

There is a positive relationship between supported employment and quality of life. Supported employment seems to improve the quality of life for individuals with autism. Sheltered work does not seem to improve quality of life for individuals with autism.

URL:

http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00170

Disabilities:

Populations:

Outcomes:

Return to work

NIDILRR Funded:

Research Design: