Predictors of success for state vocational rehabilitation for clients with traumatic brain injury

Authors: Jones, C. J., Perkins, D. V., & Born, D. L.
Year Published 2003
Publication Archives of Physical Medicine and Rehabilitation
Volume 84
Number 2
Pages 161-167
Publisher Elsevier
Background

Return to work after a Traumatic Brain Injury (TBI) is an important outcome and often considered a primary measure to evaluate the effectiveness of rehabilitation. Research in Traumatic Brain Injury is disjointed and most related to vocational rehabilitation includes small sample sizes and other weaknesses. A more complete investigation of the relationship between vocational rehabilitation services and outcomes of individuals with TBI may help determine determine predictors of vocational success.

Purpose

Find what descriptive characteristics of vocational rehabilitation clients with TBI contribute to the prediction of successful vocational outcomes.

Setting

This study included individuals with TBI served by the Missouri vocational rehabilitation agency in various settings.

Sample

Seventy eight individuals with Traumatic Brain Injury who were served by the Missouri DVR were selected from a sample of 220 individuals. The majority of the participants were single, white (82%) males (71%). The average length of time from injury to referral to DVR was 9.2 years and the average age was 36.7 years. The majority had a high school education or less(76%). Twenty five percent reported a history of substance abuse and 17 indicated a history of a learning disability.

Data Collection
Control

A neuropsychological evaluation to measure a range of skills was given to each participant. Additional information was obtained from DVR and included: type of services provided, work status variables at the time the person was referred to DVR, work status variable at the time the person's case was closed by DVR, and cost of services. Demographic information was obtained from the client and psychologist.

Findings

Seventeen percent of the individuals in the sample had a successful DVR case closure; however 2 of these people were working in a sheltered workshop. Services such as vocational guidance and counseling, and on the job training predicted vocational outcome.
Other variables such as severity of injury, neuropsychological evaluation findings, and demographics did not.

Conclusions

The study can not be generalized to all individuals with TBI, as it focused only on those served by DVR. Larger sample sizes are needed that follow the person for longer periods of time after VR case closure. Future research should focus more on the environmental factors such as the provision of VR services, increasing access to transportation etc...that impact community participation and less on medical and psychosocial variables.

URL http://www.ncbi.nlm.nih.gov/pubmed/12601645
Disabilities Specific learning disabilities | Traumatic brain injury (TBI)
Populations White / Caucasian | Male & Female
Outcomes Employment acquisition | Return to work
NIDILRR Funded Yes
Research Design Observational
Peer Reviewed Yes