Enhancing self-determination in job matching in supported employment for people with learning disabilities: An intervention study

Authors: 
Kissinger, D. B.
Year Published: 
2002
Publication: 
Journal of Vocational Rehabilitation
Volume: 
17
Number: 
2
Pages: 
125-135
Publisher: 
IOS Press
Background: 

Self determination helps individuals with disabilities take an active role in their lives. There is a growing body of research indicating how self determination can be used to assist individuals with disabilities who are using supported employment to assist them with work. Some research indicates increases in autonomy among individuals using supported employment who learn self determined behaviors.

Choosing a job of one‚ own may enhance a person‚ success at work and overall career progression. People who choose their own jobs may select work that matches personal preferences. They may also be more motivated to do the job which can enhance job retention. In order to choose a job, job seekers in supported employment, must become aware of the possibilities. They must also learn about their abilities and work preferences. Research is needed to measure the impact of self determination training on adults with disabilities who want to go to work.

Purpose: 

The purpose of this study was to measure the impact of a two phase self-determination package for adults with learning disabilities entering the job market for the first time.

Setting: 

The setting was two agencies that offered supported employment in South Wales and 20 job sites that offered a variety of tasks. Each participant was required to attend 3 job tasters for six sessions or 2 job taster sessions in each of three job types. Job tasters are short (4 hours), unpaid, time limited work experiences in the workplace. They allow individuals with disabilities to sample a variety of job duties and work cultures.

Sample: 

Forty individuals aged 19 to 52 years participated in the study. Each person had a label of mental retardation (referred to as LD in UK). The majority or 78% were attending adult training centers at the time of referral. One person dropped out of the study and 4 were involved in the pilot study. Twelve job seekers took part in the baseline phase, 12 in Intervention 1 and 11 in Intervention 2. More than half of the participants were rated as requiring only minimum assistance in daily living activities. A small number required regular personal care and close supervision. All were capable of interpreting picture prompts as a mean to communicate.

Data Collection: 

Observations were conducted on the second, fourth and sixth job taster sessions along with the reviews by each participants. Responses on key variables were recorded using continuous frequency counts throughout each taster session and review. Job review forms were also a source of data, providing information on accuracy of recall and consistency with choice. Job seeker independence was calculated by dividing the frequency of job coach assistance by the duration in minutes of each observation. Job tasters and reviews were measured separately. The extent to which job coach question required job seekers to express preferences and self appraise performances on tasks were also recorded. All questions were recorded under 3 sub categories: those asked in yes or no, open ended and option formats. Three types of job seeker responses were coded. The consistency of job preferences was measured by agreement between ratings of enjoyment of a task during the job taster review and an overall rating in response to the question: how much did you enjoy your job. Reliability was obtained for all key observational variables and was represented by the extent of agreement between observers. Observational data was analysed using the SPSS statistical package for Windows. A one-way ANOVA was used to evaluate the extent of change resulting from the introduction of Interventions 1 and 2, using a critical region of p < 0.01.

Intervention: 

During baseline staff received no specific instructions on how to conduct the job tasters. There were two interventions. Intervention 1 was an introduction to self determination and systematic taster reviews. Job coaches received a day of training on self determination. Then a written questionnaire was provided for job coaches to evaluate the job seekers job performance, likes and dislikes etc... If the jobseeker could read he or she completed the questionnaire. Job coaches were also encouraged to use open ended and option questions and avoid yes/no formats during job taster sessions and reviews. During reviews job coaches were assisted by a profile form. Intervention 2 included the introduction of a pictorial job review profile. A second one day training was conducted 4 months after intervention one. Job coaches were encouraged to assist job seekers with completing the job review independently. For those who could not read a pictorial questionnaire was used. Those who could read and write were given the option of writing their responses to the questions if preferred.

Control: 

Comparison conditions were individuals with no intervention.

Findings: 

Intervention 1 led to a reduction in job coach assistance during taster sessions and reviews. Intervention 2 led to a further drop in job coach assistance during reviews. The results also indicated that job seekers were coming up with and expressing personal preferences that were consistent with statements they made earlier.

Conclusions: 

The interventions seemed to work on a practical level. Job coaches were able to adopt the approaches. Participants with mild and moderate learning disabilities were able to complete pictorial job reviews with no or minimal prompting. More research is needed.

URL: 
http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00152
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

A controlled study of services to enhance productive participation among people with HIV/AIDS

Authors: 
Killackey, E., Jackson, H. J., & McGorry, P. D.
Year Published: 
2008
Publication: 
American Journal of Occupational Therapy
Volume: 
62
Number: 
1
Pages: 
36-45
Publisher: 
American Occupational Therapy Association
Background: 

With improved treatment options, more individuals with HIV/AIDS are surviving longer and returning to productivity. Few studies have examined interventions that improve employment outcomes for HIV/AIDS survivors.

Purpose: 

This study assessed the effectiveness of a model program designed to increase productive participation among people living with HIV/AIDS within supportive-living facilities. The model program is entitled Enabling Self-Determination (ESD).

Setting: 

This study was implemented in four supportive living units in metropolitan Chicago, IL. These units exclusively serve individuals with HIV/AIDS.

Sample: 

The study sample consisted of 65 individuals with HIV/AIDS who were randomly assigned to the intervention group or a standard care group. The study group was predominantly male (82%) and African-American (71%).

Data Collection: 

Demographic and impairment data were collected at baseline. Information on engagement in productive activities (either employment, education, or volunteering) was collected at three, six, and nine months following completion of the ESD or standard treatment.

Data analysis consisted of first comparing the two groups to determine if they differed on baseline variables. Then, chi-square analyses were used to compare employment status at the three, six, and nine-month checkpoints.

Intervention: 

The ESD model consists of eight weekly one-hour sessions led by an Occupational Therapist. Sessions were designed with both educational and peer support components. Examples of sessions include: Managing one‚ own physical and mental health; Developing skills and habits for independent living; Developing occupational roles, habits, and skills; Building vocational confidence (job search, interviewing, etc.); and Learning self-advocacy and self-management skills.

Control: 

A non-randomized two-group design was used. This design was used because having both intervention and control conditions in the same residence would have contaminated the study. Two residences served as the intervention settings, and the other two as standard treatment settings.

Findings: 

No significant differences were found between the two groups. Of the original 65 participants, employment outcome data could be obtained for 46. Attrition rates were not significantly different for the two groups. Participants in the ESD group were significantly more likely to be employed at each of the three checkpoints. Employment rates for the ESD group were more than double those of the standard treatment group.

Conclusions: 

The findings of this study support the efficacy of the ESD model for individuals with HIV/AIDS, and that the benefits can be sustained over time. Replication of the ESD model with larger study groups and other populations would more fully evaluate the efficacy of the model.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/18254429
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Vocational rehabilitation of participants with severe substance use disorders in a VA Veterans Industries Program

Authors: 
Walker, W. C., Marwitz, J. H, Kreutzer, J. S., Hart, T., & Novack, T. A.
Year Published: 
2004
Publication: 
Substance Use and Misuse
Volume: 
39
Number: 
13
Pages: 
2513-2523
Publisher: 
Marcel Dekker
Background: 

The VA Veterans Industries programs have been established across the country to provide a therapeutic gateway to gainful employment for veterans who have physical and mental disabilities or addictive disorders. Eighty percent of patients referred to vocational rehabilitation programs have a history of severe substance use disorders. Despite the interest in the vocational rehabilitation of substance users (Hawkins and Catalano, 1985), little empirical evidence exists about which specific vocational rehabilitation services promote successful employment outcomes.

Purpose: 

The purpose of this study was to evaluate the effectiveness of the Veterans Industries program, a component of the Addictions Partial Hospitalization Program (APHP) at the Houston Veterans Affairs Medical Center (VAMC). Outcome rates are reported including employment, abstinence, and housing support.

Setting: 

The study was conducted at the Houston, TX VAMC within the APHP, an addiction treatment program.

Sample: 

The study sample consisted of 80 veterans who were out-patients of the APHP and who were referred for vocational rehabilitation. The mean age of patients was 45 (range 29–59). Participants were predominantly male (98%) and African-American (62%). Most (68%) were Vietnam era veterans. At enrollment, 100% were unemployed, 73% were homeless, and 15% were receiving a disability pension.

Data Collection: 

Data were collected at intake for age, education, military history, training, employment history, earnings, disability, disability compensation, substance use, and living situation. Employment data were collected following program exit and at three-month follow-up.

Intervention: 

Veterans Industries is a therapeutic work-for-pay program in which the VA contracts with private industry and federal agencies for work to be performed by veterans. These Compensated Work Therapy (CWT) programs have been established since the 1950s. The majority of veterans are involved in outpatient substance user programs and live in VA domiciliaries or supportive housing in the community. In addition to therapeutic work, veterans receive job readiness training group, assistance with job placement, and referral to the state vocational rehabilitation service for assistance with supportive housing in a drug-free environment.

Control: 

The study used a pre/post intervention design, without a control or comparison group.

Findings: 

Of 80 patients, 72 (90%) successfully completed APHP and received a regular discharge. This means that they completed 4 weeks of partial hospital treatment and graduated to outpatient treatment consisting of group therapy twice a week. Fifty-nine percent of the homeless veterans received supportive housing. All veterans who remained abstinent and continued to participate in work therapy received supportive housing. The average length of service was 3 months. Forty-three of the 80 veterans (54%) obtained competitive employment. The majority of jobs were in entry-level service positions including housekeeping, building maintenance, security, shipping, and receiving. A follow-up conducted 3 months after discharge from Veterans Industries indicated that 60% maintained competitive employment.

Conclusions: 

The study findings support the conclusion that vocational services improve the employment rates of clients leaving treatment. The existence of job counseling, job placement, and job development services in clinics is positively correlated with the difference between admission and discharge employment rates.

URL: 
http://www.tandfonline.com/doi/abs/10.1081/JA-200034695?journalCode=isum20
NIDILRR Funded: 
Peer Reviewed: 
Yes

Supported employment for persons with traumatic brain injury: A preliminary investigation of long-term follow-up costs and program efficiency.

Authors: 
Wehman, P., Lau, S., Molinelli, A., Brooke, V., Thompson, K., Moore, C., & West, M.
Year Published: 
2003
Publication: 
Archives of Physical Medicine and Rehabilitation
Volume: 
84
Number: 
2
Pages: 
192-196
Publisher: 
Elsevier
Background: 

Research shows that individuals with traumatic brain injury (TBI) often experience great difficulty returning to competitive employment postinjury. Challenges arise from cognitive, physical, sensory and/or psychosocial problems. Supported employment is one approach in vocational rehabilitation that has been used to assist individuals with significant disabilities, including TBI, with returning to preinjury work or securing and maintaining new employment.In the individual placement approach typically a vocational professional known as an employment specialist or job coach, works one to one with the individual. The specialist assist the person with locating employment by developing job opportunities. Then, once the individual is hired the specialist provides and facilitates on-the-job supports such as: skills training and/or identifying various types of supports (ie. compensatory memory strategies, assistive technology) to help the new hire learn how to perform the job and meet the employer‚ performance standards. Furthermore, long-term follow-up services are offered throughout the duration of a person‚ employment. During this time, additional on-the-job assistance is available, and, as indicated, select case management services related to resolving off-the-job-site issues that if left unattended would impact job retention, are provided. Information on cost and benefits is needed to determine the efficacy of this approach for individuals with TBI.

Purpose: 

The purpose of this study was to investigate the long-term follow-up costs associated with supported employment. It also examined wage and employment characteristics for individuals with moderate to severe traumatic brain injury (TBI) received supported employment services over a 14-year time span.Specifically, this research sought to answer the following questions:(1) What is the average cost of supported employment services for individuals with TBI? (2) What is the average length of employment for individuals with TBI who have received supported employment services? and (3) How do benefits (ie, participant income) compare with costs of supported employment during a 14-year time period (from 1985 to 1999)?

Setting: 

The setting was multiple employment sites where individuals worked.

Sample: 

The sample size included 59 individuals with moderate to severe TBI who were consecutively referred for supported employment services. The sample was restricted those who were employed in at least one job during the study period. The eligibility criteria for receiving supported employment services included the following: the person was between the ages of 18 and 64 years, and had sustained a moderate to severe TBI, as indicated by length of coma greater than 24 hours or a Glasgow Coma Scale score of less than 13 on admission to the hospital. In addition, individuals had to present clear indications of the need for ongoing vocational intervention to return to preinjury employment or to obtain and maintain new employment. These indications came from the individual‚ post injury employment history or from reports from his/her family, physician, or vocational rehabilitation counselor. The demographics of the group were as follows. The majority (81%) were males; (75%) were white. The average age was 33 years. The majority (64%) had a high school diploma or less education. The majority (71%) were working prior to injury.

Data Collection: 

Data were collected on individuals who used supported employment services to assist them with gaining and maintaining work anytime between 1985 to 1999.Data about each participant's length of employment, wages, and costs associated with service delivery were collected by the employment specialist assigned to serve the person. For those individuals who had been employed in more than one job over the years, data on length of employment and cost of service delivery were combined. Analyses were performed to examine the costs of supported employment, employment characteristics (e.g., wages, length of employment), and benefit-cost ratios of supported employment for individuals with TBI. Descriptive statistics were calculated for length of employment, costs associated with supported employment services, and wages earned. Subgroup comparisons were also performed to examine the influence of length of employment on wages and supported employment costs. Calculations were based on individual clients, not job placements. Therefore, employment and billing data were combined and averaged for individuals who worked in more than 1 job over the study period.

Intervention: 

The intervention was individualized supported employment services.

Control: 

Subgroup comparisons were performed to take a look at the influence of length of employment on wages (less than and greater than 2 years) and cost of services.

Findings: 

Participants worked an average of 30 hours per week. and earned between $3.35 (minimum wage at the time) and 11.99 an hour. The average length of employment was 43 months. Average earnings were cited as $633.63 per month. Average gross earnings was $26,129.74. The majority of the sample worked over 2 years and approximately 25% had worked 7 years or more.The average hourly billing cost associated with the provision of supported employment services was $10,349.37; with a mean cost of $8614.00. This resulted in a mean monthly cost of $202.00 per participant.The subgroup cost-earning comparison revealed that cost were substantially less for those who maintained employment for 2 or more years. Individuals earned an average of $17,515.00 more than the cost associated with service implementation.

Conclusions: 

Supported employment is a cost effective way to assist individuals with TBI with gaining and maintaining employment. Over time the cost associated with long term services (ie. follow along) decreases.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/12601649
NIDILRR Funded: 
Peer Reviewed: 
Yes

Supported employment for young adults with autism spectrum disorder: Preliminary data

Authors: 
Wehman, P., Schall, C., McDonough, J., Molinelli, A. Riehle, E., Ham, W., & Thiss, W.
Year Published: 
2012
Publication: 
Research & Practice for Persons with Severe Disabilities
Volume: 
37
Number: 
3
Pages: 
160-169
Publisher: 
Tash Publishing
Background: 

There is extremely limited information about using a supported employment approach to assist individuals with autism with gaining and maintaining employment in the community. Among the few studies that do exist, most are descriptive in nature. More research is needed.

Purpose: 

This study took a close look at the work histories of individuals with ASD over a 23 month period of time. The purpose was to examine the effects of supported employment in assisting them with employment.

Setting: 

The setting included a variety of different workplaces. This included: health care field, retail, recreational and educational field, food service and janitorial industry.

Sample: 

Thirty three individuals with ASD were included in the study. Each was referred for supported employment services by a vocational rehabilitation counselor. The majority were white (76%) and males (76%). The average age of participants was 22 years old. Seventy percent of the individuals reported a secondary disability. All participants had received a high school diploma or equivalency diploma. Around 40% had some college. Over 90% had either no or short intermittent work histories. More than three fourths had high social interaction support needs. Notably close to a third or 13 individuals had participated in a extended work internship at a hospital that was modeled after the Project SEARCH approach.

Data Collection: 

Employment specialist traced actual time spent either directly or indirectly working for the person with ASD across various types of supported employment interventions. This included developing a vocational profile about the person served, developing a job, job site training, and long term supports to enhance job retention. All data were stored in password protected database. The employment specialist's intervention time and participant outcomes were aggregated across the group of participants and over time.

Intervention: 

The intervention was individualized supported employment services. This is an approach that supports one person at a time with gaining and maintaining work in a real job for real pay in the community.

Control: 

There was no control. Due to the exploratory nature of the study no comparison group was used.

Findings: 

Twenty seven or 82% of those served went to work in an entry level occupation. They earned between $7.25 and $10.50 per hour.Mean hours worked was 23 per week.The average intervention time for various interventions was as follows:completing a job seeker profile was about 9 hours; job development around 30 hours (notably some of the individuals went to work where they interned which reduced the hours needed to develop a job); job site training and support 107 hours; and long term support 27 hours.

Conclusions: 

An individualized supported employment approach can assist individuals with ASD with gaining and maintaining employment. More research is needed.

URL: 
http://rps.sagepub.com/content/37/3/160.full.pdf
NIDILRR Funded: 
Peer Reviewed: 
Yes

Employment outcomes among AFDC recipients treated for substance abuse in Washington State

Authors: 
Wong, K. K., Chiu, L. P., Tang, S. W., Kan, H. K., Kong, C. L., Chu, H. W., & Chiu, S. N.
Year Published: 
2000
Publication: 
Milbank Quarterly
Volume: 
78
Number: 
4
Pages: 
585-608
Publisher: 
The Milbank Memorial Fund
Background: 

The scope of substance abuse problems within the welfare population is unclear. The prevalence of alcohol and drug abuse appears to vary among welfare populations. Studies are inconsistent in regards to the impact substance abuse treatment has on employment outcomes.

Purpose: 

The purpose of the study was to evaluate the effects of substance abuse treatment on employment outcomes among AFDC recipients admitted to treatment in Washington State during a two-year period beginning July 1994.

Setting: 

The setting included state supported substance treatment facilities.

Sample: 

The study sample was made up of 5,038 AFDC clients.

Data Collection: 

Three state computer databases provided data for analysis. The client treatment database provided information on client characteristics and treatment activities. Computer records from the Employment Security Department provided employment data and earning information. The Economic Services Administration of the Department of Social and Health Services provided welfare payment data.

Intervention: 

The intervention was treatment for substance abuse.

Control: 

The comparison was no treatment for substance abuse.

Findings: 

The study showed that substance abuse treatment was associated with increased employment and earnings. Relative to the comparison groups, AFDC clients in the treatment groups were more likely to become employed following treatment.

Conclusions: 

Treatment appeared to enhance employment and earnings among AFDC clients, the level of earnings achieved remained modest with 42% of clients having no earned income in the two-year follow up period and an additional 14% having less than $1000 of earned income. This may indicate that the goals of employment and self-sufficiency underpinning TANF may be achievable for only a small minority of welfare recipients with addiction and substance abuse problems, unless ancillary vocational services are provided along with treatment.

URL: 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751174/
Populations: 
NIDILRR Funded: 
Peer Reviewed: 
Yes

Developing employment services for criminal justice clients enrolled in drug use treatment programs

Authors: 
Kendall, E., Muenchberger, H., & Gee, T.
Year Published: 
2004
Publication: 
Substance Use and Misuse
Volume: 
39
Number: 
13
Pages: 
2491-2511
Publisher: 
Informa Healthcare
Background: 

Employment is a critical issue in assisting parolees in reintegrating into their communities. However, departments are not typically structured to provide employment services. In addition, parolees often have inadequate work histories or skills to obtain quality employment. Alcohol and drug use and misuse can complicate employment pursuits further. Substance abuse is highly prevalent among offenders, and the research suggests that a substantial majority use illicit drugs.

Purpose: 

The purpose of this study was to evaluate the effectiveness of four vocational approaches on employment outcomes. The four approaches included (1) job skill development and supported employment, (2) life skill development, (3) job training, and (4) welfare-to-work.

Setting: 

The study was conducted in multiple licensed substance abuse treatment centers in the city of Philadelphia, PA.

Sample: 

The study sample consisted of 245 formerly incarcerated individuals receiving substance abuse treatment.

Data Collection: 

Programmatic records were reviewed for each of the four interventions for program completion and employment outcomes. In addition, a 12-month follow-up was conducted of 36 consecutive admissions to the Job Skills Development and Supported Employment Program.

Intervention: 

Job Skill Development and Supported Employment intervention was a six-month program to introduce participants with limited employment experience to the culture of work. Participants were engaged in a six hour per day work training program, followed by a 20 hours per week of supported employment for a maximum of six months. At the completion of the supported employment phase, participants were assisted in locating competitive employment.

Life skill development consisted of a six- to nine-month instructional program targeted toward a specific vocational goal. Participants entered into non-paid internships and then were assisted in locating paid employment in that field.

The Job Training Program was an intensive six-week Environmental Technician training program leading to certification or licensing in one of several job classifications, such as Hazardous Materials Handler, Lead Removal, etc. Completion of the program was followed by job placement assistance.

The Welfare-to-Work Program was developed specifically for women receiving welfare assistance and consisted of substance abuse treatment, educational opportunities, and job training assistance.

Control: 

There were no separate control or comparison groups. Individuals served as their own controls.

Findings: 

Of the 245 clients, 191 (77.9%) completed their respective program and 134 (54.6%) secured external competitive employment. Sixty percent of those employed following completion of the Job Skills Development and Supported Employment Program received health benefits, and 100% of those who were employed following completion of Job Training had health benefits.

The 12-month follow-up found that 50% of the sample had completed the program and 25% were employed at the time of contact. Parole violations or re-incarcerations were reported for 32% of the sample. Employment rates were significantly higher for those who completed the program.

Conclusions: 

The four projects show promise for formerly incarcerated clients receiving substance abuse treatment. However, the lack of a consistent funding stream to maintain vocational services is an impediment for expanding services to all offenders. The short duration of various grants limited opportunities to develop a comprehensive system.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/15603011
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Outcomes-based funding for vocational services and employment of people with mental conditions

Authors: 
Gentry, T., Kriner, R., Sima, A., McDonough, J., & Wehman, P.
Year Published: 
2005
Publication: 
Psychiatric Services
Volume: 
56
Number: 
11
Pages: 
1429-1435
Publisher: 
American Psychiatric Publishing
Background: 

Individuals with mental health condition have low employment rates. In order to promote better employment outcomes policy makers have investigated funding strategies. This includes outcomes funding paying the provider for milestones. However, there is limited evidence about this approach.

Purpose: 

The purpose of this study was to describe the employment experiences of individuals with psychiatric disabilities, who received services through an outcomes based funding program in New York. The study questions were What was the likelihood that participants in the performance based contracting demonstration secured a placement and retained work? And what factors were associated with securing a placement,time to secure a placement and job retention?

Setting: 

The settings for this study were seven non-profit social services agencies in New York state who submitted proposals for and were funded for an outcome-based service funding demonstration project.

Sample: 

Seven non profit social service agencies in New York State participated in the study. They represented various regions from city to rural. They also ranged in size from 40 to 2000 employees. Each offered vocational rehabilitation services. Some offered other types of services too like housing, mental health etc...

Data Collection: 

Data was reviewed for individuals who were still active at the end of the study period. The likelihood that placements retained their jobs was assessment using life tables. Logistic regression was used too. SPSS 12.0 was used to perform all analyses.

Intervention: 

The intervention was the implementation of a milestone-based reimbursement system for providing employment services to individuals with psychiatric disabilities.

Control: 

The study used a pre/post design with agencies serving as their own controls.

Findings: 

At the end of the demonstration, 171 of 310 consumers with mental illness remained active. The mean age of these individuals was 42 years, and most or 57% were male. Over a third or 35% lived in supported housing. Most receive federal income assistance. About half (47%) completed some or received a post secondary degree. Thirty three percent had a diagnosis of schizophrenia. This was followed by 23% other mood disorders, 22% bipolar and 14% schizoaffective disorder and 9% other. Among the 171 participants,70 were placed in a job and 38 were placed more than once. The most frequent type of job was administrative and sales at 24% each. At the end of the demonstration, 73% of the participants were employed and 54% had retained employment for 6 months. Factors related to outcomes included: number of hours provider expended assisting the consumer on a weekly basis, length of time to job acquisition, consumer enrollment with state vocational rehabilitation services, and quality of jobs developed.

Conclusions: 

Outcomes based funding leads to successful employment outcomes for individuals with mental illness. Rates of placement and retention are comparable to those of other vocational programs. More research is needed.

URL: 
http://www.ncbi.nlm.nih.gov/pubmed/16282263
Disabilities: 
Populations: 
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
No

Clinical differential analysis of persons with autism in a work setting: A follow-up study

Authors: 
García-Villamisar, D., Wehman, P., & Navarro, M. D.
Year Published: 
2000
Publication: 
Jounal of Vocational Rehabilitation
Volume: 
14
Number: 
3
Pages: 
183-185
Publisher: 
IOS Press
Background: 

Adults with autism have typically not been considered suitable candidates for employment in the workforce. This is despite a multitude of information on employment of people with severe disabilities and published examples of how individuals with autism have successfully gained and maintained work in their communities using supported employment. People with autism remains underrepresented in supported employment programs. There is little research that focuses on analysis of differential efficacy between various employment modalities (ie. supported employment versus sheltered work).

Purpose: 

The purpose of this study was to analyze the differential impact of supported employment versus sheltered work. The authors hypothesized that the group enrolled in the sheltered workshop would have more pronounced autistic symptoms at the end of the program than the group who participated in supported work.

Setting: 

The study took place in sheltered workshops and a variety of community/supported employment settings.

Sample: 

Fifty one individuals with autism participated in the study. Twenty six individuals in sheltered work program were matched to 25 individuals with autism in supported work program. The average age of those in sheltered work was around 22 years for both groups. The majority of participants in both groups were male. The average IQ was around 56 for the sheltered work group and 57 for the supported work group. Individuals in the supported work program worked in jobs that were predominantly in service sectors.

Data Collection: 

Data was collected using the Childhood Autism Rating Scale (CARS) an instrument for screening and diagnosis of autism that covers 14 domains generally affected by severe problems in autism, plus an overall category of impression of autism. The sheltered work group was compared with the supported work group using repeated measures of analysis of variance. Mean and standard deviation scores for CARS were reported for the sheltered work and supported work groups.

Intervention: 

There were two interventions. One was sheltered work. The other was supported work.

Control: 

The sheltered work group was compared with the supported work group using repeated measures of analysis
of variance.

Findings: 

At the start of the study 1996 there was no difference between total CARS scores between the two groups. In 1999 the sheltered work group showed more pronounced symptoms of autism. The supported employment group showed no variation in pathology between 1996-1999. The sheltered group showed higher pathological severity.

Conclusions: 

Individuals with moderate autism in the supported work program were employed in their communities. These individuals did not see a change in their pathology over the 3 year study period. Individual who were in the sheltered work group showed a deterioration in their pathology during this time frame.

URL: 
http://content.iospress.com/articles/journal-of-vocational-rehabilitation/jvr00081
Populations: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes

Predictors of successful return to work from HIV-related disability

Authors: 
Drake, R. E. & Bond, G. R.
Year Published: 
2004
Publication: 
Journal of HIV/AIDS and Social Services
Volume: 
3
Number: 
3
Pages: 
89-96
Publisher: 
Journal of HIV/AIDS and Social Services
Background: 

Many individuals with HIV/AIDS experience periods of unemployment as their physical symptoms increase. However, some in treatment do continue or return to employment.

Purpose: 

The purpose of this study was to compare a sample of individuals with HIV/AIDS who successfully return to employment and those that do not. The factors included disease-related factors and service-related factors.

Setting: 

The setting was an HIV/AIDS primary care clinic of a large, university-affiliated hospital.

Sample: 

The study sample consisted of 135 patients whose records indicated that they had successfully regained employment following disease-related job loss. A matched cohort of individuals with HIV/AIDS who had not regained employment was selected as a comparison group.

Data Collection: 

The data consisted of patient clinical records related to HIV/AIDS treatment and symptoms and services delivered. Statistical analyses consisted of descriptive statistics and analysis of variance (ANOVA).

Intervention: 

The majority of predictor variables were related to HIV/AIDS, such as CD4 cell count and length of time in treatment. However, the effects of one intervention were also included, the provision of mental health services.

Control: 

A matched comparison group was selected consisting of individuals with HIV/AIDS who had not returned to work following disease-related job loss.

Findings: 

Substance use disorders were more prevalent in those who had not achieved return to work. Those who had returned to work were more likely to have received mental health assessment and treatment.

Conclusions: 

Mental health services may serve as a gateway to return to work for many individuals with HIV/AIDS. In addition, identifying patients who are already being treated by the mental health team in order to assess their desire and ability to return to work is an important first step in increasing the effectiveness of a return to work program.

URL: 
http://www.tandfonline.com/doi/abs/10.1300/J187v03n03_07?journalCode=whiv20
Outcomes: 
NIDILRR Funded: 
Research Design: 
Peer Reviewed: 
Yes