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Carter EW, Lanchak ER, Guest L, McMillan ED, Taylor JL, Fleming LP, Dao A. Family Perspectives on the Complexities of Pursuing Integrated Employment for Adults With Intellectual and Developmental Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:219-236. [PMID: 37104859 DOI: 10.1352/1944-7558-128.3.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/10/2022] [Indexed: 05/25/2023]
Abstract
The road to employment is not often easy for individuals with intellectual and developmental disabilities (IDD). Families know firsthand the complexities and challenges of obtaining employment for their members with extensive support needs. The purpose of this qualitative study was to identify the critical barriers they encounter in this important pursuit. We interviewed 60 parents (and other caregivers) whose family members with intellectual disability and/or autism had sought and/or obtained paid work. The difficulties they described were extensive and multifaceted. Specifically, participants identified 64 different barriers attributed to six primary areas: individuals, families, schools, service systems, workplaces, and communities. Their unique insights amplify the need for new approaches for promoting integrated employment. We offer recommendations for research and practice aimed at better understanding and ameliorating barriers to meaningful work for adults with IDD.
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Affiliation(s)
- Erik W Carter
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Emily R Lanchak
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Laura Guest
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Elise D McMillan
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Julie Lounds Taylor
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Laurie P Fleming
- Elise D. McMillan, Julie Lounds Taylor, and Laurie P. Fleming, Vanderbilt University Medical Center
| | - Ahn Dao
- Ahn Dao, Vanderbilt University. Erik. W. Carter is now at Baylor University
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Carter EW, Lanchak ER, Guest L, McMillan ED, Taylor JL, Rowley H. "More Than a Paycheck": Parent Perspectives on Meaningful Work for Individuals With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:145-157. [PMID: 36996279 DOI: 10.1352/1934-9556-61.2.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/27/2022] [Indexed: 05/16/2023]
Abstract
Increasing employment outcomes for individuals with intellectual and developmental disabilities (IDD) remains an enduring emphasis of research, policy, and practice. Parents are often primary partners in the pursuit of meaningful work for their family members with IDD. This qualitative study examined the views of 55 parents regarding the importance of this pursuit and the features of employment that matter most to them. Participants discussed a range of reasons they valued employment for their family members with IDD, including factors that extended beyond a paycheck. Likewise, they described an array of features that they considered to be important to their family member thriving in the workplace (e.g., inclusivity, match with interests, opportunities for growth). We offer recommendations for promoting integrated employment among families and conceptualizing employment outcomes within future research.
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Affiliation(s)
- Erik W Carter
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Emily R Lanchak
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Laura Guest
- Erik W. Carter, Emily R. Lanchak, and Laura Guest, Vanderbilt University
| | - Elise D McMillan
- Elise D. McMillan and Julie Lounds Taylor, Vanderbilt University Medical Center
| | - Julie Lounds Taylor
- Elise D. McMillan and Julie Lounds Taylor, Vanderbilt University Medical Center
| | - Hannah Rowley
- Hannah Rowley, Vanderbilt University. Erik W. Carter is now at Baylor University
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Schutz MA, Schwartzman B, Awsumb JM, Burgess L, Carter EW, Taylor JL. Pathways to paid work for youth with severe disabilities: Perspectives on strategies for success. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND: Paid work during high school serves as a steppingstone to postsecondary employment for young adults with severe disabilities. Yet youth with significant cognitive impairments rarely have the opportunity to experience paid work during high school. OBJECTIVE: The purpose of this study was to identify the range of facilitators that promote paid employment for youth with severe disabilities during high school. METHODS: We conducted individual and focus group interviews with 74 special educators, adult agency providers, school district leaders, family members of youth with severe disabilities, and local employers. RESULTS: Participants discussed 36 facilitators spanning nine major categories: collaboration, training and information, attitudes and mindsets, supports for youth, youth work experiences, knowledge and skill instruction, staffing, individualization, and transportation. We identified similarities and differences in the factors emphasized by each of the five stakeholder groups. CONCLUSION: Renewed attention should be focused on key practices and partnerships needed to facilitate community-based work experiences for youth with severe disabilities prior to graduation.
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Affiliation(s)
| | - Ben Schwartzman
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Jessica M. Awsumb
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Leah Burgess
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - Erik W. Carter
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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Barczak MA, Cannella-Malone HI. Self-management of vocational skills for people with significant intellectual disabilities: A systematic review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629520987768. [PMID: 33596682 DOI: 10.1177/1744629520987768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Access to employment opportunities is associated with increased quality of life for people with intellectual and developmental disabilities; however, many adults with intellectual and developmental disabilities struggle to find employment. One reason they may have difficulty achieving employment is an inability to work independently. Self-management interventions have been used to promote independence in the workplace for people with intellectual and developmental disabilities by involving them in changing their own behavior. In this literature review, we identified 47 peer-reviewed, single-case design studies in which researchers investigated the use of self-management interventions as an intervention component to improve the vocational skills for people with intellectual and developmental disabilities. Visual analysis of the data indicated that most participants were successful at improving skills related to on-task behavior, task completion, independent transitions, and self-initiations. Potential directions for future research and implications for practice are discussed.
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Rosner T, Grasso A, Scott-Cole L, Villalobos A, Mulcahey MJ. Scoping Review of School-to-Work Transition for Youth With Intellectual Disabilities: A Practice Gap. Am J Occup Ther 2020; 74:7402205020p1-7402205020p23. [PMID: 32204780 DOI: 10.5014/ajot.2019.035220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Youth with intellectual disabilities (ID) have persistently poor work outcomes. Occupational therapy can support school-to-work transition but is underrepresented in transition practice. OBJECTIVE To identify and describe interventions within the scope of occupational therapy for youth with ID who are transitioning from school to work. DATA SOURCES MEDLINE, ERIC, PsycINFO, and CINAHL were searched, and hand searching was performed in relevant peer-reviewed journals. STUDY SELECTION AND DATA COLLECTION Included were peer-reviewed, English-language articles published from 2004 to 2017 describing studies focused on youth with ID with no significant co-occurring physical diagnoses who were transitioning from U.S.-based school settings to paid employment. Data extraction was managed using Google Drive. Data were organized on extraction sheets by trained reviewers. The quality of each study was assessed using questions adapted from the Critical Appraisal Skills Program checklist. FINDINGS A total of 35 articles were included, 7 of which used randomized controlled designs. All articles described interventions aligned with the Occupational Therapy Practice Framework: Domain and Process (3rd ed.), but specific mention of occupational therapy was notably absent from the literature. Interventions had little and generally low-level evidence supporting their use. CONCLUSIONS AND RELEVANCE Significant and concerning gaps exist in the literature on school-to-work transition for youth with ID, likely impeding evidence-based practice. No included article mentioned occupational therapy or had a contributor who was an occupational therapy practitioner. Practitioners should advocate for occupational therapy's role in transition and contribute reports of occupational therapy transition services for youth with ID to the literature. WHAT THIS ARTICLE ADDS This study demonstrates that occupational therapy is poorly represented in literature describing transition services for youth with ID. Although the articles described interventions within the occupational therapy domain, these interventions were not provided by occupational therapy practitioners and did not have a strong evidence base.
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Affiliation(s)
- Taryn Rosner
- Taryn Rosner, OTD, OTR/L, is Director of Occupational Therapy, MOCO Movement Center, Kensington, MD;
| | - Anna Grasso
- Anna Grasso, MS, OTR/L, CAPS, is Academic Fieldwork Coordinator and Assistant Professor, Salus University, Elkins Park, PA
| | - Louise Scott-Cole
- Louise Scott-Cole, MSOT, OTR/L, is Occupational Therapist, Wake County Public School District, Cary, NC
| | - Alison Villalobos
- Alison Villalobos, OTD, OTR/L, is Occupational Therapist, SenseAbilities Speech and Occupational Therapy Services, Riverside, CA
| | - M J Mulcahey
- MJ Mulcahey, PhD, OTR/L, FASIA, is Professor of Occupational Therapy and Director, Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA
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Shogren KA, Schalock RL, Luckasson R. The Use of a Context-Based Change Model to Unfreeze the Status Quo and Drive Valued Outcomes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2018. [DOI: 10.1111/jppi.12233] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Carter EW, McMillan E, Willis W. The TennesseeWorks Partnership: Elevating employment outcomes for people with intellectual and developmental disabilities. JOURNAL OF VOCATIONAL REHABILITATION 2017. [DOI: 10.3233/jvr-170909] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erik W. Carter
- Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Elise McMillan
- Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Wanda Willis
- Peabody College, Vanderbilt University, Nashville, TN, USA
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Bumble JL, Carter EW, McMillan E, Manikas AS, Bethune LK. Community Conversations on Integrated Employment: Examining Individualization, Influential Factors, and Impact. JOURNAL OF DISABILITY POLICY STUDIES 2017. [DOI: 10.1177/1044207317739401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bumble JL, Carter EW, McMillan ED, Manikas AS. Using community conversations to expand employment opportunities of people with disabilities in rural and urban communities. JOURNAL OF VOCATIONAL REHABILITATION 2017. [DOI: 10.3233/jvr-170883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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