A Health,Function,and Career Development Framework for People with Learning Disabilities

Abstract

Background

People with learning disabilities (LDs) are a large and growing segment of the American and global disability communities, but they tend to underutilize vocational rehabilitation (VR) services.

Objective

This article presents a contextual career development framework, the Illinois Work and Well-Being Model (IW²M), as an intervention schematic that can be applied to facilitate positive VR outcomes for people with LDs.

Methods

The framework encompasses the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home.

Results

A case study is used to illustrate how the framework can be used in VR assessment, case planning, and service delivery.

Implications

A discussion of implications regarding VR practice and research is offered, with the overall goal of reinforcing career development as the foundation of VR services for people with LD and other disabilities.

Conclusions

VR professionals can use the health, function, and career development framework to provide responsive, goal-oriented, and customer-directed services that lead to a wide range of positive outcomes for VR participants with LD.

Keywords

learning disabilities learning disorders vocational rehabilitation career development Illinois Work and Well-Being Model

Research evidence is incontrovertible that paid employment in the competitive labor market is beneficial to the physical health, psychological well-being, and quality of life of people with and without disabilities, including people with learning disabilities (LD; Collett, 2023; Cowan & Rumrill, 2025; de Boer, 2005; Dutta et al., 2008). A foundational premise underlying the vocational rehabilitation (VR) process is that work is an integral factor in providing avenues for economic security and access to health insurance, in facilitating social participation, and in improving health and life satisfaction (Krause & Rumrill, 2024; Roessler et al., 2018). Indeed, work is considered a fundamental human right of people with disabilities and the primary focus of rehabilitation counseling services (Chan et al., 2025; Strauser, 2021). Accordingly, using scientifically validated interventions based on theoretical models to enhance employment has been an important focus of governmental policy and programs. Even so, there is a significant disparity in the access to employment services, level of employment, and labor market participation for individuals with disabilities compared to non-disabled people (Institute on Disability, 2018; Kessler Foundation, 2024; Stapleton, 2024). One segment of the disability community that continues to experience difficulties in seeking, securing, and maintaining employment after completing public school programs is the sizable population of people with LD.

Learning Disabilities

Learning problems and LD are not interchangeable terms. Learning problems are viewed as environmentally caused (Andrew & Andrew, 2017), whereas LDs are considered to have a neurological etiology (i.e., to result from a central nervous system impairment; Getzel & Gugerty, 2001). Therefore, LD is not seen as resulting from economic disadvantage, ineffective educational practices, sensory deficits (including vision or hearing), sociocultural factors (e.g., difficulties understanding a language), or lack of opportunities for learning at home. Although the presence of such factors may complicate educational attainment and VR planning, they are not considered to be the cause of the LD (Rubin et al., 2016). It has remained difficult for clinicians to pinpoint the cause or origin of a particular person's LD (Andrew & Andrew, 2017).

LD was first recognized and defined by the U.S. federal government in 1968 (Kirk, 1968). According to the established definition provided by the Individuals with Disabilities in Education Improvement Act (IDEA; U.S. Department of Education, 2004), LD is “a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia” (U.S. Department of Education, 2004, Sec. 300.8 (c) (10). One noteworthy feature of LD is that it is an invisible disability, which refers to a disability that has symptoms that “…are not always obvious to the onlooker, but can sometimes or always limit daily activities” (Invisible Disabilities Association, n.d.). Moreover, LD also includes a heterogeneous set of learning difficulties that reflect a continuum of difficulty levels across individuals (Fletcher et al., 2019; Grigorenko et al., 2020). LDs also frequently co-occur with other mental health and behavioral disorders such as depression, anxiety, and bipolar disorder (Cederlöf et al., 2017).

Within the U.S., children and adolescents are most often diagnosed with a LD within the context of a school-based, IDEA-driven approach to eligibility determination often overseen by a school psychologist. When working with adults or children and adolescents outside the K-12 school system, most mental and behavioral health professionals (e.g., psychiatrists, neurologists, clinical psychologists, or neuropsychologists familiar with learning theory, the brain, and educational systems) follow guidelines outlined in either the Diagnostic and Statistical Manual of Mental Disorders -Fifth Edition -Text Revision (DSM-5-TR; American Psychiatric Association, 2022) or the International Classification of Diseases, Eleventh Revision (ICD-11; World Health Organization, 2022) to determine whether an individual has a LD in the area of reading, written language, or mathematics. These classification systems stipulate that for an LD to be present, the symptoms must be persistent over time, even following the implementation of research-based interventions, and that the individual's learning ability is not better explained by intellectual disabilities, sensory deficits (including vision or hearing), inadequate educational opportunities, social disadvantages, or cultural differences. Unlike the IDEA definition of specific learning disability, which considers areas of functioning outside and beyond reading, mathematics, and written expression (e.g., oral expression and listening comprehension), the DSM-5-TR and ICD-11 definitions of LD focus almost exclusively on difficulties in the areas of reading (including fluency and comprehension), mathematics (including math calculation, reasoning, and problem-solving), and written expression.

Historically, a standardized, valid, and reliable intelligence test (e.g., Wechsler Adult Intelligence Scale–Fourth Edition; Wechsler, 2008) and achievement test (e.g., Woodcock-Johnson IV Tests of Achievement [WJIV-ACH]; Schrank et al., 2014) have been used to establish the diagnosis. This follows from a model wherein LD was operationalized as an observation of a statistically significant difference between an individual's cognitive ability, as measured by an intelligence test, and their current level of academic performance, as measured by an academic achievement test, with the observed cognitive test standard score being higher than their current academic achievement test standard score (Fletcher et al., 2019). More current theoretical models have stepped away from this discrepancy-based model toward a more comprehensive model that allows other criteria to be used in the identification of LD; and although a standardized academic achievement test is generally a part of the evaluation process, a standardized cognitive ability test is no longer necessary and used at the discretion of the evaluator.

As part of a comprehensive approach to assessing LD, it is also advisable to include interviews, observations surrounding functional performance in applied settings, a review of educational and work-related documents, narrowband tests of achievement in areas of under-performance (e.g., written language, math computation, and/or reading fluency and comprehension), and a neuropsychological test as deemed appropriate (American Psychiatric Association, 2022; Andrew & Andrew, 2017; Cowan & Rumrill, 2025). In addition to gathering data that demonstrate whether or not the individual meets the criteria as having a LD, the diagnostic process should focus on identifying and documenting information that can be used to drive interventions based on the individuals relative strengths and areas of functional limitations.

Students with LD comprise the largest category of individuals receiving special education and transition services in American public schools. Recent estimates show that 2.3 million LD students are currently learning under the aegis of an individualized education program (IEP), which is the guiding document for special education services in the U.S. This figure represents roughly 5 percent of the total public-school enrollment (National Center for Education Statistics, 2020). When children and adults are included, approximately 4.6 million Americans (1.7% of the population) have LD. The incidence of LD is higher among males, and even more elevated for those living in poverty (Rubin et al., 2016). It must be emphasized that these figures pertain only to those people who have been diagnosed with LDs; due to multiple factors (e.g., lack of awareness about symptoms associated with LD and limited access to assessment by qualified individuals) it is not known how many people are living with undetected or undiagnosed LDs (Wagner et al., 2020).

Educational and employment outcomes among people with LD compare very unfavorably with those of non-disabled people. Students with LD drop out of school at three times the rate of their peers without disabilities (Li et al., 2023). One in two students with LD experiences a disciplinary removal, such as suspension or expulsion. Approximately 68% of individuals with LD receive a high school diploma, yet only 54% have a goal of attending two- or four-year college. One in two young adults with LD has some type of involvement with the criminal justice system within eight years of leaving high school; one in three has been arrested (Rubin et al., 2016).

When seeking to establish their careers, young adults with LD often find themselves in vulnerable positions in the workforce (Rubin et al., 2016). In one study, only approximately 46% of youth with LD held regular paid employment within two years of leaving high school (Cameto et al., 2003). Working-age adults with LD are twice as likely to be unemployed compared to those without disabilities (Cortiella & Horowitz, 2014; National Center for Learning Disabilities, 2017). Those with LD who are employed frequently hold jobs whose requirements fall below their skills and qualifications, also known as underemployment (Chan et al., 2021; Li et al., 2023). The National Center for Learning Disabilities (2017) indicated that 92 percent of individuals with LD had annual incomes of under $50,000 within eight years of leaving high school, and most earned $25,000 or less. Only nineteen percent of young adults with LD disclose their condition to their employers. Less than five percent report receiving workplace accommodations (Cortiella & Horowitz, 2014; National Center for Learning Disabilities, 2017).

Experts continually maintain that discriminatory conduct toward workers with LD is a persistent problem, one that may partially account for the high rates of unemployment and underemployment in this population (Cowan & Rumrill, 2025; Rubin et al., 2016; Sansosti et al., 2017). Leslie et al. (2023) found that the most common forms of workplace discrimination experienced by workers with LD center on inequitable termination decisions, failure to provide reasonable accommodations, and unfair treatment in the hiring process. This remains the case despite these forms of discrimination being prohibited by the Americans with Disabilities Act of 1990 (ADA, 1990; Public Law 101-336), the Rehabilitation Act of 1973 (Public Law 93-112), and amendments to the Rehabilitation Act contained in the 2014 Workforce Innovation and Opportunity Act (WIOA, 2014; Collett, 2023). When workers with LD complain to the U.S. Equal Employment Opportunity Commission (EEOC) about unfair treatment in the workplace under the ADA, they have their complaints upheld less than 25 percent of the time (Leslie et al., 2023).

Existing research suggests that young workers with LD mainly experience challenges at work in five areas: inefficiency due to the slow pace of work, lack of accuracy associated with a high error rate on reading tasks and/or written correspondence, difficulty in the sequencing of tasks because of problems following instructions or completing projects with multiple steps, time management and difficulty with planning, and ineffective social skills (Sansosti et al., 2017). Moreover, many people with LD struggle with soft skills (e.g., social skills); self-determination (Price et al., 2003); and difficulties in comprehension (e.g., listening and reading comprehension), sensory processing, communication, and use of technology and tools in the workplace (Sansosti et al., 2017). There is no doubt that students with LDs exiting public schools need empirically validated VR interventions to prepare them to find and retain employment (Strauser, 2021).

Given the increased emphasis on competitive integrated employment (CIE) for transition-age youth with disabilities that was spurred by the WIOA of 2014 (Rubin et al., 2016), career preparatory services for the growing numbers of young people with LD must take into account the myriad psychosocial and educational implications of this disabling condition and the need to match the young person's work environment and job demands to their physical and mental capabilities. It is important to remember that LD is usually not readily apparent to others in the person's educational, employment, or community environments, which can often lead to stigmatization on the part of others and difficulty in arranging needed accommodations at school or at work (Job Accommodation Network [JAN], 2025; Smart, 2020).

Unfortunately, as of this writing, there is no generalized approach for helping people with LD obtain or maintain employment. The effects of LD are highly individualized, so the more individualized the rehabilitation plan is, specifically in regard to the person's skills and assets, limitations, accommodation needs, and long-term career goals, the better (Sansosti et al., 2017; Strauser, 2021). Overall, employer support and willingness to modify working conditions or environments are predictive of employment success for people with LD, but it remains the case that the well-validated supported employment model is rarely utilized with learning disabled workers (Li et al., 2023). Taking advantage of volunteer and part-time work opportunities and gradually transitioning to full-time work can be a helpful strategy for people with LD who are beginning their careers (Collett, 2023). For the growing numbers of students with LD who pursue postsecondary education, connecting with career services and engaging in paid employment during college training are essential career preparatory activities.

Career Development and LD

It is a generally accepted fact that work across the life cycle (i.e., career development) is closely tied to meeting basic needs and increased physical and psychological well-being for individuals with disabilities and chronic health conditions (Strauser, 2021). In VR, CIE is considered to be the ultimate outcome; therefore, it is important to acquire an understanding of the personal and environmental factors that impact an individual's career development, employment, and the associated physical and psychological health benefits derived from engaging in paid work. Career development is a multifaceted, lifelong process of an individual's efforts to develop and maintain connection with productive activities such as education, paid work, and providing care to important family members and others of significance (Strauser, 2021). It encompasses both structure and long-term changes in behavior (Herr & Cramer, 1992), and it is directly applicable to individuals with LD and other congenital disabilities (Koch & Rumrill, 2017; Sansosti et al., 2017).

More specifically, career development can be conceptualized as an interaction of an individual's behavioral, affective, and cognitive processes that are influenced by contextual variables (e.g., family, socioeconomic status [SES], gender). Some experts have suggested that career development consists of three cyclical phases: 1) awareness (making sure the environment fits with the individual's values, skills, etc.), 2) acquisition (job seeking and placement), and 3) maintenance (what it takes to keep a job; Peterson et al., 1991; Sampson, 2004; Saunders et al., 2000; Strauser, 2021).

Because a person's career is a cyclical developmental process that is affected by a variety of individual and systemic factors, it would seem important to have an operational model for conceptualizing the career development process for individuals with LD. In the remainder of this article, the Illinois Work and Well-Being Model (IW²M) is presented as a conceptual framework that can be used to guide career development, VR services, and research as they relate to individuals with LD. The IW²M is designed to be parsimonious in nature to facilitate broad application yet refined enough to promote in-depth analysis related to each of the domains and factors that embody the model. After a summary of the IW²M, there will be a brief discussion of the Model's implications for services and research related to individuals with LD.

The Illinois Work and Well-Being Model

The IW²M (see Figure 1) identifies the interaction of contextual, career development, and participation domains as key elements in explaining how personal, environmental, treatment-related, educational, and potential interventions serve as facilitators or barriers related to overall societal participation. The framework has three major domains with an intervention component that facilitates the interaction between the contextual and career development domains and has direct and indirect effects on the participation domain. The type and focus of interventions are not specified in the over-arching model and no theoretical orientation is preferred. Conceptually, the three domains and the intervention component of the framework provide a structure to operationalize how career development and employment are related to overall participation of individuals with LD.

Figure 1.
The Illinois career development framework.

The IW²M is not designed to replace specific vocational psychology theories that attempt to explain or describe important vocational psychology constructs such as decision-making, motivation, interests, values, resilience, or personality development. Instead, in applying the IW²M, those constructs and theories are viewed as important process-oriented factors that are inherent and embedded in the framework. In addition, like the framework's domains and factors, these process factors should be points of relevant and valuable career development and employment research – and in direct service provision in VR.

Illinois Work and Well-Being Domains

As can be seen in Figure 1, the IW²M consists of Contextual, Career Development and Participation domains that interact to provide a structure for understanding the career and employment development of individuals with LD. The Interventions component is purposefully situated between the Contextual and Career Development domains. As a result, the model holds that career interventions directly and indirectly influence both the Contextual and Career Development domains and have an indirect effect on the Participation domain. Each domain is comprised of factors, which allows for analysis at both individual domain and factor levels. As a result, domains and factors can be conceptualized as both independent and interdependent in nature. All arrows between domains and factors are bi-directional, indicating a reciprocal effect between the model's components. Relationships between domains, factors, and interventions can be positive, negative, or neutral; the valence of the directional impact is determined by the situationally specific activities, expressions, and reactions to both specific and broad stimuli. More detailed discussions of the IW²M, its domains, and related factors can be found in Strauser et al. (2019). These are outlined in summary form in Table 1.

Table 1.
Domains, Factors and Components of the Illinois Work and Well-Being Model.

Domain Factors Components

Contextual Personal
Personality

Interests

Values

Gender

Age

Ethnicity

Aptitude

SES

Education attainment

Identity

Past personal experiences

Temperament

Environmental
Individual level
Individual systems of support; support network

Services level
Services and resources available

Cultural/legal systems levels
Societal and cultural attitudes; political and legal factors (Falvo, 2014; Peterson & Rosenthal, 2005)

Functional/Limitations
Capacity: actual ability
Maximum function-greatest degree of function possible

Performance: actually does
Optimal functioning-subjective viewpoint of the individual and derived from individual goals and experience

Physical Communication (expression & reception)

Emotional

Cognitive

Executive functioning

Career Awareness
Vocational identity

Career awareness

Vocational maturity

Work personality

Acquisition
Job seeking skills

Impression management

Resume development

Maintenance
Carry out required job tasks

Meet production demands

Complete normal workday

Engage co-workers

Participation Home
Independent living,

Self-care at home (bath, cook) Maintain house (clean),

Wash cloth

Choose or create contexts suitable to meet personal needs and values

Manage everyday affairs

Society/Social
Appropriate social relationships

Meaningful and trusting intimate relationships

Understands give and take of human relationships

Community
Concerned about the welfare of others

Engages in appropriate community activities

Access and use appropriate transportation

Engage in appropriate civic activities

Work
Maintain steady employment

Meet the demands of work

Engage in career development

Earn appropriate wages

Implications for People with LD

There are a number of implications associated with applying the Illinois model to increase the community and employment participation of people with LD. The IW²M was developed to guide researchers in examining the domains, factors, and participation outcomes related to career development and employment of individuals with disabilities. The model presents researchers with both within-and across-domain analyses and examination at the factorial level. The Model also provides a mechanism for practitioners to operationalize the factors and domains that may be contributing to decreased labor market participation for individuals with LD. Practitioners can use the framework to gain an understanding of service delivery strengths and potential areas of need. In the paragraphs to follow, specific implications for services and research are briefly discussed.

Case Conceptualization and Service Delivery

The IW²M has potential implications for the provision of VR services for individuals with LD at both the individual and program levels. At the individual level practitioners can apply the Model to conceptualize cases to identify specific needs and develop case strategies to ensure that services address specific factors of need across and within domains. Applying the IW²M allows practitioners to conduct a multilevel analysis of the individual through the identification of primary, secondary, and tertiary relationships and effects between factors and domains. Across domains, the model allows practitioners to identify the individual's personal, environmental, and functional contextual factors and examine if they are acting as facilitators or barriers regarding the various factors in the career development domain. Based on the multilevel analysis, specific interventions and services can be targeted to reduce the negative effect of specific contextual factors while leveraging the impact of other positive factors.

The multilevel analysis is also dynamic in nature, allowing for continual between and within factor analysis as the individual's needs, facilitators, and barriers evolve and change in response to the impact of the specific services and interventions provided. For example, initial interventions and services may be directed at facilitating and helping the individual gain a better understanding of their emotional and cognitive functioning (Contextual Domain) to help promote increased vocational identity and awareness (Career Domain). Presuming that the services and interventions provided are effective in helping the individual gain an increased understanding of their emotional and cognitive functioning, which in turn increases vocational identity and awareness, the practitioner can build on that success to determine across domain and within domain impact and develop relevant clinical hypotheses and questions that will guide additional interventions, services, and supports. For example, in the Career Domain, does the individual's increased vocational identity and awareness allow the individual to request job modifications that can facilitate job maintenance (Within Domain)? Does increased clarity regarding emotional and cognitive functioning and increased career awareness increase an individual's level of participation in social and community activities (Across Domain)? In the following paragraphs, we provide a case study to illustrate how the IW²M can be used in a multilevel analysis to facilitate effective service delivery to individuals with LD.

A Case Study: Matthew

Matthew is a 61-year-old man who works as a vehicle service coordinator and scheduler in the service department at a medium sized automotive dealer. Matthew was diagnosed as having LD in reading fluency and retention more than 40 years ago while attending a small technical college where he took a series of classes related to careers in the automotive industry. Like many adults with LD, Matthew sometimes has difficulties processing multiple types of information and multitasking. He also has difficulty learning and remembering new information. Matthew works well with the public and knows quite a bit about the specific makes and models of vehicles serviced at the dealership where he works. However, as the sophistication of the technology and components within the vehicles serviced at the dealership has increased, Matthew has “fallen behind” in terms of what some of the service needs are (e.g., which system[s] may be failing) and the types of services that may be required to remedy each diagnostic situation. As compared to when he first started working at the dealership, there are many more types of system failures and diagnostic codes he needs to know to meet the demands of the job. Furthermore, the service department recently upgraded to a more comprehensive scheduling software system that requires Matthew to enter a diagnostic code as well as case-specific service category code for each appointment.

Historically, Matthew has been able to keep up with the demands of the job. Matthew's manager is aware of his LD and has made some accommodations for Matthew in the past. For example, she helped Matthew create multiple hand-written “cheat sheets” to guide him in his work. She also helped him color code some aspects of his work within the context of organizing his workspace to maximize efficiency and success. However, due to the changes in the types and breadth of services needed in newer cars along with the new scheduling software he is learning for the job, Matthew is having a difficult time remembering multiple diagnostic codes and learning and remembering which service codes are linked to each of the diagnostic codes. Moreover, he is becoming overwhelmed with the scheduling system that is different from the old system he used.

Because Matthew is experiencing difficulties performing the necessary daily functions of his long-held, full-time job, he is worried that he may have to stop working altogether. The possibility of early retirement worries Matthew because he does not have enough money in pension plans and savings to fully support himself. Matthew has no children, and his wife is deceased. He lives modestly in a small condominium and can meet his monthly expenses with his paycheck, but he would need to receive disability benefits to pay his bills and cover medical costs if he stops working before age 65. Matthew's employer offers long-term disability insurance, but he is worried that inquiring about the policy might cause his employer to look unfavorably upon the accommodations that Matthew currently uses on the job. He stated, “If they know I’m thinking about going out on disability, they might just fire me and be done with it, then I would have no income, and possibly no health insurance.” He also stated that he doesn’t want to “rock the boat at this time.” Matthew reports that this situation is taking a toll on him; specifically, he reports feeling “stressed out while at work” and that he is frequently unable to settle down to sleep at bedtime.

Matthew's internalized concern that he may need to retire prematurely has created significant uncertainty regarding his future financial security and has created self-doubt regarding his vocational identity. He is unsure about other workplace accommodation strategies, such as memory enhancement applications or ‘apps’ for his iPhone and enhanced workplace organization measures, that might allow him to extend his career. Matthew is not well versed regarding his eligibility for long-term disability insurance and/or Social Security Disability Insurance (SSDI), and he is hesitant to ask for help due to fear of losing his job.

Matthew's situation can be conceptualized as a primary across domain effect, with his perception of his cognitive functioning (Contextual Domain) potentially impacting his job maintenance (Career Domain). The impact of his across-domain concern regarding functioning and job maintenance is contributing to a secondary within-domain effect; his concerns regarding his ability to keep working (Job Maintenance)are creating doubts regarding his vocational identity (Awareness). Finally, because of his decreased vocational identity, Matthew is starting to question personal factors such as his cognitive and emotional abilities, his financial security, his individual and career values, and his ability to manage stress. As a result, his decreased level of vocational identity is contributing to his decreased emotional functioning, which would be considered a tertiary across-domain effect (see Figure 2.).

Figure 2.
Primary, secondary and tertiary effects using the Illinois Work and Well-Being Model.

Engaging in across and within domain level analysis may allow the practitioner to conceptualize the types of direct and indirect services and interventions that can be employed to maximize career and vocational outcomes. Using the example above, to address the primary impact of Matthew's functioning on job maintenance, the practitioner may choose to examine potential job accommodations and modifications with primary emphases on concentration, repeated reading, memory, adjusting some goals, and the use of technology to assist with organization and recall. Indirectly, the practitioner may recommend that Matthew identify and participate in health promotion activities offered through a local community health care facility that will provide benefits to both his physical and mental health and overall well-being.

In addressing secondary and tertiary influences, the practitioner may choose to implement a combination of direct and indirect services. For example, the practitioner may work with Matthew to develop self-advocacy skills that allow him to collaboratively engage his supervisor about his ability to meet the demands of the job. In addition, the practitioner may also provide vocational counseling focused on helping Matthew gain knowledge regarding additional job accommodation strategies that could be utilized to promote vocational identity, and/or focused on different employment opportunities within his current place of employment or with another company. These measures would allow Matthew to examine how the accommodations could be used to help him meet the demands of his current position or convert to another type of work (if he wishes to do so), thereby preserving or reinforcing his level of vocational identity. At the indirect level, the practitioner may recommend that Matthew seek mental health counseling to help manage his perceived stress and uncertainty regarding his employment and financial situations. The practitioner might also make a referral to a financial planner and possibly a certified disability benefits specialist to help Matthew understand the retirement and disability benefits he could access if he decides to stop working altogether. The key to promoting success for each client is that practitioners use the IW² Model to leverage both direct and indirect services synergistically to provide a continuum of support across domains (Contextual, Career Development) and levels (primary, secondary, tertiary) so that VR services become fully integrated and not fragmented.

Research

Owing to the unique and multifaceted career and employment needs of individuals who have LDs, there is a pressing need to conduct research aimed at gaining an understanding of the factors impacting career and employment outcomes. The IW²M can be used to develop a comprehensive research strategy to address the career and employment needs of individuals with LD.

As a first measure, the model can be used to identify specific areas in need of research development. Career development research within the context of VR has been limited in scope and has focused almost exclusively on issues related to the awareness factor, which does not take into account the lifespan perspective that is required to meet the needs of people with conditions such as LD that are present from childhood throughout life. This line of inquiry may be especially prudent given the larger segment of the population being occupied by aging adults coupled with adults living older and possibly working more years. By applying this conceptual model, it becomes very clear that there are many other areas that need to be examined to gain a basic understanding of the career development process as it relates to adults with LD. For example, to date, very little, if any, research has taken an integrated approach to examining how the factors within the Career Development domain interact with each other from a broad life-cycle perspective.

Additionally, the Model emphasizes broader societal participation as the ultimate end goal of the career development process, which is consistent with current rehabilitation counseling training and philosophy (Rubin et al., 2016). However, the majority of the extant career and employment research in rehabilitation counseling has exclusively focused on the career development domain factors and constructs, such as career readiness and vocational identity, with minimal focus on the overall goal of how and why these factors and constructs relate to improving societal participation and overall well-being (Strauser et al., 2013). Future research should focus on gaining an understanding of the interaction between the Career and Contextual domains that contribute to employment and participation, as well as developing interventions that facilitate this process for individuals with LD across the work-life cycle.

Moreover, this model expands the traditional focus of career development research from the within-domain to the across-domain level. This is an important expansion because it enlarges the scope of the research focus and places an emphasis on more complex questions related to the interactions among career development, health, and treatment related factors. For example, the development of research questions that address the interaction between health and functioning and the multiple factors within the Career Development domain would be important to address, and this would require advanced analysis to examine the multi-level and mediator and moderator effects between factors and domains.

Finally, this model provides guidance for conducting research focused on developing interventions that emphasize effective interaction among multiple domains and between domain factors, because it takes into account direct and indirect effects. For example, an intervention directed at job placement for a transition-age youth with LD should not exclusively address factors within the Career Development domain, but should also take into account factors from the Contextual domain such as personal, environmental, and functional skills and limitations. In addition, by examining direct and indirect effects, research can conceptualize and analyze the primary, secondary and tertiary impact of interventions and conduct analyses using mediator and moderator variables to gain a full understanding of an intervention's impact on the individual's participation and overall physical and psychological well-being.

Implications

The IW²M offers several important implications for future research and practice. The Model can guide developmentally focused investigations into early career trajectories for individuals with LD, particularly during the transition from high school into early adulthood, a period in which risks for unemployment and labor-market disengagement are especially pronounced. Longitudinal research grounded in the IW²M could clarify how contextual factors in early adulthood shape long-term vocational outcomes and how early indicators such as self-determination and executive functioning relate to later career stability. The Model also has the potential to strengthen coordination across service systems. Individuals with LD often interact with VR agencies, postsecondary educational disability services, mental health providers, employers, and benefits counselors, yet these systems rarely operate in an integrated manner. Because the IW²M's domains are broad and interconnected, it can serve as a shared framework that enhances interdisciplinary communication, reduces service fragmentation and supports more coherent, person-centered planning across settings.

Conclusion

The IW²M is a multi-domain conceptual model that can guide career development and employment research and services for individuals with LD. The Model's domains and associated factors have been explained in this article, and participation in the areas of work, society, community, and home have been considered as important outcomes of the VR process. A case study was used to illustrate the model's applicability in addressing the career development and life circumstantial needs of a person with LD. Summaries of the model's implications for direct service and research were also presented. All told, the elements of this conceptual model are recommended to readers as a vehicle for broadening the scope and impact of VR services for people with LD and other neurologically based disabilities.

Domain	Factors	Components
Contextual	Personal	Personality Interests Values Gender Age Ethnicity Aptitude SES Education attainment Identity Past personal experiences Temperament
	Environmental Individual level Individual systems of support; support network Services level Services and resources available Cultural/legal systems levels Societal and cultural attitudes; political and legal factors (Falvo, 2014; Peterson & Rosenthal, 2005)
	Functional/Limitations Capacity: actual ability Maximum function-greatest degree of function possible Performance: actually does Optimal functioning-subjective viewpoint of the individual and derived from individual goals and experience	Physical Communication (expression & reception) Emotional Cognitive Executive functioning
Career	Awareness	Vocational identity Career awareness Vocational maturity Work personality
	Acquisition	Job seeking skills Impression management Resume development
	Maintenance	Carry out required job tasks Meet production demands Complete normal workday Engage co-workers
Participation	Home	Independent living, Self-care at home (bath, cook) Maintain house (clean), Wash cloth Choose or create contexts suitable to meet personal needs and values Manage everyday affairs
	Society/Social	Appropriate social relationships Meaningful and trusting intimate relationships Understands give and take of human relationships
	Community	Concerned about the welfare of others Engages in appropriate community activities Access and use appropriate transportation Engage in appropriate civic activities
	Work	Maintain steady employment Meet the demands of work Engage in career development Earn appropriate wages

Footnotes

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The contents of this article were developed, in part, under a grant for the Vocational Rehabilitation Technical Assistance Center for Quality Employment, H264K200003, from the U.S. Department of Education. However, the contents do not necessarily represent the policy of the U.S. Department of Education, and readers should not assume endorsement by the Federal government.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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