Demographic and service-related correlates of competitive employment outcomes among state-federal vocational rehabilitation clients with learning disabilities: A purposeful selection logistic regression analysis

Abstract

BACKGROUND:

People with learning disabilities (LD) face challenges with labor force participation and postsecondary education. Research is limited on the success of vocational rehabilitation (VR) services for those with LD.

OBJECTIVE:

This study investigated the extent to which demographic characteristics, Social Security benefits, and VR services influence competitive employment outcomes for people with LD.

METHODS:

The Rehabilitation Services Administration’s Case Service Report (RSA-911) database for Fiscal Year 2013 was examined using a purposeful selection multivariate logistic regression analysis.

RESULTS:

Results indicated that participants who received on-the-job support, technical assistance, job placement, occupational/vocational training, maintenance, college or university tuition assistance, readers, other services, on-the-job training, information and referral, counseling and guidance, transportation, job search assistance, job readiness training, supported employment, and diagnostic and treatment services from the state-federal VR program were significantly more likely to achieve competitive employment than were participants who did not receive those services. In addition, higher levels of educational attainment, being male, being Caucasian, receiving a greater number of VR services over a shorter period of time at a higher level of case expenditure, and not receiving Social Security disability benefits were positively associated with competitive employment outcomes.

CONCLUSION:

Overall, the number and type of VR services had more influence on competitive employment than did demographic variables or Social Security disability benefits.

Keywords

Learning disabilities vocational rehabilitation employment

1 Introduction

In recent years, vocational rehabilitation (VR) counselors and health care professionals have increasingly recognized the importance of employment as a health promotion intervention for people with chronic illnesses and disabilities (Chan, Chiu, Bezyak & Keegan, 2012). There is ample evidence demonstrating significant correlations between unemployment and health problems including cardiovascular disease, hypertension, and musculoskeletal disorders (Pharr, Moonie & Bungum, 2012; Quarells Liu, & Davis, 2012). Unemployment affects health through poverty related-stressors, negative effects on psychosocial factors, and increased involvement in risky health behaviors (Strauser, 2013). Individuals who are unemployed also experience higher rates of chronic stress, anxiety, depression, substance abuse, and mental health hospitalizations than those who are employed (Henkel, 2011; Roelfs, Shor, Davidson & Schwartz, 2011).

The detrimental consequences of unemployment are especially problematic for people with learning disabilities (LD) given their low rate of labor force participation and their limited success in postsecondary education (Wehman, 2013). Students with LD comprise the largest category of individuals receiving special education and transition services in American public schools. Current estimates indicate that 2.4 million American public school students have learning disabilities—a number representing roughly 5 percent of the total public school enrollment (National Center for Education Statistics, 2014). Including children and adults, approximately 4.6 million Americans, or 1.7 percent of the population, have been identified as having learning disabilities. The incidence of LD is higher among males, much higher for those living in poverty, and nearly equal across ethnicities (Rubin, Roessler & Rumrill, 2016).

According to Cortiella and Horowitz (2014), 68 percent of students with LD receive a regular diploma from high school and 12 percent receive a certificate of completion, whereas about 19 percent drop out of high school. As these students with LD leave secondary education, about 67 percent enroll in some type of postsecondary education, a rate similar to the general population. Although students with LD enroll in post-secondary education at the same rate as the general population, it is mostly in two-year and community colleges; their attendance rate at these institutions is more than twice that of their non-disabled peers (National Center for Education Statistics, 2014). Only 17 percent of students with LD who enroll in postsecondary education receive classroom accommodations and/or other supports from their colleges or universities, and they are nearly four times less likely to complete their postsecondary degree programs than are non-disabled students (National Center for Education Statistics, 2014).

Transition services are designed to facilitate the movement of transition-age youth to postsecondary settings and can include activities related to postsecondary education, vocational education, employment, adult education, independent living, and/or community participation (Individuals with Disabilities Education Improvement Act [IDEA], 2004). Moreover, services are based on individual needs, strengths, preferences and interests and can include the development of employment and other post-school objectives, the development of post-school adult living objectives, the acquisition of daily living skills, and functional vocational evaluation if appropriate (IDEA, 2004).

Transition requirements have been included in the IDEA for over 20 years. The latest reauthorization in 2004 specifies that a transition-oriented Individualized Education Program (IEP) must be in effect no later than the age of 16, or younger if determined necessary by the IEP team, and updated annually. The transition IEP must include measureable postsecondary goals based on assessments related to training, education, employment, and independent living skills as well as transition services (including courses of study) needed to assist the child in reaching those goals. The student must be invited to the IEP meeting when postsecondary goals are being discussed, and a representative from a participating agency that is likely to be paying for or providing transition services should be invited to the child’s IEP team meeting (Wehman, 2013).

Despite the requirement for transition planning, post-school adult outcomes for individuals with LD and other disabilities have fallen short in comparison to individuals who do not have disabilities. Of the working-age population of adults with LD, an estimated 46 percent are employed (Rubin et al., 2016), compared to the 81 percent employment rate of working-age adults in the general populace of the United States (Strauser, 2013). Moreover, only five percent of employed adults with LD report using on-the-job accommodations to meet their disability-related needs (Cortiella & Horowitz, 2014). Wehman (2013) also pointed out that people with LD who are employed, especially transition-age youth, frequently work in jobs whose requirements fall below their skills and qualifications (also known as underemployment), and that workers with LD are frequent targets of discriminatory conduct on the part of employers.

Many individuals with LD and other disabilities are unaware of the changes in their rights and responsibilities when making the transition from secondary to postsecondary settings. In addition to being unaware of their rights and responsibilities, many transition-age youth with LD do not understand the nature of their disability, how it impacts their learning and ability to work, what accommodations are needed, and how to communicate their needs to postsecondary instructors and employers. Training skills associated with developing self-advocacy often address these areas (Merchant & Dintino, 2011).

Self-determination and self-advocacy have been identified as important skills that are necessary for, and contribute to, the successful transition from secondary to postsecondary settings for people with disabilities (Abery, 1994; St. Peter, Field & Hoffman, 1992; Fiedler & Danneker, 2007; Berry, Ward & Caplan, 2012; Morningstar, Frey, Noonan, Ng, Clavenna-Deane, Graves, Kellems, McCall, Pearson, Wade & Williams-Diehm, 2010). However, despite the many curricula developed and amount of research conducted on self-determination and self-advocacy, there is still little evidence that these skills are being directly taught in high school or that formal training exists in postsecondary settings (Fiedler & Danneker, 2007; Test, Fowler, Brewer & Wood, 2005; Morningstar, Frey, Noonan, Clavenna-Deane, Graves, Kellems, McCall, Pearson, Wade & Williams-Diehm, 2010). For transition-age youth with LD, disappointing employment outcomes continue to suggest the need for more effective self-determination and self-advocacy supports as these individuals leave public schools and seek to join the labor market.

Disparities in employment outcomes also suggest that people with LD need open and seamless access to adult-service programs that focus on employment and independent community living (McDonough & Revell, 2010). The state-federal vocational rehabilitation program is the nation’s largest provider of employment supports to Americans with disabilities (Ditchman et al., 2013; Dutta, Gervey, Chan, Chou & Ditchman, 2008). Available to people with LD and other disabling conditions in all 50 states and United States territories (Rubin et al., 2016), this program provides a wide range of services designed to lead to successful employment, including assessment, counseling and guidance, training, job search assistance, job placement, on-the-job support, and assistive technology (Ditchman et al., 2013). Any individual with a disability who can benefit from these services and who requires assistance to prepare for, enter, engage in, or retain gainful employment is eligible to participate in the VR program (Ditchman et al., 2013). Recipients of Social Security Disability benefits are presumed eligible for VR services if they are deemed feasible for future employment following receipt of services (Rehabilitation Services Administration, 2013).

Research is limited and inconclusive regarding the effectiveness of VR services in promoting successful employment for people with LD. Migliore et al. (2014) found that successful employment rates for VR consumers with LD, autism spectrum disorders, and other neurodevelopmental disorders have generally declined in recent years, and they vary significantly from state to state. This disappointing trend is occurring at a time when more people with LD (especially transition-age youth) than ever before are enrolling in VR services (Rubin et al., 2016), so the relationship between people with LD and the nation’s largest employment program for Americans with disabilities is marked by a growing yet increasingly unmet need for assistance.

In an effort to better understand the factors that influence employment outcomes for VR clients with LD, the present study utilized the most recently available data from the US Department of Education’s Rehabilitation Case Service Report (RSA-911) database. The specific purpose of this study was to investigate the relationship of demographic variables, receipt of Social Security disability benefits, and VR service-related variables to employment outcomes for people with LD. Many of these factors have been examined in previous research, but the present study represents the most contemporary perspective on the VR program’s role in preparing this growing clientele for the world of work.

2 Method

2.1 Participants

Participants in this study included 39,275 VR clients with LD between the ages of 16 and 75 at the time of application for services whose cases were closed as either successfully rehabilitated (i.e., competitively employed) or unsuccessfully rehabilitated (i.e., not competitively employed) during Fiscal Year 2013. Sixty percent of the participants were male and 40 percent were female, and they reported a mean age of 20.92 (SD = 7.91) at the time of application for VR services. Most of the participants did not have a high school diploma (57.1%), 21 percent were high school graduates, 5.1% had associate’s degrees, and 0.7 percent had bachelor’s degrees. Most of the sample (52%) were White or Caucasian; 24.9 percent were Black or African American; 19.8 percent were Hispanic or Latino; 1.7% were American Indian or Alaska Native; and 1.6% were Asian, Native Hawaiian, or Other Pacific Islander. Some 10.4% of the participants were receiving monetary and/or health insurance benefits from the Social Security Administration’s disability programs (i.e., Social Security Disability Insurance [SSDI] and Supplemental Security Income [SSI]) at the time of application for VR services.

2.2 Variables

2.2.1 Independent/predictor variables

Two sets of predictor variables were considered for their relationships to the criterion variable of competitive employment at the time of case closure. Demographic variables including age, gender, race, educational attainment and receipt of disability benefits comprised the first set of predictors. Disability benefits referred to receipt of SSI or SSDI from the Social Security Administration. VR services that can be provided to people with LD comprised the second set of predictors. A detailed description of these services can be found in Table 1.

Table 1
Description of services provided by state vocational rehabilitation agencies

Type of services Description of services

Assessment Services provided and activities performed to determine an individual’s eligibility for VR services, to assign an individual to a priority category of a state VR agency that operates under an order of selection, and/or to determine the nature and scope of VR services to be included in the Individual Plan for Employment (IPE); included in this category are trial work experiences and extended evaluation.

Diagnosis and treatment of impairments Surgery, prosthetics and orthotics, nursing services, dentistry, occupational therapy, physical therapy, speech therapy, and drugs and supplies; this category includes diagnosis and treatment of mental and emotional disorders.

VR counseling and guidance Discrete therapeutic counseling and guidance services necessary for an individual to achieve an employment outcome, including personal adjustment counseling; counseling that addresses medical, family, or social issues; vocational counseling; and any other form of counseling and guidance necessary for an individual with a disability to achieve an employment outcome; this service is distinct from the general counseling and guidance relationship that exists between the counselor and the individual during the entire rehabilitation process.

College or university training Full-time or part-time academic training above the high school level that leads to a degree (associate, baccalaureate, graduate, or professional), a certificate, or other recognized educational credential; such training may be provided by a four-year college or university, community college, junior college, or technical college.

Occupational/vocational training Occupational, vocational, or job skill training provided by a community college and/or a business, vocational/trade, or technical school to prepare students for gainful employment in a recognized occupation; this training does not lead to an academic degree or certification.

On-the-job training Training in specific job skills by a prospective employer; generally the individual is paid during this training and will remain in the same or a similar job upon successful completion; this category also includes apprenticeship training programs conducted or sponsored by an employer, a group of employers, or a joint apprenticeship committee representing employers and a union.

Basic academic remedial or literacy training Literacy training or training provided to remediate basic academic skills needed to function on the job in the competitive labor market.

Job readiness training Training to prepare an individual for the world of work (e.g. appropriate work behaviors, methods for getting to work on time, appropriate dress and grooming, methods for increasing productivity).

Disability-related, augmentative skills training Service includes, but is not limited to, orientation and mobility, rehabilitation teaching, training in the use of low vision aids, Braille, speech reading, sign language, and cognitive training/retraining.

Miscellaneous training Any training not recorded in one of the other categories listed, including GED or high school training leading to a diploma.

Job search assistance Job search activities that support and assist a consumer in searching for an appropriate job; may include help in preparing resumes, identifying appropriate job opportunities, and developing interview skills, and may include making contacts with companies on behalf of the consumer.

Job placement assistance A referral to a specific job resulting in an interview, whether or not the individual obtained the job.

On-the-job supports Support services provided to an individual who has been placed in employment in order to stabilize the placement and enhance job retention; such services include job coaching, follow-up and follow-along, and job retention services.

Transportation services Travel and related expenses necessary to enable an applicant or eligible individual to participate in a VR service; includes adequate training in the use of public transportation vehicles and systems.

Maintenance services Maintenance means monetary support provided for those expenses such as food, shelter, and clothing that are in excess of the normal expenses of the individual, and that are necessitated by the individual’s participation in an assessment for determining eligibility and VR needs or while receiving services under an individualized plan for employment (IPE).

Rehabilitation technology The systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation; includes rehabilitation engineering services, assistive technology devices, and assistive technology services.

Reader services Services for individuals who cannot read print because of blindness or other disability; includes reading aloud and transcribing printed information into Braille or sound recordings if requested by the individual; generally are offered to individuals who are blind or deaf-blind but may also be offered to individuals unable to read because of serious neurological disorders, specific learning disabilities, or other physical or mental impairments.

Interpreter services Sign language or oral interpretation services performed by specially trained persons for individuals who are deaf or hard of hearing, and tactile interpretation services for individuals who are deaf-blind; includes real- time captioning services; does not include language interpretation.

Personal attendant services Those personal services that an attendant performs for an individual with a disability such as bathing, feeding, dressing, providing mobility and transportation, and so on.

Technical assistance services Technical assistance and other consultation services provided to conduct market analyses, to develop business plans, and to provide resources to individuals in the pursuit of self-employment, telecommuting, and small business operation outcomes.

Information and referral services Services provided to individuals who need assistance from other agencies (through cooperative agreements) not available through the VR program.

Other services All other VR services that cannot be recorded elsewhere; included here are occupational licenses, tools and equipment, initial stocks and supplies, and medical care for acute conditions arising during rehabilitation and constituting a barrier to the achievement of an employment outcome.

Type of services	Description of services
Assessment	Services provided and activities performed to determine an individual’s eligibility for VR services, to assign an individual to a priority category of a state VR agency that operates under an order of selection, and/or to determine the nature and scope of VR services to be included in the Individual Plan for Employment (IPE); included in this category are trial work experiences and extended evaluation.
Diagnosis and treatment of impairments	Surgery, prosthetics and orthotics, nursing services, dentistry, occupational therapy, physical therapy, speech therapy, and drugs and supplies; this category includes diagnosis and treatment of mental and emotional disorders.
VR counseling and guidance	Discrete therapeutic counseling and guidance services necessary for an individual to achieve an employment outcome, including personal adjustment counseling; counseling that addresses medical, family, or social issues; vocational counseling; and any other form of counseling and guidance necessary for an individual with a disability to achieve an employment outcome; this service is distinct from the general counseling and guidance relationship that exists between the counselor and the individual during the entire rehabilitation process.
College or university training	Full-time or part-time academic training above the high school level that leads to a degree (associate, baccalaureate, graduate, or professional), a certificate, or other recognized educational credential; such training may be provided by a four-year college or university, community college, junior college, or technical college.
Occupational/vocational training	Occupational, vocational, or job skill training provided by a community college and/or a business, vocational/trade, or technical school to prepare students for gainful employment in a recognized occupation; this training does not lead to an academic degree or certification.
On-the-job training	Training in specific job skills by a prospective employer; generally the individual is paid during this training and will remain in the same or a similar job upon successful completion; this category also includes apprenticeship training programs conducted or sponsored by an employer, a group of employers, or a joint apprenticeship committee representing employers and a union.
Basic academic remedial or literacy training	Literacy training or training provided to remediate basic academic skills needed to function on the job in the competitive labor market.
Job readiness training	Training to prepare an individual for the world of work (e.g. appropriate work behaviors, methods for getting to work on time, appropriate dress and grooming, methods for increasing productivity).
Disability-related, augmentative skills training	Service includes, but is not limited to, orientation and mobility, rehabilitation teaching, training in the use of low vision aids, Braille, speech reading, sign language, and cognitive training/retraining.
Miscellaneous training	Any training not recorded in one of the other categories listed, including GED or high school training leading to a diploma.
Job search assistance	Job search activities that support and assist a consumer in searching for an appropriate job; may include help in preparing resumes, identifying appropriate job opportunities, and developing interview skills, and may include making contacts with companies on behalf of the consumer.
Job placement assistance	A referral to a specific job resulting in an interview, whether or not the individual obtained the job.
On-the-job supports	Support services provided to an individual who has been placed in employment in order to stabilize the placement and enhance job retention; such services include job coaching, follow-up and follow-along, and job retention services.
Transportation services	Travel and related expenses necessary to enable an applicant or eligible individual to participate in a VR service; includes adequate training in the use of public transportation vehicles and systems.
Maintenance services	Maintenance means monetary support provided for those expenses such as food, shelter, and clothing that are in excess of the normal expenses of the individual, and that are necessitated by the individual’s participation in an assessment for determining eligibility and VR needs or while receiving services under an individualized plan for employment (IPE).
Rehabilitation technology	The systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation; includes rehabilitation engineering services, assistive technology devices, and assistive technology services.
Reader services	Services for individuals who cannot read print because of blindness or other disability; includes reading aloud and transcribing printed information into Braille or sound recordings if requested by the individual; generally are offered to individuals who are blind or deaf-blind but may also be offered to individuals unable to read because of serious neurological disorders, specific learning disabilities, or other physical or mental impairments.
Interpreter services	Sign language or oral interpretation services performed by specially trained persons for individuals who are deaf or hard of hearing, and tactile interpretation services for individuals who are deaf-blind; includes real- time captioning services; does not include language interpretation.
Personal attendant services	Those personal services that an attendant performs for an individual with a disability such as bathing, feeding, dressing, providing mobility and transportation, and so on.
Technical assistance services	Technical assistance and other consultation services provided to conduct market analyses, to develop business plans, and to provide resources to individuals in the pursuit of self-employment, telecommuting, and small business operation outcomes.
Information and referral services	Services provided to individuals who need assistance from other agencies (through cooperative agreements) not available through the VR program.
Other services	All other VR services that cannot be recorded elsewhere; included here are occupational licenses, tools and equipment, initial stocks and supplies, and medical care for acute conditions arising during rehabilitation and constituting a barrier to the achievement of an employment outcome.

2.2.2 Dependent/outcome variable

Competitive employment was the outcome variable in this study. It is defined by the Rehabilitation Services Administration as working either full time or part time in an integrated setting, self-employment, or a Business Enterprise Program for minimum wage or higher. Minimum wage is the state or Federal minimum wage, whichever is higher. If a client was not competitively employed after receiving VR services and completing his or her individualized rehabilitation program, the case was considered unsuccessful. If a client was competitively employed at the time of case closure, his or her case was considered successful.

2.3 Statistical analysis

Multivariate logistic regression analysis was performed to delineate the relationships between the predictor variables and criterion variable of competitive employment. Hosmer, Lemeshow, and Sturdivant (2013) suggested employing the “purposeful selection” of predictor variables in logistic regression analysis to build the most parsimonious and “best-fit” model that can be adopted. Purposeful selection also ensures that regression models include all of the important predictor variables. The research team applied the 7 steps of the purposeful selection method:

Identifying variables that have one-on-one significant relationships with the outcome variable using an α level of 0.20 or 0.25 to recruit every important predictor variable.

Entering all variables that were found to have significant relationships with competitive employment at step 1 using the “enter” method.

Retaining variables that were significant using an α level of 0.05, and removing variables that were not significant when their removal did not change the β coefficients of the significant variables by more than 20%.

Entering variables that were not significant at step 1 into the regression model one at a time and retaining them if they turned out to be significant.

Examining the variables and changes in the model more closely.

Checking interactions between the variables in the model.

Assessing adequacy of the model and checking the model’s fit (Hosmer et al., 2013).

3 Results

3.1 Descriptive statistics and between-group analyses

Results indicated that, after completing VR services, more than half of participants achieved competitive employment (54.4%; N = 21,369). On average, participants were provided 3.92 (SD = 2.27) VR services, and the median case expenditure for all participants was $1,854. The mean duration of VR services for all participants was 29.88 months (SD = 22.02).

Results also revealed that vocational rehabilitation counseling and guidance (provided to 56% of participants), assessment (52.1%), and job placement (39.6%) were the three most frequently provided services. In descending order, other types of services were provided to the following percentages of participants: job search assistance (34.3%), transportation services (29.6%), other services (25.2%), information/referral (20.9%), diagnostics and treatment (19.7%), job readiness training (19.5%), college or university tuition assistance (16.6%), on-the-job support (15.7%), occupational or vocational training (14.0%), maintenance (13.9%), miscellaneous training (13.6%), supported employment (7.3%), and on-the-job training (4%). Rehabilitation technology (3%), readers (2.2%), technical assistance (2.2%), remedial training (1.9%), augmentative skills training (0.9%), personal attendants (0.6%), and interpreters (0.1%) were provided to three percent of participants or less.

The mean number of services provided to participants who achieved competitive employment (M = 4.44, SD = 2.28) and the median cost of those services ($2,820) were significantly higher than the mean number of services (M = 3.31, SD = 2.09) and the median case expenditure ($1,153) for those who did not achieve competitive employment (t(39,263) = –50.72, p < 0.001). VR clients with LD who achieved competitive employment were in the VR program for significantly less time on average (M = 28.84 months, SD = 21.71) than those who did not achieve competitive employment (M = 31.11, SD = 22.12; t _(39263) = 10.19, p < 0.001).

3.2 Logistic regression analysis

In order to determine the relationship between the predictor variables and competitive employment for VR clients with LD, a multiple logistic regression was conducted. The predictor variables included in the regression model were age at application (16–24 transition age, 25–35 young adults, 36–54 middle aged adults, 55 and above older adults; 16–24 years was the reference category); gender (male, female; female was the reference category); race/ethnicity (White or Caucasian, Black or African-American, American Indian or Alaska Native, Asian or Pacific Islander, and Hispanic or Latino; White or Caucasian was the reference category); education level at application (special education, less than high school, high school graduate, associate’s degree, bachelor’s degree or higher; bachelor’s degree or higher was the reference category); receiving disability benefits (SSI, SSDI, no SSI/SSDI; no SSI/SSDI was the reference category) and vocational rehabilitation services received.

In the first step of the analysis, all of the predictor variables except disability related augmentative skills training and interpreter services had significant relationships with the competitive employment criterion at the p < 0.20 level. Age, assessment, basic academic remedial and literacy training, miscellaneous training, transportation, rehabilitation technology, and attendant services were not significant at p < 0.05 levels in the presence of other predictor variables. The insignificant variables were removed one at a time. When miscellaneous training was removed, transportation services turned out to be significant. Therefore, transportation services was retained. Next, disability related augmentative skills training and interpreter services were put back into the model, but neither were significantly associated with competitive employment. The final model included gender, race, education level at application, disability benefits, diagnosis and treatment of impairments, vocational rehabilitation counseling and guidance, college or university training, occupational/vocational training, on-the-job training, job readiness training, job search assistance, job placement assistance, on-the-job supports, transportation, maintenance, reader services, technical assistance services, information and referral services, other services, and supported employment services as predictor variables that had significant relationships with competitive employment for VR clients with LD.

As for the final model, the omnibus test was significant (χ² (26, N = 39265) = 6061.36 p < 0.001, indicating that the predictor variables were significantly related to the outcome variable. The Nagelkerke R² of 0.19 indicated that predictors had a moderate effect on the outcome variable. The model accurately classified 70.6% of competitively employed clients and 62.4% of clients who had unsuccessful outcomes. Specifically, males were more likely to obtain competitive employment (OR = 1.33; 95% CI 1.27–1.39) than females. African-American, American Indian or Alaska Native, Asian or Pacific Islander, and Hispanic clients were less likely to obtain competitive employment (OR = 0.66, 0.63, 0.79, 0.84; 95% CI 0.63–0.70, 0.53–0.73, 0.67–0.93, and 0.79–0.89, respectively) than white clients. Clients with associate’s degrees, bachelor’s degrees, or higher levels of education were more likely to obtain competitive employment (OR = 1.24, 2.01 95% CI 1.11–1.38, 1.51–2.67) than were clients whose education ended in special education. Clients who did not receive disability benefits were more likely to obtain competitive employment (OR = 1.89; 95% CI 1.76–2.03) than clients who received disability benefits. The odds ratios for the VR services as predictor variables are provided below.

The odds of clients who received on-the-job support services obtaining competitive employment after completing the VR program were 2.73 times (OR = 2.73; 95% CI: 2.53–2.94) greater than the odds of those who did not receive on-the-job support services.

The odds of clients who received technical assistance services obtaining competitive employment were 2.73 times (OR = 2.73; 95% CI: 2.19–3.39) greater than those of clients who did not receive technical assistance services.

The odds of clients who received job placement services obtaining competitive employment were 2.64 times (OR = 2.64; 95% CI: 2.51–2.77) greater than those of clients who did not receive job placement services.

The odds of clients who received occupational/vocational training services obtaining competitive employment were 1.97 times (OR = 1.97; 95% CI: 1.84–2.10) greater than those of clients who did not receive occupational/vocational training services.

The odds of clients who received maintenance services obtaining competitive employment were 1.76 times (OR = 1.76; 95% CI: 1.64–1.88) greater than those of clients who did not receive maintenance services.

The odds of clients who received college or university training services obtaining competitive employment were 1.66 times (OR = 1.66; 95% CI: 1.57–1.77) greater than those of clients who did not receive college or university training services.

The odds of clients who received reader services obtaining competitive employment were 1.43 times (OR = 1.43; 95% CI: 1.17–1.74) greater than those of clients who did not receive reader services.

The odds of clients who received other services obtaining competitive employment were 1.32 times (OR = 1.32; 95% CI: 1.25–1.39) greater than those of clients who did not receive other services.

The odds of clients who received on-the-job training services obtaining competitive employment were 1.32 times (OR = 1.31; 95% CI: 1.17–1.48) greater than those of clients who did not receive on the job training services.

The odds of clients who received information and referral services obtaining competitive employment were 1.21 times (OR = 1.21; 95% CI: 1.14–1.29) greater than those of clients who did not receive information and referral services.

The odds of clients who received vocational rehabilitation counseling and guidance services obtaining competitive employment were 1.18 times (OR = 1.18; 95% CI: 1.13–1.24) greater than those of clients who did not receive vocational rehabilitation counseling and guidance services.

The odds of clients who received transportation services obtaining competitive employment were 1.05 times (OR = 1.05; 95% CI: 1.00–1.11) greater than those of clients who did not receive transportation services.

The odds of clients who received job search assistance obtaining competitive employment were 1.05 times (OR = 1.05; 95% CI: 1.00–1.10) greater than those of clients who did not receive job search assistance services.

Participants who received job readiness training services had a 7% reduction in the odds of obtaining competitive employment in comparison to participants who did not receive job readiness training services (OR = 0.93; 95% CI: 0.87–0.98).

Participants who received supported employment services had a 14% reduction in the odds of obtaining competitive employment in comparison to participants who did not receive supported employment services (OR = 0.86; 95% CI: 0.78–0.94).

Participants who received diagnostic and treatment services had a 22% reduction in the odds of obtaining competitive employment in comparison to participants who did not receive diagnostic and treatment services (OR = 0.78; 95% CI: 0.73–0.82).

4 Discussion

There are a number of limitations that should be considered when interpreting the present findings. First, this study used archival data with an ex-post-facto design; therefore, it is not possible to draw cause-and-effect inferences regarding the relationships among study variables. Next, the primary disability of participants in this study, learning disability, was not necessarily diagnosed in accordance with clinical diagnostic criteria. In some cases, the learning disability classification may have come from the subjective judgments of rehabilitation counselors or from participants’ self-reports. It is therefore possible that some of the participants in this study did not actually have learning disabilities. Moreover, the RSA-911 database does not provide information on various types and severity levels of learning disabilities.

The RSA-911 database is compiled for administrative purposes rather than research purposes. In that regard, rehabilitation counselors, during data collection, may have recorded services based on their recall rather than a review of case files. In addition, although the RSA 911 database includes 18 cross-checks to minimize input errors, there may remain some inaccuracies due to counselors’ misrecording of client and case service information.

Finally, the present study examined data from only one year, 2013. Consequently, it is unclear whether findings in this investigation change over time for VR clients with learning disabilities. Multi-year investigations would enable researchers to place vocational rehabilitation services and outcomes for people with learning disabilities within important (and dynamic) historical, political, and economic contexts.

Even with these limitations, findings from this study indicate that client demographic variables, receipt of Social Security disability benefits, and VR services significantly predicted employment outcomes for people with LD, the majority of whom were between the ages of 16 and 30. Because the average age of participants in this study was less than 21 years at the time they enrolled in VR services, much of the following discussion focuses on issues facing transition-age youth with LD.

In terms of demographic predictors of competitive employment outcomes, it is noteworthy that the employment barriers experienced by Americans with LD in general are even more pronounced for women and members of traditionally underrepresented racial and ethnic groups. The fact that women and non-Caucasian participants in this study were significantly less likely to exit the state-Federal VR program competitively employed provides another example of the double disadvantagement that beleaguers people with disabilities who are women or members of racial/ethnic minority groups in obtaining employment (Koch & Rumrill, 2016; Lewis & Burris, 2012; Smart, 2009). Tailored VR recruitment and service delivery efforts are required to ensure that women and minority group members with LD have equal access to and derive equal benefits from VR services as are afforded males and Caucasians with LD.

Participants in this study who received Social Security disability benefits were nearly twice as likely to not be competitively employed as their counterparts who did not receive these benefits. This finding underscores the powerful systemic disincentive to seeking, securing, and maintaining gainful employment that exists within Social Security disability programs (Strauser, 2013). Indeed, the benefits paid by the Social Security Administration’s two disability programs (i.e., SSDI and SSI) are predicated on the beneficiary being too disabled to work (Marini, 2003). When this determination is made during the critically important career developmental stages of exploration and establishment (Hartung, 2013; Super, 1990), which were the stages that most participants in this study were in by virtue of their young age, people with LD and other disabilities often integrate the external confirmation of their disabled status into their self-concepts – self-concepts that do not necessarily include the role of worker (Migliore et al., 2014). Unemployment and receipt of disability benefits then conjoin in a long-term self-fulfilling prophecy that is very difficult to change. Strauser et al. (2010) reported that only one percent of VR clients who received SSDI benefits at the time of application for services were successfully rehabilitated in competitive employment. In order to change this pattern, people with LD need assistance in understanding disability benefits, especially the impact of paid employment on receiving those benefits.

On-the-job support, technical assistance, job placement, occupational/vocational training, maintenance, college or university tuition assistance, readers, on-the-job training, information and referral, vocational rehabilitation counseling and guidance, transportation, job search assistance, job readiness training, supported employment, and diagnostic and treatment services were significantly related to competitive employment outcomes.

Most notably, on-the-job support, technical assistance, and job placement services were the strongest predictors of the employment outcome criterion. The odds of obtaining competitive employment were 2.73 times higher for participants who received on-the-job support, 2.73 times higher for participants who received technical assistance, and 2.64 times higher for participants who received job placement services.

In other words, people with LD who received on-site support services like job coaching, assistance in identifying and implementing on-the-job accommodations, follow-up, follow along, and job retention support had significantly enhanced employment prospects – as did those who received assistance from rehabilitation professionals in obtaining employment. These findings underscore the importance of supported employment services (which were another significant predictor of competitive employment; Wehman et al., 2012) and targeted job placement services delivered by qualified rehabilitation providers – especially during the critically important exploration and establishment phases of career development that characterize the young age range of most participants in this study (Hartung, 2013; Wehman, 2013). Coupling these effective VR services with hands-on work experience is indicated as a powerful way to improve employment outcomes for youth with LD. In a recent study, youth with LD and other neurodevelopmental disabilities were more likely to be competitively employed if they had participated in a nine-month internship while receiving supported employment services as compared to their counterparts who had received supported employment services without the internship (Schall, Wehman, et al., 2015).

Also more likely to obtain competitive employment were participants in this study who received more VR services at higher expenditure levels over a shorter period of time. Given the young age of most participants in this study, this finding underscores the importance of intensity in the services designed to facilitate transition from adolescence to adulthood (Cimera, 2011). Improved linkages between public high school special education personnel and adult service providers such as VR counselors would help ensure that youth with LD receive the intensive services that yield the most positive outcomes.

The present findings also underscore the importance of education as a conduit to competitive employment for people with LD. Perhaps not surprisingly, participants who held an associates degree or higher were significantly more likely to emerge from the VR program in competitive employment than were participants whose formal education consisted of special education services. For the entire sample, as clients’ educational levels increased, so did their employment rates; although it should be noted that less than one percent of participants had completed bachelor’s degrees by the time they enrolled in VR services. Based on this finding and the strong recommendation of other researchers (Cimera, 2011; Wehman, 2013), VR professionals and other service providers must encourage people with LD, especially transition-age youth, to pursue additional formal training and education after high school as a means of developing high-level, marketable, and generalizable skills that will improve their future prospects for employment and economic self-sufficiency. Of course, college tuition assistance must be accompanied by academic supports such as tutoring, training in cognitive support technology, and consultation regarding classroom accommodations if students with LD are to succeed in postsecondary education (Wehman, 2013).

Given the change in supports, rights, and responsibilities for students with disabilities who are transitioning from secondary to postsecondary educational settings, individuals with LD need to know the nature of their disability, how it impacts their learning, what accommodations are needed, and how to communicate that information to faculty members and disability service providers. In order to do this effectively, students with LD need to be taught self-advocacy and self-determination skills.

It has been suggested that teaching these skills while students with disabilities are still in high school contributes to successful transition to postsecondary education, but the extent to which these skills are included in public school special education programming is unknown as transition planning and services vary widely across schools (Goldberg, Higgins, Raskind & Herman, 2003; Hitchings, Luzzo, Ristow, Horvath, Retish & Tanners, 2001). Therefore, VR counselors must be prepared to include self-advocacy and self-determination skills as part of the Individualized Plan for Employment that guides the VR process (Rubin et al., 2016).

In examining the accommodations provided in postsecondary settings and supports provided by VR agencies for transition-age youth with LD, there seems to be a gap between what these individuals need and what they actually receive in order to achieve successful outcomes in postsecondary education and employment settings. To address this discrepancy, more effective communication and collaboration needs to take place among secondary, postsecondary, and VR service providers.

Kohler, Gothberg, Fowler, and Coyle (2016) stated that post-school outcomes of students with disabilities improve when educators, families, students, and community members and organizations work together on transition planning. The Taxonomy for Transition 2.0 created by Kohler and colleagues (2016) provides a model that focuses on fostering the successful transition of individuals with disabilities to postsecondary and employment settings. There are five primary elements of the model that include: Student focused planning, student development, interagency collaboration, family engagement, and program structure. Student focused planning includes an emphasis on student participation, which requires students to have self-determination skills. Student development highlights employment and occupational skills. The category of interagency collaboration suggests an interdisciplinary framework to assist with transition focused planning and identifies who is involved in planning and service delivery, and activities to guide that collaboration (Kohler et al., 2016).

Finally, one has to ask whether the 54.4 percent VR success rate observed in this study of clients with LD is an acceptable result of services; if not, developing methods for improving employment outcomes is necessary. According to a report by Graham and West (2014), there have been a number of studies that have demonstrated better competitive employment outcomes for youth with other disabilities, some of whom had moderate and severe impairments (the present study did not include data on the severity of participants’ impairments).

In the effort to improve VR success rates for transition-age youth with LD, it is imperative that these youth who are enrolled in high school or college programs gain hands-on work experience in integrated community settings. A number of recent studies bear witness to the high positive correlation between paid employment during high school or college and competitive employment outcomes after graduation among young people with various disabling conditions (Carter, Austin & Trainor, 2011, 2012; Wehman, Sima, et al., 2014).

5 Conclusion

Findings from this investigation are generally consistent with previous studies indicating that client demographic variables, Social Security disability benefits, and VR services are significant predictors of the employment outcomes of VR clients with disabilities. Particularly, this study revealed that on-the-job support, technical assistance, and job placement services strongly correlated with competitive employment. Results also indicated that having higher levels of educational attainment, receiving more VR services at a higher level of expenditure over a shorter period of time, being male, being of Caucasian descent, and not receiving Social Security disability benefits made participants more likely to obtain competitive employment. Stakeholders in the employment success of people with LD will be well served to consider the factors that predict successful rehabilitation as they identify and implement services to meet the needs of this growing VR clientele.

Conflict of interest

None to report.

Footnotes

Acknowledgments

Preparation of this manuscript was supported by the Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) at the State of Wisconsin- Department of Workforce Development with funding provided by the U.S. Department of Education, Office of Special Education Programs (OSEP) Cooperative Agreement (H418P130004). The ideas, opinions, and conclusions expressed, however, are those of the authors and do not represent recommendations, endorsements, or policies of the U.S. Department of Education.

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