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

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

3 Results

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.