An exploration of Asian Americans in the state vocational rehabilitation system by disability type

Abstract

BACKGROUND:

The limited amount of information available on Asian Americans with different types of disability in vocational rehabilitation (VR) system has been a major obstacle to developing appropriate policies and practices.

OBJECTIVE:

Using the Rehabilitation Service Administration data (RSA-911), this study investigated the associations between demographic characteristics, VR service patterns, and employment outcomes of Asian Americans. Whether the relationships differed by type of disabilities (i.e., sensory/communicative, physical, cognitive, and psychiatric disabilities) among Asian Americans was also examined.

METHODS:

A series of chi-squared tests, one-way analysis of variance (ANOVA), and logistic regression were conducted to examine the associations and differences among demographic characteristics, service patterns, and employment outcomes across four major disability groups.

RESULTS:

Each disability group showed different service patterns that indicate unique consumer needs, individualized services and supports to be delivered in a culturally sensitive manner. Along with the demographic profiles of Asian Americans, factors significantly associated with competitive employment in each group were identified.

CONCLUSIONS:

This explorative study’s finding implies VR practitioners’ need to understand individual needs by disability type as well as characteristics of Asian culture, and need to develop and implement effective strategies and services to assist this population.

Keywords

Asian Americans with disabilities competitive employment rehabilitation rehabilitation service administration vocational outcome

1 Introduction

Asian Americans are one of the fastest growing racial/ethnic minority groups in the United States [1, 2]. The number of Asian Americans has increased steadily over the past several decades. The U.S. Census Bureau estimates Asian Americans and Pacific Islanders (AAPIs), comprised of 5.6% of the U.S. population in 2014, will grow more than 40.1 million (9.6% of the U.S. population) by the year 2060 [3]. Despite of the fast-growing rate, Asian Americans have been largely ignored in discussion of race even this group has experienced a long history of oppression in the United States [4]. More specific to disability issues, the prevalence of disabilities among Asian Americans across all ages, gender, and education levels in 2014 was reported 6.9% compared to 12.6% of all U.S. populations [5]. Although the percentage of the Asian American group seems relatively small, it should not be interpreted, as this group needs less disability related service compared to other ethnic groups. Due to limited research conducted to identify service needs among Asian Americans with disabilities, it is still unknown what resources Asian Americans want to have and what challenges they experience in the service system.

Asian Americans have often been known as the most underserved and difficult to reach group in social support systems including mental health services [6]. Researchers have examined possible reasons why Asian Americans are underserved and difficult to reach out [7]. First, there is a prevalent belief that Asian Americans have overcome their minority status and often make successful adjustment in American society [8] and they are often viewed as model minorities who have attained the American dream [4, 9]. However, this model minority myth may foster another type of discrimination against Asian Americans. For example, Asian Americans with disabilities may not access services because disability is considered a family issue, not an issue of service accessibility and discrimination. Thus, they often believe disability is shameful and represents family failure and in turn, disability should be hidden from the public and be handled within the families [2].

1.1 Asian Americans with disabilities in the state-federal VR system

Employment is perceived as a symbol of independent living and psychosocial adjustment for individuals with disabilities in the United States. In addition, employment helps individuals with disabilities combat poverty and provides a strong sense of belonging [10]. Individuals with disabilities who are employed report higher scores on self-efficacy and quality of life measures, compared to individuals who are unemployed [11]. Despite positive psychosocial outcomes associated with employment, many people with disabilities continue to encounter challenges in securing employment [12].

In the United States, rehabilitation services have existed since 1920 and are primarily responsible for the administration of state vocational rehabilitation (VR) agencies to provide employment-related services for individuals with disabilities. State-federal rehabilitation service programs spend more than $2.5 billion every year to help people with disabilities gain employment [13]. The goal of VR service programs is to help people with disabilities obtain and retain employment. The value of state VR services has been supported empirically in the rehabilitation literature. However, most of the studies regarding minority status on VR services have been focused on African Americans with disabilities [14]. The number of studies targeting Asian Americans is extremely limited. For example, Wilson [15] indicated that African Americans were included in nine major VR studies addressing racial backgrounds and VR acceptance, whereas Asian Americans were included in only three out of the nine studies.

Several researchers utilized the national Rehabilitation Service Administration data (RSA-911) [16 –19] as part of their investigation to examine the effectiveness of VR services where Asian Americans were included with other ethnic groups. In relation to the acceptance rate to the state-federal VR system, two studies found that racial/ethnic minority applicants were more likely to exit the VR agency without eligibility determination than White American applicants [17, 19]. Wheaton and Hertzfeld [18] indicated that White Americans were most likely to have successful rehabilitation outcomes compared to other minority groups with similar forms of disability. However, most of these studies did not reveal Asian American specific information in their studies. Park and colleagues [14] conducted a study to examine disparity in three different closure types between AAPIs and White Americans with disabilities using the RSA-911 database and found that AAPIs were less likely to be accepted and achieve successful employment outcomes compared to White Americans. Similarly, Kim-Rupnow and colleagues [20] found that AAPIs with disabilities were significantly underserved across most of states in the U.S. and there was no one source of referral significantly more effective than another in assisting AAPIs with disabilities apply for VR service.

It is important to note that the limited amount of information available on Asian Americans with disabilities has been a major obstacle to developing appropriate policies and practices that address the needs of this population. The National Technical Assistance centers for minority groups funded by the Rehabilitation Services Administration (RSA) under the U.S. Department of Education reviewed previous studies published, and found that very little empirical data existed on the various factors related to AAPIs receiving VR services [20]. Furthermore, little research on Asian Americans with disabilities in the state-federal VR system has been conducted and published for the past 10 years, despite the ever increasing trends of a growing Asian population in the U.S.

Evidently, it is crucial to increase the research effort to investigate Asian Americans with disabilities in the state-federal VR system. For example, identifying service trends among Asian Americans in the state-federal VR system and predictors of successful VR outcomes will help rehabilitation counselors identify the vocational rehabilitation services needs for Asian Americans with disabilities, potentially developing better outreach strategies to help them engage in the service system and also achieve better employment outcomes.

The purpose of the study is twofold: (1) to investigate whether demographic characteristics, service patterns and employment outcomes of Asian Americans were different by type of disabilities; and (2) to examine how differently demographic characteristics and type of services contribute to employment outcomes of four disability subgroups (sensory/communicative, physical, cognitive, and psychiatric disability) among Asian Americans with disabilities in the state-federal VR agency. Additionally, this study attempted to identify key factors associated with Asian Americans compared to other ethnic groups within each disability groups. Specifically, the following research questions were of interest of the current study:

Are there any differences in demographic characteristics, service patterns and employment outcomes among four disability groups of Asian Americans who received plan-based services from the state-federal VR agencies?

Which demographic characteristics and type of services are related to the employment outcomes of Asian Americans of different disability subgroups?

2 Method

2.1 Participants

The data used in the current study was extracted from the U.S. Department of Education’s Rehabilitation Service Administration Case Services Report database (RSA-911) for fiscal year (FY) 2013. The database contains information about clients who received state VR services such as demographic information, duration, cost and types of services, and employment outcomes. In FY 2013, a total of 589,402 individuals exited the state-federal VR system whereas 6,817 (1.2%) were Asian Americans. Specifically, 821 individuals (12%) exited the VR system before an eligibility determination, 1,607 (23.6%) were determined to be eligible for the services, but no established Individualized Plan for Employment (IPE) and 57 (0.9%) were closed from an order of selection waiting list. While 2,074 individuals (30.4%) received services but were not employed, 2,258 (33.1%) were successfully employed. Of those with an employment outcome, 2,166 consumers were competitively employed. In order to increase validity of comparisons and implication, only 4,332 Asian Americans who exited the VR agency with VR services initiated based on their IPEs were included in the analyses.

According to the primary impairments, the sample was categorized into four major disability groups to study the associations of individual characteristics and VR services with employment outcomes: sensory/communicative (e.g., visual impairment/blindness, hearing impairment/deafness), physical (e.g., arthritis, spinal cord injury), cognitive (e.g., intellectual disabilities, learning disabilities, autism spectrum disorder), and psychiatric disabilities (e.g., anxiety, depression, schizophrenia). The individual characteristics of the sample by type of disability are presented in Table 1.

Table 1
Demographic characteristics of participants by primary disability type (N = 4,332)

Variable Sensory/ Physical Cognitive Psychiatric

Communicative N = 884 N = 1,207 N = 1,268 (%)

N = 973 (%) (%) (%)

Gender

  Male 540 (55.5) 488 (55.2) 761 (63) 731 (57.6)

  Female 433 (44.5) 396 (44.8) 446 (37) 537 (42.4)

Age

  Up to 24 314 (32.3) 172 (19.5) 831 (68.8) 304 (24)

  25–34 171 (17.6) 160 (18.1) 185 (15.3) 376 (29.7)

  35–54 314 (32.3) 398 (45) 169 (14) 497 (39.2)

  55–64 127 (13.1) 129 (14.6) 18 (1.5) 88 (6.9)

  65+ 47 (4.8) 25 (2.8) 4 (0.3) 3 (0.2)

Level of Education at App

  Less than HS 246 (25.3) 183 (20.7) 408 (33.8) 199 (15.7)

  Special education 45 (4.6) 17 (1.9) 333 (27.6) 62 (4.9)

  HS diploma or equivalency 243 (25) 207 (23.4) 292 (24.2) 338 (26.7)

  Some post-secondary 439 (45.1) 477 (54) 174 (14.4) 669 (52.8)

Employment Status at App

  Employed in integrated settings 296 (30.4) 123 (13.9) 128 (10.6) 113 (8.9)

  Extended/unpaid/family worker/homemaker 22 (2.3) 7 (0.8) 15 (1.2) 10 (0.8)

  Not employed 655 (67.3) 754 (85.3) 1064 (88.2) 1145 (90.3)

SSI/SSDI Cash Benefits

  Yes 271 (27.9) 247 (27.9) 343 (28.4) 429 (33.8)

  No 702 (72.1) 637 (72.1) 864 (71.6) 839 (66.2)

Co-occurring AODA

  Yes 14 (1.4) 62 (7.0) 65 (5.4) 125 (9.9)

  No 959 (98.6) 822 (93) 1142 (94.6) 1143 (90.1)

Competitive Employment Outcome

  Yes 587 (60.3) 399 (45.1) 602 (49.9) 578 (45.6)

  No 386 (39.7) 485 (54.9) 605 (50.1) 690 (54.4)

Variable	Sensory/	Physical	Cognitive	Psychiatric
Gender
Male	540 (55.5)	488 (55.2)	761 (63)	731 (57.6)
Female	433 (44.5)	396 (44.8)	446 (37)	537 (42.4)
Age
Up to 24	314 (32.3)	172 (19.5)	831 (68.8)	304 (24)
25–34	171 (17.6)	160 (18.1)	185 (15.3)	376 (29.7)
35–54	314 (32.3)	398 (45)	169 (14)	497 (39.2)
55–64	127 (13.1)	129 (14.6)	18 (1.5)	88 (6.9)
65+	47 (4.8)	25 (2.8)	4 (0.3)	3 (0.2)
Level of Education at App
Less than HS	246 (25.3)	183 (20.7)	408 (33.8)	199 (15.7)
Special education	45 (4.6)	17 (1.9)	333 (27.6)	62 (4.9)
HS diploma or equivalency	243 (25)	207 (23.4)	292 (24.2)	338 (26.7)
Some post-secondary	439 (45.1)	477 (54)	174 (14.4)	669 (52.8)
Employment Status at App
Employed in integrated settings	296 (30.4)	123 (13.9)	128 (10.6)	113 (8.9)
Extended/unpaid/family worker/homemaker	22 (2.3)	7 (0.8)	15 (1.2)	10 (0.8)
Not employed	655 (67.3)	754 (85.3)	1064 (88.2)	1145 (90.3)
SSI/SSDI Cash Benefits
Yes	271 (27.9)	247 (27.9)	343 (28.4)	429 (33.8)
No	702 (72.1)	637 (72.1)	864 (71.6)	839 (66.2)
Co-occurring AODA
Yes	14 (1.4)	62 (7.0)	65 (5.4)	125 (9.9)
No	959 (98.6)	822 (93)	1142 (94.6)	1143 (90.1)
Competitive Employment Outcome
Yes	587 (60.3)	399 (45.1)	602 (49.9)	578 (45.6)
No	386 (39.7)	485 (54.9)	605 (50.1)	690 (54.4)

2.2 Variables

2.2.1 Dependent variables

The dependent variable used in this study was competitive employment. Competitive employment is defined in the RSA-911 manual as employment in an integrated setting, self-employment, or employment in a state-managed Business Enterprise Program (BEP) that is performed on a full-time or part-time basis, and for which an individual is compensated at or above the minimum wage.

2.2.2 Independent variables

Two sets of predictor variables used in this study include demographic characteristics of the sample and VR services they received. Demographic variables included gender, age, education level at the time of application (i.e., less than high school, special education, high school [HS] diploma or equivalency, post-secondary education), pre-service employment status (i.e., employment in integrated settings, extended/unpaid/family worker/homemaker, not employed), co-occurring disability (i.e., alcohol or other drug abuse [AODA], depression), and work disincentive variables such as Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) at the time of application. The last set of predictors included type of VR services received (see Table 2 for detailed descriptions for each type of services). For more accurate data analysis and valid implications, the final model included services utilized by at least 5% of consumers in each disability group.

Table 2
Descriptions of VR services [21]

Type of service Description

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, physical, and speech therapy, and drugs and supplies; included in this category are diagnosis and treatment of mental and emotional disorders

Vocational rehabilitation counseling and guidance Discrete therapeutic counseling and guidance services necessary for an individual to achieve an employment outcome (i.e., 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)

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; 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, a business, vocational/trade, or technical school to prepare students for gainful employment in a recognized occupation, not leading to an academic degree or certification

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

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

Job readiness training Training to prepare an individual for the world of work, such as 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, such as 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; helping in preparing resumes, identifying appropriate job opportunities, and developing interview skills, and 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 to stabilize the placement and enhance job retention, such as 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, such as adequate training in the use of public transportation vehicles and systems

Maintenance Monetary support provided for 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 that are incurred while an individual receives services under an 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 including 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 including reading aloud and transcribing printed information into Braille or sound recordings if requested by the individual; 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 including real-time captioning services but not 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

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, such as 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 service	Description
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, physical, and speech therapy, and drugs and supplies; included in this category are diagnosis and treatment of mental and emotional disorders
Vocational rehabilitation counseling and guidance	Discrete therapeutic counseling and guidance services necessary for an individual to achieve an employment outcome (i.e., 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)
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; 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, a business, vocational/trade, or technical school to prepare students for gainful employment in a recognized occupation, not leading to an academic degree or certification
On-the-job training	Training in specific job skills by a prospective employer; the individual is paid during this training and will remain in the same or a similar job upon successful completion; included in this category are apprenticeship training programs conducted or sponsored by an employer, a group of employers, or a joint apprenticeship committee representing both employers and a union
Basic academic remedial or literacy training	Literacy training or training provided to remediate academic skills needed to function on the job in the competitive job market
Job readiness training	Training to prepare an individual for the world of work, such as 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, such as 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; helping in preparing resumes, identifying appropriate job opportunities, and developing interview skills, and 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 to stabilize the placement and enhance job retention, such as 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, such as adequate training in the use of public transportation vehicles and systems
Maintenance	Monetary support provided for 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 that are incurred while an individual receives services under an 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 including 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 including reading aloud and transcribing printed information into Braille or sound recordings if requested by the individual; 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 including real-time captioning services but not 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
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, such as 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

2.3 Data analysis

Data were analyzed using IBM SPSS 23. A series of chi-squared tests for categorical (e.g., gender, race) and one-way analysis of variance (ANOVA) for continuous independent variables (e.g., days from plan to closure) were used to examine any differences in individual characteristics, service patterns, and employment outcomes among four major disability groups. In addition, a separate logistic regression was conducted to investigate the associations among demographic characteristics, VR service patterns, and employment outcomes. In the first model, the effects of demographic variables on competitive employment outcome were examined. In the second model, 17 VR service variables were entered into the model to examine their effects on employment outcome.

3 Results

3.1 Descriptive analyses

As displayed in Table 1, there were several notable differences in terms of distributions of individual characteristics across four disability groups. For example, the sensory/communicative disability group had a higher proportion of transition-aged youth (ages up to 24) as well as those ages 35–54. While Asian Americans with cognitive disabilities were comprised of a higher proportion of transition-aged youth (68.8%), physical and psychiatric disability groups were more likely comprised of working age adults aged 35 to 54 (45% and 39.2% , respectively).

The observed discrepancy in age seemed associated with the differences in the highest level of education and employment status at the time of application among the disability groups. All Chi-squared test results indicated four disability groups were significantly different in terms of all individual characteristics. Specifically, a higher proportion of Asian Americans with psychiatric disabilities reported receiving SSI/SSDI cash benefits, X² (3, N = 4, 332) = 14.19, p = 0.00 and having co-occurring AODA, X² (3, N = 4, 332) = 70.09, p = 0.00 while a higher percentage of those with sensory/communicative disabilities were employed at the time of application, X² (6, N = 4, 332) = 251.19, p = 0.00

In addition to the individual characteristics, whether the duration of VR process was differed by the disability type was examined. While the average time for Asian Americans to become eligible for VR services was 38.6 days, ANOVA results, F (3, 4,328) = 3.64, p = 0.01, η² = 0.003 indicated it took a longer time for those with physical disabilities (42.6 days) than others with sensory (35.7 days), cognitive (36.7 days) or psychiatric (39.9 days) disabilities. In regard to length of time from plan development to closure, the average days for Asians Americans with psychiatric disabilities (786 days) was significantly shorter than those of individuals with other three disabilities (ranged from 800 to 1,005 days), F (3, 4,328) = 12.19, p < 0.001, η² = 0.008. Meanwhile, the average case expenditures were significantly higher for individuals with sensory/communicative disabilities (M = $10,268), compared to the physical (M = $5,566), cognitive (M = $4,597), and psychiatric (M = $4,150) disability groups, F (3, 4,331) = 63.359, p <. 001, η² = 0.04. Despite being statistically significant, the results should be interpreted with cautions due to very low effect sizes.

Five of the 22 types of services, which were utilized by less than 5% of the study sample, were excluded in the data analyses (i.e., on-the-job training, basic remedial or literacy, technical assistance, reader, and personal attendant services). Service patterns were different by type of disabilities (see Table 3). While counseling and guidance and assessment services were commonly utilized by Asian Americans regardless of type of disabilities, a higher proportion of Asians Americans with sensory/communicative disabilities received diagnosis and treatment (56.7%) and rehabilitation technology services (40%), compared to those with other disabilities. However, job related services (i.e., job search, job placement, on-the-job support) were less frequently utilized by those with sensory/communicative disabilities. On the contrary, Asian Americans with cognitive disabilities were more likely to receive job related services such as job readiness training (19.2%), job search assistance (38.9%), job placement assistance (38.9%), and on-the-job supports (27.8%). For the physical disability group, they were more likely to receive transportation services (44.2%) and less to on-the-job support (11.1%) and job readiness services (9.3%). Moreover, a relatively higher proportion of Asian Americans with psychiatric disabilities received transportation (47.5%), job search (42.2%) and job placement assistance (38.9%), and maintenance services (11.0%).

Table 3
VR services received by each disability group

Service^a Sensory/ Physical Cognitive Psychiatric

Communicative (%) (%) (%) (%)

Assessment 56.1 50.2 51.2 52.4

Diagnosis and treatment 56.7 36.5 19.4 33.4

VR counseling and guidance 60.2 50.8 51.2 52.4

College or university training 21.5 19.7 14.7 13.2

Occupational/vocational training 8.0 12.7 10.0 12.6

Job readiness training 14.5 9.3 19.2 14.0

Miscellaneous training 10.6 7.9 7.9 8.5

Job search assistance 27.3 34.6 38.9 42.2

Job placement assistance 25.2 32.7 38.9 38.9

On-the-job supports 11.7 11.1 27.8 18.4

Transportation service 36.1 44.2 33.1 47.5

Maintenance 11.0 9.7 8.5 11.0

Rehabilitation technology 40.0 10.0 2.3 1.4

Information and referral 22.4 18.2 21.4 17.0

Interpreter service 19.9 1.9 0.7 1.3

Augmentative skills training 14.2 1.5 1.4 0.9

Other services 34.3 29.4 22.9 31.9

Service^a	Sensory/	Physical	Cognitive	Psychiatric
Assessment	56.1	50.2	51.2	52.4
Diagnosis and treatment	56.7	36.5	19.4	33.4
VR counseling and guidance	60.2	50.8	51.2	52.4
College or university training	21.5	19.7	14.7	13.2
Occupational/vocational training	8.0	12.7	10.0	12.6
Job readiness training	14.5	9.3	19.2	14.0
Miscellaneous training	10.6	7.9	7.9	8.5
Job search assistance	27.3	34.6	38.9	42.2
Job placement assistance	25.2	32.7	38.9	38.9
On-the-job supports	11.7	11.1	27.8	18.4
Transportation service	36.1	44.2	33.1	47.5
Maintenance	11.0	9.7	8.5	11.0
Rehabilitation technology	40.0	10.0	2.3	1.4
Information and referral	22.4	18.2	21.4	17.0
Interpreter service	19.9	1.9	0.7	1.3
Augmentative skills training	14.2	1.5	1.4	0.9
Other services	34.3	29.4	22.9	31.9

Note: ^aOn-the-job training, Basic Remedial or Literacy Training, Reader Services, Personal Attendant, Technical Assistance were excluded in the further regression analyses since these services were provided to the sample participants minimally (<5%).

For the competitive employment outcomes, a total of 2,166 Asian Americans (50%) were competitively employed after receiving VR services. Specifically, individuals with sensory/communicative disabilities had the highest success rate (60.3%), compared to 49.9% for those with cognitive, 45.6% psychiatric, and 45.1% physical disabilities.

3.2 Logistic regression analyses

A logistic regression analysis was conducted separately for each disability group to examine the associations between individual characteristics, VR services, and employment outcomes. The first set of variables entered into the logistic regression model was demographic variables, which included age, gender, education level, co-occurring AODA, provision of work disincentives at the time of application, and pre-employment status. In the second model, types of VR services utilized by 5% or more individuals in each disability group were included as predictors of competitive employment outcome at closure. The omnibus tests for each of the logistic regression model were found to be significant. The Nagelkerke R² was ranged from 0.13 to 0.23, indicating medium effect size for the associations between VR services and employment outcomes. The Hosmer and Lemeshow goodness of fit tests indicated non-significant results for Asian Americans with sensory/communicative disabilities (p = 0.318), the physical disability group (p = 0.953), the cognitive disability group (p = 0.615), and the psychiatric disability group (p = 0.730) indicating that the final models for all four groups fit the data well.

Several demographic covariates (e.g., age, gender, level of education) were identified as significant predictors for employment outcomes (see Table 4). Age was found to be a significant predictor for only the physical disability group. Those aged between 25 and 34 years were 1.73 times more likely to be employed, OR = 1.73; 95% CI [1.07–2.8], than those who are below 25. Gender was also a significant predictor for the physical disability group; females with physical disabilities were 1.37 times more likely to be employed, OR = 1.37; 95% CI [1.03–1.81], than males. In addition, education level was a significant predictor for the psychiatric disability group, but not for other three disability groups. Individuals with some post-secondary education had a higher chance of employment outcomes, OR = 1.57; 95% CI [1.10–2.22]. Employment status at the time of application was significantly related to employment outcomes for all four major disability groups. The odd for those with sensory/communicative disabilities who were unemployed at the time of application, compared to those who were working in integrated settings, was 0.15 (vs. OR = 0.30 for physical; OR = 0.43 for cognitive; OR = 0.48 for psychiatric disabilities). In other words, Asian American consumers with sensory/communicative disabilities who were employed in integrated settings were 6.7 times (3.3, 2.3, and 2.1, respectively) more likely to achieve an employment outcome than those who were unemployed at the time of application. The receipt of SSI/SSDI benefits also significantly decreased the odds of employment for all disability groups, except the cognitive disability group. Co-occurring AODA were negatively associated with employment outcomes for people with sensory disabilities indicating an 85% lower chance of obtaining employment, OR = 0.15; 95% CI [0.03–0.70], but not for other disability groups.

Table 4
Odds ratio for demographic characteristics by disability group

Variable Sensory Physical Cognitive Psychiatric

Communicative OR OR [95% CI] OR [95% CI]

OR [95% CI]

Gender^a

  Female 1.04 [0.78–1.39] 1.37 [1.03–1.81]* 0.87 [0.69–1.11] 1.16 [0.92–1.46]

Age

  25–34 1.22 [0.79–1.90] 1.73 [1.07–2.80]* 1.06 [0.74–1.52] 1.20 [0.86–1.66]

  35–54 1.01 [0.68–1.49] 1.19 [0.80–1.79] 0.83 [0.57–1.21] 1.05 [0.76–1.43]

  55–64 0.65 [0.39–1.10] 1.12 [0.68-1.86] 0.69 [0.26–1.84] 0.93 [0.56–1.54]

  65+ 1.10 [0.51–2.38] 0.66 [0.25–1.72] 1.38 [0.81–2.33] 0.66 [0.06–7.48]

Level of Education at App

  Special education 0.98 [0.50–1.92] 1.13 [0.38–3.32] 0.84 [0.62–1.13] 1.43 [0.80–2.58]

  HS diploma or equivalency 0.78 [0.52–1.17] 1.36 [0.89–2.09] 1.13 [0.82–1.55] 1.31 [0.91–1.90]

  Some postsecondary 0.90 [0.61–1.33] 1.17 [0.80–1.72] 1.27 [0.85–1.89] 1.57 [1.10–2.22]*

Employment Status at App

  Extended/unpaid/family worker/homemaker 0.06 [0.02–0.16]*** 0.11 [0.01–0.97]* 0.22 [0.07–0.76]* 0.90 [0.224–3.43]

  Not Employed 0.15 [0.10–0.22]^* 0.30 [0.19–0.46]^* 0.43 [0.29–0.64]^* 0.48 [0.32–0.72]^*

  SSI/SSDI cash benefits 0.50 [0.37–0.69]^* 0.46 [0.33–0.63]^* 0.85 [0.65–1.12] 0.70 [0.55–0.89]**

  Co-occurring AODA 0.15 [0.03–0.70]* 0.64 [0.36–1.12] 1.38 [0.81–2.33] 1.03 [0.71–1.50]

Variable	Sensory	Physical	Cognitive	Psychiatric
Gender^a
Female	1.04 [0.78–1.39]	1.37 [1.03–1.81]*	0.87 [0.69–1.11]	1.16 [0.92–1.46]
Age
25–34	1.22 [0.79–1.90]	1.73 [1.07–2.80]*	1.06 [0.74–1.52]	1.20 [0.86–1.66]
35–54	1.01 [0.68–1.49]	1.19 [0.80–1.79]	0.83 [0.57–1.21]	1.05 [0.76–1.43]
55–64	0.65 [0.39–1.10]	1.12 [0.68-1.86]	0.69 [0.26–1.84]	0.93 [0.56–1.54]
65+	1.10 [0.51–2.38]	0.66 [0.25–1.72]	1.38 [0.81–2.33]	0.66 [0.06–7.48]
Level of Education at App
Special education	0.98 [0.50–1.92]	1.13 [0.38–3.32]	0.84 [0.62–1.13]	1.43 [0.80–2.58]
HS diploma or equivalency	0.78 [0.52–1.17]	1.36 [0.89–2.09]	1.13 [0.82–1.55]	1.31 [0.91–1.90]
Some postsecondary	0.90 [0.61–1.33]	1.17 [0.80–1.72]	1.27 [0.85–1.89]	1.57 [1.10–2.22]*
Employment Status at App
Extended/unpaid/family worker/homemaker	0.06 [0.02–0.16]***	0.11 [0.01–0.97]*	0.22 [0.07–0.76]*	0.90 [0.224–3.43]
Not Employed	0.15 [0.10–0.22]^***	0.30 [0.19–0.46]^***	0.43 [0.29–0.64]^***	0.48 [0.32–0.72]^***
SSI/SSDI cash benefits	0.50 [0.37–0.69]^***	0.46 [0.33–0.63]^***	0.85 [0.65–1.12]	0.70 [0.55–0.89]**
Co-occurring AODA	0.15 [0.03–0.70]*	0.64 [0.36–1.12]	1.38 [0.81–2.33]	1.03 [0.71–1.50]

Note: OR = odds ratio, 95% CI = 95% confidence intervals. ^aDemographic covariates: gender (with male as the reference group), age (with <25 as the reference group), level of education (with less than high school graduate or equivalent as reference group), employment status at app (with being employed in integrated setting at the time of application as the reference group), SSI/SSDI cash benefit (with no receipt of receiving SSI/SSDI cash benefits as reference group), co-occurring AODA (with no co-occurring AODA as reference group). ^***p < 0.001; **p < 0.01; *p < 0.05.

According to a series of logistic regression results conducted to examine the relationships between services received and employment outcomes, several VR service variables were found to predict significantly the employment outcomes across four major disability groups. Table 5 presents the logistic regression analysis results.

Table 5

Odds ratio for services by disability group

Service^a	Sensory/	Physical	Cognitive	Psychiatric
	Communicative	OR	OR [95% CI]	OR [95% CI]
	OR [95% CI]
Assessment	0.92 [.68–1.25]	0.88 [0.65–1.18]	1.26 [0.97–0.63]	0.82 [0.64–1.06]
Diagnosis and treatment	1.53 [1.15–2.04]**	1.26 [0.93–1.69]	0.93 [0.67–1.29]	0.89 [0.69–1.17]
VR counseling and guidance	2.19 [1.59–3.04]^***	1.61 [1.16–2.23]**	0.92 [0.68–1.24]	0.89 [0.66–1.18]
College or university training	1.27 [0.88–1.84]	1.27 [0.88–1.84]	1.35 [0.94–1.94]	0.90 [0.62–1.3]
Occupational/vocational training	0.89 [0.53–1.52]	0.77 [0.50–1.2]	1.13 [0.74–1.73]	1.20 [0.83–1.73]
Job readiness training	0.54 [0.35–0.84]**	0.83 [0.50–1.38]	0.65 [0.47–0.92]*	0.88 [0.61–1.27]
Miscellaneous training	0.83 [0.52–1.34]	1.40 [0.82–2.4]	1.52 [0.92–2.48]	1.46 [0.93–2.3]
Job search assistance	1.27 [0.88–1.82]	1.02 [0.74–1.41]	1.19 [0.90–1.58]	1.06 [0.82–1.38]
Job placement assistance	1.88 [1.28–2.77]**	2.46 [1.78–3.42]***	4.76 [3.55–6.39]***	3.62 [2.73–4.8]***
On-the-job supports	3.62 [2.11–6.20]***	1.59 [0.99–2.56]	2.18 [1.62–2.93]***	2.63 [1.88–3.66]***
Transportation service	0.55 [0.40–0.78]**	0.74 [0.53–1.02]	1.12 [0.84–1.49]	1.09 [0.84–1.43]
Maintenance	1.56 [0.95–2.56]	1.36 [0.84–2.21]	1.46 [0.91–2.33]	2.09 [1.38–3.15]^***
Rehabilitation technology	1.80 [1.30–2.46]***	1.43 [0.89–2.28]	—	—
Information and referral	0.86 [0.58–1.26]	1.09 [0.73–1.64]	0.89 [0.62–1.28]	0.95 [0.67–1.36]
Interpreter service	0.67 [0.46–0.98]*	—	—	—
Augmentative skills training	0.46 [0.30–0.72]**	—	—	—
Other services	0.85 [0.63–1.16]	1.40 [1.01–1.95]*	1.46 [1.07–1.99]*	1.65 [1.26–2.16]***

Note: OR = odds ratio, 95% CI = 95% confidence intervals. ^a Some VR service variables were not included as predictors because the number of clients receiving these services was minuscule. ^***p < 0.001; **p < 0.01; *p < 0.05.

For the individuals with sensory/communicative disabilities, the following services were identified as significantly associated with the competitive employment: diagnostic and treatment services, OR = 1.53; 95% CI [1.15–2.04], VR counseling and guidance, OR = 2.19; 95% CI [1.59–3.04], job placement, OR = 1.88; 95% CI [1.28–2.77], on-the-job support, OR = 3.62; 95% CI [2.11–6.20], and rehabilitation technology, OR = 1.80; 95% CI [1.30–2.46]. However, services such as job readiness training, OR = 0.54; 95% CI [0.35–0.84], transportation services, OR = 0.55; 95% CI [0.40–0.78], interpreter services, OR = 0.67; 95% CI [0.46–0.98], and augmentative skills training, OR = 0.46; 95% CI [0.30–0.72] were negatively associated with employment outcomes for those with sensory/communicative disabilities.

In the physical disability group, VR counseling and guidance services, OR = 1.61; 95% CI [1.16–2.23] as well as job placement services, OR = 2.46; 95% CI [1.78–3.42] were found to be significant predictors of successful employment outcomes. Further, individuals who received other services were 1.4 times more likely to be employed than those who did not, OR = 1.40; 95% CI [1.01–1.95].

For the individuals with cognitive disabilities, while job placement, OR = 4.76; 95% CI [3.55–6.39], on-the-job support, OR = 2.18; 95% CI [1.62–2.93], and other services, OR = 1.46; 95% CI [1.07–1.99], were found to contribute to employment outcomes, job readiness training decreased the odds of employment by 0.65 times, OR = 0.65; 95% CI [0.47–0.92].

Lastly, in the psychiatric disability group, individuals who received job placement services were 3.62 times, OR = 3.62; 95% CI [2.73–4.8], more likely to be employed than those who did not. In addition, on-the-job support, OR = 2.63; 95% CI [1.88–3.66], and other services, OR = 1.65; 95% CI [1.26–2.16], were also positively related to achieving competitive employment outcomes. Additionally, it is noted that maintenance services, OR = 2.09; 95% CI [1.38–3.15], were specifically associated with employment outcomes of the psychiatric disability group.

4 Discussion

The purpose of this study was to identify factors related to the competitive employment outcomes of Asian Americans and to examine whether the identified factors differ among the four disability groups. This exploratory study found significant differences in predictors of competitive employment outcomes across the four major disability groups of Asian Americans.

4.1 Demographic characteristics associated with employment outcomes

Consistent with a previous study [22], the study results showed that employment status at the time of application was significantly associated with employment outcomes for all four major disability groups. However, in contrast to previous literature, age and gender were not significant predictors for Asian Americans, except for those with a physical disability. A possible reason to have a different result found in this study would be associated with culture in Asian community that often have strong ties to family. In fact, family and cultural influence on vocational and health-related help seeking has been assumed to play a major role in many Asian cultures [23]. Due to beliefs about and negative attitudes toward disability in Asian families, Asian Americans with disabilities may be reluctant to seek formal help outside their families and instead choose to be self-employed, regardless of their demographic characteristics such as age or gender.

Furthermore, in Asian studies, traditional vocational expectations for females with a disability tend to be lower than those for males in general. In fact, according to the U.S. Bureau of Labor Statistics [24], the labor force participation rate of Asian American women (55.8%) in 2014 was lower than Asian American men (72.4%). Although Asian American females with physical disabilities showed a slightly higher successful employment rate than Asian American males in this study, caution should be heeded when interpreting this result. Due to the limited research examining individual characteristics related to employment outcomes in Asian Americans with disabilities, it is not clearly known if age and gender differences in employment rates reflects a larger population of Asian American with disabilities.

When looking at pre-service education level related to employment outcome, individuals with higher education levels at the time of application have shown a higher chance of employment success [22]. Specifically, in contrast to the previous study that found no significant association between pre-service education level and competitive employment outcomes for the psychiatric disability group, but for sensory/communicative and physical disability groups [22], our findings showed that education level was a significant predictor for Asian Americans with only psychiatric disabilities.

Among all disability groups, a higher proportion of Asian American consumers with psychiatric disabilities received SSI/SSDI cash benefits and had co-occurring AODA, which is consistent with previous findings [22]. The current findings further indicate the adverse effect of SSI/SSDI cash benefits on employment across three disability groups: sensory/communicative, physical, and psychiatric disability. Studies found that provision of work disincentives increases the risk of being unemployed [25, 26]. Specifically, individuals who are at high risk of being unemployed or underemployed may weigh the financial benefits of paid work against the real possibility of losing disability-related benefits [22, 27]. Co-occurring AODA was a risk factor for Asian American consumers with sensory/communicative disabilities only. No such effect was found in other disability groups.

In this study, the overall employment outcome rate for Asian Americans with sensory/communicative disabilities (60.3%) was higher than individuals with cognitive (49.9%), psychiatric (45.6%), and physical disabilities (45.1%). Within samples, the duration of the VR services was significantly shorter for Asian Americans with psychiatric disabilities than other three disability groups. This result was consistent with a previous finding that disconnect between time spent in the state-federal VR system and relatively low employment outcome for individuals with physical and psychiatric disabilities due to a renewed legislative focus on provision of services to individuals with the most significant disabilities [22].

4.2 VR service patterns and effects on employment outcomes

The study findings supported that each disability group showed different service patterns, which would reflect different needs each disability group has. Thus, service patterns and the effectiveness of services should be considered along with consumer characteristics. Asian American consumers with sensory/communicative disabilities were more likely to receive diagnosis and treatment, rehabilitation technology, interpreter, and augmentative skills training services but less likely to use job related services (e.g., job search, job placement services, and on-the-job support) than other disability groups. As a higher proportion of them (30.4%) were already employed at the time of application, they were more likely to need services or replacement for the assistive devices (e.g., hearing aids, low vision aids) to maintain their current jobs. For those who were unemployed at application, however, job related services appeared associated with successful outcomes. The logistic regression results also supported the effectiveness of these services.

The current study shows that diagnostic and treatment services, VR counseling and guidance, job placement, on-the-job support, and rehabilitation technology were significant predictors of employment success for this population. This finding is also consistent with other studies that accommodations and assistive technology (i.e., low vision aid, speech output, special lightning, special devices to use phones, Braille services) are significantly associated with employment outcomes across racial and ethnic groups [22, 28]. On the other hand, this study shows that job readiness training, transportation, interpreter services, and augmentative skills training were found to be negatively associated with employment outcomes. Paralleled to the previous study, the current study findings also indicate that the need for transportation expenses (assistance) was a risk factor that reduced the odds of employment outcome for the sensory/communicative disability group [22]. However, it should be noted that this finding should be interpreted not in the context of service effectiveness but as the contextual variables that would reflect additional needs of consumers. In other words, although some services (e.g., job readiness training, transportation) were found negatively associated with employment outcomes, VR practitioners should consider providing the services that are customized to the needs of individualized consumers and their stage of career development.

For the group with cognitive disabilities, they were more likely to receive job related services than those with other types of disabilities. As seen above, this group was composed of a higher percentage of secondary students and youth (i.e., 69% were younger than 25) who had no postsecondary education and work experiences, yet. Their needs were more related to job exploration, job search, job experience, and job coach on the top of quality counseling and guidance. Accordingly, the logistic regression results indicated that job placement, on-the-job support, and other services were positively associated with achievement of competitive employment in the cognitive disability group. Previous research consistently found that job placement services were the greatest contributor to predicting employment for youth with cognitive disabilities [29 –31]. More recently, the effect of supported employment was strong for youth who were Social Security beneficiaries, special education students, and individuals with intellectual disabilities or autism [32].

Interestingly, the present study found that the receipt of job readiness training reduced the chance of achieving successful employment outcomes. However, this result should be interpreted with caution. Although job readiness training services have little research basis to support their effectiveness, it is suggested that during the planning process, VR practitioners should assist the consumer with identification of vocational needs and goal and determine the need for training. While some individuals with cognitive disabilities may not necessitate a need for job readiness training, job readiness training opportunities can be beneficial for transition-aged youth with cognitive disabilities, who have not been exposed to job readiness training or actual work experiences, to develop basic employability skills.

A relatively higher proportion of Asian consumers with psychiatric disabilities received job search, job placement, and transportation services. Considering their individual characteristics, this group of individuals had, on average, higher education, possibly previous work experiences, and received SSI/SSDI cash benefit at the time of application. In addition to job placement and on-the-job supports, it is noted that maintenance services appeared associated with employment outcomes. Previous studies found job placement service as the most significant predictor of competitive employment as well as on-the-job-support for individuals with psychiatric disabilities [26, 33]. Further, it is interesting to note that maintenance services were found to be significant predictor of employment success for this population but not for the other three disability groups. This finding stands in contrast with the previous study [22] that found the importance of maintenance services for all disability groups.

Compared to the overall service receipt rates, Asian Americans with physical disabilities did not show prominent patterns in receiving certain services. They were somewhat likely to receive transportation services and less likely to receive job readiness and on-the-job support services, which might be related to achieving employment outcomes. This is similar to findings within the vocational rehabilitation literature using the RSA 911 data [34] regarding VR service patterns. According to the logistic regression results, VR counseling and guidance services, job placement, and other services were related to achieving their employment goal among those with physical disabilities. Interestingly, while on-the-job supports were significantly related to successful employment for persons with sensory/communicative, cognitive, and psychiatric disabilities, it was found to be not significant for individuals with physical disabilities. Unlike other disabilities, physical disabilities are rather broad, which can reflect needs for individuals with disabilities in general.

5 Implications for research and practice

This exploratory study attempted to identify demographic characteristics and types of VR service associated with employment outcomes of Asian Americans with four different types of disability including sensory/communicative, physical, cognitive, and psychiatric disabilities.

Even under the same race umbrella as Asian Americans with disabilities, the study findings deliver a message that they had different service needs depending on the type of their primary disability and the effective VR services were also different across disability groups. Although some of the findings were consistent with those drawn from the previous studies focusing on different populations, several distinct results raise further questions that cannot be accounted for from the information provided by the RSA-911 dataset. While a number of studies identified age or level of education at the time of application as a factor significantly related to employment outcomes, this study found the inconsistent results from the previous literature. However, given the limited study efforts investigating employment or VR service outcomes for Asian American populations, it is difficult to explain what such unique results indicate, whether they are consistent over years, and how such findings would influence the service provision for Asian Americans with disabilities.

More in-depth studies examining specific characteristics, barriers, challenges, and helpful strategies and supports that are associated with use of VR services and generating successful employment outcomes for Asian Americans with disabilities need to be further conducted. Future research can be investigated through two different venues: qualitative method such as community based participatory research method and quantitative data analysis. Using a collaborative approach to research that involves all stakeholders in the research process, future research further needs to focus more on identifying service gaps and unique needs and challenges of Asian Americans with specific disabilities, practitioners, community support groups, and administrators to enhance understanding of a given phenomenon and the social and cultural dynamics of the community [35].

In addition, other contextual variable such as household members, poverty level, community support, and cultural factors should be included to see if any of them can influence the use of VR services and the status of employment outcomes. Adding cultural factors as study variables in the future studies may provide valuable information on how cultural values, beliefs, and expectations can influence rehabilitation processes for Asian Americans with disabilities. Understanding consumers’ perceptions of service access and employment in cultural contexts helps VR practitioners develop strategies and supports for their consumers to deal with challenges and to secure and maintain successful employment. Moreover, it may also emphasize the significance of providing VR practitioners with multicultural competence training so that they could obtain culturally sensitive counseling techniques in every aspect of the counseling process available for the counselors.

There is limited previous research on employment outcome for Asian Americans with disabilities specifically using the RSA-911 data, which may make it difficult to support the current study findings in cultural contexts. Therefore, future studies need to make more effort to produce evidence in better serving Asian Americans with disabilities so that they can achieve successful employment goals. It is recommended to use multi-year RSA-911 data to assess more accurate effects of variables on employment outcomes. With such information, VR practitioners could become more aware of the unique needs and challenges to career perceptions, pursuits for Asian Americans with different types of disabilities and move toward a more individualized approach for each sub-disability group.

VR practitioners need to be sensitive to identifying unique service needs that Asian American consumers have. For instance, the findings from the current study suggested that receiving rehabilitation technology services can be significantly related to the successful competitive employment for Asian Americans with sensory/communicative disabilities. Therefore, when working with individuals with such disabilities, VR practitioners may consider whether a consumer can benefit from assisting in the informed choice about the use of such technological devices or receiving assistive technology services that can enhance functioning [36]. On the other hand, consistent with prior studies, job related services (e.g., job placement, on the job supports) were associated to employment outcomes regardless of consumer disabilities. This finding suggests that VR practitioners need to not only properly apply job placement strategies as part of career development activities, but also actively utilize job coaching and job retention services when necessary.

With regard to job related services, VR practitioners also need to be aware of different cultural values held on a career choice or job prestige between Asian Americans and European Americans [37]. For instance, one’s career choice may be strongly tied to the family needs and expectation in Asian American culture [38]. It is important for VR practitioners to help them make a rational career decision based on analyzing their job interests, skills, and the current job market and demands in order to achieve their goals [37]. Also within Asian American culture, career decision-making process may often be placed with the family involvement, which may result in misunderstanding of Asian Americans as indecisiveness or dependence. Rehabilitation professionals may not only put more efforts to understand different Asian cultural values, beliefs, expectations, and family dynamic, but also provide education to Asian Americans and their families about VR service process as well as their rights and responsibilities [20]. Establishing positive consumer-counselor relationships will also help VR practitioners identify individual needs and encourage consumers to go through the VR service process.

6 Limitations

There are a number of limitations to be noted. First, utilizing the RSA-911 database, the category of Asian American does not capture all individual variability and environmental characteristics that may influence the employment environments of Asian American consumers with disabilities such as language proficiency, immigration status, level of acculturation, household numbers, and poverty level. Therefore, the generalizability of the study may be limited. Second, although the RSA-911 is a useful dataset for examining employment outcomes from the state-federal VR service system, the impact of cultural values, beliefs, and expectations among this population should be also considered because such perceptions can create barriers to VR service access, patterns, as well as employment outcomes. In addition, because the RSA-911 data rely on self-report from the counselor as well as the consumer, missing factors that may have influenced the results could be also present. Finally, this study used an exploratory, ex post facto research method; thus, a causal relationship between variables could not be established.

7 Conclusion

Although the results in the present study showed similar profiles of service predictors for each disability group among Asian Americans, compared to previous studies, it contributes to a knowledge base about Asian Americans with disabilities in the state-federal VR service system. Mostly, Asian Americans with sensory/communicative disabilities tend to look for more rehabilitation technology related services and the physical disability group tends to receive transportation services rather than job related services. However, all four major disability groups were likely to achieve positive employment outcomes when they received job placement assistance. Further, on-the-job support was found to be a significant predictor for employment outcomes in three disability groups (i.e., sensory/communicative, cognitive, and psychiatric disability) except the physical disability group. Our findings suggest that VR practitioners ensure the provision of VR services that respond appropriately to the needs of Asian Americans with disabilities and consider outreach to these groups to more effectively serve and help them successfully interact with the VR system. Additional in-depth research is needed for to better understand individual and environmental variables associated with barriers and challenges to VR services leading to positive employment outcomes for Asian Americans with disabilities in cultural contexts.

Conflict of interest

None to report.

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Variable	Sensory/	Physical	Cognitive	Psychiatric
	Communicative	N = 884	N = 1,207	N = 1,268 (%)
	N = 973 (%)	(%)	(%)
Gender
Male	540 (55.5)	488 (55.2)	761 (63)	731 (57.6)
Female	433 (44.5)	396 (44.8)	446 (37)	537 (42.4)
Age
Up to 24	314 (32.3)	172 (19.5)	831 (68.8)	304 (24)
25–34	171 (17.6)	160 (18.1)	185 (15.3)	376 (29.7)
35–54	314 (32.3)	398 (45)	169 (14)	497 (39.2)
55–64	127 (13.1)	129 (14.6)	18 (1.5)	88 (6.9)
65+	47 (4.8)	25 (2.8)	4 (0.3)	3 (0.2)
Level of Education at App
Less than HS	246 (25.3)	183 (20.7)	408 (33.8)	199 (15.7)
Special education	45 (4.6)	17 (1.9)	333 (27.6)	62 (4.9)
HS diploma or equivalency	243 (25)	207 (23.4)	292 (24.2)	338 (26.7)
Some post-secondary	439 (45.1)	477 (54)	174 (14.4)	669 (52.8)
Employment Status at App
Employed in integrated settings	296 (30.4)	123 (13.9)	128 (10.6)	113 (8.9)
Extended/unpaid/family worker/homemaker	22 (2.3)	7 (0.8)	15 (1.2)	10 (0.8)
Not employed	655 (67.3)	754 (85.3)	1064 (88.2)	1145 (90.3)
SSI/SSDI Cash Benefits
Yes	271 (27.9)	247 (27.9)	343 (28.4)	429 (33.8)
No	702 (72.1)	637 (72.1)	864 (71.6)	839 (66.2)
Co-occurring AODA
Yes	14 (1.4)	62 (7.0)	65 (5.4)	125 (9.9)
No	959 (98.6)	822 (93)	1142 (94.6)	1143 (90.1)
Competitive Employment Outcome
Yes	587 (60.3)	399 (45.1)	602 (49.9)	578 (45.6)
No	386 (39.7)	485 (54.9)	605 (50.1)	690 (54.4)

Service^a	Sensory/	Physical	Cognitive	Psychiatric
	Communicative (%)	(%)	(%)	(%)
Assessment	56.1	50.2	51.2	52.4
Diagnosis and treatment	56.7	36.5	19.4	33.4
VR counseling and guidance	60.2	50.8	51.2	52.4
College or university training	21.5	19.7	14.7	13.2
Occupational/vocational training	8.0	12.7	10.0	12.6
Job readiness training	14.5	9.3	19.2	14.0
Miscellaneous training	10.6	7.9	7.9	8.5
Job search assistance	27.3	34.6	38.9	42.2
Job placement assistance	25.2	32.7	38.9	38.9
On-the-job supports	11.7	11.1	27.8	18.4
Transportation service	36.1	44.2	33.1	47.5
Maintenance	11.0	9.7	8.5	11.0
Rehabilitation technology	40.0	10.0	2.3	1.4
Information and referral	22.4	18.2	21.4	17.0
Interpreter service	19.9	1.9	0.7	1.3
Augmentative skills training	14.2	1.5	1.4	0.9
Other services	34.3	29.4	22.9	31.9