Journal of Visual Impairment & Blindness

The purpose of this study was to investigate how services are provided to state–federal vocational rehabilitation consumers with comorbid traumatic brain injury (TBI) and visual impairment and the prevalence of and competitive employment rates for this population.

We utilized a mixed-methods approach by incorporating interview data from 51 vocational rehabilitation agency administrators (to identify strategies used to serve these consumers) and case service data (to identify prevalence and competitive employment rates at the agency level). We combined the data to examine the relationship between strategies used and the prevalence of and employment outcomes for this population. A modified grounded theory approach was used for qualitative data analysis and descriptive statistics, and analyses of variance were used for quantitative data analyses.

Strategies used to serve these consumers included collaboration between counselors, involvement of external organizations, specialized TBI units or caseloads, staff training in TBI, and personnel with dual expertise in TBI and visual impairment. Over a third of agency administrators reported that they did not do anything special or different to serve this population. The average percentage of consumers with visual impairments who also had TBIs being served by agencies was 2.1%. Their average competitive employment rate by agency was 43.2%. Employing staff with dual expertise in TBI and visual impairment was associated with serving a greater percentage of consumers and having a higher competitive employment rate.

No agencies had a unique service delivery program or method to serve this population, perhaps due to its low prevalence. Agencies had substantial variability in the proportion of consumers with TBI and visual impairment served and their competitive employment rates. Implications for practitioners: Training vocational rehabilitation professionals to develop expertise in both TBIs and visual impairments may help agencies better serve these consumers.

In this study, the author examined the association between general self-efficacy (GSE) and employment status in working-age adults with retinitis pigmentosa (RP; N = 183). The author further examined the associations between employment status and factors that were previously found to be linked to employment outcomes in individuals with visual impairments: educational attainment, mobility tool use (i.e., use of dog guide or cane), ability to drive, age, gender, and age at onset of visual impairment.

Multiple logistic regression was used to analyze cross-sectional data collected online in 2015.

Findings indicated that individuals with RP who have a bachelor’s degree or higher had significantly higher odds of being employed (p < .01) and that individuals with RP who use a cane or dog guide had significantly lower odds of being employed (p < .01). Although not statistically significant, findings further indicated that individuals with RP who have higher GSE had higher odds of being employed (p = .07) and that individuals who are able to drive had 130% higher odds of being employed (p = .06).

Results demonstrated an association between GSE and employment status, after controlling for factors that were previously linked to employment outcomes in individuals with visual impairment.

Self-efficacy is an alterable cognitive construct and may be the target of interventions to increase employment outcomes for adults with RP or other eye conditions.

Employed applicants for vocational rehabilitation need timely services to improve the likelihood of their successful job retention or career advancement. Little research exists that examines timeliness of services among employed applicants, particularly for applicants with visual disabilities. This study investigated time from vocational rehabilitation application to a signed Individualized Plan for Emplolyment (IPE) for employed applicants with visual disabilities.

The sample of 5,096 competitively employed vocational rehabilitation applicants from the FY2015 RSA-911 report was combined with survey responses from 51 vocational rehabilitation agencies about services to persons with visual disabilities. Multilevel modeling was used to examine effects of state-level and individual-level characteristics and cross-level interactions on the length of waiting time from vocational rehabilitation application to signed IPE.

The time from application to IPE was shorter for employed applicants with visual disabilities who received services from separate vocational rehabilitation agencies compared to that of combined vocational rehabilitation agencies. Employed vocational rehabilitation applicants with visual disabilities waited longer if they were younger, non-White, or received disability benefits. Official job-retention policies in state vocational rehabilitation agencies appeared to reduce the delay of IPE implementation for persons with secondary disabilities, for applicants who received disability benefits, and for persons who worked more hours per week.

Additional research to determine how vocational rehabilitation can provide services to employed persons as soon as possible after application is indicated, particularly for persons applying to combined agencies.

Vocational rehabilitation providers should explore ways to expedite service delivery, particularly for persons who are younger, non-White, or receiving disability benefits. Implementing official vocational rehabilitation policies for addressing job-retention and career-advancement cases may be one avenue to expedite services to some employed applicants.

This study describes the characteristics of, services received by, and labor market outcomes of applicants with visual impairments to three state vocational rehabilitation programs. Our objective is to both document cross-state variation in vocational rehabilitation clientele and services and provide new insights on the longitudinal labor market outcomes of clients with visual impairments (i.e., blindness or low vision). This analysis is a first step in assessing the returns to vocational rehabilitation services for this population.

We first created a unique longitudinal data set by matching administrative records on applicants who are visually impaired in state fiscal year 2007 from three vocational rehabilitation agencies to 8 years of employment data from state Unemployment Insurance programs. Using these data, we examined cross-state variation in the descriptive statistics for important client explanatory variables and vocational rehabilitation service categories. We then compared the long-term labor market outcomes of clients receiving services (treated) to untreated individuals.

We documented two important findings. First, there were substantial differences in client characteristics, services provided, and costs across the three states. Second, the long-run labor market analysis was consistent with vocational rehabilitation services having no employment effect but a positive earnings effect.

Labor market results indicate vocational rehabilitation services provided persistent earnings benefits. Yet the substantial cross-state heterogeneity suggests these labor market results might not be generalizable and should be interpreted with caution. We explain what was missing from this analysis and why the results should not be thought of as causal.

This article gives practitioners a sense of a unique new data set on vocational rehabilitation and labor market variables for applicants with visual impairments. We highlight the importance of cross-state variation and linking vocational rehabilitation data to long-term employment measures. The question of how best to inform the efficacy of different vocational rehabilitation strategies for clients with visual impairments is left for future researchers to consider.