Vocational rehabilitation services and employment outcomes for adults with cerebral palsy in the United States

Abstract

Aim The aim of this study was to examine the relationship between vocational rehabilitation services provided and work outcomes among people with cerebral palsy (CP), taking in to account demographic characteristics. Method From the US Department of Education Rehabilitation Service Administration Case Service Report (RSA‐911) database, data from 3162 individuals with CP (1820 males [57.6%] and 1342 females [42.4% age range 16–54y) whose cases were closed in 2009, were used in this study. A total of 1567 cases (49.6%) were closed with clients being categorized as ‘successful employment’ and 1595 cases (50.4%) were closed with clients being classified as unemployed. Results Multivariate logistic regression was used to examine the relationship between services provided and work outcomes with regard to demographic characteristics. Males aged between 26 and 54 years old with higher education attainment were more likely to be employed. Individuals receiving disability benefits were less likely to be employed. After controlling for the effect of demographic and work disincentive variables, five vocational rehabilitation services significantly predicted employment outcomes (p<0.05), including (1) on‐the‐job training; (2) job placement assistance; (3) on‐the‐job support; (4) maintenance services; and (5) rehabilitation technology. Interpretation Medical and health professionals need to be aware of vocational rehabilitation agencies as a resource for providing medical, psychological, educational, and vocational interventions for adults with CP to help them maximize their employability, to address their much needed work adjustment skills, to establish independent living, and to eventually reach their full potential in participation in society.

Course of employment in adults with cerebral palsy over a 14‐year period

“…7,21 In our analyses, we did not differentiate competitive from sheltered employment, which may have precluded such an association. A high education level has found to be significant for achieving competitive employment in adults with CP.…”

“…A high education level has found to be significant for achieving competitive employment in adults with CP. 7,21 In our analyses, we did not differentiate competitive from sheltered employment, which may have precluded such an association. However, the figure shows that the most substantial contrast between competitive and sheltered employment lies between subgroups with different education levels.…”

The State of the Science Conference

“…People with multiple sclerosis (MS) face unique barriers to employment, since MS is associated with a wide range of physical, cognitive, and emotional symptoms that appear episodically and unpredictably (Roessler & Rumrill, 2003;Rumrill et al, 2013). In addition, a number of researchers have reported that individuals with cerebral palsy (CP) continue to experience significantly lower rates in getting and keeping employment in comparison to individuals without disabilities (Huang et al, 2013;Magill-Evans, Galambos, Darrah, & Nickerson, 2008). As a final example, the National Spinal Cord Injury Statistic Center reported information on 28,450 individuals with SCI in the National Spinal Cord Injury Database.…”

Employment outcomes for adults with cerebral palsy: an issue that needs to be addressed

“…Huang et al. describe factors that contribute to employment outcomes in adults with CP who received vocational rehabilitation services, and provide some insights into the complexity of achieving such outcomes . The role of higher education and increased services in achieving employment are particularly germane to health care providers.…”

“…Therapy services, called related services in school systems, which support educational outcomes are mandated by law. Activities of daily living, expressive language skills (which can be provided by augmentative devices when speech is not possible), social skills, and arm/hand use are routine therapy outcomes for occupational and physical therapists and speech‐language pathologists that have been identified as important to future employment . Driver education and/or use of community mobility systems when available are aspects of work that can be initiated in the school system, especially when vocational rehabilitation services are part of transition planning.…”