Keynote-Autistic-Spectrum-Disorders-Dr.-Paul

Report
Supported Employment:
What Have We Learned
After 30 Years?
Paul Wehman, Ph.D., Virginia Commonwealth University
Professor of Physical Medicine and Rehabiliaion
Director VCU-RRTC
European Union on Supported Employment 20th Anniversary Conference
Dublin Ireland, June 12, 2013
Supported Employment:
What Have We Learned
After 30 Years?
Persons with significant intellectual disabilities
can work in open/competitive employment
• (eg. Mank, D. 1997; Mank, D. 2000; Wehman, P.
1981; Wehman, P., Parent, W. et. al 1987)
1980’s
Persons with severe mental illness can
work in competitive employment
• (eg. Bond, G. et. al. 2008; Bond, G. 2004; Drake, R.
& Bond, G. 2008)
1990’s
Persons with classic autism
can work in competitive employment
• (eg. Howlin ,P. et. al. 2005; Wehman, P., Lau, S. et.
al. 2012,
Wehman, P., Schall, C. et. al. 2013)
2003-2013
Persons with severe traumatic brain injury can
work in competitive employment
• (eg. Wehman, P. et. al. 1990; Wehman et. al. 2005;
Wehman, Chen et. al. 2013; Chesnut, R. et. al.
1999; & Hart T. et. al. 2010)
1990’s
Persons with spinal cord injury can work
in competitive employment
•
(eg. Inge, K. et. al. 1998; Ottomanelli, L. et. al. 2009;
Ottomanelli, L et. al 2012)
Late 1990’s
To
Mid 2000’s
Segregated day programs &
extended prevocational services
are not necessary for
open/competitive employment
• (eg. Wehman,P. & Kregel, J. 1998; Brown, L. et. al.
2006)
Effective job coaches/employment specialists are a
critical bridge for long term successful
open/competitive employment
Supported employment is more cost
effective than day program services
• (eg. Cimera, R. 2007; Cimera, R. 2010)
Internships can be significant enhancers for
long term open/competitive employment
• (eg. Daston, M. et. al. 2012; Luecking, R. 2009;
Luecking, R. 2011;
Symonds,P. & Luecking, R. 2013)
Paid work while in school before
graduation greatly facilitates
open/competitive employment
• (eg. Carter, E. et. al. 2011; Wehman, P., McDonough, J.
et. al. 2013)
Quality of life & independence
is greatly improved through
supported employment
• (eg. Garcia-Villamisar, D. et. al. 2002; Jahoda, A. et.
al. 2008; Verdugo, M. A. et. al. 2009; Wehman, P.,
Sima, A., et. al. 2013)
Parents support of individuals with significant
disabilities capacity to work greatly increases
likelihood of successful open/supported
employment
• (eg. Wehman , P. 2013)
What’s going on in the world of
supported employment?
Supported Employment:
A World Wide Phenomena
The Current Gold Standard for Individuals with
Disabilities & their Families
People with disabilities say: (Migliore, A. et. al. 2007)
A “Slot” in sheltered workshop is not enough
“Let us work in business”
Real Work with Supports - Now!
Pre = Never
Spain
• Providing SE for over 20 years
• SE initiatives up from 24 (1995) to 57 (2004)
• Since start of SE program (2005) up to 207
(2010)
• International leaders in Quality of Life research
(Jordán de Urries F.B., & Verdugo, M
2010;Verdugo, M et al 2009)
Ireland
• Government support
• Ireland’s Presidency of the Council of the EU
• Job Shadow Day & National Supported
Employment Week
• Open Door Project
• Innovation and dedication
United Kingdom
• Youth SE initiatives show improved work rates
• Project SEARCH pilot study
• Growing body of SE research (eg. quality of job,
services, inclusion, cost benefit)
• Calls for investment in intensity & type of support
in relation to needs; policies to improve
availability & flexibility of jobs (Beyer, S. 2012)
Australia
• Data driven approach to analyze and
monitor performance
• Services “uncapped”(2010) individuals no
longer need to be placed on waiting list &
can receive immediate access to service
they require
Challenges for the Future
1. Close all Sheltered facilities and Segregated Day
Programs and Re-Direct Funds for
Open/Competitive Employment
2. Make Open/Competitive Employment the First
Choice for all
3. Make Funds Available to persons with Disabilities
to Spend on their own Job Coach and Provider
Challenges (cont)
4. Set Goals for Placement of Persons with
Disabilities Each Year between Now and
2018
5.Create Training Institutes for Employment
Specialists to Establish Supported
Employment Competencies
6. Create country Wide Business Disability
Networks
References
• Beyer, S. (2012). The progress towards integrated employment in
the UK. Journal of Vocational Rehabilitation, 37(3), 185-194.
• Bond, G. R. (2004). Supported employment: Evidence for an
evidence-based practice. . Psychiatirc Rehabilitation Journal, 27,
345-359.
• Bond, G., Drake, R. & Becker, D. (2008). An update of randomized
controlled trials of evidence-based supported employment, 31(4),
280-290.
• Brown, L., Shiraga, B. & Kessler, K. (2006). The quest for ordinary
lives: the integrated post-school vocational functioning of 50 workers
with significant disabilities. Research and Practice for Persons with
Severe Disabilities, 31(2):93-121.
• Carter, E.W., Austin, D.& Trainor, A. (2011). Factors associated with
the early work experiences of adolescents with severe disabilities.
American Journal of Intellectual and Developmental
Disabilities,49(4), 233-247.
References
•
•
•
•
•
Cimera, R.E. (2007). The cumulative cost-effectiveness of supported and
sheltered employees with mental retardation. . Research and Practice for
Persons with Severe Disabilities, 32(4),247-252.
Cimera, R.E. (2010). National cost efficiency of supported employees with
intellectual disabilities: 2002-2007. American Journal of Intellectual and
Developmental Disabilities, 115, 19-29.
Chesnut, R.M., Carney, N., Maynard, H., Mann, N.C., Patterson, P. & Helfan,
M. (1999). Summary report: evidence for the effectiveness of rehabilitation for
persons with traumatic brain injury. Journal of Head Trauma Rehabilitation,
4(2), 176-188.
Daston, M., Riehle, E. & Rutkowski, S. (2012) High School Transition that
Works: Lessons Learned from Project Search. Baltimore, MD, Paul H.
Brookes Publishing Co.
Drake, R. & Bond G. (2008). The future of supported employment for persons
with severe mental illness. Psychiatric Rehabilitation Journal 1(4),367-376.
References
• Garcia-Villamisar, D., Wehman, P. & Navarro, M.D. (2002).
Changes in the quality of autistic people’s life that work in supported
and sheltered employment: a 5-year follow-up study. . Journal of
Vocational Rehabilitation, 17(4),309-312.
• Hart, T., Dijkers, M., Whyte, J., Braden, C., Trott, C. & Fraser, R.
(2010). Vocational interventions and supports following job
placement for persons with traumatic brain injury. Journal of
Vocational Rehabilitation, 32 (3),135-150.
• Howlin, P. , Alcock, J. & Burkin, C. (2005). An 8 year follow-up of a
specialist supported employment service for high-ability adults with
autism or Asperger syndrome. Autism. 9(5), 533–549.
• Inge, K., Wehman, P., Strobel, W., Powell, D., & Todd, J. (1998).
Supported employment and assistive technology for persons with
spinal cord injury: Three illustrations of successful work supports.
Journal of Vocational Rehabilitation, 10, 141-152.
References
• Jahoda, A., Kemp, J., Riddel, S. & Banks, P. (2008). Feelings about
work: a review of the socio-emotional impact of supported
employment on people with intellectual disabilities. Journal of
Applied Research in Intellectual Disabilities, 21(1), 1- 18.
• Luecking, R.G. (2009). The way to work: how to facilitate work
experiences for youth in transition. Baltimore, MD, Paul H. Brookes
Publishing Co.
• Luecking, R.G. (2011). Connecting employers with people who
have intellectual disabilities. American Journal of Intellectual and
Developmental Disabilities 49(4),261-273.
• Mank,D., Cioffi, A. & Yovanoff, P. (1997, June). Analysis of the
Typicalness of Supported Employment Jobs, Natural Supports, and
Wage and Integration Outcomes. Mental Retardation. 35, 3, 185197.
References
•
•
•
•
Mank,D., Cioffi, a. & Yovanoff, P. (2000, December). Direct Support in
Supported Employment and Its Relation to Job Typicalness, Coworker
Involvement, and Employment Outcomes. Mental Retardation: 38,(6) 506516.
Migliore, A., Mank, D. , Grossi , T. & Rogan, P. (2007). Integrated
employment or sheltered workshops: preferences of adults with intellectual
disabilities, their families, and staff. Journal of Vocational Rehabilitation,
26(1) 5-19.
Ottomanelli, L., Goetz, L., McGeough, C. , Suris , A., Sippel, J., Sinnott, P., et
al. (2009). Methods of a multisite randomized clinical trial of supported
employment among veterans with spinal cord injury. Journal of Rehabilitation
Research & Development, 46(7), 919-30.
Ottomanelli, L. , Goetz, L., Suris, A., McGeough, C., Sinnot, P., Toscano,
R.,et al. (2012). The effectiveness of supported employment for veterans with
spinal cord injuries: results from a randomized multi-site study. Archives of
Physical Medicine and Rehabilitation, 930(5),740–747.
References
• Symonds, P. & Luecking, R.G. (2013) Open employment in
Australia. Journal of Vocational Rehabilitation, 38(3),215-222.
• Wehman, P. (2013). Transition from School to Work: Where
are we and where do we need to go? Career Development
for Exceptional Individuals-35th Anniversary issue, 36(1), 58 –
66.
• Wehman, P., Chen, C., Targett, P., West, M., & Cifu, G. (in
press, 2013). Transition planning and postsecondary
educational outcomes for youth with TBI. NeuroRehabilitation.
• Wehman, P. & Hill, J. (1981, February). Competitive
employment for moderately and severely handicapped
individuals. Exceptional Children, 338-346.
References
• Wehman, P., Hill, J.W., Wood, W., & Parent, W. (1987). A report on
competitive employment histories of persons labeled severely
mentally retarded. Journal of the Association of Persons with Severe
Handicaps, 12(1), 11-17.
• Wehman, P., Inge, K. J., Revell, G., & Brooke, V. A. (2007). Real
Work for Real Pay: Inclusive Employment for People with
Disabilities. Baltimore: Paul Brookes Publishing Co.
• Wehman, P., Lau, S., Molinelli, A., Brooke, V., Thompson, K., Moore,
C., et al. (2012). Supported employment for young adults with
autism spectrum disorder: Preliminary data. Research and Practice
for Persons with Severe Disabilities, 37(3), 1-10.
• Wehman, P. & Kregel, J. (1998). More than a Job: Securing
satisfying careers for people with disabilities. Baltimore: Paul
Brookes Publishers.
References
• Wehman, P., Kreutzer, J., West, M., Sherron, P., Zasler, N., et
al. Return to work for persons with traumatic brain injury: A
supported employment approach. (1990) Archives of Physical
Medicine and Rehabilitation, 71, 1047-1052.
• Wehman, P. McDonough, J. , Schall, C., Molinelli, A.&
Riehle,E. (in press). Project SEARCH implementation at high
school level for youth with autism . Teaching Exceptional
Children.
• Wehman, P., Schall,C., McDonough, J., Kregel, J., Brooke, V.,
Molinelli, A., et al. (2013). Competitive employment for youth
with autism spectrum disorders: Early results from a
randomized clinical trial. Manuscript submitted for publication.
References
• Wehman, P., Sima, A., Ketchum, J.M., West,
M.D., Chan, F., & Luecking, R. (2013).
Predictors of successful transition from
school to competitive employment for youth
with disabilities. Manuscript submitted for
publication.
• Wehman, P., Targett, P., West, M. & Kregel,
J. (2005). Productive work and employment
for persons with TBI: What have we learned
after 20 years? Journal of Head Trauma
Rehabilitation 20(2), 115-127.

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