bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between the Grooved Pegboard Test and Clinical Motor Symptom Evaluation Across the Spectrum of Parkinson's Disease Severity
Authors: Sage Michael D. , Bryden Pamela J. , Roy Eric A. , Almeida Quincy J.
Published: December 2019

Background: The Unified Parkinson's Disease Rating Scale (UPDRS) is the gold standard for assessing Parkinsonian symptoms, yet objective outcome measures are needed to complement the UPDRS in research and clinical practice. Objective: This study aimed to investigate the relationship between performance on the Grooved Pegboard Test (GP) and clinical assessment of Parkinson's motor symptoms with the UPDRS. Methods: A large sample of individuals with Parkinson's disease (n = 191) were assessed with the GP and UPDRS motor section. The GP was separated into a place (more representative of visuospatial accuracy) and remove phase (general representation of motor speed and bradykinesia). Both tests were completed at peak anti-parkinsonian medication levels, and UPDRS subscores were calculated to represent upper-limb control, rigidity, bradykinesia, and tremor. A subsequent correlation analysis was completed. Results: The strongest relationships were between the GP place phase (both limbs) and total UPDRS motor score (affected: r = 0.604, less-affected: r = 0.587), upper-limb control (affected: r = 0.367, less-affected: r = 0.426), rigidity (affected: r = 0.479, less-affected: r = 0.457) and body bradykinesia (affected: r = 0.375, less-affected: r = 0.438). The GP remove phase had weak positive relationships with total UPDRS scores (affected: r = 0.31, less-affected r = 0.31) and body bradykinesia (r = 0.31). Conclusions: Clinical assessment of upper-limb control, rigidity and bradykinesia are well represented by the GP place phase. Interestingly, it appeared that GP performance of the more affected limb may be more representative of motor severity in the early stages of disease, while more research is needed to understand the utility of the GP in the advanced stages of disease.
Pilot Study Assessing the Feasibility of Applying Bilateral Subthalamic Nucleus Deep Brain Stimulation in Very Early Stage Parkinson's Disease: Study Design and Rationale
Authors: Charles David , Tolleson Christopher , Davis Thomas L. , Gill Chandler E. , Molinari Anna L. , Bliton Mark J. , Tramontana Michael G. , Salomon Ronald M. , Kao Chris , Wang Lily , Hedera Peter , Phibbs Fenna T. , Neimat Joseph S. , Konrad Peter E.
Published: December 2019

Background: Deep brain stimulation provides significant symptomatic benefit for people with advanced Parkinson's disease whose symptoms are no longer adequately controlled with medication. Preliminary evidence suggests that subthalamic nucleus stimulation may also be efficacious in early Parkinson's disease, and results of animal studies suggest that it may spare dopaminergic neurons in the substantia nigra. Objective: We report the methodology and design of a novel Phase I clinical trial testing the safety and tolerability of deep brain stimulation in early Parkinson's disease and discuss previous failed attempts at neuroprotection. Methods: We recently conducted a prospective, randomized, parallel-group, single-blind pilot clinical trial of deep brain stimulation in early Parkinson's disease. Subjects were randomized to receive either optimal drug therapy or deep brain stimulation plus optimal drug therapy. Follow-up visits occurred every six months for a period of two years and included week-long therapy washouts. Results: Thirty subjects with Hoehn & Yahr Stage II idiopathic Parkinson's disease were enrolled over a period of 32 months. Twenty-nine subjects completed all follow-up visits; one patient in the optimal drug therapy group withdrew from the study after baseline. Baseline characteristics for all thirty patients were not significantly different. Conclusions: This study demonstrates that it is possible to recruit and retain subjects in a clinical trial testing deep brain stimulation in early Parkinson's disease. The results of this trial will be used to support the design of a Phase III, multicenter trial investigating the efficacy of deep brain stimulation in early Parkinson's disease.
Exploring Hypersexual Behavior in Men with Parkinson's Disease: Is it Compulsive Sexual Behavior?
Authors: Bronner Gila , Hassin-Baer Sharon
Published: December 2019

Background: A range of impulse control disorders has been described in Parkinson's disease, including compulsive sexual behavior. Excessive sexual demands of parkinsonian men can lead to considerable tension within the couple. Thorough sexual interviews reveal that these cases may reflect various types of sexual dysfunctions that present as hypersexuality. Objective: This study aims to analyze cases of presumed and true compulsive male sexual behavior, and to propose a practical tool for clinicians, assisting them with the diagnosis and management of compulsive sexual behavior and other sexual dysfunctions in parkinsonian patients. Methods: We describe four male patients with Parkinson's disease from the movement disorders clinic, which were referred to the sex therapist as suspected hypersexuality. Results: The sexual assessment revealed that only one of the cases involved true hypersexuality due to compulsive sexual behavior. The other three presented with erectile dysfunction, difficulties reaching orgasm (delayed ejaculation), and a gap in desire within the couple. Conclusions: Complaints about hypersexual behavior in patients with Parkinson's disease must be carefully evaluated, involving a multidisciplinary team. A comprehensive diagnostic and therapeutic algorithm is suggested.
Genetics and the Neurodegenerations: Musings of a Gadfly
Authors: Stern Gerald
Published: December 2019

An elderly perplexed clinician who has lived through the molecular revolution briefly considers the potential of genetics in elucidating the causes of neurodegenerations and expresses certain reservations.
Impaired Complex-I Mitochondrial Biogenesis in Parkinson Disease Frontal Cortex
Authors: Thomas Ravindar R. , Keeney Paula M. , Bennett James P.
Published: December 2019

Parkinson's disease (PD) can include a progressive frontal lobe α-synucleinopathy with disability from cognitive decline and cortico-limbic dysregulation that may arise from bioenergetic impairments. We examined in PD frontal cortex regulation of mitochondrial biogenesis (mitobiogenesis) and its effects on Complex-I. We quantified expression of 33 nuclear genome (nDNA)-encoded and 7 mitochondrial genome (mtDNA)-encoded Complex-I genes, 6 Complex-I assembly factors and multiple mitobiogenesis genes. We related these findings to levels of Complex-I proteins and NADH-driven electron flow in mitochondria from these same specimens reported in earlier studies. We found widespread, decreased expression of nDNA Complex-I genes that correlated in some cases with mitochondrial Complex-I protein levels, and of ACAD9, a Complex-I assembly factor. mtDNA-transcribed Complex-I genes showed ~ constant expression within each PD sample but variable expression across PD samples that correlated with NRF1. Relationships among PGC-1α and its downstream targets NRF1 and TFAM were very similar in PD and CTL and were related to mitochondrial NADH-driven electron flow. MicroRNA arrays revealed multiple miRNA's regulated >2-fold predicted to interact with PGC-1α or its upstream regulators. Exposure of cultured human neurons to NO, rotenone and TNF-alpha partially reproduced mitobiogenesis down-regulation. In PD frontal cortex mitobiogenesis signaling relationships are maintained but down-regulated, correlate with impaired mitochondrial NADH-driven electron flow and may arise from combinations of nitrosative/oxidative stresses, inflammatory cytokines, altered levels of mitobiogenesis gene-interacting microRNA's, or other unknown mechanisms. Stimulation of mitobiogenesis in PD may inhibit rostral disease progression and appearance of secondary symptoms referable to frontal cortex.
Vibration Therapy for Parkinson's Disease: Charcot's Studies Revisited
Authors: Kapur Sachin S. , Stebbins Glenn T. , Goetz Christopher G.
Published: December 2019

The 19th century neurologist, J-M Charcot, used a vibration chair for treating Parkinson's disease (PD). He documented improvement, but few subsequent studies examined vibration treatment. Using a specialized lounge chair, we conducted a rater blinded, randomized trial of body vibration vs. no vibration in 23 PD patients. The primary outcome measure was change from baseline in the motor section of the MDS-UPDRS. Both vibration and no vibration groups significantly improved after one month of daily treatments. However, there was no significant difference between the two treatment groups, suggesting that non-specific or placebo factors had an effect on PD motor function.
Predictors of financial self-sufficiency among Social Security beneficiaries with psychiatric disabilities
Authors: Russinova Zlatka , Rogers E. Sally , Ellison Marsha Langer , Bloch Philippe , Lyass Asya , Wewiorski Nancy
Published: December 2019

This study explored the predictors of financial self-sufficiency among Social Security beneficiaries with psychiatric disabilities. The study was conducted with individuals who were either past or current disability beneficiaries and who had sustained competitive employment as evidenced by their involvement in a longitudinal investigation on sustained employment among persons with serious mental illnesses. We conducted an exploratory cross-sectional study employing a survey methodology to determine what factors were associated with participants' capacity to leave the Social Security disability rolls due to gainful employment. We used a stepwise approach to data analysis to explore the association of demographic, clinical, vocational and motivational factors with financial self-sufficiency. Results suggested that individuals with higher occupational status, higher levels of proactive coping and without medical comorbidities were more likely to terminate Social Security disability benefits and achieve financial self-sufficiency due to gainful employment. Study findings can inform the development of innovative interventions targeting these malleable predictors associated with financial self-sufficiency among persons with psychiatric disabilities.
Supports and barriers to higher education and employment for individuals diagnosed with mental illness
Authors: Schindler Victoria P. , Kientz Mary
Published: December 2019

OBJECTIVE: This study examined supports and barriers to higher education and employment based on quantitative and qualitative reports of individuals diagnosed with mental illness who were enrolled in a program that addressed higher education and employment goals. PARTICIPANTS: Forty-eight adult participants with various mental health diagnoses. METHODS: A one-group posttest quantitative survey design and qualitative focus groups were used. RESULTS: The mean number of supports for higher education was 9.8 and for employment was 6.2. Quantitative supports with the highest endorsement rates reflected a combination of supports internal and external to the individual. The qualitative data reflected supports primarily external to the individual. The mean number of barriers for higher education was 4.8 and for employment was 4.25. Barriers common to both higher education and employment in the quantitative and qualitative data reflected internal barriers such as fears and anxieties, lost motivation and inability to concentrate. CONCLUSIONS: Quantitative and qualitative results demonstrate that substantial internal and external supports and barriers exist for individuals diagnosed with mental illness with goals of higher education and employment. Individuals would benefit from an approach that is customized and includes an evaluation of supports and barriers and internal and external resources to address them.
Supported employment – improving competitive employment for people with mental illness: The role of motivation and social network
Authors: Brantschen Elisabeth , Kawohl Wolfram , Rössler Wulf , Bärtsch Bettina , Nordt Carlos
Published: December 2019

BACKGROUND: Self-motivation, subjective norms, and support of social network are central factors in supported employment. OBJECTIVE: To measure these factors a short questionnaire was developed and tested. METHODS: 116 people with mental illness were enrolled. RESULTS: In the present study we found that self-motivation was high; 98% of the consumers think competitive employment is important or very important. The perceived motivation of the social network was also high, but significantly lower than self-motivation. Furthermore, the consumers assume that their social network supports their desire to work. CONCLUSION: People with mental illness are motivated to work, they are not idle.
One-Stop Career Center Customer Satisfaction Questionnaire:	Psychometric properties of an instrument that can be used by individuals with	and without disabilities
Authors: Gervey Robert , Gao Ni
Published: December 2019

Customer satisfaction is an important construct to measure within One-Stop Centers. Workforce Investment Boards have used mystery shoppers and various ad hoc measures of customer satisfaction to evaluate and monitor services and accessibility issues within the One-Stops for persons with disabilities. This paper describes an empirically derived, multidimensional customer satisfaction scale that can be used by persons with or without disabilities. Items were administered to a sample of 200 One-Stop customers, many of whom had numerous visits to the One-Stop setting over a 6-month period. A principle component factor analysis resulted in the development of a brief scale containing 24-items and four factors. Chronbach alpha reliability estimates are good. Concurrent validity studies are reported. Differences in customer satisfaction between persons with and without disabilities are examined.
Survey results from a national survey of community rehabilitation	providers holding special wage certificates
Authors: Inge Katherine J. , Wehman Paul , Revell Grant , Erickson Doug , Butterworth John , Gilmore Dana
Published: December 2019

The purpose of this paper is to present the findings from a national survey of a random sample of community rehabilitation programs (CRPs) that hold Special Wage Certificates established under Section 14(c) of the Fair Labor Standards Act (FLSA), 29 U.S.C. 214(c). The intent of the survey was to identify the types of services provided, the trends in the employment services, and the factors that were perceived as inhibiting and facilitating integrated employment outcomes. The survey results are categorized for this report in the following three areas: 1) characteristics of community rehabilitation programs, 2) organizational change trends, and 3) factors that influence the type of employment program utilized by consumers with disabilities.

Representative results from the survey are that overall, facility-based programs continue to be the predominant service provided by community rehabilitation programs holding 14(c) certificates. Of the 20,075 staff members identified as serving consumers, only 1,741 (8.7% are reported as working with individuals earning at least minimum wage. Although competitive employment and individual supported employment services among these CRPs are growing at a faster rate than other services, use of facility-based services continues to expand. Overall, the findings indicate that the organizations that provide daily services to those Americans with disabilities utilizing 14(c) certificates are continuing to predominately support facility-based work and non-work activities versus services leading to integrated employment outcomes.
Assistive technology: Impact on education, employment, and	independence of individuals with physical disabilities
Authors: Stumbo Norma J. , Martin Jay K. , Hedrick Brad N.
Published: December 2019

The purpose of this manuscript is to discuss how assistive technology impacts individuals with disabilities in relation to their education, employment, and ability to live independently. Appropriately selected and utilized assistive technology is imperative for individuals to approach an even par with their non-disabled peers. This paper specifically addresses a number of key questions: How important is assistive technology (AT) to the success of individuals with disabilities in education, employment, and achieving independence? If AT is important, in what ways is it important? What essential need(s) are met by the use of AT in education, employment, and independence? What remain as unresolved issues and questions regarding the use of AT by individuals with disabilities as they pursue postsecondary education, meaningful careers, and living independently? This review notes that AT is a foundational support that produces multiple and life-altering benefits. While we know much about the impact of AT on the lives of individuals with disabilities, many unanswered issues and questions remain.
The monetary benefits and costs of hiring supported employees: A	pilot study
Authors: Cimera Robert Evert
Published: December 2019

This paper illustrates the implementation of a new cost-accounting methodology that can be used to measure the monetary outcomes of supported employment from the perspective of employers. The methodology attempts to ascertain which "type" of employee (i.e., workers with disabilities versus workers without disabilities) is most economical for employers to hire. Avenues for future research are also presented.
A life-cycle perspective on the transition to adulthood among	children receiving Supplemental Security Income payments
Authors: Davies Paul S. , Rupp Kalman , Wittenburg David
Published: December 2019

Youth who receive cash benefits from the Supplemental Security Income (SSI) program, the largest federal program that provides cash payments to low-income youth with severe disabilities and their families, face several challenges in transitioning into adulthood. From a human capital development perspective, the disabilities and health problems during childhood and early adulthood as well as the family environment form important inputs that will likely influence long-term adult outcomes. This paper provides a review of some of the challenges these youth face in transitioning into adulthood using a life-cycle framework and presents descriptive statistics on their challenges and outcomes into early adulthood. Our summary illustrates the challenges that SSI youth face as they make the transition to adulthood and shows how the long-term employment and program outcomes of this population have changed over time. The findings provide a broader framework for the remaining five papers in this issue and underscore the need for rigorous testing of promising interventions and a carefully balanced mix of statistical and econometric analyses based on longitudinal data sources with a long time horizon.
Family caregiving and employment among parents of children with	disabilities on SSI
Authors: Rupp Kalman , Ressler Steve
Published: December 2019

Parental and family inputs are particularly important for children with disabilities receiving benefits from the Supplemental Security Income (SSI) program. These children often need disability or health-related care, and nonfamily sources provide only limited access. This is the first study to analyze family and nonfamily caregiving for these children with disabilities based on nationally representative quantitative data from the National Survey of SSI Children and Families (NSCF), a survey focusing on SSI recipient children with disabilities. The data suggests substantial variability in the need for caregiving among children on SSI. We find that there is also substantial variation in family inputs related to parental education, living arrangements, the presence of other children of preschool age and other factors that affect the quality and quantity of caregiving. Our analysis confirms that family caregiving is much more substantial for these children than nonfamily caregiving, and that caregiving from both sources is associated with various indicators of the nature and extent of disabilities. We find some – but weaker – evidence of an association between the child's disabilities and parental employment. Overall, while there is some substitution between parental employment and caregiving there appears to be a substantial net burden on the family arising from the child's needs for caregiving. We also find that there are significant predictors of family caregiving and parental employment that are unrelated to the child's disabilities. Most of these show opposite relationships to caregiving and parental employment – negative for one, positive for the other or vice versa. However, better parental education substantially increases the odds of both caregiving and parental employment. Parental disability sharply reduces the odds of parental employment and somewhat increases the odds of reported family caregiving. Overall, the challenges are especially substantial for single mothers who cannot share the extra burden of raising a child with severe disabilities with a spouse.
Providing supports to youth with disabilities transitioning to	adulthood: Case descriptions from the Youth Transition Demonstration
Authors: Luecking Richard G. , Wittenburg David
Published: December 2019

Post-school employment rates for youth with significant disabilities remain intractably low. An important policy concern is whether youth who receive disability cash benefits from the Social Security Administration (SSA) are obtaining the necessary supports to make a successful transition to adult life. The SSA initiated the Youth Transition Demonstration (YTD) projects in an attempt to develop services and supports to assist youth in making a successful transition into adulthood. This article provides a detailed description of the intervention components for the YTD projects and presents three case descriptions to illustrate how youth can potentially benefit from these services. The selected cases in this paper illustrate the potential for youth with disabilities to leverage project services and move into employment.
Gender differences in employment outcomes of individuals with developmental disabilities
Authors: Boeltzig Heike , Timmons Jaimie C. , Butterworth John
Published: December 2019

The paper presents employment outcomes of men and women with developmental disabilities (DD) who recently entered individual employment with the support of a community rehabilitation provider (CRP). The findings are based on an analysis of the National Survey of Community Rehabilitation Providers, Individual Employment Outcomes Survey, conducted between 2004 and 2005 by the Institute for Community Inclusion at the University of Massachusetts in Boston. Survey results show that while men and women with DD are earning meaningful wages, women with DD are working fewer hours in lower-wage jobs and earn less money, although only the latter was found to be statistically significant. Significant gender differences were found, however, with respect to the types of jobs men and women with DD held in individual employment. Overall, outcome findings suggest consistency with previous research. The paper concludes with a discussion of the implications of these findings and provides directions for future research.
Creating organizational commitment to change: Key to consumer employment success in a supportive housing agency
Authors: Gao Ni , Waynor William R. , O'Donnell Shannon
Published: December 2019

Supportive housing programs are highly effective in reducing recidivism and preventing homelessness among individuals with serious mental illness. However, supportive housing programs have not focused on increasing employment outcomes among consumers residing in their programs. In addition, creating organizational commitment among supportive housing providers towards improving consumer employment outcomes remains a major challenge. This article describes how an agency made an organizational transformation from providing traditional housing services to developing an in-house supported employment service, and successfully increased consumer competitive employment rates from 13% to 54% within two years. The organizational change strategies and interventions that can be generalized to other housing providers are discussed.
Challenges and opportunities related to the employment of people with multiple sclerosis
Authors: Rumrill Jr. Phillip D.
Published: December 2019

This article describes the current employment scene for individuals with multiple sclerosis (MS) and discusses a number of factors that have been associated with the high rate of joblessness among people with this chronic, unpredictable disease. Implications for research, policy, and vocational rehabilitation service delivery are presented throughout the article.
The relationship of self-management and disease modifying therapy use to employment status among adults with multiple sclerosis
Authors: Bishop Malachy , Frain Michael P. , Rumrill Phillip D. , Rymond Christopher
Published: December 2019

People with multiple sclerosis (MS) may face numerous barriers to employment retention. Comprehensively understanding these barriers is important for implementing effective vocational rehabilitation interventions. Although several demographic and MS-related variables have consistently been found to be related to employment status, self-management and adherence to treatment have infrequently been evaluated in this context. This article explores the relationships between employment status and the use of disease-modifying therapy and self-management among a community-based sample of adults with MS using both bivariate and multivariate analyses. Group comparisons between employed and unemployed adults with MS suggested that both self-management and DMT use are significantly related to employment. In a stepwise binary logistic regression analysis, age, duration in years diagnosed with MS, and scores on a multi-dimensional MS self-management scale were positively related to employment. The results are discussed in terms of their implications for rehabilitation intervention.
Predictors of vocational stability in multiple sclerosis
Authors: Fraser Robert T. , Clemmons David , Gibbons Laura , Koepnick David , Getter Amy , Johnson Erica
Published: December 2019

This study examined salient disability, demographic, psychosocial, and neuropsychological variables as predictors of employment stability for vocational rehabilitation clients with MS served at the University of Washington (1998–2003). Although a number of variables were initially significantly related to vocational stability (e.g., Personal Capacities Questionnaire score, number of months employed in the last 2 years, and the Activities of Daily Living-MS Scale score), only the FAS Controlled Oral Word Association Test-3, a measure of verbal fluency and executive functioning, remained significant (p < 0.01) when controlling for multiple comparisons. Implications are discussed in relation to vocational rehabilitation assessment and intervention planning.
Spreading a positive message about work, earnings and benefits through peer networking: Findings from the Peer Employment Benefits Network
Authors: Sulewski Jennifer Sullivan , Kugler Rick , Kramer John
Published: December 2019

Misunderstanding and fears about the impact of earnings on benefits represent a significant barrier in the return-to-work efforts of people with disabilities. This pilot project evaluated an approach to spreading a positive message about work and dispelling myths about the effects of work on Social Security benefits through outreach and networking in the disability community. A peer leadership project was developed by enlisting 33 people with disabilities, mainly through disability advocacy organizations, who had experience with disability benefits. They received several days of basic training about work incentives, networking strategies, and community resources that support employment. These peer leaders then developed and pursued outreach plans in their communities. Peer leaders reported making 1046 contacts through their personal networks. One hundred and thirty of the people contacted participated in a survey rating the quality of the interaction and their activities involving employment. The majority of respondents reported they had received helpful information from the peer leaders and had less concern about the negative effects of work on benefits; approximately one-quarter took some steps toward going to work. The evidence from this project suggests that a peer to peer approach may be effective in promoting a positive message about and creating interest in employment.
Assessment of vocational functioning in serious mental illness: A review of situational assessment and performance based measures
Authors: Peer Jason E. , Tenhula Wendy
Published: December 2019

There has been an intensified focus on assessment of community functioning in individuals with serious mental illness (SMI). Several reviews of functional measures for SMI have been published, yet the assessment of vocational functioning has received limited attention. The purpose of this review was to describe existing measures of vocational functioning developed for individuals with SMI. Twelve measures were identified: 9 situational assessments and 3 performance based measures. Information on the development, intended purpose, administration and psychometric properties of each measure was compiled from published reports. To further evaluate and compare these measures they were each rated on 4 criteria: practicality, reliability, validity, and comprehensiveness. Results indicated that no single measure emerged as superior across all criteria. Most measures had adequate reliability and tended to be well validated, particularly those developed in a research context, while situational assessments had greater practicality. Few measures provided information on their sensitivity to change as a result of intervention. Suggestions for use of specific measures for clinical assessment and outcome evaluation purposes are presented. Challenges to implementation of these measures in contemporary vocational rehabilitation settings are identified and the need for further research in this area is highlighted.
Choosing and choice making are not the same: Asking “what do you want for lunch?” is not self-determination
Authors: Agran Martin , Storey Keith , Krupp Michael
Published: December 2019

Promoting choice making has become an important focus of disability services and supports and a basic component in service delivery. Although much of the choice making literature has involved demonstrations that individuals with intellectual and severe intellectual disabilities can be taught to make choices, limited research exists on the types of choices individuals make and the extent to which these choices are supported. Further, input about choice making has ostensibly been obtained from service providers or support personnel and not from consumers themselves. This study examines input provided by consumers with varying support needs, served in different types of employment programs, on the choice-making opportunities they were provided, if their choices were supported, and if they thought choice making was important, among other questions. The implications of the findings are discussed.
The effects of multiple categorization on perceptions of discrimination, life domains, and stress for individuals with severe mental illness
Authors: Glover Crystal M. , Corrigan Patrick , Wilkniss Sandra
Published: December 2019

The purpose of this paper is to provide further understanding of the influence of multiple categorization on perceptions of discrimination in people with severe mental illness (SMI), including reasons they feel discriminated against (e.g. race) and in what context (e.g. employment). Multiple categorization is defined as simultaneously belonging to race (i.e. Black, White) and gender (i.e. male, female) groups. This paper addresses four questions: 1. How do four subgroups (i.e. Black males, Black females, White males, and White females) of individuals with SMI differentially perceive discrimination? 2.How do these subgroups differentially perceive discrimination as occurring due to various categorizations (i.e. mental disability/ability, race, and gender)? 3. How do these subgroups differentially perceive being discriminated against in life domains (i.e. employment, education, and housing)? 4. How do these subgroups differentially experience stress related to discrimination in life domains? Six hundred and four individuals with SMI participating in the baseline interview for a study on consumer operated services completed a four-part Discrimination Questionnaire. Analyses indicated multiple categorization (i.e. belonging to different subgroups such as White females) influences feeling discriminated against, attributions of discrimination to various categorizations, and stress related to discrimination in employment. However, findings did not indicate multiple categorization influences discrimination in employment.
Rehabilitation readiness: A construct validity study of the University of Rhode Island Change Assessment for Vocational Counseling (URICA-VC) scale for persons with mental illness
Authors: Gervey Robert
Published: December 2019

Purpose/objectives: The study aims to confirm the factorial structure of the URICA-Vocational Counseling (URICA-VC), a scale that has been specifically designed for use in vocational rehabilitation programs. Furthermore, the study explores the clinical utility of the URICA-VC readiness construct within a sample of individuals with psychiatric disabilities seeking competitive employment. Research method/design: Using a sample of 296 individuals with psychiatric disabilities pooled from three separate programs, the author examined the construct validity of the scale using factorial structural analysis, discriminative validity and predictive validity tests. Results: The results confirm the URICA-VC three-factor solution. These three factors discriminate between individuals with varying levels of interest and involvement in vocational rehabilitation services. However, predictive validity is mixed. Conclusion/implications: The use of the URICA-VC for clinical decision-making and research purposes should be carefully considered given the degree of false negatives and positives generated by stage of change categories.
The effects of peer tutoring interview skills training with transition-age youth with disabilities
Authors: Bobroff Sheryl , Sax Caren L.
Published: December 2019

This paper examines the effectiveness of peer tutors teaching interview skills to transition-age youth with disabilities. Findings from studies show that students with disabilities do not receive adequate instruction in preparing for employment due to a variety of reasons. One strategy to improve employability skills is through the use of well-trained peer tutors to assist in teaching interviewing strategies. Providing training, structure, and support are important to designing a successful peer-tutoring program. Peer tutoring is beneficial to both tutors and tutees; it provides opportunities for self-advocacy and self-determination. The 6 students who participated in this 11-week study improved their interviewing skills when compared to their baseline data. Students with histories of behavior problems engaged in positive social interactions. Initial results indicate that the use of peer tutoring is an effective approach for students with disabilities to improve their abilities to interview for employment.
Effectiveness of a comprehensive, manualized intervention for improving productivity and employability following brain injury
Authors: Niemeier Janet P. , DeGrace Shy M. , Farrar Lindsay F. , Ketchum Jessica S. , Berman Alice J. , Young Jason A.
Published: December 2019

Unemployment rates continue to hover at 39% for persons with brain injury because of persistent neurobehavioral deficits that limit their employability. This paper reports findings of a prospective, repeated measures design and controlled trial of a 20-session, manualized, employability-enhancing intervention for community-dwelling persons with acquired brain injury attending six work-centered clubhouses. A total of 71 clubhouse members were assigned, in order of their signing up to participate in the study, to either receive the 20 intervention sessions or to be in a waiting control group. Employment and productivity status were measured pre- and post-treatment. Analyses revealed modestly significant treatment effects for employment status and productivity. The program also appears to have a positive effect on job stability. These results were moderated by whether the participant had disability income and their ratings, by clubhouse staff, of their employability. Persons who had disability income and had high employability ratings from staff were less likely to be employed following treatment. There was not a significant difference between treatment and control participants in work-related knowledge, employability ratings, or a measure of effort in the rest of the clubhouse program activities.
The impact of the Great Recession upon the unemployment of Americans with disabilities
Authors: Fogg Neeta P. , Harrington Paul E. , McMahon Brian T.
Published: December 2019

Recent data from the U.S. Bureau of Labor Statistics allows assessment of the impact of the Great Recession on working age persons with disabilities in America. Following an overview of the nature and scope of the Great Recession, the labor market experiences of persons with and without disability are compared for 16 of the 22 months of its duration. Differences which favor those without disabilities were detected in the labor market activity rate, the official unemployment rate, and in the desire for work among those who have quit the workforce. These differences persist among subgroups based upon age and educational attainment. The level of educational attainment appears to not provide the same level of insulation from the consequences of labor market downturns for persons with disabilities as it does for persons without disabilities. Finally, the reasons for unemployment are quite different for persons with and without disabilities.
Job matching assessment: Inter-rater reliability of an instrument assessing employment characteristics of young adults with intellectual disabilities
Authors: Morgan Robert L.
Published: December 2019

Job matching has been defined as an assessment of individual characteristics in relation to job requirements. The purpose of this study was to assess the inter-rater reliability of a job matching assessment instrument designed for young adults with disabilities. Participants included 21 young adults with intellectual disabilities. Post-high school teachers and job coaches served as raters. The young adult participants first identified 2–3 preferred jobs. Five pairs of raters completed the job matching assessment to identify the job that was best matched to the participant's current characteristics. Ratings were based on 106 O*NET job dimensions related to knowledge, skill, and ability. Findings indicated relatively high inter-rater agreement. However, across job dimensions, data indicated high variability with disagreements apparent for particular ones (e.g., Knowledge of English Language, Safety Awareness Skill). Findings are discussed in relation to the importance of identifying preferred, well-matched jobs for individuals with intellectual disabilities.
Impact of early intervention programs for working adults with potentially disabling conditions: Evidence from the national DMIE evaluation
Authors: Gimm Gilbert , Ireys Henry , Gilman Boyd , Croake Sarah
Published: December 2019

This article presents initial findings from the national DMIE evaluation, which used random assignment to test whether a program of enhanced health and employment supports for working adults with potentially disabling conditions can reduce the likelihood of applying for federal disability benefits and improve employment retention. Analyses are based on a total of 4,054 participants in demonstrations from four states (Hawaii, Kansas, Minnesota, and Texas). The demonstration was effective in reducing applications to federal disability programs 12 months after enrollment using combined data from the two largest state demonstrations (4.8 percent in the treatment group versus 6.9 percent in the control group). Evidence of short-term impacts on monthly hours worked was mixed across the states. Although these initial findings suggest modest positive effects of an early intervention program, longer term effects should be examined in future studies.
Preventing disability among working participants in Kansas' high-risk insurance pool: Implications for health reform
Authors: Hall Jean P. , Moore Janice M. , Welch Greg W.
Published: December 2019

Health conditions that prevent individuals from working full time can restrict their access to health insurance. For people living in the 35 states that offer high-risk pools, coverage is available but premiums are 125–200% of standard rates. Additionally, high cost-sharing means enrollees often defer needed care because they must pay large amounts out of pocket. Lack of access may lead to poor health outcomes and disability. The Kansas DMIE investigated whether improving insurance coverage for such a group would improve their health status and reduce their risk of transition to full Social Security disability. Half of the 508 participants received enhanced benefits and nurse case management, the other half received usual risk pool coverage. Outcomes were measured through telephone surveys, focus groups, and claims analysis. Utilization of services increased and health status stabilized for the intervention group, while health status of the control group significantly declined. These findings have broad implications because some plans to be offered under the Patient Protection and Affordable Care Act of 2010 (P.L. 111–148) have similarly high out-of-pocket costs. Considering the long-term cost of full disability, providing adequate health insurance benefits for individuals at high risk of disability may be cost effective.
Community action teams: An infrastructure for quality service delivery
Authors: Smith Tammy Jorgensen , Clark Brenda , DiLeo Dale
Published: December 2019

This article describes a four-year initiative designed to lay the groundwork for building a sustainable training and technical assistance system in supported employment for community rehabilitation providers, individuals with disabilities, and other stakeholders in Florida. The Supported, Competitive, Integrated Employment Training Teams (SCIETT) project has demonstrated the development of Community Action Teams, a major component of the Employment First Movement, and brings lessons learned to assist other states and communities in replicating the process.
Individual placement and support illustrated in the Swedish welfare system: A case study
Authors: Bejerholm Ulrika , Larsson Lars , Hofgren Caisa
Published: December 2019

Individual Placement and Support (IPS) results in more people with severe mental illness obtaining employment in comparison to traditional vocational rehabilitation approaches. The implementation challenges of IPS vary across countries and contexts. However, the implications for IPS delivery and thus the IPS principles have not been studied in Sweden, which this embedded case study aims to investigate. The study was bounded by a single case, which was equivalent to the implementation of IPS in a Swedish city over 18 months. Data was collected from multiple units of information and consisted of interviews, documents and audio materials. A content analysis was used. The results showed that the first four IPS principles were challenged by the welfare system. Work capacity, in terms of amount of working hours per week, was evaluated differently in IPS and in the welfare system's prevocational services. In addition, the type of welfare benefit was decisive for IPS delivery and could be withdrawn if the IPS participant did not enter the prevocational rehabilitation situated within the welfare service. The differences of vocational approaches as experienced by professionals led to frustration, but also positive statements regarding how to increase integration between the welfare services and IPS. The authors discuss the tangible result and suggestive recommendations are made.
Work Incentive Counseling as a workplace support
Authors: Kregel John , O'Mara Susan
Published: December 2019

Many Social Security disability beneficiaries are employed and many more would like to enter or reenter the workforce. Among the self-reported obstacles to employment identified by beneficiaries are: (1) fear of losing benefits; (2) fear of losing health care coverage; and (3) unpredictable administration of available Social Security work incentives. Work Incentive Counseling is an employment support that can assist beneficiaries to overcome these obstacles and pursue their self-chosen employment and financial independence goals. Available data confirm that Work Incentive Counseling is a cost-effective support that improves the employment outcomes of Social Security disability beneficiaries.
Post-course outcomes of apprenticeships and traineeships for people with disability in Western Australia
Authors: Lewis Greg , Thoresen Stian H. , Cocks Errol
Published: December 2019

Whilst the literature consistently argues that vocational education and training, including apprenticeships and traineeships, contribute to positive employment outcomes for people with disability, little is documented regarding their post-course outcomes, particularly over time. This paper presents a retrospective outcome analysis of 253 apprentices and trainees with disability who were placed and supported by EDGE Employment Solutions (EDGE) between 2000 and 2010. EDGE, established in 1984 as a Disability Employment Service (DES) in Perth, Western Australia, has actively pursued apprenticeships and traineeship for people with disability in Australia since the 1990s. Post-course outcomes, including income, hours worked, and job durability, were analysed and compared with matched pairs of current EDGE registrants with similar socio-demographic characteristics who had not commenced an apprenticeship or traineeship. The retrospective outcome analysis found significantly better post-training outcomes for participants in the “completed” apprenticeship cohort than those achieved by their matched pairs. Improved outcomes were evident in higher hourly wages, more hours worked per week, higher weekly wages, and greater job durability. Better outcomes were also achieved by participants in the “completed” traineeship cohort and “did not complete” apprenticeship cohort. The outcomes for participants in the “did not complete” traineeship cohort did not differ significantly from the comparison group on most outcome measures.
The impact of work incentive benefits counseling on employment outcomes: Evidence from two return-to-work demonstrations
Authors: Delin Barry S. , Hartman Ellie C. , Sell Christopher W.
Published: December 2019

This study examined the influence that different amounts of work incentive benefits counseling had on consumers' employment outcomes. It also examined the influence of prior employment on service provision. Data were combined from two return-to-work projects in Wisconsin. Participants were volunteers receiving Social Security disability benefits and typically had stronger post-disability employment histories than the general SSDI and SSI populations. The amount of benefits counseling provided had positive and statistically significant impacts on all three outcomes, with estimated gains of $34 in earnings and $37 in income in each calendar quarter over a two year period. The gain in the quarterly employment rate was 1.1%. Having strong employment outcomes in the period between establishing eligibility for a Social Security disability program and entering one of the return-to-work projects proved a strong predictor of how much service an individual participant received.