Predictors of Competitive Employment for Blind and Visually Impaired Consumers of Vocational Rehabilitation Services

In this study, four variables were found to have a significant association with competitive employment outcomes for blind and visually impaired consumers of vocational rehabilitation services. These variables were the receipt of education as a rehabilitation service that resulted in an educational certificate or degree, having worked since the onset of the disability, reason for applying to vocational rehabilitation related to obtaining a job, and the relationship between the counselor and the consumer being rated as high quality. People who are visually impaired have traditionally had difficulty obtaining employment. According to the American Foundation for the Blind (n.d.), an estimated 40%-45% of working-age persons who are visually impaired are employed. Although this current estimate is higher than the dismal percentages that have traditionally been reported (Dickerson, Smith, & Moore, 1997), it is still low. It is lower than the estimates for people with other disabilities and much lower than the employment rate of the general population (Kirchner, Schmeidler, & Todorov, 1999). For this reason, there have been numerous studies on the employment of persons who are visually impaired. Specifically, a considerable amount of research has been conducted on the employment outcomes of visually impaired persons, particularly consumers of vocational rehabilitation services (see, for example, Giesen & Ford, 1986; Giesen et al., 1985; Hill, 1989; Kirchner & Johnson, 1997; Kirchner & Peterson, 1982; Knowles, 1969). Generally, the purpose of this type of research is to determine the consumers' characteristics or variables that are associated with successful outcomes for these consumers. This information can then be used to help providers of rehabilitation services identify consumers who may have more difficulty achieving a successful employment outcome and to intervene to increase the likelihood of successful employment. In addition, if specific service-related factors are identified as being related to successful outcomes, file:///A|/H-Capell.txt (1 of 18)6/1/2005 8:06:31 AM file:///A|/H-Capell.txt rehabilitation counselors can use this information to decide which services to provide to consumers. Until recently, the only large source of data on vocational rehabilitation consumers has been the yearly data set published by the federal Rehabilitation Services Administration: the RSA-911 database. Now a longitudinal data set of such consumers has become available for public use: the Longitudinal Study of the Vocational Rehabilitation Services Program (LSVRSP). A multitude of studies are possible with these data, but of particular interest to the field of visual impairment is the issue of competitive employment for consumers of vocational rehabilitation services. Review of the literature In one of the earliest studies on employment issues for blind or visually impaired consumers of vocational rehabilitation services, Knowles (1969) used data on 461 legally blind consumers in the Los Angeles area to investigate differences between those whose vocational rehabilitation was successful versus those for whom it was not. He used both univariate and multivariate techniques to analyze his data and determined that the five variables that had the most important relationship to the success of vocational rehabilitation services were good orientation and mobility skills, a high level of vocational classification prior to rehabilitation, a younger age at the onset of visual impairment, a greater number of years of visual impairment, and a younger age at the start of rehabilitation. Kirchner and Peterson (1982) evaluated the vocational rehabilitation outcomes of visually impaired consumers during fiscal year 1980 using nationwide data on vocational rehabilitation (from the R-300 form, which was the predecessor to the RSA-911 data). Based on comparisons of percentages across these groups, they focused their investigation on consumers whose cases were closed in homemaker status, but included a comparison with those whose cases were closed in competitive employment and sheltered workshops. They found that consumers whose cases were closed in competitive employment were more likely to have a lesssevere visual impairment, to have only one disability (visual impairment), to be male, to be younger, not to receive social security benefits, and to be employed at the time of their application for services. A comprehensive study that addressed the employment outcomes of legally blind consumers of vocational rehabilitation services was conducted by Giesen et al. (1985). In addition to their own analyses, the researchers provided a thorough review of the literature on employment outcomes (through the early 1980s) for file:///A|/H-Capell.txt (2 of 18)6/1/2005 8:06:31 AM file:///A|/H-Capell.txt individuals who were blind or visually impaired. Their sample consisted of 619 consumers from four strategically selected state vocational rehabilitation agencies for persons who are blind. The study incorporated approximately 100 potential predictor variables in the stepwise discriminate analysis of types of employment outcomes (competitive, homemaker, sheltered workshop, or unemployed). Of the 52 significant variables that were identified in this analysis, the most important predictors of the types of employment outcomes were (in order of importance) age at the onset of blindness, the rating of the original occupational goal on the total raw score vocational quotient job-difficulty index, expenditures for personal or vocational adjustment training, gender, the primary source of support at referral, the highest grade completed, the receipt of noninstitutional training, the receipt of institutional training (education or business or vocational school training), the receipt of physical restoration services, and the number of additional disabilities. Other variables that also significantly predicted employment were the receipt of social security disability insurance during the rehabilitation process, the number of occupations held prior to referral, the time (in months) from the previous occupation and referral, the length of employment in the previous occupation, and race. Consumers whose cases were closed in competitive employment were significantly different from those whose cases were closed with other outcomes in the following ways: They were more likely to have personal sources of support at referral, to have had the highest number of years of education at application, to have received more institutional training, to have had the fewest number of additional disabilities, and to have had a higher score on the job-difficulty index for their original vocational goal. Giesen and Ford (1986) conducted a similar study with the same sample of 619 vocational rehabilitation consumers, but focused on persons whose cases were closed as unsuccessful and how they differed from those whose cases were closed in competitive employment, homemaker status, or employment in sheltered workshops. Hill (1989) conducted a study of the determinants of employment outcomes for blind and visually impaired consumers who were successfully rehabilitated by state vocational rehabilitation agencies. She, like Giesen et al. (1985), investigated the specific categories of successful closure. Using national R-300 data for fiscal year 1982, Hill compared consumers whose cases were closed in competitive employment, in sheltered workshops, and in self-employment with those whose cases were closed as homemakers, using a multinomial logit model. file:///A|/H-Capell.txt (3 of 18)6/1/2005 8:06:31 AM file:///A|/H-Capell.txt She primarily evaluated the effects of the characteristics of individual consumers and the vocational rehabilitation services they received on the type of outcome. Overall, the most important predictors of work status were age at the closure of the case and gender, with younger age and being male associated with better employment outcomes. Other variables that specifically predicted competitive closure over homemaker closure were a greater number of years of education completed; a less-severe visual impairment; never having been married; and the receipt of personal adjustment training, on-the-job training, or receiving a college education as a service. The presence of a major secondary disability reduced the likelihood that the consumer's case would be closed in competitive employment, whereas the presence of a minor secondary disability increased the likelihood. Leonard, D'Allura, and Horowitz (1999) conducted a study of the factors that are associated with employment among blind and visually impaired consumers of vocational placement services from a private rehabilitation organization (Lighthouse International). They collected their data by telephone interview and were able to include many variables that were not available in other analyses of employment outcomes of persons who are blind or visually impaired. They used logistic regression to determine which factors could predict employment at follow-up after the receipt of vocational placement services. Unfortunately, their sample was small (N = 91), and their analyses may not have had sufficient power. The only significant predictors in their model were having attended an integrated school, using print as the primary reading medium, and having received technology training. These results may have been different from those of other studies because the researchers had many unique variables to choose from for inclusion in their model and included only those that had the greatest bivariate correlation with employment status. Additional factors may have been that a population other than consumers of vocational rehabilitation services was used and that long-term employment, rather than employment at the closure of the cases, was evaluated. A study by Kirchner et al. (1999) also used a population other than consumers of vocational rehabilitation services. Using the nationally representative 19941995 National Health Interview Survey on Disability (NHIS-D) data, they conducted several analyses that focused on employment in conjunction with age, health, and level of vision loss (blind or legally blind versus other visual impairments). This data was collected by the National Center for Health Statistics. These variables were found to be significantly related to whether a visually impaired person was employed. Kirchner et al. also identified file:///A|/H-Capell.txt (4 of 18)6/1/2005 8:06:31 AM file:///A|/H-Capell.txt additional variables that had an influence on employment, such as whether the person had ever worked for pay and whether the person had an additional disability. An "interest in working" was thought to be a potentially important factor in whether individuals were employed, but the NHIS-D database did not include a suitable variable to assess this possibility. Self-reported health status was found to have a profound effect on employment status, particularly for those who were aged 18-54. When the effects of both health status and multiple impairments were combined for those aged 18-69, the results were dramatic. These results were especially striking for those who are legally blind: only 30% of those who reported excellent or good health and had multiple disabilities were employed, whereas 70% of those who reported excellent or good health and a single disability (blindness) were employed. (It should be noted that 80% of the legally blind persons in this study had multiple disabilities.) The percentages for those with less-severe visual impairments were 56% and 73%, respectively. Using logistic regression, Kirchner et al. (1999) also evaluated the effects of a larger combination of factors on the employment rates of these individuals. They determined that race or ethnicity and education, in addition to age and health, were important predictors of employment. Gender was not found to be a predictor of employment in their model. The variables that previous students have commonly found to be associated with employment or employment outcomes for blind and visually impaired consumers are gender, educational level, having additional disabilities, work history information, the receipt of financial assistance, level of vision loss, age at the onset of vision loss, and current age, with race sometimes providing relevant information for the analyses (Giesen & Ford, 1986; Giesen et al., 1985; Hill, 1989; Kirchner & Peterson, 1982; Kirchner et al., 1999; Knowles, 1969). I used the results from the prior research in this area to help determine which variables to include in the current analysis. The research question investigated was, Which variables are associated with successful employment outcomes for blind and visually impaired consumers of vocational rehabilitation services? I was also interested in determining the size of the effect (the importance) of each variable on success in achieving competitive employment.