Evaluating differences in demographics, services, and outcomes for vocational rehabilitation consumers with hearing loss versus consumers with other disabilities. (Hearing Loss vs. Other Disability Groups).Many persons with disabilities are excluded from full participation in the nation's labor force (Louis Harris Louis Harris (born 6 January 1921) is an American opinion-polling entrepreneur, journalist, and author. He ran one of the best-known polling organizations of his time, Louis Harris and Associates (LHA) which conducted so-called Harris polls. & Associates, 1998). This is a major reason for the existence of the federal-state vocational rehabilitation Noun 1. vocational rehabilitation - providing training in a specific trade with the aim of gaining employment rehabilitation - the restoration of someone to a useful place in society (VR) program. The primary goal of this program, under the direction of the Rehabilitation rehabilitation: see physical therapy. Services Administration (RSA (1) (Rural Service Area) See MSA. (2) (Rivest-Shamir-Adleman) A highly secure cryptography method by RSA Security, Inc., Bedford, MA (www.rsa.com), a division of EMC Corporation since 2006. It uses a two-part key. ), is to assist those with disabilities obtain, or retain, employment. For over 75 years, VR has improved the lives of persons with disabilities by providing an individualized in·di·vid·u·al·ize tr.v. in·di·vid·u·al·ized, in·di·vid·u·al·iz·ing, in·di·vid·u·al·iz·es 1. To give individuality to. 2. To consider or treat individually; particularize. 3. program of services leading to employment outcomes that result in notable gains in their economic status (Department of Education, 1999). Despite the value of this program, many persons with disabilities experience difficulties in obtaining jobs even after the provision of rehabilitation services. For example, of the consumers closed during fiscal year 1997 who received VR services, 61% obtained some form of employment, while the remaining 39% did not (Capella Capella, brightest star in the constellation Auriga; Bayer designation α Aurigae; 1992 position R.A. 5h16.1m, Dec. +45°59'. Capella is a yellow giant star of spectral class G8 III and is also a spectroscopic binary star with a component , 2001). Several authors have evaluated the efficacy efficacy /ef·fi·ca·cy/ (ef´i-kah-se) 1. the ability of an intervention to produce the desired beneficial effect in expert hands and under ideal circumstances. 2. of the VR program, either overall or by individual state program, primarily targeting employment as the key outcome variable (e.g., Butterworth, Schalock, & Gilmore Gilmore is a surname, and may refer to: People
American mathematician and physicist who formulated the theoretical foundation of physical chemistry, developed vector analysis, and conducted optical and thermodynamic research. Noun 1. , 1990; Platt n. 1. (Mining) See Lodge, n. os> , 1995; Walls, Misra, & Majumder, 2002). Although not evaluated as frequently, another relevant question is whether the VR services received and related outcomes differ by type of disability. In particular, this is a relevant question for individuals with hearing loss (Note: for brevity Brevity Adonis’ garden of short life. [Br. Lit.: I Henry IV] bubbles symbolic of transitoriness of life. [Art: Hall, 54] cherry fair cherry orchards where fruit was briefly sold; symbolic of transience. , this term will be used to represent all persons who are deaf, late-deafened, hard of hearing, or deaf-blind), as success in obtaining employment through VR services by this group has decreased substantially (Rehabilitation Services Administration [RSA], 2000). Even though the prevalence prevalence /prev·a·lence/ (prev´ah-lins) the number of cases of a specific disease present in a given population at a certain time. prev·a·lence n. of hearing loss has increased (Ries, 1994; RSA, 2000), RSA recently noted a 10-year decline in the total number of successfully rehabilitated VR consumers with hearing loss (RSA, 2000). The percentage of consumers with hearing loss, of the total number of consumers successfully rehabilitated each year, has also declined during this period. This trend prompted RSA to call for state agencies to examine their policies and procedures Policies and Procedures are a set of documents that describe an organization's policies for operation and the procedures necessary to fulfill the policies. They are often initiated because of some external requirement, such as environmental compliance or other governmental related to caseloads of consumers with hearing loss. Research is necessary to investigate this issue. The University of Arkansas The University of Arkansas strives to be known as a "nationally competitive, student-centered research university serving Arkansas and the world." The school recently completed its "Campaign for the 21st Century," in which the university raised more than $1 billion for the school, used Rehabilitation Research and Training Center for Persons who are Deaf or Hard of Hearing has been mandated to conduct research in this area during its current 5-year funding period. This study represents the first piece of research in a series of projects. Investigating outcomes for persons with hearing loss is also important when one considers the large number of individuals in this group. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. a recent Vital and Health Statistics report, published by the National Center for Health Statistics National Center for Health Statistics (NCHS) is part of the Centers for Disease Control and Prevention (CDC), which is part of the United States Department of Health and Human Services. NCHS is the United States' principal health statistics agency. , 8.3% of the population in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. has a hearing loss (Adams Adams, town (1990 pop. 9,445), Berkshire co., NW Mass., in the Berkshires, on the Hoosic River; inc. 1778. Its manufactures include chemicals, textiles, and paper products. The Berkshire region attracts tourists year-round. , Hendershot, & Marano, 1999). Approximately ap·prox·i·mate adj. 1. Almost exact or correct: the approximate time of the accident. 2. 11.5 million persons between the ages of 18 and 64 have some level of hearing loss (Adams et al., 1999). Given that they are of working age, these people would potentially be candidates for VR services. Despite the high incidence of hearing loss in the population, the percentage of persons with hearing loss served by VR is relatively low in terms of the total population of all those who receive services. The low levels of participation and decrease in successful outcomes for consumers with hearing loss could be related to a variety of factors. One hypothesis An assumption or theory. During a criminal trial, a hypothesis is a theory set forth by either the prosecution or the defense for the purpose of explaining the facts in evidence. is that the VR system may not be meeting the needs of this group of consumers. This failure could result in fewer successful closures, as well as fewer persons from this group seeking VR services. A section of the 19th Institute on Rehabilitation Issues document, "Serving the Underserved--Principles, Practices, and Techniques" focused on persons who are hard of hearing (Corthell & Yarman, 1992). This document reported that this population frequently does not receive appropriate services, as VR counselors are often inexperienced in·ex·pe·ri·ence n. 1. Lack of experience. 2. Lack of the knowledge gained from experience. in and not aware of the multiple services persons who are hard of hearing may need. One avenue to begin assessing the hypothesis that the VR system is not meeting the needs of the entire group of consumers with hearing loss is to make comparisons between them and VR consumers with other disabilities. This type of assessment will provide information that may lay the groundwork for additional research. It is also a good starting point Noun 1. starting point - earliest limiting point terminus a quo commencement, get-go, offset, outset, showtime, starting time, beginning, start, kickoff, first - the time at which something is supposed to begin; "they got an early start"; "she knew from the because data is currently available from RSA to make the comparisons of interest. Other authors previously examined the employment outcomes of persons with hearing loss served by VR through analysis of extant ex·tant adj. 1. Still in existence; not destroyed, lost, or extinct: extant manuscripts. 2. Archaic Standing out; projecting. case service data on the state or national level (El-Khiami, 1986; Moore Moore, city (1990 pop. 40,761), Cleveland co., central Okla., a suburb of Oklahoma City; inc. 1887. Its manufactures include lightning- and surge-protection equipment, packaging for foods, and auto parts. , 2001a, 2001b; Moore & Schroedel, 2001a, 2001b). Overall, VR services lead to positive employment outcomes for significant numbers of this population. For example, Walls and Fullmer (1997) compared the types of employment obtained by consumers with different disabilities. Their results indicated that persons with hearing loss obtained jobs that were comparable to other disability groups. Moore (2001a) examined RSA-911 data for fiscal year 1996 to determine, among other objectives, whether certain VR services were significantly associated with successful closures for persons with hearing loss. All four services he evaluated (assessment, restoration, counseling and guidance, and job placement) were associated with successful closure. Moore (2001b) also examined fiscal year 1997 RSA-911 data to evaluate differences in services received and employment outcomes for successfully closed consumers in three categories: deaf, hard-of-hearing adj. 1. having a reduced ability to hear, but not fully deaf; partly deaf. Adj. 1. hard-of-hearing - having a hearing loss hearing-impaired deaf - lacking or deprived of the sense of hearing wholly or in part , and late deafened deaf·en v. deaf·ened, deaf·en·ing, deaf·ens v.tr. 1. To make deaf, especially momentarily by a loud noise. 2. To make soundproof. v.intr. . The relationship between VR services and work status at closure was also investigated, with the finding that college or university training, business or vocational Vocational Relating to an occupation, career, or job. Mentioned in: Myers-Briggs Type Indicator training, on-the-job on-the-job adj. Acquired or learned while working at a job: on-the-job training. Adj. 1. on-the-job training, and job placement were predictive of competitive employment at closure for this population. Moore and Schroedel (2001a) recently took another step in evaluating VR service delivery to individuals with hearing loss, by providing descriptive information on the demographic characteristics, VR services, and case outcomes for subgroups of this population, as well as providing comparisons with the general population of VR consumers. I took the next step in evaluating VR services and outcomes for consumers with hearing loss, by using statistical analyses to compare their experiences and outcomes to those of the general population of persons served by VR (i.e., persons from other disability groups). The purpose of this project was to evaluate VR service delivery for consumers with hearing loss. Acceptance rates, characteristics of persons served, services provided, and resulting employment outcomes were examined through analysis of national case services data. This study compared participation and outcomes of the target population with the general population of rehabilitation consumers with other types of disabilities. The primary research questions investigated were: 1. How do acceptance rates of consumers with hearing loss compare to consumers with other disabilities? 2. How do demographic characteristics of consumers with hearing loss compare to consumers with other disabilities? 3. How do specific services received by consumers with hearing loss compare to consumers with other disabilities? 4. How do costs of services received by consumers with hearing loss compare to consumers with other disabilities? 5. How do employment outcomes of consumers with hearing loss compare to consumers with other disabilities? The demographic variables evaluated in this study were (a) sex, (b) age, (c) education level, (d) race, (e) severity of disability, and (f) work status at application. All 17 services listed in the RSA-911 data were included in the evaluation of Research Question 3, as well as total number of services received. Employment outcomes were evaluated in terms of (a) whether the consumers obtained employment or not, and, if closed successfully, (b) type of employment obtained (e.g., competitive employment, self-employment Method Data for the study were obtained from the national RSA-911 database for fiscal year (FY) 1997, which is maintained by the Rehabilitation Services Administration (RSA). This database includes information about each person whose case was closed during that year. In addition to primary and secondary disability type, RSA-911 variables from three major categories were extracted from the database: consumer characteristics, services obtained, and employment outcomes. The variables included in the study were selected because they were considered the most relevant to the research in terms of identifying discrepancies in consumer characteristics, services, or outcomes for consumers with hearing loss versus other consumers. For the analysis of differences in acceptance rates, the entire population of VR consumers in the FY 1997 data was used (N = 586,021). For the majority of the remaining analyses, the consumer population was those who had been closed successfully or unsuccessfully un·suc·cess·ful adj. 1. Having an unfavorable outcome: an unsuccessful venture. 2. Failing to attain something desired or intended: an unsuccessful entrepreneur. after receiving VR services (i.e., Status 26 or Status 28 closures, respectively; N = 347,731). The number of consumers with hearing loss (as either their primary or secondary disability) was determined by creating a subset A group of commands or functions that do not include all the capabilities of the original specification. Software or hardware components designed for the subset will also work with the original. based on disability codes (i.e., codes between 231 and 299; n = 23,992). In order to obtain equal sized groups, a random sample of 23,992 consumers was drawn from the population of consumers with other types of disabilities closed in Status 26 or 28. These two samples were combined, for a total sample size of 47,984 consumers. This sample was used to address most of the analyses associated with Research Questions 2 through 5. For a few analyses, a subset of this sample was used. Differences in terms of the first two measures of employment outcomes were assessed for both the complete sample of 47,984 persons and a reduced sample consisting of only persons who were not competitively employed at application (n = 35,385). For the third measure of employment outcomes, availability of medical insurance, another reduced sample was used. Persons from the full sample who were closed successfully and did not have medical insurance available through an employer at application (n = 26,760) were included in this analysis. Information on demographic characteristics for each group is provided in the analyses for Question 2; therefore, it is not repeated here. However, the types of disabilities reported for persons in the comparison group are not included. Because this information may be of interest to the reader, type of disability for consumers in the other disability group (n = 23,992) is provided in Table 1. Due to the large sample sizes used for these analyses, most significance test results were expected to be statistically significant. Therefore, in order to deem a finding important or meaningful, practical significance of the differences between the groups also had to be established. Practical significance was evaluated with a measure of association or an effect size for each statistical significance test. Analyses were conducted with SAS (1) (SAS Institute Inc., Cary, NC, www.sas.com) A software company that specializes in data warehousing and decision support software based on the SAS System. Founded in 1976, SAS is one of the world's largest privately held software companies. See SAS System. [R] Version 8.2. Chi-square chi-square (ki´skwar) see under distribution and test. chi-square n. was used to evaluate research questions involving categorical That which is unqualified or unconditional. A categorical imperative is a rule, command, or moral obligation that is absolutely and universally binding. Categorical is also used to describe programs limited to or designed for certain classes of people. variables. Measures of association used in evaluating practical significance for these analyses were phi coefficients Noun 1. phi coefficient - an index of the relation between any two sets of scores that can both be represented on ordered binary dimensions (e.g., male-female) fourfold point correlation, phi correlation and/or and/or conj. Used to indicate that either or both of the items connected by it are involved. Usage Note: And/or is widely used in legal and business writing. odds ratios. A phi coefficient is a measure of association derived de·rive v. de·rived, de·riv·ing, de·rives v.tr. 1. To obtain or receive from a source. 2. from the Pearson Pear·son , Lester Bowles 1897-1972. Canadian politician who served as prime minister (1963-1968). He won the 1957 Nobel Peace Prize for his role in the negotiation of a solution to the Suez crisis (1956). chi-square statistic statistic, n a value or number that describes a series of quantitative observations or measures; a value calculated from a sample. statistic a numerical value calculated from a number of observations in order to summarize them. , with values ranging from -1 to 1 for 2 X 2 tables. However, because the variables of interest here are nominal Trifling, token, or slight; not real or substantial; in name only. Nominal capital, for example, refers to extremely small or negligible funds, the use of which in a particular business is incidental. NOMINAL. Relating to a name. , the direction of the association is irrelevant Unrelated or inapplicable to the matter in issue. Irrelevant evidence has no tendency to prove or disprove any contested fact in a lawsuit. irrelevant adj. and only absolute values will be reported. Odds ratios are another measure of association, available for 2 X 2 tables only. When the variables being tested are independent of each other, the odds ratio will equal one. Differences between groups based on the continuous variables (i.e., age, education level, number of services, and cost of case services) were evaluated with the analysis of variance The discrepancy between what a party to a lawsuit alleges will be proved in pleadings and what the party actually proves at trial. In Zoning law, an official permit to use property in a manner that departs from the way in which other property in the same locality procedure. Cohen's d was the effect size used to measure practical significance of these findings. Results Acceptance Rates and Demographic Characteristics Because of the large number of significance tests conducted, the statistical results will not be listed here. The reader is instead referred to the table associated with the research question. Effect sizes or measures of association and descriptive statistics descriptive statistics see statistics. for each group are provided in the tables. Question 1 investigated whether differences existed between the groups in terms of acceptance rates. A significantly higher percentage of consumers with hearing loss were accepted for services. Question 2 involved evaluating differences between groups on several demographic characteristics. Significant differences were found in terms of sex, with a higher percentage of females served in the hearing loss group than in the other disability group. Consumers in the hearing loss group were significantly older, on average, than consumers in the other disability group. Significant differences were found between the groups based on race, with a substantially higher percentage of Whites and lower percentage of African-Americans served in the hearing loss group. There were also significant differences between the groups in terms of work status at application. The most relevant difference was that consumers with hearing loss were more likely to be competitively employed at application than those with other disabilities. Although there were statistically significant differences between the groups on severity of disability, the difference in percentages was small. There were not significant differences between the groups in terms of education level, with the average educational level of the groups virtually identical. Detailed information (including group percentages) for the categorical variable analyses presented above is provided in Table 2. Table 3 provides information for the analyses associated with the continuous variables. Case Service Variables Question 3 addressed VR services received. The total number of services received differed between the groups, as consumers with hearing loss obtained significantly more services. No practically significant differences between groups were found on receipt of the following services: (a) Job finding services, (b) Job placement, (c) On-the-job-training, (d) Counseling and guidance--substantial, (e) Other services, and (t) Rehabilitation engineering Rehabilitation engineering is the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities. . A significantly higher percentage of consumers with hearing loss received the following services: (a) Restoration, (b) Assistive technology Hardware and software that help people who are physically impaired. Often called "accessibility options" when referring to enhancements for using the computer, the entire field of assistive technology is quite vast and even includes ramp and doorway construction in buildings to support devices, (c) Assistive technology services, (d) Assessment, and (e) Personal assistance services (which includes interpreters). A significantly higher percentage of consumers with other disabilities received the following services: (a) College or university training, (b) Business and vocational training, (c) Adjustment training, (d) Miscellaneous training, (e) Maintenance, and (f) Transportation. Data on the receipt of VR services, including percentages of each group receiving the service, are provided in Table 4. Question 4 addressed whether differences existed in terms of amount of money spent on case services. Results indicated that significantly more money was spent on consumers with hearing loss than consumers with other disabilities. Refer to Table 3 for statistical test results and associated group means and standard deviations In statistics, the average amount a number varies from the average number in a series of numbers. (statistics) standard deviation - (SD) A measure of the range of values in a set of numbers. . Employment Outcomes Question 5 addressed differences in employment outcomes for the two groups. When evaluating the entire sample, a significantly higher percentage of consumers with hearing loss were closed successfully. There was also a difference in the same direction when evaluating the reduced sample (i.e., only those not competitively employed at application). However, the actual percentage differences were smaller with the reduced sample, as indicated by the odds ratio value being closer to one. Differences in employment outcomes were also assessed by comparing type of successful closure for those closed in Status 26. For the full sample, significant differences were found. Primary differences were that a smaller percentage of consumers with hearing loss obtained competitive employment and a larger percentage of these consumers were closed as homemakers. These differences were much more pronounced when comparing the reduced sample. Consumers with hearing loss had a substantially smaller percentage closed in competitive employment, while having a substantially larger percentage closed in homemaker status. An additional evaluation of employment outcomes was conducted involving the availability of medical insurance through an employer at close. No significant differences between the groups were found on this variable. Table 5 provides results for the statistical tests covering employment outcomes, as well as group percentages for each analysis. Follow-up follow-up, n the process of monitoring the progress of a patient after a period of active treatment. follow-up subsequent. follow-up plan Analyses Significant differences between the groups were found for three service variables that involve training: (a) College or university training, (b) Business or vocational training, and (c) Miscellaneous training. Because training is an important service in terms of future employability, even small differences in these areas are relevant. Consumers with hearing loss received all three of these services less frequently. One reason for this difference may have been that more consumers with hearing loss than consumers with other disabilities were competitively employed at application. Therefore, additional analyses based on information obtained from the initial analyses investigated for this study were conducted. The full sample of 47,984 was reduced to include only those persons not competitively employed at application (as was done with the analyses of employment outcomes), resulting in a sample size of 35,385. Chi-square analyses were conducted again with this reduced sample for the three training service variables. Results indicated no practically significant differences between groups in terms of (a) College or university training, [chi square chi square (kī), n a nonparametric statistic used with discrete data in the form of frequency count (nominal data) or percentages or proportions that can be reduced to frequencies. ] (1, N = 35,385) = 4.31, p = .04 ([PHI] = .01; OR = .94), or (b) Miscellaneous training, [chi square] (1, N = 35,385) = 20.31, p < .0001 ([PHI] = .02; OR = 1.13). Significant differences between the groups in terms of receipt of business or vocational training remained, [chi square] (1, N = 35,385) = 97.50, p < .0001 ([PHI] = .05; OR = 1.37). Discussion The results indicate that there are significant differences in several areas of the VR experience for consumers with hearing loss compared to consumers with all other disabilities, as well as differences in terms of the two groups' demographic characteristics. A substantially higher percentage of persons with hearing loss were accepted for services compared to persons with other disabilities. In fact, the odds of being accepted for VR services were 2.7 times higher for persons with heating loss (as evidenced by the odds ratio of .37 associated with this contingency table contingency table n. A statistical table that shows the observed frequencies of data elements classified according to two variables, with the rows indicating one variable and the columns indicating the other variable. ). In terms of demographic characteristics, consumers with hearing loss were significantly older on average than consumers with other disabilities. This finding might be expected as hearing loss is often associated with aging. Differences that were not expected included a larger percentage of consumers with hearing loss being female (51% of the heating loss group, while only 45% of the other disability group were female). According to the U.S. Census Bureau Noun 1. Census Bureau - the bureau of the Commerce Department responsible for taking the census; provides demographic information and analyses about the population of the United States Bureau of the Census (2000), the incidence of heating loss in the population is considerably higher in males than females. The finding in this study raises a question of whether a proportion of men with hearing loss are not being served by VR. It is important to investigate why, in a population that men represent a clear majority, a higher percentage of women are being served. Another significant difference between the groups was found in terms of race. A higher percentage of consumers with hearing loss were White while a lower percentage were African-American, compared to consumers with other disabilities (differences in percentages of other racial groups were minimal). However, in this case, there is evidence that the prevalence of hearing loss is lower in the African-American population than in the White population in the U. S. (Adams et al., 1999). Another difference in terms of demographic characteristics was that a substantially higher percentage of consumers with hearing loss were competitively employed at application. This difference in percentage was large, with 21% more consumers with hearing loss working in the labor force at application. One possible reason for this finding is that these consumers are older and may have lost some or all of their hearing after a long history of employment. In this case, they would perhaps need assistance with accommodations and assistive technology to maintain employment. However, some people in this situation would also need assistance in finding alternative employment if their jobs required hearing at a level no longer possible for them. Some evidence for this hypothesis is provided by evaluating the work status at application for consumers classified by RSA as having a post-vocational hearing loss. A substantially higher percentage of these consumers, compared to those classified as having a pre-lingual or pre-vocational hearing loss, were competitively employed at application (46% versus 32%). However, both of these percentages are substantially higher than the percentage of consumers with other disabilities who were competitively employed at application (i.e., approximately 16%). Although there were significant differences in terms of the services received by each group, many of these differences could be anticipated based on type of disability. The services received more frequently by consumers with hearing loss are ones that are likely to be needed by this population. For example, restoration, which involves medical interventions such as surgery or therapy, is often provided to improve hearing or communication ability. Obtaining hearing aids Hearing Aids Definition A hearing aid is a device that can amplify sound waves in order to help a deaf or hard-of-hearing person hear sounds more clearly. or other assistive hearing devices would fall under assistive technology devices and services, and personal assistance services includes the use of interpreters. Assessment, which includes diagnosis and evaluation services, was also received slightly more frequently by this group, although the vast majority of each group received the service. When evaluating the entire sample, slight to moderate differences in terms of the receipt of some training service variables were found. However, when evaluating only those consumers who were not competitively employed at application, these differences decreased. In fact, the only difference that remained significant was the percentage of consumers provided business or vocational training. It seems sensible that persons who are competitively employed at application will not have as much need for training services. It follows that this variable primarily accounted for the initial differences between the groups. There was a significant difference between the groups in amount of money spent on consumers' cases, with an average of $486 more spent on cases for consumers with hearing loss. Although this is a moderately large amount, it must be evaluated in the context of the variability of case cost. Extremely high standard deviations were found for the average case cost of each group, with the standard deviation of the hearing loss group being the largest. This indicates that the hearing loss group had even greater variability than the other group, which may mean that several high outliers increased the average for this group. The large variability also resulted in a small effect size for this difference. Therefore, although a difference in the group means does exist, it is attenuated Attenuated Alive but weakened; an attenuated microorganism can no longer produce disease. Mentioned in: Tuberculin Skin Test attenuated having undergone a process of attenuation. by the high variability of the average case cost for each group. The differences found between the groups in terms of employment outcomes are important. The comparisons made with the reduced sample (of only those not competitively employed at application) will be discussed, as this is a more accurate portrayal of differences between groups based on receipt of VR services. A substantially higher proportion of consumers with hearing loss than with other disabilities were closed successfully. However, evaluation of the type of employment outcomes obtained indicates that fewer consumers with hearing loss were closed competitively (77% versus 86% for the other disability group) and more were closed as homemakers (17% versus 8%). Differences between the other closure statuses were small. This finding is relevant because competitive employment is generally considered the most desirable closure available. Although a higher percentage of consumers with hearing loss (of those not competitively employed at application) are closed successfully, many are not working in the labor force at the time of case closure. If non-competitive work was the goal of the consumer at application, this outcome is appropriate. Although it seems unlikely that a substantially greater percentage of consumers with hearing loss would have the career goal of homemaker, compared to consumers with other disabilities, it is not possible to assess this as information on occupational goal at application is not available in the RSA-911 data. However, some evidence that homemaker may not have been the original occupational goal of this many consumers with a hearing loss is that only 5% of the sample were classified as homemakers at application. As stated previously, this study can only be considered a starting point in investigating the issue of the reduction in number and percent of successful closures for VR consumers with hearing loss, and it has limitations. A primary limitation of the study is the use of an ex-post Ex-Post Another term for actual returns. Notes: Ex-post translated from Latin means "after the fact." Companies may try to obtain ex-post data to forecast future earnings. See also: Actual Return, Ex-Ante facto Fac´to adv. 1. (Law) In fact; by the act or fact. De facto (Law) See De facto. design, which does not allow establishment of causal causal /cau·sal/ (kaw´z'l) pertaining to, involving, or indicating a cause. causal relating to or emanating from cause. relationships. Having a large national database such as RSA-911 available for this type of research is certainly valuable. However, using pre-existing Adj. 1. pre-existing - existing previously or before something; "variations on pre-existent musical themes" pre-existent, preexistent, preexisting antecedent - preceding in time or order data limits the conclusions that can be drawn from the analyses. Another limitation is the restricted number of variables available for comparison. Although many variables are included in the RSA-911 database, several additional variables would have been of interest in this study, such as prior work history, occupational goal at application, and whether a degree or certificate was obtained (if the person received training). Conclusions The purpose of this investigation was to determine whether differences existed between VR consumers with hearing loss and consumers with other disabilities in terms of acceptance rates, demographic characteristics, services received, and employment outcomes. The impetus Impetus is a stimulus or impulse, a moving force that sparks momentum. Impetus may also refer to:
In terms of demographic characteristics, a larger percentage of women than men with hearing loss were served by VR. This finding is relevant as a substantially larger percentage of the population of persons with hearing loss are men (U.S. Census Bureau, 2000). This may mean that there are a number of men with hearing loss who are not being served by VR. In terms of services (networking) Terms Of Service - (TOS) The rules laid down by an on-line service provider such as AOL that members must obey or risk being "TOS-sed" (disconnected). received, the only potential bias against persons with hearing loss is that fewer of this group received business or vocational training, compared to consumers with other disabilities, even after taking employment status at application into account. Of course, this would represent a bias against consumers with hearing loss only if they needed the service to reach their job goal but it was not provided to them. A relevant finding of this study related to employment outcomes was that a higher percentage of consumers with hearing loss were closed successfully, although fewer of those closed successfully were placed in competitive employment. Despite a high percentage of successful closures being a positive outcome, it does not explain why there has actually been a 10-year trend of a decline in the number of consumers with hearing impairment hearing impairment n. A reduction or defect in the ability to perceive sound. obtaining employment outcomes. Also, when a substantial percentage of these successful closures are being closed as homemakers, this may not necessarily be the optimal outcome for these consumers. The question of why a substantially greater percentage of consumers with hearing loss were closed as homemakers is relevant and deserves more attention. To further investigate this consistent decrease in number of consumers with hearing loss being closed successfully, analyses could be conducted that compare the number of persons applying for services each year, during the 10-year period of the decline and before, to determine whether the number of persons with hearing loss who seek services is also consistently decreasing. If this is found to be the case, research involving direct contact with persons with hearing loss should be conducted, to determine why they have or have not sought services from VR. If it is not found to be the case, the decrease in successful closures may have originated in a smaller percentage of consumers with hearing loss obtaining an employment outcome, compared to the years prior to the noted decrease. Further research is needed in this area to understand the documented decrease in successful outcomes. Research beyond extant data studies, such as case audits and direct contact with consumers and non-consumers, would provide more detailed information and is certainly needed. This knowledge will help VR to ensure that consumers with hearing loss receive the assistance they require to obtain successful outcomes.
Table 1
Type of Primary Disability for Other Disability Group
Type of disability Frequency Percent
Alcohol/drug dependence 3,187 13%
Amputation 285 1%
Mental retardation/autism 941 4%
Mental or emotional conditions 5,972 25%
Orthopedic impairments 5,813 24%
Traumatic brain injury 620 3%
Visual impairments 2,001 8%
Other conditions 5,173 22%
TOTAL 23,992 100%
Table 2
Acceptance Rates and Demographic Characteristics: Categorical Variables
[chi
Variable df N square] [PHI] OR Percent
Acceptance rates 1 586,021 3081.43 * .07 .37 Accepted
HL group 90%
Other group 77%
Sex 1 47,984 185.25 * .06 .78 Female
HL group 51%
Other group 45%
Race 4 47,984 554.62 * .11 -- White/Black
HL group 77%/12%
Other group 69%/20%
Severity 1 47,984 40.31 * .03 .86 Severe
HL group 82%
Other group 80%
Work status at 8 47,984 3633.31 * .28 -- Competitive-
application ly
HL group employed
Other group 37%
16%
* p < .0001
Table 3
Comparisons on Continuous Variables: Age, Education Level, Number of
Services, and Case Cost
Variable Group df F d M
Age Hearing loss 1,47982 603.72 * .22 40.63
Other disability 37.41
Education Hearing loss 1,47982 0.20 -- 11.77
Other disability 11.76
Services Hearing loss 1,47433 399.93 * .18 4.81
Other disability 4.40
Case cost Hearing loss 1,47982 70.33 * .08 3,511.10
Other disability 3,025.07
Variable Group SD
Age Hearing loss 15.70
Other disability 12.92
Education Hearing loss 2.50
Other disability 2.28
Services Hearing loss 2.27
Other disability 2.19
Case cost Hearing loss 6,987.25
Other disability 5,636.44
* p < .0001
Table 4
Receipt of VR Services
[chi
Variable df N square] [PHI] OR
Adjustment training 1 47,983 324.70 * .08 1.61
Assessment 1 47,984 138.37 * .05 .72
Asst. technology devices 1 47,436 3279.94 * .26 .21
Asst. technology services 1 47,436 3325.68 * .26 .23
Business/voc. training 1 47,984 325.24 * .08 1.68
College/univ. training 1 47,984 65.48 * .04 1.22
Counseling & guidance 1 47,984 1.71 .01 1.03
Job finding 1 47,984 25.64 * .02 1.10
Job placement 1 47,984 19.92 * .02 1.09
Maintenance 1 47,984 135.79 * .05 1.32
Miscellaneous training 1 47,984 139.81 * .05 1.34
On-the-job training 1 47,984 3.39 .01 1.07
Other services 1 47,984 2.53 .01 .97
Personal assistance 4 47,360 2554.81 * .23 --
Rehabilitation engineering 1 47,436 3.78 .01 .88
Restoration 1 47,984 2479.06 * .23 .39
Transportation 1 47,984 535.47 * .11 1.60
Variable Percent receiving service
HL group Other group
Adjustment training 11% 17%
Assessment 89% 86%
Asst. technology devices 27% 7%
Asst. technology services 30% 9%
Business/voc. training 9% 14%
College/univ. training 15% 17%
Counseling & guidance 81% 81%
Job finding 36% 39%
Job placement 30% 31%
Maintenance 16% 20%
Miscellaneous training 15% 19%
On-the-job training 7% 8%
Other services 26% 26%
Personal assistance 11% 1%
Rehabilitation engineering 2% 2%
Restoration 51% 29%
Transportation 24% 34%
* p < .0001
Table 5
Employment Outcomes
Variable [chi
Sample df N square] [PHI]
Group
Type of closure Full 1 47,984 1086.34 * .15
HL/Other
Reduced (a) 1 35,385 258.88 * .09
HL/Other
Type of 26 closure All 26 5 31,885 126.18 * .06
closures
HL/Other
Reduced (b) 5 21,204 401.06 * .14
HL/Other
Medical insurance Reduced (c) 1 26,760 3.85 .01
HL/Other
Variable
Odds Percent:
Group
Type of closure 1.91 Successful
HL/Other 74%/59%
1.43 Successful
HL/Other 65%/56%
Type of 26 closure -- Competitive
HL/Other 86%/88%
-- Competitive
HL/Other 77%/86%
Medical insurance .95 Available
HL/Other 39%/38%
(a) Includes all consumers who were not competitively employed at
application.
(b) Includes consumers who were not competitively employed at
application and were closed successfully.
(c) Includes consumers closed successfully who did not have medical
insurance available through an employer at application.
* p < .0001
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A person who cannot detect sound at an amplitude of 20 decibels in a frequency range of from 800 to 1,800 vibrations per second is said to be (pp. 136-144). Silver Spring, MD: American American, river, 30 mi (48 km) long, rising in N central Calif. in the Sierra Nevada and flowing SW into the Sacramento River at Sacramento. The discovery of gold at Sutter's Mill (see Sutter, John Augustus) along the river in 1848 led to the California gold rush of Deafness and Rehabilitation Association. Gibbs, W. E. (1990). Alternative measures to evaluate the impact of vocational rehabilitation services. Rehabilitation Counseling rehabilitation counseling, n counseling started in the United States in 1920 to assist individuals disabled by industrial accidents; originally included physical, psychologic, and occupational training; expanded over the next 70 years and laid the Bulletin, 34(1), 33-43. Louis Harris & Associates (1998). 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Moore, C. L. (2001b). Disparities in job placement outcomes among deaf, late-deafened, and hard-of heating consumers. Rehabilitation Counseling Bulletin, 44(3), 144-150. Moore, C. L. & Schroedel, J. G. (2001a). A national profile of the vocational rehabilitation of Americans with hearing loss. Unpublished monograph mon·o·graph n. A scholarly piece of writing of essay or book length on a specific, often limited subject. tr.v. mon·o·graphed, mon·o·graph·ing, mon·o·graphs To write a monograph on. . Little Rock: University of Arkansas, Rehabilitation Research and Training Center for Persons who are Deaf or Hard of Hearing. Moore, C. L. & Schroedel, J. G. (2001b). A profile of Kentuckians with hearing loss served by the state vocational rehabilitation agency. Unpublished report. Little Rock: University of Arkansas, Rehabilitation Research and Training Center for Persons who are Deaf or Hard of Hearing. Platt, J. J. (1995). 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Bureau of the Census - the bureau of the Commerce Department responsible for taking the census; provides demographic information and analyses about the population of the United States Census Bureau (2000). Statistical abstract of the United States The Statistical Abstract of the United States is a publication of the United States Census Bureau, an agency of the United States Department of Commerce. Published annually since 1878, the statistics describe social and economic conditions in the United States. (120th ed.). [On-line document]. Available from http://www.census.gov/prod/2001pubs/statab/sec03.pdf. Walls, R. T., & Fullmer, S. L. (1997). Competitive employment: Occupations after vocational rehabilitation. Rehabilitation Counseling Bulletin, 41, 15-25. Walls, R. T., Misra, S., & Majumder, R. K. (2002). Trends in vocational rehabilitation: 1978, 1988, 1998. Journal of Rehabilitation, 68(3), 4-10. Michele Michele murders wife’s lover; hides body under cloak. [Ital. Opera: Puccini, The Cloak, Westerman, 362–363] See : Murder E. Capella, Ph.D., CRC (Cyclical Redundancy Checking) An error checking technique used to ensure the accuracy of transmitting digital data. The transmitted messages are divided into predetermined lengths which, used as dividends, are divided by a fixed divisor. , RRTC RRTC Rehabilitation Research and Training Center RRTC Rochester Rail Transit Committee RRTC Red River Trade Council RRTC Rice Research and Training Centre (Egypt) on Blindness & Low Vision, P.O. Box 6189, MS State, MS 39762. Email: mcapella@colled.msstate.edu See .edu. (networking) edu - ("education") The top-level domain for educational establishments in the USA (and some other countries). E.g. "mit.edu". The UK equivalent is "ac.uk". |
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