Identifying and providing vocational services for adults with specific learning disabilities.

Identifying and Providing Vocational Services for Adults with Specific Learning Disabilities

Clients with Specific Learning Disabilities present a significant challenge to professionals in the field of Rehabilitation. Identification of persons with learning disabilities is complicated by the wide array of performance characteristics that may be present. A theoretical framework is presented that will allow professionals to identify and evaluate individuals with learning disabilities. Case studies are used to illustrate the diagnostic process. Also presented are recommendations for vocational counseling and guidance, remediation of job-related skill deficits, and job placement.

Specific learning disabilities are a heterogeneous group of disorders which are both persistent and pervasive throughout an individual's life (National Joint Committee on Learning Disabilities, 1987). As learning disabled children reach adulthood their problems increase in complexity. Thousands of children identified as learning disabled in years past have grown into adulthood. Other adults exhibit characteristics of learning disability, but have not been formally identified (Thomas, 1982). Because of a lack of knowledge concerning appropriate diagnostic procedures, older adolescents and adults with specific learning disabilities are often denied access to the academic instruction, prevocational preparation and vocational counseling that they need in order to develop adult skills and abilities (Crimando & Nichols, 1982). Few professionals are prepared to work with the adult learning disabled population and few employers are aware of, or sensitive to, the needs of adults with specific learning disabilities (Shofner, 1981; Thomas, 1981). The learning disabled adult presents a significant challenge to practitioners in the field.

The Vocational Rehabilitation Act of 1973 (Public Law 93-112) mandated that persons with disabilities could not be excluded from jobs or any activity or training program receiving federal funds solely on the basis of a handicapping condition. Section 7 of the Rehabilitation Act Amendments of 1986 (Public Law 99-506) lists Specific Learning Disabilities among the handicapping conditions included under the 1973 Act. Among the issues that must be addressed if vocational rehabilitation facilities are to successfully meet the needs of adults with learning disabilities are (a) how to identify and evaluate the learning disabled adult for rehabilitation eligibility and (b) how to provide appropriate rehabilitation services for adults with specific learning disabilities. The purpose of this article is to address these two issues.

Identifying Adults With Specific Learning Disabilities

Federal law defines specific learning disability as follows: "Specific learning disability" means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. The term includes such conditions as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. The term does not include children who have learning problems which are primarily the result of visual hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage (U.S. Department of Education, 1981, p. 5557). The definition was originally designed to be used in the identification of learning disabilities in school aged children, and has been criticized because of vagueness and for reliance on exclusion clauses to define the population (Lynch & Lewis, 1988). For example, the federal definition excludes learning problems that are due primarily to sensory impairments, mental retardation, motor handicaps, or to environmental, cultural or economic disadvantage. This attempt at definition by exclusion indicates the difficulty involved in operationally defining specific learning disabilities.

Defining learning disability is complicated by several factors. First, the etiology is frequently unknown and undetectable. Parents, clients and professionals are often baffled by the lack of any apparent reason for the learning disabled person's inability to learn. Neurological or organic explanations, though often hypothesized, can seldom be confirmed (Crimando & Nichols, 1982; Shofner, 1981).

Often there are no obvious physical or behavioral manifestations. Sometimes the learning disabled individual is hyperactive, perseverative, impulsive or easily distracted from the task at hand (Thomas, 1982). Some individuals exhibit difficulty with auditory or visual perception (U.S. Department of Education, 1981). A particularly troublesome complicating factor is that all of the characteristics previously listed are not always present in every case (Shofner, 1981).

Another complicating factor is the varied array of combinations of learning and performance manifestations displayed by persons with specific learning disabilities (Levinson, 1980). Learning disability is not characterized by only two or three performance characteristics, such as reversing words, writing backwards, or memory difficulties. In fact, there are many combinations of learning and performance characteristics that vary from one client to another (Thomas, 1981).

The complicated nature of specific learning disability, then, renders it difficult to identify, measure and evaluate (Levinson, 1980). There is no one valid test that can be used as the test for specific learning disability (Crimando & Nichols, 1982). Efforts to create a valid test for learning disability have been unsuccessful to date. Given the complex nature of the disability, the potential for development of such a test in the near future is minimal.

What is needed is a theoretical framework that will allow diagnosticians to use existing assessment instruments to identify and evaluate learning disabled individuals. Rather than focusing on a specific diagnostic test, the diagnostician should focus on identifying any discrepancy that might exist between an individual's potential achievement and actual achievement as revealed by his performance on a variety of diagnostic measures. A specific learning disability, though possibly manifested at an early age, will also be manifested in job performance since many children with learning disabilities continue to experience learning difficulties after entering adulthood (Shofner, 1981). To measure the discrepancy between potential and actual achievement, two general types of diagnostic instruments are needed, one type to measure potential achievement and one to measure actual achievement.

Probably the best available way to measure a client's potential is by administering an individual intelligence test. Though not perfect, intelligence tests can be used by trained evaluators to predict a client's general potential to succeed at intellectual tasks (Salvia & Ysseldyke, 1988). The best way to measure actual achievement is to administer standardized academic achievement tests (Thomas, 1982). Administration of other valid tests to measure non-academic skills such as motor performance might also be desirable (Crimando & Nichols, 1982). Theoretically, a significant discrepancy between potential achievement and actual performance indicates the presence of a specific learning disability (U.S. Department of Education, 1981).

There is a variety of valid tests that can be used to measure academic achievement. Most tests designed to measure academic achievement through high school level would probably be appropriate for use with adults since a significant deficit would likely be revealed on such tests. Nevertheless, achievement tests standardized on adult populations would be best. Also preferred would be achievement tests that allow an analysis of skills in each academic area tested.

The presence of a significant discrepancy is determined by analysis of the client's profile of overall achievement based on the test results. The typical profile of a person with a learning disability includes an average to above average intelligence quotient, average to above average achievement scores in most academic areas and one or a few significant deficits that, given all other scores, would not have been predicted. The deficit areas might be related to each other or they might be independent. The measured intelligence quotient must be at least 80 because, by definition, people with learning disabilities have at least average intelligence.

The client may exhibit other accompanying problems such as distractibility, impulsivity, coordination difficulties and social skill deficits (Crimando & Nichols, 1982). These attributes are best measured by screening devices such as check-lists and structured observation scales (Kaufman, 1985). Whatever other accompanying problems are present, the overall profile will be inconsistent. It will not be a generally depressed achievement profile. A generally depressed achievement profile would suggest an explanation other than specific learning disability. For example, such a profile could be attributable to low client motivation, cultural/environmental factors, impaired intellectual ability or mental retardation. All of these explanations would tend to result in a general suppression of academic achievement, whereas the profile of an individual who has a learning disability would display more academic "peaks" than "valleys."

A scale is used to plot the profile of assessment results (see Figure 1). Included are an individually administered intelligence test, all subtests of academic achievement tests administered, motor performance tests and any other norm-referenced evaluative measures.

The numbers along the left side of the scale indicate percentile ranks. The client's performance on each evaluation measure should be converted to a percentile (using norm tables in the respective test manuals) and plotted at the proper points on the scale. Then a graph of the overall profile can be completed by connecting the plotted points.

A given score on the profile can be evaluated as follows:

1st to 11th percentile - extremely low score

12th to 23rd percentile - low score

24th to 50th percentile - low average score

51st to 77th percentile - high average score

78th to 89th percentile - high score

90th to 99th percentile - extremely high score.

These criteria for evaluating each score were derived by determining the percentile ranks that correspond to stanines in a normal distribution. Any score at the 23rd percentile or below would fall in the lower 3 stanines. A score between the 24th and 77th percentiles would fall in the middle 3 stanines and a score at the 78th percentile or above would fall in the top 3 stanines.

When examining the profile of a client with a learning disability, one would expect to see most scores plotted at or above the 50th percentile. One would expect to see one or a few scores plotted at or below the 23rd percentile, indicating a significant discrepancy between potential achievement (as indicated by overall performance and IQ) and actual achievement in one or a few specific areas, as indicated by the low scores on the profile.

Determining when a discrepancy is significant is sometimes difficult and requires clinical judgement, considering all the facts of the case. For example, if two of a client's scores were plotted at the 18th percentile, and none of the other scores exceeded the 30th percentile, then a significant discrepancy would probably not be indicated. Even though the majority of the client's scores could be classified as low average, the two low scores would not dramatically differ from the rest and the profile would indicate that all of the scores fall into the same general pattern of achievement. Therefore, specific learning disability would be contraindicated. A diagnostic key in determining whether a discrepancy is significant is to examine the relationship between the low scores (i.e., scores below the 23rd percentile) and all other scores, deciding whether the low scores are consistent with the overall pattern. To illustrate the diagnostic process, two case studies will be considered, one of a client who was found not to be learning disabled and one of a client who was found to have a learning disability.

Case Study 1

R.W. was a male college student whose chronological age was 20 years 3 months at the time he was evaluated. The initial interview revealed that R.W. was encountering significant academic difficulty despite his high motivation to succeed and an IQ of 90 as measured by the Wechsler Adult Intelligence Scale-Revised (WAIS-R; Wechsler, 1981). A general battery of academic achievement tests included the following: Peabody Individual Achievement Test (PIAT: Dunn & Markwardt, 1970), Woodcock Reading Mastery Tests-Revised (Woodcock, 1987) and Peabody Picture Vocabulary Test-Revised (Dunn & Dunn, 1981). Additionally, informal tests were used to evaluate motor performance, visual-motor integration, visual perception, note-taking skills, oral expression, written expression and ability to follow simple directions. Results of all informal testing indicated normal ability. Intelligence quotient and achievement test scores were converted to percentile ranks and were plotted on the assessment profile (see Figure 1).

Examination of R.W.'s profile of assessment results indicated a generally depressed set of scores. All scores were at or below the 27th percentile. As a result, specific learning disability was eliminated as a probable diagnosis. Given R.W.'s profile, a more probable explanation would include sub-average intellectual functioning, mental retardation, low motivation or environmental/cultural disadvantage. R.W.'s IQ of 90 eliminated an intellectual explanation and several witnesses attested to his high motivation to succeed. R.W. came from a middle class family that valued education. In this case the evaluator faced a dilemma in explaining R.W.'s learning difficulties.

A second interview with R.W. revealed the explanation. It seems that during his years in grades 7 through 9, R.W. chose to deemphasize academics in favor of athletics. In fact, during this time he developed a negative, almost hostile, attitude toward academics and frequently missed class or generally failed to participate academically. When his attitude improved around grade 10, he had lost a lot of academic ground but was still able to perform well enough to graduate from high school. Nevertheless, R.W.'s three lost years put him at a sizeable disadvantage in later years and resulted in academic difficulties that were not caused by a specific learning disability.

Case Study 2

L.S. was a female college student whose chronological age was 20 years 5 months when she was evaluated. Though her measured IQ was 112, L.S. was failing all coursework and was on academic probation. The initial interview revealed that L.S. had to study very hard in high school to earn essentially average grades. She underwent an assessment battery comparable to the one administered to R.W., in Case Study 1. Again, results of all informal evaluation indicated normal ability in the areas tested. Intelligence quotient and achievement test scores were converted to percentile ranks and were plotted on the assessment profile (see Figure 2).

Examination of the profile of assessment results revealed that all scores except two were in at least the average range, and four scores (including IQ) were high average. Given L. S.'s IQ score and her overall achievement profile, two scores were unusually low. Her scores in spelling and word attack skills were at the 4th and 16th percentiles respectively, indicating a significant discrepancy between potential or predicted achievement and actual achievement.

In the case of L. S. the deficit areas were probably related to each other since certain skills required for decoding unfamiliar words are also required for successful spelling. One might wonder how L. S. performed so well (64th percentile) in reading recognition while performing so poorly in word attack. The explanation is that L. S. had built a substantial sight word vocabulary by memorizing hundreds of words that she could neither spell nor decode phonetically. Thus she did well on the test that measured the ability to identify memorized English words, but she did poorly on the tests that measured the ability to spell familiar words or to decode words with which she was unfamiliar.

Despite her relatively high IQ, her average to above average performance in most academic areas and her employment of compensatory strategies (i.e., memorizing an impressive sight word vocabulary), L. S. was still encountering great academic difficulty and was diagnosed as learning disabled. As might be expected, she performed poorly on any task that required the ability to spell or to decode unfamiliar words.

Summary of Diagnostic Procedures

To identify a client with a specific learning disability, the diagnostic process should include: (a) relevant medical, educational, and work history obtained through client interview, (b) a measure of the client's potential as determined by an individually administered intelligence test, (c) a measure of academic achievement as determined by a battery of norm-referenced achievement tests and (d) a measure of any other abilities deemed pertinent by the diagnostician, such as visual-motor integration, visual and auditory perception, motor skills, oral expression, written expression or adaptive skills. Considering the client's history, intellectual potential and profile of achievement test data, a specific learning disability can usually be identified.

Vocational Services for Learning Disabled Adults

After it has been determined that a client has a specific learning disability, several areas of concern should be addressed. These areas of concern include vocational counseling and guidance, job-related learning remediation, job-related interpersonal skills, specific vocational skills, and job placement and maintenance.

Vocational Counseling and Guidance

Information from the academic assessment of a client with a learning disability will be helpful in determining his/her functional limitations and how these limitations might preclude success in certain vocational situations. The client can be counselled accordingly. Obviously, if the client is weak in the area of reading, s/he should be directed away from vocations which require a great amount of reading. The same is true relative to mathematical skills, written language skills and oral language skills. Weak motor skills would negate placement in jobs requiring well developed motor skills. Counseling can assist the client in matching his/her skills to vocations in which his/her strengths are maximized and his/her weaknesses are minimized.

The following suggestions have been offered for optimizing the match between client and vocational placement (Vocational Rehabilitation Center of Allegheny County [VRCAC], 1984):

1. Clients who perseverate or dislike change may do well in a repetitious job.

2. Hyperactive clients might do better in jobs requiring physical activity and extra productivity.

3. Jobs requiring constant adaptation to changing circumstances or impatient employers should be avoided.

4. Persons with auditory perceptual handicaps need a quiet workplace rather than jobs with a high level of background noise.

5. Persons with perceptual problems should not be placed in jobs requiring complex visual analysis.

6. The general social climate at the work site should be considered relative to whether a worker with a learning disability will be well received.

Job-Related Learning Remediation

The fact that adults with learning disabilities continue to have academic problems and should be viewed as lifelong learners supports the need for remediation programs for persons with learning disabilities who are motivated to master academic skills in adulthood that they might not have been motivated to master when they were in school. Surveys indicate (Hoffman et al., 1987) that adults with specific learning disabilities continue to encounter difficulty with reading, spelling, arithmetic, and memory. Okolo and Sitlington (1986) suggested that academic instruction be conducted in the context of the types of skills that are required in the world of work. Such an instructional emphasis would be more efficient and probably more motivating than basic remedial education.

Some people with learning disabilities are recognizing that attending college is a realistic goal (Cowan, 1985). With an effective program of counseling and academic support, a person with high motivation can make dramatic gains. When students are successful, they can become more independent. This combination of academic success and reduced academic dependency on others can lead to increased self-confidence.

One remedial technique involved in serving college students with learning disabilities involves the teaching of compensatory strategies. These compensatory strategies are intended to allow the student to minimize the effect of the disability on academic performance (Vogel, 1982). Compensatory strategies are a first step rather than a solution. The ultimate goal of the intervention is to develop academic skills to the degree that the need for accommodations, though possibly never negated, is minimized.

Examples of compensatory strategies include using a dictionary to improve spelling, using a word processor to alleviate handwriting difficulties, tape recording lectures to enhance poor notetaking skills or using oral textbooks to compensate for severe reading difficulties. Other accommodations can include extra time for examinations and assignments, oral examinations, note takers, and modified assignments. Compensatory strategies do not change what is to be learned, nor do they decrease the student's need to learn it. Rather, they alter the instructional process so the student has an equitable chance to learn and to demonstrate what has been learned without being unfairly penalized by his/her disability.

Job-Related Interpersonal Skills

Several authors have identified a variety of social-emotional difficulties experienced by adults with specific learning disabilities. These difficulties include emotional instability (Haig & Patterson, 1980), social imperception leading to significant communication difficulties (Smith, 1983), and poor self-esteem and related low scores on a social skills test (Hechtman, Weiss, & Perlman, 1980). Blalock and Dixon (1982) concluded that many adults with learning disabilities exhibit more affective deficits than strengths. One survey (Association for Children and Adults with Learning Disabilities, 1982) indicated that many learning disabled adults have significant problems with frustration, depression, lack of self-confidence, and control of emotions and temper. For some adults, these problems interfere with job performance.

Support groups and counseling are needed to help some adults with learning disabilities overcome their frustration and lack of self-confidence resulting from years of academic failure in school and possibly in the work place. Often when these individuals measure themselves against their perception of what an adult should be, they view themselves as failures (Crimando & Nichols, 1982). A starting point for successful intervention in this area might be to help the client arrive at a realistic appraisal of successful personal adjustment (Polloway, Smith, & Patton, 1984).

While there are a number of effective social skills programs currently on the market for use in classroom settings, adults with more severe problems may require more intensive psychological therapy.

Specific Vocational Skills

A growing body of literature indicates that adults with learning disabilities need advanced vocational skill training. Personnel from the National Center for Research in Vocational Education (Selz, Jones, & Ashley, 1980) concluded that, after basic reading, writing, and math skills, the ability to use tools and equipment on the job was the most important worker competency identified by employers. Ruffner's (1981) study of members of the American Management Association identified lack of marketable skills and poor job preparation as factors hampering the employment of handicapped persons. While many students are trained for blue-collar and social service positions, employment demands are for applicants with technical training. Individuals with learning disabilities need training in technical fields due to the emergence of high technology industries which demand specific vocational skills training. Surveys of adults with learning disabilities indicate that most have received little or no vocational counseling and guidance (Hoffman et al., 1987). Secondary and post-secondary programs must be provided if these individuals are to be trained for vocational competence. The provision of such services should minimize the need for these individuals to receive vocational rehabilitation services in later life if their personal abilities and skills can be matched to job requirements. Clients with relatively extensive work histories, average intelligence levels, and academic ability levels higher than grade 5.0 seem to be appropriate candidates for counseling and guidance rather than more comprehensive vocational rehabilitation services (VRCAC, 1984).

Job Placement and Maintenance

Finding a job suited to the individual's disabilities and abilities is a high priority goal for adults with specific learning disabilities. Knowing where to find a job, knowing how to get job training, and filling out job applications have been cited as major vocational problems for these individuals (Hoffman et al., 1987). Personnel from the Research and Demonstration Project on Improving Vocational Rehabilitation of Learning Disabled Adults at Woodrow Wilson Rehabilitation Center conducted a survey (Minskoff, Sautter, Hoffman, & Hawks, 1987) to identify factors leading to successful job placement and job maintenance of adults with learning disabilities. Of the employers surveyed 72% reported willingness to hire handicapped workers and make allowances such as allocating extra time for training, offering more support and encouragement, and providing a job suited to the particular person's abilities; but, only 51% reported willingness to hire the learning disabled. The difference in the figures is likely related to lack of knowledge about learning disabilities.

Perhaps employers feel that they can understand handicaps they can see, whereas they cannot understand cognitive handicaps (such as learning disability) which are not readily apparent (Crimando & Nichols, 1982; Mithaug, 1979). The fact that only 15% of those surveyed had ever hired a person with a learning disability indicated a lack of any basis for evaluating the quality of work of learning disabled persons. An obvious conclusion from this study is that, before workers with learning disabilities can be expected to succeed in the job market, an intensive program of information dissemination and public relations must be implemented (Minskoff et al., 1987). Otherwise, potentially productive persons will continue to be vocational underachievers because of the misperceptions of others.

Summary

Presented in this article were a model for identifying Specific Learning Disabilities in adults and recommendations for services that address the needs of this population. A thorough knowledge of the client's strengths and weaknesses gained through educational and vocational assessment coupled with an understanding of how the learning disability will affect the client's potential job performance will significantly improve the counselor's ability to assist the client in securing successful employment. In addition, the counselor would be prepared to make recommendations to the employer concerning any accomodations or job modifications that the client requires in order to perform his/her job successfully. It should be emphasized that persons with learning disabilities are quite diverse in terms of characteristics. Therefore, the unique needs and abilities of each individual should be considered. [Figure 1 and 2 Omitted]

ROBERT G. SIMPSON and BOBBIE T. UMBACH are with the Department of Rehabilitation and Special Education at Auburn University in Alabama.