Predicting the likelihood of job placement: a short-term perspective.

During the past decade, numerous books and articles have documented the proliferation and success of supported employment programs for individuals with mental retardation and other developmental disabilities. These studies have reported data concerning the type of training models used, demographic and functional characteristics of the individuals who have participated, the types of employment positions they have obtained and the range of benefits and wages they have earned (Ellis, Rusch, Jho-Ju, & McCaughrin, 1990). In general, these studies can be characterized by their synchronic analyses of large data sets. In contrast, microanalyses emphasize specific issues about specific populations over an extended period, and provide a more detailed understanding of an individual's needs (DeStefano, 1990; Shafer, Banks, & Kregel, 1991).

In recent years supported employment programs have begun to serve individuals with learning disabilities (Levy, et al., 1993; Gaylord-Ross, et al., 1988), and psychiatric disabilities (West, Revell, & Wehman, 1992; Trotter, Minkoff, Harrison, & Hoops, 1988; Danley & Anthony, 1987). As the number of programs for individuals with various disabilities continues to grow, a shift from standardized programming to more inclusive and individualized service provision for diverse populations is required (Leung, 1993; Usdane, 1993; Danley & Anthony, 1987). This theme has been articulated in a number of recent articles discussing the changing cultural, ethnic and racial demographics in the U.S. and their impact upon rehabilitation professionals and practices (Botuck, et al., 1993; Wilson, O'Reilly & Rusch, 1991).

With the expansion of supported employment to diverse populations, detailed examination of the patterns of training and support for individuals with different disabilities is needed in order to determine the type of training and support needed. In fact, the first six months is a critical period in all employment programs because it is during this time that the type and the amount of training an individual will require for job placement and job maintenance is critical to her continued success. As researchers in an applied setting, our purpose is to provide information which will support practitioners in enabling individuals to actualize their vocational plans as well as to guide administrators in the design and implementation of programs for diverse populations. To do this, examination of the effects of various disability categories together with individual characteristics is required. As programs serve increasingly diverse populations, these considerations become important on the individual and on the programmatic level as administrators design and implement programs for more varied populations.

The purpose of the present study was to examine characteristics which would predict the likelihood of job placement during the first six months of program participation. Age, gender and diagnostic category as well as previous employment, type of financial assistance from government sources and life satisfaction score were examined. These variables were selected from literature examining factors which have been associated with employment outcomes (Sitlington & Frank, 1993a; Fourqurean, Meisgeier, Swank & Williams, 1991; Edgar,1988; Hasazi, Gordon & Roe, 1985, gender; Conley, 1986, employment history; Anthony and Jansen, 1984, financial assistance; Louis Harris & Associates, 1986, life satisfaction).

Method

Program Overview and Location

Participants were involved in an individualized training program targeted to be completed within three months. On a daily basis, individuals participated in vocational skills and employability behavior training. Individualized, vocationally focused counseling was provided on a weekly basis, and regularly scheduled case conferences, to which family members/caregivers were invited, were held. Through a process which integrated skill training, job seeking assistance and job development efforts a match was made between skills, abilities and interests and an employment opportunity in the community.

All placements were in community businesses, in jobs which paid the industrial standard (which was always at or above minimum wage) and were a minimum of 30 days. Intensive, on-site supports from an employment training specialist were provided for as long as was needed. Each program site was housed in a community-based location, accessible by public transportation. Services were provided at program sites as well as at a variety of competitive job sites throughout New York City and the metropolitan area.

Participants

Between January 1990 and December 1991,200 individuals began training and participated in the study. As can be seen in Table 1, which presents initial intake information on the participants, the average age of the participants was 24.3 years (SD=7.69). Forty-one percent of the participants (n=81) had a primary diagnosis of mental retardation with most functioning in the mild to moderate range, 38% (n=76) had a primary diagnosis of severe learning disability(1) and 21% (n=43) had a primary diagnosis of psychiatric disability. Twenty-nine percent of the participants (n=49) had secondary diagnoses as well. Eighty percent of the participants (n=161) were minority group members, and 29% (n=58) were Spanish speaking. Seventy-seven percent of the participants (n=154) resided with their families, 15.5% (n=31) lived independently, and 7.5% (n=15) lived in group homes or supervised apartments. Fifty percent (n=100) had been competitively employed prior to entering the program.

Table 1
Frequency Distribution of Participants' Characteristics

   Characteristic                       f                %

Primary Diagnosis:
  Mental Retardation                    81              40.5
  Learning Disability                   76              38
  Psychiatric Disability                43              21.5

Secondary Diagnosis:
  None                                  141             70.5
  Learning Disability                   11              5.5
  Psychiatric Disability                15              7.5
  Other                                 33              16.5

Age:
  17 - 21                               103             51.5
  22 - 29                               60              30
  30 - 39                               26              13
  40 - 61                               11              5.5

Gender:
  Men                                   112             56
  Women                                 88              44

Race:
  African American                      97              48.5
  Latino                                56              28
  White                                 39              19.5
  Other                                 8               4

Residence:
  Lives with Family(2)                  154             77
  Group Home                            6               3
  Supported Apartment                   9               4.5
  Lives Independently                   31              15.5

Benefits Status:
  Individual and Family Benefits        37              18.5
  Individual Benefits                   76              38
  Family Public Assistance              22              11
  No Individual or Family Benefits      65              32.5

(2) Parents/Grandparents/Siblings

Measures

The data reported in this study were obtained from a longitudinal project designed to describe specific aspects of the job training process as well as to examine specific post-training outcome criteria over time. Information concerning the training process and actual employment outcomes as well as information regarding the amount and type of specific financial assistance received by the individual or her family from government sources was collected on a monthly basis. In addition, comprehensive socio-demographic and background information was collected at intake when each individual also completed a modified version of the Andrews and Withey Scale of Life Satisfaction (Andrews & Withey, 1976). All of this information was completed by the participant (with the assistance of an employment counselor when needed) and returned to the research department. The data were analyzed using SPSS/PC+, version 5.1.

Results

Thirty-three percent (n=65) of the participants were employed during their first six months in the program. Of those, 40% (n=26) were employed before their target work dates. Logistic regression was used to estimate the conditional probability of working within the first six months of participation in the program given a set of independent variables. In the initial analysis the independent variables used were: diagnostic category (coded using two dummy variables), age, gender, whether the individual had previously been competitively employed, type of financial assistance at entrance (individual, family, individual and family, no financial assistance) and total score on the Andrews and Withey Scale of Life Satisfaction (Andrews & Withey, 1976). A stepwise logistic regression equation identified age, gender and diagnostic category as key variables. In a second stage analysis all of the two-way interactions were considered but only the age x gender interaction was found to be significant. The final logistic regression model contained the following variables: diagnostic category, gender, age, and gender x age. Table 2 presents the final results in terms of the log odds of working. In Table 2, the variable [DX1.sub.(1)] contrasts the group with mental retardation with the group with psychiatric disability and [DX1.sub.(2)] contrast the group with learning disabilities with the group with psychiatric disabilities. From Table 2 the logarithm of the odds of working can be expressed by the following equation: LO = 2.4653 + 1.3087([DX1.sub.(1)] + 1.24([DX.sub.(2)] - 0.079(age) - 3.5047(gender) -0.1006(age x gender). From this equation the probability of working can be expressed as P = [e.sup.LO]/([1+e.sup.LO]). The rank ordering of the three diagnostic groups in terms of their probabilities of working is highest for those individuals with mental retardation (MR), followed by those with learning disabilities (LD) followed by those with psychiatric disabilities (PSYCH). However, it should be noted that whereas the difference between MA/PSYCH and LD/PSYCH is large and statistically significant (see Table 1), this is not the case for the MR/LD comparison whose probabilities were similar. Therefore the MR/LD group is combined. Figure 1 presents the probability of working for women and men separately as a function of age for the two groups (MR/LD) and (PSYCH). As can be seen in Figure 1, age is more of a determining factor for women than for men. This can be seen by the steeper slope for women than for men. Moreover, within each diagnostic group, women below the age of 35 have less of a probability of being employed than men and men above the age of 35 have a lesser probability of being employed than women.

[Figure 1 ILLUSTRATION OMITTED]

Table 2

Variable:                          B         S.E.      P Value

Primary Diagnosis([Dx.sub.1])                           .050
[Dx.sub.1(1)]                      1.31      5.28       .010
[Dx.sub.1(2)]                      1.24      6.06       .050
Gender                             -3.50     1.141      .002
Age                                -0.08     .061       .199
Age x Gender                        0.10     .043       .050
Constant                            2.46     1.596      .122

Discussion

This research examined the association between individual characteristics (gender, age, diagnostic category) previous employment, a measure of life satisfaction, the type of financial assistance an individual received from government sources, and obtaining employment placement within six months of program entry. With respect to diagnostic category, we found that individuals with moderate to mild mental retardation and severe learning disabilities were placed in jobs at similar rates. This is consistent with our previous findings (Levy et al., 1993) concerning placement rates over a two-year period. In contrast, individuals with psychiatric disabilities had lower probabilities to be placed than either those with mental retardation or severe learning disabilities. A number of studies have reported poorer outcomes for individuals with psychiatric disabilities than other disability groups (Andrews et al., 1992; Marshak, Bostick, & Turton, 1990). One factor which may contribute to this finding relates to the time of onset of mental illness which often occurs during later adolescence or young adulthood, a time when individuals with developmental disabilities are already participating in employment programs and/or have become familiar with the resources and support systems they require to successfully obtain employment in the community. Trotter, Minkoff, Harrison, & Hoops (1988) found a relationship between onset of disability and employment for individuals with a psychiatric diagnosis. They found that individuals with a diagnosis made at age 19 or younger were nearly twice as likely to be employed as individuals with adult onset. In addition they report that an individual's adjustment to disability may play a positive role in becoming employed by facilitating acceptance of the disability and enabling the development of strategies to meet challenges. According to Bilby (1992) a major obstacle in the placement of individuals with psychiatric disabilities relates to their adjustment to the work place and not insufficient work skills.

The finding of poorer placement outcomes for participants with psychiatric disabilities relative to individuals with mental retardation and learning disabilities highlights the need to review the different approaches currently advocated for individuals with psychiatric disabilities by rehabilitation counselors. The transitional employment model assumes that the individual is not ready for immediate placement without a transitional phase of being exposed to different work environments. In contrast, the supported employment model criticizes the need for this transitional period. Bilby (1992) has presented evidence supporting the use of the transitional employment model with individuals with psychiatric disabilities who can not be expected to immediately enter the work force. This view is substantiated by the Fountain House Foundation Study (1985) which demonstrated that participation in a transitional employment program significantly improved the employment rate over an extended time period. Therefore it is not surprising that in the present study which examined job placement in the initial six months of participant entry, individuals with psychiatric disabilities had lower rates of job placement as compared to those individuals with mental retardation/learning disabilities.

By far the most significant finding was that within each disability category, the age by gender interaction contributed to differential placement probabilities. In early adulthood, the probability that men would obtain a job placement was greater than for women. However this probability reversed after age 35 when women were more likely to obtain placement than men. The results concerning the age by gender interaction highlight the importance of examining gender related differences across the life span. Although gender related differences in employment outcomes for people with disabilities are widely recognized, i.e., women are employed at lower rates than are men (Sitlington & Frank, 1993a; Edgar, 1988; Hasazi, et al., 1985) and have poorer employment outcomes i.e., lower wages (Levy, et al, in press; Sitlington & Frank, 1993b); reduced benefits (Levy, et al., in press); more restricted jobs (Levy, et al., 1993); etc., age-related gender differences been received less attention. What are the reasons women over the age of 35 are more likely to be placed than women who are younger? One way this question can be answered is through retrospective examination of the life histories of women participants. Exploration of factors such as women's involvement in family caregiving, parental involvement/investment in their daughters' becoming employed, and the specific activities women were involved in prior to participation in supported employment could provide possible explanations for the finding. For example, if women over 30 had previously attempted to become employed but had been unsuccessful in their attempts, then there would be a need for "second chance" programs. Such programs could offer employment opportunities to women with disabilities who had been unsuccessful in earlier attempts. On the other hand, were we to find that many women had not been engaged in employment seeking activities in early adulthood, it would suggest "expanding pre-placement activities for women in order to enable them to make more informed choices regarding job opportunities and carrying out satisfying career plans" (Botuck, et al, 1993, p.222).

The results of this study also uncover a need to examine the seemingly static rate of placement among males beyond early adulthood. Moreover, in addition to the need for descriptive studies to provide further explanation for all of the heretofore mentioned patterns, there is a need for cross-sequential studies to determine if these patterns will persist over time.

Acknowledgement

For reprints of this article, please contact Joel M. Levy, DSW, Chief Executive Officer, Young Adult Institute, 460 W. 34th Street, New York, New York 10001.

(1) All members of this diagnostic category were assessed as learning disabled by school personel, as well as determined to be serverely disabled by state vocational rehabilitation counselors in accordance with criteria based upon the federal definition of "severe handicap" and as outlined in Program Assistance Circular RSA-PAC-90-7 (Carney, NC; 1990).

(2) Parents/Grandparents/Siblings

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Received: February 1994 Revision: May 1994 Acceptance: July 1994