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An alternative approach to employment for people with deaf-blindness.

An Alternative Approach to Employment for People with Deaf-Blindness

Deaf-blindness, one of the most isolating and debilitating conditions known to man, demands a specialized approach to comprehensive services. A particular challenge is the provision of employment services which will allow people to experience success in spite of their profound multiple handicaps. An estimated 40,000 Americans have this condition. No other population with disabilities faces a greater likelihood of exclusion from the work force and being at such extreme risk for chronic unemployment.

Established in 1967 by a unanimous act of Congress, the Helen Keller National Center (HKNC) operates under the general supervision of the Rehabilitation Services Administration. It is authorized under Title II of the Rehabilitation Amendments of 1986 and funds for its operation are appropriated annually by Congress. Headquartered in Sands Point, New York, HKNC offers its consumers (who are referred and sponsored by their state vocational rehabilitation agencies) individualized diagnostic evaluation and short-term comprehensive rehabilitation training. The center also operates an extensive network of field services through its 10 regional offices, a National Training Team, Technical Assistance Center (TAC), and some 26 affiliated agencies. These affiliates are public and private agencies that receive temporary financial assistance and training from HKNC to develop and/or expand services for the deaf-blind population throughout the country.

The center's program focus is the provision of personal adjustment training in communication skills, orientation and mobility, personal hygiene and skills of daily living, home management, and other areas related to increasing the capacity of the individual to participate more fully in his/her home community. In addition to deaf-blindness, many clients have other diabling conditions, such as mental retardation, orthopedic and cardiac problems and diabetes.

Traditionally, vocational options for people with profound and/or multiple disabilities have been limited to a narrowly defined continuum, including placement in work activity centers, sheltered workshops or, less frequently, fully competitive environments. An alternative approach to employment in community-based work settings is supported employment. Yet, 2 years ago, HKNC's TAC, funded through a cooperative agreement with the U.S. Department of Education, Special Education Programs, conducted a search to identify supported employment programs serving people with deaf-blindness. TAC found that although there were community-based work programs for school age youths with deaf-blindness, there was a paucity of comparable programs for adults who are deaf-blind.

In response to this obvious program need, supported employment became a major priority for TAC. Activities have consisted primarily of intensive training workshops to build the necessary knowledge base to develop supported employment sites and offer practical learning experiences. Onsite consultation and followup were provided, as needed. The TAC Project has been a partner in the successful programming and implementation of supported employment in Kentucky, Georgia, Colorado, Illinois, Florida, and Washington, D.C.

One of HKNC's affiliates, the Arizona Department of Economic Security, Services for the Blind and Visually Impaired, has been actively involved with The Community Outreach Program for the Deaf (COPD) in Tucson, which received a supported employment grant to serve people with deaf-blindness. Rod Ferrell, the affiliate coordinator of deaf-blind services, reports that one participant in the project, Robert Burdine, a former HKNC client who was employed as a member of a work crew, is now an independent houseman at the Plaza International Hotel. Connie Ochs, nearing completion of her training at HKNC is slated for supported employment in Tucson as well. COPD recently received a 3-year federal grant to provide "Comprehensive Community Adjustment for Deaf-Blind Youths and Adults in Transition" which will demonstrate an integrated model of community living, work and social skills. For example, Mr. Burdine is living in an Adult Developmental Home in his own independent apartment and is a happy, well adjusted, contributing citizen. "We realize that supported employment is a new philosophy that will require `systems change.' We consider HKNC's TAC a vital partner in our commitment to try new techniques for serving persons who are deaf-blind," Mr. Ferrell noted.

According to TAC Director Angela Covert, "In the early days of the TAC Project, the suggestion that individuals with deaf-blindness and other severe disabilities might live and work in the community was generally met with skepticism, if not outright rejection. Supported employment was quickly dismissed as `it will never work.' In 3 short years, there has been a discernible shift in this attitude with a greater willingness to `make it work.' Although there has been great progress, the task is enormous and continuing efforts are needed to insure that all adults with deaf-blindness have opportunities to live and work in the community."

Several years ago, HKNC expanded its traditional personal adjustment training curricula to include community-based employment training in a unique "Work Experience Program" (WEP). Formalized a year ago, the program exposes clients to a variety of realistic work settings in local communities and now incorporates the principles and practices of supported employment, stressing the need for intensive and perhaps ongoing support. Some clients have had little or no job experience. Others, who already understand the subtleties and expectations of the workplace, need to explore new opportunities, develop new skills or learn to deal with the adjustment of hearing and/or visual deterioration or loss.

The center's WEP Coordinator, Dennis Brady, first meets with the client to consider vocational goals and review pertinent background information. A situational assessment may be made in a work experience on campus - in bookkeeping, food service, braille proofreading, and teacher's aide, to name a few. The client's abilities, aptitudes and personal preferences are essential. Armed with these facts and cognizant of the job market outlook, the coordinator matches the client with a community job off campus.

The community "work providers" are typical of most employers. They have no special communication skills, they've never hired an employee who is deaf-blind and are often resistant, but the jobs are typical positions that anyone would perform.

Each match is unique, as are the preparatory work and the required strategies for support systems. Usually, the coordinator prospects sites looking for challenging jobs, always networking and using contacts where possible.

The following case example illustrated HKNC;s WEP:

* Carment Rios, a resident of California, is deaf and visually impaired. She has good writing skills and a knowledge of English. The Long Island district Social Security office needed assistance in processing some 3,000 monthly applications. After a site visit to determine of the physical working environment was suitable, the WEP coordinator met with the key people who would interface with Ms. Rios. Then they met with Ms. Rios, with Mr. Brady as interpreter. A Social Security employee, who later assigned and verified Ms. Rios' work, first taught Mr. Brady the tasks. Acting as job coach, he instructed Ms. Rios in four specific tasks involved in alphabetizing applications by date and returning them to her co-worker. Simple adjustments were made to accommodate glare from large exterior windows. Mobility training focused on routes to her worksite in the building, to the restrooms and to the lunchroom. Assertiveness training encouraged Ms. Rios to communicate her needs to others. After five supportive sessions at the office, Ms. Rios was able to negotiate on her own. HKNC provides transportation. According to District Manager Anita Jankowski, "Carment is terrific. She has a positive attitude toward her work and works very hard. She has definitely been an asset to us."

* Working in the cafeteria at nearby St. Francis Hospital, Leonard Fergerson's job coach was an instructor from HKNC's communications department. He needed to learn job-related vocabulary in written and sign language modes. He couldn't read the lunch menu, and was thus unable to order for himself. His time skills needed sharpening to enable him to identify "break time." A Center mobility specialist reinforced Mr. Fergerson's indoor cane skills in the congested cafeteria.

* An "enclave" is another alternative approach to the supported employment model. Four HKNC clients are working at Independent Living Aids, Inc., where they label brochures, stuff envelopes, zip code letters, collate, and staple papers. A WEP intern and residence aide serve as job coaches during this experience, which occurs 2 days each week. Supports included mobility training for routes from their worktable to restrooms and breakroom. Prompting, to keep clients on their tasks, is ongoing. An HKNC van transports them about 45 minutes each way.

"The ultimate evaluation of everything we do and provide at HKNC is what happens to, for and with our clients once they return home," states HKNC Director Stephen Barrett. To help implement this concept, the center's placement specialist identifies a client's residential and vocational goals, building on knowledge accumulated during training, with input from the client, state counselor and HKNC's regional representatives and affiliates, if appropriate.

Networking with state counselors, other professionals, government agencies, and civic groups in the client's hometown, as well as HKNC affiliates and regional representatives, the placement specialist searches for local resources: potential employers, residential programs and ancillary services (i.e., interpreters, transportation, continued training in braille or ASL, recreation, home maintenance). Once services and employers are known, a field visit is made to assess the worksite, analyze the job and make any needed modification. "I assist, facilitate and advocate for the client," explains Jeremy Burwell, HKNC senior placement specialist. "It means getting applications started, setting up interview appointments, negotiating systems, stressing the individual's eligibility for services. Once a client is placed, followup services are necessary to ensure successful long-term placement. One of the major areas of concern when seeking job opportunities for people who are deaf-blind is attitudinal barriers. There is a real lack of knowledge by the public and professionals of what a person with deaf-blindness can do. This is still an underserved population, even though many people are working in a host of jobs, from assemblers, clerk-typists and lab assistants to computer programmers, word processor operators, teachers, counselors, mechanics, and engineers," said Mr. Burwell. He cited a few examples of recent job placements:

* Tom "P," in his early 30's, has Usher's syndrome. Originally an electronics assembler, he enrolled at HKNC when his vision began to deteriorate. After skills training, job readiness, counseling, and career exploration, he participated in the center's teacher's aide program and was later hired by Overbrook School for the Blind in Philadelphia as a teacher's aide and sign language instructor.

* During his early 20's, "D.L.," deaf-blind due to maternal rubella syndrome, expected his training outcome to be sheltered employment. After a work experience in food service on and off campus, HKNC staff realized that "D.L." had potential for employment in the competitive market. A videotape of his performance and a written recommendation from his community employer was sent to the referring agency along with recommendations for ongoing food service training. Soon after, he was working full-time in a fast-food restaurant and is presently being considered for a supervisory position.

* "G.M.," a young woman, also deaf-blind as a result of rubella syndrome, participated in a baking and cooking work experience on campus. She is now working and training in a community-based bake shop in Westchester County, New York. Consultation was provided by the HKNC mobility and home management staff and an interpreter/job coach was facilitated through other local community agencies.

The Helen Keller National Center has been addressing the needs of a population which is perhaps one of the most challenging to vocational rehabilitation. HKNC Director Barrett and his staff believe that early planning, identification and coordination of support services, training of vocational rehabilitation staff and employers in the local community, and matching clients' support needs with local resources will lead to employment and integrated living in the home community for people with deaf-blindness. The service models at center headquarters and nationwide are also applicable to other profoundly disabled populations. They are surely valuable to administrators and staff of rehabilitation training centers which are attempting to define or expand their role in providing employment-related services. But the ultimate evaluation of HKNC's highly structured approach to supported employment and living, and to its training and service delivery system, rests with the consumers themselves.

Ms. Hausman is Director of Public Relations, Helen Keller National Center for Deaf-Blind Youths and Adults.
COPYRIGHT 1989 U.S. Rehabilitation Services Administration
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1989, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Author:Hausman, Barbara
Publication:American Rehabilitation
Date:Mar 22, 1989
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