Article Details

Research Database: Article Details

Citation:  Chiu, C. Chan, F., Bishop, M., da Silva Cardoso, E., & O'Neill, J (2013). State vocational rehabilitation services and employment in multiple sclerosis. Multiple Sclerosis Journal, 19 (12), 1655-1664.
Title:  State vocational rehabilitation services and employment in multiple sclerosis
Authors:  Chiu, C. Chan, F., Bishop, M., da Silva Cardoso, E., & O'Neill, J
Year:  2013
Journal/Publication:  Multiple Sclerosis Journal
Publisher:  Sage Publications
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes
Research design:  Database mining

Structured abstract:

Background:  Diagnosis of multiple sclerosis (MS) usually occurs for adults in the early years of their careers. Individuals with MS have higher rates of unemployment and underemployment than the general population. The unemployment rate has been estimated at 56 to 58%. However, it has been reported that the majority of those unemployed would prefer to be working.
Purpose:  This study used a large national data set to explore the effectiveness of vocational interventions in promoting employment outcomes for people with MS. The data was retrieved from the the U.S. Department of Education, Rehabilitation Services Administration's (RSA) Case Service Report (RSA-911) database.
Setting:  Mike
Study sample:  There were data for 1920 individuals with MS whose cases were either closed successfully or unsuccessfully in competitive employment. Of this number, 68.8% were male and 31.2% were female. The majority (98.6%) were identified as having significant disabilities. The authors provide a detailed table of the participant's demographics.
Intervention:  Interventions were described as the services provided by state vocational rehabilitation (VR) agencies. A detailed table is provided in the article with definitions of each of the services provided to include but not limited to assessment, VR counseling, college or university training, on-the-job training, job placement assistance, transportation and so forth.
Control or comparison condition:  Mike
Data collection and analysis:  Data were extracted from the RSA-911 database, which is a large archival database provided annually to RSA by state VR agencies across the country.
Findings:  After receiving VR services, 48.1% of the sample were employed. No gender differences were found between the individuals who were employed vs unemployed. There was a significant difference between racial and ethnic backgrounds. African American clients had lower employment rates when compared to whites. More clients in the employment group had higher levels of education than those in the unemployed group. Significantly more unemployed individuals at closure were receiving disability-related medical or cash benefits. The successfully employed group were found to spend significantly less time in services than the unsuccessful group. However, the employed group received significantly more services. The most frequently used services were comprehensive assessment and counseling and guidance. This was followed by diagnosis and treatment of impairments and job placement assistance. The odds of clients with MS who have a college or higher degree finding employment were 1.86 times greater than the odds of those with less than a high school degree. However, college education as a VR service is negatively associated with employment outcomes. After controlling for the effect of the demographic covariates, five VR services were found to significantly increase the chance of successful employment outcomes. This included counseling and guidance, job placement assistance, on-the-job supports, maintenance services, and assistive technology services. Other detailed findings are highlighted in the article.
Conclusions:  The study underscored the importance of early referral of people with MS to state VR agencies. The possibility of returning to work independently is reduce dramatically once a person moves from short-term disability benefits to long-term disability benefits.

Disabilities served:  Multiple sclerosis
Populations served:  Gender: Female and Male
Race: American Indian or Alaska Native
Race: Asian
Race: Black / African American
Race: White / Caucasian
Ethnicity: Hispanic or Latino
Interventions:  Assistive technology
Job search and placement assistance
On-the-job training and support
Rehabilitation counseling
Vocational assessment
Vocational rehabilitation
Outcomes:  Employment acquisition