Individuals with mental disabilities: perceptions of work limitations

This research investigates the perceptions that individuals with mental illnesses have about the employment experience as a whole. Survey data from 72 respondents with mental disabilities were used to identify areas of perceived work limitations. Comparisons regarding employee work performance were made between eleven individuals with mental disabilities and their supervisors. Functional limitations identified by respondents with mental disabilities and the characteristic symptoms set forth in the Diagnostic and Statistical Manual of Mental Disorders were compared. Overall findings showed that individuals with mental disabilities in this study had problems in the areas of judgment, initiative, interacting and rapport with co-workers and supervisors, frustration tolerance and coping with job stress, and adapting to changes at work. Comparison of identified work task difficulties with diagnostic criteria indicate active symptomatology to have an effect on job performance. Recommendations regarding occupational therapy assessment approaches and roles to facilitate ADA implementation are presented.

Profile of Florida: Services in transitional housing programs for homeless women with children

Family homelessness is a disturbing social problem in the United States. This study was conducted to determine the scope of components that included services and programs available for homeless women with children in transitional housing programs in Florida and the effectiveness of these components in helping these women move towards independence. Primary data for this study were obtained through questionnaires sent to directors of homeless centers in Florida. Supportive services offered by these centers were evaluated to determine if they enabled homeless women with children to become self-sufficient. The findings of this research indicated that regardless of the size, length of participation, and scope of services provided by the centers, these women showed gains in their ability to move toward self-sufficiency. The results support the hypothesis that transitional housing programs have a positive effect on homeless women with children. ^

*Postsecondary access for individuals with psychological disabilities: An analysis of federal rulings and institutional philosophies, *policies, and practices

This study was a qualitative investigation, with demographic quantitative features, of post-secondary educational access and legal guidelines for individuals with psychological disabilities. Although disability laws have positively influenced post-secondary educational attitudes and practices relative to accommodating many individuals with disabilities, prevailing stigmas regarding mental illness have discouraged the equal access to higher education for individuals with psychological disabilities. Little research concentrating on this area was found.^ Thirty-six relevant legal case decisions, focusing on a variety of realms of higher education, were scrutinized. The policies, procedures, and practices of six Southeastern United States universities were analyzed through official documents and participant responses from disability service providers and other university employees. Comparisons were made between legal cases, and within and between universities. Case findings also provided standards through which participating university practices could be studied.^ The legal analysis revealed that most institutions did not discriminate against individuals with psychological disabilities. Practices of a few of these institutions, however, suggested non-compliance despite favorable decisions on their behalf. Institutions found to have discriminatory practices were cited for inadequate procedures, or for presumptive assessments of the educational functioning levels of individuals with psychological disabilities.^ Participant university practices generally suggested disability law compliance; however, certain campus interventions were determined to be ineffective in identifying, addressing, and communicating about the educational needs of individuals with psychological disabilities. The most effective services for these individuals, who were described as rapidly increasing in number but lagging in self-advocacy and acceptance by others, went beyond legal requirements.^ Recommendations were made for institutional practices concerning disability-related documentation, written standards and operations, and student identification and referral. Directions for future research focused on study skills training for students; exposure of mental health professionals to client educational needs; and expansion of the current research, on a nationwide collegiate level, and a parallel analysis focusing on business and industry. ^

Organizational response to employment under the ADA of workers with psychiatric disabilities: Four case studies

Title 1 of the Americans with Disabilities Act (ADA) requires all employers, public and private, with more than fifteen employees to provide reasonable accommodation to qualified individuals with disabilities if the accommodation would, within limits, allow the individual to perform the essential functions of the job. Seven years after Congress enacted the law and five years after the initial provisions became effective, little information is available about the experience of organizations faced with requests for workplace accommodation.^ The question addressed in this study is: How are organizations responding to the ADA mandate to fit individuals with psychiatric disabilities in the workplace? The data sources are three organizations that allowed access to this sensitive information, and a fourth that had two disability discrimination charges filed against it.^ A brute-force case method approach applied to the four organizations yields the following information: Attorneys are hesitant to allow inquiry into company policy owing to fear of litigation; workers are not disclosing and requesting accommodation; tacit accommodation of long-standing employees appears to be a regular practice; knowledge of the intent of the ADA makes a difference in terms of equality of treatment; and insensitivity to employee privacy results in an adversarial situation.^ Implications are relevant to the need to improve lines of communication between human resource, EEO, supervisory, and legal staff; consequences of failure to address accommodations on an explicit level; need for better understanding of the availability and use of outside resources for achieving accommodation; and improvement of self-advocacy and disclosure by the employees with disabilities. ^

The effect of self-operated prompts on leisure participation by persons with mental retardation

The use of permanent prompts for individuals with severe disabilities has been shown to be effective in acquiring new skills, improving the accuracy and maintenance of existing skills, and in eliminating the need for trainer prompts. However, this technology has not been evaluated for its potential impact in promoting leisure participation. In this study, two men with mental retardation were administered auditory and/or visual prompts to investigate their effect on increasing participation in a leisure activity. In addition, their performance was evaluated to establish whether continuous versus intermittent schedules of the prompts would influence participation. The data were collected using a partial interval observation system and evaluated using a multiple baseline and an alternating treatment design. While both men increased their participation modestly in the leisure activity, there was no substantial difference between the two prompting schedules. ^

Examining a proposed job retention model for adult workers with mental retardation in supported employment

This quantitative study investigated the predictive relationships and interaction between factors such as work-related social behaviors (WRSB), self-determination (SD), person-job congruency (PJC), job performance (JP), job satisfaction (JS), and job retention (JR). A convenience sample of 100 working adults with MR were selected from supported employment agencies. Data were collected using a survey test battery of standardized instruments. The hypotheses were analyzed using three multiple regression analyses to identify significant relationships. Beta weights and hierarchical regression analysis determined the percentage of the predictor variables contribution to the total variance of the criterion variables, JR, JP, and JS. ^ The findings highlight the importance of self-determination skills in predicting job retention, satisfaction, and performance for employees with MR. Consistent with the literature and hypothesized model, there was a predictive relationship between SD, JS and JR. Furthermore, SD and PJC were predictors of JP. SD and JR were predictors of JS. Interestingly, the results indicated no significant relationship between JR and JP, or between JP and JS, or between PJC and JS. This suggests that there is a limited fit between the hypothesized model and the study's findings. However, the theoretical contribution made by this study is that self-determination is a particularly relevant predictor of important work outcomes including JR, JP, and JS. This finding is consistent with Deci's (1992) Self-Determination Theory and Wehmeyer's (1996) argument that SD skills in individuals with disabilities have important consequences for the success in transitioning from school to adult and work life. This study provides job retention strategies that offer rehabilitation and HR professionals a useful structure for understanding and implementing job retention interventions for people with MR. ^ The study concluded that workers with mental retardation who had more self-determination skills were employed longer, more satisfied, and better performers on the job. Also, individuals whose jobs were matched to their interests and abilities (person-job congruency) were better at self-determination skills. ^

Maternal-Fetal Attachment and Health Behaviors among Women with HIV/AIDS

Background: Mothers with HIV often face personal and environmental risks for poor maternal health behaviors and infant neglect, even when HIV transmission to the infant was prevented. Maternal-fetal attachment (MFA), the pre-birth relationship of a woman with her fetus, may be the precursor to maternal caregiving. Using the strengths perspective in social work, which embeds MFA within a socio-ecological conceptual framework, it is hypothesized that high levels of maternal-fetal attachment may protect mothers and infants against poor maternal health behaviors. Objective: To assess whether MFA together with history of substance use, living marital status, planned pregnancy status, and timing of HIV diagnosis predict three desirable maternal health behaviors (pregnancy care, adherence to prenatal antiretroviral therapy–ART, and infant’s screening clinic care) among pregnant women with HIV/AIDS. Method: Prospective observation and hypothesis-testing multivariate analyses. Over 17 consecutive months, all eligible English- or Spanish-speaking pregnant women with HIV ( n = 110) were approached in the principal obstetric and screening clinics in Miami-Dade County, Florida at 24 weeks’ gestation; 82 agreed to enroll. During three data collection periods from enrollment until 16 weeks after childbirth (range: 16 to 32 weeks), participants reported on socio-demographic and predictor variables, MFA, and pregnancy care. Measures of adherence to ART and infant care were extracted from medical records. Findings: Sociodemographic, pregnancy, and HIV disease characteristics in this sample suggest changes in the makeup of HIV-infected pregnant women parallel to the evolution of the HIV epidemic in the USA over the past two decades. The MFA model predicted maternal health behaviors for pregnancy care (R2 = .37), with MFA, marital living status, and planned pregnancy status independently contributing ( = .50, = .28, = .23, respectively). It did not predict adherence to ART medication or infant care. Relevance: These findings provide the first focused evidence of the protective role of MFA against poor maternal health behaviors among pregnant women with HIV, in the presence of adverse life circumstances. Social desirability biases in some self-report measures may limit the findings. Suggestions are made for orienting future inquiry on maternal health behaviors during childbirth toward relationship and protection.

The effects of writing process instruction on the writing and reading performance of students with learning disabilities

The purpose of this study was to determine the efficacy of a writing process approach for the instruction of language arts with learning disabled elementary students. A nonequivalent control group design was used. The sample included 24 students with learning disabilities who were in second and third grade. All students were instructed in resource room settings for ninety minutes per day in language arts. The students in the treatment group received instruction using the writing process steps to create complete meaningful compositions on self-chosen topics. A literature-based reading program accompanied instruction in writing to provide examples of good writing and to provide a basis for topic selection. The students in the control group received instruction through the use of the county-adopted textbooks and accompanying worksheets. The teacher followed basic textbook and curriculum guide suggestions which consisted mainly of fill in the blank and matching type exercises. The treatment group consisted of 12 students: five second-graders and seven third-graders. The control group consisted of 12 students: four second-graders and eight third-graders. All students were pretested and posttested using the Woodcock-Johnson Tests of Achievement-Revised (WJ-R ACH) for writing samples and the Woodcock Reading Mastery Test (WRMT) for reading achievement. T-tests were also done to investigate the gain from pre to post for each reading or writing variable for each group separately. The results showed a highly significant difference from pretest to posttest for all writing and reading variables for both groups. Analysis of Covariance showed that the population mean posttest achievement scores for all variables adjusted for the pretest were higher for the treatment group than those for the control group.

A comparative analysis of self-determined evaluations of work performance and support needs by adults with mental retardation in supported work and in sheltered workshop environments

The purpose of this study was to determine if there was a difference in the self-determined evaluations of work performance and support needs by adults with mental retardation in supported employment and in sheltered workshop environments. The instrument, Job Observation and Behavior Scale: Opportunity for Self-Determination (JOBS: OSD; Brady, Rosenberg, & Frain, 2006), was administered to 38 adults with mental retardation from sheltered workshops and 32 adults with mental retardation from supported employment environments. Cross-tabulations with Chi-square tests and independent samples t-tests were conducted to evaluate differences between the two groups, sheltered workshop and supported work. Two Multivariate Analyses of Variance (MANOVAs) were conducted to determine the effect of work environment on Quality of Performance (QP) and Types of Support (TS) test scores and their subscales. ^ This study found that there were significant differences between the groups on the QP Behavior and Job Duties subscales. The sheltered workshop group perceived themselves as performing significantly better on job duties than the supported work group. Conversely, the supported work group perceived themselves to have better behavior than the sheltered workshop group. However, there were no significant differences between groups in their perception of support needs for the three subscales. ^ The findings imply that work environment affects the self-determined evaluations of work performance by adults with mental retardation. Recommendations for further study include (a) detailing the characteristics of supported work and sheltered workshops that support and/or discourage self-determined behaviors, (b) exploring the behavior of adults with mental retardation in sheltered workshops and supported work environments, and (c) analysis of the support needs for and understanding of them by adults with mental retardation in sheltered workshops and in supported work environments. ^

The Effect of Active Student Responding in Computer-Assisted Instruction on Social-Studies Learning by Students with Learning Disabilities: A Brief Report

An alternating treatment design was used to compare the effects of three student response conditions (Clicking, Repeating, and Listening) during computer-assisted instruction on social-studies facts learning and maintenance. Results showed that all students learned and maintained more social-studies facts taught in the Repeating condition followed by the Clicking condition.

Integrating Individuals with Developmental Disabilities into the Open Labor Market

This qualitative study addresses attitudes concerning employing individuals with developmental disabilities (DD) and identifies factors limiting their integration into the workplace. Four themes emerged: lack of infrastructure, awareness, family support, and the need for ongoing training and development. A proposed model of integrating individuals with DD in the workplace is discussed.

Development of Knowledge Domains and an Instrument to Assess Probation Officers’ Knowledge of Offenders with Intellectual Disabilities

The purpose of this study was to develop knowledge domains and an instrument to assess probation officers’ knowledge levels of offenders with intellectual disabilities by utilizing a synthesis of subject matter analysis technique and a comprehensive review of literature. Results can be used to develop effective training for probation officers.

A Human Resource Development Performance Improvement Model for Workers with Mental Retardation in Supported Employment

This literature review discusses the factors for successful job retention of adult workers with mental retardation, including external factors related to work environments and internal issues of the individual worker. Through the synthesis of the literature, a performance improvement model for supported employment is discussed based on Holton’s (1999) human resource development/performance improvement model.

Psychosocial barriers to self -care among Hispanic women with type 2 diabetes mellitus

This cross-sectional survey-designed study investigated the presence and influence of psychosocial barriers to diabetes self-management practices among Hispanic women with type 2 diabetes mellitus. Women (n = 128) who were diagnosed and being treated for type 2 diabetes were recruited from the Miami-Dade area in South Florida. A Beck Depression Inventory-II, Diabetes Care Profile, Diabetes Knowledge Test, Diabetes Empowerment, Multidimensional Health Locus of Control, and Perceived Stress Scales were administered, along with assessment of diet through a 24-hour recall and anthropometric evaluation by body composition analysis and body mass index computation. ^ Mean (± SD) age for subjects was 50.15 ± 15.93 and age at diagnosis was 42.46 ± 14.69. Mean glycosylated hemoglobin (A 1C) was 8.55 ± 1.39. Diabetes education had not been received by 46.9% of subjects. Psychosocial status had previously been evaluated in only 4 participants. Forty percent of participants were assessed as depressed and 17% moderately to severely so. Depression correlated significantly (p < 0.01) with A1C (r = 0.242), perceived stress (r = 0.566), and self-rated health (r = −0.523). Perceived stress correlated significantly (p < 0.01) with A1C (r = 0.388), understanding of diabetes (r = 0.282), self-rated health (r = −0.372) and diabetes empowerment (r = −0.366). For Cuban women, perceived stress (β = 0.418, p = 0.033) was the only significant predictor of A1C, while among non-Cuban Hispanic women, self-reported health (β = −0.418, p = 0.003) and empowerment (β = 0.432, p = 0.004) were better predictors. The most desirable DM status among the women surveyed (high diet adherence, low exercise barriers, and A1C ≤ 7) was associated with superior self-rated health, more support from family and friends, and greater empowerment. ^ This study revealed the error in considering Hispanics a homogenous entity in treating disease, as their cultural backgrounds and concentration in a community can greatly influence management of a chronic disease like diabetes. The strong correlations found between diabetes-related health indicators and psychosocial factors such as depression and perceived stress suggest that psychosocial assessment of patients must be more strongly advocated in diabetes care. Psychosocial assessment of ethnically diverse diabetic populations is especially vital if greater knowledge is to be gained about their barriers to self-care so that diabetes treatment and thus outcomes are enhanced. ^

The effect of active student responding in computer -assisted instruction on social -studies learning by students with learning disabilities

The purpose of this study was to compare the effects of three student response conditions during computer-assisted instruction on the acquisition and maintenance of social-studies facts. Two of the conditions required active student responding (ASR), whereas the other required an on-task (OT) response. Participants were five fifth-grade students, with learning disabilities enrolled in a private school. An alternating treatments design with a best treatments phase was used to compare the effects of the response procedures on three major dependent measures: same-day tests, next-day tests, and maintenance tests. ^ Each week for six weeks, participants were provided daily one-to-one instruction on sets of 21 unknown social-studies facts using a hypermedia computer program, with a new set of facts being practiced each week. Each set of 21 facts was divided randomly into three conditions: Clicking-ASR, Repeating-ASR, and Listening-OT. Hypermedia lesson began weekly with the concept introduction lesson, followed by practice and testing. Practice and testing occurred four days per week, per set. During Clicking-ASR, student practice involved the selection of a social-studies response by clicking on an item with the mouse on the hypermedia card. Repeating-ASR instruction required students to orally repeat the social-studies facts when prompted by the computer. During Listening-OT, students listened to the social-studies facts being read by the computer. During weeks seven and eight, instruction occurred with seven unknown facts using only the best treatment. ^ Test results show that all for all 5 students, the Repeating-ASR practice procedure resulted in more social-studies facts stated correctly on same-day tests, next-day tests, and one-and two-week maintenance tests. Clicking-ASR was the next most effective procedure. During the seventh and eighth week of instruction when only the best practice condition was implemented, Repeating-ASR produced higher scores than all conditions (including Repeating-ASR) during the first six weeks of the study. ^ The results lend further support to the growing body of literature that demonstrates the positive relation between ASR and student achievement. Much of the ASR literature has focused on the effects of increased ASR during teacher-led or peer-mediated instruction. This study adds a dimension to that research in that it demonstrated the importance of ASR during computer-assisted instruction and further suggests that the type of ASR used during computer-assisted instruction may influence learning. Future research is needed to investigate the effectiveness of other types of ASR during computer-assisted instruction and to identify other fundamental characteristics of an effective computer-assisted instruction. ^