Marjorie F. Olney

Beyond Adjustment: Integration of cognitive disability into identity

This study results from a series of focus groups during which university students, all of whom were diagnosed with disabilities that affect mental or cognitive functioning, met to discuss the challenges that they face, as well as the supports and strategies that help them to surmount social and academic obstacles. Participants had a range of labels including brain injury, neurological impairment, psychiatric disorder and learning disability. Gleaned from transcripts and field notes, this paper makes explicit the processes that students used to develop a self-perception that positively integrates their experience of disability. These complex processes included self-definition of difficulties, coping with limitations, identity management and embracing ones difference. Integration of disability into identity did not appear to be a staged process for these participants. Rather, they considered the implications of being labelled disabled simultaneously and from several perspectives. Findings are discussed in terms of adjustment of two groups whose members have different experiences from those in the majority: survivors of sexual abuse and racial minorities.

Racial Disparities in VR Use and Job Placement Rates for Adults with Disabilities

Racial and ethnic disparities in access to vocational rehabilitation (VR) services and the efficacy of those services are a perennial concern of rehabilitation practitioners. This study used data from the Disability Supplement to the 1994 and 1995 National Health Interview Surveys (NHIS) to assess VR services utilization and employment outcomes among different racial and ethnic groups of working-age adults with disabilities. Racial disparities in the socioeconomic status of VR recipients were identified. Minorities received different types of VR services than did European Americans. European American VR recipients had the highest rates of competitive employment, whereas African American VR recipients were placed in noncompetitive employment more often than other racial groups. Policy and programming implications for VR professionals are discussed.

National Estimates of Vocational Service Utilization and Job Placement Rates for Adults With Mental Retardation

Data from the 1994 and 1995 Disability Supplements of the National Health Interview Survey (NHIS) were used to estimate rates of utilization of vocational services and examine employment outcomes for adults with disabilities who have received vocational services. Those living outside the formal long-term care system, and who were self or proxy identified as having mental retardation, were compared with other adults with disabilities. Analyses suggest that compared to other working-age persons with disabilities, adults with mental retardation (a) have a different population profile, (b) receive different types of services, (c) experience similar levels of satisfaction, (d) have much lower rates of competitive employment, and (e) are much more likely to be employed in segregated work settings. Research and policy implications of findings are discussed.

Job Discrimination in the Post-ADA Era Estimates from the 1994 and 1995 National Health Interview Surveys

The Americans with Disabilities Act (ADA) of 1990 was intended to facilitate employment, job retention, and workplace promotion of individuals with disabilities by protecting them from job discrimination. However, ongoing questions have been raised about the efficacy of the legislation. This study uses population data from the Disability Supplement to the 1994 and 1995 National Health Interview Surveys to assess rates of work discrimination among adults with disabilities ages 18 and older. The analysis suggests that nearly a 10th of all adults with disabilities who were in the workforce during the 5-year period immediately following passage of the ADA experienced some form of job discrimination. People who reported job discrimination were more likely to be younger and poorer and to have more severe disabilities than those who did not report any discrimination. About a third of the respondents who experienced discrimination left the workforce permanently. The implications of these findings for rehabilitation practice are discussed.

Communication Strategies of Adults with Severe Disabilities: Supporting Self-Determination.

Individuals with significant developmental disabilities are often considered by others to be dependent and incompetent. They are frequently defined by their deficits rather than their abilities. New concepts such as self-determination have challenged researchers and service providers to think differently about the abilities of individuals considered to have severe intellectual disabilities. Analysis of communicative events between individuals with and without severe disabilities provides evidence that individuals who are often considered least able to do indeed communicate, asserting control over their environments and activities. Careful attention to communication reveals that behaviors that on the surface appear to be random, maladaptive, or challenging are purposeful, even useful. The author proposes that embedded in each communicative act, there is a drive toward self-determination, but that in order for self-determination to be actualized, communication partners must learn to apprehend, and respond appropriately to, the messages.

‘We are the forgotten victims’: Perspectives of adult siblings of persons with traumatic brain injury

Primary objective: This study determined how the lives of a cross-national sample of adult siblings had changed since their brothers and sisters incurred a traumatic brain injury. Research design: A total of 272 participants provided responses to the question, ‘How is your life different since your sibling had a TBI?’ Responses were analysed through the constant comparative method of textual analysis. Methods and procedures: Responses were collected through a mailed-survey. The analysed question appeared at the end of a 243-item quantitatively-based survey containing five open-ended questions. Outcomes and results: Three themes emerged: (1) ‘Family impacts’ such as growing up with a sibling with TBI and impact on family closeness; (2) ‘Caring’ including caring for and about the family member; and (3) ‘Making sense of the experience’ through adjustment and personal development. Conclusions: The study demonstrates that having a sibling with a TBI can result in profound and enduring negative and positive life changes for non-injured siblings. Professionals need to attend to the needs of siblings for support and guidance and should be considered as key informants about their injured family members during intake and service planning.

Reading between the Lines: A Case Study on Facilitated Communication:

This is a qualitative study that examines the facilitated communication method within the context of general communication. “Reading” another person, or understanding the intent and meaning of an individuals communication, is a complex process that encompasses verbal and nonverbal messages. Various strategies employed by both the facilitated communication user and communication partner to interpret and clarify messages are examined in depth.

The Benefits Trap Barriers to Employment Experienced by SSA Beneficiaries

In the first of two rounds of interviews, 12 Social Security Administration (SSA) beneficiaries, all of whom professed a desire to work, discussed their perspectives on barriers to employment. Two years later, 8 of the 12 engaged in a second round of interviews. Only 1 of the 8 participants had succeeded in becoming self-supporting. After a review of the literature concerning the effects of SSA procedures in discouraging beneficiaries from seeking full-time work, the authors tell the stories of these participants and then analyze the findings using a phenomenological framework. They conclude by positing suggestions for how to improve outcomes for SSA beneficiaries in the future.

A National Profile of SSDI Recipients and Applicants Implications for Early Intervention

Less than one half of 1% of Social Security Disability Insurance (SSDI) beneficiaries currently return to work. The 1999 Ticket-to-Work and Work Incentives Improvement Act (TWWIIA) charged the Social Security Administration with investigating early intervention strategies to divert some of the persons applying for benefits into work support programs before they enroll in SSDI. Any early intervention programming will require greater understanding of the claimant population. This analysis used data from the 1994 and 1995 National Health Interview Surveys to compare the estimated 3.3 million working-age SSDI claimants to the estimated 3.6 million beneficiaries. These comparisons showed substantial heterogeneity in both groups but found that claimants were less disabled, in better health, and more likely to be employed than beneficiaries. Both groups tended to have low incomes, and nearly 20% of claimants lacked health insurance. Approximately 70% of applicants (2.3 million) and beneficiaries (2.6 million) have not received vocational support services and do not believe that they need such services. These findings suggest that demand for vocational services vouchers may be low.

Anatomy of commitment: an in vivo study.

A self-evaluation of one small but innovative agency providing supported living and other community supports to individuals with developmental disabilities is presented. Key elements that appear to perpetuate a culture of commitment among direct support and supervisory staff are described. Agency staff people have achieved the capacity to listen and respond to individuals and honor their choices. In order to assure that individuals get what they need, staff members take appropriate initiative, work outside of their assigned hours, and support one another. Whereas most human service organizations function within the parameters of well-defined policies and procedures, the agency described here operates more flexibly. The observed pattern of organizational dynamism and reflexivity is compared to that of a living organism.