T7: State-of-the-Science Conference on Community
Integration for Persons with TBI
Roundtable Discussion - April 12, 2007
Topic Area: Employment
Facilitators: Paul Wehman, Ph.D. and Robert Fraser,
Ph.D.
Recorder: Margaret A. Struchen, Ph.D.
- What research should be addressed in
the future to further the field and address the
most relevant gaps in our knowledge? What models/methods
should be utilized?
- Improving the evidence base for addressing
employment outcomes for the most severely
affected individuals with disability.
- No evidence from randomized clinical
trials has been provided, yet plenty of
evidence that vocational specialist can
find and place those with significant
disability.
- Design randomized clinical trials to
validate use of employment specialist,
the specific services provided by the
employment specialist that are most effective,
and what intensity of services is optimal.
(Model work after that by Becker, Drake,
and others).
- Investigating impact of TBI Medicaid waivers
and their use to address broad spectrum of
services in flexible manner to enhance employment
outcomes (e.g., transportation, employment,
etc.).
- Does blended funding (Vocational Rehabilitation,
TBI Medicaid Waiver) lead to most efficient
resources to enhance employment outcomes?
(Model of funding support has been used for
mental retardation and developmental disability
population).
- Clarification of what vocational services
are being provided — service definition
and enhanced specification of interventions
in scientific literature produced.
- What spillover effects occur with employment
services and outcomes? Collection of multisite
and multifactorial data to evaluate the potential
changes in other areas of functioning as a
result of return to work (RTW) (e.g., satisfaction
with life, emotional functioning, awareness,
cognitive functioning, etc.).
- How does the issue of self-awareness affect
employment services and outcomes?
- How can we identify and support the use
of varying disability services to address
the varying needs of persons with TBI, who
have broad heterogeneity in their areas of
strengths/weaknesses? How can we increase
awareness among funders about need to address
broad and varying issues (physical, cognitive,
emotional, behavioral) seen in typical clients
with TBI?
- How does assistive technology facilitate
return to work?
- Does use of cognitive orthoses lead
to increased likelihood of employment
with decreased need for service provision?
- Who can benefit with assistive technology
with what levels of support?
- How do employer's attitudes affect employment
outcomes? What interventions/methods can be
utilized to address attitudinal barriers?
- How can we proactively seek out employers/employment
settings that would be interested in hiring
persons with brain injury?
- Evaluating specific aspects of models involving
job coaching/case management/co-worker supports
and the contributions made to improving employment
outcomes.
- Examination of number of hours provided,
types of services provided, cross-site
evaluations.
- What training and technical assistance
will improve quality of services?
- How are such services best implemented
in various work settings?
- How can the use of customized employment
models enhance employment outcomes for persons
with brain injury?
- What training/skills sets needed for
job development specialists who must identify
niche jobs or create such positions?
- Which persons with TBI/what environments
are best suited to this type of model?
- What is the role of self-employment models
for persons with TBI?
- How can job coaching and or peer/family/friend
supports be utilized to facilitate successful
outcomes?
- How can resource ownership be shared?
- Which persons with TBI/what environments
are best suited to this type of model?
- How can telework jobs be utilized/adapted
for persons with TBI?
- How can models like that utilized by the
International Executive Service Corporation
be utilized to leverage specialized knowledge
that individuals with brain injury might have?
Can the role of consultant, mentor, etc. be
established to leverage those skills?
- What models work best for those individuals
injured prior to having established job experience?
- What components of what models work best
for what individuals? How do blended models
work? How efficient/effective are various
models/blended models?
- Development and use of trauma registry to
assist with finding out differences between
mildly versus moderately-severely injured
individuals with regard to services needed
and methods most effective to enhance employment
outcomes.
- What collaborations could be fostered to address
this topic area?
- National Institute on Disability and Rehabilitation
Research (NIDRR)
- Centers for Disease Control (CDC)
- Department of Labor
- Department of Defense/ Department of Veterans
Affairs
- Mental Retardation and Developmental Disabilities
(MR/DD)
- Mental Health and Mental Retardation (MH/MR)
- International Executive Service Corporation
- Others??? Time limitations precluded further
listing of potential collaborators.
