Office Of Vocational Rehabilitation Research Articles

Successful vocational rehabilitation innovations: Building a better toolbox

BACKGROUND: Kentucky Office of Vocational Rehabilitation (OVR) and Minnesota Vocational Rehabilitation Services (VRS) successfully participated in a randomized control trial of an intervention designed in partnership with more than 100 VR personnel and twenty state VR agencies to identify effective practices for increasing earnings outcomes of Social Security Disability Insurance (SSDI) beneficiaries receiving VR services. OBJECTIVE: This paper introduces articles in the Special Issue to tell the story of the SGA Model Demonstration from design, testing, and impact evaluation. METHODS: The SGA Model Demonstration began reviewing administrative data, collecting expert opinion, and exploring current practice in eight state VR agencies. After an eighteen-month period of capacity building, two state VR agencies randomized local offices and implemented a rapid coordinated team approach. RESULTS: State VR agencies are successfully participating in rigorous research activities including model demonstrations with experimental designs. CONCLUSIONS: Model demonstrations that include experimental designs are effective strategies to improve knowledge and build a better practitioner toolbox to advance employment outcomes of VR clients.

Hearing the Need for College Prep

Hearing the Need for College Prep

Accountability and Empathy Effects on Medical Students' Clinical Judgments in a Disability Determination Context for Low Back Pain

Accountability has been shown to affect clinical judgments among health care providers in several ways. It may increase a provider's motivation for accuracy, leading to more deliberative judgments, or it may enhance biases that evaluators consistently demonstrate with patients with chronic pain. In this study, medical students read a vignette about a hypothetical patient referred for evaluation of severe low back pain by the Office of Vocational Rehabilitation. Accountability to the patient was either weak (consultative 1-time evaluation) or strong (ongoing primary care provision); societal accountability was either weak (evaluation information as secondary source for disability determination) or strong (evaluation information primary to disability determination). Participants then made judgments regarding validity of the patient's presentation, influence of psychosocial factors on the presentation, and patient's level of pain, distress, and disability, and completed an empathy measure. Results showed that empathy had strong associations with symptom validity and severity judgments. With empathy as a covariate, 3 crossover interactions emerged. Judgments of symptom validity were lower when the 2 forms of accountability were inconsistent (ie, one weak and the other strong) than when they were consistent (ie, both weak or both strong). Likewise, judgments of psychosocial factors and pain/distress/disability were higher under consistent accountability conditions than when accountability conditions were inconsistent. This pattern may imply conflict avoidance or self-protection as a motivation for judgments under inconsistent accountability. This study demonstrated that role demands can affect symptom judgments in complex ways, and that empathy may play both direct and moderating roles. Because physicians are the primary gatekeepers regarding disability determination in both consultative and treating roles, accountability may have significant mediating effects on such determinations. PerspectiveThis study demonstrated that medical student judgments of pain-related symptoms were strongly associated with their levels of empathic concern. Student judgments of symptom validity and psychosocial influences on patient adjustment were differentially affected by their level of accountability to the patient and society in a disability determination process.

Fort Monroe Revisited

MANY DEAF AND HARD OF HEARING ADULTS today are experiencing great difficulty passing professional certification and licensing examinations-what we call high stakes tests. This situation is most unfortunate considering their great strides in achieving professional status in recent decades in many fields. Today there are deaf and hard of hearing K-12 teachers, university professors, social workers, clinical and school psychologists, certified public accountants, investment brokers, leisure services providers, linguists, lawyers, biologists, chemists, mathematicians, writers, historians, computer programmers, web designers, and even some doctors. This list would have astonished deaf and hard of hearing people as recently as the 1950s. How did this happen? In his 1987 book, Meeting the Challenge: Hearing-impaired Professionals in the Workplace, deaf scholar Alan B. Crammatte describes the period between 1960 and 1982 as era in which humanitarian revolution . . . brought many hearing-impaired citizens out of the closet of meek isolation into the active arena of competition for training, jobs, and recognition (p. 1). Crammatte lists many events that, in his opinion, collectively led to growing assertiveness among deaf people to seek changes beneficial to all deaf and hard of hearing Americans. One such event, probably forgotten now by all but a few people, was a 1961 meeting in Hampton, Virginia, called Monroe Workshop #2. This meeting, Crammatte states, brought local and national deaf leaders and hearing professionals from across the nation to develop organizations and programs that would meet the needs of hearing-impaired people. The workshop was sponsored by the [U.S. Department of Health, Education, and Welfare's] Office of Vocational Rehabilitation (OVR) but was administered by deaf persons; it proved to be a watershed for hearing-impaired people. Many of the recommended actions became actualities in subsequent years. More importantly, a ferment grew among deaf leaders which led many a printer and craftsperson to aspire to more challenging roles as full-time professionals or administrators. (pp. 3-4) In light of all that has happened since, it is fascinating to read this brief summary of apparently seminal meeting that occurred forty-five years ago, during which deaf leaders were charting their vision of the kinds of organizations and programs needed to enable deaf and hard of hearing people to reach higher than had previously seemed realistic. Equally interesting in a different way is the following description of the preceding year's meeting, Monroe Workshop #1: an OVR-sponsored conference on research [that] involved hearing school administrators (an ancient paternalistic pattern). However, the two deaf participants so impressed OVR officials that plans began soon after for a gathering of hearing-impaired leaders the next year (p. 3). My point in mentioning the Fort Monroe Workshop #1, which consisted mainly of hearing administrators, is not to compare the participants to a group so infamously paternalistic as, say, the hearing delegates at the 1880 Conference of Milan but to contrast them to that group. Thinking, no doubt, of the Civil Rights movement, which focused national attention so unflinchingly on the plight of segregated black people, Crammatte states that the period that began in the 19505 constituted era of humanitarian concern for minorities. Such concern obviously affected the hearing delegates at the first workshop, who paid attention to the two deaf attendees, recognized their mistake in not inviting a sufficient number of deaf people, and took action immediately to correct this error by arranging for a follow-up conference that would be led by deaf participants. Crammatte describes the second Fort Monroe Workshop as a defining moment, in other words, not only because many of the ideas presented led to genuine progress for deaf people but also because deaf leadership was recognized and appreciated at the meeting. …

Concurrent and Predictive Validity of Two Scales to Assess the Fidelity of Implementation of Supported Employment.

The ability of the Individual Placement and Support (IPS) and the Quality of Supported Employment Implementation Scale (QSEIS) fidelity scales to predict independently rated SE adherence and percentage of clients closed by the Office of Vocational Rehabilitation (OVR) was tested at 23 SE sites. QSEIS Total score (r = .47), Integration subscale (r = .53), and Support subscales (r = .61) correlated with SE adherence. Total QSEIS score also predicted OVR closure rate (r = .42). Correlations between IPS (sub)scale scores and the criterion measures were non-significant. The results support QSEIS validity and provide evidence that fidelity to the SE model is associated with better employment outcomes.

Effects of Ecological and Standardized Vocational Assessments on Office of Vocational Rehabilitation Counselors' Perceptions Regarding Individuals with Developmental Disabilities

The purpose of this study was to examine the effects of an ecological and a standardized vocational assessment on Office of Vocational Rehabilitation (OVR) counselors' perceptions of individuals with developmental disabilities. One hundred and forty-one OVR counselors with experience in making funding decisions were randomly assigned to read either an ecological or a standardized vocational assessment report on an individual with developmental disabilities. Each group (ecological or standardized) then responded to 3 items on a questionnaire regarding job coach funding approval, time required for training, and employment outcome for the individual with disabilities. No statistically significant differences were found between groups with respect to job coach funding decisions. In contrast, significant differences between the 2 groups indicated that OVR counselors in the ecological assessment group perceived the individual with disabilities to need less training time, and to be more likely to remain on the job after job coaching was terminated than those in the standardized assessment group. Implications in terms of OVR funding decisions and directions for research are presented.

A Slide-Tape Standardized Orientation to Vocational Rehabilitation Services

Existing research on information dissemination methods has revealed that audio-visual methods provide a valuable and effective technique for orienting clients to rehabilitation programs and services. The intention of this project was to devise an audio-visual presentation (designed for the Office of Vocational Rehabilitation in Syracuse, New York) to sensitize clients and stimulate their involvement in the rehabilitation process. The results indicated several advantages of utilizing audio-visual methods over presently used methods in terms of cost effectiveness and client satisfaction. This study suggests that the standardized audio-visual presentation is a useful tool for providing information to prospective clients, and is potentially very valuable for further research and program evaluation.

The public image of institutions.

unnecessary delay of care when it is needed, b) unnecessary and “final” separation of child from family, c) unnecessary trauma for child and family. It emphasizes therapeutic rather than custodial aspects of institutions. Contrary to the apprehensions of some, instituting a voluntary commitment procedure does not result in a flood of unnecessary admissions; in fact, it has the opposite effect. The superintendent is not obligated to accept voluntary patients, or those for whom community care seems more appropriate. Many retarded persons have considerable potential for job adjustment. The Office of Vocational Rehabilitation, at national and state levels, op. crates special programs for placing the retarded. Some industries have tried programs which indicate that for some kinds of work, impairment may be an advantage rather than a liability, a

REHABILITATING the CARE in NURSING HOMES

F ILLINOIS WE ARE rehabilitating the care given in qu lif ed, licensed nursing homes to aged, chronically ill, and disabled patients. We are changing nursing homes from grim, gray places where patients lead static lives to homes in which patients are helped and encouraged to become as independent as their physical limits permit and to lead active and useful lives. This is the work of the Rehabilitation Education Service which became a permanent division of the Illinois Public Aid Commission in 1960. The service was initiated with a three-year pilot study conducted by the Commission, in cooperation with the Institute of Physical Medicine and Rehabilitation of Peoria, and the Office of Vocational Rehabilitation. The project was the first of its kind to be initiated in the United

Total Rehabilitation of Epileptics—Gateway to Employment.

This book is based upon proceedings of an institute sponsored by the Office of Vocational Rehabilitation, U.S. Department of Health, Education, and Welfare, and National Epilepsy Leagure, and the University of Illinois School of Medicine. This was the first national institute on the total rehabilitation of epileptics and was conducted May 25 through May 27, 1960, in Chicago. The institute was for the specific purpose of developing informational materials for this publication. Every participant was selected by the planning committee as an authority in some phase of epilepsy, rehabilitation, or employment. Their papers are presented in the contents and are followed, in most instances, by discussions which drew upon a wide range of professional experience and allowed for expression of divergent thought as well as formulation of opinion and statements of agreement. This compendium of information is intended as a resource handbook for individuals, agencies, and organizations concerned with the

Erratum: Space Cooperation: U.S. Outlines Plan for United Nations Role

In the announcement on the National Rehabilitation Research-Training Center [ Science 134, 1351 (27 Oct. 1961)], the U.S. Public Health Service was erroneously credited with establishing the center. The center was established by the U.S. Department of Health, Education, and Welfare's Office of Vocational Rehabilitation.

Erratum: Space Cooperation: U.S. Outlines Plan for United Nations Role

In the announcement on the National Rehabilitation Research-Training Center [Science 134, 1351 (27 Oct. 1961)], the U.S. Public Health Service was erroneously credited with establishing the center. The center was established by the U.S. Department of Health, Education, and Welfare's Office of Vocational Rehabilitation.

THE PICNIC BASKET (a one-act play, 30 minutes, produced for the Office of Vocational Rehabilitation, U. S. Department of Health, Education, and Welfare, by PLAYS FOR LIVING, a division of Family Service Association of America.)

THE PICNIC BASKET (a one-act play, 30 minutes, produced for the Office of Vocational Rehabilitation, U. S. Department of Health, Education, and Welfare, by PLAYS FOR LIVING, a division of Family Service Association of America.)

Head-Position Identification

A binaural recording of traffic sounds that reached an artificial head oriented in five different positions was presented to five subjects, each of whom responded under four different criteria. A Type II ROC curve for the five listeners was linear, P(Y|C)=0.60 P(Y|I)+0.44, and therefore consistent with a guessing model and inconsistent with the detection theory model, Further analysis of the results showed that performance (percent correct and information transmitted) was independent of criterion and did not change systematically over successive trials. (This work was supported by contract from the Office of Vocational Rehabilitation.)

Book Reviews : Rehabilitation Centers Today, by Henry Redkey. A report on 77 rehabilitation centers, prepared in co-operation with the Conference of Rehabilitation Centers, and published by the Office of Vocational Rehabilitation. 231 pp. u.s. GOVT. PRINTING OFFICE. Washington, 1959. $1

Book Reviews : Rehabilitation Centers Today, by Henry Redkey. A report on 77 rehabilitation centers, prepared in co-operation with the Conference of Rehabilitation Centers, and published by the Office of Vocational Rehabilitation. 231 pp. u.s. GOVT. PRINTING OFFICE. Washington, 1959. $1

Books Reviewed

Guiding Today's Children, by Los Angeles County Superintendent of Schools OfficeRichard Hill Byrne, Professor of Education, University of Maryland.Discipline, Achievement, and Mental Health: A Teacher's Guide to Wholesome Action, by E. L. Phillips, D. N. Wiener, & N. G. HaringMental Hygiene in Teaching, by Fritz Redl & William W. Wattenberg. Second edition.Private Practice in Clinical Psycholology, by Theodore H. BlauThe Education of Teachers, Curriculum Programs, Report of the Kansas TEPS Conference, 1959, The National Commission on Teacher Education and Professional StandardsPlanning a College Union Building, by Chester Arthur BerryRehabilitation of Deaf‐Blind Persons, Office of Vocational Rehabilitation, U. S. Department of Health, Education and Welfare and The Industrial Home for the Blind

Training Normal Hearing to Greater Usefulness: A Progress Report

There is current widespread interest in the use of hearing by blind individuals for the purpose of better orientation and better mobility. The Office of Vocational Rehabilitation is now supporting at least three hearing projects of major proportions. The most recent grant was made to C. W. Shilling Auditory Research Center, in Groton, Connecticut. They are equipped with the most modern instrumentation and, according to John Dupress, of the American Foundation for the Blind, they intend to do research which will lead to the identification of auditory cues used by skilled blind travelers. They also intend to design training material for the rehabilitation of blind persons who are not able to travel independently with a cane or a dog. Matching funds for this project have been provided by Seeing Eye, Inc., Morristown, New Jersey. A second project has been in progress about two years at the Industrial Home for the Blind, in Brooklyn, New York. Their objective is service to blind individuals who are hard of hearing. An excellent description of this project, written by Dr. Moe Bergman, the principal investigator, appeared in the December 1959 issue of the New Outlook.1 In the same issue of the New Outlook there appeared also an introduction to the hearing research project in progress at the Cleveland Society for the Blind.3 Our purpose is to develop methods for training normal hearing of blinded persons to greater usefulness. The following article describes the research further and presents some findings.—F.M.N.

Intelligibility of Natural and Distorted Speech Led through Ten Hearing Aids to Normal and to Deafened Individuals

Three female and two male voices were taped reading sentences which were re-recorded after being led through ten hearing aids with electroacoustic characteristics ranging from very good to poor. Normal ears and ears with varying types and degree of deafness were used. A latin square design assured proper comparisons among aids. Each listener repeated 100 colloquial sentences which were taped under a natural speaking condition, 100 under a nasal-plus-speeded condition, and 100 under an interrupted speech condition. Comparisons of normal and deafened groups in terms of percentage of words correctly understood show that the deafened group always did poorer even though corrective amplification was used. In most cases the hearing aids were ranked in similar orders by both groups within a speech category, but were ranked differently from the natural voice condition to the distorted conditions, especially by normals. The data have also been analyzed in terms of the minimum number of voices and types of speech distortion necessary to provide an adequate test battery for such purposes. Comparisons have been made between performance on each aid versus the many electroacoustic characteristics known for each aid. (This research is supported in part by the Office of Vocational Rehabilitation.)

SOMATO-PSYCHOLOGIC STUDIES IN PARKINSONʼS DISEASE I. An Investigation into the Relationship of Certain Disease Factors to Psychological Functions

1The Psychological Services of St. Barnabas Hospital for Chronic Diseases and the New York University Post Graduate Medical School. This investigation was sponsored in part by the Sister Elizabeth Kenny Foundation; Office of Vocational Rehabilitation, Department of Health, Education, and Welfare; and the Allen P. and Josephine B. Green Foundation. The authors wish also to express their gratitude to Dr. I. S. Cooper, Director of the Department of Neurologic Surgery at St. Barnabas for his cooperation and encouragement, and to Miss Jodi Wood, research assistant to the Psychological Services, St. Barnabas Hospital.

Instructing Nursing Home Personnel in Rehabilitation Techniques

IN ILLINOIS, as in most other States, complete and intensive rehabilitation services are limited to a, few urban areas, not-ably Chicago and Peoria. Elsewlhere in the State public and private nursing homes are expanding rapidly to care for chronically ill and disabled persons. Some of these persons at other times and under other circumstances, would have been hospital patients. But hospital care for such patients is frequently inappropriate, unavailable, or economically prohibitive, or no agencies are available to help them obtain hospital care. In many sections of Illinois hospital care is not available in the patient's community, and the local physician must rely upon the nursing home for inpatient care wlhen care at home cannot be provided. The shrinking size of private dwellings and the dwindling number of family members available to provide home care has further increased the use of commercial and county nursing homes for both private pay patients and recipienits of public assistance. Likewise, there is frequent evidence of the need for general hospitals to concern themselves more with measures to prevent the development of conditions which may require nursing home care after a hospital stay. The vocational rehabilitation of residents of nursing homes presents several significant problems. For instance, in the average Illinois community there is often little knowledge or appreciation of the philosophy and techniques of rehabilitation and the vocational potentials that may emerge from physical rehabilitation. Similarly, there is often little knowledge of the interests or services of the Federal Office of Vocational Rehabilitation and its counterparts in many of the States. The Office of Vocational Rehabilitation, the Forest Park Founidation of Peoria, through the Peoria Institute of Physical Medicine and Rehabilitation, and the Illinois Public Aid Commission joined forces to colnduct a 3-year research demonstration project, the rehabilitation education service. Begun in February 1957, the project, the first of its kind in the United States, proposed to look for the answers to these questions. * What a-re the rehabilitation needs among patients of a selected group of public and private nursing homes? * Can the existing staffs of these homes, in cooperation with local physicians and services in the local community, meet these needs if they receive adequate training in the philosophy and techniques of rehabilitation? * What kind of training can be developed to provide staffs with a knowledge of rehabilitation techniques and to increase their appreciation of the philosophy of physical and vocational rehabilitation? * What kinds of teaching materials can be developed that other agencies and schools can Mr. Hackley is coordinator of the rehabilitation education service of the Illinois Public Aid Commission, Peoria. The project is supported by grants from the Office of Vocational Rehabilitation, Department of Health, Education, and Welfare, the Forest Park Foundation of Peoria, and the Illinois Public Aid CommLssion.