Vocational Rehabilitation Training Research Articles

The Influence of Demographics and Workforce Innovation Opportunity Act (WIOA) Employment and Training Services on Employment Outcomes for Teenagers Receiving Supplemental Security Income (SSI) and Their Parents

Transition age youth with disabilities and their families can access a variety of Workforce Innovation Opportunity Act (WIOA)-funded employment and training services. This study evaluated the impact of these services on youth and parent employment outcomes. These services were coordinated as part of the Wisconsin Promoting Readiness of Minors in SSI (PROMISE) federal demonstration grant. Youth with disabilities receiving Supplemental Security Income (SSI) benefits were randomly assigned to ‘usual’ services, including those available through school and vocational rehabilitation (VR) transition services, or ‘enhanced’ case management and transition services through the Wisconsin PROMISE demonstration. Parents who consented to participate could receive educational, employment, and financial self-sufficiency services and support through the Family Service Plan (FSP) connected to the youth’s PROMISE VR case. Youth and parents could also choose to receive WIOA Title I and Title III employment and training services, as well as Youth Apprenticeship, available through the Wisconsin Department of Workforce Development’s Division of Employment and Training (DET). A hierarchical logistic regression analysis demonstrated that VR services predicted higher youth employment rates and DET services predicted higher youth and parent employment rates. A linear regression analysis demonstrated that PROMISE services predicted higher youth wages and DET services predicted higher youth and parent employment wages. Findings suggest the coordination of employment-focused services across programs leads to increases in employment outcomes. Limitations and implications are discussed regarding the relationship between VR services, DET employment and training services, and employment outcomes.

지적장애인의 직장 내 대인관계 경험에 관한 현상학적 연구

The purpose of this study is to reveal the content and structure of interpersonal experiences in the workplace of people with intellectual disabilities. To achieve this purpose, 10 workers with intellectual disabilities in their 20s and 30s were selected as research participants by applying a phenomenological research method, and data collected through in-depth interviews were analyzed based on Giorgi's five-step procedure. First, 7 components and 22 sub-components were derived from the interpersonal experience of intellectually disabled people, and 7 components were 'interpersonal relationship with non-disabled people', 'interpersonal relationship formation at work', 'resolution of interpersonal conflicts at work', and 'wish for the future'. Second, the interpersonal experience structure of people with intellectual disabilities in the workplace was identified as the structure of the experience according to the relationship object and the temporal and situational context, focusing on seven components. Accordingly, this study is meaningful in that it revealed the interpersonal experience of people with intellectual disabilities at work and derived the desire for interpersonal relationships of people with intellectual disabilities. Based on these results, it is possible to build a work structure that considers the psychological characteristics of people with intellectual disabilities in the work place in the field of vocational rehabilitation. In addition, it is expected to contribute to overall interpersonal relationships in the vocational rehabilitation training process for people with intellectual disabilities, such as using them as basic data for developing interpersonal relationship programs at counseling sites.

Vocational Rehabilitation To Enhance Return to Work After Trauma: Findings From A Non-Randomised Feasibility Study

<h3>Research Objectives</h3> To assesses the feasibility of delivering a telehealth vocational rehabilitation (VR) intervention to enhance return to work and improve quality of life and wellbeing in people post-trauma. <h3>Design</h3> Non-randomised single-arm mixed-methods feasibility study. <h3>Setting</h3> Participants were recruited from two UK major trauma centres (MTCs). The intervention was delivered virtually (or face-to-face where necessary) in participants' homes. <h3>Participants</h3> Adult patients (n=10) 16-69 years, admitted to participating UK MTCs with Injury Severity Score (ISS) >8, recruited ≤12 weeks post-injury. Eligible participants were employed (paid or unpaid) or in full-time education at injury onset. Treating occupational therapists (OTs) and clinical psychologists (CPs) (n=6) trained in ROWTATE VR. <h3>Interventions</h3> ROWTATE is an individually-tailored job retention intervention, delivered by OTs, who act as case-coordinators, and CPs. It commences 12-weeks post-injury and is delivered for up to 12 months. It involves: assessing impact of injury; work-focused rehabilitation; planning/monitoring phased return-to-work; liaising with employers/healthcare team; educating patients/employers about injury impact; early identification, monitoring and support for psychological problems. Due to COVID-19, the intervention was adapted for remote delivery (video/phone call) and OTs/CPs trained in remote delivery. <h3>Main Outcome Measures</h3> Study completion. Intervention fidelity, barriers and enablers to delivery, acceptability and usefulness; acceptability of remote intervention training. <h3>Results</h3> At 6 months: 90% started intervention ≤12 weeks post-injury, 103 OT sessions (M=10.3, range 5-19); 99% OT sessions delivered remotely, 6 patients referred to CP; 22 sessions (M=3.7, range 1-5), 100% remote. Fidelity: OT: 90%-100% across patients, CP: 82%-100% across patients. No participant withdrawals. Treating therapists and all participants found the intervention acceptable. <h3>Conclusions</h3> Remote VR training and delivery is feasible and acceptable to OTs/CPs and trauma survivors. Findings have informed a definitive randomised controlled trial. <h3>Author(s) Disclosures</h3> No conflicting interests.

허혈성 심장질환 환자의 심장재활

The number of patients with ischemic heart disease is increasing worldwide. And mortality and treatment costs are also increasing. Cardiac rehabilitation is effective in reducing disease recurrence, readmission, and mortality rates. Therefore, it is strongly recommended to introduce cardiac rehabilitation after ischemic heart disease. The cardiac rehabilitation team consists of rehabilitation medicine doctors, rehabilitation nurses, physical therapists, occupational therapists, clinical psychologists, nutritionists, and social workers. Cardiac rehabilitation programs include risk factor management, physical activity, medication management, psychological problem management, vocational rehabilitation training, and vocational counseling. Individual treatment programs should be created for each patient. Prior to the introduction of a rehabilitation program, the patient

P077 Upskilling rheumatology therapists in work rehabilitation: an evaluation of the Workwell training programme

Abstract Background/Aims Keeping people with arthritis working is an important goal of rehabilitation. Rheumatology therapists may provide work advice to employed patients but conducting a structured work assessment and providing vocational rehabilitation (VR) is unusual. As part of a VR trial, we developed a VR training course (Workwell). The course consisted of 3 elements: a pre-training self-study module (reading on ergonomics and activity analysis; activity analysis of at least 2 videos of people working; observing people working); a 2-day training course (how to conduct a structured work interview (the Work Environment Survey: WES); case studies; planning work interventions; practical workshops about VR strategies and solutions; addressing disclosure; writing reports); followed by a 1:1 one hour telephone call practising conducting the WES with a trainer, developing a treatment plan, and individual feedback. A “Workwell Solutions Manual” was also provided for use in practice, with information on legislation, patient booklets and work solutions linked to problems identified in the WES. Our aim was to evaluate therapists’ views about the course and its impact. Methods All therapists attending the Workwell course were asked to complete questionnaires pre- and post-training. These included: knowledge of and confidence in providing VR (measured on a 0-4 scale of very limited to excellent); the Evidence Based Practice Attitude Scale (EBPAS); and views about course content and duration. Results Three courses were delivered: 32/40 attendees completed pre-and-post training questionnaires. All were occupational therapists (OTs): 30 women and 2 men; 2 NHS Band 5, 15 Band 6, 11 Band 7 and 4 Band 8; with 11 (SD 7) years’ experience in Rheumatology. Median scores of Knowledge of: VR; the VR process; VR strategies; relevant legislation and policies; and Confidence in: conducting a work assessment; and identifying work solutions, significantly increased from 1 (limited: IQR 1-2) to 3 (good: IQR 2-3) (p &amp;lt; 0.001). Total EBPAS scores did not change. However, Openness sub-scale scores did (i.e. extent to which willing to use new research -based interventions): Pre 2 (moderate: IQR2-3) to Post 3 (great: IQR 3-3): p = 0.04. Most (i.e. 26-30) considered very/extremely relevant: the pre-training self-study; conducting the WES and case studies; practical workshops (workstation assessment; upper limb strategies; load handling; environment; disclosure); and the post-training 1:1 practice WES, treatment planning and feedback. The training about using the WES (roleplay by trainers; case studies and 1:1 telephone practice) was considered the most beneficial aspect. Of the 21 commenting on course length, 16 considered it about right and 5 wanted longer. Conclusion The 2-day VR course, plus 2 days self-study, led to significant improvements in knowledge and confidence in delivering VR amongst attending OTs. Work is a key component of OT. This training course could help expand work services in Rheumatology to keep patients working. Disclosure A. Hammond: None. S. Woodbridge: None. R. O'Brien: None. A. Ching: None. J. Parker: None.

Effect of Vocational Rehabilitation Training Camp on Patients with Spinal Cord InjuryReturning to Society

Objectives:To investigate the therapeutic effect of vocational rehabilitation training camp on patients with spinal cord injury(SCI)returning to society.Methods:A total of 34 patients with spinal cord injury who were hospitalized and received rehabilitation treatments in Xiangya Boai Rehabilitation Hospital from October 2017 to October 2019 were recruited and randomly divided into control group(16 cases)and observation group(18 cases)according to the random number table method.The control group received conventional rehabilitation treatment(including basic training,daily life activity training,traditional Chinese medicine therapy,etc.)for 6 hours a day,5 days a week,for 12 weeks.The observation group added 2 weeks of vocational rehabilitation training camp on the basis of conventional rehabilitation treatment,10 hours a day,5 days a week,for 2 consecutive weeks,a total of 14 weeks.Patients in two groups were evaluated using general self-efficacy scale(GSES),community integration questionnaire(CIQ),and the lam assessment of stages of employment readiness(LASER)before and after treatment.The statuses of returning to work of patients were followed up by telephone six months after discharge.Results:There were no statistically significant differences between the two groups in GSES scores and CIQ scores before treatment(P>0.05).There were statistically significant differences in GSES scores(20.89±4.86∶31.44±3.42),CIQ-family integration scores(4.39±1.24∶10.50±1.72),CIQ-social integration scores(2.78±0.94∶8.06±1.86),CIQ-production activity scores(0.50±0.62∶3.06±0.80)and LASER scores of the observation group before and after treatment(P<0.05).There were statistically significant differences in GSES scores(22.06±5.53∶28.63±4.54),CIQ-family integration scores(4.69±1.14∶6.69±1.49),CIQ-social integration scores(3.75±0.93∶6.19±1.17),CIQ-production activity scores(0.75±0.68∶2.13±0.62)and LASER scores of the control group before and after treatment(P<0.05).After treatment,there were statistically significant differences in GSES scores(31.44±3.42∶28.63±4.54),CIQ-family integration scores(10.50±1.72∶6.69±1.49),CIQ-social integration scores(8.06±1.86∶6.19±1.17),CIQ-production activity scores(3.06±0.80∶2.13±0.62),and LASER scores between the two groups(P<0.05).Six months after discharge,the rate of returning to work of SCI patients in the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Vocational rehabilitation training camp can significantly improve the general self-efficacy,community integration,willingness to work and the rate of returning to work of patients with spinal cord injury.

A Horticultural Therapy Program Focused on Succulent Cultivation for the Vocational Rehabilitation Training of Individuals with Intellectual Disabilities.

We aimed to develop a horticultural therapy program for the vocational rehabilitation of individuals with intellectual disabilities and examine its effects. Individuals with intellectual disabilities (n = 28, average age: 33.23 ± 4.9 years) were recruited from a welfare center in Jecheon, South Korea. They participated in eight weekly sessions of a horticultural therapy program consisting of common succulent cultivation techniques at a specialized succulent cultivation farm located in Jecheon, South Korea. Before and after the program, we assessed hand function (grip strength, pinch force, and hand dexterity, evaluated using a hand dynamometer, Jamar hydraulic pinch gauge, and grooved pegboard, respectively), emotional behavioral strategies (evaluated using the emotional behavioral checklist), and social skills (evaluated using the social skill rating system-teacher form). After participation in the horticultural therapy program, individuals with intellectual disabilities displayed significantly improved hand function, emotional behavior, and social skills (all p < 0.05). This study demonstrates the potential of horticultural therapy focused on succulent cultivation for the vocational training of individuals with intellectual disabilities. Future studies should investigate the effects of the program in a larger cohort.

Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial

BackgroundInflammatory arthritis leads to work disability, absenteeism and presenteeism (i.e. at-work productivity loss) at high cost to individuals, employers and society. A trial of job retention vocational rehabilitation (VR) in the United States identified this helped people keep working. The effectiveness of this VR in countries with different socioeconomic policies and conditions, and its impact on absenteeism, presenteeism and health, are unknown. This feasibility study tested the acceptability of this VR, modified for the United Kingdom, compared to written advice about managing work problems. To help plan a randomized controlled trial, we tested screening, recruitment, intervention delivery, response rates, applicability of the control intervention and identified the relevant primary outcome.MethodsA feasibility randomized controlled trial with rheumatoid, psoriatic or inflammatory arthritis patients randomized to receive either job retention VR or written information only (the WORK-IA trial). Following three days VR training, rheumatology occupational therapists provided individualised VR on a one to one basis. VR included work assessment, activity diaries and action planning, and (as applicable) arthritis self-management in the workplace, ergonomics, fatigue and stress management, orthoses, employment rights and support services, assistive technology, work modifications, psychological and disclosure support, workplace visits and employer liaison.ResultsFifty five (10%) people were recruited from 539 screened. Follow-up response rates were acceptable at 80%. VR was delivered with fidelity. VR was more acceptable than written advice only (7.8 versus 6.7). VR took on average 4 h at a cost of £135 per person. Outcome assessment indicated VR was better than written advice in reducing presenteeism (Work Limitations Questionnaire (WLQ) change score mean: VR = −12.4 (SD 13.2); control = −2.5 (SD 15.9), absenteeism, perceived risk of job loss and improving pain and health status, indicating proof of concept. The preferred primary outcome measure was the WLQ, a presenteeism measure.ConclusionsThis brief job retention VR is a credible and acceptable intervention for people with inflammatory arthritis with concerns about continuing to work due to arthritis.Trial registrationISRCTN 76777720. Registered 21.9.12.

Developing a Virtual Reality-Based Vocational Rehabilitation Training Program for Patients with Schizophrenia.

Maintaining employment is difficult for patients with schizophrenia because of deterioration of psychosocial and cognitive functions. Such patients usually require vocational rehabilitation training, which is both demanding and costly. In this study, we developed a virtual reality-based vocational rehabilitation training program (VR-VRTP) for such patients and evaluated its feasibility as an alternative to traditional rehabilitation programs. We developed the VR-VRTP to include various situations commonly encountered in two types of occupations: convenience store employee and supermarket clerk. We developed practical situations, as well as a system for providing feedback, to ensure patients would not lose interest during training. Nine participants each performed the VR-VRTP repeatedly per week for a total of 8 weeks. At baseline and after training, all participants were evaluated using the following clinical and neuropsychological tests: Manchester Scale, Clinical Global Impression, Personal and Social Performance Scale (PSP), Hamilton Depression Rating Scale, Zung Depression Rating Scale, Beck Anxiety Inventory, Wisconsin Card Sorting Test, Stroop Test, Rey-Osterrieth Complex Figure Test (RCFT), and Auditory Verbal Learning Test (AVLT). After training, patient scores improved on the PSP, general symptoms on the Manchester Scale, AVLT, and delayed recall on the RCFT. The Manchester positive symptom score showed a trend of improvement. No significant changes were observed for other measures. The VR-VRTP may improve general psychosocial function and memory, potentially influencing real-world vocational performance. These findings provide preliminary evidence regarding the utility of the VR-VRTP in patients with schizophrenia.

Development and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package

Background In a feasibility randomised controlled trial, training was developed to equip occupational therapists to deliver early specialised traumatic brain injury vocational rehabilitation in the English National Health Service (NHS). Method The package was developed by experts in vocational rehabilitation and traumatic brain injury, and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and ease of use of the package. Interviews were analysed using the framework approach. Results Five trained therapists were interviewed regarding the package. Results were organised into six categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; and (6) lessons for future implementation. Conclusion The therapists reported acquiring the knowledge necessary to implement the intervention. The data indicate that the training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. The training materials are valued by therapists but require time for familiarisation, and reminders from mentors help put training into practice. The therapists have concerns about implementing the interventions within a research context, which researchers should address.

Speed of psychomotor reactions of pupils of the vocational rehabilitation training centre

The aim of the research is to assess the change of psychomotor reactions of persons having intellectual disorders by applying individual programmes for development of physical abilities. 12 individuals with mild intellectual disorders and 13 individuals with moderate intellectual disorders who attend the vocational rehabilitation training centre participated in the research. The research was carried out on the ground of linear experiment methods. Assessment of the psychomotor reactions speed was carried out using hardware and software Ergos II Work Simulator. After the fi rst assessment, individual programmes for development of physical abilities have been designed and applied; the main aim of the programmes was to develop psychomotor reactions of people with intellectual disorders by applying physical exercises.

The Development and Evaluation of a Vocational Rehabilitation Training Programme for Rheumatology Occupational Therapists

People with inflammatory arthritis rapidly develop work disability, yet there is limited provision of vocational rehabilitation (VR) in rheumatology departments. As part of a randomized, controlled trial, ten occupational therapists (OTs) were surveyed to identify their current VR provision and training needs. As a result, a VR training course for OTs was developed which included both taught and self-directed learning. The course included: employment and health and safety legislation, work assessment and practical application of ergonomic principles at work.Pre-, immediately post- and two months post-training, the ten OTs completed a questionnaire about their VR knowledge and confidence On completion, they reported a significant increase (p < 0.01)in their knowledge and confidence when delivering vocational rehabilitation. They rated the course as very or extremely relevant, although seven recommended more practical sessions. The preference for practical sessions was highlighted, in that the aspects they felt most beneficial were role-playing assessments and sharing ideas through discussion and presentations.In conclusion, the course was considered effective in increasing both knowledge and confidence in using VR as an intervention, but, due to time constraints within the working day, some of the self-directed learning should be incorporated into the training days. Copyright © 2013 John Wiley & Sons, Ltd.

A Study on the development of the key performance indicators of the vocational rehabilitation training for the students with disabilities

A Study on the development of the key performance indicators of the vocational rehabilitation training for the students with disabilities

Toward Successful Management of Vocational Rehabilitation Services for People with Disabilities: A Data Mining Approach

This study proposes a multi-level data analysis approach to identify both superficial and latent relationships among variables in the data set obtained from a vocational rehabilitation (VR) services program of people with significant disabilities. At the first layer, data mining and statistical predictive models are used to extract the superficial relationships between dependent and independent variables. To supplement the findings and relationships from the analysis at the first layer, association rule mining algorithms at the second layer are employed to extract additional sets of interesting associative relationships among variables. Finally, nonlinear nonparametric canonical correlation analysis (NLCCA) along with clustering algorithm is employed to identify latent nonlinear relationships. Experimental outputs validate the usefulness of the proposed approach. In particular, the identified latent relationship indicates that disability types (i.e., physical and mental) and severity (i.e., severe, most severe, not severe) have a significant impact on the levels of self-esteem and self-confidence of people with disabilities. The identified superficial and latent relationships can be used to train education program designers and policy developers to maximize the outcomes of VR training programs.

PROTOCOL: Post‐basic Technical and Vocational Education and Training (TVET) Interventions to Improve Employability and Employment of TVET Graduates in Low‐ and Middle‐income Countries

PROTOCOL: Post‐basic Technical and Vocational Education and Training (TVET) Interventions to Improve Employability and Employment of TVET Graduates in Low‐ and Middle‐income Countries

GUIDANCE: Development of a guidance programme for students with special educational needs in Kenya: a study on personal orientation

In this article, Franciscah Wamocho, lecturer and chairperson, Geoffrey Karugu, senior lecturer, both in the Department of Special Education, and Augustine Nwoye, Associate Professor in the Department of Psychology, all from Kenyatta University in Nairobi, argue that people with disabilities are likely to need the support of counselling services. The study reported here sought to collect baseline data that could be used in designing a comprehensive guidance programme for students with disabilities in secondary phase special schools and vocational rehabilitation training centres in Kenya. A personal orientation inventory was employed to measure values and behaviours among 229 students with visual impairments, hearing impairments and physical disabilities. The results reveal that the students with special educational needs may be non‐self‐actualising. The trend suggests that students with special needs may be living in the past or future with a lot of regrets and negative sentiments. Taking account of insights derived from Maslow's theory of self‐actualisation and other related literature, the findings of this study appear to reinforce the need for a guidance and counselling programme to be developed for students with special educational needs in Kenya. This study reveals the direction that such a programme could take if it is to be of benefit to a Kenyan clientele with special educational needs.

Estimating treatment effects for discrete outcomes when responses to treatment vary: an application to Norwegian vocational rehabilitation programs

This paper analyzes the impact of interventions on discrete outcomes when responses to treatment vary among observationally identical persons. Using a latent variable model motivated by economics, we show how to define and identify various mean treatment effects as well as the distribution of treatment effects for discrete outcomes. The framework is based on discrete choice models with unobservables generated by factor structures. Responses to treatment vary among persons who are observationally identical, and agents participate in the program on the basis of their idiosyncratic response to treatment. We apply the model to study the Norwegian Vocational Rehabilitation training program.

A networking approach to rehabilitation service delivery in the developing nation/states of Micronesia.

The people of Micronesia , those inhabitants of a collection of over 2,000 islands and atolls encompassing three million square miles of Western Pacific Ocean, have developed by the establishment of three political entities, compacts of Free Association with the United States (United Nations Administrators of the area under the designation of the U.S. Trust Territory of the Pacific Islands). These emerging nations aim for self-sufficiency in all areas of national endeavor within specified periods of time. The University of Guam's Vocational Rehabilitation Training Program has addressed itself to the issue confronting not only these newly emerging nation/states of Micronesia , but indeed, those developing nations which currently struggle with the social, cultural and economic issues of providing for its citizenry , appropriate rehabilitation programming which meets criteria of high quality services to the largest number of people within an attainable cost structure. Initial findings suggest this Third World Rehabilitation community refrain from adopting a polarity of thinking approach in the design and delivery of Rehabilitation services. The logical extension of such either/or planning attempts seems only to limit current and future Rehabilitation programming effort. Rather, a comparative cost analysis of selected rehabilitation services and accompanying travel expenses related to providers from both sides and throughout the Pacific, demonstrates that an admixture approach, which includes all available sources of services, warrants further investigation as a viable programming model for the nation/states of Micronesia to utilize as they develop locally based Vocational Rehabilitation Service programs of their own.

Editorial

Editorial POSTSECONDARY EDUCATION FEDERALLY ESTABLISHED REGIONAL PROGRAMS Over the last two decades the federal government has helped develop four regional programs for deaf and hard-of-hearing students. These are the St. Paul Technical Vocational Institute (TVI), California State University at Northridge (CSUN), Delgado Community College, and Seattle Central Community College. Two of these programs have been absolutely outstanding and the other two have been well above average. All have objective follow-up data demonstrating the dividends returned on the educations they provide. In the face of this record of success, including excellent fiscal return on tax dollars invested, it is sad that these four programs now face possible extermination because of withdrawal of federal support. The government seems unable to distinguish between an expense and an investment. The paradox these proposed cutbacks represent is especially pronounced when one considers the huge influx of rubella-deafened youth who will be needing postsecondary education during the next five years. This influx has been fully documented by epidemiological studies and is a clear and indisputable fact. Rehabilitation Centers and Programs Seven rehabilitation programs exist in the U.S. that serve primarily those postsecondary deaf students who cannot or choose not to attend 4year or community colleges. These programs are highly or totally dependent on state rehabilitation funds. As these funds have been cut drastically at a national level, the rehabilitation centers have made gross reductions in the support services necessary for meaningful participation on the part of most deaf clients. The effects of these cutbacks are especially damaging to those deaf youths who are most in need of services. It was these few rehabilitation programs that were trying to meet the needs of the lower third of the deaf population desperate for training. If this third of the deaf population is to survive as economically independent contributing members of society, they must have comprehensive vocational rehabilitation training. Federally Established National Programs Historically, Gallaudet College and the National Technical Institute for the Deaf have been treated generously by the federal government . While they too now face fiscal cutbacks in the face of the increasing needs represented by the "rubella bulge," there are cushions in their budgets which do not exist in the other postsecondary programs. Other Postsecondary Programs There are about 34 other postsecondary programs in the U.S. that have some support services for deaf students. These programs vary tremendously in quality. Most provide training for local clients only. All of these programs depend to some extent on state vocational rehabilitation funds, which in turn depend directly on matching federal money. These federal funds have been drastically cut, crippling the 34 local programs for deaf clients. Overview The network of 48 postsecondary programs with support services for deaf youths and adults is facing near annihilation due to federal fiscal cutbacks. The problem is compounded by federal efforts to take the teeth out of the VR Act of 1973 (and revisions) and P.L. 94-142. This further erodes the financial resources available by eliminating interpreting services and other aspects of equal access. A national plan to meet the postsecondary needs of deaf youth is needed. The current fiscal cutbacks jeopardize all but two of the programs now available. Without adequate postsecondary opportunities, most deaf youth will face unemployment or dead-end routine jobs with low pay and little job satisfaction. McCay Vernon, Ph.D. Editor ANNOUNCEMENT The Annals has changed its subscription policy from a calendar year basis to an annual anniversary basis beginning with the February 1983 issue. February 1983 issues are being sent to unrenewed subscribers to minimize problems as a result of this change of policy. Future subscriptions will terminate 1 or 2 years from receipt of renewal. A.A.O. I February 1983 ...