Absence of conflict of interest.
The study's objective was to examine the impact of Supported Employment (SE), through Vocational Rehabilitation (VR), on competitive employment.
The study used a regression matched comparison group design to compare the outcomes of program participants to non-participants. The primary data source for the study was the US Department of Education, Rehabilitation Services Administration Case Service Report (RSA-911) database.
The study found that across the subgroups SE intervention increased competitive employment. The study found a positive statistically significant relationship between an SE intervention and competitive employment for individuals with intellectual disabilities, autism spectrum disorders or schizophrenia.
This study receives a low evidence rating due to unobserved variables. This means we are not confident that the estimated effects are attributable to Supported Employment (SE); other factors are likely to have contributed.
Individual Placement and Support and Vocational Rehabilitation Program
Features of the Intervention
Over 30 states have adopted an Employment First Initiative (EFI) to advance integrated competitive employment as the first option for individuals with disabilities receiving publicly funded employment services within the state. Advancing SE is one component of the movement towards improving EFIs. VR is a joint federal-state program that assists eligible individuals with disabilities to obtain and retain competitive employment at market wages in an area of their vocational interests. SE facilitates competitive employment or traditional employment in an integrated setting with ongoing support services for individuals with the most severe disabilities. The VR initiative serves people who have a physical or mental disability that creates a substantial impediment to employment; people who can benefit from the provision of VR services; and people who require VR services to maintain and prepare for gainful employment.
Features of the Study
The study used a regression matched comparison group design. The authors matched people who received SE interventions through VR programs to those who received other VR programs using propensity scores developed from socio-demographic information. The sample consisted of 182,719 individuals with disabilities. VR participants who received SE were the program group. SE treatment included services provided in the competitive employment context, voluntary consumer participation, a rapid job search, integrated rehabilitation and mental health services, individualized support, a focus on consumer preferences, and ongoing support. Individuals who received VR services that were not SE programs comprised the control group.
The study created nine similar subgroups based on matched demographic characteristics to conduct its analysis. The authors compared the outcomes of program participants to non-participants using statistical tests.
The primary data source was the US Department of Education, Rehabilitation Services Administration Case Service Report (RSA-911) database. The RSA-911 data contain information related to demographics, disability, types of VR services, and employment outcomes for clients receiving state VR services in the U.S. The data are furnished annually to RSA by state VR agencies. Data from the RSA-911 for fiscal year 2010 to 2013 for the entire United States were extracted for this study.
- The study found that across the groups there is a positive effect of SE intervention on employment. The effect was strongest with people with a mean age of 19 years who received SSI disability benefits and people with intellectual disabilities or autism who graduated from regular high school.
Considerations for Interpreting the Findings
The study does not account for all potential confounding factors. The study does not account for cross-state variation in the labor market or differences in the amount and scope of services provided by various VR agencies. This information was not available in the study data source.
Causal Evidence Rating
This study receives a low evidence rating. The quality of causal evidence presented in this report is low because the authors did not account for pre-intervention employment trends, which could influence the successful employment created by SE. This means that we are not confident that the estimated effects are attributable to Supported Employment through Vocational Rehabilitation services; other factors are likely to have contributed.