Transitional employment training for SSI recipients with intellectual disabilities (Prero & Thornton 1991)

The process study found that the demonstration was generally successful in finding placements for participants in jobs in which they could succeed. At the end of the program, 34 percent of the participants were in permanent jobs, earning an average of $111 per week. Program costs—also a focus for the study—averaged $7,650 per participant, but the authors estimated that the same services would cost about $5,600 when provided by a longer-term operation, given about $2,000 in costs per participant that went toward initiating and phasing out the demonstration. Summarized next are lessons on specific program components and phases.

• Recruitment. Sites found recruitment challenging and were able to recruit only 5 percent of those eligible for the demonstration. The authors discussed several possible explanations. First, parents might have been unconvinced of the appropriateness of transitional employment for their special needs children, and concerned that needed supports would not be available beyond the lifespan of the demonstration. Another (unsubstantiated) concern among potential participants might have been that program participation could lead to the determination that they were not disabled and therefore ineligible for SSI benefits. Finally, other agencies were reluctant to provide referrals, either because they were competing for similar participants or because they had the same concerns about transitional employment as parents of SSI recipients.
• Screening. It was challenging to predict up front whether participants would benefit from the program, which led to higher program costs. In general, the study found that subjective assessments of the participants’ enthusiasm, the availability of external supports, and generally, the likelihood of the participants succeeding at the workplace, were better predictors of participants’ progress than quantifiable factors such as intelligence quotient scores or the presence of secondary disabling conditions.
• Job development. Many employers were not open to offering transitional employment positions. Exceptions were the food service and hotel industries, which were more willing than other industries to consider hiring workers with special needs. However, they also offered multitask jobs such as dishwashing that were more difficult for those with intellectual disabilities to undertake.
• Job placement and training. Placements in potentially permanent positions were more successful than placements in training-only positions. In permanent placements, job coaches could help trainees adjust to the exact environment in which they would be working long term—providing training on very specific job tasks, facilitating communication with other employees, and ensuring that needed supplementary services were in place. By contrast, in training-only jobs, participants had to apply what they learned in one position to another and adapt to new settings, schedulers, and coworkers. Training-only positions were more cost-efficient and easier to arrange (especially when they were at the grantee’s own facilities) and catered to participants with particularly severe handicaps who needed extra time to adapt to a work setting.
• Transportation. The lack of suitable transportation options led to participants undertaking difficult commutes, taking nearer jobs to which they were not ideally suited, not being placed at all, and even being screened out of the program entirely. Sites drew on both public and private means of transportation to meet participants’ needs and devoted considerable time and resources to travel training—even having coaches put participants on buses in person.
• Job coaches. Job coaches took on wide-ranging responsibilities, even picking up production shortfalls experienced by the participants in early days at the job to ensure employers’ satisfaction and increased chances of job retention. The job coaches had highly varied experience and expertise; however, the study found that even those who did not have relevant educational or professional qualifications, and who were therefore the most inexpensive to hire, were effective in their roles as long as they received appropriate supervision.
• Adapting services to participants’ needs. Meeting the needs of the demonstration’s diverse participants required a flexible approach to program design and service provision. Services that were not required components of the program—such as case management—were needed to address the challenges faced by beneficiaries with intellectual disabilities. Successful programs also offered a wide variety of placements so that individual needs and interests would be fulfilled.