Prero, A.J., & Thornton, C. (1991). Transitional employment training for SSI recipients with intellectual disabilities. Social Security Bulletin, 54(11), 2-25.
- This article summarized the findings of a process evaluation of the Transitional Employment Training Demonstration, which aimed to transition Supplemental Security Income (SSI) recipients with intellectual disabilities to permanent employment. To achieve this goal, the demonstration provided participants with short-term training for potentially permanent jobs in which they would conduct tasks for their employers and interact with nondisabled colleagues.
- The study developed findings on recruitment, training, placement, and the provision of other services by collecting data from all eight program sites. It drew on several qualitative sources, such as program staff interviews, observations of service provision, and program documents, as well as a few quantitative sources, including program, survey, and SSI administrative data.
- The study found that it was feasible to successfully place a wide variety of SSI recipients with intellectual disabilities in mainstream jobs using transitional employment services. However, the programs faced several challenges in program design and implementation. Recruitment and job placement could be difficult, given opinions among caregivers and employers that people with intellectual disabilities cannot perform well in competitive jobs. Job placement was hampered further by the lack of suitable transportation options.
Transitional Employment Training Demonstration
Features of the Intervention
The Social Security Administration launched the Transitional Employment Training Demonstration in 1985, awarding grants to eight organizations in eight states to help SSI recipients with intellectual disabilities obtain and retain competitive employment. In total, 745 SSI recipients were recruited for the demonstration, about 5 percent of those who were eligible. Its key strategies were to (1) place participants in potentially permanent positions in which they would be able to conduct all relevant tasks and interact with those who were not disabled; (2) provide short-duration training on specific job functions, general job-related capabilities such as task and time management, and social and life skills needed in the workplace; (3) provide ongoing monitoring and job retention services; and (4) provide any supplementary services needed, such as transportation or travel training.
Sites tried to ensure that their participants were positioned for success at their places of employment by working with employers to ensure that participants were given time to grow into their roles and achieve regular production rates, facilitating connections between participants and other employees, modifying jobs so that they met the needs of those with intellectual disabilities, and matching participants to jobs that aligned closely with their interests and capabilities.
Features of the Study
The effectiveness of the demonstration was evaluated using a randomized controlled trial (see link here for the CLEAR profile of the study containing those results). The process study summarized in this profile used data from the universe of sites to understand how to improve training to advance employment outcomes and align services more effectively with the needs of those with intellectual disabilities, all while ensuring that services remained cost-efficient. Qualitative data were collected through (1) the review of the standard operating procedures and financial reports of each site, (2) interviews with site managers and other personnel, (3) participation in joint meetings with staff from all sites, and (4) observations of intake interviews and trainings. The evaluators also drew on quantitative data on the beneficiaries to provide context. Sources included survey and SSI administrative data on earnings and benefit payments, site data on program costs, and data on job retention from an unspecified source. The article implied that these data were collected over the course of the two-year program implementation period.
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.
Considerations for Interpreting the Findings
This article provided insights on how to structure and implement transitional employment programs, offering a background and history of transitional employment as context before discussing lessons from the implementation of the demonstration and their implications for program design. It made skillful use of both quantitative and qualitative data. It used quantitative data to offer preliminary insights into program effectiveness and cost-effectiveness. It mainly drew on qualitative data to develop findings on program implementation and best practices for the future. The article did not discuss data collection and quality assurance methods, which prevented a thorough assessment of data reliability. However, the authors thoughtfully assessed the strengths and weaknesses of their analysis. They noted that the qualitative data were collected by different site monitors but in a uniform way across sites, which facilitated comparison across transitional employment approaches, a key process study goal. They explained to readers, however, that the process study conclusions did not have the same level of validity as impact analysis