id) initEditor(); ?>
Vocational Rehabilitation Service Models
for Individuals with Autism Spectrum Disorders
R.3 Research Study PDF Print E-mail

R3: Best Practices Model Identification in Vocational Rehabilitation
This quality improvement study will focus on perceived best practices implemented by VR service providers and the extent to which they are linked to successful employment outcomes for people with ASD. Outcomes from this study will include empirical assessment of practices perceived as effective by VR professionals, and identification and dissemination of those that are linked to successful outcomes. The VR autism project will develop a replicable best practice manual of programs and models that can be adopted and adapted for use in other settings.

The project has a goal to increase awareness and use of perceived vocational rehabilitation best practices for achieving Status 26 closures or competitive employment in integrated settings. One activity of the project involves the identification of best practices in obtaining successful employment placements for individuals with ASD.


Research Questions

The project’s research questions that will be investigated are:

  1. What are the perceived vocational rehabilitation best practices for achieving successful competitive job placements in integrated work settings for consumers with ASD?

  2. What common factors, if any, do best practices possess?

  3. Do service settings that adopt a best practice demonstrate the same level of successful outcome as the original service program?

Method

These research questions will be investigated through the following methodology:
SEDL will draw on its experience in identifying, validating, and disseminating best practice models in the rehabilitation and public education arenas. Best practice identification is a methodology often used in the vocational rehabilitation and education fields to produce information about strategies and practices that are associated with positive outcomes (Hanson, 1996). In emerging fields or with emerging populations, it often functions as a predecessor to more rigorous experimental research. Best practice approaches have been used, for example, by the Center for Development and Disability and the University of New Mexico to identify strategies for reducing barriers to employment for persons with significant disabilities and by the Vocational Studies Center at the University of Wisconsin to address vocational rehabilitation services for persons with learning disabilities.

The project’s best practice identification involves, first, nomination of best practices by vocational rehabilitation administrators, based on their perceptions regarding the practice’s effectiveness in yielding positive employment outcomes, followed by a screening process that requires detailed description and empirical data documenting those outcomes.

Project staff will survey state VR directors across the U.S. and ask them to nominate the service providers (vendors) with whom they contract that are perceived to be doing an exceptional job of placing people with ASD into successful Status 26 closures or competitive integrated employment placements.

Project staff then will contact nominated service provider organizations and ask them to provide in-depth information about their service delivery, service environment, and short and long-term outcomes. Vendors who are unable to provide such data will not be considered further but will receive technical assistance from project staff regarding data collection methods and instrumentation that can be used to initiate outcome-oriented data collection efforts. Where adequate information is available, nominees will be screened, and those not meeting selection criteria will be eliminated.

Through awareness and free-of-charge technical assistance resources provided by the project, SEDL anticipates that service providers will begin to adopt or adapt best practice models. (SEDL has had successful experience in facilitating this best practice adoption approach with a variety of types of rehabilitation service providers.) When this type of “transportability” occurs, data will be solicited from the adopting service providers regarding their measures of efficiency and effectiveness.

Nominations will be solicited annually following the initiation of the nomination process in Year 1. A Validation Manual and Information Request Form will be made available to each nominated program indicating an interest in pursuing designation as a best practice example.


Sample

There are currently 80 VR state agencies in the US. Approximately 30 are agencies that serve the blind; the remainder provide general services. The general service agencies are the predominant providers (or potential providers) of vocational rehabilitation services to persons with ASD. All general service VR agency directors will be asked to nominate one or more of their perceived best practice examples each year.

Service delivery vendors whose practices are nominated will have the option of providing additional information to inform the best practice model development process. Nominees providing sufficient information and meeting screening criteria for selection as best practice examples will receive a modest honorarium to help offset costs of responding as well as a certificate. Key factors of each practice, e.g. cost of operation, staffing, and outcomes, will be described to provide sufficient information for other service providers to consider adoption/adaptation of the best practice. SEDL staff will provide technical assistance as needed to help document and describe the nominated practices.


Data Collection and Measurement

Critical categories for information gathering will be identified via the project’s systematic review activities and the proceedings of the 2007 Institute on Rehabilitation Issues on Autism (Dew & Alan, 2007). SEDL will develop a Validation Manual that includes detailed definitions and descriptions of each information category. SEDL also will develop a standardized Information Request Form in paper and electronic formats to be used by each respondent to provide needed data.

SEDL staff will review the data provided and will interview service provider staff to address spurious data or inconsistent data and determine whether information categories were unclear or misunderstood or if the corresponding data is incomplete. Visual and graphic descriptions of service delivery mechanisms will also be included when possible.

Best practice examples will be selected based upon data showing the number of successful (over 90 day) placements in competitive employment settings for persons with ASD. Outcome data will be analyzed to compare success for similar degrees of disability along the autism spectrum continuum. The selected best practices will demonstrate a success rate higher than that documented by RSA in its overall reporting of annual cases closed in Status 26.


Data Analysis

Members of the project’s national advisory panel will review the service provider descriptions and data and select best practices on an annual basis. The panel will be comprised of VR state directors or their designees, researchers in ASD, ASD employment-related service providers, and persons with ASD and their family members. Based on the explicit request from NIDRR representatives that applicants in this funding competition limit the number of outside individuals solicited for participation and support, we have thus far limited our requests for involvement to a few key constituents, in order to demonstrate sufficient community support to encourage full participation from VR directors and service providers throughout the U.S. in this proposed best practice process. We have asked for and secured the participation of Susan M. Foley, Research Director for the Institute for Community Inclusion, which operates the NIDRR-funded Vocational Rehabilitation RRTC and the Opening Doors RRTC for Children and Youth with Special Health Care Needs and Disabilities; Bill Palmer, Director of the Division of Vocational Rehabilitation, Florida Department of Education; Donald R. Uchida, Executive Director of the Utah State Office of Rehabilitation and the parent of a child with autism; and Anna Hundley, President of the National Association of Providers for Adults with Autism and a member of the 32nd Institute on Rehabilitation Issues.

Data regarding the identified best practices also will be compared with data regarding practices that were nominated by VR directors but did not meet the screening criteria for designation as best practices. Scale scores for each information category will be used in regression analysis to assess which factors may be most closely associated with selection as a best practice. These data will continue to be reviewed annually to identify factors that may be more predictive of being selected as a best practice example. Cost studies will be conducted on the best practices to determine the areas of costs and the extent of costs per placement.