Serving People with Disabilities through the Workforce Investment Act's One-Stop Career Centers

This paper examines the extent to which people with disabilities are served through WIA's One-Stop system and discusses its capacity to serve people with disabilities who desire employment assistance, both in terms of common barriers to access as well as promising strategies to improve service delivery to people with disabilities

INTENTIONS TO USE TELEREHABILITATION FOR COMMUNICATION AND TREATMENT FOR VISION IMPAIRMENTS

BACKGROUND: Approximately 8.1 million people in the United States 18 and older have difficulty performing one or more daily activities because of vision impairment or blindness (Erickson, Lee, & von Schrader, 2020; Taylor, 2018). If the impairments caused by vision loss are not addressed, they can result in financial difficulties, suffering, disability, loss of productivity, and decreased quality of life (National Center for Chronic Disease Prevention and Health Promotion, 2011). Currently, in-person low vision rehabilitation services are the gold standard for teaching people how to adapt to and compensate for these deficits, however, the access and utilization of these services by people with vision impairments is poor. Telerehabilitation is one service delivery option that has been used in other settings to increase access and utilization of low vision services. This study investigated the underlying factors that are related to three stakeholder groups’ behavioral intention to use telerehabilitation as a low vision rehabilitation service delivery option. METHODS: This pilot study utilized an anonymous pre-validated online survey to collect data from people with vision impairments, eye care professionals, and vision rehabilitation professionals. Participants were recruited by email or through social media. RESULTS: Fifty-two people participated in the survey – 12 males (23%) and 40 females (77%). Participants’ ages ranged from 21 to 79 years of age (M = 45.2, SD = 12.6). Twenty-two people with vision impairments (42%) participated in the survey, followed by 21 (40%) vision rehabilitation professionals, and nine (17%) eye care professionals. Most of the participants reported feeling very comfortable with using computers (85%), mobile devices (85%), and videoconferencing software (64%). More than half of the sample reported being very skilled using computers (70%), mobile devices (76%), and videoconferencing programs (59%). All participants, except for one, reported using a computer for at least 1 year. Twenty-one participants – 3 people with vision impairments, 3 eye care professionals, and 15 vision rehabilitation professionals - reported having used telerehabilitation. Twenty participants (43%) reported having the behavioral intention to use telerehabilitation in the future while 17 participants (36%) stated that they planned on using telerehabilitation in their daily lives. For this study’s adapted and extended UTAUT model, small effect size relationships were noted between behavioral intention and performance expectancy (r = .295), and behavioral intention and resistance to change (r = .254). Age, gender, and experience were not found to be confounding variables between the predictor variables and behavioral intention. The people with vision impairment group was noted to have small effect sizes for the relationships between behavioral intention and performance expectancy (r = .218), and effort expectancy (r = .271), and technology anxiety (r = -.321). Age, gender, or experience were not found to act as confounding variables in these relationships. Eye care professionals had a moderate effect size for the relationship between behavioral intention and performance expectancy (r = .414) which appeared to be confounded by gender (r = .830) and experience (r = .671). They also had a small effect size relationship between behavioral intention and technology anxiety (r = .213) which appeared to be confounded by experience (r = .515). Gender and experience were also noted to be confounding variables for the relationship between behavioral intention and resistance to change. Age, gender, or experience were not found to act as confounding variables in these relationships. For the vision rehabilitation group, there was only one small effect size found for the relationship between behavioral intention and resistance to change (r = .243) which was noted to be confounded by experience (r = .463). CONCLUSIONS: The use of telerehabilitation as a low vision service delivery option is still a new area of inquiry. This study was the first to explore the underlying factors of three stakeholder groups’ behavioral intention to use telerehabilitation as a service delivery option. Most of the participants with vision impairments reported not having difficulty accessing traditional in-person low vision rehabilitation services, or not planning on using telerehabilitation services in the future. These findings were contrary to assertions made by previous literature (Lam and Leat, 2013; Hoque and Sorwar, 2017). Eye care professionals also reported being very comfortable and skilled with various technologies, but were more open to change and accepting of new technologies, like telerehabilitation. Therefore, eye care professionals’ behavioral intention to use telerehabilitation in the future was higher than the other two groups. The vision rehabilitation group was similar to the eye care professional group in the behavioral intention to use telerehabilitation, and similar to the people with vision impairments group in their high level of resistance to change. Like the people with vision impairments group, the vision rehabilitation professional group appeared to be satisfied with the in-person low vision rehabilitation services that are already being delivered, and may not recognize the need for another service delivery option at this time. This study provides preliminary information that can be used in future studies that seek to understand why different stakeholder groups choose to accept and plan to use telerehabilitation. Once this information is better understood, researchers can build upon this information to increase the actual use of telerehabilitation among all three stakeholder groups. Limitations of this study that impact the interpretation of this study’s results and generalizability to a broader population are poor response rates, single survey response method, stringent inclusion criteria, and accessibility issues. Recommendations for future studies consist of addressing the study’s limitations as well as the intrinsic and extrinsic factors of each stakeholder group’s behavioral intention to use telerehabilitation. Overall, this study adds to the body of knowledge in the areas of telerehabilitation and low vision rehabilitation

The CARESSES study protocol: testing and evaluating culturally competent socially assistive robots among older adults residing in long term care homes through a controlled experimental trial

Background : This article describes the design of an intervention study that focuses on whether and to what degree culturally competent social robots can improve health and well-being related outcomes among older adults residing long-term care homes. The trial forms the final stage of the international, multidisciplinary CARESSES project aimed at designing, developing and evaluating culturally competent robots that can assist older people according to the culture of the individual they are supporting. The importance of cultural competence has been demonstrated in previous nursing literature to be key towards improving health outcomes among patients. Method : This study employed a mixed-method, single-blind, parallel-group controlled before-and-after experimental trial design that took place in England and Japan. It aimed to recruit 45 residents of long-term care homes aged ≥65 years, possess sufficient cognitive and physical health and who self-identify with the English, Indian or Japanese culture (n = 15 each). Participants were allocated to either the experimental group, control group 1 or control group 2 (all n = 15). Those allocated to the experimental group or control group 1 received a Pepper robot programmed with the CARESSES culturally competent artificial intelligence (experimental group) or a limited version of this software (control group 1) for 18 h across 2 weeks. Participants in control group 2 did not receive a robot and continued to receive care as usual. Participants could also nominate their informal carer(s) to participate. Quantitative data collection occurred at baseline, after 1 week of use, and after 2 weeks of use with the latter time-point also including qualitative semi-structured interviews that explored their experience and perceptions further. Quantitative outcomes of interest included perceptions of robotic cultural competence, health-related quality of life, loneliness, user satisfaction, attitudes towards robots and caregiver burden. Discussion : This trial adds to the current preliminary and limited pool of evidence regarding the benefits of socially assistive robots for older adults which to date indicates considerable potential for improving outcomes. It is the first to assess whether and to what extent cultural competence carries importance in generating improvements to well-being

Implementing Assistive Technology through Program Planning

Special education (SPED) service providers in the military are often underprepared to use the needed assistive technology (AT) in the classroom. This concurrent mixed-method study sought to explore the attitudes, skills, and quality indicators of assistive technology (QIAT) among 19 currently employed military SPED certified multidisciplinary team members. The conceptual framework of this study was based on the professional learning community model, which holds that the team members work collaboratively to educate the families it serves. All team members completed a quantitative QIAT survey and open-ended questionnaire, and individual qualitative interviews were conducted with a subsample of 8 volunteer staff. QIAT survey data were descriptively analyzed, while questionnaire data were transcribed, open coded, and thematically analyzed. All data were triangulated and member checking and peer debriefing were used to strengthen validity and credibility of the findings. Survey data revealed teachers\u27 willingness to utilize AT in the classroom, although qualitative data suggested that the multidisciplinary team lacked the knowledge to consistently and confidently utilize AT within their classes daily. Additional emergent themes included collaboration, viable resources, unifying guidelines, AT support, training, and guidance. Administrators at the local site can use these findings as guidance in the development of in-service and district AT trainings and support. Through consistent usage of these interventions, the military community can impact positive change in the lived experiences of SPED service providers and the families that it serves

The Experiences that Promote Success for Students with Intellectual Disability in Postsecondary Education

This in-depth qualitative, phenomenological (Smith & Fowler, 2009) research study attempted to understand the experiences of young adults with intellectual disability who had completed a 2-year, inclusive postsecondary education program. 13 participants (4 former students with ID, 5 parents, and 4 Postsecondary Education staff members) participated in semi-structured interviews. Interviews were coded to provide themes amongst each individual group of participants. A document review was also conducted to better understand the program components and add validity to self-reports from interviews. Results were analyzed and used to provide implications for future research and program development

A Resource Manual to College and University Academic Return for Young Adults with a Mild Traumatic Brain Injury

Purpose: Reportedly, in the United States 75% of traumatic brain injuries that occur each year are referred to as mild (Centers for Disease Control Prevention, 2010). Traumatic brain injury is the leading cause of disability each year with the highest prevalence being between ages 15-24 years (Willmott, Ponsford, Downing, & Carty, 2014). The greatest deficits experienced by college or university students with a mild traumatic brain injury (mTBI) are cognitive, psychosocial, and physical (Kennedy, Krause, & O’Brien, 2014; Marschark, Richtsmeier, Richardson, Crovitz, & Henry, 2000). The purpose of this project was to address the limited resources available to individuals with the diagnosis of a mTBI as they reintegrate back into the college or university environment. Methods: An extensive literature review was conducted to understand the most prevalent deficits an individual experiences after sustaining a mTBI. The information obtained from the review of literature was then analyzed with the utilization of the Ecological Model of Human Performance (EHP) (Turpin & Iwama, 2011). The areas of need were identified through the literature review, which found: a lack of accommodation services, cognitive deficits, physical deficits, emotional deficits, and a gap in the delivery of services. In addition, previous intervention strategies used with this population were also noted. Results: Based on the methodology described above, the researchers developed A Resource Manual to College and University Academic Return for Young Adults with a Mild Traumatic Brain Injury for college or university students who have acquired a mTBI and are returning to the academic environment. Intervention strategies were created based on the EHP model to facilitate their return. The intervention strategies utilize the EHP interventions of; create, prevent, alter/change, adapt/modify, and establish/restore. This resource manual is intended for immediate use upon the return to the academic environment, however, can be referred to throughout the college or university experience. Conclusion: Several barriers may limit the implementation of this resource manual, such as: the lack of previous implementation, the classification of a mTBI, and the focus solely on academic return. Several areas of strength for this manual include; the variety of resources that are offered for student use, the manual builds upon the most challenging areas for an individual with a mTBI, and the strategies utilized are self-empowering. It is recommended further research be conducted in continuing research based off the needs of this population

Community Rehabilitation Programs and Organizational Change: A Mentor Guide to Increase Customized Employment Outcomes

[Excerpt] For the purpose of this Guide, customized employment is defined as a process for individualizing the employment relationship between an employee and an employer in ways that meet the needs of both. Customized employment is based on an individualized negotiation between the strengths, conditions and interests of the person with a disability and the identified business needs of the employer or the self-employment business chosen by the job seeker. Job negotiation uses job development or restructuring strategies that result in responsibilities being customized and individually negotiated to fit the requirements of the job

The Mount\u27N Mover Mounting system: a consumer-centered approach to assistive technology outcomes.

Background: Research on the outcomes of assistive technology devices and services is necessary in order for consumers and other associated parties to fully realize the impact that these devices can offer to those with disabilities. A previous study found that a mounting system improved functional and psychosocial characteristics of users, and that it was used in unanticipated ways. Purpose: To improve upon the methodology of prior research conducted that evaluated the consumer’s perspective on using the Mount’n Mover mounting system. Method: A quasi-experimental research design was implemented to evaluate the device’s impact on the functional capacity and quality of life of participants that had just acquired the device. Four new users were participants in this study. Two participants used the device in a school setting, and two used the device in a community-based habilitation program. The Occupational Self-Assessment (OSA) and sections of the Assistive Technology Predisposition Assessment (ATD-PA) at pretest and three-week follow-up were administered. Personal factors, environmental conditions, and expectations for device use were also explored in relation to whether or not the device was used. Results: Marginal improvements in functional capability and quality of life were noticed, with few outcomes producing statistically significant results. No conclusions could be drawn regarding differences between those who abandoned the device and those who continued device use. Results of this study were very different to those in previous work, and environmental conditions were implicated as a potential factor. Conclusion: Limitations resulting from low sample size prevented generalization of results, but the results raise important questions regarding the potential effect of environmental conditions on device outcomes

A State Policymakers' Guide to Federal Health Reform: Part I: Anticipating How Federal Health Reform Will Affect State Roles

Examines how federal healthcare reform will affect states' tools and roles in connecting people to services, promoting coordination and integration, improving care for those with complex needs, being results-oriented, and increasing efficiencies

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197