This paper argues that people with learning disabilities are an important potential consumer of 'personalised technology' and provides case studies demonstrating some of the ways that technology can help this client group. It also outlines the main barriers to personalised technology becoming a core element of social care planning for people with learning disabilities and concludes that more needs to be done to overcome these barriers and to research and demonstrate the potential benefits to this group.
The costs and financial benefits accruing from two employment agencies were analysed over the two years of their operation. The analysis determined the net costs for society as a whole, the taxpayer and the supported employees, when reductions in welfare benefit payments and costs to previous day services, and increases in tax were taken into account. The results indicated that supported workers generally benefited financially as a result of their uptake of paid work but that costs outstripped financial benefits for the taxpayer and society as a whole. There were significant differences in net costs between the two agencies. The results also indicated that the cost‐benefit performance of the two agencies was improving overtime, suggesting that the financial benefits of providing the service could ultimately outweigh the costs involved. This is in line with the general trends found in research in the USA, but progress towards a break‐even point was much slower.
This paper reports follow‐up data on an earlier evaluative study (Rapley & Beyer, 1996) of a small community‐based dispersed housing service. With the concept of Quality of Life (QOL) becoming established in the literature as an appropriate outcome measure of service practice, the previous study reported the use of the Schalock & Keith (1993) Quality of Life Questionnaire (QOL.Q) as an adjunct to established evaluative measures of service quality. Rapley & Beyer (1996) concluded that measures such as the QOL.Q may offer a useful addition to the evaluative armoury. This study reports service outcome data collected in the same network after a 2‐year interval. A positive change in measured quality of life was observed. Overall levels of engagement were static over time. Small positive changes in levels of socially integrative and domestic activities did not reach statistical significance. Changes in QOL.Q scores were consistent with the observed changes in the detail of community and domestic participation.
Many studies of the quality of ordinary housing have relied upon objective indices, which permit only inferential judgements to be made about the quality of life of service users. Quality of Life (QOL) has recently emerged as a key outcome criterion against which to assess the success of community based services for people with intellectual disabilities. A small scale study was conducted to assess the extent to which objective measures of service quality were enhanced by the addition of a subjective, QOL, measure. Service users' engagement in domestic activity, staff contacts and participation in the local community were assessed and, in addition, the Quality of Life Questionnaire (Schalock & Keith, 1993) was completed. Data suggested that isolation and disengagement characterised the sample. Perceived QOL was correspondingly poor. It is concluded that the ordinary house remains a necessary, but insufficient, component of an integrative service model.
This workbook presents strategies based on real situations and includes example exercises throughout. It is based on the principle of developing a client-centred approach to job development and emphasizes the central importance of self-determination - ensuring that the individual makes their own choices to determine their future career.
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AbstractBackgroundPaid employment represents a challenge for people with an intellectual disability and/or autism. This paper analyses the quality of jobs offered by the Engage to Change project and their relationship to the 'typicalness' of the employment offered.MethodData on the quality of 384 paid jobs were collected, including hours worked and wages earned, and reported social integration at work. The typicalness of the employment experience was assessed for 141 young people, using the Index of Typicalness of Placement Questionnaire.ResultsThe Engage to Change project offered a wide range of jobs. There is no difference in the typicalness of the employment experience in relation to the interactions in the workplace, but there are some differences in the recruitment process for men and women.ConclusionJob coaches should make sure that, despite the procedures being 'atypical' for the workplace, the outcome is 'a typical employment experience' for each employee.
AbstractBackgroundThe study reports the impact of the Covid‐19 pandemic and lockdowns on jobs for people with intellectual disabilities and autism. The study focuses on the impact of the first and the fire‐break lockdowns and the actions taken to support young people.MethodData was collected from the cohort of young people currently working in Wales, and that received job coach support from the Engage to Change Project, on furlough arrangements, job retainment and job losses. Innovative initiatives to support young people are described.ResultsReview of the working situation during the pandemic was conducted for 184 jobs, evaluating the proportion of young people being furloughed or working remotely and compared with the general population in Wales.ConclusionsSupported employment agencies adapted their practice during the COVID‐19 pandemic, offering new and innovative ways to support young people and facilitate their return to work.
AbstractBackgroundPeople with an intellectual disability and/or autism experience low employment rates compared to the general population. This study shows what the determinants of success are in getting this group of young people into paid employment.MethodThe research is based on data collected on 1008 young people, aged 16–25, participating in the Engage to Change project across Wales, to support young people to achieve employment. A real‐time data collection system was used from their engagement and throughout their journey to employment.ResultsThis research indicates an overall employment rate of 23% for the project to date, based on total referral. Young people who engaged in 'significant work experience', such as paid placement or supported internship, had a greater employment rate of 37%.ConclusionPrevious and current real work experiences increased the chances of young people of becoming employed, above the effect of supported employment and job coach support.
The costs and outcomes of supporting seven people with severe intellectual disabilities and high support needs in part‐time employment were compared with those of a Special Needs Unit (SNU) of a day centre, both within‐subject and against an equal‐sized comparison group. The income of those employed was described. Direct observation of the employment activities and representative SNU activities were undertaken to assess participant engagement in activity and receipt of assistance, social contact in general and social contact from people other than paid staff. Costs of providing service support were calculated taking account of staff : service user ratios, staff identities and wage rates and service‐administrative and management overheads. Employment was associated with greater receipt of assistance, higher task‐related engagement in activity and more social contact from people other than paid staff. SNU activities were associated with greater receipt of social contact. Supporting people in employment was more expensive than in the SNU. Cost‐effectiveness ratios of producing assistance and engagement in activities were equivalent across the comparative contexts. The SNU was more cost‐effective in producing social involvement; employment in producing social contact from people other than paid staff.
AbstractSupported employment represents an important alternative to traditional forms of day service in Britain. Social integration in the workplace has been seen as one of its primary aims and this has been a key outcome measure in research. Few studies have looked at engagement in meaningful activity as an outcome measure. This paper describes a direct observation study which compared patterns of interaction and engagement for eight people with learning disabilities being supported in ordinary work settings and eight non‐disabled co‐workers. The results for engagement were favourable, showing no significant difference in percentage of time engaged for the two groups, although supported workers spent more time in on‐task activities than their colleagues. There was no significant difference in frequency of interaction, and who people talked with, between the groups, except where Job Coaches were present, where they became the main focus of interaction for supported workers. Content of interaction differed, co‐workers being more frequently involved in directing others and teasing and joking, while supported workers received praise and greetings more frequently. Reasons for the observed differences and implications for supported employment services are discussed.
AbstractA survey of the organisation and activities offered by all adult training centres (ATCs) in Wales was carried out in 1990. Activities were categorised under 10 headings, and the total number of 'person hours' allocated to each was calculated. The location of activities, within the ATC or elsewhere, was also noted. Over a third operated small satellite units, but the pattern of activity in these was similar to that of main centres. Only 11% of registered attenders had all their activities in the ATC, while the activities of 15% occurred elsewhere. The remainder (74%) experienced a mixture of centre based and external activities. However, across the timetable, 70% of person hours were spent inside the ATC. The vast majority of ATCs (88%) said they carried out formal reviews of client progress. The most common activity was arts and crafts, accounting for 25.3% of all person hours. Just over half (53%) of ATCs offered centre based contract work, and this represented 20.2% of all person hours. The proportion of person hours spent in the three other categories relating to work was 15.5%, the largest being work experience at 9.8%. Comments of managers suggested that increased activity in the community and work related activity were positive developments yielding significant benefits for those involved. Over £7 million of expenditure was identified, the largest elements being staff salaries (71%), and transport (15%). The mean cost per person across all reporting ATCs was £3,252 p.a. Variations in the balance of activity were found across ATCs. A cluster analysis identified four models of ATC operation, characterised as Recreation, Recreation and Personal Development, Occupation, and Employment. The models identified could not be fully attributed to such organisational factors as county of origin (implying local day service policy) or size of ATC. The paper suggests that not all activities hold the same benefits for people with a mental handicap, points to a lack of consensus on what activities should take place, and calls for an informed debate between consumers and providers.
ABSTRACTThe All‐Wales Mental Handicap Strategy was received in 1983 as a forward looking policy designed to deliver a range of community services to people with mental handicaps and their families guided by a clear articulation of principles. A ten‐year period was set, in which constituent counties would begin the process of developing local services to replace those traditionally available, aided by additional central finance especially allocated for the purpose. The commitment to achieve considerable service change in a way that accorded with a set philosophy led the Welsh Office to take concerted action to manage the Strategy and monitor its progress, attending to the planning infrastructure in counties, the basis for estimating needs, the content of plans, the formulation of progress reports, and the setting of priorities for action.This paper describes the way the Welsh Office has revised mechanisms for implementation of the Strategy in its first five years. It also reports changes in service provision achieved between 1983 and 1988. There is evidence of positive change in line with the aspirations of the Strategy, although progress in the initial years has been less good than may have been hoped. Time has been required for counties to make an effective response to the Strategy initiative. An acceleration of service development in designated core areas is anticipated over the second half of the ten‐year period.
Background Policy objectives for people with intellectual disabilities include day service modernization and the promotion of paid employment and quality of life. Quality of life is under represented as an outcome measure in vocational research. This research compares subjective and objective quality of life, and quality of work environment for adults with intellectual disabilities in supported employment, employment enterprises and day services with non‐disabled workers in community employment.Methods Comprehensive Quality of Life Scale, and Work Environment Scale were collected for people with intellectual disabilities: 17 supported employees; 10 employment enterprise workers; 10 day service attendees; and 17 non‐disabled work colleagues of supported employees.Results Supported employees reported higher objective quality of life than employment enterprise workers and day service attendees. Non‐disabled co‐workers reported higher objective quality of life and autonomy at work than the three groups of people with intellectual disabilities. Supported employees reported higher subjective quality of life than non‐disabled co‐workers.Conclusions The findings support the utility of supported employment as a means to provide constructive occupation and enhanced quality of life to people with intellectual disabilities. However, closing the gap with respect to non‐disabled co‐workers on objective quality of life measures represents a challenge and will require improving the quality of job finding and workplace support and the training provided.
This research looked at the TATE [Through Assistive Technology to Employment] Project and its delivery of ICT/AT to people with learning disabilities. It tested whether the Project affected the independence, skills, choice and control exercised by people with learning disabilities, and if staff attitudes and skills were changed. A purposive sample of 29 people with learning disabilities were selected, and keyworkers were surveyed with a postal questionnaire at two time periods. Questionnaires covered AT/ICT received and any outcomes in: independence; skills; choice and control. Staff were asked about changes in their skills and attitudes. Questionnaires were transcribed and organised into common themes. Staff became supportive of assistive technology and developed ICT skills. Service users used ICT, and developed 'life stories' using Powerpoint. A variety of AT was also installed leading to increased independence, confidence and skills. AT/ICT can improve independence and services by putting people with a learning disability at the centre of a well planned and resourced strategy.
