Työeläkekuntoutuksen vaikuttavuuden kehittäminen ja työkykyajattelu

Artikkelissa tarkastellaan työeläkelaitosten rahoittaman ammatillisen kuntoutuksen eli työeläkekuntoutuksen toimivuutta ja kehittämistä työeläkelaitosten asiantuntijoiden haastatteluiden perusteella. Viimeaikaiset tutkimustulokset työeläkekuntoutuksen vaikuttavuudesta ovat herättäneet keskustelua erityisesti työpaikalla tapahtuvien lyhytaikaisten toimien kustannustehokkuudesta. Tätä taustaa vasten artikkelin painopiste on asiantuntijoiden esiin nostamissa kehittämisajatuksissa. Aineisto muodostuu työeläkelaitosten kuntoutusasiantuntijoiden ja vakuutuslääkärien haastatteluista. Aineisto sisältää kuusi laajaa haastattelua, joissa oli yhteensä 15 haastateltavaa. Menetelmänä käytetään temaattista sisällönanalyysia. Tutkimuksen teoreettinen viitekehys muodostuu erilaisista työkyvyn edistämisen malleista. Keskeisenä kehittämisen kohteena haastatteluissa pidettiin ensinnäkin panostamista työn muokkaamiseen työkokeilujen aikana ja erilaisiin jatkotoimenpiteisiin niiden jälkeen. Toiseksi työkokeiluja pidempiaikaisemmat kuntoutustoimenpiteet,kuten työhönvalmennus ja koulutus, nähtiin usein järkeviksi vaihtoehdoiksi kestävien työllisyysvaikutusten näkökulmasta. Kolmanneksi kuntoutuksen työllisyysvaikutuksia saattaisi haastattelujen perusteella parantaa erityisesti työeläkejärjestelmän, Kelan ja työvoimapalvelujen yhteistyön tiivistäminen. Artikkeli osoittaa, minkälaisiin työkyvyn edistämisen malleihin haastateltavien esittämät kehittämisideat kytkeytyvät. Abstract Improving the effectiveness of vocational rehabilitation under the earnings-related pension scheme and the concept of work ability. Study based on interviews with experts from earnings-related pension providersIn this interview-based article we examine the effectiveness of vocational rehabilitation financed by earnings-related pension providers and its development. Recent studies on the efficiency of vocational rehabilitation have raised discussions particularly on the cost-efficiency of short-term rehabilitation at the workplace. The focal area of this article is thus on the development ideas presented by the experts. The data is based on interviews with rehabilitation experts at earnings-related pension providers and insurance physicians. The dataset consists of six extensive interviews with a total of 15 interviewees. The data is analysed using thematic content analysis. The theoretical framework of the study consists of various models of work ability. As key areas that require improvement the interviewees pointed out adjusting work tasks during work try-outs and taking various further actions after completing work try-outs. Second, longer-lasting rehabilitation measures, such as job coaching and training, were increasingly seen as viable options to achieve sustainable employment effects. Thirdly, based on the interviews, the employment effects of vocational rehabilitation may be improved through, in particular, closer co-operation between the earnings-related pension system, Kela and employment services. The article shows which types of models of work ability the development ideas of the experts are connected to. Key words: vocational rehabilitation, work ability, effectiveness, co-operation, experts, interview study

The value of employment support services for adults on the autism spectrum and/or with intellectual disabilities: Employee, employer, and job coach perspectives

BACKGROUND: Employment rates among individuals on the autism spectrum or with intellectual disabilities (ID) remain extremely low. Although job coaching services have contributed to successful employment for these individuals, few studies have examined the importance of such support, and even fewer have explored which services are valued most by stakeholders. OBJECTIVE: We examined the importance of employment support services through employee, employer, and job coach perspectives, and employee and employer satisfaction of job coach support. METHODS: A multiple-case study was designed with a community organization providing employment support to individuals on the autism spectrum or with ID, and their employers. Nine employee-employer-job coach triads evaluated the importance of specific services and rated their satisfaction with the job coach support. RESULTS: Services were rated as important, however, some discrepancies were observed between the groups in their ratings of services (e.g., soliciting regular feedback about the employee’s performance). Satisfaction was high for employees and employers; both groups indicated that they would recommend these services. CONCLUSIONS: Job coach support was highly valued by all groups, underscoring the need for these services to be widely available, and suggesting that this support may serve as a critical factor in improving employment outcomes among this population.

Using an iPad job coaching intervention to enhance food preparation skills for individuals with developmental disabilities

BACKGROUND: Technology is portable, affordable, and accessible, making it a viable support option for people with disabilities in the workplace. In the past, many supported employment programs relied on natural and paid job coaching supports with little to no use of technology. OBJECTIVE: The purpose of this two-experiment study was to investigate the use of a portable multimedia device to teach seven young adults with developmental disabilities to increase independence and decrease dependence on coaching prompts while performing a food preparation task. METHODS: Participants adhered to an industry specific protocol while using an application on an iPad that provided audio and video prompts. A multiple baseline across participants was used to show effects of the intervention on task performance and reliance on prompts. RESULTS: All participants were able to follow directions delivered to complete tasks accurately, while reducing the need for simultaneous coaching prompts. Maintenance probes were added to Study 2, and for two of three participants, newly acquired skills were maintained for eight weeks. CONCLUSIONS: Results from both studies indicated that using the iPad application to video model tasks was effective in improving and maintaining accurate skill performance, while reducing the need for prompts.

Delivering behavior analytic services in an inclusive job setting for a young adult with autism spectrum disorder: A case example

BACKGROUND: The rate of employment for adults diagnosed with Autism Spectrum Disorder (ASD) is low. This may be due in part to repetitive or disruptive behaviors associated with the ASD diagnosis and challenges to delivering services in the workplace. OBJECTIVE: This paper outlines a behavior analytic approach to providing job coaching supports in collaboration with employers in an inclusive setting. METHODS: A case example for a 26-year-old male diagnosed with ASD, employed as a data entry specialist, is highlighted. An A-B design was used to evaluate the impact of behavior analytic interventions on the rate of disruptive vocalizations. Behavior analysts and job coaches from a university-based team worked with employers to identify feasible and effective strategies. RESULTS: Rates of vocalizations decreased and maintained for 5 months following intervention fading. Social acceptability ratings from key office personnel reflected improved coworker relations and a high degree of acceptability for procedures used by the team. CONCLUSIONS: Employer collaboration was necessary for intervention design and decision making. Service providers should consider response effort for employers, the degree of normalization of strategies, how to limit disruption to productivity and the work setting, and methods for fading interventions or components of interventions.

Työnantajayhteistyö ammatillisessa kuntoutuksessa ja tuetussa työllistymisessä. Integroiva kirjallisuuskatsaus

Tässä integroivassa kirjallisuuskatsauksessa selvitettiin, miten ammatillista kuntoutusta ja tuettua työllistymistä koskevassa kansainvälisessä kirjallisuudessa on jäsennetty työnantajien ja työhönvalmennuksen ammattilaisten välistä yhteistyötä ja suhdetta. Keskityimme siihen, millaiset työnantajayhteistyön toimintatavat ja strategiat on nähty toimiviksi ja miten yhteistyösuhdetta rakennetaan ja ylläpidetään. Aineiston muodostivat yksilöityjen hakukriteerien avulla valikoidut 19 tekstiä tieteellisistä aikakauslehdistä. Aineisto analysoitiin temaattisen analyysin periaatteita hyödyntäen. Analyysissa hahmottui neljä teemaa. Keskeisiä yhteistyöhön liittyviä toimintatapoja olivat jalkautuminen työnantajien maailmaan ja tämän maailman ymmärtäminen sekä molemminpuolisten hyötyjen ja yhteisten arvojen löytäminen konsultoivan työotteen avulla. Yhteistyösuhteen rakentumisen kannalta olennaista oli pitkäkestoisten suhteiden ylläpito sekä luottamus ja työhönvalmennuksen ammattilaisen saatavilla olo. Tärkeää oli myös yhteistyötä tukevien resurssien riittävyyden varmistaminen ja resurssien vahvistaminen palveluita tuottavissa organisaatioissa. Abstract Employer cooperation in vocational rehabilitation and supported employment. An integrative literature review In this integrative literature review, we explore how the relationship and cooperation between the employers and employment specialists have been described in the international vocational rehabilitation and supported employment literature. We examine, what kind of practices and strategies of cooperation have been assessed as functional and how the cooperative relationship is built and maintained. The data consisted of 19 texts published in academic journals and selected by using customized search criteria. The data was analyzed by applying the principles of thematic analysis. Four themes were identified. Essential practices of cooperation included entering and understanding the world of the employers and furthermore, finding mutual benefits and shared values through a consultative working approach. In building the cooperative relationship, maintaining long-term relationships as well as reliability and availability of the employment specialist were crucial. In addition, it appeared important that the service provider organizations ensure and provide the sufficient resources for the cooperation. Keywords: vocational rehabilitation, job coaching, supported employment, employer cooperation

The Job Coaching Academy for Transition Educators: A Preliminary Evaluation

There is a growing urgency to equip transition-age students with intellectual and developmental disabilities for competitive, integrated employment. Prior research demonstrates the positive effects of job coaching, yet no known training exists for educators to learn how to provide appropriate employment-related supports to promote student independence and social integration. We conducted a stratified quasi-experimental design to evaluate the efficacy and social validity of a professional development pilot program for 46 transition educators across three school districts. Our findings indicate the Job Coaching Academy contributed to increased feelings of self-efficacy related to job coaching and modest growth in educators’ coaching behaviors. We share implications for practice and research in expanding targeted training opportunities for transition educators.

Peer-Mediated Literacy-Based Behavioral Interventions: A Job Coaching Strategy for Secondary Students With ASD

Many secondary students with autism spectrum disorder (ASD) are not taught employability skills and routines needed for competitive or supported employment in regular community environments. Literacy-based behavioral interventions (LBBIs) that combine print, pictures, and behavioral rehearsal are effective for promoting acquisition and maintenance of numerous skills, but have not been investigated as a job coaching intervention for individuals with ASD. In this study, a peer coworker was taught to deliver an LBBI guide to students with ASD as a job coaching intervention for three skills in an employment preparation routine: preparing and selling coffee in a work-site food truck. Results showed students’ accuracy with the skills in the work routine increased, and maintained after the intervention.

Work-Related Communication Barriers for Individuals with Autism: A Pilot Qualitative Study

This study identified situations where communication was a barrier to employment for adults with autism spectrum disorders (ASD). Informant interviewees were six college graduates with ASD who have been employed for one year. Following the qualitative inductive analysis, five communication-related themes emerged: (1) job interviewing success, (2) negotiating co-worker interactions, (3) supervisory interactions, instruction, and feedback, (4) handling customer intercommunication, and (5) communication-oriented coping strategies. Participants were relatively more successful in communication coping strategies and supervisory interaction compared to difficulties with job interviewing and co-worker interactions. Vocational rehabilitation counsellors assisting clients with ASD should prioritize job interview communication skills and social skill education specific to appropriate interactions with co-workers and supervisors utilizing role play, social skill training, and job coaching.