The disabled adolescent guidance unit

The disabled adolescent guidance unit is a panel which comprises representatives of various health professions, sheltered employment workshops and government instrumentalities associated with employment, social security and education. The aim of the panel is to advise disabled school leavers on the various options available to them. This includes recommendations on employment, leisure activities, and, when, necessary, on housing. In the years 1978 to 1984, 114 young people were seen. Average age at referral was 17 years. 66% of the disabilities were caused by neurological problems, including cerebral palsy, epilepsy, and spina bifida. Trauma accounted for 10%. A simple questionnaire was used to evaluate the usefulness of the panel. 58 of the 114 clients replied, 78% of the clients had followed the panel's recommendations, the work situation of the clients was as follows: 7% in open employment, 21% in sheltered employment, 22% undertaking further education, 10% doing voluntary work and 38% unemployed.     

Production-orientated education and training of the mentally disabled in sheltered employment (PIONIER)

Purpose : The development and realization of a production-orientated education and training system for mentally disabled people in sheltered employment in the course of the project PIONIER. It focuses on the metal and electronic branches of a workshop with a mentally disabled workforce in Alsdorf, Germany. Methods : For the development of the modules an assessment tool called MELBA was used to determine the abilities of the disabled people and the requirements of the tasks. Methods for the collection of this information was: observation, questionnaires and documents. Results : Three months after the introduction of educational measures the improvements of the capacity for learning and education of disabled persons was visible. In the same way the development of their self-reliance and social abilities was recorded. The metal working branch was capable of fulfilling every task with respect to quality issues and within set delivery times. The electro working branch was accomplished enough to create new workplaces and to get orders from the computer industry. Conclusions : By the use of a qualification system like PIONIER the tasks of the disabled employees have been enlarged and enriched. In order to cope with the increase competition sheltered workshops have to realize new ways of vocational training for mentally disabled employees.     

Status of occupancy and structure of homes, institutions and workshops for the handicapped-results of a survey in Baden-Württemberg

Despite an increasing availability of smaller decentralized facilities, the main responsibility for provision of inpatient nursing and care of disabled persons continues to lie with the homes and institutions traditionally providing long-term services for disabled people. In Baden-Wuerttemberg, a total of 70 homes and institutions, which vary greatly in size and structure, as available, comprising a total of 10,457 places in their nursing and residential sections. By far the greatest portion of the existing places (78.5 percent) is provided by institutions catering people with mental retardation. The average utilisation of the places available in homes and institutions is 97.4 percent. Client population structure in the facilities for mentally retarded persons differs appreciably from that of other facilities. This applies in particular to client age and to the treatment and therapy the individual receives. According to a 1979-1980 survey, the waiting lists of the homes and institutions comprised 785 applications for admission of disabled persons among them 290 applications for urgent admission and 495 made for precautionary reasons. A total of 9,148 places are available in sheltered workshops in Baden-Wuerttemberg. Average utilisation is 92.2 percent. Workshop population structure is characterised by a high share of younger clients. Only few openings will therefore presumably contrast with a high number of applications for entry that are expected to be forth-coming The need for sheltered workshop places will therefore continue to rise over the years ahead.     

Production-orientated education and training of the mentally disabled in sheltered employment (PIONIER)

Purpose: The development and realization of a production-orientated education and training system for mentally disabled people in sheltered employment in the course of the project PIONIER. It focuses on the metal and electronic branches of a workshop with a mentally disabled workforce in Alsdorf, Germany. Methods: For the development of the modules an assessment tool called MELBA was used to determine the abilities of the disabled people and the requirements of the tasks. Methods for the collection of this information was: observation, questionnaires and documents.

Results: Three months after the introduction of educational measures the improvements of the capacity for learning and education of disabled persons was visible. In the same way the development of their self-reliance and social abilities was recorded. The metal working branch was capable of fulfilling every task with respect to quality issues and within set delivery times. The electro working branch was accomplished enough to create new workplaces and to get orders from the computer industry. Conclusions: By the use of a qualification system like PIONIER the tasks of the disabled employees have been enlarged and enriched. In order to cope with the increase competition sheltered workshops have to realize new ways of vocational training for mentally disabled employees.     

Legal contract of workshops for handicapped people--a wish or reality?

In August 1990, the "Werkst?ttenverordnung" (the Workshops for the disabled ordinance) has been in force for ten years. Concluding a lengthy historical development, it describes an utopia seeking to implement the opportunity for personal growth and for economically viable productive activity, even-handedly and concurrently, for all disabled people covered (excepting those with very severe disablement). In everyday practice, such notions are confronted with major obstacles: growing demand; poor transition into other employment, terminal workshop employment instead; problems with performance requirements, with the dependence from customers, and with remuneration issues; insufficient promotional services for learning disabled clients whose labour performance is essential to the workshops; adjustment problems of clients with mental illness within the workshop; counting of alternative service attendants toward the staffing plan; unsolved civil and labour law issues relative to contracts involving mentally retarded persons; protection against dismissal, clients' right to freely choose the workshop, their co-determination and the rights of their relatives; the need for special educational qualification of workshop and group senior staff who have to face up to the expectations and difficulties in the day-to-day running of the workshops.     

Integration of the handicapped into the work force using electronic data processing

Successful settlement of disabled persons in gainful employment is closely contingent on both their training and the working environment present. For those disabled persons who cannot find jobs in the open market, it is possible to work in sheltered workshops. Founded on the initiative of parents of spastic children, the Saarbrücken Reha GmbH, a limited liability company for the sheltered employment of disabled persons, has for several years been employing disabled people in the field of text and data processing. This paper not only outlines some practical examples to illustrate suitable systems but also describes the types of tasks where good results can be achieved by the disabled employees.     

Vocational rehabilitation of psychiatrically handicapped people

The article describes the working concepts of "Lankwitzer Werkst?tten", a facility for vocational rehabilitation of persons with (chronic) mental illness. The working concept of this sheltered workshop is crafts- and service-oriented. Some 60 rehabilitees and sheltered workshop employees work in four small "shops". Work structures and everyday organization are somewhat unusual in that they follow general labour market conditions as closely as possible. In their working structures, the sheltered workplaces usually do not differ from workplaces in small crafts enterprises of the general labour market. As far as remuneration is concerned, the workshop is in a position to at least envisage levels of pay that will ensure independence from social assistance supplements if the facility's technical equipment can be kept current and work planning made more efficient. Within the limits of the legal possibilities, and making the most of them, both the diagnostic-prognostic benefits of the entry procedure in the work training process as well as the placement opportunities for rehabilitees in the general labour market are being utilized, with occasionally very successful outcomes.     

Vocational and occupational counseling of handicapped patients--a comprehensive social federal responsibility

The extensive vocational and employment information and counselling possibilities available in the framework of our social services system in the FRG, are aimed at attaining optimum vocational integration of the disabled clients. The legal foundations are in particular to be found in the Social Code and the rehabilitation adjustment act. Servicing some 80% of all disabled clients in this field, the Federal Employment Institute is the main financially responsible administration in vocational rehabilitation. The services and benefits provided are based on the employment promotion act and the directive of the Institute's governing body concerning industrial and vocational rehabilitation of disabled persons (AReha). Successful vocational counselling outcomes presuppose client participation; counselling contacts are free of charge to the rehabilitee, and are sought on a voluntary basis. The local employment office's medical and/or psychological services will in many cases by called in by the counsellor. If these services do not arrive at a satisfactory proposal either, vocational assessment and work testing measures in vocational training or retraining centers are indicated. Vocational preparation may in addition be useful, e.g. in the form of promotional courses and/or pre-rehabilitation courses. The catalogue of services and benefits available is complex and adjustable to individual needs. The rehabilitation measures provided invariably are aimed at achieving entry into long-term employment. When necessary, the disabled clients are followed-along by the counsellors until this goal is attained.     

Pathways leading to work--the Hamburg integration specialty service

A model project of the Federal Ministry of Labour and Social Affairs, the Hamburg Integrationsfachdienst zur Eingliederung Schwerbehinderter (IFD Hamburg, selective placement and support agency for occupational integration of persons with severe disablement) has been active since 1998 in placing people with sensory or physical handicap in the open labour market, based on cooperative partnership between Adecco Dienstleistungen, a market-oriented temporary staff business, and the vocational retraining centre Berufsf?rderungswerk Hamburg, provider of training programmes for vocational rehabilitation. The IFD combines social competence with business considerations (counselling employers, clarification of wage subsidies or grants, in-depth job analysis, preliminary selection of suitable job seekers). A proactive customer orientation vis-a-vis the prospective employer is the clear message of the IFD's consultants, which hence acts as a professional staff service for severely disabled job seekers in its dealings with the prospective customers, in their majority company decision-makers from small and medium scale firms. Counselling and support offered to the disabled clients are based on a case-management approach, in partnership with the IFD's principals, i.e., employment office, pension insurance fund, industrial injuries insurance institutes, and sometimes also health insurance funds.     

Restructuring of the specialized job market for people with disabilities through legislative reform of the Rehabilitation Act--consequences for the workshops for the disabled

The legal basis for employment of people with disabilities in sheltered Workshops for the Disabled (Werkst?tten für Behinderte, WfB) had hitherto been shaped by the 1961 Federal Social Assistance Act, the 1969 Employment Promotion Act, the 1974 Severely Disabled Persons Act with the related Workshop Ordinances of 1980 and 1996. The Act on Combating Unemployment of Severely Disabled Persons, effective as of Oct. 1, 2000 has now created a new legal foundation, which also is aimed at enhancing Workshop employees' horizontal mobility into the general job market, inter alia providing for access to Supported Employment arrangements and for availability of selective placement and support services (Integrationsfachdienste, IFD) throughout Germany. These Services also are intended as points of contact in the counselling of severely disabled school leavers in relation to placement opportunities in competitive jobs and/or integration projects or firms. Discussed from a legal perspective are the differences in sociolegal respects between such projects for severely disabled persons and employment in Workshops for the Disabled, as well as implications for the Workshops' own economic activity, also making reference to the forthcoming Book 9 of the Social Code.     

Objective obstacles in hiring disabled persons -- the employers' point of view

In the comprehensive rehabilitation process, one of the most accepted criteria for success or failure is the suitable placement of the client in the open employment market. The present study examined employer's attitudes toward hiring disabled persons. The sample consisted of 233 employers in the public and private sectors of the Israeli economy, and the method entailed interviewing each employer about his attitudes toward the risks of employing disabled persons, his actual hiring practices, and his expected response to financial aid for surmounting technical obstacles (architectural barriers and inappropriate work methods and tools). Interpretation of the results indicated that employers' reluctance to hire disabled employees was often explained by the existence of technical obstacles. However, when the possibility of financial aid for eliminating these obstacles was proposed, the employers responded with reservation. Although Israeli has mandated legislation requiring the employment of disabled war veterans, not all employers were aware of this, and almost half of those who were did not employ disabled persons. Evidently, legislation does not suffice in order to ensure actual hiring of disabled persons. In order to increase compliance with the law, and to encourage hiring of disabled persons who are not war veterans, it was suggested that more information be provided to the employers on the possibilities of employing disabled persons, with emphasis placed on the positive aspects of the disabled worker's true potential. Additional methods that should be applied to encourage employment include appropriate vocational training of disabled persons themselves and demonstration before the employers of the practical conditions under which successful employment is possible.     

Report of the work at a psychiatric transitional home (declared as a model centre in the Rheinland (author's transl)

The complete vocational and social re-integration of the psychiatrically disabled (schizophrenic type) is only possible to a certain degree, even after a temporary stay of approximately one year at a transitional home for the psychiatrically disabled where comprehensive therapeutic measures are provided. This is shown by the experiences gained during a three-year period of work with a study sample of 190 persons at the socio-psychiatric rehabilitation centre "Bodelschwinghaus" in Neuss, Federal Republic of Germany. A partial rehabilitation i.e., the ability to live in a community home and work in a workshop for the disabled was more successful. As a rule, the psychiatrically disabled need a long time in an encouraging and sheltered living situation which, nevertheless, must be open to the social environment, to obtain, in some cases, the degree of stabilisation necessary to one day lead an independent life. Accelerated measures structured according to economical and financial principles do not meet the needs of the psychiatrically disabled. This is why a rigorous separation between transitional and permanent homes is not appropriate in psychiatric rehabilitation.     

Patients with severe multiple handicaps in workshops for the handicapped--a project of the Berlin Workshops for the Handicapped GmbH (BWB) 4 December 1989 to 31 May 1990]

A project had been carried out at Berliner Werkst?tten für Behinderte GmbH (BWB) aimed at integrating cerebral palsied persons with very severe, multiple disability in a workshop for the disabled. Client workshop readiness had been determined on the criteria of social capacity, extraordinary care need at the workplace, and economic viability of work. The project, planned to last 6 months, had to be discontinued because the 9 disabled persons included in this programme refused to cooperate after a short period of time.     

Supported employment: an alternative model for vocational rehabilitation of persons with severe neurologic, psychiatric, or physical disability

Participation in paid work in competitive industry through placement in supported employment is compared and analyzed for 278 severely disabled persons. Differential outcomes are described for persons with chronic mental illness, cerebral palsy, traumatic brain injury, and dual diagnosis of chronic mental illness and mental retardation. Results indicated that supported employment appears to be an effective means of assisting these historically unemployable individuals to acquire and retain work. Cross-disability group differences were found in areas such as hourly wages, type of employment, services provided by employment specialists, and job retention. The results represent a baseline from which to evaluate future efforts at competitive work placement for persons with severe disabilities, using the supported-employment model.     

On the problem complex of the new act on the severely handicapped with respect to the workshop for the disabled (author's transl)]

One group of the disabled, i.e., the most severely handicapped, will not be able to benefit from the improvements brought about by the new Act on the Severely Handicapped, if the statutory orders of the Federal Government and the provisions of the Federal Employment Office are implemented as planned. In this event it would become extremely difficult for the severely physically handicapped to participate in the life of the community. The article demonstrates how a sheltered workshop for the disabled which, in part, looks after the most severely handicapped needing special care: - will not achieve recognition under 55 of the Act on the Severely Handicapped, - will not benefit from either institutional or individual support provided by the organisations of - the labour administration, - will not obtain contracts from either industrial or public enterprises because the orders cannot be set off against the equalisation payment, - cannot help their disabled employees to become eligible for social security benefits. This development which for the most severely handicapped represents a step backwards must be removed from those who are the most afflicted. It must not happen that efforts made at school to promote and integrate the disabled terminate in segregated facilities (nursing homes), which are run under different subsidy regulations. What is needed is a concept for appropriate care and support of the most severely handicapped and their integration into suitably equipped small groups within workshops for the disabled.     

A medical/vocational case coordination system for persons with brain injury: an evaluation of employment outcomes

OBJECTIVE: To evaluate initial placement and 1-year employment outcomes of a Medical/Vocational Case Coordination System (MVCCS) for persons with brain injury (BI) that provides: (1) early case identification and coordination, (2) appropriate medical and vocational rehabilitation interventions, (3) work trials, and (4) supported employment interventions including job coaching. PARTICIPANTS: One hundred fourteen Minnesota residents, ages 18 to 65 years, with acquired BI. MAIN OUTCOME MEASURES: Outcome: Five levels of Vocational Independence Scale (VIS). Predictor: Preinjury employment status (VIS) and years of education, severity of initial injury, time since injury, current impairment/disability as measured by the Rasch-analyzed Staff Mayo-Portland Adaptability Inventory (MPAI), and impaired self-awareness measured by staff rating and the difference between Staff MPAI and Survivor MPAI. RESULTS: At placement, 46% in independent work; 25% in transitional placements; 9% in long-term supported employment; 10% in sheltered work; and 10% not placed. At 1-year follow-up (n = 101), 53% in independent work; 19% in transitional placement; 9% in supported work; 6% in sheltered work; and 13% unemployed. Regression analyses showed time since injury and Rasch Staff MPAI predicted VIS at placement; only VIS at placement independently predicted VIS at 1-year follow-up; Rasch Staff MPAI and preinjury education level predicted time to placement. CONCLUSIONS: The MVCCS optimized vocational outcome after BI. Time since injury and impairment/disability best predicted vocational placement. Level of initial placement best predicted employment status at follow-up. Persons with greater disability required more extended time and more extensive rehabilitation services before placement.     

Vocational and social learning of people with severe disabilities in sheltered employment

In addition to prevocational centres for young people with disabilities about to enter the labour market and vocational training centres for older persons, the Federal Republic of Germany provides a network of sheltered workshops for those who are unable or unlikely to work under competitive conditions. This paper describes the programme for persons in the latter category, based on applications of learning theory, provided at the sheltered workshop in Detmold, Westphalia. It also reports various steps which have been taken to evaluate and refine the two-fold approach to training developed at this centre, based on job analysis and detailed appraisal of workers' social and psychological characteristics, and to apply that approach to persons with a wider range of disabilities.     

Epilepsy and working world--summary presentation of empirical research with special reference to reality and potential for vocational rehabilitation

Using a variety of methods (standardized and open interviewing, medical talks, ongoing counselling, expert interviews), data had been raised from almost 400 persons with epilepsy (Grand mal) of working age (16-65 yrs.), permitting their life and working situation to be characterized participant observation. The project inter alia was aimed at describing the relationship of "epilepsy and working world", to determine the extent of participation in vocational rehabilitation measures as well as their course, in order to elicit criteria pertinent for introduction of goal-directed supportive action. The study findings are outlined; a model for estimating rehabilitative need is presented; needs-based groupings are characterized, and conceptual considerations concerning vocational rehabilitation of persons with epilepsy discussed.     

Cost-benefit analysis for sheltered employment service programs for people with disabilities in Taiwan − a preliminary study

Purpose: The aim of this study is to do a cost-benefit analysis with monetary and non-monetary benefits for sheltered employment service programs and try to provide more evidence-based information for policy makers and practitioners to understand the outcomes of sheltered employment services. Method: This study analyzed 3 sheltered employment service programs for people with disabilities (2006–2007) implemented by Sunshine Social Welfare Foundation in Taiwan using cost-benefit analysis (including non-monetary benefits). Three groups were analyzed, including participants in the programs, taxpayers, and society (participants and taxpayers). Results: This study found that the net social monetary benefit was $NT29,432.07 per participant per year and the benefit cost ratio was 1.43. (In 2006–2007, $US1?=?$NT32.5 averagely around.) The net monetary benefit for the participants was between $NT7,890.86 and $NT91,890.86 per participant per year. On the non-monetary benefit side, the physical health (raised 7.49%), social relationship (raised 3.36%) domains, and general quality of life (raised 2.53%) improved. However, the psychological (decreased 1.51%) and working/environment (decreased 3.85%) domains backslided. In addition, the differences between pre-test and post-test average scores of all domains were not statistically significant. Conclusions: This study is the first to use monetary and non-monetary cost-benefit analysis methods to analyze sheltered employment service programs for people with disabilities in Taiwan. The findings indicated that sheltered employment service programs for people with disabilities could be efficient and beneficial for the whole society and sheltered employees/clients, and also helpful for raising their quality of lives.

Implications for Rehabilitation

• The sheltered employment service programs for people with disabilities can be efficient and beneficial for society as well as for sheltered employees/clients, and can be also helpful in raising their life quality.

• People with different categories of disabilities joining in sheltered employment service programs may have different outcomes. Thus, job coaches in the sheltered employment service programs might enhance the quality of counseling services for sheltered employees/clients with different categories of disabilities, sheltered employees’ working environment improvements by job redesigning and accommodation, and regularly receiving on-the-job training in these fields.

• This is the first study to do a cost-benefit analysis with monetary and non-monetary benefits for sheltered employment service programs in Taiwan. It provides firmer evidence-based information and suggestions for policy makers and practitioners as a means to better understand and improve the outcomes of sheltered employment services.