RRTC Newsletter, Winter 1998

Workplace Supports for Persons with Significant Physical Disabilities
 
While there has been a major push in recent years to | expand and improve the employment opportunities for persons with disabilities, many of those individuals with the most severe disabilities continue to be excluded from employment. Particularly, those persons with physical disabilities have not yet entered the nation's workforce. As of 1994, 68% of people with disabilities between the ages of 16 to 64 were not employed (Louis Harris Poll, 1995). People with disabilities have indicated that one of the major barriers to employment is their disability. Other barriers include employer attitudes, fear of losing benefits or insurance, unavailability of transportation, personal assistance support, and need for assistive technology. Clearly, innovative approaches to improving and expanding the provision of existing vocational rehabilitation services must be developed to facilitate the entry by this: group of individuals into competitive employment. 
 

Identifying individualized supports in the workplace, as well as the community,  will maximize a person's employment potential. This requires a way of thinking that focuses or identifying the needed supports rather than ''fixing'' the person with a disability. Support l may include job restructuring, environment l modifications, assistive technology, coworker supports, on the job training, and person l attendant services.

A person with a significant physical disability can be empowered by the application of workplace supports, but often he or she will need assistance in accessing those supports. Individuals who require assistance may benefit from supported employment services. This approach focuses on building upon the person's strengths for direct placement into paid competitive employment. An employment specialist or job coach is responsible for assisting the person with a disability in identifying and accessing the needed workplace and community supports.

Brooke, Wehman, Inge, and Parent (1995) define several roles for the job coach to include the planner, consultant, technician, and community resource roles when assisting an individual in accessing supports. For instance, the employment specialist as a planner works with the individual with a physical disability and a potential employer to identify and analyze the supports and services that may be needed for employment in the workplace (e.g., environmental modifications, job duty accommodations, etc.). Simultaneously, the employment specialist may act as a community resource by identifying supports in the community such as coordinating assistive technology services for a job site evaluation. Once these supports are identified, the employment specialist may take on the role of the technician by fabricating simple low Technology devices or by training the employee with a disability, the Employer, and coworkers in the application and use of the technology. Or, the employment specialist may assume the role of a consultant and provide on-going problem solving when technology needs change in the workplace.

When assuming these roles, the job coach essentially is acting as a "coordinator" of workplace supports. As such, he or she must have a basic knowledge of:
 

    1) the service delivery system and funding sources for technology;
    2) the assistive technology services and devices that various professionals can provide;
    3) low and high tech devices which are available off-the-shelf; and
    4) training and technical assistance on the use of devices to the consumer, employers, and coworkers. By combining assistive technology and supported employment, the best rehabilitation power is secured to facilitate employment success for these individuals with significant physical disabilities.
     
Project Access is demonstrating the inclusion of individuals with severe physical disabilities, in the nation's competitive work force. All of the customers being served by this project are receiving person-centered services, supported employment support, and assistive technology in order to be employees of community businesses. Each participant is earning at least minimum wage.

Customers plan with their employment specialists, project mentors, and identified support persons in the community to identify the types of job(s) and supports that would meet their dreams. Customers are empowered to take the lead and direct their supported employment services. This newsletter will highlight some of the successes of Project Access customers. It will present strategies for developing jobs and providing supports in the work place for persons with significant physical disabilities.
 

Employment Specialist's Support Role
 
Role Definition Application Examples
Planner Role Responsible for analyzing the services that the person with a disability is seeking and assisting the customer in developing a plan to acieve the identified outcomes. develop a marketing plan to promote the employment of persons with physical disabilities through strong personal relationships with the business community 

review financial plan for funding technology 

plan for accessible transportation options 

develop strategies to meet personal assistance needs at the job site

Community Resource Role Responsible for having knowledge of community resources in order to assist the customer in accessing and obtaining needed devices and services. identify AT service providers (OT, PT, Speech, etc.) 

compile a library of resources (e.g. catalogues, manuals, books, etc.) 

catalog reputable AT vendors 

identify personal assistance agencies or attendants

Consultant Role Responsible for entering into a consultant relationship with the customer and provide recommendations based upon knowledge and expertise. consult with customer and AT service providers to identify technology to meet specific needs 

provide employer with ADA guidelines for workplace accessibility 

consult with employer and customer for making job site modifications 

assist customer in developing self-advocacy skills and assuming responsibility for AT coordination

Technician Role Responsible for staying versed in the latest high and low assistive technologies to identify appropriate strategies to ensure skill acquisition and maintenance. provide training on device use 

install accessible software or devices on a computer 

add an adaptive door handle to a door knob 

attach a number stamp to a universal cuff

 
 
 Customers Speak Out About What Work Means to Them

What is the most important thing that work does for you?

Sandy: Independence, I feel more productive and more alive. I feel more like a person.

Josh: [Work] pays my bills and lets me live like a normal person. I don't have to rely on government for income. It gets me out into the community. I especially feel so when I walk to the Student Commons for lunch.

Luther: I love to work. I love getting out of the house. I love doing things for people. It is jun to work. It is fun to talk to my co-worker. I get something to do. I get more responsibility and independence.

 

How has work changed your life?

Rudolph: I feel financially better, and I like myself more. I feel like my life is moving forward.

Danny: I can get up knowing that I have a job to go to and make my own living.

Milton: It definitely has made me feel more important. I have found myself dealing with more people in different situations. It has made me feel more responsible. It feels good to know that other people depend on me to do a good job. More money, more money, more money!
 
What would you say to someone who is trying to find a job? 

Sandy: It has been very rewarding, but it can sometimes be very discouraging because you can't take just any job. I encourage everyone with a physical challenge to keep on looking. 

Milton: Basically, I would tell them to be yourself and to have confidence during the interview. You have to show the interviewer that you can and are responsible. Confidence is the key. 

Jewel: Go for it! Don't stop trying. It's worth it! 

Rudolph: It's a very good idea. It's a good thing. It will change you life, it really will. 

 
 

Identifying Community Work Opportunities
 

In order to locate work opportunities, the employment specialist must have a sense of the j job candidate ' s interests and talents, as well as an understanding of the challenges presented by the person' s disability. Some job seekers have an array of abilities, while others possess specific vocational skills in certain areas. An effective employment specialist will be competent at using a variety of different approaches to identify work opportunities for the various job seekers. Work opportunities come in many forms such as:
 
    1. an existing position that a person can perform either with or without accommodations, or
    2. the creation of a position through job carving or an employment proposal.
Marketing Activities

Marketing activities may involve a collective or an individualized approach. When using an individual. - T Approach, the employment specialist makes business contacts based on a specific job seeker's strengths and interests, while the collective method involves analyzing business needs and then matching this information to the strengths and desires of all job seekers. Successful employment specialists not only explore existing positions but also the viability of creating work opportunities. In both scenarios, any possibilities pursued should capitalize on the strengths and talents of those served.

Brainstorming

brainstorming can generate fresh and creative ideas about potential employment options. This is a very dynamic process which can nourish the job developer's knowledge base of community work opportunities and build upon previously gained information. First, staff identify their customers' skills and potential accommodation needs. For example, some of the Access customers have good visual skills and intellect; however, each was challenged with expressive communication skills and possessed very limited motor skills. Next, the group envisions different types of work activities which might require the use of strong visual and/or intellectual skills, but either might limit or not require the use of expressive communication and physical abilities. This helps formulate an understanding of the various types of work tasks, such as watching, monitoring, and/or checking one thing against another to identify something and perhaps make limited corrections, which should be researched.

List of Industries

Next a list of industries is generated. Each group member selects a category and arranges for an informational interview with one or more business representatives of the sample. The purpose of this meeting is to learn about overall operations as well as whether or not the types of activities which require the use of the previously mentioned skills exist. The primary goal is to gather data that will enhance the group's knowledge on the needs of a particular industry; instead of locating an employment opportunity. Details on existing jobs, as well as identification of select tasks that individuals may be able to do is collected. For instance, during an informational interview with a recruitment company, a staff member learned that a professional was auditing files to be sure they were meeting certification specifications.

The newly obtained information is then presented at the next brainstorming session and followed by a discussion of who may be interested in the type of work and what accommodations may be needed. Afterwards, a series of next steps is generated to refine and further direct marketing activities, such as other businesses which could be queried about similar work activity. New ideas on job possibilities and future directions for business contacts result from brainstorming. Such sessions can be particularly inspirational and give encouragement to staff. Armed with knowledge of the job seeker's talents and an assessment of the differing work activities which exist in the local labor market, the employment specialist is better equipped to communicate with potential employers.

Job Carving

job Carving entails reassigning one or more workers'Job duties to create a job for a new employee. Several strategies can be used when trying to sell this,J concept. One approach involves asking the business representative to investigate how business efficiency could be improved by reassigning some of the marginal job duties of employees to a new hire. The employment specialist suggests that it may be more cost effective to pay an entry level employee to perform tasks that are being done by higher paid workers. Emphasis is placed on how realigning select tasks of one or more employees could contribute to increased efficiency or productivity.

Another angle entails inquiring about company overtime specialist can suggest that the business consider exploring the work scope in order to determine if select tasks could be assigned to a part-time employee. Emphasis is placed on the fact that this could lead to big savings by cutting costs. A final approach is to investigate if there is any activity which always seems to be neglected. However, the work really needs to be accomplished regularly in order to prevent a backlog.

Every workplace is different. Some employers may see value in job creation, while others may not get it immediately. Therefore, the employment specialist must be well prepared by having a clear explanation of what is being offered. Also, the employment specialist is cautioned to avoid the word phrase "job creation". Many employers do not seem to be receptive, and perhaps rightly so, to the idea of "making" work. Perhaps the process of getting a new position is difficult, or this conjures up an ugly image of more work for the overworked. Explanations must be clear and concise, and timing, although unpredictable, is essential. Investigating general labor needs and touring a business can help facilitate discussions related to job creation. Remember, job re-structuring does not need to be a complex process. Actually some of the best results have resulted from informal conversations about personnel needs and a frank discussion of what is being sought.

For example: Mr. Smith, thank you so much for the tour. I noticed that there are several ways that some of the individuals I represent could benefit USA Company. Have you ever given any thought to the idea of job re-structuring? Many businesses have found that this is practical and saves the business money. The idea is to take a look at current staff expectations and to investigate if assigning any of their existing job tasks to another employee would actually improve departmental efficiency. Some companies have found that this makes good business sense, because their higher paid staff are freed up to do what they do best, and a person who really wants an opportunity to work is given it.
 

Case Study Example: Sandy  
Sandy is challenged by cerebral palsy that causes unsteady movement in both hands and arms. She had worked for 12 years as a desk clerk in a small local hotel but had to resign, because she was having trouble with her back. Sandy was referred to Project Access in February of 1997, at which time she had been out of work for 8 years. During that time, she had gotten married and bought a house. Sandy had decided to go back to work to contribute to the family income and to increase her sense of purpose. In her person-centered planning meeting, Sandy said that she would like to work in a medium sized office with lots of people. 
 

Job Search:

Sandy was involved throughout the job development process and was proactive in finding her position. She interviewed with a local college for a receptionist position and also looked into many area banks. Sandy and her employment specialist discussed each position and its benefits and limitations. This allowed her to make informed decisions about what position to explore further.

Sandy was offered and accepted a position in the lock box area of a bank. She viewed this as an opportunity to get her foot in the door and move into different departments of the bank. This job required her to open and collate incoming mail according to its contents. Sandy had a difficult time opening the envelopes manually so a jig was built by the rehabilitation engineer that allowed her to slide the letter onto a piece of metal and pop it open using a lever. This allowed her to complete the task using only one hand.

Even after the introduction of the "jig", Sandy still had difficulty with her production rate. After watching her use the jig, it was noted that she was adding extra steps in manipulating the work materials. A new task analysis was written that reduced the movements needed to complete the task thus reducing the time needed to finish one letter. Sandy also was required to number the envelopes that came in without checks. Instead of keeping a written tally, Sandy used a counter which was mounted on piece of wood. All she had to do was push down the counter button. Even with the technology, Sandy's production was a concern to her employers, and she was asked to resign her position.

A month after leaving the bank, Sandy was offered a position at VCU's student identification center. This position offered varied tasks and an opportunity to interact with people on a larger scale. She was hired as a customer service representative and a camera operator. The camera is operated through a computer, so it was relatively easy task to do; however Sandy had never used a computer. She spent the first week learning to operate the computer, while the employment specialist performed the other Case Study Example: Sandy functions of the job. After that week, she was comfortable enough to begin adding other tasks.

Accommodations:

Several accommodations had to be made to ensure that Sandy could perform her job independently. The first accommodation was to extend the focus knobs on the camera. This reduced the reach and made them easier for Sandy to manipulate. Next, an office chair that swiveled was purchased to make getting up and down easier. The chair also had arms to increase her stability. Finally, fine motor skills, such as writing, take Sandy a great deal of time to complete. In order to increase her speed in keeping track of who she photographed, a typewriter was obtained. Finally, a trackball was purchased to replace a standard mouse.

In The second portion of Sandy's job is to perform customer service duties. Sandy found these duties to be much more challenging. She had been out of work for so long that she had forgotten how to problem solve, this position required her to think on her feet. She used cheat sheets to remind her how to operate the office machinery, such as the encoder and the cash register. She also received a great deal of support from coworkers.

Community Support:

The next problem that she faced was in manipulating money. Sandy used a small tray to assist in carrying the money back and forth to the register. This worked especially well when large amounts of change were involved. She also had to balance her drawer both before and after her work shifts. She was able to complete this task without assistive technology, but it was very hard on her muscles. In order to make the job less cumbersome, she needed a currency counter. The cost, $1,200, was seen as prohibitive. The employment specialist was able to arrange for the donation of a used currency counter from Crestar Bank. The name of the Coordinator of Disability Services at Crestar was obtained from a colleague. The first call was made to ask for information on used or less expensive counters that could be purchased.

The coordinator replied that she would need to look into the availability of the counters, but they may be able to donate one. A call back one week later revealed that Crestar had a number of surplus counters that were acquired from a recent merger with another local bank. They would be happy to donate one to Sandy. This technology made all the difference in Sandy's confidence on her job. Additionally, she is able to count her drawer in the allotted time without great stress to her hands.

Sandy has been employed for approximately four months. She loves her job and is making many new friends. She has proven to be an asset to her employer.

Case Study Example: Thomas  
Thomas's Job:  
Pulling literature to fill information requests from Alfa Laval's Sales Department, assembling binders to send to customers, and keeping a record of what is sent out. 

Thomas's Strengths: 

    - Can grasp small objects with right hand. 
    - Can use index finger and thumb on right hand. 
    - Reads on a basic level. 
    - Has good social skills and enjoys being around others. 
    - Uses a power chair independently for mobility with a joy stick. 
    - Has good organizational skills. 
    - Is outgoing, enthusiastic, and extremely motivated to work.
Thomas's Work Challenges: 
    - Limited ability to grasp objects with his left hand. 
    - Cannot lift stacks of paper or handle boxes due to limited range of motion in elbows and shoulders. 
Issue #1: 

Assembling binders requires Thomas to insert sixteen pieces of literature into a three ring notebook. Literature was stored in an accordion style folder. The system slowed Thomas down and took up a great deal of work space. 

    Solution: 
    Two "Lazy Susan" file folders were purchased from an office supply house. Each lazy Susan held the literature for two different notebooks which Thomas was required to assemble. By using this organizational strategy, Thomas was able to rotate the low-tech solution and quickly assemble the orders for notebooks. 
Issue#2:  

Thomas pulls literature to be mailed out to customers. The company has over 166 different pieces of literature in print. The literature is stored on shelves by stock numbers. There are 4 units with 8 shelves per unit each approximately 7 ft. in height. Thomas is not able to retrieve literature that is not within his reach. 

    No Tech Solution:  

    The employment specialist worked with Thomas's supervisor to identify the flyers that he would use most often. These were stocked on the shelves within his reach. The shelves were labeled with the literature stock number. Other flyers which seldom were used were placed on the higher shelves. Thomas's supervisor agreed to monitor his binder orders and support him in pulling the literature from those shelves which he could not reach. 

    Note: In assessing the work space, it was determined that ordering or making different types of shelves or trying to rearrange the current space was not a possibility. 

Issue #3: 

As Thomas pulls the materials from the shelf and counts out the number needed to fill the mail orders. he Dlaces the literature on his lap and it spills onto the floor. If he continuously goes back to place it on the table, valuable time is lost. 

    Low Tech Solution: 

    The rehabilitation engineer made a file holder which attaches to the side of Thomas's power chair. He is able to pull literature from the shelves and transport it to his work station using this device. 

Issue #4: 

The literature that goes into the 3 ring binders has to be hole punched. Thomas is not able to use the manual hole punch which requires the use of both hands. 

    Low Tech Solution: 

    An electric hole punch was purchased from the of fice supply store. 

 
 Project Access's Mentor Program "Learning new skills, sharing with others, and enjoying the fellowship" is Milton's assessment of the mentoring component of Project Access. The project emphasizes a person-centered approach to services and utilizes PATH in developing goals. Customers plan with their employment specialists, project mentors, and support persons in the community to identify the types of jobs and supports that would meet their dreams. The mentor component represents a key component to the overall project. Its purpose is to foster self-advocacy and individual empowerment and to facilitate customer access to the community supports such as transportation and assistive technology.

The project employs two mentors who have been successfully competitively employed to train project participants to access community supports and to become self-advocates. Contacts with project customers include as-needed individual or group counseling sessions and monthly support meetings. Some of the goals include the following:
1.encouraging customers to gain control over their environments,
2.developing a deeper understanding of the importance of self-advocacy,
3.Emphasizing the importance of making responsible decisions based on sound values,
4.encouraging customers to reach out to fellow peers and others in need
5. initiating the development of comrnunity-based services and appropriate community interactions

Developing a deeper understanding of the importance of self-advocacy in the lives of persons facing severe physical challenges is how the mentoring program has been most weful to Rosita B. "I feel better about speaking my mind to others," she stresses. Rosita recently joined forces to persuade local politicians to relocate voting booths. She and other individuals with disabilities live in a large accessible apartment complex. "We only wanted them to make it easy for us to get out and vote," she added.

Dayle, Rosita, and others who reside at the apartments asked for the assistance of one of the project mentors to find lift vehicles to bring residents to the voting locations. The effort was very successful, and more than 13 citizens with disabilities were able to vote. In the past, the only option we've had has been the absentee vote, recalls, Dayle. "It is great to know that other approaches such as volunteer transportation can be obtained." Dayle expresses the feelings of many that believe that "visibility" of citizens with disabilities is a critical step toward self-esteem and community support.


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