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Purpose: Americans with rheumatoid arthritis (RA) represent an emerging vocational rehabilitation (VR) clientele. Method: Following an overview of the etiology, incidence, prevalence, and impact of RA, the authors present strategies to meet the service and support needs of Americans with RA across the phases of the VR process. Results: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to social distancing requirements resulting from the Coronavirus pandemic is emphasized throughout the article. Conclusions: RA is an emerging disability that can affect people at any age, and rehabilitation counselors must be prepared to meet the service needs of this growing clientele.

Background: In exploring the matter of sensory loss and job discrimination, the National EEOC ADA Research Project (NEARP) seeks to answer a singular question. Objective: How do persons with hearing loss (HL) vs. visual loss (VL) experience the nature and scope of workplace discrimination differently, if at all? Methods: The NEARP team uses an ex post facto, causal comparative quantitative design that includes descriptive and inferential, nonparametric statistics. Closed EEOC files involving ADA allegations of workplace discrimination filed by Americans with Hearing Loss (HL, N = 21,847) and Vision Loss (VL, N = 16,136) were compared in terms of demographics, issues, and investigatory outcomes. Results: HL and VL groups show Demographic differences to one another and to population statistics of sensory impairment in the areas of Gender and Race/Ethnicity. Regarding Issues, HL and VL groups are different from one another with respect to several prevalent matters (i.e., Discharge, Reasonable Accommodation) and small-scale matters (i.e., Hiring and Terms/Conditions). With respect to the Merit of allegations following EEOC investigation, HL and VL are very similar. Conclusion: Workplace discrimination is experienced differently for Charging Parties who experience HL vs. VL. Moreover, important differences exist Charging Parties from both sensory impairments vs. those from a General Disability Population.

Background: Social and environmental participation endeavors are theorized to shape one's general satisfaction with the overall employment situation facing people with MS. Objective: Responding to a national survey of the employment concerns of Americans with multiple sclerosis (MS), this study examined the extent to which factors at the demographic, disease-related, and social and environmental participation levels contribute to the predictability power for general satisfaction with the employment situation for people with MS. Method: Participants in this study consisted of 1,149 members of nine National Multiple Sclerosis Society (NMSS) chapters representing 21 states and Washington, DC. In a hierarchical multiple regression analysis, participants were mostly older (average age of 50 years) White (74%) individuals, nearly half of whom were unemployed (47%) but well educated (98% were high school graduates, 45% were college graduates). Findings: Findings underscore the complexity involved in predicting how satisfied people with MS are with their overall employment situation. Conclusions: Younger, less educated individuals with higher levels of perceived quality of life who were employed full-time and experiencing no or lower levels of cognitive impairment were more likely than other participants to be satisfied with 17 high-priority employment concerns.

Background: This article introduces the concept of emerging disabilities as it applies to rehabilitation counseling practice, research, policy, and education. Definition: Emerging disabilities are those that are either new to medical science or becoming more prevalent in specified subpopulations of people. A case study of a person with an emerging disability (diabetes mellitus) is presented. Implications: Implications of emerging disabilities for the field of rehabilitation counseling are discussed.

Background: Rehabilitation counselors can anticipate providing services to growing numbers of individuals who have disabilities that were acquired in (or exacerbated by) severe weather events. The impact of these events on individuals' psychosocial and vocational functioning is an important factor to address in holistic rehabilitation assessment and planning. Objectives: The objectives of this article are to (a) provide an overview of how severe weather events contribute to the onset and exacerbation of chronic illnesses and disabilities, (b) identify populations most at risk of experiencing the negative consequences of severe weather events, and (c) consider implications for rehabilitation counseling policy and practice. Methods: We reviewed literature on severe weather events and their impact on human health and functioning to better understand the impact of these events on affected individuals. Results: The review revealed that severe weather events have increased in frequency, intensity, and length, and this trend is expected to continue into the foreseeable future. Severe weather events are an emerging cause of disability that requires unique assessment and planning considerations for rehabilitation counselors. Conclusions: The increase in recent decades of severe weather events as a cause or contributor to disability has numerous implications for rehabilitation counseling practice that are discussed in this article.

Background: Many emerging disabilities that affect today's rehabilitation consumers are linked to lifestyle factors such as diet, exercise, smoking, substance use, and obesity. Lifestyle-related disabilities have dramatically increased in incidence and prevalence over the past two decades. Rehabilitation counselors play an important role in addressing the unique challenges and opportunities that face people with emerging lifestyle-related disabilities. Objective: The goals of this article are to (a) examine lifestyle factors that have changed the constellation of the American and global disability communities over the past 20--30 years; (b) examine the health, psychosocial, and vocational implications of several emerging lifestyle-related disabilities; and (c) describe the changing role of rehabilitation counselors in addressing the growing needs of consumers with these disabilities. Method: A review of the literature on lifestyle-related disabilities and rehabilitation implications indicated new service delivery considerations for working with this growing clientele. Results: Diabetes mellitus, asthma, heart disease, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), emphysema, stroke, and certain types of cancer were found to be among the most significant emerging lifestyle-related disabilities. New interventions are required to meet the rehabilitation needs of this growing clientele. Conclusions: The increased presence of lifestyle-related disabilities has numerous implications for rehabilitation practice that are discussed in this article.

Background: The expectation to remain in the labor force is a powerful indicator of long-term employment outcomes for people with multiple sclerosis (MS), and it is determined in part by perceived current job performance. Objective: This study identified correlates of perceived job performance among working adults with MS. Method: Participants included 611 members of nine National Multiple Sclerosis Society chapters representing 21 states and Washington, DC. Participants were employed, and primarily female (81%), older (average age of 48 years), and White (77%). Results: Hierarchical multiple regression analysis revealed that males, Whites, people without or with low levels of cognitive impairment, and those who reported stronger job/person matches and higher levels of job satisfaction were more likely than other participants to positively evaluate their own job performance. The aggregated predictors explained 20% of the variability in participants' job performance self-ratings. Implications: Findings show the complexity in predicting how satisfied employed people with MS are with their overall job performance, which in turn shapes their expectations and intentions about staying in or disengaging from the workforce. The implications of the findings for rehabilitation counseling interventions and for identifying adults with MS who would benefit from early intervention are discussed. [Additional funding for this research is from a Health Care Delivery and Policy Research grant from the National Multiple Sclerosis Society.]

This article describes the traumatic brain injury (TBI) epidemic that is facing America and its implications for vocational rehabilitation (VR) services. Following an overview of the incidence, prevalence, and impact of TBI, the authors suggest strategies to meet the employment and career development needs of Americans with TBI across the phases of the VR process. The importance of individualized case planning, cognitive support technology, and interface with medical and mental health professionals is emphasized throughout the article. Implications resulting from the ongoing Coronavirus pandemic are discussed., The tripartite purpose of this article is to (a) describe the nature and needs of Americans with traumatic brain injuries (TBIs), (b) examine the unique effects that TBI has on [...]

The purpose of this study was to examine differences in employment concerns among three groups of Americans with multiple sclerosis (MS; n = 1,446): Caucasians, African Americans, and Latinas/os. Participants in this study responded to a national survey of the employment and community living concerns of people with MS. Multivariate analysis of variance revealed no statistically significant between-group differences on employment concerns related to fair treatment, but between-group differences were observed in response to employment concern items related to legal rights and personal/environmental resources. Implications for future research and clinical practice in rehabilitation counseling are discussed. Keywords: Multiple Sclerosis, Employment concerns, Race/Ethnicity, Multiple sclerosis (MS) is the world's most prevalent non-traumatic neurological disorder of young adults (Murray, 2016). The prevalence of MS in the US is estimated at more than 900,000 (National [...]

As a result of legal protections and the effects of inclusive reforms (e.g., improved academic skills, heightened expectations), more students with disabilities are entering higher education than ever before. The priorities and understanding of university faculty members directly shape the educational experiences and success of the rapidly growing group of college students with disabilities. Previous research in this area has focused primarily on faculty members' knowledge of legal issues, general attitudes toward students with disabilities attending college, and willingness to make accommodations. This study expands the extant knowledge base by examining the priorities and understanding of 307 faculty members at an 8-campus university system regarding university students with disabilities in the following areas: "Legal," "Accommodations-Willingness," "Accommodations-Policy," "Universal Design for Instruction," "Disability Characteristics," and "Disability Etiquette." Participants' ratings indicated that (a) accommodation policies and disability etiquette were viewed as highly important and were being addressed satisfactorily; (b) issues related to law, Universal Design for Instruction, and disability characteristics were important but were not being addressed satisfactorily; and (c) issues related to willingness to provide accommodations were neither highly important nor being addressed satisfactorily. Implications for faculty training are discussed. (Contains 5 tables.)

A comparison of Americans with Disabilities Act (ADA) Title I case resolutions by the Equal Employment Opportunity Commission (EEOC) involving people who are visually impaired with those involving all other people with disabilities between 1993 and 2002 revealed that people who are visually impaired are more likely than are other complainants to receive settlement benefits from their employers, to withdraw their complaints after they receive benefits without intercession from the EEOC, and to receive administrative closures. In addition, they are less likely than other complainants to have charges resolved by the issuance of a right-to-sue letter from the EEOC and to receive other closures.

BACKGROUND: People with advanced cancer constitute an emerging vocational rehabilitation (VR) consumer population. OBJECTIVE: Following an overview of the nature and needs of Americans who have advanced forms of cancer, the authors present strategies to meet the service and support needs of these individuals across the phases of the VR process. METHODS: The authors present the sequential stages of the VR process, including implications for working with advanced cancer survivors during each stage. RESULTS: The importance of individualized case planning, employer consultation, workplace accommodations, interface with medical and mental health professionals, and adherence to self-care and symptom management regimens is emphasized throughout the article. CONCLUSION: Growing numbers of people worldwide are surviving advanced cancers for longer periods of time than ever before, which makes them an emerging disability population and rehabilitation clientele. [ABSTRACT FROM AUTHOR]

A three-step program to assist people with disabilities in identifying their on-the-job accommodation needs, understanding their rights to accommodations and procedures for requesting them, and communicating needs to employers is outlined. Student personnel workers can use the approach to prepare graduating students to advocate for themselves under the Americans with Disabilities Act, Title I. (MSE)

Purpose: To examine demographic, functional, and clinical multiple sclerosis (MS) variables affecting employment status in a national sample of adults with MS in the United States. Method: The sample included 4,142 working-age (20-65 years) Americans with MS (79.1% female) who participated in a national survey. The mean age of participants was 51.93 years (SD = 8.7). The dependent variable was employment status. The predictor variables included a set of demographic, functional, and MS variables. Results: The chi-squared automatic interaction detector (CHAID) analysis indicated that participants who were receiving Social Security Disability Insurance (SSDI) had significantly lower rates of employment (8.6%) than those who were not receiving SSDI (53.9%). For those not receiving SSDI, the most important factor predicting employment status was MS impact on physical functioning, as measured with the Multiple Sclerosis Impact Scale Physical Impact scale. Conclusion: The data-mining approach (i.e., CHAID analysis) provided detailed information and insight about interactions among demographic, functional, and clinical variables and employment status through the segmentation of the sample into mutually exclusive homogeneous subgroups. Implications for rehabilitation intervention, based on these subgroupings, are discussed.

Multiple sclerosis (MS) is an unpredictable, sometimes progressive chronic illness affecting people in the prime of their working lives. This article reviews the effects of MS on employment based on the World Health Organization's International Classification of Functioning, Disability and Health model. Correlations between employment and personal, functional, environmental, and participation factors are discussed along with the need for a framework for evidence-based practice regarding the employment of people with MS.

Rehabilitation counseling researchers seeking to more fully understand the phenomenon of psychosocial adaptation to disability are devoting increased attention to the impact of disability on quality of life (QOL). This impact has been of particular interest among multiple sclerosis (MS) researchers. The complex etiology, unpredictable nature, and the multiple functional limitations attendant to MS have been identified as major impediments in research efforts to develop psychometrically sound and clinically sensitive tools to evaluate the impact of MS on QOL. This article presents the results of a confirmatory factor analysis of the factor structure of the Quality of Life Scale (QOLS), which has been used in several studies to evaluate the impact of MS on QOL. The QOLS was developed to assess the self-reported QOL of people with chronic pain and evaluates the degree of satisfaction with 7 distinct domains of personal and social activity. The developers' original principal component analysis revealed a single-factor model with high levels of internal consistency reliability. It is not clear, however, how the 1-factor model fits the population of individuals with MS and how the 7 items perform in terms of their measurement of the single factor. The 1-factor structure of the QOLS did not fit the data well in this sample of individuals with MS. Subsequent model iterations that incorporated 3 error covariances provided increasingly better fit and resulted in a reasonable model fit to the data.

This article presents an overview of multiple sclerosis (MS), one of the most common neurological disorders in the western hemisphere. Medical and psychosocial aspects of the disease such as causes and risk factors, diagnosis, incidence and prevalence, symptoms, courses, and treatment are described. Existing research regarding the employment outcomes and concerns of people with MS, especially the factors associated with labor force participation, is reviewed. Intervention strategies to enable individuals with MS to retain their employment are discussed such as early education on the nature of MS, advocacy-supported disclosure, and accommodation techniques for symptom management at the workplace. Important workplace accommodations include flexible work hours and work breaks, ergonomic changes in equipment to address upper and lower body limitations, and job simplification or other compensatory strategies to minimize the impact of cognitive problems on job performance.

This literature review examined publication patterns in the journal of "Career Development and Transition for Exceptional Individuals" across 35 years of publication. Overall, 732 contributors affiliated with 267 organizations were identified in our analysis of 436 articles. Frequency counts identified the most productive scholars in terms of number of articles authored and their institutional affiliation. Twenty-three individuals, predominately representing colleges and universities, contributed 6 or more articles. Findings reflect the collaborative nature of scholarship in career development and transition and an overall trend toward multiple authored publications. There is a need to engage or support individuals affiliated with local or state education agencies, vocational rehabilitation, and community rehabilitation programs, or individuals working outside of the United States in generating scholarship, as these groups were underrepresented in our findings. Suggestions for increasing authorship representation reflecting all transition stakeholders and the importance of collaboration in building the transition and career development knowledge base are discussed.

People with multiple sclerosis (MS) often report lower quality of life (QOL) than people without disabilities. Beyond the neurological and disease-related factors associated with MS, employment status has been consistently identified as an important determinant of QOL. However, it is not clear what factors are important contributors to the QOL of older people with MS when they start to withdraw from employment due to age or to the disease. This study used data from a national survey to explore four types of variables that could impact the QOL of people with MS aged 55-88 years (N = 703, Mage = 63.0, SD = 6.1): (1) demographic characteristics (e.g., age, race/ethnicity, gender, marital status, educational attainment, financial status); (2) disease-related characteristics (e.g., MS course, number of symptoms, severity of symptoms, mobility limitations); (3) cognitive functioning; and (4) perceived stress. A backward stepwise multiple regression analysis revealed that gender, marital status, current financial status, MS course, number of symptoms, severity of MS symptoms, and perceived stress were negatively related to QOL. This research underscores the importance of investigating the potential psychological and social impact of MS on QOL beyond employment-related factors for older individuals in order to develop and deliver beneficial interventions on their behalf., Multiple sclerosis (MS) is one of the most common neurological diseases in the world, affecting an estimated 2.3 million people worldwide, and 450,000 persons in the US (National Multiple Sclerosis [...]

This article presents descriptive findings from a sub-sample of 1,512 women with multiple sclerosis (MS) that was derived from a national survey of the employment concerns of Americans with MS. Female respondents were asked to evaluate 38 employment concerns items on two dimensions, importance and satisfaction, for the purpose of identifying strengths and weaknesses in the employment policies and practices affecting the labor force participation of women with MS. Results revealed a total of 16 employment strengths and 22 employment weaknesses that must be addressed in direct service and advocacy efforts if more women with MS are to continue their careers while coping with such an intrusive and unpredictable disease. Implications of these findings for future rehabilitation programming and research are examined., The purpose of this article is to (a) describe key issues related to the employment outcomes of women with multiple sclerosis (MS) and (b) recommend effective rehabilitation interventions to address [...]

This article presents findings from an investigation of factors associated with quality of life (QOL) among Latinos with Multiple Sclerosis (MS). Using data from 206 Latino/a participants recruited through chapters of the National MS Society, factors associated with QOL were explored through multiple regression analysis. Eight predictors accounted for 47.5% of the variance in QOL scores. Five predictors were significantly associated with QOL. Greater perceived severity of MS symptoms was significantly correlated with lower QOL scores and full-time employment significantly predicted higher QOL. Finally, married/partnered participants and participants who reported fewer MS-related mental health symptoms and an ability to meet their living expenses were more likely to report higher QOL. Implications for rehabilitation professionals working with Latinos diagnosed with MS are included., The purpose of this article is to describe key determinants of quality of life (QOL) among Latinos with multiple sclerosis (MS) and to recommend interventions to help Latinos with MS [...]

This investigation examined the extent to which components of the reasoned action model predicted the intention to return to work among unemployed adults with multiple sclerosis (MS; N = 381). Examined in a hierarchical regression analysis, four classes of variables (demographic, attitude toward the behavior, subjective norms, and perceived behavioral control) were operationalized from items in a national survey of the employment concerns of Americans with MS. Findings indicated that those most likely to have a greater intention to return to work possessed the following characteristics: African American, having difficulty meeting financial obligations, and not receiving benefits ([R.sup.2] = .17). Some support was observed for including self-perceived MS severity and support from significant others as part of the model. Implications for rehabilitation counselors include helping unemployed adults with MS counter employment discrimination, learn about benefits and insurance, secure adequate finances for daily living needs, and cope with the debilitating effects of chronic illness and poverty., The purpose of this study was to examine precursors to the intention to return to work among a sample of unemployed adults with multiple sclerosis (MS). One promising approach for [...]

This article provides an overview of the medical, psychosocial, and vocational aspects of multiple sclerosis (MS), one of the most common neurological disorders in the world. New developments in the diagnosis and treatment of this increasingly prevalent disease are presented. We review recent research on the impact of MS on health and function, and on the effect of MS on employment and community participation. Finally, we describe the important considerations for rehabilitation professionals working with people who have MS and their families., The past several years have produced significant progress in the clinical understanding and treatment of multiple sclerosis (MS). Although there is no cure for MS, the recent introduction of new [...]

This article presents descriptive findings from a national survey of the employment concerns of African Americans with multiple sclerosis (MS; N = 215). Respondents were asked to evaluate 38 employment concerns items on two dimensions, importance and satisfaction. Employment concerns items with which respondents were most satisfied clustered into themes such as equal opportunity and benefits, fair treatment, information about legal rights, and access to resources. Items with which respondents were least satisfied clustered into themes such as insurance benefits, job accommodations, and employer expectations. Implications of these findings for rehabilitation policy and service delivery are examined., The purpose of this article is to describe key factors that influence the employment outcomes of African Americans with multiple sclerosis (MS) and recommend effective rehabilitation interventions to address those [...]

Because employment is a significant predictor of the quality of life of people with disabilities (Rumrill, Roessler, & Fitzgerald, 2004; Viermo & Krause, 1998), discrimination in the workplace that interferes with successful job acquisition or retention is a serious matter. Unfortunately, this type of discrimination is all too prevalent. In a survey conducted by the National Organization on Disability (National Organization on Disability, 2004), one in five employed individuals with disabilities reported that they experienced discrimination in their efforts to work. This finding of one in five workers with disabilities translates into substantial numbers of Americans who do not have fair access to employment opportunities. For example, estimates based on data from the U.S. Census Bureau (Head & Baker, 2005) indicate that approximately 50 million Americans of workforce age have disabilities.

The purpose of this study was to (a) examine the employment and career development concerns of postsecondary students with learning disabilities and Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactivity Disorder (AD/HD) and (b) develop strategies for improving their post-graduation employment outcomes. Employing an established survey method grounded in the ideals of Participatory Action Research, the researchers examined the self-perceived strengths and weaknesses of a sub-sample of 110 students with learning disabilities, ADD, and AD/HD in four states, representing seven colleges and universities, regarding their top-priority employment concerns. Students reported that their main employment-related strengths were in regard to expectations, access and accommodations, and job-seeking and technical skills. They reported their relative weaknesses to be in the areas of health insurance, implementation of the Americans with Disabilities Act, and Social Security. Focus groups of university faculty members, student service professionals, rehabilitation professionals, and students with disabilities, convened to assist in the interpretation of results and the formulation of strategies for improving career services, recommended that students' employment-related strengths be maintained and weaknesses remediated by utilizing information, research, services and curriculum, self-advocacy and self-determination, and involvement of key stakeholders. (Contains 3 tables.)

Individuals with learning disabilities are attending postsecondary institutions in rapidly growing numbers. However, they often encounter a variety of difficulties on campus, both in and out of the college classroom. One potentially fruitful avenue for improving the quality of the college experience for students with learning disabilities is to increase understanding and awareness among faculty members. In this article, we describe one such program, the Access to Quality Higher Education Project, at Kent State University. The project has provided resources, support, and training to three cohorts of 20 faculty members across three years. Participants rated the project, especially the week-long professional development institutes that are the cornerstone of the project, and its impact on their interactions with college students with disabilities and other university professionals about college students with disabilities positively. The reflections of five participating faculty members regarding the impact the project had on them and their interactions with college students with learning disabilities are presented. (Contains 1 figure and 1 table.)

This study examined the relevance of the disease-and-demographics model for explaining the employment outcomes of adults with multiple sclerosis (MS). Participating in a national survey of their employment concerns, 1,310 adults with MS provided data for the study (274 men, 21%; 1,020 women, 78%; 16 participants did not identify their gender). With an average age of 50 (SD = 12.14), most of the respondents were White (92%), well educated (97% were high school graduates, 40% were college graduates), and residing in urban and suburban areas (74%). Results from a backward stepwise multiple logistic regression analysis included the following variables as best predictors of employment status: educational attainment, severity of symptoms, persistence of symptoms, and presence of cognitive impairment/dysfunction (R[superscript 2] = 0.23). The article discusses the relationship of the findings to psychosocial and career development models in rehabilitation and to training, educational, accommodation planning, and cognitive interventions. (Contains 2 tables and 2 notes.)

Identifies factors predicting employment or lack thereof among adults with multiple sclerosis (MS). Results included the following variables as the best predictors of employment: symptom persistence, severity of symptoms, educational attainment, and presence of cognitive limitations. The relevance of the findings for rehabilitation assessment and intervention strategies is discussed. (Contains 33 references and 3 tables.) (GCP)