Employer Practices for Customized Training for Onboarding of People With Disabilities

Database Search

The electronic database searches generated a total of 244 articles. Among them, 71 articles are from PsychInfo, 68 are from Academic Search, 16 are from ABI, ProQuest Dissertations & Theses Global generated 56 articles, and Web-science generated three articles. After removing the duplicates (52 articles), 192 articles remain.

We first reviewed the titles, then the abstract and lastly the full text. (a) Title review, two of the authors reviewed the title of 192 identified articles and excluded articles obviously unrelated to “employment” and “disability or chronic illness.” Title review resulted in 150 articles after exclusion of 42 articles. The internal consistency between the two title reviewers was 83.1%. (b) Abstracts review, we defined inclusion criteria as (a) employer practices for disability-specific recruitment, (b) disability or chronic illness, and (c) including an abstract. Abstracts review resulted in 51 articles after excluding 99 articles. The internal consistency was 80.1%–81.6%. (c) Full-text review, we reviewed full text using the same criteria as the abstract review. Full-text review resulted in 27 articles, excluding 23 articles (see Figure 1).

FIGURE 1.

Scoping review flow chart

Charting the Data

The research team included one professor with expertise in demand-side employment, one senior research assistant with extensive experience in conducting systematic and scoping reviews, and three project assistants who were doctoral students in rehabilitation counselor education. Before conducting the scoping review, the senior assistant provided training on the fundamentals of scoping reviews to the doctoral students in the scoping review team. Team members also received training on demand-side employment by an expert in demand-side employment to increase team members’ knowledge and sense of demand-side employment literature in order to familiarize team members with this research topic. We extracted data, including the purpose, research methods, and result descriptions and information related to customized training efforts and results for PWD from each article. The extracted data were entered into a spreadsheet.

Collating, Summarizing, and Reporting the Results

All three members of the research team were involved in the data synthesis process by reviewing articles to identify key themes. The inter-rater reliability for findings and themes agreement between members was 85.2%. Any disagreements were discussed in meetings until we reached a consensus.

Job Training

Findings revealed the most commonly used customized training techniques were classroom style, on-the-job training, and textbooks and manuals. The tools used by companies were textbooks, transparencies, and flip charts; computers and video tapes were also used and getting more frequently nowadays; teleconferencing and interactive multimedia were used yet rarely. Professional involvement in the job training team has been found to be beneficial across the majority of studies. In a case study of people with developmental disabilities and intellectual disabilities (IDs), involving an occupational therapist for the work capacity assessment followed by on-the-job training has been found to be effective for obtaining competitive employment (Arikawa et al., 2013). In addition, professionals are expected to fully understand system utilization and local resources available and work with PWD and the community (Arikawa et al., 2013). Giesen & Hierholzer (2016), the investigation service patterns and evaluation of the impact of VR services on people with visual impairments study, special and remedial services, job-related services, evaluation, and training and supports. Job placement, job search, on-the-job support, on-the-job training, counseling and guidance, rehabilitation technology, other services, and maintenance were positively related to competitive employment.

On-the-Job Training with Specific Strategies

The importance of on-the-job training was highlighted by emphasizing the place–train model, ensuring the training is specific to the job and workplace where the job will be performed. Literature in this area focuses on specific disabilities. For instance, Brooks et al. (2002) compared different training methods used for students with learning disabilities (LDs) and evaluated catering students’ performance when trained using a real environment, a workbook, untrained tasks, and a virtual environment. The study concluded that virtual training is an effective training method for people with LD. Ruggeri-Stevens and Goodwin (2007) concluded that retraining and refreshing key points are important for all employees. Changes in work routines could affect the performance of some people with LD, and having different supervisors could cause trouble for people with LD. In terms of individuals with mental illness (MI), Bucholz and Brady (2008) suggested that literacy-based behavioral interventions by using print or pictures as an instructional medium for people with MI are successful because it helps them visualize people engaged in the desired behavior. Katz and colleagues (2013) studied the effectiveness of a social enterprise project for people with long-term MI within the community. They found the job training was successful, and participants were able to maintain an average of three hours of work daily, demonstrating an improvement in their perception of their ability to work. Executive functions were found to be challenging for the participants, suggesting a structured plan in the job training. The study also found an improvement in health-related outcomes for participants.

Transitional Models

With the introduction of customized job training above, similar research results were found. For example, transition-aged youth with specific LD might benefit from occupational/vocational job skills training; transition-aged youth with ID might benefit from monetary help to cover expenses such as the cost of uniforms, short-term expenses (e.g., shelter), initial time cost, and so on; tradition-aged youth with autism could be benefited from skills training (Kaya et al., 2016). Collaboration with prospective employers and coworkers to provide such training or identify relevant training, considering individual differences, is needed (Kaya et al., 2016). Evidence shows that when given access to effective transition services and supports, individuals with disabilities can achieve success in integrated environments (Brown et al., 2006; Hillier et al., 2007). Transition literature suggests that active employer involvement in carving jobs and developing internship sites is critical to workplace success for young adults with disabilities (Donovan & Tilson, 1998; Rutkowski et al., 2006).

An increasingly popular model for providing such services and supports is Project SEARCH, a business-led transition program that represents a demand-side transition model tailored to the needs of the employer (Rutkowski et al., 2006). Project SEARCH provides participants with a series of intensive, on-site work experiences or internships, which are physically located at the host business site. Studies showed that opportunities for on-the-job learning are directly correlated to higher rates of postschool employment (Benz et al., 2000; Carter et al., 2011; Rabren et al., 2002; Test et al., 2009). Classroom instruction with a curriculum that addresses the development of entry-level job skills as well as workplace behaviors necessary for success was also provided (Vondracek & Porfeli, 2003). Project RESEARCH model holds promise for increasing participants’ job readiness and employment rates (Müller & VanGilder, 2014). Rutkowski and colleagues (2006) concluded that project RESEARCH has resulted in tangible business benefits, such as improved turnover rates in some entry-level positions.

Another transition model, Apprenticeships, is much more common outside of the United States. Completing and undertaking apprenticeships and traineeships appear to have an equalizing effect on weekly income for PWD related to their nondisable peers (Lewis et al., 2011). Apprenticeship often starts in teenager years and involves a combination of classroom-based learning and part-time paid employment while working under an experienced person in a specific profession (Bailey, 1993). Several studies from Australia and Canada demonstrated the capacity of this program to be successfully adapted to youth with disabilities by providing more staff and having support last longer (Dos Santos Rodrigues et al., 2013; Schwartzman, 2015). In sum, the apprenticeship model appears to be more effective than the comparison model in increasing employment statuses of individuals with developmental disabilities, as it provides individuals desperately in need of vocational experiences with hands-on practice in an understanding and accepting environment. However, these results are exceptionally preliminary, and it is essential to continue this line of research into this promising vocational model (Lewis et al., 2011; Kaya et al., 2016).

Disability Diversity Training

Diversity training is an intervention intended to improve intergroup relations and reduce prejudice (Paluck, 2006). Typically, these programs are designed to enhance the skills, knowledge, and motivation of people to interact effectively with diverse others (Pendry et al., 2007). The primary motivation for most diversity training efforts is a desire for a more successful organization with better performing employees, regardless of the usage of these terms. To achieve this, diversity training usually aims to change employee behavior toward socially disadvantaged group members (Bezrukova et al., 2012). Findings revealed that diversity training is most likely to lead to positive change when upper-level managers lead the way. Although there is evidence and support for an emphasis on training management in the workplace, others have noted the importance of diversity training for all employees. Phillips and colleagues’ (2016) systematic review provided rich information for disability diversity training. In the following section, more specific information with respect to these categories will be discussed.

The diversity training duration is one of the factors influencing outcomes. Kalinoski and colleagues (2013) found diversity training lasting longer than 4 hours tended to have larger effects on affective outcomes; 4.5–6 hours was sufficient to effectively change attitudes toward diversity; however, meta-analytic findings suggest that there may be a diminishing return for training lasting greater than 8 hours. The pace of diversity training is also important for adequate skill development to occur and sufficient attention to cognitive and affective processes that underlie prejudice and discrimination. Numerous studies indicated positive effects when training was spread out over multiple weeks. Lastly, in the meta-analysis by Kalinoski and colleagues (2013) suggested in-person training are more effective than training delivered via computer.

In terms of content covered in the disability diversity training, one of the greatest content-related influences is whether the diversity training focused on a single diversity topic (e.g., race/ethnicity) or multiple diversity topics (e.g., race and gender). Training based on a single aspect has been shown to be more effective in improving cognitive outcomes. However, diversity seemed excluded from the diversity in the system review, suggesting more study is needed, given the heterogeneity within the diversity population. Another content-related factor shown to influence diversity training is the level of participant interaction or task independence that is required. Interactive diversity training programs requiring task independence or working with others have been shown to have a greater effect on cognitive outcomes. Similarly, programs using active learning methods were found to be more effective in improving both cognitive and affective outcomes than those that use only passive, lecture-based methods and videos. Recently, Madera and colleagues (2013) found evidence that goal-setting and mentoring may be valuable additions to diversity training. Setting positive behavioral goals immediately after attending diversity training results in more diversity-supportive behaviors post-training. Furthermore, participants who set goals were more likely to report positive attitudes toward diversity. Rudstam and colleagues (2013) noted that an advisory group made up of employers, PWDs, and diversity service providers were unanimous in wanting an emphasis on action over awareness.

Technology

As technology advances, technological-based devices, and tools are developed to help individuals with disabilities learn job tasks and increase job performance (Furniss et al., 1999; Giesen & Hierholzer, 2016; Paez, 2010; Van Laarhoven et al., 2009). Technology can aid rehabilitation consumers in meeting their needs, promoting skill acquisition, and overcoming their barriers in job settings (Giesen & Hierholzer, 2016; Van Laarhoven et al., 2009). Additionally, technology can be integrated into job-related training as younger people participate in the workforce (Paez, 2010). Several studies have shown the benefits of technology used for providing employment support to people with developmental disabilities (Furniss et al., 1999; Van Laarhoven et al., 2009). In Van Laarhoven and colleagues’ (2009) study, they evaluated the use of a video iPod as a prompting and feedback device for a young man with developmental disabilities in instructing job-related tasks in a community-based setting. Findings suggested that the video iPod was an effective instructional tool that helped with job-related tasks, including cleaning bathrooms and kennels, and mopping floors (Van Laarhoven et al., 2009). Over time, the participant needed fewer prompts to accomplish those tasks, which demonstrates that this device may promote independence in work settings (Van Laarhoven et al., 2009). In a similar study, a computer-aided support system was utilized to help people with severe developmental disabilities to perform complex work tasks in a real work setting (Furniss et al., 1999). Results demonstrated that this system facilitated higher work accuracy and pace when compared with pictorial instructions among six people with severe developmental disabilities (Furniss et al., 1999). Additionally, given the computer provides prompts, it helps workers stay on task and reduce distractions (Furniss et al., 1999). These findings suggest that technology-aided support systems may support individuals with developmental disabilities in work engagement and work performance (Furniss et al., 1999; Van Laarhoven et al., 2009).

Previous research has demonstrated the benefits of integrating technology in training workshops and achieving employment outcomes (Giesen & Hierholzer, 2016; Paez, 2010). In hotel and restaurant settings, the most commonly used training tools are still traditional training methods, such as on-the-job training, demonstrations, and classroom style/lecture (Paez, 2010). However, technology-based training has become more popular as younger people gain employment (Paez, 2010). Stahl (2015) found that attending digital literacy training increased clients’ marketability and accessibility to employers. Digital literacy training refers to learning how to use software programs, the internet, emails, online job search, and resume building (Stahl, 2015). In terms of employment outcomes, rehabilitation technology was positively associated with competitive employment in a sample of VR consumers with blindness or visual impairments (Giesen & Hierholzer, 2016). Specifically, consumers who received rehabilitation technology services had 105% higher odds of competitive employment compared with those without (Giesen & Hierholzer, 2016).

Vocational Rehabilitation Services

VR programs focus on empowering client’s strengths, abilities, interests, and autonomy to obtain and maintain employment (Giesen & Hierholzer, 2016; Hagner, 2000). Clients who receive VR services have been shown to gain competitive employment, self-confidence, and motivation (Giesen & Hierholzer, 2016; Kaya et al., 2016). On the other hand, rehabilitation counselors can promote the job development process for their clients by increasing their access to the primary labor market (Hagner, 2000).

Studies have demonstrated the effectiveness of VR programs in various disabilities, including clients with blindness or visual impairments, acquired brain injuries (ABIs), specific LD, IDs, and autism (Giesen & Hierholzer, 2016; Kaya et al., 2016; Macaden et al., 2009). In a sample of VR consumers with blindness or visual impairments, VR counseling and guidance were found to be positively related to competitive employment outcomes (Giesen & Hierholzer, 2016). These results suggest that addressing psychosocial issues (e.g., disability adjustment, family, and social factors) through counseling is imperative in achieving competitive employment (Giesen & Hierholzer, 2016). In another study, the VR program was effective in building clients with ABI’s confidence and providing ongoing support in the workplace (Macaden et al., 2009). The essential elements for sustaining employment were identified as internal and unconditional motivation and coping skills because individuals with ABI can learn to overcome their difficulties (Macaden et al., 2009). Macaden and colleagues (2009) also suggested the importance of pairing workers with coworkers who have personal experiences with disabilities and gaining support from employers with personal experiences, with disabilities to help clients return to work. Additionally, transition-aged youth with specific LDs, IDs, and autism benefited from job placement and on-the-job support (Kaya et al., 2016). Individualized VR services would be important to address the specific needs and their personal interests and strengths (Kaya et al., 2016). It was also discussed that gender, and educational level contributed to employment outcomes (Kaya et al., 2016).

From a rehabilitation counselor’s standpoint, Hagner (2000) suggested rehabilitation counselors to taking on a network with a neighbor, relative, or acquaintance in the job development process. By doing so, rehabilitation counselors can assist rehabilitation consumers in increasing their access to the primary labor market. Rehabilitation counselors can also assess job characteristics and negotiate with employers to aid individuals with disabilities to move from the secondary sector into the primary sector (Hagner, 2000).

Wage and Working Hours

Employment services have been shown to promote employment outcomes, such as increased wages and longer working hours (Elinson et al., 2008; Katz et al., 2013; Vargo & Dennis, 1989; Wehman et al., 2006). Through training and support, individuals with disabilities can participate in the competitive workforce. However, the limitation of providing job-related support is that it can be costly (Vargo & Dennis, 1989). Research examining community-based employment programs, customized employment services, supported employment services, and apprenticeship programs have demonstrated the effectiveness of how participants are able to obtain competitive employment and work for a significant amount of time. Vargo and Dennis (1989) evaluated a community-based employment program for PWDs and this program was successful in achieving 85% to 90% of employment. Upon completion of the program, participants earned $4.71 on average compared with their initial earning of $3.80 (Vargo & Dennis, 1989). Similarly, in a study examining customized employment services in a one-stop career center environment, participants who achieved competitive employment earned more than minimum wage from 2004 to 2006, with a mean hourly wage of $8.84 in 2004 and $8.95 in 2006 (Elinson et al., 2008). The average work hours were also consistent over the 3-year span, ranging from 25.8 hours per week in 2004 to 24.4 hours per week in 2006 (Elinson et al., 2008). Overall, findings suggested that the mean wage and weekly hours worked were the same over time, suggesting that a customized employment approach can be feasible to support individuals with disabilities and maintain the capacity of workforce development (Elinson et al., 2008). In Wehman et al. (2006) study, a client with disability benefited from the supported employment services. This client works 25 hours per week, earns $8.5 per hour, and has been employed for more than three years (Wehman et al., 2006). More recently, the “Coffee Stands” project is a VR program that provides job training for individuals with long-term MI (Katz et al., 2013). Participants worked on an average of 3.11 hours daily, which showed the training was successful in improving their work perception (Katz et al., 2013). Additionally, an apprenticeship program was carried out to help individuals with developmental disabilities gain successful employment (Schwartzman, 2015). Although not all participants achieved successful employment outcomes, their vocational activities increased (Schwartzman, 2015). For example, they started from participating in volunteering activities to working for 10 hours in a sheltered vocational setting (Schwartzman, 2015). This suggests that the apprenticeship program increased vocational status (Schwartzman, 2015).

Participant Satisfaction

Participant satisfaction refers to participants’ perceptions on the employment programs they participated in. Most studies demonstrated participants are overall satisfied with the employment services they received (Gilson & Carter, 2016; Katz et al., 2013; Vargo & Dennis, 1989). However, there are some gaps in research, including barriers for maintaining employment and spiritual wellness among individuals with MI (Becker et al., 2011; Killackey & Allott, 2013). Participants have been satisfied with their community-based employment program, VR program, coaching, and computer-based support system (Furniss et al., 1999; Gilson & Carter, 2016; Katz et al., 2013; Vargo & Dennis, 1989). Participants with disabilities who joined a community-based employment program reported high levels of satisfaction in multiple domains, including program operation, staff support, employment goal attainment, and financial independence (Vargo & Dennis, 1989). Similarly, Gilson and Carter (2016) examined a social-focused coaching package on task engagement and social interactions for young adults with autism or ID. Most participants expressed satisfaction with the audio coaching because it helps with their task performance (Gilson & Carter, 2016). A computer-aided support system showed benefits in people with severe developmental disabilities because they gain valuable work experience and integrate work into their conversations in nonwork settings (Furniss et al., 1999). From a health and well-being perspective, participants with long-term MI demonstrated an improved health-related quality of life and satisfaction but not self-esteem after six months of participating in a VR program (Katz et al., 2013).

Some gaps in the literature have not been clearly addressed. For example, there are several factors that can lead to difficulties in maintaining employment, including stigma, self-efficacy, and motivation (Killackey & Allott, 2013; Stahl, 2015). Disability status was shown to be a risk factor for finding employment at Goodwill because of the stigma associated with disabilities (Stahl, 2015). When people with severe MI have low self-efficacy and motivation, they may not be able to achieve work satisfaction because they may not be able to value the benefits of work. Another study suggested that spiritual wellness and psychosocial well-being associated with symptoms and employment outcomes are not addressed in individuals with severe MI (Becker et al., 2011). Spirituality wellness and psychosocial well-being can be important predictors of employment. Therefore, integrating those factors into the VR counseling process may help facilitate job attainment.

Employees’ Characteristics

The articles examined the relationship between employees’ characteristics and employment outcomes. Macaden and colleagues (2010) conducted multiple case studies to explore factors that affect employee retention among individuals with ABI. They found that internal and unconditional motivation and coping skills were key factors for positive employment outcomes. In specific, postinjury coping skills for common ABI sequelae such as anger, fatigue, and paranoia. In addition, both motivation and coping strategies enable one to overcome cognitive and other disabilities for individuals with ABI. Similarly, Kaya et al. (2016) investigated the relationships between demographic variables, VR services, and employment outcomes for transition-aged youth. The result indicating that education was significantly associated with competitive employment, as higher-educated individuals tend to have higher functioning levels and more life experience. Race was also found to be associated with competitive employment, and employment outcomes were more favorable for male participants than female participants.

Employer Temperatures

Several articles pointed out the potential impact of employer temperatures, such as workplace environment and employers’ attitudes on customized training efforts and employment outcomes. Hagner (2000) reviewed articles identifying both demand-side and supply-side factors in primary and secondary labor markets. The result suggested that employment outcomes are affected by a range of factors, including career self-awareness and development, individual skills, interests and abilities, as well as external factors such as employers’ attitudes.

Macaden et al. (2010) identified work environment factors, including a supportive employer, supportive coworker, and being an outstanding employee, as one of the factors associated with sustained employment for individuals with ABI. In specific, employees with ABI would benefit from having supportive employers, especially those with previous experience of disability. In addition, pairing the individual with a supportive coworker was reported to help sustain employment. Ellenkamp et al. (2016) conducted a systematic review examining work environment-related factors in obtaining and maintaining work for employees with IDs. One of the factors identified was employers’ decisions and opinions. The authors reported that employers who had previous hiring experiences displayed more positive attitudes toward employees with IDs, and social altruism was also found to be a positive work environment-related factor. Another factor that could affect customized training efforts is interaction and workplace culture, including social opportunities, personnel and teambuilding, attentions for workplace diversity, supervision, structure, and flexibility. Moreover, the value of being accepted and social support were also found to be important factors. Olson et al. (2001) examined employers’ attitudes toward individuals with ID and found out that employers perceive those workers to have a positive workplace impact and a negligible impact on human resource costs. In addition, the findings suggest that the training of coworkers and supervisors is valuable. Though employers identified training and supervision time to be higher for employees with ID, they expressed willingness to provide such accommodation, regardless of company size. Public image, workplace diversity, and competency were among the reasons for hiring, and the importance of providing training to coworkers was highlighted.

In a study describing the employment of individuals with psychiatric disabilities working as research assistants in a university-based research center, Henry and colleagues (2002) reported that workplace environment and attitudes play a major role. These findings suggested that stigma and stereotypes against individuals with psychiatric disabilities exist in workplaces, limiting the opportunity of employees to be fully integrated into the workplace. There is a need to address such stigma and a shift in organizational attitude. The authors suggested that such needs can be addressed by providing additional training to coworkers. Paez (2010) examined the perceptions of managers and supervisors of disability in the hospitality industry. The results suggested that years working for the current organization and age had a positive effect on attitudes. In addition, it was reported that managers and supervisors displayed a neutral to a positive attitude toward training and working with individuals with disabilities in general.

The findings of this scoping review indicated that many training methods, topics, and tools were evaluated by various studies. The most used training methods been discussed across studies were on the job training and demonstration. Harris and Bonn (2000) reported a need to improve training in areas such as customer service, cleaning, employee relations, communication skills, and chemical use. Managers in this study reported most of their operations were training their employees on those topics, using tools such as text and manuals and programs, simulations, audio and/or video tapes, DVDs, and CDs. Newer technologies are started to be used for training; however, some operations might not have the necessary equipment to take advantage of this technology. In addition, disabilities as one of the diversities should be included and advocated. Lastly, VR programs promote confidence and provide ongoing support for individuals with disabilities to achieve their employment goals. Given the individuals have varying abilities, needs, and wishes, individualized VR services can be particularly beneficial in addressing those factors.

In terms of work values, research has demonstrated that employment programs are feasible in supporting PWDs to earn increased wages and work for a longer duration of time. These employment outcomes not only boost PWD’s self-esteem but also their work identity in the community. PWDs are generally satisfied with their job-related support services. This demonstrates that employment-related programs are helpful as they learn job tasks, gain financial independence, value their vocational identity, and engage in community participation. Future research should address other employment-related factors to understand PWDs’ perceptions on work, such as stigma, self-efficacy, motivation, and spiritual wellness.

For employer temperatures, employees’ characteristics, employer characteristics, and workplace environments were identified as key factors influencing employment outcomes for PWDs. Studies examined employees’ characteristics and employment outcomes, such as race, education level, motivation, and coping skills (Kaya et al., 2016; Macaden et al., 2010). Literature also identified the potential impact of employer temperatures, such as workplace environment and employers’ attitudes, on customized training efforts and employment outcomes. (Ellenkamp et al., 2016; Hagner, 2000; Henry et al., 2002; Olson et al., 2001; Paez, 2010).

Our findings have implications for disability and rehabilitation service providers as well as researchers. The findings would allow disability service providers to gain better insights regarding the demand-side employers’ needs and behaviors. WIOA requires a stronger focus on employer engagement, and findings of this study will help disability service providers in their efforts to engage employers to promote customized training efforts for PWD.