[International Review of Research in Mental Retardation] Volume 29 || Employment and Intellectual Disability: Achieving Successful Employment Outcomes

Employment and Intellectual

Disability: Achieving Successful

Employment Outcomes

KAYE SMITH1, CARLENE WILSON

2,

LYNNE WEBBER1, AND JOSEPH GRAFFAM

1

1SCHOOL OF HEALTH SCIENCES

DEAKIN UNIVERSITY

BURWOOD, VICTORIA, AUSTRALIA

2DEPARTMENT OF PSYCHOLOGY

UNIVERSITY OF ADELAIDE

ADELAIDE, AUSTRALIA

In this Chapter, we will review the research that has explored variables that

can shape employment outcomes for people with an intellectual disability.

Defining ‘‘success’’ in employment outcome is diYcult—with success largely

dependent on both the opportunities available, the aspirations of the poten-

tial employee in terms of hours and conditions, and the perspective of the

person making the judgment. Thus, in some industries, casual and temporary

employment predominate and achievement of either is deemed as ‘‘success.’’

Furthermore, individuals diVer in the extent to which they seek full-time

employment; many employers and employees now prefer part-time or flexible

hours. Lastly, success can be judged from a variety of perspectives: the

employee who asks whether he or she is content with their current employ-

ment situation, and the employer who asks whether the employee is

performing in a number of areas including, but not limited to, productivity

and culture ‘‘fit.’’ In the current review, we will focus on determining employ-

ee success as measured by employer satisfaction and will attempt to anchor

this against satisfaction with employees without disabilities. Although this is

obviously only one possible way of operationalizing success, it provides the

advantage of helping us understand barriers to employment outcomes for

INTERNATIONAL REVIEW OF RESEARCH IN 261 Copyright 2004, Elsevier Inc.MENTAL RETARDATION, Vol. 29 All rights reserved.0074-7750/04 $35.00

262 Kaye Smith et al.

people with a disability. When attempting to understand influences that aVect

employment outcomes it is important to realize that influences extend beyond

the workplace and those who operate within the workplace, to the broader

environment (i.e., ecological system). For this reason, Bronfenbrenner’s

(1989) ecological systems theory has provided the framework for reviewing

research in this area. Using this framework has allowed us to conceptualize

successful employment outcomes as dynamic and complex phenomena,

resulting from interplay between individual, social, and environmental factors.

In its most recent classificationmanual, theAmericanAssociation onMental

Retardation (AAMR) has spent considerable space elaborating on the contex-

tual nature of mental retardation (AAMR, 2002). Thus, an individual’s ability

to function to the full extent of his/her capabilities can be determined by five

dimensions: (1) intellectual abilities; (2) adaptive behavior; (3) participation,

interactions, and social roles; (4) health; and (5) context. The latter has been

defined to include environments and culture. The role of the service provider is

to provide support that optimizes individual outcomes.

In this review, we will reiterate the importance of a focus at the level of

context in order to identify barriers to desired employment outcomes for

people with an intellectual disability. We will argue that it is important to

understand the environment in which employment of people with an intel-

lectual disability occurs, and to recognize that barriers need to be overcome

by appropriate levels of support in the immediate environment (microsys-

tem); the neighborhood, community, or organization (mesosystem); and the

overarching patterns of culture, society, country, and sociopolitical system

(macrosystem or megasystem). In other words, we will endorse the conten-

tion of the AAMR that the context can and must ‘‘provide opportunities

and foster well-being’’ (AAMR, 2002, p. 47). Furthermore, we will argue

that it must do this consistently across contexts because opposition, particu-

larly at a more micro-level, can eVectively interfere with support within any

other contextual level.

Bronfenbrenner’s (1989) ecological systems theory emphasized that a per-

son’s development is influenced by various contexts within which the person

operates, and that the person in turn influences these contexts. This theory

described an ecological hierarchy of four levels: (1) microsystem, (2) mesosys-

tem, (3) exosystem, and (4) macrosystem. The microsystem comprised inter-

relationships between an individual and a specific environment in which the

person operates, including interrelationships with others within that environ-

ment. The mesosystem comprised interrelationships that occur between the

diVerent microsystems in which the person operates, while the exosystem

was described as an extension of the mesosystem and included at least one

additional environment in which the person does not usually operate, but

which nonetheless impacts the person. For an employee with an intellectual

EMPLOYMENT AND INTELLECTUAL DISABILITY 263

disability, a microsystem would be the workplace, including relationships that

occur therein; a mesosystem would include other microsystems in which the

person operates, such as their home environment; and a exosystem could be

the environment of the disability support service that assists the person in their

employment. The fourth level, the macrosystem, comprised the prevailing

belief system and culture within which the microsystem, and exosystem are

embedded. Aspects, such as attitudes of the wider community toward people

with an intellectual disability and anti-discrimination legislation, would be

part of the macrosystem. Therefore, this theory extends the focus of develop-

ment beyond the individual to other factors that aVect performance. Recog-

nition of the importance of ecological factors on a person’s participation

is also consistent with a social model of disability (Barnes, 1998).

An appreciation that a complex interaction of contextual factors can aVect

the achievement of successful employment outcomes, has guided the review of

research undertaken in this Chapter. This Chapter will begin with an overview

of the literature and research of immediate relevance at the macrosystem level,

including changes in how ‘‘disability’’ has been understood in relation to the

broader ecological context, and the prevailing belief system and culture in

which employment, intellectual disability, and other forms of disability are

embedded. The second Section of the Chapter will focus on research more

directly predictive of successful employment outcomes of people with an

intellectual disability, multiple disabilities, and other forms of disability. The

third section will discuss the future directions for maximizing successful

employment outcomes of people with an intellectual disability.

I. PERCEPTIONS OF DISABILITY INCLUDING

INTELLECTUAL DISABILITY AT THE MACRO LEVEL AND

IMPLICATIONS FOR EMPLOYMENT

How intellectual disability and other forms of disabilities are perceived in

relation to the broader ecological context has been the subject of debate in

recent years. ‘‘Disability’’ is a complex multidimensional and dynamic con-

cept, and one that has been subject to various interpretations. Altman (2001)

argued that concepts of disability for research purposes reflect a growing

awareness of the multiple factors that impact on disability. He reported that

disability has been described from various perspectives, including economic,

administrative, medical, and socio-political.

An important and well documented conceptual shift in recent years

has been from a medical to a social understanding of disability, in which

disability is no longer understood solely in terms of personal attri-

butes but also as a concept that involves the physical, social, and cultural


aspects of those environments in which a person operates (Bickenbach et al.,

1999; Shakespeare, 1998; Shakespeare & Watson, 2000; World Health

Organization, 1997).

Under the medical model, strategies aimed at rectifying the ‘‘problem’’

are geared toward the individual. The social model of disability, on the

other hand, understands disability as a socially constructed issue (Oliver,

1990). The social model considers the physical and social environments as the

cause of disadvantage, and subsequently these become the foci of attention

and intervention. Whereas the medical model has focused interventions on

the individual and tended to ignore the impact of the environment on the

individual, the social model has concentrated on the environment and

tended to ignore the impact of the individual’s condition on the individual’s

experiences. However, Albrecht and Bury (2001) cautioned against the over-

simplification and categorization of disability into discrete frameworks, such

as medical or social. They argued that disability is a complex phenomenon

and more recent conceptual understandings of disability recognize the im-

portance of the interrelationship between the individual and their environ-

ment. Recognizing the importance of this interrelationship is consistent with

Bronfenbrenner’s (1989) ecological systems theory.

The World Health Organizations (WHO) (2001) International Classifica-

tion of Functioning, Disability, and Health (ICF) uses a biopsychosocial

approach to their classification of disability and functioning. The multi-

perspective approach advocated by the WHO is a blending of both the

medical and social models. The ICF is a revision of the 1980 International

Classification of Impairments, Disabilities, and Handicaps (ICIDH). Where-

as the ICIDH had a focus on the ‘‘consequences of disease,’’ the focus of the

ICF is on the ‘‘components of health.’’ The ICF understands ‘disability’ as

an umbrella term that not only covers ‘impairment,’ but also ‘activity limita-

tions’ or ‘participation restrictions.’ In considering activity and participa-

tion, the focus is on contextual factors. The ICF also diVers from the ICIDH

in recognizing the importance of the interrelationship between the individual,

and environmental and personal factors. Although personal factors are not

classified in the ICF, they are nonetheless recognized as important. That is,

the WHO now recognizes disability as a complex phenomenon that both

influences and is influenced by a range of contextual variables.

Although the importance of understanding disability, including intellectu-

al disability, within a broader ecological context has been well documented,

in countries such as Australia (Carney, 2000), the U.S., and many Western

European countries (O’Day & Berkowitz, 2001; Thornton & Project Team

of Experts, 1998) eligibility for a disability support pension is still based on

criteria of functional incapacity. Thus, these criteria define disability as a

biomedical construct (Meijers, 1997). Furthermore, eligibility for a support


pension determines eligibility for other services, including disability employ-

ment services. This form of assessment, based on the medicalmodel, places the

source of disability and hence, eligibility, within the body, rather than within

the broader environment. Thus, people are categorized and become eligible

for government support solely on the basis of a biomedical understanding of

disability. Employment, however, is contextually based; achieving successful

employment outcomes for all employees is dependent on a range of contextual

variables, such as employer attitudes, workplace culture, physical accommo-

dations, and government policies. Hence, basing eligibility for employment

support exclusively on a medical assessment has questionable validity.

A. The Context of Employment and Intellectual Disability

Historically, employment has influenced society’s perception of people

with an intellectual disability as well as other forms of disability. Industriali-

zation, with a need to work at a set rate in spaces that were often cramped

and diYcult to access, contributed to the exclusion of people with a disabili-

ty, including intellectual disability, from economic participation in their

communities (Marks, 1999; Oliver, 1990). People with a disability were seen

as ‘‘unable’’ to work, rather than ‘‘unwilling’’ to work; a distinction that

deemed them worthy of assistance from society. Disability was commonly

understood as ‘‘work disability’’ (Bickenbach, 1996). However, for people

with an intellectual disability, being labeled as ‘‘employable’’ or ‘‘unemploy-

able’’ has been a transient rather than fixed concept, and one that can be

linked to the broader environment in which employment occurs. Bickenbach

(1996) has pointed out, for example, that during times of acute labor

shortage, such as war-time, many people with a disability, who had previ-

ously been institutionalized and viewed as ‘‘unemployable,’’ were successful-

ly employed in the community or conscripted into the armed services, only

to be returned to their institutions as available labor increased at the end of

the war. This illustrates that complex relationships between political, eco-

nomic, and social factors can contribute to the designation of people with a

disability as ‘‘employable’’ or ‘‘unemployable.’’

People with a disability have experienced many forms of exclus-

ion. Ravaud and Stiker (2001) distinguished between early forms of exclu-

sion, which focused on exclusion from society (for instance, killing or

abandoning those with a disability), to more recent forms, which focus on

exclusion within society (for instance, discrimination or segregation in areas

such as employment). Albrecht et al. (2001) suggested that people with

mental conditions were more likely to be separated within their communities

than those with physical disabilities. The history of people with a disability

in society is one that recounts various forms of oppression including stigma,


segregation, sterilization, and physical and emotional abuse. It is also one that

describes recent collective struggles for human rights and dignity (Braddock

& Parish, 2001). How disability is understood is subject to the specific cultur-

al, social, and economic contexts; disability as a concept is dynamic. Russell

(1998) argued that limited and flawed information has contributed to negative

attitudes held by employers. There is a long history of people with a disability

experiencing economic and cultural disadvantage in western societies.

Economically, people with a disability have been considered one of the

most disadvantaged groups in society (Schriner, 2001). Whereas, economic

independence and empowerment can promote inclusion in the social, politi-

cal, and cultural domains of society, economic dependence can result in

social exclusion. Alston (1995) highlighted a link between economic inde-

pendence and the exercise of various rights and freedoms: ‘‘Unless the

economic and social rights dimension is also addressed, the enjoyment of

civil and political rights can easily become largely illusory’’ (p. 96). The

Australian Institute of Health and Welfare (1999) has reported a much lower

rate of employment participation (53.2%) for people with a disability than

for people without a disability (80.1%). Schriner (2001) gave a similar

account of the employment situation for people with a disability in both

Canada and the U.S. Furthermore, the International Labour Organisation

(ILO) has highlighted an interrelationship between disability and poverty,

with disability contributing to poverty and poverty contributing to disability

(Vocational Rehabilitation Branch–ILO, 1999). This interrelationship is

important, given that poverty has been linked to a restriction in the exercise

of social and economic rights (Beresford, 1996; Marks, 1999). On the other

hand, employment, with its resultant economic benefits, is an important

route to the exercise of social, political, and economic rights. As evidence

of this, recent Australian research has shown that people with an intellectual

disability who are employed in the community experience a higher quality of

life than those with an intellectual disability who are either unemployed or in

sheltered employment (Eggleton et al., 1999).

From an ecological perspective, interest in achieving successful employment

outcomes for people with a disability, including those with an intellectual

disability, extends beyond those at the microsystem (employers, employ-

ees with a disability, disability employment professionals), mesosystem

(families, advocates), and exosystem (government funding departments,

and so forth) levels. This interest is also driven by broader political, social,

and economic imperatives at the macrosystem level. The ILO (Vocational

Rehabilitation Branch–ILO, 1999) presented examples of three macro-level

imperatives for urgent attention in order to improve employment outcomes

of people with a disability. One was the increasing worldwide political

pressure for both social and economic inclusion of people with a disability,


including those with an intellectual disability. Pressure from various civil

rights groups in addition to international treaties, documents, and local

legislation have provided an increasing demand for supporting equality of

opportunity and non-discriminatory practices in employment. A second im-

perative was the large and increasing numbers of people with a disability—

estimated by the ILO to be approximately 10% of the population. The ILO

noted that whatever the ‘‘head count’’ for the proportion of people with a

disability, the social and economic outcomes have much wider impact.

A third imperative was the considerable cost implications that result from

excluding people with a disability from employment. The ILO argued that,

rather than investing resources in the form of benefits, resources should be

invested in assisting access to employment (Vocational Rehabilitation

Branch–ILO, 1999). Thus, not only does society impact on people with an

intellectual disability, but also excluding such people from employment

impacts the social, economic, and political fabric of society.

The macrosystem in which employment and disability occur reflects con-

cerns with social justice. These concerns have been evident in the rhetoric

adopted by employment-related organizations surrounding the employment

of people with a disability. Organizations, such as the European Trade

Union Committee, International Labour Organisation, and United Nations

Economic and Social Council, have all supported the equalization of oppor-

tunities for people with a disability, including an intellectual disability, in

relation to employment (European Trade Union Committee, 1995; Interna-

tional Labour OYce, United Nations Educational Scientific and Cultural

Organization, & World Health Organization, 1996; United Nations

Economic and Social Council, 1995). The ILO Convention No. 159

(1983a) and ILO Convention 168 (1983b) both support workplace inclusion

for people with a disability. Many of the initiatives important to the ecologi-

cal system in which employment and disability are embedded derive from

human rights’ initiatives at the macrosystem level. Anti-discrimination legis-

lation is an example of such initiatives. For example, the Australian Disabil-

ity Discrimination Act (1992) has been enacted to enforce many of the

human rights obligations endorsed by Australia, and the Americans with

Disabilities Act (1990) has been used in a similar way in the U.S. These

legislations require employers, at the microsystem level of the workplace,

to introduce practices that allow equality in terms of opportunities for

people with a disability. Although anti-discrimination legislation operates

at the macrosystem level and impacts on the lives of people with a disabi-

lity at the microsystem, its implementation was largely due to eVorts by

grass-roots activists operating at the microsystem level. This process de-

monstrates the important interrelationship between diVerent levels of the

ecological system.


Another influence at the macrosystem level, which also has an important

impact at the microsystem level of the workplace, is the increase in

the diversity of the population and subsequently the workforce. The increase

in the ratio of women, immigrants, older workers, and minority groups in the

workplace has resulted in an increased interest in workplace diversity (Bond

& Pyle, 1998; Stoner & Russell-Chapin, 1997). Several authors (Gilbert &

Ones, 1998; Richard, 2000; Williams & Bauer, 1994) have outlined benefits

associated with workplaces in which diversity is well managed. Hicks-Clarke

and Iles (2000) showed that a workplace culture in which diversity was

valued benefited work satisfaction and commitment of the employees. None-

theless, Stoner and Russell-Chapin (1997) argued that, despite greater diver-

sity in the workplace, many employers have not adopted practices to benefit

from this change. Employees with intellectual and other disabilities are part

of a diverse workforce and their work performance has tended to be well

regarded by employers (Hill & Wehman, 1979; Kregel & Unger, 1993;

Ravaud et al., 1992; Reisman & Reisman, 1993). However, for many em-

ployees with a disability the major barrier to successful job performance is a

lack of workplace accommodations that will help them prosper in their job

(Hendricks, 1995; Lunt & Thornton, 1994). In part, this has been recognized

in countries such as Canada, Australia, and the U.S., where the role of the

workplace environment in promoting or impeding successful employment

outcomes has been acknowledged both by the adoption of workplace prac-

tices to accommodate diversity (Bond & Pyle, 1998; Brady, 1996; Iannuzzi,

1997; LiV & Wajcman, 1996; Lynch, 1997; Stoner & Russell-Chapin, 1997)

and by anti-discrimination legislation (e.g., ‘reasonable accommodation’

requirements).

These policies and practices at the cultural and political level, together with

research confirming the satisfactory work performance of employees with a

disability, should have a direct bearing on practices adopted in employment

settings; yet high levels of unemployment for people with a disability suggest

that this outcome has not been achieved. Changes at the macro level that do not

translate to the workplace have been found in relation to anti-discrimination

legislation. For example, a study byTrupin et al. (1997) used data from theU.S.

National Health Interview survey to show that implementation of the Amer-

icans with Disabilities Act (1990) had not been successful in increasing the

employment rate of people with a disability. Similarly, Sidoti (1998), then

Acting Disability Discrimination Commissioner in Australia, commented on

a similar lack of improvement in employment rates following the promulgation

of the Disability Discrimination Act (1992).

Nonetheless, those operating in the workplace have recognized the impor-

tance of macrosystem influences for achieving successful employment out-

comes for people with a disability. In a recent Australian study, Smith (2002)


interviewed 50 managers and supervisors who had employed someone with a

disability (approximately 40% of whom had mental retardation or a learning

disability), and 40 disability employment service providers. The majority

from both respondent groups identified the Disability Discrimination Act

(>70%), had attitudes favoring social justice (>80%), and reflected disability

awareness (>80%) as important for achieving successful employment out-

comes. Thus, even though human rights measures at the macro level may

not have the desired influence on workplace practices, those directly

concerned with achieving successful employment outcomes in the workplace

nonetheless recognized their relevance.

The context in which employment and disability operate is complex, and it

would be naive to expect a direct path from legislation to workplace change.

As Bronfenbrenner (1989) has emphasized, it is the interaction between and

among various ecological factors, rather than a single factor, that influences

behavior. Hence, in addition to an array of changes, which occur at broader

ecological levels, research more directly related to the workplace, including

research that seeks the views of those who operate within the employment

context, would be expected to aVect employment outcomes directly.

II. PRACTICES THAT PROMOTE SUCCESSFUL

EMPLOYMENT OUTCOMES FOR PEOPLE WITH

INTELLECTUAL DISABILITY

A. History of Disability Employment Support

Eligibility for disability employment services in many countries is commonly

established by way of an economic administrative category. Typically, such

systems have in the past ignored the powerful influence of contextual variables

on employment outcomes. However, the development of disability employ-

ment service provision since the 1980s has reflected a more enlightened view,

consistent with an emerging understanding of disability and employment as

complex phenomena, the influences on which are diverse.

In Australia, government funding for competitive employment services

has been available since the introduction of the Disability Services Act

(1986). This funding closely followed mounting international evidence, prin-

cipally from the U.S., supporting positive employment outcomes for people

with a disability (Brolin & Brolin, 1982; Kregel et al., 1990; Rusch &

Hughes, 1990; Wehman, 1988). Employment service provision has emerged

from an early focus on simply matching the individual’s skills to the require-

ments of the job (Brolin & Brolin, 1982; Callahan & Garner, 1997), to more

recent approaches that have increasingly recognized the important interplay


between the individual and the complex network of contextual factors in

which disability and employment are embedded. Initially, if a person had

the skills for the job, they were deemed suitable for the position. Employ-

ment strategies were geared toward training the individual to perform as-

signed tasks at an acceptable rate and quality (Callahan & Garner, 1997).

These strategies were closely aligned to an understanding of disability con-

sistent with the medical model. The focus was on the initial placement of an

individual in a specific job, with an emphasis on fitting the person to the job,

not on changing the workplace environment to accommodate the person.

Training was the domain of the disability employment professional and was

focused on bridging the gap between the skills of the employee and the

demands of the job (Callahan & Garner, 1997; Moon & GriYn, 1988;

Renzaglia & Hutchins, 1988; Rogan et al., 1993).

B. Current Trends in Disability Employment Practices

Subsequent redirection of policies has recognized the relevance of the

workplace environment to achieving successful employment outcomes.

The culture within the workplace has increasingly been viewed as critical

(Callahan & Garner, 1997; Hagner, 1992) and placement practices have

increasingly embraced work-related ancillary skills, such as the ability to

form friendships, to conform to the required rules in the work place, to

interact positively with supervisors and coworkers, and to be able to access

the wider work environment. Such practices have been referred to as achiev-

ing a ‘‘person-environment fit’’ (Calkins & Walker, 1989; Schalock, 1989).

According to this view, not only is it important to be able to perform the

job, it is also important for the employee to feel accepted in the work

environment and to be accepted as a valued staV member (Hagner, 1992).

Person-environment fit places both job skills and social behaviors under

the spotlight; both need to be compatible with the work environment. Social

behaviors of people with an intellectual disability have been considered an

important aspect of successful employment outcomes (Butterworth &

Strauch, 1994; Ferguson et al., 1993; Holmes & Fillary, 2000; Martella

et al., 1993; Salzberg et al., 1986). Butterworth and Strauch (1994) showed

that both task and non-task related social skills contributed to supervisor

and co-worker ratings of the quality of work performance. Nonetheless,

although the social skills and social competence measured were shown as

important to the development of social relationships, the contribution was

small. Physical integration, not social integration, in the workplace was

considered successful for the 98 subjects in the Butterworth and Strauch

(1994) study. Salzberg et al. (1986) identified task-related social skills as

important to entry-level employment. Martella et al. (1993) showed that


individuals with an intellectual disability could be taught certain task-related

social skills (such as asking for assistance) using verbal problem-solving

strategies. Holmes and Fillary (2000) have pointed out that, although casual

workplace interactions are important for social integration, such interac-

tions require complex social skills that typically take years to acquire

through exposure to diVerent social contexts. Therefore, Holmes and Fillary

(2000) advocate that strategies need to be devised to provide this exposure.

Although the importance of social skills places the focus on the individual, it

is, nonetheless, recognition of the need to attend to the interrelationship

between the individual and their environment. In other words, the specific

social skills required to operate within a specific context (e.g., the spec-

ific employment site and specific coterie of coworkers and customers) must

be the focus of any targeted training or support.

Recognizing the importance of the social environment to satisfactory

employment outcomes is consistent with the social model of disability

(Bickenbach et al., 1999; Lunt & Thornton, 1994). Rather than expecting a

person with a disability to fit into a static work environment, there is a

realization that environments can also change to accommodate individual

needs. Employers have become important stakeholders in the development

of placement strategies and, therefore, have become increasingly viewed as

part of the ‘solution’ rather than as ‘barriers’ to eVective employment out-

comes (Flexer et al., 1994). In addition, collaboration with people with a

disability has gained momentum in being considered an important aspect of

employment service provision (European Trade Union Committee, 1995;

Parent et al., 1996). Flannery, Slovic, Treasure, Ackley and Lucas (2002)

argued for the importance of ensuring that people with a disability have the

necessary skills and knowledge to be active partners in identifying their

employment goals and the necessary resources to achieve these goals. Thus,

the importance of sharing responsibility for eVective employment outcomes

between service providers, employers, and employees with a disability has

become evident (Albin, 1992; Fabian et al., 1994). In addition, past reviews

of employment for people with an intellectual disability (Gold, 1973; Kirby,

1997) concluded that more research was needed that involved the employer

and placement agency because both recognized that these people played an

important role in the future employment of people with intellectual disabil-

ities. It has also been argued that these partnerships assist integration and

job tenure (Fabian et al., 1995).

The value of a partnership approach for successful employment outcomes

appears to have gained recognition and widespread acceptance among aca-

demics and policy specialists during the past decade (Albin, 1992; Brooke

et al., 1998; European Trade Union Committee, 1995; Fabian et al., 1995;

Flexer et al., 1994; Kenny, 1995; Mank et al., 1998; Nietupski et al., 1996;


Peterson, 1995; Petty & Fussell, 1997; Rhodes et al., 1991; Stansfeld et al.,

1995; Thornton & Project Team of Experts, 1998; Vocational Rehabilitation

Branch–ILO, 1996). However, despite the changing paradigm within which

academics have viewed employment, changes in employment practices have

been slower. Thus, although collaboration with people with a disability is now

a requirement for services funded under the Australian Disability Services Act

(1986), collaboration with employers has not been a requirement for funding

under this legislation. This is despite the fact that directing responsibility for

successful employment outcomes from disability employment professionals

to employers has been shown to improve job-retention (Fabian et al., 1993).

Involving employers in service provision shifts the role of disability employ-

ment professionals from being the sole provider of services, to one that

facilitates supports in the workplace; disability employment professionals

become consultants to the organization (Trach & Sheldon, 1999).

In addition to concerns about the compatibility of individuals and the

workplace environment (person-environment fit), attention has also been

directed at ensuring that intervention programs are compatible with work-

place environments (Callahan, 1992). This concern with designing program

implementation to be compatible with a range of aspects in the work

environment has been termed ‘‘program-environment’’ fit in the literature

(Calkins & Walker, 1989; Schalock, 1989). Program-environment fit is con-

sistent with the view that no single model of service provision works best.

Rather, intervention programs need to be tailored to specific individuals and

specific work environments (Buckley et al., 1990). Importantly, the recent

literature provides support for positive relations between program-environ-

ment fit and job retention (Calkins & Walker, 1989; Schalock, 1989). Ben-

efits from approaches that actively involve those other than disability

employment professionals (employers and co-workers) in the delivery of

workplace training have been recognized (Callahan, 1992; Fabian et al.,

1995; Hagner et al., 1992; Mank et al., 1998). For example, Mank, O’Neil,

and Jensen (1998) examined the main features of a demonstration project

in the U.S. that resulted in the employment of 55 people with a developmen-

tal disability (95% of whom had an intellectual disability). These 55 employ-

ees had worked an average of 3 years and received 3 times the wage and

benefit outcomes of other nationally supported employees. Mank et al.

(1998) stressed the importance of developing strong relationships between

employers and service providers, in particular the importance of a commit-

ment from managers and coworkers and the active involvement of co-work-

ers in training and supporting employees with a disability. Fabian et al.

(1995) also stressed the importance of a close collaboration between employ-

ers and service providers; they argued that, rather than simply focusing on

an employee’s ability to perform the job, service providers need to also


include the performance of their own service to an employer when assessing

employer satisfaction. Furthermore, Fabian et al. (1995) reasoned that

engaging employers in training their employee with a disability promoted

workplace integration.

Anti-discrimination laws in countries such as Australia, Canada, and the

U.S. place requirements on businesses to make reasonable accommodations

to workplaces, in order to promote equal access to employment opportu-

nities for people with an intellectual and other form of disability. Identifying

and implementing accommodations, in collaboration with employers (an

aspect of program-environment fit), are considered important strategies for

service providers when promoting job retention (Roessler & Rumrill, 1995;

Rumrill et al., 1998; Thornton & Project Team of Experts, 1998).

Recent approaches to employment have focused on identifying variables

important to job retention. For example, job retention and return to work

were the focus of an international research project by Thornton and Project

Team of Experts (1998). This project was a joint initiative of the ILO and the

Global Applied Disability Research and Information Network on Employ-

ment and Training, and involved participants from several countries. These

researchers noted that internationally, largely due to legal and economic

imperatives, the business sector has shown an increased interest in retaining

employees with a disability, including those with a deteriorating mental

condition. This has resulted in businesses developing policies and practices

to minimize turnover of employees with a disability. Thornton and Project

Team of Experts (1998) considered that this level of interest in job retention

was not as strongly embraced by disabled people’s organizations, where

entry to work, rather than job retention, was the overriding concern. The

importance to job retention of involving key players, including employees

with a disability, in the development and implementation of policies and

practices was highlighted by these authors, as was the importance of chang-

ing physical aspects of the workplace and workplace practices to accommo-

date the needs of people with a disability. The ILO has also reinforced

adopting a partnership approach between those operating in the employ-

ment context (the employee with a disability, employers, co-workers, and

service providers) to ensure ongoing support. That is, the environment in

which employment is embedded impacts on employment outcomes.

Because of the dynamic nature of the work environment, including those

operating within the workplace, interactions among variables influencing

employment outcomes will also operate dynamically. It is this changing

nature in the composition of variables operating in the ecological system,

which impacts on employment outcomes for a worker with a disability, and

which highlights the importance of a flexible and long-term approach to

support strategies. Yet little or no research has focused on the dynamic


interplay between variables that aVect employment outcomes of people with

a disability.

The literature reviewed thus far suggests that successful employment out-

comes for workers with an intellectual disability are influenced by both the

interaction of the person with the work environment (person-environment

fit) and the strategies adopted (program-environment fit). In addition to

service provision strategies, which reflect a growing appreciation of the

importance of the environment for achieving successful employment out-

comes, research has also been concerned with the views of employers.

Because of the central decision-making role held by employers, their opi-

nions, attitudes, and behavior toward the employment of someone with a

disability contribute an important influence on the ecological system in

which disability and employment are embedded; an ecological system that

influences whether employment outcomes are successful or not.

C. The Perceptions and Attitudes of Employers

In this section, we shall first overview the literature that has examined the

attitudes and the importance of strategies that promote the job retention of

people with a disability (Vocational Rehabilitation Branch–ILO, 1999).

A recent trend in the disability employment literature has involved a focus

on ‘natural supports’ (Butterworth et al. 1996; Callahan, 1992; Fabian et al.,

1995; GriYn, 1994; Hagner et al., 1995; Mank et al., 1997; Sandow et al.,

1993). Cimera (2001) has argued that definitions of natural supports are

varied and numerous. Butterworth et al. (1996) provided the following

definition of ‘natural supports’: ‘‘Assistance provided by people, procedures,

or equipment in a given workplace that (a) leads to desired personal and

work outcomes, (b) is typically available or culturally appropriate in the

work place, and (c) is supported by resources from within the work place,

facilitated to the degree necessary by human service consultation’’ (p. 106).

Although supports may be considered ‘natural’ to the workplace,

their successful implementation often requires extensive planning (Trach &

Mayhall, 1997; Trach & Sheldon, 1999). Providing ‘natural supports’ for

disability employment can involve: tapping into training that is available to

other employees; training co-workers to train employees with a disability;

partnership development; and the execution of training programs that incor-

porate, as near as practicable, training strategies used in that particular work

environment. By identifying factors and processes that promote successful

employment outcomes, employment programs that encompass the use of

‘natural supports’ take an approach that considers a range of factors in the

context of the workplace. Taking a contextual approach provides a social


perspective to disability employment policy, one that extends the focus

of intervention beyond the individual to the environment in which they

work (Lunt & Thornton, 1994).

A recent study by McHugh et al. (2002) indicated that the use of natural

supports by three job coaches increased workplace integration for each of

three targeted employees with a developmental disability (one per job

coach). This study comprised: training the job coaches to implement a range

of natural support strategies; recording the use of natural support strategies;

using the Vocational Integration Index to record indicators of vocational

integration; and using a social validation assessment instrument to record

the views of the employer on four questions related to social integration in

the workplace. Although the social validation assessment returned mixed

results, the Vocational Integration Index showed a general increase in all

four areas of vocational integration, with all three employees showing an

increase in the area of employee benefits.

The notion that ‘natural supports’ can facilitate employment outcomes for

people with a disability is consistent with research by Mank et al. (1998),

which has demonstrated the important relationship between workplace

practices and employment outcomes. As mentioned previously, employment

outcomes in this program showed 3-year average job tenure and three times

the wage levels of the average competitive employment placement. Charac-

teristics of their employment program included: co-worker involvement in

the design and delivery of supports; partnership development; a workplace

culture that valued and managed diversity; and long-term support. Of the 55

participants in this program, 34 with a developmental disability continued to

receive long-term support.

Post-placement support has been considered an important component of

service delivery for promoting job retention (Brooke et al., 1998; Rumrill

et al., 1998) and career advancement (Brooke et al., 1998). These authors

(Brooke et al., 1998; Rumrill et al., 1998) also recognized the importance

of within the general population of employers, some of whom have em-

ployed people with a disability, before proceeding to the literature that has

specifically targeted attitudes of employers who have used a disability em-

ployment service. Overall, this literature suggests that many factors interact

in aVecting employers’ attitudes.

Russell (International Labour Organisation Report, 1998) has argued that

inappropriate information has contributed to prejudicial attitudes among

employers about people with a disability. Both disability employment pro-

fessionals and employers have identified disability awareness training as an

important strategy in improving the employment outcomes of people with a

disability (Smith, 2002).


Tse (1994) sought the views of 38 employers in Hong Kong who had

employed someone with a mild intellectual disability. Tse reported that the

majority of these employees had received some training since commencing

work, but had been given no additional support. The employers’ expecta-

tions for employees with an intellectual disability had been met or exceeded

in all but 5 of the 25 performance areas rated. Although performance by

workers with mental retardation was significantly higher in seven areas,

including speed, reliability, and willingness to work hard, the wage earned

by these employees was 30% less than co-workers without a disability

performing similar work. Tse suggested that although lower wages in some

circumstances could result from lower productivity rates, the lower wages

reported here reflected discrimination against employees with an intellectual

disability, given that employers indicated that the productivity of mentally

retarded workers was adequate.

A range of variables has been found to influence employers’ attitudes

toward employing someone with a disability. For example, the existence of

policies on employing someone with a disability (Jones et al., 1991); higher

levels of education among managers, having a female manager, and/or being a

public sector employer (Levy et al., 1992); previous contact with a person with

a disability, and level of disability (mild, not moderate intellectual disability)

(Rimmerman, 1998) have all been associated with more favorable attitudes

toward the employment of people with a disability. However, the influence

of some variables has not been consistent across studies. Thus, whereas Levy

et al. (1993) and Rimmerman (1998) found that larger organizations held

more positive attitudes, this was not the case in a study by Kregel and

Tomiyasu (1994). Furthermore, previous contact with people with a disability

was found to be a predictor of favorable attitudes by Rimmerman (1998) but

not by Florey and Harrison (2000) or by Levy et al. (1992). This inconsistency

between studies suggests the importance of the interplay between contextual

variables. That is, ‘predictors of favorable attitudes’ do not operate in

isolation; rather, they are in turn subject to influences from other variables

operating within the employment context.

Nonetheless, one variable appears more reliable when predicting employ-

ers’ favorability in attitude toward employees with an intellectual or

other disability, namely, previous positive experience with a person with a

disability that is work-related (Levy et al., 1992, 1993; Rimmerman, 1998;

Smith, 2002). This suggests that experience with just one employee with an

intellectual disability can impact the future employment opportunities

of others with an intellectual disability, and highlights the importance of

working with employers to ensure their satisfaction with an employment

outcome.


D. Employer Satisfaction With Work Performance

Although positive experience in employing someone with a disability

appears to be an important determinant of positive employer attitudes

toward other people with a disability, little research has examined the eVect

of diVerent aspects of the employees’ work behaviors on employer satisfac-

tion. Furthermore, much of the research related to employment outcomes

for people with a disability has tended to focus on practices at just one

specific level of the ecological system—such as the workplace environment—

rather than take a broader ecological approach. Recently, Smith (2002) used

Bronfenbrenner’s (1989) ecological systems theory as a framework for ar-

ticulating how variables internal and external to the workplace environment

might influence employment outcomes. Smith’s work comprised two major

studies: one that explored variables within the workplace (e.g., speed/rate

or work) important to employer satisfaction (Smith et al., in press), and one

that identified contextual factors (e.g., community attitudes) important to

successful employment outcomes (Smith, 2002).

Smith et al. (in press) examined questionnaire responses from 656 employ-

ers, each of whom had employed a person with a disability, using the services

of a disability employment agency. Approximately 47% of these employers

employed a person with an intellectual or learning disability. Comparing the

employer ratings on employer satisfaction and work performance between

employees with and without a disability yielded three interesting findings.

First, employers rated employees with a disability significantly lower than

other employees on employer satisfaction and on each of three work perfor-

mance variables tested. The variables represented were: work performance;

speed/rate and accuracy/quality of work, and workplace climate (an amalgam

variable that included work group eYciency, supervisor eYciency, impact on

workplace morale, behavior of co-workers, inclusion in team, consistency of

work behavior, and stability of social behavior). Second, although all three

work performance variables influenced employer satisfaction with employees

with adisability, onlyworkplace climate influenced employer satisfactionwith

other employees. Third, employers were more satisfied with employees with a

disability than other employees in relation to the three variables representing

work performance. Taken together, these findings suggest that employers

have diVerent expectations for their employees with a disability than for other

employees. This highlights the complex interplay between variables at the

microsystem level of the workplace in determining employer satisfaction.

Although reasons for diVerences in the relative eVect of the work perfor-

mance variables could not be identified, Smith et al. (in press) and colleagues

speculated that the employers’ expectations and concerns could be responsible.


This would be consistent with work by Nietupski et al. (1996), who iden-

tified a lack of necessary work skills among people with a disability as an

important concern to potential employers.

Finding that the same determinants of employer satisfaction are not

common to all employees has important practical implications for service

provision, and supports the view that employer satisfaction is sensitive to a

complex interplay between factors that occur within the microsystem of the

workplace. The study by Smith and colleagues (in press) compared two

groups of employees: those with and those without a disability. An earlier

study by Salzberg et al. (1986) was concerned with the diVerences in deter-

minants of successful employment outcomes for employees with an intellec-

tual disability in diVerent kinds of jobs. These researchers reported

diVerences in the relative importance of certain work behaviors between

diVerent job types. They suggested that such diVerences were related to the

perceived importance of these behaviors to employee productivity.

Smith (2002) also investigated whether the employers’ perceptions of job-

match aVected employer satisfaction. Path analysis showed that job-match

had both a direct eVect and an indirect eVect on employer satisfaction

(through the three work performance variables previously described for

Smith et al. (in press)). Second, almost all employers who rated their satis-

faction with their employee with a disability as equal to or higher than their

satisfaction with other employees, identified their employee with a disability

as well matched to the job.

The finding that the employers’ perceptions of job-match were related

to their satisfaction has important implications for service provision. If the

goal is to achieve positive employment outcomes, then involving employers

in decisions relating to the job-match process, so that a positive perception

of job-match is developed and maintained, should help to support this goal.

Results from the Smith (2002) analysis were consistent with the literature

previously described that has recognized the importance of employer

participation in achieving successful employment outcomes (Albin, 1992;

Brooke et al., 1998; European Trade Union Committee, 1995; Fabian

et al., 1995; Kenny, 1995; Mank et al., 1998; Nietupski et al., 1996; Peterson,

1995; Petty & Fussell, 1997; Rhodes et al., 1991; Stansfeld et al., 1995;

Thornton & Project Team of Experts, 1998; Vocational Rehabilitation

Branch–ILO 1996).

In response to the question as to whether employer satisfaction with

employees with a disability aVected future hiring intentions toward other

people with a disability, Smith (2002) found that, when employers rated their

employee with a disability higher or at the same level as other employees

on employer satisfaction, they were much more likely to report an intention

to employ a person with a disability in the future than employers who rated


employees with a disability lower on employer satisfaction. This finding

is consistent with previous research linking a positive work-related experi-

ence when employing someone with a disability with the employers’ favor-

able attitudes (Diksa & Rogers, 1996; Florey & Harrison, 2000; Levy, 1992,

1993; Rimmerman, 1998). This suggests that the employers’ positive experi-

ences with one employee with a disability can aVect the future employment

intentions for other people with a disability.

This generalization from past experience to future intention to employ

someone implies that many employers are treating people with a disability as

an homogenous group. This has serious implications for service provision,

suggesting that when employers are less satisfied with their employee with a

disability than with their other employees, the employment opportunities for

other people with a disability are aVected. Thus, unfair discrimination

against other people with a disability in their employment endeavor is a

possible outcome. Millington et al. (2000) have warned against this possibil-

ity, emphasizing, that ‘‘unfair discrimination is the logical interpretation of

biased values attached to the job candidate’’ (p. 42).

A second study by Smith (2002) sought the views of employers and service

providers on aspects important to employment outcomes for people with a

disability. An ecological framework was used to interpret data from the

following three sources: (1) interviews with 50 disability employers (employ-

ers who had employed a person with a disability through a disability

employment service, 40% of whom had employed someone with an intellec-

tual disability or a learning disability); (2) interviews with 40 disability

employment service professionals; and (3) survey responses from 36 non-

disability employers (employers who had not employed someone with a

disability) to open-ended questions.

Two thematic analyses were undertaken to identify the importance of

factors at the levels of the micro-, meso-, exo-, and macro-systems. The

first was based on interviews with disability employers and service providers.

Interviewees identified characteristics at the micro, meso, exo, and macro

levels that they considered important for successful employment outcomes.

Smith (2002) found support for the impact of context on concern. Service

providers, whose involvement with employees with a disability extends

beyond the workplace, were more attuned than employers to aspects exter-

nal to the workplace that can aVect successful employment outcomes, such

as access to support services and education. Nonetheless, both employer and

union organizations have emphasized these broader concerns. For example,

an International Labour OYce report by Russell (1998) argued that a lack of

appropriate skills (academic and practical), rather than ‘‘inherent capacity,’’

prevented people with a disability, including those with an intellectual

disability, from achieving successful employment outcomes. The European


Trade Union Committee (1995) advocated the importance of broader eco-

logical factors in promoting successful employment outcomes for people

with a disability. In addition to aYrming the importance of relevant experi-

ence and qualifications in achieving economic and social integration, the

European Trade Union Committee also identified other factors, such as

adequate housing and transport.

Using an ecological framework provided Smith (2002) with a model for

understanding the similarities and diVerences in the responses of service

providers and disability employers. Nonetheless, the model could not ex-

plain why the majority of disability employers, but not service providers,

identified ‘relationships between employers and service providers’ as impor-

tant. This relationship occurs in the work environment—the microsystem

common to both respondents. Smith (2002) suggested that this unexplained

discrepancy could indicate that service providers were underestimating

the importance of their services to employers. Consistent with this interpre-

tation, a study by Fabian et al. (1995) also found that employers placed

greater emphasis on the importance of service provision than service pro-

viders themselves. Because service providers support work performance,

a behavior shown as important to employer satisfaction (Smith et al., in

press), service providers, in undervaluing the importance of their services to

employers, might be missing worthwhile opportunities for promoting

successful employment outcomes.

The second thematic analysis used the views of three groups of respon-

dents—two groups of employers (disability employers and non-disability

employers) and one group of disability employment service providers—to

analyze the barriers to successful employment outcomes and detail possible

strategies for achieving successful employment outcomes for people with a

disability. Considerably more employers (both employer groups) than ser-

vice providers identified ‘resources/costs’ as a barrier, and the importance of

service provider strategies, in particular job-match, to successful employ-

ment outcomes. This diVerence in the importance of service provider strate-

gies further supported the view that service providers can underestimate the

importance of services that they can oVer employers.

Using an ecological framework highlights the importance of attending to

the perspectives of others in the ecological system. Although somewhat

broader than the partnership approach between employers, service provi-

ders, and employees with a disability as advocated by Fabian et al. (1994),

an ecological approach is nonetheless consistent with a partnership ap-

proach because it highlights the contribution that interrelationships between

those operating at diVerent levels of the ecological system can make to

employment outcomes. Importantly, an ecological framework allows com-

plex information to be interpreted and subsequently used for augmenting


successful employment outcomes. Furthermore, using an ecological frame-

work draws attention to the dynamic nature of the interplay that occurs

between the many factors, internal and external to the workplace, which

influence employment outcomes. Thus, the Smith studies (2002, in press)

have highlighted the importance of attending to aspects in the workplace

and in the broader environment for achieving successful employment

outcomes.

III. MAXIMIZING THE ACHIEVEMENT OF SUCCESSFUL

EMPLOYMENT OUTCOMES: FUTURE DIRECTIONS

Examining employment outcomes within an ecological framework has

drawn attention to the complexities involved when considering the variables,

both internal and external to the work environment, that impact employ-

ment for people with an intellectual disability. An understanding of this

complexity is necessary in order to maximize the eVectiveness of strategies

and policies aimed at promoting successful employment outcomes. Further-

more, in highlighting the dynamic nature of the interplay between indivi-

duals and environments in which they operate, the literature reviewed here

suggests that achieving successful employment outcomes requires ongoing

monitoring of service delivery and its influence on outcomes, and an appre-

ciation of the interplay of variables in the ecological system that contribute

directly and indirectly to this outcome.

Not only are the diVerent contexts in which employment occurs dynamic,

employment aspirations of employees are also inclined to be dynamic. That is,

what constitutes a successful employment outcome for an individual can diVer

across time. The ILO argued that merely concentrating on job acquisition does

not meet the employment needs of those who have a disability. Job security and

career advancement need to be on the agenda (Vocational Rehabilitation

Branch–ILO, 1996). The ILO has argued that ensuring that workers who have

a disability have the same opportunities for career advancement as other work-

ers has received little attention from policy makers. Yet the issue of equal career

prospects is a requirement under the ILO Convention 159 (Vocational Reha-

bilitationBranch–ILO, 1996). Themajor focus of policymakers concernedwith

employment prospects for people with an intellectual disability has been place-

ment in employment, with little attention beyond job acquisition. For many

people who have a disability, employment access and career advancement are

elusive goals without the appropriate support mechanisms in place; yet such

mechanisms require funding. Ensuring equal opportunity in employment is a

social justice commitment, but the realization of the commitment is an

economic issue.


The literature reviewed herein underscores the importance of coordinated

and multi-pronged approaches to service provision that target diVerent levels

of the ecological system, including those who operate within them. Yet

research in this area is of little more than academic interest without the

practical application of this knowledge. However, much of the practical

application is dependent on adequate resourcing. In many Western countries

a large proportion of the funding related to successful employment outcomes,

such as funding for disability employment service provision, education,

and disability awareness, is government funding. Governments, however,

have both economic and social responsibilities towards the community

(Saltmarsh, 1994). These responsibilities can be influenced by conflicting

ideologies that need to be recognized. Although most governments are

committed to human rights values, tensions exist between these values and

economic rationalist policies (Saltmarsh, 1994). Ling (1999) has recently

suggested that tensions between the overt and covert goals of government

create diYculties for practitioners in the disability sector.

Tensions between social justice and economic rationalist paradigms are

just part of the wider environment in which employment and disability

operate (Smith et al., in press). The existence of these tensions highlights

the importance of recognizing interrelationships between the levels of the

ecological system. Merely identifying factors of relevance to employment

outcomes without considering the often-complex nature of the interplay

between factors, can reflect a simplistic and distorted picture of the environ-

ment in which disability and employment operate. Maximizing successful

employment outcomes is fraught with many challenges. Not only is attention

required to all levels of the ecological system in creating an environment that

supports positive employment outcomes, but also service providers must be

cognizant of factors important to this goal and negotiate a path relevant to

the employment aspirations of specific individuals with a disability, includ-

ing persons with an intellectual disability. Not only will factors important to

this goal diVer between individuals, settings, and prevailing cultures, but

these factors will fluctuate across time. For example, the literature reviewed

herein has highlighted the importance of flexible and long-term planning

approaches that account for changing goals and circumstances.

IV. CONCLUSIONS

The literature reviewed herein attests to the wide acceptance of the impor-

tance of achieving successful employment outcomes, and identifies a range of

factors that can influence this goal. Nonetheless, literature on the low rates

of employment for people with an intellectual disability also confirms the

inadequacy of current measures employed toward this goal. Bronfenbrenner


(1989) has argued for the importance of considering not just the impact of

specific variables on development, but also the eVect of the interplay between

these variables. Although Bronfenbrenner’s focus was on child development,

Smith (2002) showed Bronfenbrenner’s theory to be applicable when inter-

preting the influence of an array of factors across the ecological system on

employer satisfaction with employees with a disability, including a high

proportion with an intellectual disability. The importance of measures, both

internal and external to the workplace, in improving employment outcomes

has been recognized (European Trade Union Committee, 1995; Russell, 1998;

Smith, 2002). Yet research on employment and disability and subsequent

recommendations for improving employment outcomes, have tended to tar-

get specific levels of the ecological system, usually, the employment setting, or

disability service provision, rather than taking a multi-level approach.

The literature reviewed herein has depicted disability and employment as

dynamic and complex phenomena with diverse influences. The future chal-

lenge for the disability employment sector is to consider ways in which these

complex phenomena intersect, and how to work with this complexity to

achieve successful employment outcomes, not only for specific individuals,

but also for people with a disability in general. Scrutinizing disability and

employment within an ecological framework provides a means for clarifying

and interpreting complex information, and highlights the importance

of interrelationships both within and between the diVerent ecological levels,

including those who operate within these levels. Both this framework and the

literature reviewed uphold the importance of ensuring interrelationships

between all stakeholders involved in the employment area. These interrela-

tionships are important for the development of negotiated strategies based

on shared goals and commitments. In achieving successful employment

outcomes for people with an intellectual disability, service providers are

faced with challenges that are both exciting and considerable. Strategies

and information that can assist service providers to understand the

many layers of complexity that can impact on employment outcomes are

important in surmounting this challenge.

REFERENCES

Albin, J. (1992). Quality improvement in employment and other human services: Managing for

quality through change. Baltimore, MD: Paul H. Brookes.

Albrecht, G., & Bury, M. (2001). The political economy of the disability marketplace. In G.

Albrecht, K. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp. 585–609).

Thousand Oakes, CA: Sage.

Albrecht, G., Seelman, K., & Bury, M. (2001). Introduction: The formation of disability

studies. In G. Albrecht, K. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp.

1–8). Thousand Oakes, CA: Sage.


Alston, P. (1995). Disability and the International Covenant on Economic, Social, and Cultural

Rights. In T. Degener & Y. Koster-Dreese (Eds.), Human rights and disabled persons:

Essays and relevant human rights instruments (pp. 94–105). The Netherlands: Kluwer

Academic.

Altman, B. (2001). Disability definitions, models, classification schemes, and applications. In

G. Albrecht, K. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp.

97–122). Thousand Oakes, CA: Sage.

American Association on Mental Retardation (2002). Mental retardation: Definition,

classification and systems of support (10th ed.). Washington, DC: Author.

Australian Institute of Health and Welfare (1999). Australia’s welfare 1999: Services and

assistance. Canberra: Australia Government.

Barnes, C. (1998). The social model of disability: A sociological phenomenon ignored by

sociologists? In T. Shakespeare (Ed.), The disability reader: Social science perspectives (pp.

65–78). London: Cassell.

Beresford, P. (1996). Poverty and disabled people: Challenging dominant debates and policies.

Disability and Society, 11, 553–567.

Bickenbach, J. (1996). Economic self-suYciency and people with disabilities. Paper presented at

the Rehabilitation International Meeting, Aukland.

Bickenbach, J., Chatterji, S., Badley, E., & Ustun, T. (1999). Models of disablement,

universalism, and the international classification of impairments, disabilities, and

handicaps. Social Science and Medicine, 48, 1173–1187.

Bond, M., & Pyle, J. (1998). The ecology of diversity in organizational settings: Lessons from a

case study. Human Relations, 51, 589–624.

Brady, T. (1996). The downside of diversity. HR Focus, 73, 22–23.

Braddock, D., & Parish, S. (2001). An institutional history of disability. In G. Albrecht, K.

Seelman, & M. Bury (Eds.), Handbook of disability studies (pp. 11–68). Thousand Oakes,

CA: Sage.

Brolin, D., & Brolin, J. (1982). Vocational preparation of persons with handicaps. Ohio: Charles

E Merrill.

Bronfenbrenner, U. (1989). Ecological systems theory. Annals of Child Development, 6, 187–249.

Brooke, V., Revell, G., & Green, H. (1998). Long-term supports using an employee-directed

approach to supported employment. The Journal of Rehabilitation, 64 [On-line]. Available:

Expanded Academic, Melbourne.

Buckley, J., Mank, D., & Sandow, D. (1990). Developing and implementing support strategies.

In F. R. Rusch (Ed.), Supported employment: Models, methods and issues. Sycamore, IL:

Sycamore.

Butterworth, J., Hagner, D., Kiernan, W., & Schalcock, R. (1996). Natural supports in the

workplace: Defining an agenda for research and practice. Journal of the Association for

Persons with Severe Handicaps, 21, 103–113.

Butterworth, J., & Strauch, J. (1994). The relationship between social competence and success in

the competitive workplace for persons with mental retardation. Education and Training in

Mental Retardation and Developmental Disabilities, 29, 118–133.

Calkins, C., & Walker, H. (1989). Enhancing employment outcomes through habilitation

planning. In W. Kiernan & R. Schalock (Eds.), Economics, industry, and disability: A look

ahead. Baltimore, MD: Paul H. Brookes.

Callahan, M. (1992). Job site training and natural supports. In J. Nisbet (Ed.), Natural supports

in school, at work, and in the community for people with disabilities. Baltimore, MD: Paul

H. Brookes.

Callahan, M., & Garner, J. (1997). Keys to the workplace: Skills and supports for people with

disabilities. Baltimore, MD: Paul H. Brookes.


Carney, T. (2000). Disability and social security: Compatible or not? Paper presented at the

‘Constructing Law and Disability’ conference, December 2000. Canberra, Australia.

Cimera, R. (2001). Utilizing co-workers as ‘natural supports’: Evidence on cost eYciency, job

retention, and other employment outcomes. Journal of Disability Policy Studies, 11,

194–201.

Diksa, E., & Rogers, S. (1996). Employer concerns about hiring persons with psychiatric

disability: Results of the Employer Attitude Questionnaire. Rehabilitation Counselling

Bulletin, 40, 31–44.

Eggleton, I., Robertson, S., Ryan, J., & Kober, R. (1999). The impact of employment on the

quality of life of people with an intellectual disability. Journal of Vocational Rehabilitation,

13, 95–107.

European Trade Union Committee (1995). The employment of disabled people. Trade Union

Draft Document.

Fabian, E., Elderman, A., & Leedy, M. (1993). Linking workers with severe disabilities to social

supports in the workplace: Strategies for addressing barriers. Journal of Rehabilitation, 58,

29–34.

Fabian, E., Luecking, R., & Tilson, G. (1994). A working relationship: The job development

specialist’s guide to successful partnerships with business. Baltimore, MD: Paul H. Brookes.

Fabian, E., Luecking, R., & Tilson, G. (1995). Employer and rehabilitation personnel

perspectives on hiring persons with disabilities: Implications for job development. Journal

of Rehabilitation, 61, 42–49.

Ferguson, B., McDonnell, J., & Drew, C. (1993). Type and frequency of social interaction

among workers with and without mental retardation. American Journal on Mental

Retardation, 97, 530–540.

Flannery, K., Slovic, R., Treasure, T., Ackley, D., & Lucas, F. (2002). Collaboration and

partnership to improve employment outcomes. Journal of Vocational Rehabilitation, 17,

207–215.

Flexer, R., Goebel, G., Baer, R., Simmons, T., Martonyi, E., Shell, D., Steele, R., & Sabouski, R.

(1994). Participant, employer, and rehabilitation resources in supported employment:

A collaborative support approach. Journal of Applied Rehabilitation Counseling, 25, 9–15.

Florey, A., & Harrison, D. (2000). Responses to informal accommodation requests from

employees with disabilities: Multistudy evidence of willingness to comply. Academy of

Management Journal, 43, 224–233.

Gilbert, J., & Ones, D. (1998). Role of informal integration in career advancement:

Investigation in plural and multicultural organizations and implications for diversity

valuation [electronic version]. Sex Roles: A Journal of Research, 39.

Gold, M. (1973). Research on the vocational habilitation of the retarded: The present, the

future. International Review of Research in Mental Retardation, 12, 97–147.

GriYn, C. (1994). Organizational natural supports: The role of leadership in facilitating

inclusion. Journal of Vocational Rehabilitation, 4, 296–307.

Hagner, D. (1992). The social interactions and job supports of supported employees. In

J. Nisbet (Ed.), Natural supports in school, at work, and in the community for people with

disabilities. Baltimore, MD: Paul H. Brookes.

Hagner, D., Butterworth, J., & Keith, G. (1995). Strategies and barriers in facilitating natural

supports for employment of adults with severe disabilities. Journal of the Association for

Persons with Severe Handicaps, 20, 110–120.

Hagner, D., Rogan, P., & Murphy, S. (1992). Facilitating natural supports in the workplace.

Journal of Rehabilitation, 58, 29–34.

Hendricks, A. (1995). The significance of equality and non-discrimination for the protection of

the rights and dignity of disabled persons. In T. Degener & Y. Koster-Dreese (Eds.),


Human rights and disabled persons: Essays and relevant human rights instruments (pp.

40–62). The Netherlands: Kluwer Academic.

Hicks-Clarke, D., & Iles, P. (2000). Climate for diversity and its eVects on career and

organisational attitudes and perceptions. Personnel Review, 29, 324–345.

Hill, M., & Wehman, P. (1979). Employer and nonhandicapped co-worker perceptions

ofmoderately and severely retardedworkers.Journal of Contemporary Business, 8, 107–112.

Holmes, J., & Fillary, R. (2000). Handling small talk at work: Challenges for workers with

intellectual disabilities. International Journal of Disability, Development and Education, 47,

273–291.

Iannuzzi, J. (1997). Reaping diversity’s competitive rewards. Business Forum, 22, 4–5.

International Labour OYce, United Nations Educational Scientific and Cultural Organization,

and World Health Organization (1996). Multisectoral collaboration for the equalization of

opportunities for people with disabilities. Post-conference document based on a background

paper prepared for the ‘Subregional seminar for the promotion of multisectoral

collaboration for the benefit of disabled persons’. Geneva: International Labour OYce,

United Nations Educational Scientific and Cultural Organisation, and World Health

Organization.

International Labour Organization (1983a). Convention concerning vocational rehabilitation and

employment (disabled persons). Convention No. 159. Adopted on June 1, 1983 by the

General Conference of the International Labour Organisation.

International Labour Organization (1983b). Recommendation concerning vocational rehabilita-

tion and employment (disabled persons). Recommendation No. 168. Adopted on June 1,

1983 by the General Conference of the International Labour Organisation.

Jones, B. J., Gallagher, B. J., III, Kelley, J. M., & Massari, L. O. (1991). A survey of Fortune

500 corporate policies concerning the psychiatrically handicapped. Journal of Rehabilita-

tion, 57, 31–35.

Kenny, D. (1995). Common themes, diVerent perspectives: A systematic analysis of employer-

employee experiences of occupational rehabilitation. Rehabilitation Counseling Bulletin,

39, 54–77.

Kirby, N. (1997). Employment and mental retardation. International Review of Research and

Mental Retardation, 20, 191–243.

Kregel, J., & Tomiyasu, Y. (1994). Employers’ attitudes toward workers with disabilities: EVect

of the Americans with Disabilities Act. Journal of Vocational Rehabilitation, 4, 165–173.

Kregel, J., & Unger, D. (1993). Employer perceptions of the work potential of individuals with

disabilities. Journal of Vocational Rehabilitation, 3, 17–25.

Kregel, J., Wehman, P., Revell, W., & Hill, M. (1990). Supported employment in Virginia. In F. R.

Rusch (Ed.), Supported employment: Models, methods and issues. Sycamore, IL: Sycamore

Co.

Levy, J., Jessop, D., Rimmerman, A., & Levy, P. (1992). Attitudes of Fortune 500 corporate

executives toward the employability of persons with severe disabilities: A national study.

Mental Retardation, 30, 67–75.

Levy, J., Jessop, D., Rimmerman, A., Francis, F., & Levy, P. (1993). Determinants of attitudes

of New York state employers toward the employment of persons with severe handicaps.

Journal of Rehabilitation, 59, 49–54.

LiV, S., & Wajcman, J. (1996). ‘Sameness’ and ‘diVerence’ revisted: Which way forward for

equal opportunity initiatives? Journal of Management Studies, 33, 79–94.

Ling, L. (1999). Disability in Australia: Policy and practice. In P. Retish & S. Reiter (Eds.),

Adults with disabilities: International perspectives in the community. Mahwah, NJ:

Lawrence Erlbaum Associates.


Lunt, N., & Thornton, P. (1994). Disability and employment: Toward an understanding of

discourse and policy. Disability and Society, 9, 223–238.

Lynch, F. (1997). The diversity machine. Society, 34, 32–44.

Mank, D., CioY, A., & YovanoV, P. (1997). Patterns of support for employees with severe

disabilities. Mental Retardation, 35, 433–447.

Mank, D., O’Neill, C., & Jensen, R. (1998). Quality in supported employment: A new

demonstration of the capabilities of people with severe disabilities. Journal of Vocational

Rehabilitation, 11, 83–95.

Marks, D. (1999). Disability: Controversial debates and psychosocial perspectives. London:

Routledge.

Martella, R., Marchand-Martella, N., & Agran, M. (1993). Using a problem-solving strategy to

teach adaptability skills to individuals with mental retardation. Journal of Rehabilitation,

58, 55–60.

McHugh, A., Storey, K., & Certo, N. (2002). Training job coaches to use natural support

strategies. Journal of Vocational Rehabilitation, 17, 155–163.

Millington, M., Leierer, S., & Abadie, M. (2000). Validity and the Employment Expectation

Questionnaire: Do disability-related attitudes aVect employment selection outcomes?

Rehabilitation Counseling Bulletin, 44, 39–47.

Moon, S., & GriYn, S. (1988). Supported employment and service delivery models. In P.

Wehman & S. Moon (Eds.), Vocational rehabilitation and supported employment.

Baltimore, MD: Paul H. Brookes.

Nietupski, J., Hamre-Nietupski, S., VanderHart, N., & Fishback, K. (1996). Employer

perceptions of the benefits and concerns of supported employment. Education and Training

in Mental Retardation and Developmental Disabilities, 31, 310–323.

O’Day, B., & Berkowitz, M. (2001). Can we improve the return to work record? In G. Albrecht,

K. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp. 585–609). Thousand

Oakes, CA: Sage.

Oliver, M. (1990). The politics of disablement: A sociological approach. New York, NY: St.

Martin’s Press.

Parent, W., Kregel, J., & Johnson, A. (1996). Consumer satisfaction: A survey of individuals

with severe disabilities who receive supported employment services. Focus on Autism and

other Developmental Disabilities, 11, 207–216.

Peterson, M. (1995). Ongoing employment supports for persons with disabilities: An

exploratory study. Journal of Rehabilitation, 61, 58–67.

Petty, M., & Fussell, E. (1997). Employer attitudes and satisfaction with supported

employment. Focus on Autism and other Developmental Disabilities, 9, 15–22.

Ravaud, J., Madiot, B., & Ville, I. (1992). Discrimination toward disabled people seeking

employment. Social Science & Medicine, 35, 951–958.

Ravaud, J., & Stiker, H. (2001). Inclusion/exclusion: An analysis of historical and cultural

meanings. In G. Albrecht, K. Seelman, & M. Bury (Eds.), Handbook of disability studies

(pp. 491–512). Thousand Oakes, CA: Sage.

Reisman, S., & Reisman, J. (1993). Supervision of employees with moderate special needs.

Journal of Learning Disabilities, 26, 199–206.

Renzaglia, A., & Hutchins, M. (1988). A community-referenced approach to preparing persons

with disabilities for employment. In P. Wehman & S. Moon (Eds.), Vocational

rehabilitation and supported employment. Baltimore, MD: Paul H. Brookes.

Rhodes, L., Sandow, L., Mank, D., Buckley, J., & Albin, J. (1991). Expanding the role of

employers in supported employment. Journal of the Association for Persons with Severe

Handicaps, 16, 213–217.


Richard, O. (2000). Racial diversity, business strategy, and firm performance: A resource-based

view. Academy of Management Journal, 43, 164–177.

Rimmerman, A. (1998). Factors relating to attitudes of Israeli corporate executives toward the

employability of persons with intellectual disability. Journal of Intellectual and

Developmental Disability, 23, 245–254.

Rogan, P., Hagner, D., & Murphy, S. (1995). Natural supports: Promoting reasonable

accomodations: An essential employment service. Journal of Applied Rehabilitation

Counseling, 24, 3–7.

Roessler, R., & Rumrill, P. (1995). Promoting reasonable accomodations: An essential

employment service. Journal of Applied Rehabilitation Counseling, 26, 3–7.

Rumrill, P., Roessler, R., Battersby-Longden, J., & Schuyler, B. (1998). Situational assessment

of the accommodation needs of employees who are visually impaired. Journal of Visual

Impairment and Blindness, 92, 42–54.

Rusch, F., & Hughes, C. (1990). Historical overview of supported employment. In F. R. Rusch

(Ed.), Supported employment: Models, methods, and issues. Sycamore, IL: Sycamore.

Russell, C (1998). Education, employment and training policies and programmes for youth with

disabilities in Denmark, Germany, Spain, and the United Kingdom. Report for the

International Labour OYce.

Saltmarsh, D. (1994). Economic rationalism or something else? Labour market intervention and

workers with disabilitiesAustralian Disability Review, 2, 3–11.

Salzberg, C., Agran, M., & Lignugaris/Kraft, B. (1986). Behaviors that contribute to entry-level

employment: A profile of five jobs. Applied Research in Mental Retardation, 7, 299–314.

Sandow, D., Olson, D., & Yan, X. (1993). The evolution of support in the workplace. Journal of

Vocational Rehabilitation, 3, 30–37.

Schalock, R. (1989). Person-environment analysis: Short- and long-term perspective. In F. R.

Rusch (Ed.), Supported employment: Models, methods and issues. Sycamore, IL: Sycamore.

Schriner, K. (2001). A disability studies perspective on employment issues and policies for

disabled people. In G. Albrecht, K. Seelman, & M. Bury (Eds.), Handbook of disability

studies (pp. 642–662). Thousand Oakes, CA: Sage Publications.

Shakespeare, T. (1998) (Ed.). The disability reader: Social science perspectives. London: Cassell.

Shakespeare, T., & Watson, N. (2000). The social model of disability: An outdated ideology?

Unpublished manuscript.

Sidoti, C. (1998). The DDA and employment of people with a disability. Paper presented by the

Human Rights Commissioner and Acting Disability Discrimination Commissioner to the

South Australia Employment Placement Association.

Smith, K. (2002). Employer satisfaction with employers with a disability. Unpublished doctoral

dissertation, Deakin University, Melbourne.

Smith K., Webber L., GraVam J., & Wilson C. (in press). Employer satisfaction with employees

with a disability comparisons with other employees. Journal of Vocational Rehabilitation.

Stansfeld, S., Feeney, A., Head, J., Canner, R., North, F., & Marmot, M. (1995). Sickness

absence for psychiatric illness: The Whitehall 11 study. Social Science Medicine, 40,

189–197.

Stoner, C., & Russell-Chapin, L. (1997). Creating a culture of diversity management: Moving

from awareness to action. Business Forum, 22, 6–12.

Thornton, P., & Project Team of Experts (1998). International research project on job retention

and return to work: Strategies for disabled workers: Key issues. Geneva: International

Labour OYce.

Trach, J., & Mayhall, C. (1997). Analysis of the types of natural supports utilized during job

placement and development. The Journal of Rehabilitation, 63, 43–48.


Trach, J., & Sheldon, D. (1999). Natural supports as a foundation for supports-based

employment development and facilitation. American Rehabilitation, 25, 2–7.

Trupin, L., Sebesta, M., Yellin, E., & LaPlante, M. (1997). Trends in labor force participation

among persons with disabilities, 1983–1994. Disability Statistics Research and Training

Center, University of California.

Tse, J. (1994). Employers’ expectations and evaluation of the job performance of employees

with intellectual disability. Australia and New Zealand Journal of Developmental

Disabilities, 19, 139–147.

Vocational Rehabilitation Branch–ILO (1996). Guidelines on active training and employment

policies for disabled people in Central and Eastern Europe. Geneva: International Labour

OYce.

Vocational Rehabilitation Branch–ILO (1999). ILO policies and activities concerning vocational

rehabilitation. ILO Policy Paper. Geneva: International Labour OYce.

Wehman, P. (1988). Supported employment: Toward zero exclusion of persons with severe

disabilities. In P. Wehman & S. Moon (Eds.), Vocational rehabilitation and supported

employment. Baltimore, MD: Paul H. Brookes Co.

Williams, M., & Bauer, T. (1994). The eVect of a managing diversity policy on organisational

attractiveness. Group and Organisation Management, 19, 295–308.

World Health Organization (2001). International classification of functioning, disability, and

health. Geneva: World Health Organization.

World Health Organization (1997). ICIDH-2: International classification of impairments,

activities, and participation. A manual of dimensions of disablement and functioning. Beta-1

draft for field trials. Geneva.

Documents

[International Review of Research in Mental Retardation] Volume 29 || Employment and Intellectual Disability: Achieving Successful Employment Outcomes