Hasil untuk "Vocational rehabilitation. Employment of people with disabilities"

Allison D. Francis, Samantha Glasgow

Trinidad and Tobago (T&T) has regional influence in the Caribbean, with a diversified economy focused on energy, manufacturing, and finance compared to the tourism-related economies of most of the other Caribbean islands. Notwithstanding, this has not translated into equitable opportunities for all, specifically for people with disabilities. A lack of disaggregated employment data thwarts effective policy planning for people with disabilities. This research sought to examine the barriers to their employment in T&T. Underpinned by the social model of disability, a concurrent mixed-methods approach was employed. Emanating from interviews with people with disabilities and key informants, challenges to employment access, employer perceptions, and apathy emerged as key themes, together with the underlying issues of a lack of legislation and inequitable access to mainstream education. The survey findings indicated that 64% of employers had never employed people with disabilities, 57% expressed neutrality regarding future employment of such individuals, and 69% had not introduced workplace accommodations. A key recommendation of the study is the establishment of an employer resource centre that assists employers in creating and maintaining inclusive workplace accommodations for people with disabilities. This study is the first in Trinidad and Tobago to examine these research objectives from multiple perspectives.

Ayanda Myaka-Gama, Sibongile Mbatha, Sarah Lowick et al.

Background: Hypoxic ischaemic encephalopathy (HIE) is a common cause of neonatal death and severe neurological deficit in children, contributing to medico-legal litigation. Objectives: To describe the neurodevelopmental outcomes of infants with moderate and severe HIE at Chris Hani Baragwanath Academic Hospital and the proportions with neurodevelopmental impairment (NDI) and complications. To explore the effect of HIE severity and therapeutic hypothermia (TH) on neurodevelopmental outcome. Method: A retrospective, descriptive study at the Neonatal Neurodevelopmental Clinic included 239 infants with moderate and severe HIE, between 2015 and 2020. Neurodevelopmental outcomes were assessed by using the Griffiths Mental Developmental Scales at 1 year. General Quotient (GQ) scores defined NDI. Clinical and investigation criteria determined those with neurological complications. Results: Of the 239 infants, 211 (88.3%) and 28 (11.7%) had moderate HIE and severe HIE, respectively. Cerebral palsy (CP) was diagnosed in 9.2% and NDI in 17.1%. Severe HIE infants had significantly higher rates of NDI and CP, 50% (14) and 21.4% (6) respectively, as compared to those of moderate HIE infants, who had 12.7% (27) NDI and 7.6% (16) CP; 152(72%) moderate and 14 (50%) severe HIE infants received TH. Those who received TH were less likely to have NDI (p = 0.005), CP (p = 0.002), epilepsy and visual impairment. Conclusion: Developmental scores at 1 year of age were in the average range for the cohort, with equivalent profiles across domains. Those with severe HIE had the worst outcomes. Therapeutic hypothermia was associated with decreased CP and NDI in both groups. Contribution: This report supports the use of TH as a neuroprotective strategy in stage 2 and 3 HIE, highlighting the need for neurodevelopmental assessments at 2 years and beyond to determine longer-term outcomes and subtle deficits.

Vitaliy Shyyan, Laurene Christensen, Swati V. Chauhan

Multilingual learners with disabilities comprise an important population of diverse students that need to be empowered with accessible instructional and assessment materials on their pathways to college, career, and community readiness. These students require integrated supports for both language- and disability-related needs. Conventional approaches to accessibility often fall short in addressing the diverse linguistic, cognitive, and cultural needs of multilingual learners with disabilities. This article examines the intersection of digital accessibility and principles of universal design to create more inclusive and equitable educational environments for these students. Universal design provides a flexible framework that accommodates diverse learning needs by offering multiple means of engagement, representation, and expression. The principles of accessibility have evolved to include linguistic, cognitive, and sensory needs, which are critical for multilingual learners with disabilities. By leveraging digital tools aligned with Web Content Accessibility Guidelines (WCAG), educators can remove barriers to learning and assessment. Additionally, incorporating culturally relevant pedagogy into support systems for multilingual learners with disabilities fosters a more inclusive and affirming learning experience for these students, recognizing their unique cultural identities. The article offers considerations for various interest holders who serve multilingual learners with disabilities and advocates for the co-creation of digital resources by students, educators, and developers to ensure they meet real-world accessibility challenges. Advancements in artificial intelligence are considered as well, as they offer new possibilities for personalized learning experiences that support linguistic diversity and accessibility. By addressing the complex needs of multilingual learners with disabilities through proactive accessibility strategies, educators can create classrooms that are not only legally compliant but also equitable, culturally responsive, and empowering for all students. This approach is essential for dismantling barriers and fostering the academic success and social inclusion of multilingual learners with disabilities.

Faseeh Zulqernain, Mehandar Kumar, Laiba Zia et al.

Background: With the rising trend of sedentary behaviour and decreased physical activity among school-aged children, there is a growing concern regarding their physical health and fitness. Calisthenic exercises, bodyweight-based movements, offer a cost-effective and accessible method to improve multiple components of physical fitness without the need for equipment. Objective: To evaluate the effects of structured Calisthenic exercise program on physical fitness among school-going children. Material and Methods: This two-arm, parallel-group randomized controlled trial was conducted over 10 months at a private school in Sargodha, Pakistan. Forty-eight male children were randomly allocated into two groups: Group A (intervention group) performed structured Calisthenic exercises thrice weekly for 8 weeks, while Group B (control group) continued routine school activities. Physical fitness was assessed using the Eurofit Physical Fitness Test Battery at baseline, week 4, and week 8. Repeated measures ANOVA and independent t-tests were used for statistical analysis. Results: Significant within- and between-group improvements were observed in the intervention group across multiple fitness parameters including balance (Flamingo Balance Test, p<0.001), coordination (Plate Tapping Test, p<0.001), leg power (Standing Broad Jump, p<0.001), flexibility (Sit-and-Reach Test, p=0.03), muscular endurance (Sit-ups in 30 seconds and Bent Arm Hang, p<0.001), and aerobic capacity (20m Shuttle Run, p=0.042). Hand grip strength showed significant improvement in the intervention group over time (p=0.002), though not in comparison between groups. The control group showed minimal or no significant improvements. Conclusion: Structured Calisthenic exercises significantly enhance physical fitness components including balance, flexibility, coordination, endurance, and strength in school-aged boys. Incorporating such programs into school routines offers a practical and scalable strategy to combat physical inactivity in children. Keywords: Balance; endurance; exercise therapy; flexibility; motor skills; physical fitness Clinical trial #: NCT05149794

Aditya D. Pratama, Haunan N. Izdihar, Marilyn Moffat

Background: Daily tasks can be challenging for young individuals with motor impairments caused by brain disorders. Neurodevelopmental treatment (NDT) aims to enhance motor function by concentrating on the central nerve and neuromuscular systems. However, research on the effectiveness of NDT for children with spastic diplegia in Indonesia, particularly regarding gross motor skills and daily activities, is limited. Objectives: This study aimed to investigate the effects of NDT on activities of daily living (ADL) and gross motor skills in children with spastic diplegia. Methods: This study utilised a pre-test–post-test experimental design. Twenty children diagnosed with spastic diplegia were recruited via purposive sampling from a specialised paediatric rehabilitation centre. The Modified WeeFIM was used to assess ADL, and the GMFM-88 was utilised to measure gross motor abilities. The NDT intervention was administered over the course of 8 weeks, twice a week. Results: Activities of daily living (p  0.001, mean improvement of 13.6) and gross motor abilities (all GMFM-88 tests, p  0.05) showed significant improvements. A substantial favourable association (r = 0.702; p  0.001) was observed between GMFM-88 and WeeFIM scores, suggesting that improvements in motor skills were associated with better daily functioning. Conclusion: Neurodevelopmental treatment helped children with spastic diplegia with their everyday activities and motor function, supporting its role in promoting independence. Contribution: This study fills a gap in research by evaluating NDT’s impact on daily activities and Indonesian children with cerebral palsy and their motor function, contributing to a deeper understanding of its benefits.

Maria Zuurmond, Augustina Naami, Lyla Adwan-Kamara et al.

Background: Stigma is a barrier to inclusion for people with disabilities and mental health conditions. There is increasing recognition of the need to address stigma within disability inclusive programmes, but limited research is available on what are effective participatory approaches to stigma reduction interventions. Objectives: (1) To document participatory approaches used in the design and delivery of disability stigma reduction interventions in a disability and mental health programme in Ghana and (2) to understand the experience of programme implementers and participants in these processes, with particular attention to the leadership and involvement of people with disabilities. Method: A mixed-methods study was conducted. The data were drawn from a purposive sample of 20 in-depth interviews (IDIs) with programme staff, partners and key stakeholders, and 12 focus group discussions (FGDs) with self-help group (SHG) members, organisation of people with disabilities (OPD) members, and disability champions. We conducted thematic analysis using deductive and inductive approaches. Results: The programme adopted several approaches to participation at design and implementation stages, with a focus on the leadership of people with disabilities and people with mental health conditions. The process was seen to promote acceptability of stigma reduction approaches. Providing opportunities for building and strengthening relationships with a wide range of stakeholders was key to successful implementation. Understanding, and engaging with, power dynamics in the local context also provided important benefits. Conclusions: Participation of people with disabilities and mental health conditions is essential for the design and delivery of stigma reduction programmes in Ghana. Contribution: This study provided lessons from the field on the value of participation in reducing stigma, and the role of key stakeholders, particularly people with disabilities and mental health conditions.

Makwena M. Sibuyi, Desmond Mathye, Muziwakhe D. Tshabalala et al.

Background: Inclusive education for learners with special education needs is challenged with a rigid curricula and inadequate policy monitoring. Parental perspectives are crucial for shaping inclusive policies. However, these are insufficiently examined in the existing research and hinder improvements in special education practices. Objectives: This study explored parents’ perspectives on how special schools met the unique needs of learners living with physical disabilities. Method: A descriptive, qualitative exploratory design utilising semi-structured interviews with 11 parents from three selected special schools was adopted. Participants were recruited using a purposive non-random sampling method through telephone calls and face-to-face interviews. Transcripts were audio recorded and transcribed verbatim. Data were analysed inductively using a six-step approach to thematic data analysis on ATLAS.ti version 9. Intercoder reliability was achieved with consensus agreement. Results: Three themes emerged: (1) A lack of curriculum differentiation and its effects on the learners’ academic performance. (2) A lack of empathy and support in addressing the learners’ challenges. (3) Poor management of assistive devices. Conclusion: Parents perceived that special schools inadequately addressed their children’s needs, particularly in curriculum delivery. Insufficient assessments resulted in learners remaining in unsuitable academic stream instead of transitioning to vocational pathways. Contribution: Parental insights highlight critical areas for improvement in informing policies to enhance support for learners with special education needs.

Aniana Cruz, Marko Kuzmanoski, Gabriel Pires

Stroke is a leading cause of long-term disability and the second most common cause of death worldwide. Although acute treatments have advanced, recovery remains challenging and limited. Brain-computer interfaces (BCIs) have emerged as a promising tool for post-stroke rehabilitation by promoting neuroplasticity. However, clinical outcomes remain variable, and optimal protocols have yet to be established. This study explores strategies to optimize BCI-based rehabilitation by comparing motor imagery of affected hand movement versus rest, instead of the conventional left-versus-right motor imagery. This alternative aims to simplify the task and address the weak contralateral activation commonly observed in stroke patients. Two datasets, one from healthy individuals and one from stroke patients, were used to evaluate the proposed approach. The results showed improved performance using both FBCSP and EEGNet. Additionally, we investigated the impact of session duration and found that shorter training sessions produced better BCI performance than longer sessions.

Jessica Tang, Ali Abedi, Tracey J. F. Colella et al.

Exercise-based rehabilitation improves quality of life and reduces morbidity, mortality, and rehospitalization, though transportation constraints and staff shortages lead to high dropout rates from rehabilitation programs. Virtual platforms enable patients to complete prescribed exercises at home, while AI algorithms analyze performance, deliver feedback, and update clinicians. Although many studies have developed machine learning and deep learning models for exercise quality assessment, few have explored the use of large language models (LLMs) for feedback and are limited by the lack of rehabilitation datasets containing textual feedback. In this paper, we propose a new method in which exercise-specific features are extracted from the skeletal joints of patients performing rehabilitation exercises and fed into pre-trained LLMs. Using a range of prompting techniques, such as zero-shot, few-shot, chain-of-thought, and role-play prompting, LLMs are leveraged to evaluate exercise quality and provide feedback in natural language to help patients improve their movements. The method was evaluated through extensive experiments on two publicly available rehabilitation exercise assessment datasets (UI-PRMD and REHAB24-6) and showed promising results in exercise assessment, reasoning, and feedback generation. This approach can be integrated into virtual rehabilitation platforms to help patients perform exercises correctly, support recovery, and improve health outcomes.

Erica De Alfieri, Veronica Giaquinto, Miriam Belluzzo et al.

Background Individuals with disabilities encounter various obstacles to employment, including both environmental barriers and challenges related to work skills. Objective The aim of this work is to review the literature on effective interventions that support individuals with disabling mental issues in securing and retaining employment. Method To guarantee the inclusion of the most recent evidence, we specifically focused on articles published in English between 2014 and 2024. A total of 26 relevant studies were included in this review. Results We first explore the impact of interventions aimed at disability in the broader sense, such as Integrated Practical Placement, Direct Skills Teaching, and Traditional Vocational Rehabilitation. We then focus on interventions for people with a disabling mental illness: well-known approaches such as Supported Employment and Individual Placement and Support work well, but innovative interventions are emerging, such as psychotherapy, peer support program and Vocational Empowerment Photovoice. Involving family members and the work environment is key, while approaches focused solely on information did not have any impact. Conclusion Employment offers vital economic resources, but most importantly it also fulfils psychosocial needs by reducing the risk of social isolation and poverty. Therefore, examining effective employment interventions for individuals with disabling, serious conditions of mental illness is undeniably a critical matter.

G. Tsagaris, J. Keeler, Christopher R Carpenter et al.

Background This conceptual paper uses data from the Cuyahoga County Board of Developmental Disabilities (Cuyahoga DD) to examine this organization's Community Workforce Development program and the Employment Collaborative of Cuyahoga County (ECCC) put in place to successfully provide service to people with developmental disabilities. The history of this collaborative process involving the Cuyahoga DD, community-based organizations, governmental agencies, as well as non-profit organizations was explored. Further, the development of vocational rehabilitation (VR) trends towards business engagement (BE) and the dual customer approach have been discussed as they contribute to a successful intervention strategy. Objectives The authors analyzed the Cuyahoga DD's collaborative strategy developed to ensure community engagement in increasing IDD employment in the region. Methods This is a conceptual paper using a qualitative methodology that enabled the authors to describe, illustrate, and analyze the collaborative process to make suggestions for improvement and sustainability. Results The alternative approach to the Community Workforce Development contributed to the improvement and sustainability of employment service supports based on local collaboration and community engagement. Conclusion The application of the initial business model with minimum resources resulted in challenges that have been successfully addressed in the subsequent alternative approach to employment service support.

J. Wu, Kanako Iwanaga, Jessica M. Brooks et al.

Rehabilitation counselors play a significant role in helping people with disabilities achieve their independent living and employment goals. However, the current shortage of rehabilitation counselors driven by a well-documented wave of retirements, job dissatisfaction, and burnout is concerning as it may affect the timeliness and quality of vocational rehabilitation (VR) services. The purpose of this study was to evaluate constructs of the positive organizational psychology model of job satisfaction as predictors of job satisfaction in a sample of rehabilitation counselors ( N = 395). Hierarchical regression analysis was performed with job satisfaction as the dependent variable and four sets of predictors entered in sequential steps based on the positive organizational psychology model of job satisfaction. The final regression model accounted for 60% of the variance in job satisfaction scores (a large effect size). Work autonomy (β = .32, p < .001), work engagement (β = .36, p < .001) and organizational commitment (β = .22, p < .001) were significant predictors of job satisfaction after controlling for other variables in the regression model. Findings of this study can be used to inform leadership in state VR agencies about the development of policies and practices.

Sofia S. Letunovskaya

The author analyzes the state program “Accessible Environment”, and also identifies the features of the current situation in the field of rehabilitation of people with disabilities in the Russian Federation. Based on the identified problems, the author proposes amendments to the state program, in particular, the consolidation of an indicator reflecting the proportion of people with disabilities who have completed vocational training/retraining, as well as the inclusion of an indicator reflecting the proportion of people with disabilities who have worked at the place of employment for more than 1 year.; the inclusion of a new area that will focus on the rehabilitation of people with disabilities over the age of 60; the inclusion of a new area of psychosocial rehabilitation that helps create opportunities for people with chronic mental illness.

Aqsa Safdar, Farhan Ahmad, Aisha Amin et al.

Background: plyometric training enhances muscle function, improves dynamic strength, and potentially reduces injury risk by increasing the stiffness of the muscle-tendon complex. Objective: To determine the effects of 8-week plyometric exercises on injury prevention of domestic cricket players. Methods: A randomized clinical trial was conducted at the sports club PAF base Murid, Chakwal. A total of n=34 domestic cricket players were included in the study through a non-probability purposive sampling technique. Male players between the age gap of 18-25 years and having no history of trauma/injury in the past month were included in this study. They were randomly allocated into the plyometric group (n=18) and a conventional group (n=18). Group A received plyometric training whereas group B received conventional training. The Nine Test Battery Screening was used for assessment. The assessment was done at baseline and after the 8th week. Results: The mean age of cricketers in this study was 22.56±2.427. After 8 weeks of intervention, a significant difference was found in the plyometric group as compared to the conventional group for injury prevention using nine test battery screening with p-value (p<0.05) Conclusion: Plyometric training is effective in improving physical fitness and thus prevents injury in cricket players. plyometric training; nine test battery screening; keywords: conventional training; physical fitness; injury prevention

El-Sayed Atlam, Mehedi Masud, Mahmoud Rokaya et al.

A neuro-developmental disorder known as autism spectrum disorder (ASD) affects a significant portion of the global population. Those with ASD frequently struggle to interact and communicate with others and may engage in restricted or repetitive behaviors or interests. The symptoms of autism begin early in childhood and can continue into adulthood. Machine learning and deep learning (DL) models are employed in clinical research for the early identification and diagnosis of ASD. However, the majority of the existing models lack interpretability in their results for ASD diagnosis. The explainable artificial intelligence (XAI) concepts can be used to provide transparent and understandable explanations for models’ decisions. In this work, we present an explainable autism spectrum disorder model based on DL for autism disorder detection in toddlers and children. The primary objective of this study is to better understand and interpret the classification process and to discern the significant features that contribute to the prediction of ASD. The proposed model is divided into two distinct components. The first component employs a DL model for autism disorder detection. The second uses an XAI technique known as shapley additive explanations (SHAP) to emphasis key characteristics and explain the model’s outcomes. The model showed perfect performance on the training set, with an accuracy of 1 and a receiver operating characteristic score of 1. On the test set, the model achieved an accuracy score of 0.9886, indicating that it performed nearly as well as on the training set. The experimental results demonstrate that the proposed model has the capability to accurately predict and diagnose ASD while also providing explanatory insights into the obtained results. Furthermore, the results indicate that the proposed model performs competitively compared to the state-of-the-art models in terms of accuracy and F1-score. The results highlight the efficacy and potential of the proposed model in accurately predicting ASD in binary classification tasks.

Mark Karlov, Ali Abedi, Shehroz S. Khan

Exercise-based rehabilitation programs have proven to be effective in enhancing the quality of life and reducing mortality and rehospitalization rates. AI-driven virtual rehabilitation, which allows patients to independently complete exercises at home, utilizes AI algorithms to analyze exercise data, providing feedback to patients and updating clinicians on their progress. These programs commonly prescribe a variety of exercise types, leading to a distinct challenge in rehabilitation exercise assessment datasets: while abundant in overall training samples, these datasets often have a limited number of samples for each individual exercise type. This disparity hampers the ability of existing approaches to train generalizable models with such a small sample size per exercise type. Addressing this issue, this paper introduces a novel supervised contrastive learning framework with hard and soft negative samples that effectively utilizes the entire dataset to train a single model applicable to all exercise types. This model, with a Spatial-Temporal Graph Convolutional Network (ST-GCN) architecture, demonstrated enhanced generalizability across exercises and a decrease in overall complexity. Through extensive experiments on three publicly available rehabilitation exercise assessment datasets, UI-PRMD, IRDS, and KIMORE, our method has proven to surpass existing methods, setting a new benchmark in rehabilitation exercise quality assessment.

Mateusz Dolata, Birgit Schenk, Jara Fuhrer et al.

Case and knowledge management systems are spread at the frontline across public agencies. However, such systems are dedicated for the collaboration within the agency rather than for the face-to-face interaction with the clients. If used as a collaborative resource at the frontline, case and knowledge management systems might disturb the service provision by displaying unfiltered internal information, disclosing private data of other clients, or revealing the limits of frontline employees' competence (if they cannot explain something) or their authority (if they cannot override something). Observation in the German Public Employment Agency shows that employment consultants make use of various coping strategies during face-to-face consultations to extend existing boundaries set by the case and knowledge management systems and by the rules considering their usage. The analysis of these coping strategies unveils the forces that shape the conduct of employment consultants during their contacts with clients: the consultants' own understanding of work, the actual and the perceived needs of the clients, and the political mission as well as the internal rules of the employment agency. The findings form a twofold contribution: First, they contribute to the discourse on work in employment agencies by illustrating how the complexities of social welfare apparatus demonstrate themselves in singular behavioural patterns. Second, they contribute to the discourse on screen-level bureaucracy by depicting the consultants as active and conscious mediators rather than passive interfaces between the system and the client.

Kate Glazko, Yusuf Mohammed, Ben Kosa et al.

As Generative AI rises in adoption, its use has expanded to include domains such as hiring and recruiting. However, without examining the potential of bias, this may negatively impact marginalized populations, including people with disabilities. To address this important concern, we present a resume audit study, in which we ask ChatGPT (specifically, GPT-4) to rank a resume against the same resume enhanced with an additional leadership award, scholarship, panel presentation, and membership that are disability related. We find that GPT-4 exhibits prejudice towards these enhanced CVs. Further, we show that this prejudice can be quantifiably reduced by training a custom GPTs on principles of DEI and disability justice. Our study also includes a unique qualitative analysis of the types of direct and indirect ableism GPT-4 uses to justify its biased decisions and suggest directions for additional bias mitigation work. Additionally, since these justifications are presumably drawn from training data containing real-world biased statements made by humans, our analysis suggests additional avenues for understanding and addressing human bias.

Bernardo Caldarola, Dario Mazzilli, Aurelio Patelli et al.

Structural change consists of industrial diversification towards more productive, knowledge intensive activities. However, changes in the productive structure bear inherent links with job creation and income distribution. In this paper, we investigate the consequences of structural change, defined in terms of labour shifts towards more complex industries, on employment growth, wage inequality, and functional distribution of income. The analysis is conducted for European countries using data on disaggregated industrial employment shares over the period 2010-2018. First, we identify patterns of industrial specialisation by validating a country-industry industrial employment matrix using a bipartite weighted configuration model (BiWCM). Secondly, we introduce a country-level measure of labour-weighted Fitness, which can be decomposed in such a way as to isolate a component that identifies the movement of labour towards more complex industries, which we define as structural change. Thirdly, we link structural change to i) employment growth, ii) wage inequality, and iii) labour share of the economy. The results indicate that our structural change measure is associated negatively with employment growth. However, it is also associated with lower income inequality. As countries move to more complex industries, they drop the least complex ones, so the (low-paid) jobs in the least complex sectors disappear. Finally, structural change predicts a higher labour ratio of the economy; however, this is likely to be due to the increase in salaries rather than by job creation.

Hyun Ju Kim, Erica Jablonski, Debra L. Brucker et al.

Background As workplace flexibility can promote employment for people with disabilities, people with disabilities need information about the characteristics of organizations that are more likely to provide this environment. Objective Using the 2017 and 2022 Kessler Foundation National Employment & Disability Survey: Supervisor Perspectives, we examine organizational characteristics associated with the flexible work accommodations of working from home, flexible work schedules, and job sharing, prior to and after the COVID-19 pandemic. Methods We employ a linear probability model to investigate the impact of the COVID-19 pandemic on the provision of flexible workplaces and explore structural (industry, sector, and size) as well as cultural factors (central accommodation fund and upper management commitments) that are related to the flexible workplace practices. Results The pandemic increased flexible workplace practices. Different organizational structural and cultural characteristics are noted as correlates to providing greater workplace flexibility. Conclusion Our findings can inform job seekers with disabilities to identify organizations that are more likely to offer flexibility. In addition, this information can be useful to vocational rehabilitation professionals in supporting positive employment outcomes for people with disabilities. Employers can also use our findings to guide their diversity, equity, and inclusion efforts.