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

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arXiv Open Access 2026
Not Seeing the Whole Picture: Challenges and Opportunities in Using AI for Co-Making Physical DIY-AT for People with Visual Impairments

Ben Kosa, Hsuanling Lee, Jasmine Li et al.

Existing assistive technologies (AT) often adopt a one-size-fits-all approach, overlooking the diverse needs of people with visual impairments (PVI). Do-it-yourself AT (DIY-AT) toolkits offer one path toward customization, but most remain limited--targeting co-design with engineers or requiring programming expertise. Non-professionals with disabilities, including PVI, also face barriers such as inaccessible tools, lack of confidence, and insufficient technical knowledge. These gaps highlight the need for prototyping technologies that enable PVI to directly make their own AT. Building on emerging evidence that large language models (LLMs) can serve not only as visual aids but also as co-design partners, we present an exploratory study of how LLM-based AI can support PVI in the tangible DIY-AT co-making process. Our findings surface key challenges and design opportunities: the need for greater spatial and visual support, strategies for mitigating novel AI errors, and implications for designing more accessible AI-assisted prototypes.

arXiv Open Access 2026
Shifting Engagement With Cybersecurity: How People Discover and Share Cybersecurity Content at Work and at Home

William Seymour, Martin J. Kraemer

Cybersecurity awareness is shaped by a wide range of professional and personal experiences, including information and training at work and the sharing of news and other content at home. In order to explore how people discover cybersecurity content and the effect that participation in workplace training may have on this we present an online study of 1200 participants from the UK, US, France, and Germany. Those undertaking cybersecurity training at work showed reduced intention to share information at home, shifting the focus towards the workplace. They were also more likely to recall cybersecurity information shared by their employer than from any other source, which in turn correlated with content type and distribution channel. We critically reflect on this shift, highlighting opportunities to improve cybersecurity information sharing at work and at home.

CrossRef Open Access 2025
Comparing competitive integrated employment outcomes in the state-federal vocational rehabilitation program among individuals with cognitive, physical, and sensory functional impairments

Zaccheus J Ahonle, Tianlan Wei, Phillip D Rumrill et al.

Background State-Federal vocational rehabilitation (VR) services are available for eligible individuals with disabilities (IWD) who are interested in pursuing, obtaining, and maintaining gainful employment. Despite availability of VR services, employment outcomes of IWD compared to those without disabilities continue to be limited. Objective To examine effects of receipt of VR services on the employment outcomes of individuals with cognitive impairments (CI) compared to people with other impairments (i.e., physical and sensory impairments) while accounting for individual characteristics and patterns of VR service use. Methods Secondary data analysis using Rehabilitation Services Administration (RSA) 911 data covering cases in 2019. Hypothesized covariates and predictors of employment outcomes were divided into four groups: demographic variables, environmental/social variables, disability related variables, and receipt of VR services. The target outcome variables from the RSA 911 database were competitive integrated employment (CIE) employment outcome, hourly wage at case closure, and hours worked in a week at case closure. A hierarchical logistic regression analysis was performed using CIE as the criterion. Results Findings suggest that (a) the group including CI individuals was at a disadvantage in terms of CIE outcomes; (b) from the logistic regression, gender, education level, significance of disability, and receipt of some VR services were significantly associated with CIE outcomes (yes/no); and (c) when we examined the percentages of individuals receiving VR services, higher percentages of individuals with CI received varieties of VR services, but less assistive technology services. Conclusions Individuals with disabilities continue to experience disparate employment outcomes. The receipt of varieties of VR services facilitates IWDs to successfully obtain CIE. Receipt of VR services alone may not be the only factor that supports IWD in obtaining successful CIE. A critical investigation of the quality and type of these VR services, difference by impairment, and the economic impact of societal/environmental trends is warranted.

1 sitasi en
arXiv Open Access 2025
Vision-Based Assistive Technologies for People with Cerebral Visual Impairment: A Review and Focus Study

Bhanuka Gamage, Leona Holloway, Nicola McDowell et al.

Over the past decade, considerable research has investigated Vision-Based Assistive Technologies (VBAT) to support people with vision impairments to understand and interact with their immediate environment using machine learning, computer vision, image enhancement, and/or augmented/virtual reality. However, this has almost totally overlooked a growing demographic: people with Cerebral Visual Impairment (CVI). Unlike ocular vision impairments, CVI arises from damage to the brain's visual processing centres. Through a scoping review, this paper reveals a significant research gap in addressing the needs of this demographic. Three focus studies involving 7 participants with CVI explored the challenges, current strategies, and opportunities for VBAT. We also discussed the assistive technology needs of people with CVI compared with ocular low vision. Our findings highlight the opportunity for the Human-Computer Interaction and Assistive Technologies research community to explore and address this underrepresented domain, thereby enhancing the quality of life for people with CVI.

arXiv Open Access 2025
A Large Vision-Language Model based Environment Perception System for Visually Impaired People

Zezhou Chen, Zhaoxiang Liu, Kai Wang et al.

It is a challenging task for visually impaired people to perceive their surrounding environment due to the complexity of the natural scenes. Their personal and social activities are thus highly limited. This paper introduces a Large Vision-Language Model(LVLM) based environment perception system which helps them to better understand the surrounding environment, by capturing the current scene they face with a wearable device, and then letting them retrieve the analysis results through the device. The visually impaired people could acquire a global description of the scene by long pressing the screen to activate the LVLM output, retrieve the categories of the objects in the scene resulting from a segmentation model by tapping or swiping the screen, and get a detailed description of the objects they are interested in by double-tapping the screen. To help visually impaired people more accurately perceive the world, this paper proposes incorporating the segmentation result of the RGB image as external knowledge into the input of LVLM to reduce the LVLM's hallucination. Technical experiments on POPE, MME and LLaVA-QA90 show that the system could provide a more accurate description of the scene compared to Qwen-VL-Chat, exploratory experiments show that the system helps visually impaired people to perceive the surrounding environment effectively.

en cs.CV, cs.AI
arXiv Open Access 2025
Beliefs about Bots: How Employers Plan for AI in White-Collar Work

Eduard Brüll, Samuel Mäurer, Davud Rostam-Afschar

We provide experimental evidence on how employers adjust expectations to automation risk in high-skill, white-collar work. Using a randomized information intervention among tax advisors in Germany, we show that firms systematically underestimate automatability. Information provision raises risk perceptions, especially for routine-intensive roles. Yet, it leaves short-run hiring plans unchanged. Instead, updated beliefs increase productivity and financial expectations with minor wage adjustments, implying within-firm inequality like limited rent-sharing. Employers also anticipate new tasks in legal tech, compliance, and AI interaction, and report higher training and adoption intentions.

en econ.GN
DOAJ Open Access 2025
HIV Testing Among Women with Disabilities in Ghana

Abdul-Aziz Seidu, Ndidiamaka Nwodo, Farrukh Ishaque Saah et al.

Women with disabilities often face unique barriers to accessing healthcare, potentially increasing their vulnerability and reducing engagement with vital health services, including human immunodeficiency virus (HIV) testing. This study assessed the prevalence and associated factors of HIV-testing among women with disabilities in Ghana. Cross-sectional data from the 2017–2018 Ghana Multiple Indicator Cluster Survey, encompassing 819 women with disabilities, were analysed both descriptively and inferentially. The overall prevalence of HIV testing was 48.0% (95%CI = 44.6–51.4). Educational attainment, marital status, and geographical region were key determinants of HIV testing uptake. Women possessing a Senior High School or Tertiary level education demonstrated higher odds of HIV testing compared to those with no formal education. Women residing in Greater Accra, Volta, Brong Ahafo, and Upper West regions were more likely to have undergone HIV testing than those in the Western Region. Never-married women exhibited lower odds of HIV testing uptake than their married counterparts. No statistically significant association was found between various disability types and HIV testing uptake. Less than half of women with disabilities in Ghana had ever tested for HIV, highlighting a substantial unmet need and underscoring the urgent need for targeted interventions, including enhanced, region-specific educational and health promotion initiatives, and tailored support for never-married women with disabilities.

Vocational rehabilitation. Employment of people with disabilities
arXiv Open Access 2024
Everyday Uses of Music Listening and Music Technologies by Caregivers and People with Dementia: Survey and Focus Group Study

Dianna Vidas, Romina Carrasco, Ryan M. Kelly et al.

Music is a valuable non-pharmacological tool that provides benefits for people with dementia, and there is interest in designing technologies to support music use in dementia care. To ensure music technologies are appropriately designed for supporting caregivers and people living with dementia, there remains a need to better understand how music is currently used in everyday care at home. We aimed to understand how people with dementia and their caregivers use music technologies in everyday caring, as well as challenges they experience using music and technology. This study used a mixed methods design. A survey was completed by 77 caregivers and people with dementia to understand their use of music and technology. Of these, 18 survey respondents (12 family caregivers, 6 people living with dementia) participated in focus groups about their experiences of using music and technology in care. Transcripts were analysed with reflexive thematic analysis. Most survey respondents used music often in their daily lives, reporting a range of music technologies such as CDs, radio, and streaming. Focus groups highlighted benefits and challenges of music technologies in everyday care. Participants used music and music technologies to regulate mood, provide joy, facilitate social connection, encourage reminiscence, provide continuity before and after diagnosis, and to make caregiving easier. Challenges of using music technology in care included difficulties staying up to date with evolving technology, and low self-efficacy for technology use expressed by people living with dementia. Evidently, people living with dementia and their caregivers use music technologies to support their everyday care needs. Results suggest opportunities to design technologies enabling easier access to music and supporting people living with dementia with recreational and therapeutic music listening and music-based activities.

en cs.HC
arXiv Open Access 2024
Navigating AI Fallibility: Examining People's Reactions and Perceptions of AI after Encountering Personality Misrepresentations

Qiaosi Wang, Chidimma L. Anyi, Vedant Das Swain et al.

Many hyper-personalized AI systems profile people's characteristics (e.g., personality traits) to provide personalized recommendations. These systems are increasingly used to facilitate interactions among people, such as providing teammate recommendations. Despite improved accuracy, such systems are not immune to errors when making inferences about people's most personal traits. These errors manifested as AI misrepresentations. However, the repercussions of such AI misrepresentations are unclear, especially on people's reactions and perceptions of the AI. We present two studies to examine how people react and perceive the AI after encountering personality misrepresentations in AI-facilitated team matching in a higher education context. Through semi-structured interviews (n=20) and a survey experiment (n=198), we pinpoint how people's existing and newly acquired AI knowledge could shape their perceptions and reactions of the AI after encountering AI misrepresentations. Specifically, we identified three rationales that people adopted through knowledge acquired from AI (mis)representations: AI works like a machine, human, and/or magic. These rationales are highly connected to people's reactions of over-trusting, rationalizing, and forgiving of AI misrepresentations. Finally, we found that people's existing AI knowledge, i.e., AI literacy, could moderate people's changes in their trust in AI after encountering AI misrepresentations, but not changes in people's social perceptions of AI. We discuss the role of people's AI knowledge when facing AI fallibility and implications for designing responsible mitigation and repair strategies.

en cs.HC, cs.AI
CrossRef Open Access 2024
The Perception Gap Between Special Education School Teachers and Vocational Rehabilitation Practitioners in Teaching Vocational Readiness to Students with Intellectual Disabilities

Kazuaki Maebara, Asuka Yamaguchi

This study aimed to elucidate the perception gap regarding instructional matters between special education teachers and vocational rehabilitation practitioners involved in transition support in Japan. To this end, 126 vocational support providers affiliated with the Employment and Life Support Centers for persons with disabilities, which are vocational rehabilitation institutions in Japan, and 129 special education teachers from schools for students with intellectual disabilities in Prefecture X, Japan, were surveyed. They were asked to respond on the importance of teaching skills that constitute vocational readiness by means of a questionnaire comprising 25 items across five layers: vocational aptitude, basic work habits, interpersonal skills, daily living management, and health management, both during school and after graduation. The results revealed a perception gap in each of the first layer, vocational aptitude, and second layer, work habits. Additionally, only in the second layer, work habits, did special education teachers recognize the importance of instruction more during the school period than after graduation. Moving forward, it is necessary for both institutions involved in transition support to collaborate, focusing on students with disabilities based on the identified gap.

DOAJ Open Access 2024
Ensemble Learning-based Alzheimer’s Disease Diagnosis Using Magnetic Resonance Imaging

Hazim Saleh Al-Rawashdeh, Aminu Usman, Ashit Kumar Dutta et al.

The progressive nature and early identification requirements of Alzheimer’s disease (AD) provide an immense challenge in healthcare. The present study introduces a novel ensemble learning technique for detecting AD, using cutting-edge deep learning (DL) and classic machine learning (ML) techniques. The feature extraction process is carried out with YOLOv7 and EfficientNet B3 models, which effectively capture spatial and semantic information from brain imaging data. CatBoost and XGBoost are used as base learners, using gradient-boosting capabilities for classification. In order to improve the accuracy of predictions, support vector machines are used as meta-learners to effectively merge the results of the base models. We performed trials on a dataset from the Kaggle repository and achieved a remarkable average accuracy of 99.8%. Our methodology shows the effectiveness of integrating DL and classic ML methods in detecting AD. The ensemble architecture not only boosts the accuracy of classification but also improves the resilience and generalizability of the model. The study’s results indicate promising directions for advancing the development of precise and dependable diagnostic instruments for AD. The proposed research has the potential to assist medical professionals in identifying the condition at an early stage and planning appropriate interventions and treatments.

Vocational rehabilitation. Employment of people with disabilities
DOAJ Open Access 2024
Disability research in African Network for Evidence-to-Action in Disability affiliated countries

Callista K. Kahonde, Gubela Mji

Background: The African Network for Evidence-to-Action in Disability (AfriNEAD) is a leading role player in Africa promoting evidence-informed policies and practices for disability inclusion on the continent. This article presents findings of a desktop review that explored trends of disability research in the AfriNEAD affiliated countries. Objectives: The review explored trends of research that has been published by members of the disability research community who are contributing to AfriNEAD Conferences. Method: A Google scholar search was conducted using names of researchers who presented articles at the first six AfriNEAD Conferences, recording peer-reviewed journal publications by each author according to the eight AfriNEAD research focus areas. This was followed by a hand search of all articles published in the African Journal of Disability from AfriNEAD affiliated countries. Results: There is an exponential increase in the number of peer reviewed journal publications from AfriNEAD affiliated countries over the last two decades. Collaborations are common among authors within the same African country. International collaborations are common among authors from Africa with authors from the Global North. Conclusion: African researchers need to network and collaborate more across Africa, to promote disability research in countries where research is scarce and to focus more on research areas that are not receiving attention. Contribution: The desktop exploration is a first step for AfriNEAD to get a baseline understanding of published disability research in the countries affiliated to the network. Further research is required to understand these trends and to provide evidence necessary to address the identified gaps.

Vocational rehabilitation. Employment of people with disabilities, Communities. Classes. Races
DOAJ Open Access 2024
Evaluation of Conventional and Smart Wheelchair Technologies in the Kingdom of Saudi Arabia

Mohsen Bakouri, Sultan Alanazi, Abdullah Alqarni et al.

A significant number of people depend on the help of others to facilitate their mobility in wheelchairs. Physical disabilities hinder the mobility of persons with disabilities, making them unable to move around using conventional (manually operated) wheelchairs. Furthermore, people lack the ability to regain an upright posture if the chair falls. This study aims to evaluate conventional and smart wheelchair technologies in the Kingdom of Saudi Arabia. This study was conducted through a quantitative and cross-sectional research methodology to evaluate the effectiveness of wheelchair technologies in the Kingdom of Saudi Arabia. This is done by collecting data from wheelchair users, experts, and specialists in this field, such as medical engineers and others familiar with wheelchairs. The evaluation included the opinions of users and experts on the use of traditional and smart chairs in terms of the technologies used, ease of use, advantages, disadvantages, etc. More than 590 users and experts from all regions of the Kingdom participated in the study, and their answers were characterized by objectivity and realism. About 39% of participants indicated that smart wheelchairs are very effective, and 37.6% confirmed that these chairs can be used on many surfaces, while 23.4% expressed their appreciation that smart wheelchairs are useful for various purposes and terrains. On the other hand, the results showed that smart wheelchairs had high purchase and maintenance costs of 37.4%. This was followed by concerns about more maintenance requirements (23.5%), the need for constant charging (20.4%), and the need for users to be aware of energy use (18.7%). The results show some advantages of using traditional wheelchairs, such as low maintenance, lightweight, and often affordability. This type of chair faces many difficulties, such as crossing slopes and long distances, requiring some strength for use, and users needing assistance to move around. The study revealed significant progress in wheelchair technology, especially in smartphones and navigation. Evaluating existing wheelchair technology in Saudi Arabia has shown significant advances, especially in urban areas and healthcare institutions. Motorized electric wheelchairs are becoming increasingly popular due to their ability to enhance users’ mobility. However, the availability of high-end wheelchair models and their accompanying accessories remains limited.

Vocational rehabilitation. Employment of people with disabilities
DOAJ Open Access 2024
Influence of Photobiomodulation Therapy on Altered Plantar Pressure Distribution and Ankle Biomechanics in Individuals With Diabetic Foot Syndrome

Hrishikesh Korada, Arun Gundmi Maiya, Sharath Kumar Rao et al.

Objectives: Diabetic foot syndrome is becoming increasingly common in India with a prevalence ranging from 24.9% to 49%. Diabetic foot syndrome patients have an increased likelihood of developing ulcers in their feet. Accordingly, this study evaluates the influence of photobiomodulation on altered plantar pressure distribution and ankle biomechanics in individuals with diabetic foot syndrome.  Methods: A total of 20 diabetic foot syndrome patients with an absence of 10 g monofilament in one out of six sites at the plantar surface of feet, a biothesiometer for vibration perception threshold of >20 V, and diminished or absent ankle reflexes were included. The evaluation of ankle biomechanics was performed by SIMI motion analysis. In addition, the plantar pressure distribution was measured by the WinTrack pressure platform at baseline and the end of 10 sessions. They were treated with scanning mode on the foot plantar surface and probe laser at the popliteal fossa region for three sessions per week, for ten sessions.  Results: Plantar pressure parameters were significantly improved (P<0.01) and ankle biomechanics (P<0.01) after the intervention, respectively, except for no significant difference in the total contact area and ankle midstance kinematics. Discussion: Photobiomodulation therapy can be an effective treatment for improving foot plantar pressure redistribution and ankle biomechanics in individuals with diabetic foot syndrome.

Medicine, Vocational rehabilitation. Employment of people with disabilities
DOAJ Open Access 2024
Hip Muscle Functional Performance Among Athletes with Achilles Tendinopathy

Mahrukh Asif, Yamna Mazher, Hassan Shahid

BACKGROUND: Achilles tendinopathy is a condition affecting the Achilles tendon, causing discomfort, swelling, and decreased function. It’s common in middle-aged athletes and runners, with overuse injuries increasing due to increased sports activity. Achilles tendinopathy causes significant pain and functional limitations in athletes. Hip muscle dysfunction may occur in athletes having Achilles tendinopathy. This study aims to determine hip muscle functional performance in athletes with Achilles tendinopathy, benefiting both athletes and the therapists by designing more effective rehabilitation protocols. OBJECTIVE: To determine functional hip muscle performance among athletes with Achilles tendinopathy. METHODOLOGY: A descriptive cross sectional study was conducted at 6 different sports clubs among athletes diagnosed with Achilles tendinopathy. Six months from June, 2023 to December 2023 was the total study’s duration. Through the technique of non-probability convenient sampling, 80 participants who fulfilled the inclusion criteria were selected for the data collection. Data was collected by using single leg squat test and the findings were analyzed by using its three point ordinal rating criteria. SPSS version 21 was used to analyze the data. Single leg squat test of injured and uninjured side and participant’s demographic characteristics were collected as a descriptive statistics. RESULTS: Out of the eighty participants, 8 showed good performance, 29 fair performances, and 43 poor performances on the injured side, while 23 showed good performance, 30 fair performances, and 27 poor performances on the uninjured side. P value was found to be 0.000 (<0.05). This showed there were significant differences in functional performance of hip muscles on the injured and uninjured sides. CONCLUSION: The study concluded that the athletes who were having Achilles Tendinopathy demonstrated poor functional hip muscle performance on injured side. Significant differences in functional performance were found between injured and uninjured sides. KEYWORDS: Achilles tendon, Athletes, Overuse injury, Physical performance, Tendinopathy

Vocational rehabilitation. Employment of people with disabilities, Therapeutics. Psychotherapy
DOAJ Open Access 2024
Toward Robust Arabic Sign Language Recognition via Vision Transformers and Local Interpretable Model-agnostic Explanations Integration

Nadiah A. Baghdadi, Yousry AbdulAzeem, Hanaa ZainEldin et al.

People with severe or substantial hearing loss find it difficult to communicate with others. Poor communication can have a significant impact on the mental health of deaf people. For individuals who are deaf or hard of hearing, sign language (SL) is the major mode of communication in their daily life. Motivated by the need to develop robust and interpretable models for the deaf community, this study presents a computer-aided diagnosis (CAD) framework for Arabic SL recognition. The interpretability and management of complicated spatial connections in SL images have been limited by prior studies using convolutional neural networks. To improve accuracy and offer model transparency, the proposed CAD framework incorporates state-of-the-art technologies such as local interpretable model-agnostic explanations (LIME) and vision transformers (ViTs). ViTs use self-attention mechanisms to interpret visuals in SL, capturing global dependencies. A stacking/voting strategy is then used to aggregate predictions from many ViT models, further optimizing the system. Two large datasets, the “ArSL21L: Arabic Sign Language Letter Dataset” and the “RGB Arabic Alphabets Sign Language Dataset,” totaling over 22,000 pictures, were used to validate this approach. Metrics including intersection over union, balanced accuracy, Youden’s index, Yule’s Q, F1 score, accuracy, precision, recall, and specificity were used to assess performance. The results show that the stacking method, which makes use of many ViT models, outperforms traditional models in every performance indicator and achieves an impressive accuracy of 99.46% and 99.88% on the ArSL21L and RGB datasets, respectively. For practical applications, interpretability is ensured by using LIME, which offers clear visual explanations for the model’s predictions.

Vocational rehabilitation. Employment of people with disabilities
DOAJ Open Access 2024
Association of physical activity and risk of cardiac disease among adults

Malaika Bano , Mian Omar , Afaq Ali Shah et al.

Background: Nowadays the level of physical activity is compromised among all, especially in young adults, which may contribute to early development risk of cardiac disease. Objective: To determine the association of risk of cardiac disease with physical activity among young adults. Methods: A cross-sectional study was conducted from January 2024 to April 2024 at Iqra National University, Peshawar after approval from the ethical committee. A total of n=102 undergraduate male and female students between the age of 18-24 years were included in the study. To determine the physical activity of the participants International Physical Activity Questionnaire - Short Form was used. To evaluate the risk of cardiac disease was observed according to the National Cholesterol Education Program. Results: The mean age and BMI of the n=102 study participants were 23.22±3.4 years and 23.37±5kg/m2 respectively. The risk of cardiac disease was found in n=45(44.1%) while most of the participants (n=33) were moderately and (n=42) highly physically active with a mean METs score of 2881.51±2704.83. Physical activity (PA) is not significantly associated (p=0.44) with the risk of cardiac disease. However, gender showed a strong association (p<0.001) with the risk of cardiac disease among the participants. A total of n=24(88.8%) females had the risk, out of n=27, while n=21(28%) males had the risk of cardiac disease out of n=75 males. Conclusion: The study concluded that physical activity had a non-significant relation with the risk of cardiac disease while in the case of gender, females are more prone to have the risk of cardiac disease.

Vocational rehabilitation. Employment of people with disabilities
S2 Open Access 2023
To better meet the needs of autistic people, we need to rethink how we measure services

M. Burke, J. Taylor

Services can be critically important to support autistic individuals in reaching their full potential. Diagnostic services can open doorways to autism-related services and to treatments for co-occurring conditions, early intervention and school-based services can set the stage for learning, therapeutic services (e.g. occupational therapy, speech and language therapy, mental health services) can encourage skill building and mental health, and a variety of services related to home and community-based living (e.g. job coaches, transportation services) can support independence in adulthood. Research suggests that when autistic individuals receive services, they often demonstrate improved school and post-school outcomes (e.g. Burke, Rios, & Lee, 2019; Taylor et al., 2016). In addition to being supported by research, the importance of services is an area of consensus among stakeholders in the autism community. In a literature review about research priorities identified by autistic individuals, families of autistic individuals, researchers, and practitioners, research about services was one of the top-rated priorities (Roche et al., 2021). Autistic self-advocates report that research is needed to examine which types of services truly benefit autistic individuals (Autistic Self-Advocacy Network, 2022). Families report that information about ways to access formal services is needed to improve outcomes for their autistic family member (Aleman-Tovar et al., 2022). Researchers, practitioners, and policymakers similarly report that, to better serve autistic individuals, rigorous research that examines which services are most effective for improving quality of life and other valued outcomes is needed (e.g. Interagency Autism Coordinating Committee, 2020; Lord et al., 2022). Given the general agreement on the importance of services for supporting autistic individuals, one might think that there would be rigorous methods to measure appropriate and beneficial services across the lifespan. Unfortunately, this is not the case. A common way to measure services is by examining service receipt—specifically through dichotomizing whether or not a service is received and counting the number of services (e.g. Burke et al., 2016; Ishler et al., 2022; Kaya et al., 2018). This approach to measuring services assumes that more services are better, but such a premise may not be true. A count of services also implies that each service is equally impactful, an assumption that may be false and could point toward inefficient use of resources. Furthermore, the dichotomization method ignores several of the nuances that are important to understanding whether and when services are beneficial, including the intensity of services (e.g. How many weeks or days is the service received?), duration of the service (e.g. How many hours is the service received?), and content of the service (e.g. Does the service reflect evidence-based practices? What are the specific practices that are embedded in the service?). In further detail in another manuscript (Burke et al., under review), we outline additional ways in which extant service measures are insufficient. Measuring services in a way that moves beyond a count of services received and considers the aforementioned nuances has the potential to make research more impactful in informing practice and policy. Studies of mental health services may provide a good model for how to think about measuring nuance. It is relatively common in mental health services research to measure the type of service (e.g. inpatient, outpatient), setting of the service (e.g. psychiatric hospital, clinic, school), number of times the service was used, and benefits of the service (for an example, see the Services Assessment for Children and Adolescents, Horwitz et al., 2001). It is much less common to see comprehensive measurement of developmental disability or autism services—especially as an autistic person moves from adolescence into adulthood. For example, a study may assess whether vocational rehabilitation services are/ are not received and whether the receipt of that service is related to a greater likelihood of employment, but for research to inform practice and policy, it is likely helpful to measure the number of hours of vocational rehabilitation services, the length of time the services are received, who is performing the services, and what specific practices are being implemented. Such a detailed and comprehensive assessment can provide the information needed to understand the circumstances wherein services are effective in meeting an individual’s needs. A measure to understand when and how services are beneficial to autistic individuals will also need to assess unmet service needs and, perhaps most importantly, identify the barriers to not receiving needed services. The number of unmet service needs has been used in research about To better meet the needs of autistic people, we need to rethink how we measure services 1164495 AUT0010.1177/13623613231164495AutismEditorial editorial2023

7 sitasi en Medicine
S2 Open Access 2023
A scoping literature review of transition-related research involving youth with autism spectrum disorder

Stuart P. Rumrill, P. Rumrill, C. Gooden et al.

BACKGROUND: Owing to steadily increasing rates of autism spectrum disorder (ASD) among children, youth, and adults, it is certain that growing numbers of these individuals will need transition and vocational rehabilitation (VR) services for many years to come. ASD research has focused on identifying employment barriers rather than on effective interventions to remove or reduce those barriers. Even so, some evidence has demonstrated support for the effectiveness of specific transition-related interventions. OBJECTIVE: The purpose of this article is to review the existing literature regarding transition and employment for youth with ASD. METHOD: We begin with an overview of the clinical characteristics of ASD and its incidence and prevalence in the U.S. Then, we examine vocational issues facing individuals with ASD. RESULTS: The remainder of the article focuses on transition and VR implications with specific emphases on (a) interdisciplinary transition planning, (b) postsecondary educational supports and services, and (c) employment interventions. CONCLUSION: ASD is a high-incidence disability that presents significant service delivery and advocacy needs for young people with ASD and their families. Evidence-based employment interventions are available to help young people with ASD make smooth transitions to adulthood in the settings of their choice.

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