The relation between VR services and employment outcomes of individuals with traumatic brain injury

Journal of Rehabilitation, July-Sept, 2003 by David Gamble, Corey L. Moore

Competitively employed consumers who received work adjustment services made an average of $86.31 less per week than competitively employed consumers who did not receive work adjustment services. The descriptive statistics presented in Table 3 reflect this main effect. In a study of consumers with mental retardation, Moore et al. (2000) likewise found a significant inverse relationship between work adjustment training and weekly earnings. Due to concern for accepting a false treatment effect (Type I error), we conducted a one-way ANOVA to evaluate the relationship between work adjustment services and level of income while controlling for severity of disability. Specifically, only those consumers with severe TBI who were closed into competitive jobs were included in this analysis. The one-way ANOVA result refuted our concern: consumers with severe TBI who were provided work adjustment services (n = 127) possessed a significantly lower level of income (M = $193.32) when compared to those who were not provided work adjustment services (n = 346; M = $254.41), F (1,471) = 14.91, p < .001.

Mean weekly earnings were higher for competitively employed consumers who did not receive assessment, college, and job placement services than for their counterparts who received college services alone (see Figure 1). Reasons for this are unclear. It could be hypothesized that competitively employed clients who did not receive these services had the functional capacities, experience, skills, and training necessary to secure higher paying jobs at the onset of VR intervention. Alternatively, other variables could have influenced this interaction. For example, demographic and global VR service variables (i.e., time in rehabilitation, service costs, etc.) may be important.

In the absence of job placement, competitively employed consumers who received assessment and college services had higher weekly earnings than competitively employed consumers who received assessment services alone (see Figure 1). In the presence of job placement, competitively consumers who received college services had higher mean weekly earnings than their counterparts who did not receive college services at each level of assessment (see Figure 2). These findings along with the summary information in Table 3 affirm the important relationship of college services to the earnings capacities of consumers with TBI.

To further investigate the relationship of college on earnings for competitively employed participants, we conducted a one-way ANOVA while controlling for disability severity. Consumers with severe TBI who received college services (n = 74) had significantly higher weekly earnings (M = $306.62) than consumers with severe TBI who did not receive college services (n = 399; M = $225.28), F(1,471) = 17.87, p < .001.

College services therefore were related to closure status and weekly earnings both before and after controlling for disability severity. However, a limited percentage of the sample (9.3%) received this service. It is possible that VR professionals over-estimated the functional deficits of the participants. This premise is strengthened by an earlier study which found that clinicians tended to overestimate pathology in their clients with TBI (Faust et al., 1998).