پیش بینی مشارکت محل کار جوانان دارای ناتوانی ذهنی

Individuals with intellectual disabilities (ID) are three to four times less often employed compared to their non-disabled peers. Evidence for factors associated with work participation of young adults with ID is limited. Furthermore, studies on predictors for sustainable work participation among young adults with ID is lacking altogether. Therefore, the aim of this study was to investigate which factors predict finding as well as maintaining employment of young adults with mild ID. We obtained data on 735 young adults with mild ID, aged 15–27 years, applying for a disability benefit. The follow-up period ranged from 1.25 to 2.75 years. Motivation, expectations regarding future work level and living situation predicted finding work as well as maintaining employment for at least 6 months. In this study, especially personal factors were influential in predicting work outcome and may be suitable factors to include in interventions.

The participation rates of young adults with intellectual disabilities (ID) range from 10% to 40%, which is considerably lower than the participation rates of their peers without disability (Ireys et al., 1996, Lysaght et al., 2012b, Rose et al., 2005 and WHO and World Bank, 2011). Moreover, it has been shown that individuals with ID were 3–4 times less often employed compared to their non-disabled peers, that they were less likely to be competitively employed and more likely to work in sheltered work or segregated settings than those with other disabilities (Verdonschot, de Witte, Reichrath, Buntinx, & Curfs, 2009a). It also has been found that individuals with ID tend to work in entry level positions, earn lower wages and work fewer hours than their non-disabled peers (Jahoda et al., 2008, Kirsh et al., 2009 and Lysaght et al., 2012b). Although research suggests that individuals with ID can be a potentially valuable resource for the workforce as they are typically stable, loyal and competent employees, in daily living it is apparently a struggle for them to find and to maintain a job (Kirsh et al., 2009 and Lysaght et al., 2012b). In the Netherlands young adults with ID are mostly educated in special needs education classes. These special needs schools provide vocational training and internships for young adults with ID in the final years at school and appropriate job placements in the transition from school to work. Individuals with ID often need continuous assistance and support in the transition from school to work as well as on the job (Lindsay, 2011, Verdonschot et al., 2009a and Verdonschot et al., 2009b) to be able to develop and maintain their work skills. The lack of work and of necessary support services can make these people overly dependent on family members or social protection (Davies and Beamish, 2009, Dixon and Reddacliff, 2001 and Donelly et al., 2010). Many individuals with ID desire to participate in work (Donelly et al., 2010 and Eggleton et al., 1999), which provides them with opportunities for financial independence and independent living, as well as a structured life and meaningful social participation (Dixon and Reddacliff, 2001, Eggleton et al., 1999, Grant, 2008, Jahoda et al., 2008, Lysaght et al., 2012a and Lysaght et al., 2012b). Work allows them to have contact with other people besides family and friends (Dixon and Reddacliff, 2001, Donelly et al., 2010, Eggleton et al., 1999, Grant, 2008, Jahoda et al., 2008, Lysaght et al., 2012a and Lysaght et al., 2012b) and work may help to build their self-confidence and develop their skills (Eggleton et al., 1999 and Grant, 2008). A review on the socio-emotional impact of supported employment on individuals with ID, found competitive employment was positively related to quality of life, well-being and autonomy (Jahoda et al., 2008). This was confirmed by other studies (Claes et al., 2012, Eggleton et al., 1999 and Kober and Eggleton, 2005). However, competitive employment was not related to an increasing sense of social belonging and community integration of individuals with ID (Eggleton et al., 1999 and Jahoda et al., 2008). In contrast, Kober and Eggleton (2005) found that competitively employed individuals with ID scored higher on social belonging and community integration than their counterparts in sheltered employment. To be able to increase the employment rate of young adults with ID and the effectiveness of support programmes it is important to know which factors facilitate or hinder work participation. Knowledge of prognostic factors for sustainable work participation could provide important input for interventions in the transition from school to work and for support services while working. Personal and social factors (e.g. motivation, self-esteem, family involvement and social support) have been stated in both reviews as well as qualitative studies as being essential in securing employment for individuals with ID (Eisenman, 2003, Foley et al., 2012 and Timmons et al., 2011). Motivation has been well established in the literature (Foley et al., 2012 and Timmons et al., 2011) and has been often mentioned by practitioners to influence employment outcomes. Low self-esteem in individuals with disabilities has been found to decrease the chance of employment (Eisenman, 2003). Research also highlights the role of family members in the transition from school to work, offering career-related advice, helping to find jobs, shaping aspirations and offering practical and moral support to maintain employment (Eisenman, 2003 and Timmons et al., 2011). However, only three studies had employment status as their primary outcome (Dunham et al., 2000, Martorell et al., 2008 and Rose et al., 2005). Furthermore, work status in these studies was assessed by asking if the subjects had found a job or were currently working. No studies on sustainability of employment, i.e. finding and maintaining a job for a specified period of time, in this population were found. As a result, insight in predictors for sustainable employment among young adults with ID is limited. Sustainability of employment is important in this group as young adults with ID are vulnerable to changes and have better chances to develop their working skills in a stable work environment. As factors influencing finding work by individuals with ID may differ from factors influencing maintaining employment, it is important to take sustainability of employment into account as well. Besides the lack of appropriate work outcome measures, previous studies have been cross-sectional or retrospective in design ( Davies and Beamish, 2009, Donelly et al., 2010, Dunham et al., 2000, Martorell et al., 2008 and Rose et al., 2005). Other studies have been explorative and qualitative ( Dixon and Reddacliff, 2001, Donelly et al., 2010 and Timmons et al., 2011). No prospective longitudinal studies are known to us, meaning prognostic factors for work participation in this group are unknown. Therefore, the aim of this study was to investigate which factors predict sustainable work participation, finding as well as maintaining employment, of young adults with mild ID.