R-54: Improving Employment Outcomes for American Indian Adolescents and Adults with Learning Disabilities, Depression, and FAS/ARND

American Indian Rehabilitation Research and Training Center

Principal Investigator: Robert M. Schacht, Ph.D.
Co-investigator: Robin LaDue (Cowlitz), Ph.D., Clinical Associate Professor, University of Washington
Collaborators: John Butterworth, Ph.D., Research Director, RRTC on Promoting Employment
Sheila Fesko, Ph.D., RRTC on Promoting Employment
Chris Cunniff, MD, Associate Professor of Pediatrics, Obstetrics, and Gynecology; Chief, Section of Medical and Molecular Genetics, University of Arizona"

Project Description:

The purpose of this project is to develop innovative approaches to screening, the development of Individualized Plans for Employment, and job placement to improve employment outcomes for American Indians and Alaska Natives with learning disabilities (LD), depression, Fetal alcohol syndrome (FAS), or alcohol-related Neurodevelopmental disorders (ARND).

In understanding what is needed to improve counselors’ ability to address the work related needs of American Indian adolescents and adults who have FAS/ARND, we must first find out what has been happening to these persons when they apply or are referred to counselors to find work. The term "counselors" is meant to include vocational rehabilitation (VR) counselors, independent living counselors, school counselors, school psychologists, developmental disabilities case managers, job coaches and other interested professionals. One of the most important times for these individuals is the move from school to work.

The basic plan of this research is to identify American Indian adolescents and adults who have FAS/ARND, and to analyze their educational and vocational history, especially any experiences they may have had with high school counseling programs, skill centers, and VR. Our approach is an interdisciplinary one. That is, since FAS is a medical syndrome with consequences for behavioral and mental functioning, the research involves dialog among medical personnel, psychologists, special education personnel, and counselors with the objective of mutual understanding about how each contributes an important perspective to understanding the special needs of American Indians who have FAS/ARND. We are also seeking to interview counselors who have worked with these persons about their understanding of the needs and functional limitations of persons of FAS/ARND.

The questions we are trying to answer for this project are:

• Are counselors who work with American Indians familiar with the problems faced by people with FAS/ARND and the trouble caused by these problems?
  

• What do counselors do now while helping American Indian adolescents and adults who have FAS/ARND?
  

• What questions do counselors ask when they ask medical people for answers?
  

• Do counselors have enough answers to help American Indian adolescents and adults with FAS/ARND to make good educational and work plans?
  

• What is known about other "helpful" educational plans for American Indian adolescents who have been diagnosed with FAS/ARND?
  

• What is understood to be a "good" educational plan (e.g., high school diploma)?
  

• What is known about other "helpful" work plans for American Indian adolescents and adults who have been diagnosed as FAS/ARND?
  

• How often do the plans work for people with FAS/ARND compared with other people?
  

Purpose:

To examine the needs over time to ensure that individuals with disabilities are benefiting from AT after the initial diagnosis and setup, and to examine American Indian consumer satisfaction with assistive devices, with respect to their availability, ease of use, maintenance, and repair, as well as implications for employment outcome

Progress to Date:

Objective 1: A partial analysis of currently available data was conducted in December, 2001. Then, because of changes in RSA reporting requirements (3/16/2000, RSA-PD-00-06), the Case History Summary booklet had to be revised. This revision was completed. Meanwhile, additional information on VR services has been obtained for about 13 cases already in the database that has been extremely helpful. One of the cases has been developed as a case study. We now have about 50 American Indian and Alaska Native adolescents and adults in the database.

Objective 2: Within the past few months we have finally been able to identify more counselors to invite to participate in our survey.

Objective 3: While some progress has been made with Activity 3.1 (analyzing RSA-911 data for American Indians and Alaska Natives with LD), progress on Activities 3.2 and 3.3 have been held up pending the development of sufficient data in the Case Histories (Objective 1). In Dr. Cunniff's review of this objective, he wrote that Objective 3.0 seeks to identify characteristics associated with better employment outcomes through analysis of information from Objective 1.0 and from national data records (RSA-911). Clearly, analysis of the objective data will be helpful. The qualitative data may be of interest in developing impressions or ideas about further analyses, but these narratives will not be analyzable or cannot be objectified in such a way as to identify with certainty best practices. The statistical plan calls for use of chi-square analyses and analyses of variance, but another issue should be clarified is how the particular outcomes are going to be stratified. That is, will the top 25% be compared to the bottom 25%? Will the top half be compared to the bottom half? It is suggested that the benchmarks for success be clearly stated at the outset. The statistical plan is clear for data from the RSA-911 records, though it is less clear and/or not clearly stated for the data that will be gathered from Objective 1.0. The work plan would be enhanced if this information can be designated from the outset.

Objective 4: Since Dr. Cunniff has questioned the need for this Objective, given other priorities of the project, additional work has been done on this objective.

Objective 5: While Dr. Cunniff recognized the value of this Objective, he thought it merits development as a separate project. He "strongly" recommended that this Objective be eliminated from the project in order to accommodate activities of more central importance. Consequently, additional has been done on this objective.

Objective 6: Data is not yet sufficient for analysis of this objective. Dr. Cunniff suggested that this objective be absorbed under Objective 1.

Objective 7: Collaboration with Dr. John Butterworth resulted in useful information for the training manual. Dr. Cunniff suggested that this objective appears to be highly related to Objective 8 and that they might be combined into a single objective. Specifically, the work plan could include training with the developed training manual. That is, the training manual need not be developed independently at the trainings but could be developed in an ongoing manner based on input from trainees. Accordingly, this is the procedure we have used in the training sessions that were conducted on the Nez Perce Reservation in Idaho, at Red Lake and Minneapolis in Minnesota, and at Fort Belknap in Montana. Dr. Cunniff also wrote that this is a very important outcome of the project, since it actually identifies interventions that vocational rehabilitation counselors can use for successful outcomes. Dissemination of this information will eventually be helpful to all their American Indian clients.

Objective 8: As noted above, Dr. Cunniff suggested that Objectives 7 & 8 be combined. He also wrote that these objectives appear very solidly designed. There is a concern about Activity 8.3, which seeks to compare employment outcomes of clients before and after training. The feasibility of this type of evaluation is questionable. Consequently, additional work is being done on Activity 8.3.

Objective 9: A long web page was established for this project with links from the AIRRTC home pages. During the past year, these pages have been revised and expanded, and will be fully linked from the AIRRTC home pages by July 23, 2002.

Objective 10: A revised manual is being developed as a result of ongoing research and training activities.

Training at Ft. Belknap (3/16/2001) ·Invited presentation at The National FAS Conference (April 2001) ·Revised web pages at http://www4.nau.edu/ihd/airrtc/R-54.htm ·Presentation of 3 case studies at AIRRTC National Conference, April 2002 ·Invited presentation in Michigan (September 2002) ·National Service on Education Subcommittee, Interagency Coordinating Council on FAS Dr. Cunniff's recommendations regarding a number of activities have been implemented. As a result, Objectives 4 & 5 have been abandoned.

We have identified more counselors to invite to participate in a survey for Objective 3. As Dr. Cunniff suggested, Objective 6 will be absorbed under Objective 1, and Objectives 7 8, & 9 will be combined.

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Current IHD/AIRRTC Projects relating to:
Fetal Alcohol Syndrome(FAS)
Alcohol-Related Neurodevelopmental Disorders (ARND)
Learning Disabilities(LD)
Depression

For Links to related sites, please scroll down.

Fetal Alcohol Syndrome (FAS)

Alcohol-Related NeurodevelopmentalDisorders (ARND)

Learning Disabilities (LD)

Depression

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