Recent Trends and Issues in Vocational Rehabilitation of People with ID

Introduction

Vocation or employment is central to human existence. It enables an individual to possess a valued social position and identity that has a significant influence on self-concept and relationships with others. As an important aspect of life in today’s society, work has a substantial effect on our fundamental aspects of personality and is a major contributing factor to our levels of self-esteem. Besides earning an income, work provides opportunities for social interaction, a means of structuring and occupying time, enjoyable activity and involvement, and a sense of personal achievement. In addition, work provides an opportunity for improving skills while also providing income and financial security. Employment as a basic right of citizenship is often taken for granted. Yet, many people with intellectual disability through the non-availability of evidence-based services are excluded from this basic right. Work is considered therapeutic and essential for both the physiological survival and psychological well-being of people in contemporary societies. Conversely, unemployment can produce high levels of stress, anxiety, and depression; low levels of self-worth; and decrease opportunities for self-development, autonomy, and social contact. The shift from being employed to unemployed is significantly associated with not only an increased risk of depression, alcohol dependence, anxiety states, and psychosomatic reactions, but also stigma, aimlessness, and poverty, which combine to trigger or amplify mental health problems. Recognizing the importance of work, vocational rehabilitation professionals such as rehabilitation counselors, have consistently advocated for work as a fundamental human right of people with disabilities. (Rubin &Roessler, 1995; Wright, 1980).

The rights of people with disabilities have been given new attention with the entry into force of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in May 2008. The provisions of the CRPD contribute to other international standards concerning persons with disabilities, signaling a dramatic shift in international policy terms. In relation to training and employment, for example, states are called on to provide opportunities for disabled people alongside non-disabled people.

People with intellectual disabilities are entitled to benefit from the provisions of the CRPD and ILO Convention concerning the Vocational Rehabilitation and Employment (Disabled Persons), ACT 159 in 1983 as well as people with other kinds of disabilities. Yet, they are frequently not well placed to gain from this changed emphasis on inclusion. In many developing countries, in particular, they are often excluded from school and deprived of opportunities to acquire relevant vocational skills at all, presenting further disadvantages when it comes to seeking jobs. Yet, experience in many countries shows that, with the right training, support in the workplace as required, and the right opportunities, they can make valued contributions in the workplace and to a country’s economy (ILO,2008).

Research has shown that people with intellectual disabilities often have multiple secondary impairments, including complex physical and mental health problems (Beange et al., 1999; Einfeld et al., 2006; Hofer et al., 2009). These co-existing disabilities are particularly likely to be problems of agility, mobility, speech and language; and emotional problems including anger control, anxiety and depression. They are also more likely to experience loneliness and lack of friends (McVilly et al., 2004).

It is acknowledged that people with all categories of disabilities have experienced discrimination and stigmatization throughout the centuries. Yet, an intact intellect has historically been highly valued and often seen as the essential characteristic of being fully human (Parmenter, 2001), and people with intellectual disabilities are often the last within the community of disabled persons to receive attention. In the not-too-distant past a person with an intellectual disability “was viewed not as a second-class citizen, but rather as one who possessed no citizenship” (Stevens, 1967).

In the planning and delivery of educational and vocational programs for people with intellectual disabilities, a support needs approach to classification has significant benefits in contrast to the earlier practice of classification based on IQ levels (mild, moderate, severe and profound). Areas of functioning important to employment, where people with intellectual disabilities may need specific supports, include (ILO,2011)