Understanding Employment for People with Acquired Physical Disabilities

Background & Purpose

People with spinal cord injuries (SCI) and multiple sclerosis (MS) are both known to have workforce participation rates that lag far behind the general population, at a rate of roughly 35% for people with SCI (Ottomanelli & Lind, 2009) and as little as 20% among people with MS in which symptoms have progressed (Khan, Ng, & Turner-Stokes, 2011). While many similarities between SCI and MS exist (both are acquired physical disabilities, typically with onset during prime working years) there are many differences in how people with these conditions experience the workplace. The purpose of this study is to examine the barriers and facilitators to employment for people with SCI and MS to understand how employment supports may be shaped to be optimally useful in supporting the needs of individuals from these two disability groups.

Method

Twelve telephone focus groups were conducted with a total of 56 individuals from across the U.S. Half the focus groups were conducted with people with MS and half were with people with SCI. Roughly half of the participants from each disability group were employed and half were unemployed. A semi-structured interview protocol was used to guide each conversation. Completed focus groups were transcribed verbatim and analyzed in NVivo10. A conventional qualitative content analysis approach guided the researchers through data analysis.

Results

Results suggest that, while similarities existed, there were many differences in how people with SCI and MS experience employment. Similarities between the groups included use of self-advocacy to promote employment and the experience of challenges in transportation and discrimination, especially regarding workplace accommodation requests. Individuals with MS were uniquely concerned about the unpredictability of their condition from day to day, and over time, since the severity of MS is progressive and often involves cognitive decline. Many people with MS decided to “pass” as long as possible before disclosing their disability. People with SCI tended to focus on networking and pursuit of new job training as methods to help them find employment, perhaps, in part, because their disability onset tended to happen earlier in life. Representative quotations will be used in the presentation to illustrate key themes.

Implications

Practitioners working with individuals with acquired disabilities should be prepared for a diversity of experiences with employment. Educating people about their basic workplace rights is essential, as is understanding the contexts that enable or inhibit access to employment, such as transportation and benefits eligibility. For many people with SCI and MS, customized employment presents an excellent opportunity to enter or remain in the workforce, and such innovative approaches should be more directly supported by policy.

References

Khan, F., Ng, L., & Turner Stokes, L. (2011). Effectiveness of vocational rehabilitation intervention on the return to work and employment of persons with multiple sclerosis. New York: Cochrane Collaboration.

Ottomanelli, L. & Lind. L. (2009). Review of critical factors related to employment after spinal cord injury: Implications for research and vocational services. Journal of Spinal Cord Medicine, 32, 503-531