Feature Issue on Employment and IDD

After going through a career discovery process, Kaytie Bettincourt now works with animals.

The value of meaningful competitive integrated employment (CIE) cannot be overstated, as it offers individuals with disabilities the opportunity to earn an income and connect with their communities. Individuals with disabilities, especially those with more significant challenges, continue to be underemployed or unemployed, according to reports by the University of Massachusetts Boston’s Institute for Community Inclusion and by Lee Erickson and colleagues at Cornell University Supported employment (SE) and customized employment (CE) are essential strategies to improve employment outcomes. SE and CE are services provided by state vocational rehabilitation agencies and are designed for individuals who have historically struggled to achieve CIE. CE is tailored for those whose work experiences have been limited to segregated settings, such as facility-based programs, sheltered workshops, or subminimum wage positions, or for those who have had limited work opportunities due to low expectations.

The key differences between SE and CE emerge during the career planning and job development stages. CE, for example, uses a qualitative discovery process to explore the job seeker's strengths, interests, and needs. This discovery process is a “no-fail” approach to understanding the individual's employment potential. CE employs customized job development strategies that align with the information gathered during the discovery phase. CE job development begins by identifying businesses that match the job seeker's interests, even if these businesses are not currently hiring. Once suitable businesses are identified that match the strengths, interests, and preferences of the job seeker, an informational interview framework is used to learn more about employers, working conditions, and other potential opportunities. Customized jobs are then created and negotiated based on an employment proposal that reflects the job seeker's unique skills and interests. A key aspect of CE is that the jobs are tailored to the individual and did not exist before the negotiation.

Source: Rehabilitation Services Administration

Both supported and customized employment services are designed to help individuals with disabilities obtain and maintain competitive employment. However, questions remain about the differences in outcomes between the two services. In 2023, Tim Riesen and colleagues analyzed data from the Rehabilitation Services Administration's RSA 911 database for fiscal years 2017-2020 to examine employment status, primary occupation at exit, hourly wage, and hours worked per week for individuals receiving either SE or CE services. While individuals in SE and CE worked similar weekly hours, on average those in CE earned nearly $4 more per hour. Additionally, the data revealed proportional differences in the types of occupations individuals obtained through SE and CE. Specifically, 72% of individuals receiving SE secured jobs in four broad occupation clusters: food preparation, office and administrative support, and building and grounds cleaning and maintenance. Comparatively only 50% of those receiving CE exited into these occupations. This suggests that CE may lead to a broader range of employment opportunities. One reason for this difference is that the CE discovery and job development process involves a more intentional exploration of occupations that align with the job seeker's interests and abilities, rather than being driven solely by market demand.

Source: Rehabilitation Services Administration

Our experiences with individuals pursuing competitive employment have demonstrated firsthand how CE can lead to job opportunities outside the traditional occupations typically pursued by individuals with disabilities.

Kaytie Bettincourt worked as an assistant at a hair salon for several years before participating in the discovery process. Despite being familiar with her tasks and following a task list effectively, the salon required a full-time coach to be with her during her shifts. Although she enjoyed her work, she eventually decided to pursue a career that aligned with her passions and offered more independence. Through the discovery process, several occupational themes emerged, including advocacy, organization, and animals. Based on these themes, her employment specialist contacted the owner of a therapy dog program to learn more about the workplace culture and tasks involved. After discussions and negotiations, a customized position was created for Kaytie that matched both the company's needs and her strengths and interests. Kaytie is now the project assistant at the therapy dog program.

Encouraged by the co-owners, she continues to take on new tasks, such as making dog treats, performing administrative duties, and contributing to the outreach and development efforts. Although some tasks have been challenging, her colleagues and employment specialist are committed to supporting her as she learns. She takes pride in no longer needing a set task list and has become more flexible and adaptable in her role. Her confidence and independence continue to grow, supported by a strong natural support system at pawsandpals.org. Her positive demeanor and willingness to try new tasks have made her a valued member of the team. She was one of the first non-family members hired at the therapy dog program, and her colleagues describe her as having a special ability to connect with both people and dogs. The team has expressed their appreciation for her contributions, using phrases like “She keeps me on track” “She is a great fit,” and “We love having her here” Additionally, she has opportunities to share her personal advocacy experiences and connect with others through social media.