Supported Employment for People with Intellectual Disabilities, Autism Spectrum Disorders, and Schizophrenia: A Propensity Matched Comparison of Vocational Rehabilitation Outcomes

This study examined whether Supported Employment (SE) is an effective Vocational Rehabilitation (VR) intervention for individuals with intellectual disabilities, autism spectrum disorders, and schizophrenia who were served by the state-federal VR program. The study relied on a data extract from the U. S. Department of Education, Rehabilitation Services Administration Case Service Report (RSA-911) database that covered fiscal years 2010 through 2013. The sample consisted of 182,719 individuals, including 108,819 (59.56%) classified as having an intellectual disability; 26,086 individuals (14.28%) diagnosed with autism; and 47,814 (26.17%) with schizophrenia. A total of 31.8% of the participants reported receiving Supplemental Security Income (SSI) and 14.7% reported receiving Social Security Disability Insurance (SSDI) at the time of application for VR services. We used propensity score matching to compare the likelihood that VR clients with various demographic characteristics would receive SE as a rehabilitation intervention. A classification tree was used to identify subsets of participants who have similar propensities of receiving SE interventions based on their demographic covariates.

Results indicated a positive effect of the SE intervention for individuals with intellectual disabilities, autism spectrum disorders or schizophrenia. This effect was strongest for transition age youth (mean age of 19 years) who received Supplemental Security Income (SSI) disability benefits (15% difference in employment outcomes) and persons with intellectual disabilities or autism who graduated from regular high school (13.3% difference in employment outcomes). The propensity adjusted estimate of the overall effect of SE on VR outcomes showed that individuals who received SE had on average a 7.8% higher employment rate than individuals who did not receive SE.