Rehabilitation and Therapy Commons^™

Home Exercise Program Adherence In Physical Therapy: Application Of The Transtheoretical Model, Charis Brown

Senior Honors Theses

Home exercise programs (HEPs) are a foundational component of physical therapy (PT). However, the majority of patients are not compliant with their HEP; they lack the motivation and habits necessary to be compliant. The transtheoretical model (TTM) is a framework for understanding the decision-making of the individual and is a model of intentional change. When properly understood and applied, the TTM can improve a physical therapist’s ability to help patients to change their behavior and to become HEP compliant. This paper seeks to address patient exercise noncompliance by educating and instructing physical therapists in the application of the TTM, which …

The Perceptions Of Educators On Transition Planning & The Postsecondary Transition Readiness Outcomes Of Students With Disabilities, Marisa Duarte

Dissertations

The purpose of this quantitative descriptive research was to gain the perspective of educators on transition planning for students with disabilities in two public school districts in the state of Kentucky. The Individual Disabilities Education Act and Workforce Innovation Opportunities Act are laws requiring students with disabilities to be transition ready upon their graduation from high school. A sample of 12 educators, representing two Kentucky districts, who participate in transitioning students with disabilities, completed The Secondary Educator Transition Questionnaire survey. Data from the districts’ state report cards indicated students with disabilities were not transition ready in comparison with students without …

Motivational Interviewing In Vocational Rehabilitation: Why It Matters For People With Disabilities, Alicia Wein-Senghas

Antioch University Full-Text Dissertations & Theses

Motivational Interviewing (MI) is increasingly being trained within and integrated into public vocational rehabilitation (VR) programs based on its efficacy in related fields and yet research specific to the efficacy of MI in public VR programs is almost nonexistent. This study used a quantitative sequential design to explore relationships between MI training, MI proficiency, and VR customer outcomes within the State of Vermont’s Division of Vocational Rehabilitation (VT DVR) program. The study occurred in two phases. In the first phase, 30 VR counselors were recruited, and their level of MI proficiency was established using the Motivational Interviewing Treatment Integrity Measure …

The Role Mentoring Plays In The Transition Of Practice Of Newly Credentialed Athletic Trainers, Stacy E. Walker, Stephanie Mazerolle Singe, Julie M. Cavallario

Nursing Faculty Publications

Context: Mentoring has been identified as an important method to support newly credentialed athletic trainers during their transition to practice. Gaining a better understanding of this relationship could provide valuable insights that may assist employers and professional programs to develop a plan, which could better facilitate the transition.

Objective: To examine what aspects of the mentoring relationship provided the most benefit during transition to practice.

Design: Grounded theory.

Setting: Individual phone interviews.

Patients or Other Participants: 13 athletic trainers who graduated from a professional master's program, were certified between February and July of 2016, and obtained employment between July to …

Using Data-Enabled Performance Feedback And Guidance To Assist Employment Consultants In Their Work With Job Seekers: An Experimental Study, John Butterworth, Alberto Migliore, Kelly Nye-Lengerman, Oliver Lyons, Amy Gunty, Jill Eastman, Paul Foos

All Institute for Community Inclusion Publications

BACKGROUND:The success of job seekers with disabilities in achieving their employment goals depends in large part on the quality of employment supports that they receive from employment consultants. OBJECTIVE:To test the effectiveness of data-enabled performance feedback to assist employment consultants in implementing standards of effective employment supports. METHODS:A total of 187 employment consultants in 30 states were randomly assigned to intervention or control groups. The intervention group received data-enabled performance feedback and guidance for 12 months, whereas the control group continued with business as usual. Both groups completed baseline and quarterly surveys throughout the intervention. RESULTS:One year after baseline, the …

State Roles In Promoting Community Life Engagement: Themes From The State Employment Leadership Network’S Working Group, Jennifer Sullivan Sulewski, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

As states focus on expanding integrated employment opportunities for people with intellectual and developmental disabilities (IDD) and phasing out sheltered work, they are finding a need to concurrently examine Community Life Engagement (CLE) supports as a wrap-around to ensure individuals’ engagement in the community is maintained and they continue to receive sufficient levels of support, despite fluctuations in job status and hours. In January through June of 2017, the State Employment Leadership Network (SELN) hosted a working group of member states to discuss ideas and share strategies for encouraging quality CLE supports while maintaining a focus on Employment First (see …

Data Note: Social Security Administration Data Show A Record Low Level Of Pass Usage Among Ssi Recipients, Daria Domin, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Social Security Administration (SSA) offers a set of work incentives for Supplemental Security income (SSI) beneficiaries. Work incentive employment supports help SSI recipients go to work by minimizing the risk of losing their SSI or Medicaid benefits (Social Security Administration, 2018). One such incentive, the Plan to Achieve Self-Support (PASS), allows approved individuals to set aside earned or unearned income and resources to achieve an employment goal. The money or resources set aside are excluded from SSI income and resource tests and can be used to pay for goods or services needed to reach the goal, such as education, …

Service Provider Promising Practice - The Arc Of Westchester: Creative Partnership With Mercy College, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Arc of Westchester benefits from an agency culture that values innovative partnerships. In fact, an agency leader explained that the organization “will work with anybody who is willing to sit and talk.” This collaborative spirit led to a creative endeavor with Mercy College, a four-year school offering degrees in Business, Education, Liberal Arts, Health and Natural Sciences, and Social and Behavioral Sciences. Within Health and Natural Sciences are departments such as nursing, speech therapy, occupational therapy, physical therapy, and nutrition. The Arc of Westchester partnered with these departments to form a mutually beneficial relationship, creating opportunities for both college …

Service Provider Promising Practice - Atwork!: Creating A Robust Investment In Staff Professional Development, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

At the beginning of their transformation process, AtWork! did not have a training structure in place. Recognizing that job development required a different skill set for their staff, AtWork! made a commitment to invest in training, which they saw as “a key ingredient” to successful transformation. Investing in the development of staff skills and competencies to support the transformation process is essential. Without that investment, as one agency leader put it, “every provider is going to continue to spin their wheels with people in, people out, retraining, all those type of things.” Consequently, AtWork! invested in training its staff through …

Service Provider Promising Practice - Penn-Mar Human Services: Creating Their “2020 Strategic Plan”, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

At the beginning of the transformation process, Penn-Mar recognized the importance of robust strategic planning to understand what the organization needed to do differently to transform. Therefore, Penn-Mar created the 2020 Strategic Plan, a 5-year plan to help focus the organization, and to strategize about how to achieve their objectives. The 2020 Strategic Plan outlines Penn-Mar’s goal to close its sheltered workshop, with a set of action steps for achievement. The plan set a specific date for closure, as Penn-Mar staff argued that without it, the transformation process would “linger forever.” Penn-Mar established a task force to support the development …

Service Provider Promising Practice - Work Inc.: Developing A Community Liaison Program To Address Holistic Needs, Esther Kamau, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Leadership at Work Inc., a provider in the Boston area, thought about the holistic approach to providing individual supports even before their agency’s transformation began. Work Inc. designed its community liaisons program to have three components: volunteerism, with the intention of identifying employment opportunities and contributing to the community; recreation, “because everyone wants to have fun”; and instruction, with a focus on skill-building and identifying interests and talents. In designing and implementing the program, Work Inc. staff considered each person’s interests, and turned former workshop staff into “community liaisons.”

Service Provider Promising Practice - Arc Of Westchester: Annual Employer Appreciation Breakfast, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

The Arc of Westchester was established in in New York State in 1949 as a day school for children with developmental disabilities. It has since grown to over 800 hundred employees serving over 2000 individuals throughout Westchester county supporting children, teens, and adults with intellectual and developmental disabilities. The organization’s vision is a world where the population that they serve enjoy fulfilled lives and an inspired future while the mission focuses on strengthening families and encouraging personal choices, abilities and interests. The programs focus on the individual, helping them discover their interests, develop their talents and prepare for meaningful careers. …

Statedata: The National Report On Employment Services And Outcomes Through 2016, Jean Winsor, Jaimie Ciulla Timmons, John Butterworth, Alberto Migliore, Daria Domin, Agnes Zalewska, John Shepard, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Recent legislation and regulation governing Medicaid Home and Community-Based Services (HCBS), the Workforce Innovation and Opportunity Act of 2014 (WIOA), and settlement agreements between states and the U.S. Department of Justice are clarifying federal intent and paving the way to supporting opportunities for people with disabilities to have meaningful jobs in their communities. With an increasing emphasis on integrated employment and an Employment First philosophy, the nation is poised for transformation that could put Americans with disabilities on a path out of poverty and towards self-sufficiency. However, there remains a significant gap in employment rates between people with and without …

Building An Evidence-Based, Holistic Approach To Advancing Integrated Employment, Allison C. Hall, John Butterworth, Jean Winsor, John Kramer, Kelly Nye-Lengerman, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Since the introduction of supported employment in the Developmental Disabilities Act of 1984 and the Rehabilitation Act Amendments of 1986, there has been continued development and refinement of best practices in employment services and supports. Progress includes creative outcomes for individuals with significant support needs including customized jobs and self-employment, community rehabilitation providers that have shifted emphasis to integrated employment, and states that have made a substantial investment in Employment First policy and strategy. Despite these achievements, the promise of integrated employment remains elusive for the majority of individuals with intellectual and developmental disabilities. The number of individuals supported in …

Strengthening Employment Services For Job Seekers With Intellectual And Developmental Disabilities (Bringing Employment First To Scale, No 15), Alberto Migliore, Kelly Nye-Lengerman, Oliver Lyons, John Butterworth, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Strengthening the effectiveness of employment services for job seekers with disabilities is key for improving their employment outcomes and their financial self-sufficiency. The purpose of this brief is to examine the quality of employment services available to job seekers with disabilities, and to offer recommendations for improvement. Findings are from a longitudinal study that involved 61 employment 37 employment programs in 17 states. Data were collected through a survey employment specialists, delivered to the job developers, or participants’ business developers. smartphones every work day for one year. Based on these findings and the literature about effective employment support practices, we …

Rrtc On Advancing Employment Composite Indicator Research, Frank A. Smith, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

What?
Analysis to describe the relationship between state employment system characteristics and employment outcomes for individuals with intellectual and developmental disabilities (IDD).

Why?
To better understand higher-performing state employment systems.

How?
Researchers included individual indicators from 2013 for each state from its IDD and vocational rehabilitation (VR) agencies. We also used American Community Survey data that looked at employment outcomes and education for individuals with cognitive disability between the ages of 22 to 30, i.e. individuals who recently aged out of eligibility for services under IDEA. The resulting composite indicator (CI) represents overall state employment system performance.

A Model Of Employment Supports For Job Seekers With Intellectual Disabilities, Alberto Migliore, Kelly Nye-Lengerman, Oliver Lyons, Jennifer Bose, John Butterworth, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Interviews with 16 employment consultants-triangulated with job seekers, family members, and supervisors-revealed a model of employment supports aligned with the elements described in the literature, although with an added emphasis on (a) building trust as a key element starting from day one; (b) a circular process converging on the job match; (c) and flexible intensity of supports. The model can be used for improving clarity in communication with employment consultants about effective employment support practices for assisting job seekers with intellectual and developmental disabilities.

Data Note: State Intellectual And Developmental Disability Agencies’ Service Trends, Agnes Zalewska, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

In FY2016, an estimated 638,568 individuals received day or employment supports from state IDD program agencies. This number grew from 455,824 in FY1999. The estimated number of individuals in integrated employment services increased from 108,227 in FY1999 to 120,244 in FY2016. Despite the trend to terminate facility-based services in some states, the overall state investment continues to emphasize non-work services, rather than integrated employment services. Figure 1 shows the trends in the percentage of people served in integrated employment and facility-based and non-work settings between FY2008 and FY2016.

Service Provider Promising Practice - Transcen’S Worklink Program: Helping Individuals Gain Work Skills Through Targeted Volunteering And Other Community Life Engagement Activities, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

WorkLink is a program that enables individuals with intellectual and developmental disabilities (IDD) to work while receiving wrap-around day services. Having access to both types of supports -- community employment and Community Life Engagement (CLE) -- is particularly important for individuals with significant IDD, who often work fewer hours and need additional support to lead active and meaningful lives. The program was started in 1996 by TransCen, Inc., and is based in San Francisco, California. Day services not only help individuals establish and maintain meaningful community relationships, but also let them build important skills as they explore vocational goals and …

Service Provider Promising Practice: Flexible Scheduling And Creative Staffing - Kfi’S Support Solutions, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Headquartered in a small rural town in northern Maine, Katahdin Friends, Inc. (KFI) provides community employment and life engagement supports, as well as home supports, to individuals with intellectual and developmental disabilities (IDD). KFI’s services extend throughout northern and southern Maine, including the cities of Portland and Bangor. A flexible approach to staffing and support scheduling helps KFI ensure customized daily support schedules that meet individual goals. This approach also allows individuals to interact with a variety of direct support professionals, which is important for having a more engaged and meaningful life in the community. As of July 2016, KFI …

Service Provider Promising Practice: Braiding Community Employment And Life Engagement Services - Transcen’S Worklink Program, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

WorkLink is a program that braids community employment and life engagement services. The goal is to enable individuals with intellectual and developmental disabilities (IDD) to work while receiving wrap-around day supports, as needed. Started in 1996, WorkLink is a program of TransCen, Inc. and is based in San Francisco. WorkLink clients do not have to give up day supports when deciding to pursue work. In addition to helping individuals establish and maintain meaningful community relationships, day supports are used to discover and explore vocational goals and job options. This information then helps guide individuals’ employment planning process. At WorkLink clients …

Service Provider Promising Practice: Avenues Supported Living Services: A Staffing Approach Based On Client Relationships, Heike Boeltzig, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Avenues Supported Living Services of Valencia, California was founded in 1997 by a husband- andwife team, Scott and Lori Shepard. The agency provides supported living and community life engagement (CLE) services to individuals with intellectual and developmental disabilities (IDD). Key to Avenues’ success is a staffing approach that is grounded in client relationships. The agency limits staff hours to two shifts per week with the same individual. This is done to facilitate clientstaff matching and relationship building, but also to prevent potential burnout and frustration by ensuring both the clients they support and their staff have variety in their schedules. …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Supported Employment For Veterans With Traumatic Brain Injury: Provider Perspectives, Terri K. Pogoda, Kathleen F. Carlson, Katelyn E. Gormley, Sandra Resnick

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: In 2006, 13 sites were provided with one-time pilot funding to provide supported employment (SE) to Veterans with traumatic brain injury (TBI) history. In 2014, we surveyed SE providers at pilot and non-pilot sites that did not receive this funding. Our objectives were to identify any pilot and non-pilot site differences regarding current: (1) provision of SE to Veterans with TBI; (2) staffing and communication between the SE and polytrauma/TBI teams; and (3) provider perceptions on facilitators and barriers to providing, and suggestions for improving, SE.

Design: Mixed methods cross-sectional survey study.

Participants: Providers included a …

Ten Elements Of Organizational Transformation: Strategies For Moving Towards Integrated Employment, Jaimie Ciulla Timmons, John Butterworth, Jonathan Lucus, Thinkwork! At The Institute For Community Inclusion At Umass Boston

All Institute for Community Inclusion Publications

This session will share ten key organizational characteristics necessary to strengthen competitive integrated employment outcomes. Get a first-hand look at the RRTC’s Organizational Transformation Toolkit and explore our Provider Employment Leadership Network, a yearlong facilitated Community of Practice of provider leaders in employment. In conjunction with The Arc of the United States, this PowerPoint offers ten essential elements necessary for successful organizational transformation, along with strategies for implementing each element.

Service Provider Promising Practice: Using Staff Networks To Build Community Membership At Loqw, Oliver Lyons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

LOQW (Learning Opportunities/Quality Works) is a community skills training, service coordination, and employment services provider in northeast Missouri. LOQW employs over 100 people and serves 14 counties in northeast Missouri and 600 customers annually. Their mission is to “positively impact the lives of individuals through support, advocacy and connection to resources.” LOQW operates several satellite offices in addition to its main office in Monroe City, MO. One of these satellite offices is located in Hannibal, MO, a city with a population of less than 18,000. For comparison, Busch Stadium in nearby St. Louis can hold over twice that amount of …

Service Provider Promising Practice: Using Mobile Communication Technology At Seec, Oliver Lyons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

SEEC (Seeking Equality, Empowerment, and Community) is a Maryland-based provider of employment, community living, and community development supports to people with intellectual and developmental disabilities (IDD). Originally established in 1987, SEEC started converting from facility-based to exclusively community-based supports in 2005, and closed down its center-based program completely in 2009. Currently, all of SEEC’s supports are individualized and community-based, in keeping with the organization’s mission “to support people with intellectual and developmental disabilities to direct their lives with dignity, choice, authority, and responsibility.” SEEC provides supports to over 200 people with IDD throughout Montgomery County and the District of Columbia. …

Sexual Assault On College Campuses: An Epidemic And An Alternative Approach, Mark N. Devone

Undergraduate Research

Sexual assault is a major problem that is occurring at staggering rates on college campuses nationwide. Sexual Assault on College Campuses: An Epidemic and An Alternative Approach takes an in depth look at the problem at hand and discusses how the current ways of handling sexual assault cases and their faults. An alternative approach is introduced as a possible way to help fix the current sexual assault problem. The approach is Restorative Justice, which focuses on the rehabilitation of the offender and the healing of the victim through reconciliation techniques that include the victim, offender, and the community.

Guidepost 1: Individualize Supports For Each Person, Hannah Curren, Oliver Lyons, Jaimie Ciulla Timmons, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Community Life Engagement refers to how people with intellectual and developmental disabilities (IDD) access and participate in their communities outside of employment as part of a meaningful day. (See “What Is Community Life Engagement?” in the box on page 3.) The Community Life Engagement team has been conducting research to identify the elements of high-quality Community Life Engagement (CLE) supports. We have created a series of four Engage Briefs to examine the guideposts in detail.

Data Note: Reasons For Exiting Vr Services Without Employment, Alberto Migliore, Cady Landa, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Only 23% of adults with intellectual disabilities work, compared to 73% of people without disabilities (statedata.info). To bridge this gap, the vocational rehabilitation (VR) program offers valuable services including assessment, job search assistance, and counseling. In FY 2014, over 46,000 adults with intellectual disabilities exited the national VR program. About 38% of them reported an employment outcome. However, a large proportion of them exited without employment, and were reported as either having lost interest in receiving services (29%), or unable to be located by VR staff (17%). These two reasons combined represented 46% of the total number of case closures …