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The Impact of Vocational Interventions on Vocational Outcomes, Quality of Life, and Community Integration in Adults with Childhood Onset Disabilities: A Systematic Review

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Abstract

Purpose Despite the desire and ability to work, individuals with childhood onset disabilities are under-represented in employment. Vocational interventions alleviate some barriers to obtaining and maintaining employment for this population. The research question addressed is: What is the impact of vocational interventions on vocational outcomes, quality of life (QoL), and community integration (CI) in adults with childhood onset neurological disabilities including cerebral palsy (CP), spina bifida, and acquired brain injury (ABI)? Methods A literature search was conducted in multiple electronic databases. All experimental and observational studies with comparator group(s) were included. Two reviewers independently completed titles and abstracts screening, full text screening, data abstraction, and risk of bias assessment. Results Seventeen studies were eligible for final inclusion including three randomized-controlled trials, four non-randomized studies, and ten observational studies. Sixteen of seventeen studies included only individuals with ABI, while one study included individuals with CP. Vocational interventions from experimental studies were mainly components of multi-faceted interventions. Most observational studies were from the United States Vocational Rehabilitation Service. Conclusions Vocational interventions may be effective in improving vocational outcomes, QoL, and CI for individuals with ABI. There is limited experimental evidence on interventions that specifically target employment. Observational data suggest that receiving job placement assistance, on-the-job training and supports, counselling/guidance, maintenance, and supported employment successfully predicted employment outcomes.

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Fig. 1

Adopted from the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) [27]

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Authors and Affiliations

  1. Toronto Rehabilitation Institute, University Health Network, Toronto, Canada

    Zechen Ma, Mark Bayley & Sarah Munce

  2. Faculty of Medicine, University of Toronto, Toronto, Canada

    Priya Dhir

  3. University of Toronto Libraries, University of Toronto, Toronto, Canada

    Laure Perrier

  4. LIFEspan Service, Toronto Rehabilitation Institute, Rumsey Centre –University Health Network, 345 Rumsey Road, Toronto, ON, M4G 1R7, Canada

    Sarah Munce

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  1. Zechen Ma
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Correspondence to Sarah Munce.

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ZMa has been supported by the Institute of Medical Sciences at the University of Toronto under the Summer Undergraduate Research Program; and by the University Health Network Toronto Rehabilitation Foundation. The authors report no conflicts of interest.

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Ma, Z., Dhir, P., Perrier, L. et al. The Impact of Vocational Interventions on Vocational Outcomes, Quality of Life, and Community Integration in Adults with Childhood Onset Disabilities: A Systematic Review. J Occup Rehabil 30, 1–21 (2020). https://doi.org/10.1007/s10926-019-09854-1

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