RehabWire - Volume 8, Number 5, June 2006

For June, RehabWire looks at current research in services for people with sensory disabilities, especially people who are blind, deaf, or deafblind.

NIDRR Grantees on the Cutting Edge.

Persons Aging with Hearing and Vision Loss, Mississippi State University (H133A020701) led by B.J. LeJeune, MEd, CVRT, CRC. Richard Johnson, EdD, Project Officer.
Abstract: This project investigates strategies to improve outcomes for persons who are over 55 with hearing and vision loss, especially those who have a sensory disability and acquire a second as a result of the aging process. The project conducts a variety of research, development, training, and dissemination activities and evaluates both technology and model service delivery approaches for improving employment and community integration options. The project solicits direct input from key stakeholders as part of the ongoing planning, development, and implementation of research activities. These activities include the use of focus groups, a panel of experts, and a study sample that includes a nationally representative sample of older individuals who are blind or visually impaired and losing their hearing, and those who are deaf or hard of hearing and losing their vision. This is a collaborative project of the RRTC on Blindness and Low Vision at Mississippi State University (see below), San Diego State University, and the Helen Keller National Center for Deaf-Blind Youths and Adults.
Find out more at: www.blind.msstate.edu

RRTC on Improving Vocational Rehabilitation Services for Individuals Who Are Blind or Have Severe Visual Impairments, Mississippi State University (H133B010101) led by J. Elton Moore, EdD. Delores Watkins, Project Officer.
Abstract: This program includes a variety of research and training activities that focus on improving VR services for individuals who are blind or have severe visual impairments. Activities include: (1) investigating and documenting the impact of changes in disability and employment legislation on the unique employment-related needs of individuals who are blind or have visual impairments, as well as their impact on service delivery options and policy; (2) investigating, documenting, and analyzing existent state and federal data sets to determine different employment outcomes for persons who are blind or have visual impairments and the relationship of the outcomes to client and service provider characteristics; (3) investigating and documenting how state VR agencies, other public agencies, and private service providers overcome environmental barriers in order to improve employment outcomes for individuals who are blind or have visual impairments; (4) developing a national information and resource referral database for the training needs of state business enterprise program facilities, developing and delivering training programs to meet the identified training needs, and developing measures that can be used to evaluate the efficacy of the training; (5) conducting three conferences to train VR staff on state-of-the-art information and computer technology for individuals who are blind or have visual impairments; and (6) conducting a coordinated and advanced program of training in rehabilitation research focusing on blindness and low vision, including training in applied research methodology that is designed to increase the number of qualified doctoral-level researchers working in the area of blindness rehabilitation.
Find out more at: www.blind.msstate.edu

Toward Equity: Innovative, Collaborative Research on Interpreter Training, DBT, and Psychological Testing, University of Rochester (H133A031105) led by Robert Pollard, PhD. Bonnie Gracer, Project Officer.
Abstract: The research activities of this project focus on three thematic categories: mental health interpreting, dialectical behavior therapy (DBT), and psychological testing. The interpreter training project builds upon the Deaf Wellness Center’s (DWC) prior innovations in interpreter training and applies them to four geographically dispersed urban settings. A team of experts in the mental health interpreting field employs the DWC’s demand-control schema approach and implements a five-month program of training and supervision with a local interpreter pool. DBT is a highly structured treatment approach focusing on emotional regulation and behavioral self-control. The three-part DBT project adapts DBT materials and methods to maximize treatment access and efficacy with three deaf consumer populations: those with language skills, those with limited language, and those with comorbid psychiatric and substance abuse problems. The Signed Paired Associates Test and the ASL Stories Test are tests of verbal learning and memory for sign language users. The extensive data that exists at the DWC regarding the tests’ psychometric properties and clinical utility implications are analyzed. A second testing project is the development of a psychosis symptom rating scale. The goal is to produce a tool that clinicians can employ to reliably and validly identify the nature and severity of psychotic symptomatology in deaf individuals. Finally, the project includes a psychological testing casebook, written based on reviews of hundreds of DWC psychological testing case files.
Find out more at: www.urmc.rochester.edu/dwc/scholarship/Equity.htm

Rehabilitation Research and Training Center on Improving Vocational Rehabilitation Services for Individuals Who Are Deaf or Hard of Hearing, University of Arkansas (H133B010501) led by Douglas Watson, PhD. Richard Johnson, EdD, Project Officer.
Abstract: This program conducts coordinated research and training to enhance the rehabilitation outcomes of persons who are deaf or hard of hearing who are served by VR and related employment programs. The ultimate goal of these efforts is to improve the capacity of the VR system and related programs to address the career preparation, entry, maintenance, and advancement, as well as the community living needs, of the target population. Research activities include: investigating the impact of changes in federal employment and rehabilitation legislation and policy on the delivery of services to the target population; investigating the impact of business practices that contribute to accessible work and workplace supports to enhance the employment of the target population; and identifying, developing, and assessing rehabilitation-related innovations that enhance employment and community living outcomes of the target population.
Find out more at: www.uark.edu/deafrtc

Development and Evaluation of a Quality of Life Instrument for Individuals with Adult-Onset Hearing Loss, San Diego State University (H133G030191) led by Carren J. Stika, PhD. Carol Cohen, Project Officer.
Abstract: This project develops a standardized, psychometrically rigorous quality of life instrument for individuals with adult-onset hearing loss that is conceptually linked to the full range of functional domains commonly impacted by hearing loss, and which quantifies respondents’ perceptions of domain satisfaction and subjective well-being. Further, the quality of life instrument integrates the new paradigm of disability, whereby environmental, cultural, and personal variables are considered in relation to the individual’s disability. The enhancement of quality of life has recently been recognized as the essential purpose of health care and rehabilitation. Research is showing that it is the individual’s subjective well-being rather than the objective health condition or functional status that determines treatment-seeking behavior, compliance with treatment, and treatment outcome.
Find out more at: chhs.sdsu.edu/slhs/stika/research1/

The Texas Trilingual Initiative: Providing Effective Communication for Persons who are Deaf or Hard of Hearing and Hispanic, University of Arizona (H133G040115) led by Roseann Gonzalez, PhD and Paul Gatto, CPhil. Richard Johnson, EdD, Project Officer.
Abstract: The Texas Trilingual Initiative is an innovative and efficient Trilingual Interpreter Certification Program that addresses an under-recognized “trilingual” language barrier (American Sign Language (ASL), English, and Spanish) that affects deaf and hard of hearing Hispanics. This barrier presents access problems for deaf and hard of hearing Hispanics, who may use only ASL but must communicate with both English and Spanish speakers, often at the same time. This trilingual language barrier often affects Hispanic deaf and hard of hearing children who learn ASL in school, but whose parents speak Spanish and whose service providers speak English. Providing access to critical educational, health, legal, and social services requires interpreters who can competently bridge these three differing cultures and languages. This certification program — to be conducted in partnership with the Texas Department of Assistive and Rehabilitative Services - Division for Deaf and Hard of Hearing Services — includes the development, piloting, and validation of beginning and advanced level trilingual interpreting certification tests to assess interpreting capability from Spanish/English to ASL and ASL to Spanish/English.
Find out more at: nci.arizona.edu

VRA-NET: Developing a Network of Trained Paraprofessionals to Address Personnel Shortages in Vision Rehabilitation, Lighthouse International (H133G050058) led by Karen R. Seidman, MPA. Edna Johnson, Project Officer.
Abstract: This project pilot tests a state-of-the art, accessible, online, and mentored training program with students and mentors in state and private agencies for the blind and those with visual impairments around the nation. Lighthouse International’s VRA-Net development initiative is based on the successes of previous projects involving the development of both comprehensive curricula and an accessible online training program for Vision Rehabilitation Assistants. The overall goal is to address a severe shortage of trained vision rehabilitation personnel, while increasing the availability of specialized vision rehabilitation services to meet the burgeoning population of adults with visual impairment in the U.S. The objectives of the project are to demonstrate the effectiveness of an accessible, online, mentored, and competency-based paraprofessional training program; promote the employment of persons with visual impairments, other conditions, and from disadvantaged backgrounds by providing a career path for these paraprofessionals in the field of vision rehabilitation; and evaluate and compare the implementation of onsite and remote mentors during the online and mentored training process.

Please note: These abstracts have been modified. Full, unedited abstracts, as well as any available REHABDATA citations, are available at naric.com.

According to the Disability Statistics Center’s Disability Status Reports, 2.8% of working-age people in the US in 2004 had a sensory disability. Of those, 47.3% were employed full- or part-time. For further statistics, visit disabilitystatistics.org

Current Literature: Selections from REHABDATA

Moore, E. (2003) Using program evaluation to improve service delivery for older individuals who are blind. Journal of Visual Impairment and Blindness, 97(1), 42-45. NARIC Accession Number: J44915. Project Number: H133B010101.
Abstract: Article provides recommendations for evaluating independent living (IL) programs for older adults who are blind or have low vision. The strategies are intended to help state agencies and IL staff to improve the service delivery in IL programs by addressing policy, training, and fiscal and audit issues.

Wheeler-Scruggs, K. (2003) Discerning characteristics and risk factors of people who are deaf and low functioning. Journal of Rehabilitation, 69(4), 39-46. NARIC Accession Number: J46795. Project Number: H133B010501.
Abstract: Article discusses ways in which VR service providers can identify people who are deaf and hard of hearing and have one or more functional limitations relating to employment and/or independent living, referred to as low functioning and deaf (LFD). Case files were reviewed and interviews were conducted with 50 people with hearing loss who had received services from a state VR agency to identify characteristics and risk factors for LFD. Primary characteristics identified include limited communication skills, reading level at or below the third grade, poor social and emotional skills, and transitional support needed to maintain employment or to live independently. Risk factor identified are grouped into three categories: (1) personal attributes (ethnicity, substance abuse, and secondary disabilities); (2) social conditions (lack of family support, lack of appropriate role models, low socioeconomic status, lack of participation in family and cultural traditions, and discrimination due to deafness); and (3) service delivery (lack of interpreters, lack of access to available services, inadequate funding, and inappropriate diagnosis).

Anderson, G., Boone, S. (2003) Impact of federal legislation and policy on VR services for consumers who are deaf or hard of hearing: Perspective of agency administrators and program specialists. American Annals of the Deaf, 148(4), 315-322. NARIC Accession Number: J47138. Project Number: H133B010501.
Abstract: Article discusses results from a national survey of administrators and program specialists at 43 state VR agencies concerning the impact of federal employment legislation and rehabilitation policies on the provision of services to people with hearing loss. Study focused on the following initiatives: (1) the Workforce Investment Act, (2) Order of Selection policies, (3) interagency agreements between VR and postsecondary education programs, (4) the comprehensive system of personnel development, and (5) the Ticket to Work and Work Incentives Improvement Act. Key findings concerning the response rate, case closure trends, trends in counselor employment, the effects of legislation and policy on provision of VR services, the extent of the shortage of VR counselors and allied personnel, and the role and function of administrators and program specialists. Article concludes with a summary of state agencies’ priorities and needs regarding technical assistance for VR professionals.

Bowe, F. (2003) Transition for deaf and hard of hearing students: A blueprint for change. Journal of Deaf Studies and Deaf Education, 8, 485-493. NARIC Accession Number: J47544. Project Number: H133F020002.
Abstract: Article reviews research related to transition services offered to youth with hearing loss to prepare them for life after high school. The definition and requirements related to transition services as provided under the Individuals with Disabilities Education Act (IDEA) are discussed. A case is presented for providing vocational services during the secondary years, rather than after graduation from high school. Research on successful transition programs is reviewed and a plan is offered for designing appropriate transition services for deaf and hard of hearing students at risk of become "low-functioning deaf" as adults.

Capella-McDonnall, M. (2005) Predictors of competitive employment for blind and visually impaired consumers of vocational rehabilitation services. Journal of Visual Impairment & Blindness, 99(5), 303-315. NARIC Accession Number: J49162. Project Number: H133B010101.
Abstract: Study identified variables associated with successful employment outcomes of consumers of VR services who were blind or visually impaired. Four variables were found to be predictors of successful employment: (1) the receipt of education as a rehabilitation services that resulted in an educational certificate or degree, (2) having worked since the onset of the disability, (3) reason for applying to VR related to obtaining a job, and (4) the relationship between the counselor and the consumer being rated as high quality.

Miller, K. (Ed.). (2004) Circle of unity: Pathways to improving outreach to American Indians and Alaska Natives who are deaf, deaf-blind, and hard of hearing. NARIC Accession Number: O15965. Project Number: H133B010501.
Abstract: Publication presents information to assist community counselors, vocational rehabilitation counselors, tribal rehabilitation counselors, and others who are interested in improving outreach to American Indians and Alaskan natives who are deaf, deaf-blind, and hard of hearing. Chapters include information on the diversity of the population, their social and environmental issues, and effective approaches to service provision, as well as a list of helpful resources.

The Cochrane Library
The Cochrane Library of Systematic Reviews lists 6 reviews for hearing impairment, 10 for visual impairment, 25 for blindness, 12 for deafness, and 2 for sensory impairments. Cochrane also lists clinical trials, methods studies and reviews, technology assessments, and economic evaluations. Visit thecochranelibrary.org for more information.

Where Can I Find More? A quick keyword search is all you need to connect to a wealth of disability and rehabilitation research. NARIC’s databases hold more than 75,000 resources. Visit www.naric.com/research to search for literature, current and past research projects, and organizations and agencies in the US and abroad.

Additional Resources

American Sign Language as a foreign language? Sure!
According to the Clerc Center at Gallaudet University, 40 US states recognize American Sign Language as a foreign language that may be offered to students for credit.

woman holding her hand in the ASL sign for I Love You. Photo Credit: Crystal Lindo, San Bernardino, CA