Restricted accessResearch articleFirst published online 2026
Competitive integrated employment outcomes for transition-aged young adults with cognitive disabilities: Assistive technology and supported employment services
Transition-aged young adults (TAYA) with cognitive disabilities face significant challenges in achieving competitive integrated employment (CIE). Despite being the largest group of vocational rehabilitation (VR) service users, they frequently experience poor employment outcomes at program exit. Limited research has assessed the impact of assistive technology (AT) and supported employment (SE) services on achieving CIE, particularly during and after the coronavirus disease 2019 (COVID-19) pandemic.
Objective
This study examined the independent associations of AT and SE services with achieving CIE at program exit and evaluated variations in CIE outcomes across the pre-COVID, during-COVID, and post-COVID periods among TAYA with cognitive disabilities served by state VR programs.
Methods
A retrospective cross-sectional analysis of data from the Rehabilitation Services Administration's Case Service Report (July 2017–June 2022) was conducted, involving 238,561 TAYA with cognitive disabilities. Logistic regression analyses examined associations between AT/SE services and CIE outcomes, including interaction terms to assess variations over time.
Results
Among TAYA with cognitive disabilities, 96.8% had significant disabilities, 90.9% were unemployed, and 83.0% were not enrolled in post-secondary education. Over half of participants (55.9%) did not achieve CIE at program exit. Only 1.4% received AT services and 10.7% received SE services. Both AT and SE services were positively associated with achieving CIE, and the effects of these services varied across the COVID-19-related periods.
Conclusions
The study indicates that AT and SE services were positively associated with achieving CIE outcomes. These findings underscore the importance of prioritizing access to these services through state VR programs to better support employment transitions.
McKee-RyanFSongZWanbergCR, et al.Psychological and physical well-being during unemployment: A meta-analytic study. J Appl Psychol2005; 90: 53–76.
2.
ReichardAStranskyMBruckerD, et al.The relationship between employment and health and health care among working-age adults with and without disabilities in the United States. Disabil Rehabil2019; 41: 2299–2307.
3.
ShandraCLHoganDP. School-to-work program participation and the post-high school employment of young adults with disabilities. J Vocat Rehabil2008; 29: 117–130.
4.
RouxARastJNye-LengermanK, et al.Identifying patterns of state vocational rehabilitation performance in serving transition-age youth on the autism spectrum. Autism Adulthood2019; 1: 101–111.
5.
ChenJLeaderGSungC, et al.Trends in employment for individuals with autism spectrum disorder: A review of the research literature. Rev J Autism Dev Disord2014; 2: 115–127.
6.
TaylorJAvelloneLBrookeV, et al.The impact of competitive integrated employment on economic, psychological, and physical health outcomes for individuals with intellectual and developmental disabilities. J Appl Res Intellect Disabil2022; 35: 448–459.
ChenJSungCPiS. Vocational rehabilitation service patterns and outcomes for individuals with autism of different ages. J Autism Dev Disord2015; 45: 3015–3029.
12.
KayaCHsuSRumrillP, et al.Differential vocational rehabilitation service patterns and outcomes for transition-age youth with specific learning disabilities: Implications in the COVID-19 era. J Vocat Rehabil2021; 54: 59–70.
13.
NewmanLWagnerMKnokeyAM, et al.The post-high school outcomes of young adults with disabilities: NLTS2 Report. Menlo Park, CA: SRI International, 2011.
U.S. Department of Education. RSA-911 Case Service Report, FY 2019. Available at: https://rsa.ed.gov (accessed 4 November 2024).
16.
WehmanPChanFDitchmanN, et al.Effect of supported employment on vocational rehabilitation outcomes of transition-age youth with intellectual and developmental disabilities: a case control study. Intellect Dev Disabil2014; 52: 296–310.
17.
SchallCWehmanPBrookeV, et al.Employment interventions for individuals with ASD: the relative efficacy of supported employment with or without prior project SEARCH training. J Autism Dev Disord2015; 45: 3990–4001.
18.
KayaCChanFRumrillP, et al.Vocational rehabilitation services and competitive employment for transition-age youth with autism spectrum disorders. J Vocat Rehabil2016; 45: 73–83.
19.
BrossLTraversJMunandarV, et al.Video modeling to improve customer service skills of an employed young adult with autism. Focus Autism Other Dev Disabl2019; 34: 226–235.
20.
BurkeRAllenKHowardM, et al.Tablet-based video modeling and prompting in the workplace for individuals with autism. J Vocat Rehabil2013; 38: 1–14.
21.
CollinsJCollet-KlingenbergL. Portable electronic assistive technology to improve vocational task completion in young adults with an intellectual disability: A review of the literature. J Intellect Disabil2018; 22: 213–232.
22.
DamianidouDArthur-KellyMLyonsG, et al.Technology use to support employment-related outcomes for people with intellectual and developmental disability: An updated meta-analysis. Int J Dev Disabil2019; 65: 220–230.
23.
KuoHGeorgeSReynoldsJ. Promoting disability employment with avail® – a pilot study for feasibility and preliminary efficacy. Disabil Rehabil Assist Technol2024; 19: 1899–1906.
24.
Morash-MacneilVJohnsonFRyanJ. A systematic review of assistive technology for individuals with intellectual disability in the workplace. J Spec Educ Technol2018; 33: 15–26.
25.
RandallKJohnsonFAdamsS, et al.Use of a iPhone task analysis application to increase employment-related chores for individuals with intellectual disabilities. J Spec Educ Technol2020; 35: 26–36.
26.
SauerAParksAHeynP. Assistive technology effects on the employment outcomes for people with cognitive disabilities: A systematic review. Disabil Rehabil Assist Technol2010; 5: 377–391.
27.
ZallioMOhashiT. The evolution of assistive technology: A literature review of technology developments and applications. In: ZallioM(ed.), Human factors in accessibility and assistive technology, AHFE 2022 international conference, 2022, vol. 37, pp.487–493. AHFE International.
28.
OkyereCFisherMParkJ, et al.The impacts and experiences of COVID-19 on employment for individuals with disabilities. J Rehabil2021; 87: 25–32.
29.
WongJEzeifeNKudlaA, et al.Employment consequences of COVID-19 for people with disabilities and employers. J Occup Rehabil2022; 32: 464–472.
30.
HewittASmithJWeintraubL. COVID-19 and persons with intellectual and developmental disabilities: Implications for future policy, practice, and research. Am J Intellect Dev Disabil2022; 127: 270–277.
31.
HartleyMBourgeoisP. The commission on rehabilitation counselor certification code of ethics: An emerging approach to digital technology. Rehabil Res Policy Educ2020; 34: 73–85.
32.
HartleyMBourgeoisPClarkeB. Ethics of technology practice: Beliefs and behaviors of certified rehabilitation counselors during the COVID-19 pandemic. Rehabil Couns Bull2023; 66: 244–256.
33.
ButterworthJ. Employment challenges and opportunities post COVID. In: Interagency Committee on Disability Research virtual symposium on employment for youth and young adults with disabilities: Translating evidence amid the COVID-19 pandemic, 2021. Boston: Institute for Community Inclusion.
34.
MahoehneyDLeeSBershadskyJ, et al.How did employment consultants adjust and innovate services to respond to the COVID-19 pandemic?J Vocat Rehabil2024; 60: 87–97.
35.
AndersonCBrinckETrainorA, et al.Technology and communication considerations for engaging youth receiving supplemental security income (SSI) benefits. Rehabil Couns Bull2021; 65: 79–87.
36.
PogodaTDillahunt-AspillagaCKeleherV, et al.Implementing supported employment for veterans with traumatic brain injury through remote counseling during COVID-19. J Rehabil2021; 87: 64–70.
37.
SchallCBrookeVRoundsR, et al.The resiliency of employees with intellectual and developmental disabilities during the COVID-19 pandemic and economic shutdown: A retrospective review of employment files. J Vocat Rehabil2021; 54: 15–24.
38.
SinclairJGilsonCWhirleyM, et al.“It’s an opportunity to get opportunities”: A brief report on the working lives of individuals with intellectual and developmental disabilities during the COVID-19 pandemic. Dev Disabil Netw J2020; 1: 45–52.
39.
CucinottaDVanelliM. WHO Declares COVID-19 a pandemic. Acta Biomed2020; 91: 157–160.
40.
FuentesKLindsayS. Workplace accommodations during the COVID-19 pandemic: A scoping review of the impacts and implications for people with disabilities. WORK2023; 74: 381–406.
41.
SprongMDallasBPaulE, et al.Rehabilitation technology services and employment outcomes among consumers using division of rehabilitation services. Disabil Rehabil Assist Technol2019; 14: 445–452.
42.
HuangICheingGRumrillP, et al.Characteristics of people with disabilities receiving assistive technology services in vocational rehabilitation: A logistic regression analysis. J Vocat Rehabil2016; 45: 63–72.
43.
RosencransMArangoPSabatC, et al.The impact of the COVID-19 pandemic on the health, wellbeing, and access to services of people with intellectual and developmental disabilities. Res Dev Disabil2021; 114: 103985.
44.
BradleyV. How COVID-19 may change the world of services to people with intellectual and developmental disabilities. Intellect Dev Disabil2020; 58: 355–360.
45.
Bennett GayleDYuanXKnightT. The coronavirus pandemic: Accessible technology for education, employment, and livelihoods. Assist Technol2024; 36: 352–359.
AlshamraniKGrahamJRollM, et al.Supported employment and technology utilization for young adults with neurodevelopmental disabilities during and following the COVID-19 pandemic: A multi-stakeholder focus group study. J Vocat Rehabil2025; 63: 43–58.
48.
DrakeRSedererLBeckerD, et al.COVID-19, unemployment, and behavioral health conditions: The need for supported employment. Adm Policy Ment Health2021; 48: 388–392.
49.
WagnerJTasséMOrnanG. Implementation of remote support services: Pre-COVID-19. J Policy Pract Intellect Disabil2022; 19: 340–349.
50.
ArthanatSElsaesserLBauerS. A survey of assistive technology service providers in the USA. Disabil Rehabil Assist Technol2017; 12: 789–800.
51.
BarzegarianBSaxC. Rehabilitation counsellors: Incorporation of assistive technology device selection and referrals into professional practice. Disabil Rehabil Assist Technol2011; 6: 378–385.
52.
Estrada-HernándezNWheatonJDawsonR, et al.Current status of assistive technology education in rehabilitation counseling programs. Rehabil Educ2007; 21: 117–123.
53.
FroehlichRLinkowskiD. An assessment of the training needs of state vocational rehabilitation counselors. Rehabil Couns Bull2002; 46: 41–49.
54.
KuoHKosciulekJ. Rehabilitation counsellor perceived importance and competence in assistive technology. Disabil Rehabil Assist Technol2023; 18: 1259–1265.
55.
NollAOwensLSmithR, et al.Survey of state vocational rehabilitation counselor roles and competencies in assistive technology. WORK2006; 27: 413–419.
56.
Riemer-ReissM. Rehabilitation professionals’ perceived competencies in assistive technology selection and referral: A preliminary analysis. J Appl Rehabil Couns2003; 34: 33.
BurgessSCimeraR. Employment outcomes of transition-aged adults with autism spectrum disorders: A state of the states report. Am J Intellect Dev Disabil2014; 119: 64–83.
59.
CimeraRCowanR. The costs of services and employment outcomes achieved by adults with autism in the US. Int J Res Pract2009; 13: 285–302.
60.
KayaC. Demographic variables, vocational rehabilitation services, and employment outcomes for transition-age youth with intellectual disabilities. J Policy Pract Intellect Disabil2018; 15: 226–236.
61.
LawerLBrusilovskiyESalzerM, et al.Use of vocational rehabilitative services among adults with autism. J Autism Dev Disord2009; 39: 487–494.
62.
MiglioreAButterworthJZalewskaA. Trends in vocational rehabilitation services and outcomes of youth with autism: 2006–2010. Rehabil Couns Bull2014; 57: 80–89.
63.
ShattuckPNarendorfSCooperB, et al.Postsecondary education and employment among youth with an autism spectrum disorder. Pediatrics2012; 129: 1042–1049.
64.
GrigalMMiglioreAHartD. A state comparison of vocational rehabilitation support of youth with intellectual disabilities’ participation in postsecondary education. J Vocat Rehabil2014; 40: 185–194.
65.
MiglioreATimmonsJButterworthJ, et al.Predictors of employment and postsecondary education of youth with autism. Rehabil Couns Bull2012; 55: 176–184.
66.
MillerSSaxCTuckerM. Examining associations between postsecondary education, earnings, and provision of college and university training related to individuals with intellectual and developmental disabilities served by vocational rehabilitation. J Rehabil2019; 85: 22–34.
67.
MooreESchellingA. Postsecondary inclusion for individuals with an intellectual disability and its effects on employment. J Intellect Disabil2015; 19: 130–148.
68.
SungCSánchezJKuoH, et al.Gender differences in vocational rehabilitation service predictors of successful competitive employment for transition-aged individuals with autism. J Autism Dev Disord2015; 45: 3204–3218.
69.
WehmanPSimaAKetchumJ, et al.Predictors of successful transition from school to employment for youth with disabilities. J Occup Rehabil2015; 25: 323–334.
