The impact of concomitant disabilities on employment outcomes for state vocational rehabilitation clients with traumatic brain injury

Abstract

Objective: To investigate the effect of traumatic brain injury (TBI) and concomitant disabilities on vocational outcomes.

Design: Non-experimental, prospective analysis of adults who qualified for services with the Missouri Division of Vocational Rehabilitation (MDVR) based on a history of TBI.

Participants: 139 MDVR clients with non-acute TBI, followed from enrollment until case closure, who were divided into 5 groups (TBI only; TBI + orthopedic injury; TBI + seizure; TBI + psychological disorder; TBI + learning disability).

Main outcome measures: Demographic characteristics; injury severity; neuropsychological functioning; and employment status at case closure.

Analyses: Multivariate analysis of variance and non-parametric methods were used to evaluate differences in outcome variables between the TBI Only and other 4 groups.

Results: Statistically non-significant trends between the groups suggested less successful employment outcomes for persons with TBI and concomitant psychological disorders (11%) and learning disabilities (8%) vs. persons with orthopedic injuries (23%), seizure disorders (32%), or TBI only (26%).

Conclusions: Concomitant psychological and learning disabilities, compared to concomitant physical disabilities, are associated with greater employment difficulties for persons with TBI. VR clients with psychological and learning disorders may require additional services/interventions to enhance their vocational outcomes.