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Abstract

BACKGROUND:

The onset of the COVID-19 pandemic forced an immediate change to the delivery of employment supports and services for jobseekers and workers with intellectual and developmental disabilities (IDD) across the United States.

OBJECTIVE:

This study examines how employment consultants and employment program managers adjusted the delivery of their supports to continue to provide services to jobseekers and employees with IDD during the pandemic.

METHOD:

A total of 11 employment consultants and employment program managers from 10 states participated in semi-structured interviews about the effects of the pandemic on their provision of employment services and on the people they support. The data were analyzed thematically.

RESULTS:

Four overarching themes regarding changes in support delivery were identified: 1) Immediate needs at pandemic onset; 2) Preparing for jobs; 3) Finding jobs; and 4) Keeping jobs.

CONCLUSION:

The adaptations and innovations made to employment services during the pandemic, especially regarding remote services, offer new and innovative approaches to helping people with IDD find and keep employment beyond the pandemic.

Keywords

COVID-19 pandemic employment consultants employment support and services intellectual and developmental disabilities

1 Introduction

The onset of the COVID-19 pandemic necessitated sudden and dramatic changes to daily life across the United States. For many, the area of life that was most heavily affected by the pandemic was work. Millions of Americans faced pay cuts, furloughs, lay-offs, and/or a shift to remote work (Cho et al., 2021; Houtenville et al., 2021). For people with disabilities who receive supports to find and maintain employment, the COVID-19 pandemic additionally created an immediate need to shift the provision of employment services. Prior to the pandemic, employment supports were delivered almost exclusively in-person and were heavily reliant on employment consultants visiting businesses to make connections, negotiate jobs, and check-in with employees (Migliore et al., 2010). These practices became difficult and sometimes impossible to continue during the early months of the pandemic. However, even with shutdowns and stay-home orders, many employers still needed employees, and many jobseekers with disabilities wanted to continue to look for new jobs or keep their existing jobs (Sinclair et al., 2020).

Employment participation of people with disabilities, particularly those with intellectual and developmental disabilities (IDD), has always been significantly lower than the general public. During the pandemic, the workforce participation of people with disabilities has continued to lag dramatically behind that of the general public, although the number of people with disabilities in the workforce recovered more quickly during 2021 than for people with no reported disability (Kessler Foundation and University of New Hampshire, 2022). In December 2021, the employment-to-population ratio of working-age individuals with disabilities was 31.3%, a historic high, compared with 72.5%, below pre-pandemic levels, for working-age individuals without disabilities.

While more remains to be learned about the long-term effects of the COVID-19 pandemic on employment for people with IDD, this group was especially hard hit by the initial workforce shifts of the pandemic: they were less likely than the general public to be in positions that moved into remote work and more likely to work in industries that had mass layoffs and furloughs, such as retail, entertainment, and food services (Schall et al., 2021). Many people with IDD also chose to leave the workforce during the pandemic because of their vulnerability to severe illness from COVID-19 or the vulnerability of a caregiver (Brooks, 2020). Data from 7 states suggest that early in the pandemic only 46% of individuals with an IDD who received supports to work in individual competitive integrated jobs continued to work, while 38% had been furloughed or laid off and 14% were not working for personal reasons (Butterworth, 2021). Those who became unemployed or left the workforce during the pandemic may experience difficulties in reentering the workforce for a number of reasons, including ongoing concerns about health risks as the pandemic lingers, competition with unemployed jobseekers without disabilities, and lack of access to needed employment supports (Bradley, 2020; Brooks, 2020; Rosencrans et al., 2021).

Increased unemployment of people with IDD, whether chosen or forced, is a concerning trend. Much research has shown the adverse effects that unemployment can have on an individuals’ physical and emotional health (Tiggemann & Winefield, 1984; Mucci et al., 2016). During the COVID-19 pandemic, individuals who lost their jobs have experienced higher symptoms of depression, anxiety, and stress than those who remained employed (Fisher et al., 2020; McDowell et al., 2021; Nelson et al., 2020). People with IDD have indicated that the pandemic increased their sense of social isolation and loneliness and disrupted their daily routines, all of which can have major effects on physical and emotional health (Embregts et al., 2020; Jesus et al., 2021; Rosencrans et al., 2021; Strauser et al., 2021). Furthermore, increased unemployment of people with IDD can create additional stressors and challenges for family caregivers who rely on the time their family member is at their job to perform their own job or for respite (Bradley, 2020). All of these factors point to the importance of continuing supports for people with IDD to find jobs and stay employed, even during a worldwide pandemic.

There have been numerous research papers published about the effects on health, healthcare, education, and residential services for people with IDD during the COVID-19 pandemic and other natural and man-made disasters (Landry et al., 2016; Landes et al., 2021; Jeste et al., 2020; Mills et al., 2020; Rosencrans et al., 2021). Some research has shown how the COVID-19 pandemic has affected the employment status of people with disabilities (Embregts et al., 2020; Rosencrans et al., 2021; Schall et al., 2021). There has been little research, however, on how formal employment supports for people with IDD change and how employment support professionals continue to deliver this important service during disruptive events.

There is also a gap in the research regarding the use of remote supports for employment services. Much of the existing literature about remote supports focuses on the use of remote or virtual supports in residential settings (Friedman & Rizzolo, 2017; Tasse et al., 2020; Zaagsma et al., 2020) and the use of telehealth for healthcare and therapy (Hinton, 2017; Jeste et al., 2020; Pellegrino & DiGennaro Reed, 2020). The purpose of this paper is to describe how employment support professionals adapted and innovated employment supports— including the use of remote supports— during the pandemic using data collected through interviews of employment consultants across the United States. The overarching research question was: how did employment consultants adjust the delivery of employment supports for jobseekers and employees with IDD in response to the COVID-19 pandemic?

2 Method

2.1 Recruitment

Employment consultants and employment program managers were recruited for this study in April and May 2020. “Employment consultants” are defined as individual employment program staff that support individuals with IDD to find and maintain competitive, integrated employment. The term “employment consultants” encompasses many different job titles, including job specialist, job developer, job coach, career consultant, business developer, etc. “Employment program managers” are defined as individuals who supervise a team of employment consultants. Participants in this study were identified from groups of participants engaged in previous research conducted by this research team (Butterworth et al., 2020). The previous research involved 179 employment consultants from 29 states who completed a short daily survey on their phones to record how they had been spending their time at work, with whom they had been spending it, and where they had been working. These data were analyzed to assess the participants’ implementation of best practices in supporting jobseekers to find employment and were examined alongside their placement outcomes.

For this study, participants were selected through meeting one of three criteria: (1) having the most placements of job seekers with IDD, (2) spending the most time delivering supports related to hiring during the previous research studies compared with other participants in those studies, or (3) being most engaged with activities like communities of practice during previous research. High-performing participants were selected for this study because they had demonstrated competency and/or engagement with their job. The research team chose to focus this study on how skilled, experienced employment consultants shifted their delivery of supports during the pandemic because the team believed this group would be better positioned to innovate and effectively adapt their services than less skilled employment consultants. Researchers contacted 27 potential participants by phone and then email to invite them to participate in the current study and received responses from 16.

2.2 Participants

There were a total of 11 participants from 10 states. Of those 11 participants, 10 described their primary roles as employment consultants and one as employment program managers. The participants provided services in the following states: California, Colorado, Delaware, Minnesota, Missouri, New York, Pennsylvania, Rhode Island, Tennessee, and Washington. At the beginning of the pandemic, six participants provided only remote supports, one participant provided mostly remote supported with limited in-person, three participants continued to provide in-person supports while adding remote supports for individuals who desired it, and one participant experienced a complete suspension of all employment services. The demographics of the participants can be found in Table 1.

Table 1
Descriptive information on employment consultants

Information %

Gender

Female 33

Male 67

Race/ethnicity

White 78

Black/African American 11

American Indian/Alaska Native 11

Highest degree earned

High school graduate 11

Associate degree or 2-year degree 22

Bachelor’s or 4-year degree 44

Master’s degree 22

Certified employment support professional (CESP)

Yes 44

No 56

M SD

Years in current position 6.2 3.4

Years in other previous direct service 11.9 8.5

position in disability services

Number of staff participant supervises 3.3 4.9

Number of people with intellectual and 37.3 54.6

developmental disabilities on current

caseload

Number of people with other disabilities 7.0 9.3

on current caseload

Note. Not all employment consultants provided demographic information.

Information		%
Gender
Female		33
Male		67
Race/ethnicity
White		78
Black/African American		11
American Indian/Alaska Native		11
Highest degree earned
High school graduate		11
Associate degree or 2-year degree		22
Bachelor’s or 4-year degree		44
Master’s degree		22
Certified employment support professional (CESP)
Yes		44
No		56
	M	SD
Years in current position	6.2	3.4
Years in other previous direct service	11.9	8.5
position in disability services
Number of staff participant supervises	3.3	4.9
Number of people with intellectual and	37.3	54.6
developmental disabilities on current
caseload
Number of people with other disabilities	7.0	9.3
on current caseload

2.3 Procedure

Researchers contacted potential participants by email to invite them to participate in the current study. After an employment consultant indicated interest in participating, researchers scheduled the interview. Prior to the interview, participants were sent an IRB-approved consent form, a link to complete a demographic survey, and the interview protocol. The demographic survey contained questions about typical demographic information (e.g., gender, race, age), experience in the disability service field, the participants’ current caseload, and the effects of COVID-19 on their work status. The interview protocol contained questions about the effects of COVID-19 on employment consultants, their work, and the people they support. The protocol specifically included questions about how day-to-day supports have changed during the pandemic.

All interviews lasted 40 to 60 minutes and were conducted via video conferencing technology. The video interviews began with a review of the consent form followed by a semi-structured interview focused on the questions in the interview protocol that had been provided to participants beforehand. At least two researchers joined each video call; one primary researcher facilitated the interview while the other researcher or researchers took notes and asked additional questions at the end of the interview. All interviews were then transcribed.

2.4 Data analysis

The interviews were coded line-by-line using a basic thematic analysis to identify themes and subthemes within and across the interviews. Researchers built a codebook that included all themes and subthemes as they analyzed the interviews. As researchers analyzed subsequent interviews, they used the themes identified in the codebook; if a new theme or subtheme was identified that was not yet in the codebook, the researchers added it. This method was used to ensure that researchers were using similar language to describe the same theme and helped to identify the point of saturation (i.e., when researchers were no longer adding new themes).

Approximately two-thirds of interviews were coded by two researchers to improve consistency and reconcile discrepancies in the coding structure. There typically was no difference in the themes identified by the two researchers except in the level of specificity of a code within a theme or categorization of a code across themes (e.g., the subtheme “remote supports” might have been included under either of the themes “client impacts” or “changes to employment consultant duties”). Seven major themes regarding the effects of the pandemic were identified from the data: effects on clients, changes in supports, effects on employment consultants’ jobs and duties, employer practices, guidance from state agencies, state policy changes, and provider-level responses. For the focus of this report, only sections of the interviews that were coded under the theme “changes in supports” were included in the analysis. All codes falling under the “changes in supports” theme were analyzed and sorted into subthemes.

3 Results

Under the theme of “changes in supports,” 4 subthemes emerged: 1) immediate needs at pandemic onset; 2) preparing for jobs; 3) finding jobs; and 4) keeping jobs. A summary of these subthemes can be found in Table 2.

Table 2
Summary of subthemes within “changes in supports” theme

Subtheme Examples

Immediate needs at Informed decisions, supporting

pandemic onset life beyond work

Preparing for jobs Remote planning and skill building,

virtual community engagement,

Pre-ETS

Finding jobs Virtual networking and outreach,

adjustments to job goals

Keeping jobs Remote supports, transitional supports,

safety protocols, natural supports

Subtheme	Examples
Immediate needs at	Informed decisions, supporting
pandemic onset	life beyond work
Preparing for jobs	Remote planning and skill building,
	virtual community engagement,
	Pre-ETS
Finding jobs	Virtual networking and outreach,
	adjustments to job goals
Keeping jobs	Remote supports, transitional supports,
	safety protocols, natural supports

3.1 Immediate needs at pandemic onset

Participants explained that they needed to take on service activities that they were unaccustomed to providing to meet individuals’ immediate needs at the onset of the pandemic. Many participants stated that one of the first steps to be taken when businesses began to shut down and stay-home orders were issued was to support individuals to make informed decisions about their employment. They talked with the person, their family, and their support team to ensure the person understood the risks of continuing to work or search for a job and the downsides of leaving their job or discontinuing their search:

“And some people, if they don’t feel comfortable [going to work], that’s okay. What can they feel comfortable with and what are we doing? Let’s break it down. I’m going to break it down to the fact that, does this make sense right now? What are your pros and cons? What is your guardian or your home’s pros and cons and what do we need to do to support you right now if it’s not going to be going out [to work]?”

Supporting clients to make an informed choice about their employment options was not necessarily a new role for employment consultants, but at the start of the pandemic many spent a disproportionate amount of their time focused on supporting informed choices. Furthermore, the participants noted how the context— incomplete and frequently shifting information about COVID-19— created new challenges to providing this service activity.

For individuals who lost jobs or halted their job search, participants described providing supports beyond traditional employment services to help each person through the forced life changes brought on by the pandemic. They assisted individuals in applying for unemployment benefits and connected them to other support professionals like independent living staff. One participant explained that they were calling each individual on their caseload to see how they could support each person’s social well-being:

“Our next thing that we’re talking about is relationships and how can we support people to connect through this time, you know, at 6 feet apart. Who’s important to them if they don’t have family? Who’s important to them that they need to get together with? That’s what we’re figuring out now on an individual basis for people.”

While some states expanded allowable billable activities to cover some of these supports and others provided retainer payments to service providers that allowed employment consultants to offer any needed support, some provider organizations allowed their staff to provide these “extra” supports without receiving any reimbursement.

3.2 Preparing for jobs

At the start of the pandemic, many participants experienced people on their caseloads pausing their job search or leaving their employment. For individuals who chose to halt their job search or stop working until they felt safe to continue, participants shifted their supports to preparing for future employment. A strategy participants used to engage jobseekers was to offer remote supports planning opportunities, such as job-related skill-building. One participant held virtual money management classes, and others practiced virtual mock interviews. A participant explained how the skill-building classes led to growth in social connections and leadership skills of some individuals:

“What it’s done is opened up these eyes to look at these people that are working but not as much or not working and they’re getting involved in all this stuff, and they’re leading classes. I’ve done virtual job-keeping skills workshops on Zoom. It’s been kind of fun, and they will talk to each other when they’re not doing it. They’ve created their own groups with each other. I have people that have been on the job for 14 years and people that are just starting out, and so they kind of mentor each other. It’s been pretty cool to see.”

Another employment consultant supported people to connect to supports planning opportunities available to the general public virtually that were not offered virtually before the pandemic, such as classes at a local community college. While remote supports became a necessary and useful form of service provision for all of the participants, it was not without its challenges. Participants shared that it was more time consuming to prepare for virtual meetings because of the time needed to teach the technology to the person. They also noted that it was difficult to engage with some individuals virtually because of difficulties accessing or understanding the technology. Some participants said that remote supports are less effective than in-person supports because it is difficult to share body and face cues with the person and to understand how the individual interacts with others in community settings.

The drop in caseloads in spring 2020 turned the focus of a couple of participants to providing remote Pre-Employment Transition Services (Pre-ETS) because students were still in school (albeit remotely). One participant focused on delivering classes on learning about career clusters and practicing job-related skills, such as interview skills. Another employment consultant recruited their 16-year-old son to help them create video playlists on YouTube for a Pre-ETS class. They led “virtual job shadows” by showing videos of what it is actually like to do a job, focusing on jobs that students are often interested in but that can be difficult to shadow in-person during non-pandemic times:

“It’s actually cool, because if you’re gonna do a job shadow with a PCA, you don’t usually get to go in–because of client confidentiality–and see them working. But these YouTube videos, we’re able to see them using a lift to move a client from a bed to a chair. When we do an informational interview, we don’t usually get that. And so, now I’m like, ‘Holy crap, this is a tool I can use with a face-to-face interview when we get to that point.”’

For one Pre-ETS class, a participant set up informational interviews over Zoom with business leaders in the community. This ended up proving more convenient for the business leaders than having to physically come into the school.

3.3 Finding jobs

To support job seekers to find jobs, participants tried virtual networking and outreach. One employment consultant moved their job clubs to virtual settings. Other strategies included arranging virtual coffee dates between the job seeker and people in their network to discuss job paths or opportunities and supporting the person to join virtual meetings of affinity groups that match their interests.

“We’re trying to use this time to take a deep dive into people’s social capital, organizing virtual coffee days. If you’re interested in photography, then trying to find those online meetups of photographers and build some of those personal connections that might help once we’re able to re-enter [once stay-home orders end].”

Participants shared that some people did not feel safe working around others until the pandemic ended. Some employment consultants supported individuals to explore self-employment options that fit within health and safety guidelines. For example, one employment consultant was supporting a person who was seeking office work prior to the pandemic. This person is in a high-risk group and did not want to seek office-based work during the pandemic. Instead, their employment consultant worked with them to seek a loan to build raised bed gardens so the person could make money selling plants while working on their own and feeling safe.

Nonetheless, all participants stated that they would continue to incorporate remote supports into services after the pandemic because of the convenience and accessibility for some individuals. Some employment consultants noted that using technology to access remote supports was, in and of itself, a way for the person to build job-related skills:

“I think, moving forward, it’s going to be important to maybe add that component of showing people that want to learn how to access Zoom, how to access their email, how to access training, and other stuff besides Solitaire or YouTube. I think it will help a lot, so people don’t feel left out of it all. We’re trying to use FaceTime with people and showing what’s going on and to include them in FaceTime and kind of set them up through Zoom. And then they’ve done that.”

3.4 Keeping jobs

At the beginning of the pandemic, nearly every participant had to find ways to provide remote job coaching support because state policies or employer restrictions did not allow them to visit all individuals at their work sites. To support these employees, participants learned to rely on tablets, FaceTime, texting, and phone calls to check-in and provide real-time supports. One employment consultant negotiated with a company to move the training of someone recently hired completely online; the participant then used Google Hangouts and screen sharing to provide support to the person during the online training.

Changes in the workplace forced participants to take on new roles and find creative solutions to new problems with the people they support. For individuals who were furloughed from their jobs, several participants noted that they took on a liaison role in checking in with employers about the person’s job status and timeline for returning to work. When individuals did return to work, participants had to find ways to support the person to learn and understand safety guidance. For example, one participant talked about the challenge of finding a solution to complying with a mask mandate for an employee with specific sensory needs. Participants had to adjust the type of supports they provided to people who were working as the employees and employers tried to navigate the workplace during a pandemic. One participant shared:

“[We are] doing that work very differently. Those conversations were so different. They weren’t the typical, ‘Yeah, work’s going great.’ It’s more like, ‘Okay, now I gotta wear a mask at work and that bothers me.’ And you know, the curve balls we were getting weren’t daily normal.”

All participants who were supporting people who were still employed agreed that taking individualized approaches to teaching about COVID-19 safety and guidelines was vital. Working one-on-one rather than with groups of individuals became the norm during the pandemic due to safety reasons, but participants noted that this also resulted in better delivery of employment services. Some participants explained that the COVID-19 pandemic highlighted the importance of providing individualized, person-centered supports and that services should continue to be provided in this way after the pandemic. One participant shared:

“The things that I think are the most positive [coming out of the pandemic] are primarily that we’re in this paradigm shift that mandates individualization. I think that among other providers, among my own staff, there’s a fair amount of attention at this point being paid to individualization, which I hope is going to be an ongoing positive thing.”

Several of the participants noted that being forced to limit or eliminate in-person supported employment for some people helped them realize that people need less support than previously believed. Some employees receiving supports did well with less direct supports from the employment consultants and learned to better use natural supports. A couple of participants explained that this could have long-term effects on their job; they wondered if the people who have been thriving on the job without formal supports would want to go back to having an employment consultant visit them while they were working. One participant shared:

“I think the biggest thing I’m learning from this is that [people receiving supports] can do more, and we need to allow them to show that they can do more and allow them to do that on their own, instead of babysitting people. I think that in the long-term⋯really being mindful in the beginning to allow them to learn and grow on their own instead of us being there. The dynamic should look a little different, really teaching them how to advocate for themselves and looking for natural supports. It hit me in the head like a brick, like, ‘Whoa, they can do it.”’

4 Discussion

In the interviews, participants described how the COVID-19 pandemic forced them to rethink and innovate how they support jobseekers with IDD to find and maintain competitive, integrated employment. Participants were able to adapt to stay-home orders and other restrictions: they found solutions to new and unforeseen challenges, created ways to provide supports remotely, and were flexible in the services they provided to meet the immediate needs of those they support. Because of the rapid pace at which the effects of the pandemic spread throughout the country and the constantly changing information on responding to the pandemic, participants and their organizations were often left to figure out how to safely and effectively continue to deliver employment services with minimal guidance from state or federal agencies.

Many people refer to the COVID-19 pandemic as “unprecedented” or a “once in a lifetime” occurrence. There is undoubtedly truth in that, but there is also the reality that disrupting events that throw off our sense of “normal” occur more frequently than global pandemics. Natural disasters, recessions, and political or social upheaval can all force a sudden and unexpected change in how supports for people with disabilities can and should be provided, and it is essential that preparedness plans account for the needs of people with disabilities in returning to the workforce (Jesus et al., 2020). Rehabilitation counselors have indicated that they do not receive adequate training for delivering emergency-preparedness-related services in their training programs, and that confidence in providing this support increases with training (Sprong et al., 2018). In a recent national survey, vocational rehabilitation counselors and service provider staff named maintaining continuity of services during natural or human-caused disasters as a priority for technical assistance needs (Bishop et al., 2021). Lessons learned from the pandemic about adaptive and innovative supports can be used to rethink and improve employment services post-pandemic and during future disruptive events.

This is particularly true for the use of remote supports, which have become normalized in employment services during the COVID-19 pandemic and will continue to be used beyond the pandemic (Timmons et al., 2022). There is almost no published research on this topic. Remote supports can increase the accessibility of services to many people with disabilities, particularly those living in rural regions, who frequently have limited options for accessible in-person supports (Adams et al., 2019; Jesus et al., 2020). As shown in examples described by the participants in this study, remote options opened up opportunities and connections that job seekers may not have had even before the pandemic due to where they live or transportation challenges. Even if these connections don’t directly lead to employment, using technology to meet and stay connected with others can increase feelings of independence, expand friendships and support networks, provide opportunities to pursue personal interests, and deepen a sense of human connection (Barlott et al., 2020; Paul et al., 2021). For those receiving on-the-job supports, remote service options result in a reduced presence of external support staff at their work location; this could enhance their relationships with coworkers and decrease the sense that the person is different from other employees. The use of technology in remote services also presents opportunities for individuals to build important technology-related skills that are vital to much of the modern workforce and have historically been under-emphasized for many people with IDD.

Another key finding of this study is the importance of prioritizing individualized, community-based supports rather than congregate and group supports. Individualized, person-centered supports, in addition to being safer during a pandemic, are more flexible and responsive to each person’s individual needs and situations and are considered key to supporting people with IDD to successfully find and maintain competitive, integrated employment (Nord et al., 2013; Wehman et al., 2018). Federal legislation and policies such as the Workforce Innovation and Opportunity Act and Home and Community Based Service Final Rule, in addition to the Olmstead v. L.C. Supreme Court rulings have led services in the direction of individualized, person-centered supports over center-based and congregate supports for many years. Many states have implemented policies to follow suit. This study provides support to the value of this transition.

The themes that did not emerge from this study’s findings also provide insight into employment support practices during the COVID-19 pandemic. Six activities are identified by Migliore et al. (2018) as the elements that form a comprehensive model of employment support: building trust, getting to know the job seeker, arranging for supports planning, finding tasks/finding jobs, circling back and adjusting the intensity of supports, and providing supports after hire. Getting to know the job seeker— or the process of learning about the person’s interests, strengths, and abilities— was not raised by any of the participants. Likely, this is due in part to the timing of the interviews very early in the pandemic when many states were still experiencing shutdowns. Most participants were focused on supporting people on their existing caseloads and were receiving few, if any, new referrals for people interested in beginning a job search at the onset of a pandemic.

4.1 Strengths and limitations

This study had a number of strengths. Participants from 10 states representing various regions of the United States were interviewed, providing diverse perspectives of state and regional responses to the pandemic. The sample was drawn from employment consultants and employment service managers who had previously participated in research. All participants were experienced in their positions and had shown through participation in research projects to be engaged in and effective at their jobs. The participation of experienced, high-performing employment consultants and managers provides clearer insight into the most effective support strategies being used during the pandemic and facilitates the development of recommendations for post-pandemic employment service provision. Also, the interviews for this study were conducted in the early months of the COVID-19 pandemic while many states were experiencing shutdowns, likely resulting in more accurate descriptions of participant activities than if the interviews had been conducted retroactively.

There are also limitations to this study. This was a small study with 11 employment consultants, so results are not generalizable to employment consultants across the United States. Another limitation is the focus of the interviews on the early months of the COVID-19 pandemic. Because the interviews took place very early in the pandemic, many services and job searches were put on hold, and programs were receiving few new referrals. Consequently, this study does not address how the pandemic affected the process of getting to know a job seeker at the start of employment services. Finally, because employment consultants and employment service managers exclusively were interviewed, the findings do not reflect the perspectives and experiences of job seekers, their families, or employers.

4.2 Recommendations

While this is a small study with a limited perspective, there are implications for research, policy, and practice. Much more research is needed to understand the best uses of remote services in supporting people with IDD to find and keep jobs. These types of supports are becoming widely adopted with little understanding beyond anecdotal as to their effectiveness. State agencies and policymakers must consider extending the use of billable remote employment services beyond the pandemic to ensure this support remains an option for those who find it more accessible or more flexible than in-person services. It will also be important for provider organizations to continue to explore new technologies and innovative ways of offering remote employment services to jobseekers with disabilities, particularly regarding getting to know a job seeker’s interests, strengths, and abilities at the start of services. Provider organizations should also examine and reassess their use of formal, on-site supports and prioritize fading of supports and promotion of natural supports whenever possible.

There is also a need for more research on how to best support employment consultants during disruptive events (from policy and organizational perspectives) and how to train them to effectively provide individualized, creative supports during such times. The COVID-19 pandemic has helped to reveal a significant gap in emergency preparedness plans for people with disabilities: the continuation of employment supports for people working in essential jobs. Many people with disabilities needed or wanted to continue to work during the pandemic, and many state and provider organizations did not immediately have plans for how to continue those supports. Both policymakers and provider organizations should consider how to provide employment services when needed in future emergencies or disasters and the roles employment consultants can have in supporting people during these times, even outside of their regular employment-focused activities.

After the pandemic has come to an end and life and services have found a “new normal,” researchers should examine the long-term effects of the pandemic on job supports for people with IDD in order to consider new directions the field may take. Along with understanding how supports will change beyond the pandemic, it will be essential to better understand the perspectives of the people who receive those supports. Further research about how people with IDD receiving employment services perceive the changes to their supports that have been brought about by the COVID-19 pandemic is critical. Individualized, person-centered services were supported in this study as key to helping people find and keep jobs during the pandemic. As policymakers and service providers examine employment services post-pandemic, they should prioritize individualized services over center-based and group options due to their flexibility and effectiveness in promoting successful community employment outcomes.

5 Conclusion

This study provides early insight into the ways in which employment program staff adapted and innovated services for people with IDD during the COVID-19 pandemic, including ways in which they developed remote supports to continue service delivery during stay-home orders and other restrictions. As indicated by the participants in the interviews, some of the adaptations and innovations made to employment services during the pandemic are promising new approaches to helping people with IDD find and keep employment and will prevail beyond the pandemic. Understanding the ways in which employment services change and the most effective ways to implement these service innovations will be important to supporting more people with IDD to successfully secure competitive, integrated employment.

Footnotes

Acknowledgments

The authors thank Dr. Kelly Nye-Lengerman (University of New Hampshire’s Institute on Disability) and Dr. Kai Gunty (private practice) for their contributions to the design and implementation of this study and the employment consultants who contributed their knowledge and experiences to this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

This study was determined to be exempt from approval by the institutional review board at the University of Minnesota (study number 00012721).

Funding

The development of this manuscript was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), Administration for Community Living (ACL), and U.S. Department of Health and Human Services (HHS) (grant #90RTCP0003). The content of this presentation does not necessarily represent the policies of NIDILRR, ACL or HHS.

Informed consent

Informed consent was obtained from all individual participants involved in the study.

References

Adams,

, Corbin,

, O’Hara,

, Park,

, Sheppard-Jones,

, Butler,

, Umeasiegbu,

, McDaniels,

, Bishop,

M. L.

(2019). A qualitative analysis of the employment needs and barriers of individuals with intellectual and developmental disabilities in rural areas. Journal of Applied Rehabilitation Counseling, 50(3), 227–240. https://doi.org/10.1891/0047-2220.50.3.227

Barlott,

, Aplin,

, Catchpole,

, Kranz,

, Le Goullon,

, Toivanen,

, Hutchens,

(2020). Connectedness and ICT: Opening the door to possibilities for people with intellectual disabilities. Journal of Intellectual Disabilities, 24(4), 503–521. https://doi.org/10.1177/1744629519831566.

Bishop,

, Lee,

, Zhou,

(2021, June 14–18). Identifying vocational rehabilitation outreach and service training priorities: A national survey from diverse perspectives [Conference presentation]. 2021 Association of People Supporting Employment First Virtual Conference, United States.

Bradley,

V. J.

(2020). How COVID-19 may change the world of services to people with intellectual and developmental disabilities. Intellectual and Developmental Disabilities, 58(5), 355–360. https://doi.org/10.1352/1934-9556-58.5.355.

Brooks,

J. D.

(2020). Workers with disabilities may remain unemployed long after the COVID-19 pandemic (Issue Brief No. 30). Syracuse University Lerner Center for Public Health Promotion. https://lernercenter.syr.edu/2020/06/15/ib-30/.

Butterworth,

(2021). Employment Challenges and Opportunities post COVID [Powerpoint slides]. Institute for Community Inclusion, University of Massachusetts Boston. https://works.bepress.com/john-butterworth/65/

Butterworth,

, Migliore,

, Nye-Lengerman,

, Lyons,

, Gunty,

, Eastman,

, Foos,

(2020). Using data-enabled performance feedback and guidance to assist employment consultants in their work with job seekers. An experimental study, Journal of Vocational rehabilitation, 53(2), 189–203. DOI:10.3233/JVR-201096.

Cho,

S. J.

, Lee,

J. Y.

, Winters,

J. V.

(2021). Employment impacts of the COVID-19 pandemic across metropolitan status and size. Growth and Change, 52(4), 1958–1996. https://doi.org/10.1111/grow.12540.

Christensen,

J. J.

(2020). Employment first in a time of pandemic. Developmental Disabilities Network Journal, 1(1), 11–14.

10.

Embregts,

P. J. C. M.

, van den Bogaard,

K. J. H. M.

, Frielink,

, Voermans,

M. A. C.

, Thalen,

, Jahoda,

(2020). A thematic analysis into the experiences of people with a mild intellectual disability during the COVID-19 lockdown period. International Journal of Developmental Disabilities. Advance online publication. https://doi.org/10.1080/20473869.2020.1827214.

11.

Fisher,

J. R. W.

, Tran,

T. D.

, Hammarberg,

, Sastry,

, Nguyen,

, Rowe,

, Popplestone,

, Stocker,

, Stubber,

, Kirkman,

(2020). Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey. Medical Journal of Australia, 213(10), 458–464. https://doi.org/10.5694/mja2.50831.

12.

Friedman,

, Rizzolo,

M. C.

(2017). Electronic video monitoring in Medicaid home and community-based services waivers for people with intellectual and developmental disabilities. Journal of Policy and Practice in Intellectual Disabilities, 14(4), 279–284. https://doi.org/10.1111/jppi.12222

13.

Hinton,

, Sheffield,

, Sanders,

M. R.

, Sofronoff,

(2017). A randomized controlled trial of a telehealth parenting intervention: A mixed-disability trial. Research in Developmental Disabilities, 65, 74–85. https://doi.org/10.1016/j.ridd.2017.04.005

14.

Houtenville,

A. J.

, Paul,

, Brucker,

D. L.

(2021). Changes in the employment status of people with and without disabilities in the United States during the COVID-19 pandemic. Archives of Physical Medicine and Rehabilitation, 102(7), 1420–1423. https://doi.org/10.1016/j.apmr.2021.03.019

15.

Jeste,

, Hyde,

, Distefano,

, Halladay,

, Ray,

, Porath,

, Wilson,

R. B.

, Thurm,

(2020). Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID-19 restrictions. Journal of Intellectual Disability Research, 64(11), 825–833. https://doi.org/10.1111/jir.12776

16.

Jesus,

T. S.

, Bhattacharjya,

, Papadimitriou,

, Bogdanova,

, Bentley,

, Arango-Lasprilla,

J. C.

, Kamalakannan,

(2021). Lockdown-related disparities experienced by people with disabilities during the first wave of the COVID-19 pandemic: Scoping review with thematic analysis. International Journal of Environmental Research and Public Health, 18(12). https://doi.org/10.3390/ijerph18126178

17.

Jesus,

T. S.

, Landry,

M. D.

, Jacobs,

(2020). A “new normal” following COVID-19 and the economic crisis: Using systems thinking to identify challenges and opportunities in disability, telework, and rehabilitation. Work, 67(1), 37–46. https://doi.org/10.3233/WOR-203250

18.

Kessler Foundation and the University of New Hampshire. (2022). nTIDE Special COVID-19 Edition: Workers with disabilities overcome pandemic setbacks, outpacing people without disabilities to set new records for employment. https://kesslerfoundation.org/press-release/ntide-special-covid-19-edition-workers-disabilities-overcome-pandemic-setbacks.

19.

Landes,

S. D.

, Turk,

M. A.

, Damiani,

M. R.

, Proctor,

, Baier,

(2021). Risk factors associated with covid-19 outcomes among people with intellectual and developmental disabilities receiving residential services. JAMANetwork Open, 4(6), 1–11. https://doi.org/10.1001/jamanetworkopen.2021.12862

20.

Landry,

M. D.

, Sheppard,

P. S.

, Leung,

, Retis,

, Salvador,

E. C.

, Raman,

S. R.

(2016). The 2015 Nepal earthquake(s): Lessons learned from the disability and rehabilitation sector’s preparation for, and response to, natural disasters. Physical Therapy, 96(11), 1714–1723. https://doi.org/10.2522/ptj.20150677

21.

McDowell,

C. P.

, Herring,

M. P.

, Lansing,

, Brower,

C. S.

, Meyer,

J. D.

(2021). Associations between employment changes and mental health: US data from during the COVID-19 pandemic. Frontiers in Psychology, 12, 1–5. https://doi.org/10.3389/fpsyg.2021.631510

22.

Migliore,

, Nye-Lengerman,

, Lyons,

, Bose,

, Butterworth,

(2018). A model of employment supports for job seekers with intellectual disabilities, Journal of Rehabilitation, 84(2), 3–13.

23.

Houtenville,

A. J.

, Paul,

, Brucker,

D. L.

24.

Mills,

W. R.

, Sender,

, Lichtefeld,

, Romano,

, Reynolds,

, Price,

, Phipps,

, White,

, Howard,

, Poltavski,

, Barnes,

(2020). Supporting individuals with intellectual and developmental disability during the first 100 days of the COVID-19 outbreak in the USA. Journal of Intellectual Disability Research, 64(7), 489–496. https://doi.org/10.1111/jir.12740

25.

Mucci,

, Giorgi,

, Roncaioli,

, Perez,

J. F.

, Arcangeli,

(2016). The correlation between stress and economic crisis: A systematic review. Neuropsychiatric Disease and Treatment, 12, 983–993. https://doi.org/10.2147/NDT.S98525

26.

Nelson,

B. W.

, Pettitt,

, Flannery,

J. E.

, Allen,

N. B.

(2020). Rapid assessment of psychological and epidemiological correlates of COVID-19 concern, financial strain, and health-related behavior change in a large online sample. PLOS ONE, 15(11), 1–16. https://doi.org/10.1371/journal.pone.0241990

27.

Nord,

, Luecking,

, Mank,

, Kiernan,

, Wray,

(2013). The state of the science of employment and economic self-sufficiency for people with intellectual and developmental disabilities. Intellectual and Developmental Disabilities, 51(5), 376–384. https://doi.org/10.1352/1934-9556-51.5.376

28.

Paul,

C. D.

, Thomas,

E. V.

, Doulin,

A. M.

, Hussain,

S. Z.

, Jimenez,

(2021). Using wireless technology to support social connectedness in individuals with intellectual and developmental disabilities: A focus group study. Journal of Special Education Technology. Advance online publication. https://doi.org/10.1177/01626434211004133

29.

Pellegrino,

A. J.

, DiGennaro Reed,

F. D.

(2020). Using telehealth to teach valued skills to adults with intellectual and developmental disabilities. Journal of Applied Behavior Analysis, 53(3), 1276–1289. https://doi.org/10.1002/jaba.734

30.

Rosencrans,

, Arango,

, Sabat,

, Buck,

, Brown,

, Tenorio,

, Witwer,

(2021). The impact of the COVID-19 pandemic on the health, wellbeing, and access to services of people with intellectual and developmental disabilities. Research in Developmental Disabilities, 114, Article 103985. https://doi.org/10.1016/j.ridd.2021.103985

31.

Rumrill,

P. D.

, Koch,

L. C.

, Strauser,

D. R.

(2021). Introduction to the special issue: Employment and vocational rehabilitation considerations for people with disabilities during and after the COVID-19 pandemic. Journal of Vocational Rehabilitation, 54(1), 1–3. https://doi.org/10.3233/JVR-201121

32.

Schall,

, Brooke,

, Rounds,

, Lynch,

(2021). The resiliency of employees with intellectual and developmental disabilities during the COVID-19 pandemic and economic shutdown: A retrospective review of employment files. Journal of Vocational Rehabilitation, 54(1), 15–24. https://doi.org/10.3233/JVR-201113

33.

Sheppard-Jones,

, Avellone,

, Rumrill,

, Seward,

(2021). Impact of COVID-19: Considerations for individuals with developmental disabilities across major life domains. Journal of Vocational Rehabilitation, 54(1), 5–13. https://doi.org/10.3233/JVR-201112

34.

Sinclair,

, Gilson,

C. B.

, Whirley,

, Li,

(2020). 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. Developmental Disabilities Network Journal, 1(2). https://digitalcommons.usu.edu/ddnj/vol1/iss2/7/

35.

Sprong,

M. E.

, Dallas,

B. K.

, Soldner,

J. L.

(2018). Emergency preparedness knowledge and confidence in providing services for people with disabilities: An exploratory analysis among rehabilitation counseling students. Journal of Rehabilitation, 84(3), 57–65.

36.

Strauser,

D. R.

, Sullivan,

D. O.

, Greco,

C. E.

, Strauser,

D. G.

(2021). COVID-19 and Marginalized Workers: Issues for Vocational Rehabilitation, Journal of Rehabilitation. 87(1), 17–24.

37.

Tassé,

M. J.

, Wagner,

J. B.

, Kim,

(2020). Using technology and remote support services to promote independent living of adults with intellectual disability and related developmental disabilities. Journal of Applied Research in Intellectual Disabilities, 33(3), 640–647. https://doi.org/10.1111/jar.12709

38.

Tiggemann,

, Winefield,

A. H.

(1984). The effects of unemployment on the mood, self-esteem, locus of control, and depressive affect of school-leavers. Journal of Occupational Psychology, 57(1), 33–42. https://doi.org/10.1111/j.2044-8325.1984.tb00145.x

39.

Timmons,

, Sulewski,

, Winsor,

, Bose,

, Christensen,

(2022). Moving Forward after COVID-19: Implications for Ongoing Use of Remote and Virtual Supports in Promoting and Supporting Integrated Employment. Research to Practice, Issue 61. Boston, MA: University of Massachusetts Boston, Institute for Community Inclusion. https://www.thinkwork.org/moving-forward-after-covid-19-implications-ongoing-use-remote-and-virtual-supports-promoting-and

40.

Weerakoon,

S. M.

, Jetelina,

K. K.

, Knell,

, Messiah,

S. E.

(2021). COVID-19 related employment change is associated with increased alcohol consumption during the pandemic. American Journal of Drug and Alcohol Abuse. Advance online publication. https://doi.org/10.1080/00952990.2021.1912063

41.

Wehman,

, Taylor,

, Brooke,

, Avellone,

, Whittenburg,

, Ham,

, Brooke,

A. M.

, Carr,

(2018). Toward competitive employment for persons with intellectual and developmental disabilities: What progress have we made and where do we need to go. Research and Practice for Persons with Severe Disabilities, 43(3), 131–144. https://doi.org/10.1177/1540796918777730

42.

Zaagsma,

, Volkers,

K. M.

, Koning,

M. H. M.

, van Hove,

, Schippers,

A. P.

(2020). The usefulness of offering 24/7 online support within a wider mix of professional services for people with intellectual and developmental disabilities living independently: A qualitative, multiple case study, Inclusion, 8(2), 138–154. https://doi.org/10.1352/2326-6988-8.2.138

How did employment consultants adjust and innovate services to respond to the COVID-19 pandemic?

Abstract

BACKGROUND:

OBJECTIVE:

METHOD:

RESULTS:

CONCLUSION:

Keywords

1 Introduction

2 Method

2.1 Recruitment

2.2 Participants

2.4 Data analysis

3 Results

3.2 Preparing for jobs

3.3 Finding jobs

3.4 Keeping jobs

4 Discussion

4.1 Strengths and limitations

4.2 Recommendations

5 Conclusion

Footnotes

Acknowledgments

Conflict of interest

Ethics statement

Funding

Informed consent

References