Abstract:
Chronic unemployment is common for individuals with traumatic brain injuries. It is estimated that 50 percent of individuals with TBI who receive no or unspecified rehabilitation services following their injury have problems with chronic unemployment. Of those that do return to work, 75 percent lose their jobs within 90 days - half of them resigning and half of them being fired. In order to return to work, many individuals with TBI seek services from state vocational rehabilitation (VR) programs, such as the Missouri Division of Vocational Rehabilitation (MO-DVR). Most VR programs routinely request neuropsychological evaluations that were developed in the 1940s for diagnostic purposes. These tests are no longer typically used in rehabilitation settings and are of limited functional utility for VR counselors planning the vocational rehabilitation of their clients. The MO-DVR is now requesting a functional evaluation that provides information based on a broad range of neuropsychological abilities (not tests) that have practical relevance. The functional evaluations measure such things as intelligence, academic abilities, attention, memory, language, visual-spatial skills, and sensory-motor skills. By requesting functional evaluations, VR counselors will get better information, clients will get better services, and clients will have increased vocational and financial success, and higher satisfaction with MO-DVR services. This project will compare the employment success of clients who receive the new functional evaluations with clients from previous years who received the diagnostic tests. It will be determined if the functional evaluations improve the vocational and financial outcomes of individuals with TBI. This project will also compare whether individuals from rural communities have better or worse vocational and financial outcomes than individuals from urban settings. The research will determine which factors result in the best vocational and financial outcomes for individuals with TBI who receive MO-DVR services.