Investigating the Relationship Between Quality of Life, Job Satisfaction, Functional Ability, and Job Performance of Supported Employees Lori Ann Noonan Garcia

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2003 Investigating the Relationship Between Quality of Life, Job Satisfaction, Functional Ability, and Job Performance of Supported Employees Lori Ann Noonan Garcia

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THE FLORIDA STATE UNIVERSITY COLLEGE OF EDUCATION

INVESTIGATING THE RELATIONSHIP BETWEEN QUALITY OF LIFE, JOB SATISFACTION, FUNCTIONAL ABILITY, AND JOB PERFORMANCE OF SUPPORTED EMPLOYEES

By LORI ANN NOONAN GARCIA

A Dissertation submitted to the Department of Special Education and Rehabilitation Counseling Services in partial fulfillment of the requirements for the degree of Doctor of Philosophy

Degree Awarded Fall Semester, 2003

The members of the committee approved the dissertation of Lori Ann Noonan Garcia defended on November 3, 2003.

______(signed) Bruce M. Menchetti Professor Directing Dissertation

______(signed) Sande Milton Outside Committee Member

______(signed) Andrew B. Oseroff Committee Member

______(signed) Mary Frances Hanline Committee Member

Approved: Mary Frances Hanline, Chairperson, Department of Special Education

The Office of Graduate Studies has verified and approved the above named committee members.

This dissertation is first dedicated to the memory of my mother, Carol Ann Kleck Noonan, for without you I simply would not be. This dissertation is also dedicated to my brother Michael and my sister Gina, whom I love dearly. Finally, this dissertation is dedicated to all those who thought they couldn’t get through it and did, and also to those who thought they’d get through it and didn’t. Remember, it ain’t over ‘til its over.

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ACKNOWLEDGMENTS

The author of this dissertation wishes to give a special thanks to the people who participated in this study. Hopefully I’ve done you justice. The support from my friends, especially Kelly and Mabel simply cannot go unmentioned. May you live all the days of your life, my friends, and thank you both so much! Finally, I wish to recognize the patience, support, and guidance of my major professor and friend, Dr. Bruce M. Menchetti, as well as those who so willingly served on my committee. I am sincerely grateful to you all. Okay, enough of this mush, let’s get to the good stuff!

TABLE OF CONTENTS

List of Tables ……………………………………………………………….. vii List of Figures ……………………………………………………………… x Abstract …………………………………………………………………….. xi 1. INTRODUCTION ……………………………………………………… 1 Significance of Research …………………………………………... 1 Purposes of Research ……………………………………………… 10 Research Questions ………………………………………………… 11 Expected Outcomes ……………………………………………….. 11 Definitions ………………………………………………………… 13 2. REVIEW OF THE LITERATURE ………………………………….... 17 Catalysts for Change ………………………………………………. 17 Normalization ……………………………………………………… 18 Mental Retardation: An Evolving Concept ………………………… 19 Conceptualizing Quality of Life …………………………………… 21 Defining Quality of Life …………………………………………… 21 Assessing Quality of Life …………………………………………. 23 Quality of Work Life ……………………………………………… 26 Work and People with Disabilities ……………………………….. 28 Work and Quality of Life ………………………………………… 30 Quality of Work Life and Job Satisfaction …………………….… 31 Job Satisfaction ………………………………………………….. 32 Job Satisfaction of Workers with Disabilities …………………… 36 Summary of Quality of Life and Job Satisfaction ...…………….. 47 Job Performance …………………………………………………. 48 Functional Ability …………………………………………………... 52 Conclusion …………………………………………………….….. 58

3. METHODOLOGY …………………………………………………….. 60 Research Questions ……………………………………………….. 60 Population ………………………………………………………… 61 Sample …………………………………………………………..…. 61 Procedures ………………………………………………………….. 68 Variables …………………………………………………………… 74 Instrumentation ……………………………………………………. 76 Data Analysis of Quality of Life and Job Satisfaction ……………. 85 Data Analysis of Functional Ability and Job Performance ……….. 94 Data Analysis of Functional Ability and Quality of Life …………. 102 4. RESULTS ……………………………………………………………… 105 Research Questions ……………………………………………….. 105 Quality of Life and Job Satisfaction ………………………………. 106 Functional Ability and Job Performance ………………………….. 111 Functional Ability and Quality of Life ……………………………. 117 5. CONCLUSION ………………………………………………………… 124 Major Findings ……………………………………………………. 124 Significance ……………………………………………………….. 129 Limitations ………………………………………………………… 131 Implications for the Future ……………………………………...… 132 APPENDICES A. Forms …………………………………………….……………. 138 B. Annotated Cross-Tabulations of Participant Demographics ….. 144 C. Survey Agreements …………………………………………….. 178 REFERENCES ……………………………………………………………. 184 BIOGRAPHICAL SKETCH ……………………………………………… 202

LIST OF TABLES

1.1 Constructs Assessed in Relation to Job Satisfaction for Workers Without Disabilities (WWOD) and Workers With Disabilities (WWD)…………………………………………………………...…. 35

3.1 Age, Ethnicity, and Gender …………………………………………… 64

3.2 Marital Status, Children, and Residence ……………………………... 64

3.3 Education, IQ, and Primary Disability ……………………………..… 65

3.4 Months Employed, Hours Worked per Week, and Wage Earned per Hour ………………………………………………………..…... 66

3.5 Employment/Workshop History and Company Tenure ………..……. 66

3.6 Job Areas and Titles ………………………………………………..… 67

3.7 Employee Benefits ………………………………………………….... 67

3.8 Inter-rater Reliability for JOBS and FAI …………………………..… 70

3.9 Inter-rater Reliability for QOL.Q …………………………………..… 72

3.10 Inter-rater Reliability for JDI/JIG …………………………………..... 73

3.11 Instruments, Sources of Data, Administration, and Description of Content .………………………………………………………….. 77

3.12 Age, Ethnicity, and Gender by FAI Group …………………….…..… 96

3.13 Marital Status, Children, and Residence by FAI Group …………...… 97

3.14 Education, IQ Score, and Primary Disability by FAI Group ……...… 98

3.15 Months Employed, Hours Worked, and Wages Earned by FAI Group …………………………………………………………... 99

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3.16 Employment/Workshop History and Company Tenure by FAI Group ………………………………………………………….. 100

3.17 Employee Benefits by FAI Group ……………………………………. 100

4.1 QOL.Q and JDI/JIG Median Scores and Minimum- Maximum Scores …………………………………….…………… 106

4.2 Spearman’s rho Correlation Coefficients …………………………… 108

4.3 FAI and JOBS Median Scores and Minimum-Maximum Scores …... 111

4.4 Instrument Median Scores and Minimum-Maximum Scores by High and Low FA Groups ……………………………………. 114

4.5 Wilcoxon-Mann-Whitney Test of Two Independent Samples ……… 116

B.1 Instrument Median Scores and Minimum-Maximum Scores by Ethnicity ………………………………………………………… 146

B.2 Instrument Median Scores and Minimum-Maximum Scores by Gender …………………………………………………………... 147

B.3 Instrument Median Scores and Minimum-Maximum Scores by Marital Status …………………………………………………… 148

B.4 Instrument Median Scores and Minimum-Maximum Scores by Number of Children …………………………………………….. 150

B.5 Instrument Median Scores and Minimum-Maximum Scores by Residence …………………………………………………….… 152

B.6 Instrument Median Scores and Minimum-Maximum Scores by Diploma Type ………………………………………………….. 154

B.7 Instrument Median Scores and Minimum-Maximum Scores by Primary Disability ……………………………………………... 156

B.8 Instrument Median Scores and Minimum-Maximum Scores by Primary Disability of MR/Not MR .…………………………… 159

B.9 Instrument Median Scores and Minimum-Maximum Scores by Employment History …………………………………………… 160

B.10 Instrument Median Scores and Minimum-Maximum Scores by Company Tenure ………………………………………………. 162

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B.11 Instrument Median Scores and Minimum-Maximum Scores by Employment Status ……………………………………………. 165

B.12 Instrument Median Scores and Minimum-Maximum Scores by Monthly Earnings ……………………………………………… 167

B.13 Instrument Median Scores and Minimum-Maximum Scores By Sheltered Workshop History ………………………………….. 170

LIST OF FIGURES

2.1 Mean FAI and IQ Scores for Employment Model Groups Before Matching……………………………………………………. 55

2.2 Quality of Life Scores by Level of Severity of Disability…….……… 57

4.1 JOBS Composite Median Comparisons Among High and Low Functional Ability Groups …………………………………… 120

4.2 JOBS – Daily Living Activities Median Comparisons Among High and Low Functional Ability Groups ………………………… 121

4.3 JOBS – Behavior Median Comparisons Among High and Low Functional Ability Groups …………………………………… 122

4.4 JOBS – Job Duties Median Comparisons Among High and Low Functional Ability Groups …………………………………… 123

B.1 Highest Job Satisfaction Medians by Demographic Groups ………… 172

B.2 Highest Quality of Life Medians by Demographic Groups …………. 173

B.3 Highest Quality of Job Performance by Demographic Groups ……… 175

B.4 Highest Type of Support by Demographic Groups ………………….. 176

ABSTRACT

This study measured the quality of life, job satisfaction, functional ability, and job performance of 40 people with developmental disabilities receiving supported employment services from a north Florida provider. Quality of life and job satisfaction was assessed via interviews with supported employees, using the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a) and the Job Descriptive Index (JDI; Smith, Kendall, & Hulin, 1997), including the Job in General (JIG) scale, respectively. Functional ability and job performance of supported employees was assessed by employment consultants (ECs), who completed the Functional Assessment Inventory (FAI; Crewe & Athelstan, 1981) and the Job Observation and Behavior Scale (JOBS; Rosenberg & Brady, 2000a). Results of Spearman rank order correlations indicated a significant relationship between overall quality of life and general job satisfaction. Further, significant correlations between the competence/productivity subscale of the QOL.Q and certain aspects of the job (JDI), specifically, work, pay, and supervision were found. Results of Wilcoxon-Mann-Whitney tests of two independent samples according to high and low functional ability revealed a significant difference between groups on quality of job performance, while no significant difference between groups on type of job support or overall quality of life was found. Examination of median scores of job performance, however, revealed that despite functional ability group differences, the majority of supported employees achieved average job performance with intermittent support, when compared to workers who weren’t receiving support and performing the same competitive jobs. Implications for future practice, personnel preparation, policy, and research are suggested.

CHAPTER 1 INTRODUCTION

Every story can enhance life or destroy it. Every story can lift us or depress us. Every story can make a hero or a scapegoat. Stories sustain if not make a person’s world. And thus, the storyteller holds a certain power (and responsibility), for the storyteller is usually safer than those about whom he or she spins tales. From Burton Blatt, 1987, The Conquest of Mental Retardation (Taylor & Blatt, 1999, p. 141)

This study measured the quality of life, job satisfaction, functional ability, and job performance of 40 people with developmental disabilities receiving supported employment services from a north Florida provider. Quality of life and job satisfaction was assessed via interviews with supported employees, using the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a) and the Job Descriptive Index (JDI; Smith, Kendall, & Hulin, 1997), including the Job in General (JIG) scale, respectively. Functional ability and job performance of supported employees was assessed by employment consultants (ECs), who completed the Functional Assessment Inventory (FAI; Crewe & Athelstan, 1981) and the Job Observation and Behavior Scale (JOBS; Rosenberg & Brady, 2000a). Significance of Research Quality of Life as a Construct for Evaluating Services The conceptualization and measurement of quality of life is important for several reasons. One of the most important reasons, according to Schalock (1996) is the recent paradigm shift in services for people with developmental disabilities, such as mental retardation. Emphasis has changed from a service- to a consumer-driven model of planning and supports (Perrin, 1999) with the primary goal of providing meaningful integration. Both physical and social integration

have also been identified as a key outcome of Wolfensberger’s (1972) Principle of Normalization (Flynn & Aubry, 1999). Consistent with components typically described in quality of life models, Wolfensberger (1972) said this about integration for a person: …integration is achieved when he [or she] lives in a culturally normative community setting in ordinary community housing, can move and communicate in ways typical for his [or her] age, and is able to utilize, in typical ways, typical community resources: developmental, social, recreational, and religious facilities; hospitals and clinics; the post office; stores and restaurants; job placements; and so on. Ultimately, integration is only meaningful if it is social integration; i.e., if it involves social interaction and acceptance, and not merely physical presence (p. 48). Flynn and Aubry (1999) pointed out that integration (or social inclusion) is a primary component within quality of life models, such as that proposed by Schalock (1996, 1997). Further, Heal (1999) argued that quality of life research might provide a means for determining the extent of normalization or social integration experienced by people with disabilities. Problems measuring quality of life. Borthwick-Duffy (1996) discussed a variety of issues for professionals to consider when determining the quality of life of people with developmental disabilities. She pointed out that measurement of quality of life depends on the purpose of the evaluation. For example, quality of life can serve as a guiding concept in special education transition programs and an indices by which residential placement is evaluated. Further, and as intended in the proposed study, quality of life can provide an overall concept to which employment outcomes can be related. Heal and Sigelman (1996) provided a discussion of methodological issues, as well as guidelines, for those wishing to measure quality of life. They identified four fundamental methods of measuring quality of life for people with and without developmental disabilities: (a) objective versus subjective, (b) absolute versus direct, (c) self- versus proxy-report, and (d) participant- versus investigator-developed instruments. Objective measures consider life circumstances, such as employment, residence, and supports. Subjective methods, however, reflect a personal perspective, such as satisfaction with work or home. Quality of life determinations can also be made using absolute or direct measures (Heal and Sigelman, 1996). Absolute refers to direct indexes, which identify specific aspects of life, whereas relative assessment involves making comparisons to a standard or in relation to

other peoples’ situations. Another approach is through self-report, where individuals are asked to give their personal account, such as through an interview. In contrast, proxy reports are responses elicited from others, and include behavioral observations. The last method of measuring quality of life involves the use of participant- or investigator-developed measures. Participant-developed measures are derived from unstructured techniques, including interviews and observations, while an investigator-developed method refers to instruments, such as the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a) that were designed by researchers. Heal and Sigelman (1996) pointed to several factors that can affect responses in survey research, including: (a) task variables, (b) interview variables, and (c) respondent variables. Examples of task variables included the order survey questions may be asked and the type of questioning techniques and formats used, such as open versus closed-ended and multiple-choice versus yes/no. Interview variables include factors such as the interviewer’s age, gender, race, and social class. Respondent variables specific to adults with cognitive disabilities include the likelihood to acquiesce and underreport during interviews employing open-ended question formats. Heal and Sigelman (1996) suggested that survey research involving people with developmental disabilities should include response formats such as either/or and multiple-choice. Pictures can be used for people with limited communication skills. Use of proxies, who provide additional information could also be of benefit. They concluded that survey research involving people with developmental disabilities should incorporate a blend of approaches (Heal and Sigelman, 1996). While considering the methodological issues and recommendations provided by various researchers, it is critical to consider the observations of Borthwick-Duffy (1996): As expected, quality of life has shifted in the last decade from being primarily a topic of academic discourse, often focusing on issues related to the dimensional structure and subjective versus objective perspectives, to playing a vital role in decisions that have a major impact on people’s lives (p. 105). Job Satisfaction Components and Relationship to Quality of Life Most quality of life theorists concur that employment plays a major role in meaningful integration and assists in the attainment of factors typically associated with a quality life. As

appealing as this theory is, little evidence exists to empirically link employment to quality of life or quality of work life (Kiernan & Marrone, 1997). Kiernan and Marone (1997) describe quality of work life as: …the degree of an individual’s satisfaction with his/her role, relationships, and duties in the workplace. This satisfaction is predicated on a variety of factors affecting the individual including, but not limited to, personality variables, family expectations, social cultural norms, workplace culture, and concrete facets of the job within the setting where the duties are performed (p. 64-65). Kiernan and Marone (1997) also reported that there is no consensus of evidence to support a direct relationship between quality of work life and job satisfaction. They did, however, indicate that quality of work life can be attributed to a person’s assessment of several workplace characteristics, including interesting and varied tasks, equitable compensation, comfortable working conditions, and opportunities for socialization, decision making, and promotion (Kiernan & Marrone, 1997). The workplace characteristics described by Keirnan and Marone (1997) contributing to a quality work life reflect the same aspects typically associated with job satisfaction. Perceptions of pay, supervision, coworkers, promotion, and the job itself are domains within standardized instruments examining job satisfaction (Smith, Kendall, & Hulin, 1969). Further, some researchers have explored the intuitively appealing link between life and job satisfaction of workers without disabilities (see London, Crandall, and Seal, 1977). Others have examined the effects of employment models on the quality of life of people with developmental disabilities (see Eggleton, Robertson, Ryan, & Kober, 1999). Finally, the most commonly used instruments examining quality of life include domains and items specifically assessing the respondent’s satisfaction with his or her employment situation. Despite the availability of instruments and recent increase in consumer-driven outcomes in service delivery, however, research examining job satisfaction, or its relationship to overall quality of life remains limited for people who have developmental disabilities. Problems measuring job satisfaction. Several researchers have noted the scarcity of research examining job satisfaction of workers with disabilities (Moseley, 1988; Parent, Kregel, & Johnson, 1996; Seltzer, 1984). McAffee (1986) pointed out the challenge of assessing perspectives of people with limited communication skills and the lack of adequate instruments

for assessing their job satisfaction. Also confounding the issue was a lack of consistent measures in determining job satisfaction of workers with disabilities. McAffee and McNaughton (1997a, 1997b) pointed out that the complexity of the concept, paired with the limited cognitive, verbal, and vocabulary abilities of some people with disabilities, could make job satisfaction difficult to assess. Further, the issues identified by Heal and Sigelman (1996) that make quality of life assessment challenging, such as methods employed, task variables, and respondent characteristics, are the same problems that need to be addressed when attempting to determine an individual’s job satisfaction. In summary, a review of the research available examining the quality of life and job satisfaction of people with disabilities revealed that comparisons across studies are complicated by the lack of consistency in the measures used. Further, few studies have explored the relationship between quality of life and job satisfaction using standardized, valid, and reliable instruments. Consequently, such efforts could add to existing literature, and ultimately enhance both satisfaction with, and quality of, life and employment for people with disabilities. Functional Ability: What is it and how is it measured? According to Crewe and Athelstan (1984), functional ability can be described as a person’s “…behavioral capacities [and limitations] together with key environmental factors…” (p. 1). Bolton, Bellini, and Neath (1996) pointed out the importance of determining the impact of a disability when assessing a person’s rehabilitative needs and strengths. Areas typically assessed include adaptive behavior, cognition, communication, environmental orientation, motor functioning, physical condition, and vocational qualifications (Bolton et al., 1996). A commonly used instrument for determining a person’s capacities and environmental factors he or she encounters is the Functional Assessment Inventory (FAI) by Crew and Athelstan (1981). Clearly, functional ability, as measured by such instruments as the FAI (Crewe & Athelstan, 1981), is an important consideration when determining the supports and services needed to enhance quality of life domains, such as employment. Functional ability versus IQ. Typically, studies on people with disabilities report participant characteristics, such as intelligence quotient (IQ) and disability category. However, many have pointed to the inability of these types of categorizations to provide information useful for planning and support development (e.g., Alper, 2003; Browder & Spooner, 2003; Thurlow & Elliott, 1998).

In contrast, functional ability is multidimensional construct, which can provide comprehensive and individualized information to guide supports and services for people with disabilities (Bolton, 1984). As pointed out by Thurlow and Elliott (1998), assessment for post- school planning and services for people with disabilities must go beyond traditional measures to include a person’s aptitudes, skills, and functional abilities. Alper (2003) discussed the evolution of definitions describing people with disabilities, such as mental retardation. Such definitions originally focused on arbitrarily determined IQ scores, which were purported to predict a person’s ability. More recently, a few organizations, such as the American Association on Mental Retardation (AAMR), have expanded their definitions of specific disabilities to include areas reflective of adaptive or functional ability. Clearly, functional ability is multidimensional construct. Evaluation of a person’s functional ability, which reflects strengths, limitations, and environmental factors, can provide comprehensive and individualized information to guide supports and services for people with disabilities (Bolton, 1984). Assessment for post-school planning and services for people with disabilities must go beyond traditional measures to include a person’s aptitudes, skills, and functional abilities (Thurlow & Elliott, 1998), as well as the context and environment in which the person lives (Szymanski, 1998, p. 128). In summary, assessments that measure a person’s functional capacity, while also considering environmental factors (i.e., Functional Assessment Inventory; Crewe & Athelstan, 1981) have the potential to yield more useful information than traditional disability labels and IQ scores, when planning supports and services for people with disabilities. Job Performance: What is it and how is it measured? A final area, which is critical to quality of life outcomes such as successful employment, is job performance. Bolton, Bellini, and Brookings (2000) affirmed that one of the underlying assumptions of rehabilitation is that successful competitive employment leads to increased independence and empowerment of people with disabilities. According to Rosenberg and Brady (2000b), all workers, with or without disabilities, are expected by their employers to demonstrate specific work-related behaviors. Therefore, favorable supervisor evaluations and the capacity of a person to maintain employment are directly related to the person’s ability to perform successfully on the job.

Consequently, it is necessary that service providers, educators, and others supporting people with disabilities to attain and maintain successful employment have a means for assessing behaviors affecting job performance. Behaviors typically associated with job performance include personality, sociability, and work habits (Berkson, 1981; Rosenberg & Brady, 2000b; Warren, 1961). Personality factors include characteristics such as honesty, emotional stability, and cheerfulness. Sociability factors include evaluation of interactions with coworkers. Work habits include behaviors related to quality and quantity of work, attendance, and punctuality. Job performance and functional ability. The final area for review pertains to the impact of functional ability on job performance. Studies have indicated that people with more significant limitations in functional ability tend to be in sheltered workshops versus competitive employment settings (see Coker & Osgood, 1995). Sheltered workshops have been described as a means for providing training in work-related skills prior to competitive employment for people with disabilities (Block, 1997). Consequently, it is quite possible that the more significant a person’s functional limitations are, the less likely her or she is to demonstrate skills traditionally associated with successful job performance. However, there does not appear to be any studies examining whether people who have been identified as having either a high or low functional ability perform differently on measures of job performance. Summary. In summary, this study appears to provide the first collective examination of relationships between quality of life and job satisfaction and the impact of functional ability on job performance and quality of life for people with disabilities. This study is an attempt to address this significant gap in the literature. Brief Description of Instruments Four instruments were used to assess quality of life, job satisfaction, functional ability, and job performance. These are: (a) Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a); (b) Job Descriptive Index (JDI), including the Job in General (JIG) scale (Smithet al., 1997); (c) Functional Assessment Inventory (FAI; Crewe & Athelstan, 1981); and (d) Job Observation and Behavior Scale (JOBS; Rosenberg & Brady, 2000a). A brief description of each instrument follows. Quality of Life Questionnaire (QOL.Q). Schalock and Keith (1993a) designed the Quality of Life Questionnaire (Q.OLQ) for use with people who have cognitive disabilities. When used with people who have limited communication skills, the Q.OLQ should be completed

by significant others (i.e., proxies) who are familiar with the person’s current residential, leisure, and work situations. The Q.OLQ provides scale scores on four areas: life satisfaction, competence/productivity, empowerment/independence, and social belonging/community integration. Each section is comprised of 10 items and respondents select from one of three words or phrases that best describe how the person feels about his or her life, home, work, friends, and family. For example, item 22 in Empowerment/Independence asks, “Who decides how you spend your money?” to which the respondent selects from “I do,” “I do, with assistance from others,” or “Someone else decides.” Job Descriptive Index (JDI), including the Job in General (JIG) scale. The JDI (Smith, Kendall, & Hulin, 1969, 1997) was designed to measure short-term satisfaction among five main job facets: (a) work on the present job, (b) present pay, (c) opportunities for promotion, (d) supervision, and (e) coworkers. The JDI is designed such that respondents read a list of words or phrases for each of the five facets and are asked to select the response (Yes/No/?) that best reflects his or her current feelings. Half of the words or phrases are worded favorably while the remaining half are worded unfavorably. For example, a favorable item from the People at Work facet is “helpful,” for which a respondent described using “Yes” indicates satisfaction, whereas a “No” response indicates dissatisfaction. Conversely, an unfavorable item from the Pay facet is “underpaid,” for which a respondent described using “Yes” indicated dissatisfaction, whereas a “No” response indicates satisfaction. Finally, if a respondent is unsure, he or she can select the “?” response. In 1984, Seltzer modified the JDI for use with people who had cognitive disabilities, such as mental retardation. In addition to reducing the number of items from 72 to 61, she also included questions to clarify the words or phrases addressing the various facets of job satisfaction. The proposed study will use the: (a) original number and presentation order of items presented in the JDI, (b) questions developed by Seltzer (1984), and (c) additional questions to clarify for respondents those words or phrases not included in the Seltzer study. Since 1985, the JDI has also included the Job in General (JIG) scale, which is purported to provide an overall measure of long-term job satisfaction. The JIG provides a long-term measure of global job satisfaction. The JIG was designed to reflect both the importance of the five facets of job satisfaction and their interactions with personal and situational factors affecting job satisfaction. The JIG is comprised of eighteen words or phrases, including: good,

undesirable, and poor. As with the JDI, the JIG asks respondents to select a response (Yes/No/?), which best reflects how each word or phrase describes how the person feels most of the time about his or her job. To assist in clarification and response validity, the proposed study will add synonyms to the words included in the JIG. Functional Assessment Inventory (FAI). Created by Crewe and Athelstan (1981), the Functional Assessment Inventory (FAI) provides a systematic enumeration of a person’s vocational strengths and limitations. The FAI yields an evaluation of both behavioral capacities and key environmental factors affecting an individual’s capacity for work or other activities. There are 30 items assessing a variety of areas, including learning ability, memory, vision, hearing, speech, mobility, endurance, and loss of time from work. Ratings on each item range from zero to three, where a zero indicates no significant impairment and a score of three indicates a significant impairment. Over the past 20 years, the FAI has been determined as a reliable, valid, and comprehensive evaluation of vocationally relevant behaviors (Bolton, 1984; Heinemann, Crown, & McMahon, 2000). Job Observation and Behavior Scale (JOBS). The final instrument used in this study is the JOBS by Rosenberg and Brady (2000a). The JOBS provides an evaluation of employment performance for individuals with and without disabilities, and is considered ideal for use with supported employees. Information yielded by the JOBS can be used to determine the quality of a worker’s performance, identify individual strengths and supports needed, and examine both progress and effectiveness of supports over time. The JOBS is comprised of 30 items reflecting three patterns of job performance: work-required daily living activities (13 items), work-required behavior (8 items), and work-required job duties (9 items). Sample items for work-required daily living activities include attendance, verbal communication, and work schedule. Work-required behaviors include stress tolerance and work endurance, while quantity of work and cleanliness of work environment are examples of work-required job duties. Additionally, there are four questions following each section, which ask if the particular pattern of job performance: (a) is adequate enough to maintain employment, (b) adequate enough to receive a raise and/or promotion, (c) if a decrease in support would have an adverse effect, and (d) if change in support would enhance performance. Finally, the JOBS assesses quality of performance and type of support across the three patterns of job performance.

Purposes of Research The purposes of this research included adding to the limited body of research examining quality of life of people with developmental disabilities using a standardized instrument. Consequently, another function of this study was to contribute to efforts establishing the QOL.Q (Schalock & Keith, 1993a), which is still considered to be a relatively new instrument (Cummins, 1997). Similarly, this study was intended to add to the research measuring job satisfaction of workers with disabilities. Using a standardized instrument, such as the JDI/JIG (Smith et al., 1997), can continue the efforts of Seltzer (1984), Abrams, DonAroma, and Karan (1997), and McAfee and McNaughton (1997a, 1997b) in providing a basis of comparison amongst studies exploring job satisfaction of workers with disabilities. Also notable is the potential of this study to add to the literature and understanding of how functional ability impacts job performance. Although the FAI (Crewe & Athelstan, 1981) is an established instrument for assessing functional ability, the JOBS (Rosenberg & Brady, 2000a) is a very new instrument. Thus, efforts at examining job performance and level of support for workers who varied according to functional ability has the potential to enhance the validity of the JOBS. Finally, this study examined whether quality of life differed for people based upon their functional ability. As with the quality of life and job satisfaction research, these, too, seem to be underrepresented areas of study that could benefit from further research. Cumulatively, this study appears to provide the first collective examination of relationships between quality of life and job satisfaction and the impact of functional ability on job performance and quality of life for people with disabilities. Most importantly, however, the intention behind this study was to provide a systematic method for assessing quality of life, job satisfaction, functional ability, and job performance of supported employees. Such efforts can improve the supports and services provided by the employment consultants and assist with monitoring for funding and accreditation of the participating agency’s employment program. Ultimately, however, a program-wide effort at systematic evaluation of quality of life outcomes and related factors has the potential to enhance meaningful and personally satisfying integration of the people they serve.

Research Questions Several research questions exploring the quality of life, job satisfaction, functional ability, and job performance of employees with disabilities participating in supported employment were addressed in this study: Quality of Life and Job Satisfaction 1. What correlations exist between overall quality of life (as measured by the QOL.Q) and global job satisfaction (as measured by the JIG scale)? 2. What correlations exist between competence/productivity (as measured by the subscale of the QOL.Q) and various aspects of job satisfaction (as measured by the JDI)? Functional Ability and Job Performance 3. What differences exist in either quality of job performance or level of support (as measured by the JOBS subscales) between groups of supported employees assigned to one of two general categories of functional ability? Functional Ability and Quality of Life 4. What difference exists in quality of life (as measured by the QOL.Q) between groups of supported employees assigned to one of two general categories of functional ability (as measured by the FAI)? Expected Outcomes Based upon a review of the literature surrounding quality of life, job satisfaction, functional ability, and job performance of people with disabilities, some hypothetical outcomes of data analyses were examined. Quality of Life and Job Satisfaction According to Kiernan and Marone (1997), the relationship between quality of life and job satisfaction has not been established. The correlation between global measures of quality of life and job satisfaction were tested using the Quality of Life Questionnaire (QOL.Q) total score and the Job in General (JIG) score. Correlations on aspect measures of job satisfaction and quality of life were tested using (a) Job Descriptive Index (JDI) work score and QOL.Q competence/productivity (cp) score, (b) JDI pay score and QOL.Qcp score, (c) JDI promotion score and QOL.Qcp score, (d) JDI supervisor score and QOL.Qcp score, and (e) JDI coworker score and QOL.Qcp score.

The following null and alternative hypotheses were tested to determine if there was a relationship between global quality of life and global job satisfaction scores:

Ho1: there is no significant association between QOL.Q total score and the JIG score.

Ha1: there is a positive association between QOL.Q total score and JIG score. The following null and alternative hypotheses were tested to determine if there was a relationship between various aspects of job satisfaction and the competence/productivity aspect of quality of life:

Ho2: there is no significant association between JDI work score and the QOL.Qcp score.

Ha2: there is a positive association between JDI work score and the QOL.Qcp score.

Ho3: there is no significant association between JDI pay score and the QOL.Qcp score.

Ha3: there is a positive association between JDI pay and the QOL.Qcp score.

Ho4: there is no significant association between JDI promotion score and the QOL.Qcp score.

Ha4: there is a positive association between JDI promotion score and the QOL.Qcp score.

Ho5: there is no significant association between JDI supervisor score and the QOL.Qcp score.

Ha5: there is a positive association between JDI supervisor score and the QOL.Qcp score.

Ho6: there is no significant association between JDI coworker score and the QOL.Qcp score.

Ha6: there is a positive association between JDI coworker score and the QOL.Qcp score. Functional Ability and Job Performance The following null and alternative hypotheses were tested to determine if there was a significant difference in job performance between high and low functional ability groups:

Ho1: there is no significant difference in JOBS performance score for supported employees who have a high functional ability and those who have a low functional ability.

Ha1: there is significant difference in JOBS performance score for supported employees who have a high functional ability and those who have a low functional ability. The following null and alternative hypotheses were tested to determine if there was a significant difference in level of support between high and low functional ability groups:

Ho2: there is no significant difference in JOBS support score for supported employees who have a high functional ability and those who have a low functional ability.

Ha2: there is significant difference in JOBS support score for supported employees who have a high functional ability and those who have a low functional ability. Functional Ability and Quality of Life Finally, in an attempt to expand the literature as it relates to quality of life for people with disabilities who have different functional abilities, the last research question asked if there was a difference in quality of life (as measured by the QOL.Q) between groups of supported employees assigned to one of two general categories of functional ability. The following null and alternative hypotheses were tested to determine if there was a significant difference in quality of life between high and low functional ability groups:

Ho1: there is no significant difference in QOL.Q total score for supported employees who have a high functional ability and those who have a low functional ability.

Ha1: there is significant difference in QOL.Q total score for supported employees who have a high functional ability and those who have a low functional ability. Definitions The following is intended to provide the reader with clarification of relevant terminology and definitions used throughout the text of this study. Adaptive Behavior: when used in conjunction with the FAI (Crewe & Athestan, 1984), refers to limitations in interpersonal and adaptive skills. Adult Congregate Living Facility (ACLF): typically refers to community-based residential facilities or group homes housing less than 10 people. Affirmative Industry: refers to those settings, which employ both workers with and without disabilities for producing goods and/or services. They can be either small franchises or large manufacturers; in this study, it does not include entrepreneurial-type businesses. Competitive Employment: refers to community-based employment during which employees with disabilities work at jobs and earn wages commensurate with coworkers who do not have disabilities. Deinstitutionalization: refers to the movement of people with disabilities from institutions into community residences typically inhabited by people without disabilities.

Developmental Disability: According to Section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (P.L. 106-204), a developmental disability is defined as: …a severe, chronic disability of an individual that – is attributable to a mental or physical impairment or combination of mental and physical impairments; is manifested before the individual attains age 22; is likely to continue indefinitely; results in substantial functional limitations in 3 or more of the following areas of major life activity; (I) Self-care; (II) Receptive and expressive language; (III) Learning; (IV) Mobility; (V) Self-direction; (VI) Capacity for independent living; (VII) Economic self-sufficiency; and (VIII) reflects the individual’s need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated (pp. 8-9). Discrepancy Theory: refers to evaluations of satisfaction which are based upon a person’s comparison of his or her current situation with that of his or her past, or to comparisons of one’s situation with that of others. Employment Consultant: also known as job coach, is the person who provides supported employment services to the worker with disabilities. Enclave: refers to employment models that place small groups of people with disabilities into a permanent work site, such as an electronics company, which typically employ workers without disabilities. Functional ability: “…client’s behavioral capacities [and limitations] together with key environmental factors…” (Crewe & Athelstan, 1984, p. 1). Global job satisfaction: “…overall feelings about the job….reactions to various aspects of the job in a single integrated response (Ironson, Smith, Brannick, Gibson, & Paul, 1989, p.194). Integrated Employment: similar to competitive employment, people with and without disabilities work side by side in the job setting. Job Coach: also known as employment consultant, is the person who provides supported employment services to the worker with disabilities. Job Performance: in general, refers to the demonstration of a variety of work-related skills, such as work quality, timeliness, interactions, and attendance in the job place.

Job Satisfaction: in general, can refer to perception and fulfillment of factors encountered in the workplace. Job satisfactions: “…feelings or affective responses to facets of the situation” (Smith et al., 1969, p. 6). Level of support: refers to the “…type of support which the employee receives during the entire work shift or work day” (Rosenberg & Brady, 2000b, p. 8) for work-required daily living activities, behaviors, and job duties. Normalization: means making “…available to all persons with intellectual or other impairments or disabilities those patterns of life and conditions of everyday living that are as close as possible to, or indeed the same as, the regular circumstances and ways of life of their communities and their cultures” (Nirje, 1999, p. 17). Overall employment performance: “…reflects the actual performance of employees’ observable work-related daily living skills, behaviors, and job duties….and includes the skills, attitudes and behaviors necessary for continued employment, promotions and pay increases in entry-level work settings” (Rosenberg & Brady, 2000b, p. 1). Primary disability: predetermined disability label that has been assigned to supported employee, as indicated in records, such as mental retardation, autism, cerebral palsy, behavior disorder, etc. Quality of job performance: a comparison of “…the employee’s performance to workers not receiving supports who perform the same competitive job” (Rosenberg & Brady, 2000b, p. 8) on work-required daily living activities, behaviors, and job duties. Quality of Life: “…is the outcome of individuals meeting basic needs and fulfilling basic responsibilities in community settings (family, recreational, school and work). Individuals who are able to meet needs and fulfill responsibilities in ways satisfactory to themselves and to significant others in community settings experience a high QOL in those settings (Schalock, 1990, p.143 [cited by Cummins, 1997, p. 209]). It is further defined as “…a personal, subjective phenomenon that is a result of the following three levels of experience: personal characteristics and objective circumstances; the perceptions of significant persons; and one’s personal beliefs about what is important and how the world works” (Schalock & Keith, 1993b, p. 8). Quality of Work Life: refers to:

…the degree of an individual’s satisfaction with his/her role, relationships, and duties in the workplace. This satisfaction is predicated on a variety of factors affecting the individual including, but not limited to, personality variables, family expectations, social cultural norms, workplace culture, and concrete facets of the job within the setting where the duties are performed (Kiernan and Marrone, 1997, p. 64-65). Sheltered Employment: has been used synonymously with sheltered workshops, because people working in them receive a wage, albeit small, for some tasks. Sheltered Worker: refers to the person attending and participating in sheltered workshop activities. Sheltered Workshop: refers to programs typically attended by people with disabilities that provide training in, and sometimes monetary compensation for, completion of work-related tasks. Social Role Valorization theory: refers to “the application of what science has to tell us about the enablement, establishment, enhancement, maintenance and/or defence [sic] of valued social roles for people” (Thomas & Wolfensberger, 1999, p. 125). Supported Employee: refers to the person who is participating in, and receiving services consistent with, supported employment. Supported employment: According to Section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (P.L. 106-204), supported employment services are defined as: …services that enable individuals with developmental disabilities to perform competitive work in integrated work settings, in the case of individuals with developmental disabilities – (A) (i) for whom competitive employment has not traditionally occurred; or (ii) for whom competitive employment has been interrupted or intermittent as a result of significant disabilities; and (B) who, because of the nature and severity of their disabilities, need intensive supported employment services or extended services in order to perform such work (p. 13).

CHAPTER 2 REVIEW OF THE LITERATURE

If history is a collection of events which come to life for us because of what some actors did, some recorders recorded, and some reviewers decided to retell, a [person] attempting to interpret an historical event must first of all get the facts straight. But he [or she] must apply to this task what he [or she] has learned, namely to see in all factuality some relativities which arise from the actors’, the recorders’, and the reviewers’ motivations. From Eric H. Erickson, 1969, Gandhi’s Truth, p. 55

This chapter is intended to provide the reader with a brief overview of the primary concepts investigated in the proposed study. To begin, the reader will learn about some the major theories and movements leading up to the concept we know today as quality of life in relation to people with disabilities. From this, the focus will narrow to aspects surrounding work life, employment, and, ultimately, job satisfaction of people with disabilities. Following discussion of quality of life and job satisfaction of people with disabilities, research questions will be posed about the nature of the relationship between these concepts. Next, the reader can expect an exploration of the literature surrounding functional ability and job performance of people with disabilities. Finally, research questions about the nature of functional ability and job performance for people with disabilities will be presented. Catalysts for Change Treatment of, and services for, people with developmental disabilities have changed considerably over the past 35 years. The most significant catalysts for change occurred around 1968, with the political-economic policy of deinstitutionalization and the subsequent social policy of community integration that developed. Several social advocates, including Burton Blatt and Fred Kaplan who photographed a pictorial essay of U.S. institution entitled Christmas in

Purgatory, heavily influenced policy development in the 1970s. As people with intellectual disabilities moved from large institutions to smaller, community-based settings, interventions for facilitating a culturally normalized, humanized, and integrated experience emerged (Stark & Faulkner, 1996). From 1977 to 1996, there was a decrease of more than 122,000 people with developmental disabilities living in institutions (Palley & VanHollen, 2000). This movement from institutions into the community was encouraged by the 1987 Amendment to the Americans with Disabilities Act, a social policy emphasizing life satisfaction, community integration, and productivity (Fullerton, Douglass, & Dodder, 1999). By 1997, the population of public institutions was reported to be approximately 58,000 (Stancliffe & Lakin, 1999). Normalization The normalization movement was an internationally influential human services paradigm, which focused on making patterns and conditions of everyday life available to all people, regardless of intellectual ability (Flynn & Nitsch, 1980). Influences of the work of Abraham Maslow in 1954 can be seen in the conceptualization of the Normalization principle. For example, Abraham Maslow (1954/1987, 1968/1999) studied the characteristics of people he identified as successful and possessing healthy personalities, theorizing that human motivation is best described within the context of a basic need hierarchy. These five basic needs are: 1) physiological (e.g., homeostasis [normal state of the blood stream] or appetite), 2) safety, 3) belongingness and love, 4) esteem, and 5) self-actualization (e.g., reaching one’s potential). As each need is satisfied, the next higher need emerges, and so on. Therefore, once the lower-order needs are met, a person can work towards the higher-order needs and eventually become self-actualized (Maslow, 1954/1987, 1968/1999). Considerations of both basic and higher order needs were evidenced in “normalization” efforts promoting deinstitutionalization and integration for people with disabilities. First conceptualized in 1968 by Bendt Nirje in Sweden: the Normalization principle means that you act right when you make available to all persons with intellectual or other impairments or disabilities those patterns of life and conditions of everyday living that are as close as possible to, or indeed the same as, the regular circumstances and ways of life of their communities and their cultures (Nirje, 1999, p. 17).

As described by Nirje (1999), there exist facets of normal patterns to which people with disabilities have a right: 1. A normal rhythm of the day. 2. A normal rhythm of the week. 3. A normal rhythm of the year. 4. The normal experiences of the life cycle. 5. Normal respect for the individual and the right to self-determination. 6. The normal sexual patterns of their culture. 7. The normal economic patterns and standards of their community. 8. The normal environment patterns and standards in their community (p. 17). Wolf Wolfensberger (1972) is credited with introducing the Normalization principle to the United States. Subsequently, the principle of normalization (Wolfensberger, 1972) has been identified as the “…single most influential concept in development and implementation of services for people with disabilities” (McVilly & Rawlinson, 1998, p. 203). In conjunction with deinstitutionalization efforts, influence of the normalization movement was evidenced in the social and behavioral sciences research. For example, behavioral interventions were utilized by many as a way to improve community integration of people with disabilities. Meyers (1978) edited a collection of research studies, which focused on adaptive behavior “training” to improve the quality of life for people with severe and profound mental retardation. Focus was on such outcomes as reduction of rocking behavior, following verb-noun instructions, and non-vocal teaching of reading and writing skills. Again, emphasis on training people to display more socially acceptable behaviors was thought to increase chances of deinstitutionalization, promote normalization, and, ultimately, enhance a person’s quality of life. Some might argue, however, that behavioral interventions are not culturally normative. Mental Retardation: An Evolving Concept Finally, a consideration of how the concept of mental retardation has evolved over the years is presented. Alper (2003) discussed the evolution of definitions describing people with disabilities, such as mental retardation. Such definitions originally focused on arbitrarily determined IQ scores, which were purported to predict a person’s ability. More recently, a few organizations, such as the American Association on Mental Retardation (AAMR), have expanded their definitions of specific disabilities to include areas reflective of adaptive or

functional ability. A brief review of how the definition of mental retardation has evolved over the past century follows. Early definitions of mental retardation were broad and indistinct and assumed that mental retardation could not be cured. It wasn’t until the 1900s that definitions became more focused and considered adaptive behavior (Crane, 2002). Over the years, the most widely used definition of mental retardation was developed and periodically revised by the AAMR. For example, the 1961 definition identified anyone scoring one standard deviation (15 points) below the mean (100) on an IQ test as having mental retardation (IQ = 85 or below). Although adaptive functioning was included in the definition, it received little attention in diagnoses. By 1973, a new definition was adopted that reduced the cut-off score to two standard deviations below the mean (IQ = 70 or below) and included consideration of deficits in adaptive behavior. The 1977 definition retained the 1973 definition but allowed up to 10 points above an IQ score of 70 if there were significant deficits in adaptive behavior. The AAMR’s 1983 definition included a more detailed description of adaptive behavior, because they recognized that an IQ score alone could not adequately account for mental retardation. Despite these efforts, however, actual measurement of adaptive behavior was seldom accurately implemented. Consequently, another definition was developed by the AAMR in 1992, which characterized mental retardation by sub average IQ and significant limitations in two or more adaptive skill areas, such as communication, self-care, and work. Although this definition increased the focus on, and measurability of, adaptive behaviors, it still relied heavily on IQ scores. As a result, another definition of mental retardation was proposed in 2002, which de- emphasized psychometric measures and relied more heavily upon community observation and clinical judgments. According to the 2002 definition developed by the AAMR, mental retardation is characterized by limitations in intellect, as well as conceptual (e.g., reading and writing), practical (e.g., dressing and using the telephone), and social (e.g., self-esteem and responsibility) adaptive behavior skills, which originated before 18 years of age. Five assumptions guide use of this definition: (a) limitations must be considered within the person’s typical environment, (b) assessments must be culturally and linguistically sensitive, (c) evaluation must include consideration of strengths as well as limitations, (d) efforts should result in a profile of support

needs, and (e) over time, provision of individually tailored supports will enhance a person’s life functioning (AAMR, 2002). As we will see in the section that follows, the concept of “quality of life” has also evolved from the narrow, deficit-base, and behaviorally oriented concept exemplified by the studies edited by Myers (1978), for example, to one that recognizes the multidimensional aspects of human life, as well as the importance of personal self-worth and abilities when describing a quality life for people with developmental disabilities. Conceptualizing Quality of Life The influence of the classical works of Nirje (in 1969), Wolfensberger (1972, 1983), and Maslow (1954) are still evident in today’s literature, as professionals all over the world take a much broader approach to conceptualizing and defining quality of life for people with disabilities. For example, the Administration on Developmental Disabilities National Quality of Life Project of 1987 produced the first volume of international perspectives on quality of life (Goode [Ed.], 1994). Contributing Danish theorists, Holme, Holst, and Perlt (1994), pointed out that “quality of life is not something a person simply has or receives but something the individual actively works to create along with other people, as long as certain basic conditions are fulfilled” (p. 10; bold and italics added). Finally, when considering the many conceptualizations of quality of life presented in recent literature, Brown (1999) cautioned readers on the difference between a quality life and the quality of life: Focusing on a quality life sets striving for the best possible as the goal of all work in this area….Focusing on the quality of life can simply mean…that we explain and understand all the ways in which the lives of people with intellectual disability are not ideal, and may never be as good as the rest of us (p. 301).

Defining Quality of Life Many definitions for quality of life have been proposed (see Cummins, 1997; Dennis, 1993; Felce & Perry, 1995; Goode, 1994). This review focuses on the definition proposed by Shalock (1990), which states that quality of life: …is the outcome of individuals meeting basic needs and fulfilling basic responsibilities in community settings (family, recreational, school and work). Individuals who are able

to meet needs and fulfill responsibilities in ways satisfactory to themselves and to significant others in community settings experience a high QOL in those settings (p.143 [as cited by Cummins, 1997, p. 209]) Quality of life is multifaceted concept, which can be defined in a variety of ways. Despite how one defines quality of life, however, it is important to remember: quality of life is a dynamic, interdependent facet of each individual’s freedom from diminishing unnecessary restraints and conditions, opportunities for self-actualization and achievement, recognition of personal capabilities and competencies, and the awareness of an individual’s continuing contributions as a member of the human society (American Association on Mental Retardation, 2000, p. 5). Quality of Life from a Personal Perspective It is crucial, then, for all professionals and policy makers to bear in mind the following, as pointed out by the members of The National Quality of Life Project: Quality of life is a concept that gives primacy to the individual’s point of view. It can and should account for the experiences of persons with severe cognitive, emotional, or physical disabilities and reflect the very different ways such persons may see the world and set goals within it (Goode, 1994, p. 148). Others have also addressed the personal or self-defined aspect of quality of life. For example, Butterworth, Steere, and Whitney-Thomas (1997) stressed that, “ quality of life is a subjective concept that has meaning only as experienced and expressed by the individual” (p. 20). According to Taylor and Bogdan (1996) quality of life “has no meaning apart from what a person feels and experiences. It is a question of how people view or what they feel about their lives and situations and not what others attribute to them” (p. 16). Undeniably, however, quality of life is also influenced by more objective, external, and social factors, such as social status, employment, earnings, and housing. Due to its multidimensional, subjective, and objective nature, Taylor and Bogdan (1996) suggested the following propositions when considering the quality of life of people with developmental disabilities: (a) quality of life may be experienced differently by different people, (b) the study of quality of life requires that labels be set aside, (c) quality of life inquiry requires a personal perspective, (d) the study of quality of life poses a methodological challenge, (e)

studying quality of life requires in-depth knowledge of the person, and (f) definitions and conceptions of quality of life must respect people’s subjective experience (p. 17). Assessing Quality of Life Recent research represents a wide range of approaches to measuring the various aspects of quality of life for people with developmental disabilities. According to Dennis (1993), in the quantitative approach researchers typically use social and psychological indicators, as well as ecological analyses, to determine goodness of fit between person and environment. Whereas, qualitative research methods used to determine quality of life usually involve longitudinal, naturalistic, and ethnographic studies (Dennis, 1993). Many researchers have taken a multiple-measure approach to assessing quality of life (e.g., Campo, Sharpton, & Thompson, 1997; McVilly, Burton-Smith, & Rawlinson, 2000; Schalock , 1997, 1996; Wehmeyer & Schwartz, 1998). For example, Campo et al. (1997) compared the results of an earlier version of the Quality of Life Index (Keith, Schalock, & Hoffman, 1986) to data obtained from interviews with residential staff providers serving sixty adults with severe or profound mental retardation. Campo and colleagues (1997) recommended caution when interpreting scores on the index for this population, however, because of low correlation with interview data. There have been other, innovative approaches to assessing quality of life, as well. For example, Canadian researchers, Brown, Brown, & Bayer (1994) recommended assessing quality of life by determining the discrepancy between a person’s achieved and unmet needs and desires: This refers to the subjective, or perceived, and objective assessment of an individual’s domains. The greater the discrepancy, the poorer the Quality of Life. It includes the extent to which an individual increasingly controls aspects of life regardless of original baseline (p. 41) Finally, Hughes and Hwang (1996) reviewed 87 studies assessing the quality of life for more than 9,000 people with developmental disabilities, and created an extensive framework for measuring quality of life. They identified 15 dimensions ranging from normalization to social status. Heal (1999) adapted Hughes and Hwang’s (1996) classification of quality of life dimensions, to include the following: a) well-being (e.g., psychological, physical, material); b) socialization (e.g., relationships, acceptance, recreation, civic responsibility); c) employment; d)

self-determination and supporting skills; e) normalization (e.g., community integration); and f) support services received (p. 199). Regardless of the approach, methodology, or instrument used to assess quality of life, it is crucial that we remember the following: The general idea…about quality of life is the more a person’s life has what that person wants and needs, the better the quality of that person’s life. The key to that definition [and subsequent assessment] is that a person has to be able to want things, to know he or she wants things, and to be able to communicate those wants (Rosenberg, 1994, p. 176). The Quality of Life Questionnaire Schalock and Keith (1993a) developed the Quality of Life Questionnaire (QOL.Q) for use with people who have disabilities. The QOL.Q measures four domains: life satisfaction, competence/productivity, empowerment/ independence, and social belonging/community integration. The QOL.Q (Schalock & Keith, 1993a) was designed to provide both a subjective and objective measure of quality of life and according to Cummins (1997) it is the most commonly used instrument. A review of available literature indicated that most researchers focused on developing psychometric properties of the QOL.Q, rather than using the instrument to determine the quality of, and satisfaction with life, as reported by people with disabilities and/or proxies. Rapley and Lobley (1995) investigated the factor stability of the QOL.Q (Schalock & Keith, 1993a) using scores from 193 people with learning disabilities. Results of principal component factor analysis with oblique rotation revealed four factors, which were consistent with those identified by Schalock, Keith, and Hoffman in 1990. Theta coefficients ranged from .79 to 89 on the four factors; coefficients greater than .79 were deemed acceptable. Consequently, Rapley and Lobley (1995) concluded that the QOL.Q (Schalock & Keith, 1993a) demonstrated acceptable internal consistency and had a stable factor structure. Campo, Sharpton, and Thompson (1996) examined the measurement characteristics of an earlier version of the QOL.Q, known as the Quality of Life Index (Keith, Schalock, & Hoffman, 1996) for 60 people labeled with severe to profound mental retardation. Using principal component factor analysis, results indicated that factor loadings were similar to those obtained by Schalock, Keith, Hoffman, and Karan in 1989 during the early stages of instrument

development. However, Campo et al. found that Cronbach alpha coefficients on the three subscales ranged from .344 to .540, while the alpha coefficient for the total score was .556. They adapted the scoring keys, but alpha coefficients never exceeded .656. Due to the low internal consistency, Campo et al. (1996) concluded that results from the Quality of Life Index (Keith et al., 1989) should be interpreted with caution when derived from homogeneous groups. Eggleton, Robertson, Ryan, and Kober (1999) evaluated the impact of employment on quality of life for 50 people with disabilities. People were grouped according to whether they were competitively employed or unemployed. The unemployed group consisted of those who remained at home and those attending a sheltered workshop. It was hypothesized that people with disabilities who were competitively employed would experience greater quality of life than those who were unemployed. Eggleton et al. further hypothesized that: (a) people with disabilities who entered competitive employment directly from home would report greater quality of life than those who remained at home, (b) people with disabilities who entered competitive employment from a sheltered workshop would report greater quality of life than those who remained in a sheltered workshop, and (c) people who attend a sheltered workshop would report greater quality of life than those who remain at home. These alternative hypotheses were tested across both global and subscale QOL.Q scores. Results indicated that the instrument had good internal consistency (Cronbach alpha coefficient was .900 for QOL.Q total score). Wilcoxon’s Matched Pairs test indicated that the employed group reported significantly higher total quality of life than the non-employed group (Z = -.429, p < .0001); the group who went directly from home to work reported significantly higher total quality of life than the group who remained at home (Z = -.294, p < .002); and the group who moved from the sheltered workshop reported significantly higher total quality of life than the group who remained in the workshop (Z = -.317, p < .001). The Mann-Whitney U (used to compare un-match groups) revealed that the group attending the workshop reported significantly higher compentence/productivity than the group who remained at home (Z = -.1.84, p < .033 [the Z statistic is used in both analyses for n > 15, because distributions of summed ranks approach normality as sample size increases]). Eggleton et al. (1999) provided evidence to support their theory that people with disabilities who are employed experience greater quality of life than those who are unemployed. Further, competitive employment has the potential to enhance quality of life for people with intellectual disabilities.

In a more recent study, Kober and Eggleton (2002) examined the factor stability of the QOL.Q (Schalock & Keith, 1993a) using scores from 172 people with intellectual disabilities participating in sheltered and competitive employment settings. The sample was dichotomized on several variables, including functional ability (as measured by the FAI, Crewe & Athelstan, 1981). Results of principal axis factor analysis with varimax rotation indicated that three of the factors (competence/productivity, empowerment/independence, and belongingness/community integration) were stable across groups with varying functional ability. On all three factors, coefficients of congruence exceeded .940. In contrast, a coefficient of congruence could not be calculated on the satisfaction factor for the groups dichotomized according to functional ability. Further, three of the four remaining coefficients were below .940, when groups were dichotomized according to: random split halves (.589); open vs. supported employment (.907), and open vs. supported employment and job seekers (.921). From these results, it may be concluded that the questions corresponding to the satisfaction factor in the instrument do not correlate consistently with the satisfaction factor during analyses for various groupings. This finding is in contrast to original factor analyses during instrument development that all four factors, including the satisfaction factor, was stable across various groups of people. Additionally, Kober and Eggleton (2002) found that individuals in the low functional ability group (FAI > 22) were those in sheltered workshops. Whereas, most people in competitive employment demonstrated higher functional ability. Results of the QOL.Q, such as subscale or total scores for groups, were not reported. As described by Cummins (1997) and indicated previously, the QOL.Q (Schalock & Keith, 1993a) is the most commonly used instrument for determining the quality of, and satisfaction with life for people with disabilities. However, the QOL.Q (Schalock & Keith, 1993a) is still a relatively new instrument and research examining the quality of life using the QOL.Q remains limited. Quality of Work Life The majority of quality of life theorists concur that one of the chief factors leading to a quality life and life satisfaction is the opportunity for employment. For example, in the quality of life literature analysis conducted by Hughes and Hwang (1996), employment was identified as a frequently measured outcome among the 87 studies reviewed. Employment (i.e., vocational skills) represented 12.1% (150) of the total measures of all studies reviewed, exceeded only by

social relationships (i.e., social skills training) at 15.9% (198) and psychological well-being (i.e., life satisfaction) at 14.7% (183). Wolfensberger (1983) also recognized the importance of meaningful employment .In an expansion of the normalization principle, Wolfensberger (1983) formulated the Social Role Valorization (SRV) theory, which was defined as “the application of what science has to tell us about the enablement, establishment, enhancement, maintenance and/or defence [sic] of valued social roles for people” (Thomas & Wolfensberger, 1999, p. 125). According to Wolfensberger (1983), the utmost goal of “Normalization” is that all people, regardless of perceived ability, hold those roles deemed as valued in their society. He postulated that roles through such activities as employment allow individuals, who may otherwise be devalued, to enhance their personal capabilities and social images. In turn, individuals who hold socially valued roles (such as “worker,” “prep chef” or “environmental specialist”) will be respected by their community and afforded more of the “good life” than those individuals who hold less valued roles (such as “unemployed” or “handicapped”). As recently stated by Thomas and Wolfensberger (1999), “SRV proposes that people who hold valued roles in society are more apt than people who hold devalued roles to be accorded the ‘good things in life’ by their society” (p. 125). As appealing as this theory is, little evidence exists to empirically link employment to quality of life or quality of work life (Kiernan & Marrone, 1997). In fact, some theorists separate quality of work life from quality of life, claiming that each is a separate issue. For example, Kiernan and Marrone (1997) pointed out that, quality of work life should not be viewed as a subset of quality of life, because an increase in one does not automatically indicate an increase in the other. Kiernan and Marrone (1997) described quality of work life as: …the degree of an individual’s satisfaction with his/her role, relationships, and duties in the workplace. This satisfaction is predicated on a variety of factors affecting the individual including, but not limited to, personality variables, family expectations, social cultural norms, workplace culture, and concrete facets of the job within the setting where the duties are performed (p. 64-65). Although instruments exist to evaluate some of these variables, such as job-facet satisfaction, research exploring the relationship of job satisfaction with quality of life is limited for people with disabilities. In contrast, numerous studies exist examining the impact of factors

such as employment models on quality of life for people with disabilities. Before presenting a select review of these studies, however, a brief discussion of work and people with disabilities is warranted. Also included is a description of two of the most common employment models that people with disabilities participate in, namely: sheltered workshops and supported employment. Work and People with Disabilities Early efforts at assisting people with disabilities integrate into their communities included programs purportedly designed to provide training in work-related skills prior to competitive, community-based employment (Block, 1997). In the 1960s sheltered workshops dominated the programs available to people with developmental disabilities (Wehman & Bricout, 1999). Emphasis was on training and acquisition of vocational skills, such as complex task assembly, that were deemed necessary before people with disabilities were able to enter community-based employment settings (see Gold, 1972, 1973, 1980). During this time, few would experience real, competitive employment. Instead most people with disabilities would spend their days in segregated settings earning significantly below minimum wage (Kregel, 1997) completing “work” often characterized by repetitive and mundane tasks (Griffin, Rosenberg, Cheyney, & Greenberg, 1996; Lam & Chan, 1988). Throughout the 1980s and 1990s, emphasis on sheltered workshops decreased, while community-based employment options increased. Programs began providing services such as supported employment for people with even the most significant disabilities (Mank, Cioffe, & Yovanoff, 1998). One of the primary differences between sheltered and supported employment models is that in sheltered employment, individuals must achieve a certain level of proficiency before the can be considered as “appropriate” for integrated employment (Block, 1997). Whereas, one of the key elements of the supported employment model is job training provided in the actual work setting (Krauss & MacEachron, 1982). The supported employment model has been identified as the most effective means for assisting people with developmental disabilities obtain and maintain competitive employment (Block, 1997; Wehman & Kregel, 1995). Among those benefiting from supported employment services are people with visual impairments and blindness (Griffin & Kendall, 1989), hearing impairments and deafness (Danek, Seay, & Collier, 1989), intellectual disabilities (Fesko, Temelini, & Graham, 1997), psychiatric disabilities (MacDonald-Wilson, Mancuso, Danley, & Anthony, 1989) and mental illness (Marone, Balzel, & Gold, 1995).

According to Butterworth and Gilmore (2000) the number of people with developmental disabilities in supported employment has steadily increased. In 1988, there were 32,471 supported employees, while the number of people participating in non-work and facility-based programs reached 242,102. By 1996, the number of people participating supported employment grew by more than 200% (98,315), however, the number of people in facility-based programs (work and non-work) also continued to increase (12% or 320,359). Clearly, the past 15 years has witnessed an increased emphasis on integrated employment for people with developmental disabilities (Fesko & Butterworth, 2001). More recent efforts are reflected in the mission statement of the Presidential Task Force on Employment of Adults with Disabilities. Established by Executive Order in 1998, the task force emphasized the need to include adults with disabilities in gainful employment at a level commensurate to the general population (Fesko & Butterworth, 2001). Despite national efforts, however, most people with developmental disabilities continue to spend the majority of their days in segregated facilities rather than integrated employment (Dreilinger, Gilmore, & Butterworth, 2001; Mank et al., 1998). Results from the most recent National Survey of Day and Employment Programs for People with Developmental Disabilities, conducted by the Institute for Community Inclusion, indicated that in 1999, there were 107,820 people in integrated employment, while 362,022 people were participating in facility-based and non-work services (Dreilinger et al., 2001). According to Mank et al. (1998) this population has yet to fully access community-based, integrated employment efforts, such as supported employment, which was originally conceptualized for people with the most significant disabilities. Furthermore, Donovan and Tilson (1998) described the 1990s as a decade of progress and frustration, pointing out that: “people with disabilities have gained tremendous visibility, myths and stereotypes have been exploded, focus is increasingly on what an individual has to offer rather than his/her limitations and yet the path to true opportunity and equality remains disturbingly narrow” (p. 16). In evidence, Mank, et al. (1998) reported that, despite the capabilities demonstrated by people with significant disabilities, average supported employment wages ($464 per month) remain well below poverty level. Even worse, average wages for sheltered workers was reported to average $150 per month. The results of these and other studies, however, have not gone unnoticed. Dreilinger et al. (2001), from the Institute for Community Inclusion, noted several recent policies changes that might influence future

programs and services. For example, in 2001 the Rehabilitation Services Administration proposed removing “sheltered workshop” placements as a successful vocational rehabilitation outcome. Clearly, evidence supporting the move from facility-based non-work services to community-based integrated employment indicates a potential to improve the quality of employment and life outcomes for people with disabilities. Work and Quality of Life As indicated previously, numerous researchers have explored the impact of employment on the quality of life of people with disabilities. Some studies focus on employment outcomes, such as earnings, for various disability groups. For example, Fesko et al. (1997) compared the employment outcomes of individuals with mental retardation and other disabilities and found that people with physical disabilities were earning the highest hourly wage ($7.74), followed by people with sensory impairments ($6.81) and mental illness ($5.64), while people with mental retardation required the most intensive job support and earned the lowest hourly wage ($4.87). Interestingly, the workers with mental retardation reported the highest levels of job satisfaction, perceived competence, and level of comfort when asking co-workers or supervisors for assistance (Fesko, et al., 1997). As Donovan and Tilson (1998) have reminded us: “employment remains, for most of us, the most telling indicator we have of status and achievement. It not only makes possible our creature comforts, but is a major factor in defining who we are to society and ourselves” (p. 16). Several studies have compared quality of life issues for people in sheltered and community-based, competitive employment. For example, Sinnott-Oswald, Gliner, and Spencer (1991) evaluated the quality of life of 29 people with and without disabilities. Ten people with disabilities were in workshop settings, while 10 people with (and 9 people without) disabilities were in competitive employment. The researchers developed their own survey to assess quality of life and compared scores for sheltered and supported employment workers. Results indicated that people with disabilities who were participating in supported employment evidenced greater self-esteem, involvement in leisure activities, mobility, and perceptions regarding job skills and change in income than their sheltered workshop counterparts. Inge, Banks, Wehman, Hill, and Shafer (1988) also compared competitive and sheltered workers on quality of life. They developed the Quality of Life Matching Scale to match participantss according to age, gender, and the following characteristics: (a) physical

involvement (walks or used wheelchair), (b) sensory involvement (hearing and/or visual impairments), (c) functional level (mild, moderate, severe or profound mental retardation), (d) inappropriate behavior (behaviors interfering with work), (e) work skills (work rate and task attention), and (f) parental support (interest and ability to provide transportation). Inge et al. (1988) conducted pre- and post-tests assessing adaptive behavior using the American Association on Mental Deficiencies (AAMD) Adaptive Behavior Scale. These researchers also measured and health factors, such as body fat, blood pressure, weight, pulse). Finally, they used a parent/guardian survey to assess community, leisure, and recreational participation, domestic, social, vocational skills, appearance, and financial activity. Results indicated that those in competitive, supported employment experienced significant increases in financial activity, health (weight control and hand strength), social and vocational skills, and language development (AAMD scale), when compared to the sheltered workshop group. Reid, Green, and Parsons (1998) compared select outcomes of people with multiple and severe disabilities who were in sheltered and supported employment. Results also indicated that those workers participating in supported employment, which offered more purposeful work, demonstrated greater active and alert behaviors than their sheltered workshop counterparts. Quality of Work Life and Job Satisfaction Consistent with job satisfaction literature (see Locke, 1969; Smith, 1992), quality of work life can be attributed to a person’s assessment of several workplace characteristics, including interesting and varied tasks, equitable compensation, comfortable working conditions, and opportunities for socialization, decision making, and promotion (Kiernan & Marrone, 1997). Again, Kiernan and Marrone (1997) indicated that there is no consensus of evidence to support a direct relationship between quality of work life and job satisfaction. However, some researchers have explored the intuitively appealing link between life and job satisfaction. For example, London et al. (1977) investigated the contribution of job and leisure satisfaction to the perception of quality of life of 1,297 people. Multivariate analysis of variance (MANOVA) of responses to five questions about job satisfaction (JS), six questions about leisure satisfaction (LS), and one question assessing quality of life (QOL) revealed that 25% of the QOL variance was accounted for by JS and LS combined. Inter-correlation analyses revealed that specific JS items contributing significantly to QOL included work itself (r = .29, p<.05), pay, fringe benefits, and security (r = .25, p<.05).

London et al. (1977) also found that JS contributed significantly to QOL for several subgroups, including those of higher socioeconomic (SES), college graduates, and white-collar workers. For those with low SES, no education beyond 11th grade, and unmarried blacks, neither JS nor LS significantly contributed to their QOL. London et al. (1977) concluded that, although their study is limited to the questions and participants employed, organizations and programs should consider the relative importance of job and leisure satisfaction to overall quality of life when designing and implementing motivational work strategies and leisure facilities. Despite the limited empirical evidence directly linking job satisfaction with quality of work life or quality of work life with overall quality of life, there is no shortage of literature emphasizing these intuitively appealing associations. Job Satisfaction Influences of early theorists have naturally shaped how the concept of job satisfaction is understood today. Theories relating to the relationship between work and motivation have informed industry and guided research. Consequently, a discussion of these theories precedes a review of the literature examining job satisfaction for workers with and without disabilities. To begin, Maslow (1971) extended his theory of motivation into the industrial setting, impacting views and practices within work and management (Cox, 1970). He described eupsychian management as focusing on the types of conditions, work, management, and compensation that foster fulfillment, prosperity, and health for both the organization and the workers. According to Maslow: …this is not about some new tricks of management, or some “gimmicks” or superficial techniques that can be used to manipulate human beings more efficiently for ends not their own. This is not a guide to exploitation. No, it is rather a clear confrontation of one basic set of orthodox values by another newer system of values which claims to be not only more efficient but also more true. It draws some of the truly revolutionary consequences of the discovery that human nature has been sold short, that man has a higher nature which is just as “instinctoid” as his lower nature, and that this higher nature includes the needs for meaningful work, for responsibility, for creativeness, for being fair and just, for doing what is worthwhile and for preferring to do it well. To think of “pay” in terms of money alone is clearly obsolete in such a framework. It is true that the lower need-gratifications can be bought with money—but when they are already fulfilled, then

people are motivated for higher kinds of “pay,” e.g., belongingness, affection, dignity, respect, appreciation, honor, as well as the opportunity for self-actualization and the fostering of the highest values—truth, beauty, efficiency, excellence, justice, perfection, order, lawfulness, etc. There is obviously much to think about here, not only for the Marxian or the Freudian, but also for the political or military authoritarian or the “bossy” boss or for the liberal (p. 228) Similar to Maslow’s hierarchy of need concept, Herzberg (1966/1972) described the “duality” of man, theorizing that humans have two sets of needs: basic or primary (animal-like) drives include avoidance of pain, hunger, and other forms of deprivation, whereas higher-order (human-like) drives refer to the need for psychological growth and to reach one’s potential. Herzberg extended his concept of duality of the nature of man to the realm of work, developing a theory of job satisfaction, which attributed work-related attitudes to certain aspects of the job categorized as either “satisfiers” or “dissatisfiers.” Herzberg (1966/1972) described a 1965 study in which he interviewed 200 accountants and engineers about work-related events that affected their job satisfaction, performance, relationships, and sense of well-being. Five factors contributing to job satisfaction, or “satisfiers,” were identified: achievement, advancement, recognition, responsibility, and work itself. Conversely, several “dissatisfiers” were identified: administration, company policy, interpersonal relations, salary, and working conditions. Herzberg (1966/1972) noted that the dissatisfiers were basic, environmental, and temporary in nature, while satisfiers were higher-order, psychological, and self-actualized in nature. As a result, he named the dissatisfiers “hygiene” factors and the satisfiers “motivation” factors. Hence, the motivation-hygiene theory of job attitudes was developed. Herzberg suggested that results of interviews demonstrated that, although people who sought contextual (versus task-related) hygiene factors were avoiding dissatisfaction, they were not achieving job satisfaction. On the contrary, people who typically sought motivation factors were able to achieve job satisfaction, because factors related to tasks possess the characteristics necessary for personal growth and psychological stimulation. Since Herzberg’s original study, numerous others have explored and verified the applicability of his motivation-hygiene theory to job satisfaction (see Herzberg, 1966/1972; Soliman, 1970; Williamson & Karras, 1970).

Locke (1969), however, disagreed with Herzberg’s theory that factors related to motivation could only cause satisfaction (and not dissatisfaction) and hygiene-related factors could only cause dissatisfaction (and not satisfaction). Locke pointed to numerous studies that failed to corroborate his theory, stating that factors related to the work itself (i.e., achievement, failure) determined both satisfaction and dissatisfaction. Locke (1969) defined job satisfaction as “…the pleasurable emotional state resulting from the appraisal of one’s job as achieving or facilitating the achievement of one’s values” (p. 316). Job dissatisfaction was defined as “…the unpleasurable emotional state resulting from the appraisal of one’s job as frustrating or blocking the attainment of one’s job values or as entailing disvalues” (Locke, 1969, p. 316). The appraisal process used to determine job satisfaction or dissatisfaction consist of three elements: (a) perception of some aspect of the job, (b) a value standard, and (c) a judgment of the relationship between the two. The end result is either a sense of satisfaction with, or discrepancy between what is perceived and what is valued as it relates to one or more aspects of the job. Shortly after Locke’s (1969) article entitled, What is Job Satisfaction?, Solimon (1970) published a study in which he described his attempts to reconcile the predominant theories on job satisfaction. He examined the motivation-hygiene research and found that the majority (18 of 21) of studies using Herzberg’s techniques, or modifications of it, supported the motivation-hygiene theory. The majority (15 of 18) of studies using a different method did not substantiate Herzberg’s theory. Solimon concluded that the motivation-hygiene theory was a function of its own method. Solomon suggested that environmental or workplace conditions influenced what the worker found satisfying and dissatisfying. In other words, employees whose basic needs are being deprived in the workplace will find hygiene factors (e.g., salary, relations with coworkers and supervisors, working conditions) to be a more powerful source of satisfaction than motivators (e.g., recognition for achievement, advancement). Although not cited by Solomon 1970), his suggestions align with the hierarchy of needs theory first proposed by Maslow in 1954 and later applied to industry in 1971. In addition to the numerous theories on the nature of job satisfaction, research and literature is also extensive on numerous constructs related to attaining satisfaction with one’s work. However, as Table 1.1 demonstrates, the majority of this job satisfaction research focuses on workers without disabilities.

Table 1.1 Constructs Assessed in Relation to Job Satisfaction for Workers Without Disabilities (WWOD) and Workers with Disabilities (WWD) Disabilities

Construct WWOD WWD Study  Absenteeism  Hackett & Guion (1985)**  Porter & Steers (1973) Adaptation  Zedeck, Jackson, & Marca (1983) Age  Kacmar & Ferris (1989)  Schwab & Heneman (1977) Change (perceived and actual)  Hardin (1965) Community characteristics  Wild & Kempner (1972) Consumer choice  Abrams, DonAroma, & Karan (1997) Cultural differences  Slocum & Topichak (1972) Demographic groupings  Golembiewski (1978) Dimensionality  Fried & Ferris (1986) Dimensions of work  Schwab & Heneman (1977) Economic benefits  Coker, Osgood, & Clouse (1995) Employer expectations  Millington, Leierer, & Abadie (2000) Employment models   Coker, Osgood, & Clouse (1995)  Griffin, Rosenberg, Cheyney, & Greenberg (1996)  Seltzer (1984) Environmental components  Arvey, Bouchard, Segal, & Abraham (1989)  Porter & Steers (1973) Equity theory  Pritchard, Dunnette, & Jorgenson (1972) Evaluation apprehension  White, Mitchell, & Bell (1977) Factors affecting  Jurgensen (1978) Functional specialty  Adams, Laker, & Hulin (1977) Genetic components  Arvey, Bouchard, Segal, & Abraham (1989) Goal setting  White, Mitchell, & Bell (1977) Happiness  Smith (1992) Health  Ironson (1992)  Zedeck, Jackson, & Marca (1983) Incentives  Locke (1968) Intelligence  Ganzach (1998) Job adjustment  Peckham (1951) Job attachment  Koch & Steers (1978) Job characteristics  Adler, Skov, & Salvemini (1985)  Ronan (1970) Job factor importance  Starcevich (1972)  Williamson & Karras (1970) Job importance  Iris & Barrett (1972) Job level  Adams, Laker, & Hulin (1977) Job perception  James & Tetrick (1986) Job performance  Abramis (1994)  Cranny, Smith, & Stone (1992)*  Iaffaldano & Muchinsky (1985)**  Inkson (1978)  Jacobs & Solomon (1977)  Katzell, Thompson, & Guzzo (1992) Pritchard et al. (1972)   Talkington & Overbeck (1975)  White, Mitchell, & Bell (1977) Job stress  Ironson (1992)  Sandman (1992) Job turnover  Koch & Steers (1978)  Porter & Steers (1973) Job withdrawal  Roznowski & Hulin (1992) Leisure satisfaction  London, Crandall, & Seals (1977) Life satisfaction  Cramer (1995)  Iris & Barrett (1972) Life stress  Erickson, Pugh, & Gunderson (1972) Maslow’s Hierarchy of Needs  Hall & Nougaim (1968)

Table 1.1 – continued  Construct WWOD WWD Study

Motivation  Reiter, Friedman, & Molcho (1985)  Walsh & Birkin (1979) *annotated bibliography Motivation-hygiene theory  Soliman (1970)  Williamson & Karras (1970) Negative affectivity  Levin & Stokes (1989) Organizational factors  Porter & Steers (1973) Paid/unpaid workers  Ronen (1970) Perceived over-qualification  Johnson & Johnson (2000) Personal factors  Porter & Steers (1973) Person-environment fit  Dawis (1992) Plant characteristics  Wild & Kempner (1972) Psychological climate & affect  James & James (1992) Quality of life  London, Crandall, & Seals (1977) Self esteem  Griffin, Rosenberg, Cheyney, & Greenberg (1996)  Inkson (1978) Shift work schedules  Zedeck, Jackson, & Marca (1983) Social cues  White, Mitchell, & Bell (1977) Social information processing models  Stone (1992) Social interactions  Rosenberg (1979) Status congruency  Erickson, Pugh, & Gunderson (1972) Systems view  Wernimont (1972) Task motivation  Locke (1968) Transitional outcomes  McAfee & McNaughton (1997a & 1997b) Turnover intention  Zedeck, Jackson, & Marca (1983) Vocational adjustment  Harold (1955) Vocational interests  Reiter, Friedman, & Molcho (1985) Vocational needs   Melchiori & Church (1997) Work adjustment   Melchiori & Church (1997)  Rosen, Halenda, Nowakiwska, & Floor (1970) Work conditions   Harold (1955) Work factors  Porter & Steers (1973) Work values   Cohen & Rusalem (1964) Work role ambiguity  Abramis (1994)

Comparatively, studies over the past 30 years exploring the job satisfaction and related constructs for workers with disabilities remains limited. As pointed out by Moseley (1988), attempts to improve job performance, productivity, and efficiency has led many researchers to identify components affecting employee satisfaction, such as compensation, decision-making, supervision, opportunities for advancement, and many more. Further, Moseley (1988) reminds us, “the literature on job satisfaction points to the central position work occupies in people’s lives and to the factors that make work a meaningful experience. [and] These issues have many implications for…individuals with disabilities” (p. 212). Job Satisfaction of Workers with Disabilities A review of the past 50 years of literature reveals that job satisfaction is one of the least researched topics focusing on people with disabilities (Abrams, DonAroma, & Karan, 1997;

McAfee & McNaughton, 1997a; Moseley, 1988; Seltzer, 1984). Several reasons for this obvious gap in the literature have been suggested, including the fact that people with mental retardation have not traditionally been given much choice in job selection, and subsequently, their preferences and feelings of satisfaction have not been seen a important (Abrams et al., 1997; Seltzer, 1984). Other reasons for ignoring the satisfaction of people with disabilities may also include their traditionally high unemployment rate and the limited applicability of existing satisfaction measures (Abrams et al., 1997; Nisbet & York, 1989). Finally, the complexity of the concept, paired with the limited cognitive, verbal, and vocabulary abilities of some people with disabilities (e.g., mental retardation), can make job satisfaction difficult to assess (McAfee & McNaughton, 1997a). Despite these challenges, however, several researchers have conducted studies on the job satisfaction of people with disabilities. Following a brief historical overview, a chronological review of these studies is provided. Earlier studies (1950s through mid 1980s) about workers with disabilities focused on what was referred to as “work adjustment” issues, which included such topics as socialization, behavior, and, occasionally, job satisfaction. In the mid 1980s research, although still limited, began its shift to addressing job satisfaction as its own entity or single area worthy of more focused interest. Seltzer (1984) surmised that the lack of job satisfaction research for workers with disabilities was due primarily to two issues: (a) failure to recognize it’s importance, and (b) assessment difficulties. McAfee (1986) remarked on the generalization problem inherent in a cross-categorical approach to studying the literature on the job satisfaction of workers with disabilities, but concluded there were no alternatives due to the general lack of research in this area. McAffee pointed out the challenge of assessing perspectives of people with limited communication skills and the lack of adequate instruments for assessing their job satisfaction. Moseley (1988) highlighted the contrast in the quantity of job satisfaction research for workers without disabilities, reporting on the review conducted by Locke in 1983 on some 3,350 studies prior to 1973 (exemplified in Table 1.1) versus the scarcity of research for workers with disabilities. The current review of the literature includes approximately 20 studies conducted between 1951 and 2000, which resulted from an exhaustive search of educational and rehabilitation databases, as well as reviews of references of articles obtained. Finally, although many studies included some report of job satisfaction, they were often times briefly discussed

with little to no detail concerning methods or instruments utilized. However, whatever was found was included, which serves to illustrate the truly limited research base that exists to date. To begin the review, one of the earliest studies reporting satisfaction among workers with disabilities was conducted by Peckham in 1951. He surveyed vocational counselors (VCs) to determine the job adjustment of 80 people with mental retardation who had participated in job training, placement, and follow-up, and case closure. Numerous indicators of work adjustment were studied, including worker satisfaction. For example, nine of ten VCs reported that salary dissatisfaction was the third most common adjustment problem, which often led the employees to feel as if they were victimized and quit. Peckham (1951) concluded that the two most common adjustment problems, lack of acceptance and social/vocational sophistication, were related and that curriculums should include community-based job internships and classroom practice (i.e., interviews, form completion). Peckham (1951) recommended on-the-job training, which could help address the majority of adjustment problems for job applicants with mental retardation. In 1955, Harold explored employment, working conditions, and vocational adjustment of 74 people discharged from an institutional training school for the “feeble-minded and epileptic.” The 74 workers were divided into two categories: industrial group (majority employed as unskilled or semi-skilled laborers; n = 29) and institutional group (majority employed in hospitals or institutions; n = 45). Several aspects of employment were examined, including worker satisfaction. Results indicated that 93% of the industrial group was satisfied with working conditions, coworkers, and tasks, while 75% of the institutional group expressed satisfaction with their employment. Also in 1955, Krishef and Hall examined the employment and job attitude of 155 competitively employed people with mental retardation, the majority of which had previously been institutionalized. Among data collected and analyzed, an undefined measure of job attitude indicated that the majority of workers (87%) were satisfied with their current job, while 14% were dissatisfied with their pay, work, and/or coworkers. In 1964, Cohen and Rusalem studied the work values of 85 children with and without mental retardation and found that the rankings differed according to subgroups. Children were asked to rank the following nine occupational values in order of importance: advancement, benefits, independence, interesting work, prestige, relations with others, salary, security, and working conditions. For example, boys with mental retardation (both “institutionalized” and

“non-institutionalized”) ranked benefits (vacation, social security, retirement plans) first, while boys without disabilities ranked advancement first. Girls without disabilities ranked interesting work first, girls with mental retardation (“non-institutionalized”) ranked working conditions (good hours, pleasant surroundings) first, and girls with mental retardation (“institutionalized”) ranked relations with others as first. The top three rankings among children without disabilities were advancement, interesting work, and security (steady job). Whereas, the top three rankings among children with mental retardation living in or out of institutions varied to some extent, but included: advancement, benefits, interesting work, relations with others, security, and working conditions. Cohen and Rusalem (1964) noted that, in general, the children without disabilities seemed to place somewhat greater importance on advancement and postulated that cultural values may have had a depressing affect on the aspirations of children with mental retardation. Also notable (yet not emphasized) was the importance placed upon relationships with others by the majority of children with disabilities, as compared to boys and girls without disabilities who ranked this value as seventh and fifth, respectively. Limited opportunities for peer interaction, especially for those children living in the institution, may be a contributing factor. In 1970, Rosen, Halenda, Nowakiwska, and Floor explored the job satisfaction of 92 people with mental retardation who were former residents of an institution. The majority of the participants in this research were employed in semi-skilled, service-related jobs (i.e., custodians, kitchen workers). Job satisfaction was assessed using the Minnesota Scale of Employment Satisfaction (MSES), which measures general job satisfaction, working conditions, supervision, compensation, co-workers, and sensitivity. Study participants were significantly less satisfied when compared with MSES norms for workers without disabilities (t = 2.53, p < .05). No significant differences existed between the study participants and the norm group of workers with disabilities. The two areas of greatest dissatisfaction for the former residents were compensation (also ranked first in importance by 80% of sample) and sensitivity, which refered to perspectives of one’s position in the social hierarchy at work. At the time, Rosen et al. (1970) concluded there is “…a need for providing the retarded with a more realistic expectation of the roles they will play in industry after leaving the institution or sheltered workshop setting” (p. 39). In 1975, Talkington and Overbeck explored the job satisfaction and job performance of 90 women with mental retardation residing and working in a public facility. The women were

assigned to either a satisfied or dissatisfied group based upon the charge counselor’s perspective of how each woman felt about her work and training. Next, work supervisors rated the women on several work-related behaviors (i.e., dependability, neatness, efficiency). Overall, the satisfied group was rated significantly higher in seven of the ten job performance behaviors (interest, efficiency, carefulness, interest, dependability, responsibility, and pleasantness) than the dissatisfied group. Talkington and Overbeck (1975) concluded that these findings were similar to those found by others who’ve studied workers without disabilities and that workers who are satisfied in their job demonstrate greater dependability, efficiency, and attendance than those who are dissatisfied (citing Herzberg, 1966 and Bittell, 1972). Further, the authors stated that, for workers with mental retardation, “the data herein indicate satisfaction is a variable significantly related to job performance…” (Talkington & Overbeck, 1975, p. 19). In 1979, Rosenberg evaluated the job satisfaction and social interactions of 60 men labeled with mild mental retardation working in uni- and multi-disability workshops. Job satisfaction was measured using a nineteen-item survey addressing three areas: (a) workshop (i.e., working conditions, wages, supervision, relationships, interest, hours); (b) environmental (i.e., family, travel, leisure, job placement opportunities); and (c) personal (i.e., self-esteem, self- appraisal). The survey yielded both an overall satisfaction score and 19 factor scores. Social interactions were assessed through an observation rating scale addressing ten areas, including socialization, supervision, and counseling. Results indicated no difference in overall job satisfaction between the uni- and multi-disability groups. However, significant differences between groups existed on five of the job satisfaction subscales. Workers in the multi-disability group were less satisfied with job placement opportunities, wages, vacation and leisure time, and demonstrated lower self-esteem. Further, dissatisfaction with wages was the most common area expressed by both groups. Finally, no significant correlation existed between social interaction and overall job satisfaction for either group. Rosenberg (1979) concluded that the two settings reflected two different cultures in which both social interactions and job satisfaction varied. For example, staff in the uni-disability workshop tolerated and engaged in more socialization with employees, whereas socialization in the multi-disability workshop was considerably less and tended to focus on work-related topics. The multi-disability workers also expressed patterns of job dissatisfaction reflective of those found in competitive work settings. Further, workers in the multi-disability workshops demonstrated work behaviors appropriate for

competitive work, whereas those in the uni-disability workshops appeared destined for long-term placement, which was purported as evidence for a continuum of rehabilitation settings. Finally, Rosenberg (1979) surmised that job satisfaction was related more to “…the atmosphere surrounding the job rather than the frequency of contact with people” (p. 207). In 1984, Seltzer assessed the job satisfaction of 65 people with mental retardation who were participating in sheltered workshops and competitive employment. She reviewed records and social histories, assessed work performance, the work environment, and satisfaction with community living. Instruments used included the Community Adjustment Scale (by Seltzer & Seltzer, 1976) and the Job Descriptive Index (JDI; by Smith, Kendall, & Hulin, 1969), which she modified by changing the self-administered instrument (72 items) into a 61-item structured interview (JDI-Revised; Seltzer, 1984). Findings revealed that the workshop was not a satisfying alternative for those who were previously competitively employed and feelings of job satisfaction were associated with specific attitudes and skills, relating to socialization and communication. Seltzer (1984) concluded satisfaction was not simply a reaction of the worker to the job, rather the reaction of the worker given his or her own frame of reference as determined by specific skills and attitudes. In 1985, Reiter, Friedman, and Molcho examined the motivation, vocational interest, and job satisfaction of 83 Israeli adults labeled with mild to moderate mental retardation living and working in an agricultural community. Results of a questionnaire based upon Herzberg’s 1959 theory of work motivation revealed that hygiene (extrinsic) factors (i.e., workplace conditions, supervision, and policy) were more important to the majority of workers than were motivation (intrinsic) factors (i.e., advancement, recognition, and achievement). Results of an occupational interest inventory indicated that the top three preferred jobs for women were office work, domestic, and laundry, while men preferred office work, industry, and laundry. Finally, level of job satisfaction was determined based upon data gathered about the worker’s assessment of their actual job and satisfaction with it according to a 5-point likert scale. Job satisfaction level was used to group participants: satisfied (n = 54), dissatisfied (n = 11), and neutral (n = 18). Correlational analyses revealed that absenteeism was significantly related to dissatisfaction (rho = .18, p < .04) and hygiene factors of working conditions (rho = .31, p < .002). Reiter et al. (1985) concluded that quality of life for resident-workers can be positively affected by involvement in decision-making about jobs they do. Further, strengthening motivation (intrinsic)

factors, such as interest, achievement, and decision-making, may enhance transition from the facility into community-based employment. In 1986, McAffee conducted a review of available job satisfaction literature for workers with disabilities. As indicated previously, limitations within the research included inconsistent measures and inappropriate cross-disability generalizations. McAfee suggested several areas in need of further research, including more specific and sophisticated measures of job satisfaction for workers with disabilities, which are longitudinal in nature, and provide comparisons among workers with and without disabilities. Moseley (1988) also reviewed job satisfaction research on people with disabilities, noting the scarcity of studies in this area. Moseley (1988, citing Gruneberg, 1979) suggested a definition of job satisfaction as the “match between the characteristics of the job and his or her own personal and social needs, feelings of significance and worth, and expectations for the working experience” (p. 212). Moseley (1988) concluded that greater job satisfaction was associated with a person’s increased control over tasks and work conditions; ability to function as part of a team; and the ability to perform tasks of a complexity to sufficient hold one’s interest. “The idea that persons with mental retardation, for example, excel in dull repetitive tasks appears to be based on handicappist prejudice rather than evidence” (Moseley, 1988, p. 217). Also in 1988, Lam and Chan explored the job satisfaction of 50 people (49 with mental retardation, one with epilepsy) working in a sheltered workshop. Analysis of results from an adaptation of the Minnesota Satisfaction Questionnaire (MSQ; Weiss, Dawis, England, and Lofquist, 1967) showed that workers were most satisfied with the work itself and least satisfied with company policy and practice (mean ratings 4.46 and 3.94, respectively; range: 1 to 5). Further, workers differed significantly on job satisfaction scores according to level of mental retardation (t[48] = 2.22, p < .05). Workers with intelligence quotients (IQ) above 55 had a lower job satisfaction score (M = 48.32, SD = 9.26) than workers with an IQ of 54 or below (M = 53.68, SD = 7.34). Lam and Chan (1988) concluded that reasons for differences in job satisfaction among sheltered workers might include variation in workshop environment and work according to perceived ability, worker preferences, and worker’s comparisons of own job with those in competitive employment. Recommendations included replacement of menial and

repetitive contractual labor with more technical and challenging work, and employment in competitive, integrated work settings. In 1989 Nisbet and York interviewed and observed six adolescents with “moderate to severe” disabilities, who were working in integrated settings, as well as parents, residential service providers, and teachers. Information gained was used to develop a list of behaviors related to job satisfaction. Included among the indices of job satisfaction were: (a) consistently attends work, (b) shows positive facial expressions, (c) interacts with co-workers, (d) communicates positive aspects of job with others, and (e) demonstrated adult-like behavior. Results indicated that, despite limited cognitive and/or communication abilities, five of the six adolescents interviewed were able to respond in some fashion, indicating preferences regarding pay, breaks, and interacting with coworkers. Nisbet and York (1989) stressed the importance of including observations of work-related behaviors (i.e., attendance, facial expressions, and interactions with coworkers and supervisors) when determining the job satisfaction of people who have limited communication skills. In 1993, Houser interviewed 27 people with disabilities who were placed into competitive employment. Using the MSQ (Weiss et al., 1967), Houser (1993) found that participants were most satisfied with such aspects of the job as keeping busy, doing things for others, and doing different things, whereas the lowest satisfaction was associated with pay, amount of work, chances for advancement, and opportunities to tell others what to do. Also in 1993, Test, Hinson, Solow, and Keul studied the job satisfaction of people with disabilities who were participating in supported employment. They suggested that, although data collection on outcomes (e.g., earnings, job retention) and cost effectiveness are necessary, researchers in the field need to focus on “next generation” issues, such as the social validity of supported employment programs. According to Test and colleagues (1993), this can be accomplished through collecting data directly from consumers, for example, determining job satisfaction to socially validate the quantitative outcomes traditionally studied. After developing their own 20-item job satisfaction questionnaire, thirty-four supported employees were interviewed. Results indicated that 67% were satisfied with their job; 76% were satisfied with pay; 97% were happy with their job coach; 92% preferred supported employment to sheltered workshop; 20% identified friendships as the most important aspect of the job; and 61% had a

chosen their job. As suggested by Test et al. (1993), results from job satisfaction surveys can guide future supported employment services, and ultimately, enhance consumers’ quality of life. In 1995 Coker, Osgood, & Clouse interviewed 160 people with disabilities participating in sheltered employment (SHE), enclave (E), affirmative industry (AI), or supported employment (SE). The affirmative industry model refers to those settings, which employ both workers with and without disabilities for producing goods and/or services. They can be either small franchises or large manufacturers; small businesses tend to employ workers with higher functional skills (i.e., mental illness), whereas employees in the larger businesses reflect a wider variety of disability categories. Coker et al. noted that the people participating in the affirmative industry models examined in their study were not involved in entrepreneurial business ventures, which is in contrast to how AIs have been traditionally conceptualized. Enclaves were described as employment models that place small groups of people with disabilities into a permanent work site, such as an electronics company, which typically employ workers without disabilities. The job coach model refers to a form of supported employment during which a job coach provides one-on-one, intensive, on-site job training and follow-along services for people with disabilities. The last model, sheltered employment, represents two types of programs: a sheltered workshop and a work activity center. Historically, sheltered workshops were viewed as means for transitioning people with less significant disabilities into the workforce, whereas work activity centers typically served people with more significant disabilities by preparing them for the sheltered workshop. Transition from either setting was based upon the person’s “productive capacity” (Coker et al., 1995). Coker et al. collected and analyzed job-related demographic and economic information, as well as data from their own job satisfaction survey. Results indicated that supported employees had the highest job satisfaction, job awareness, and hourly wage, while the people in sheltered workshops experienced the lowest job satisfaction. Coker and colleagues (1995) also noted that the only valid cost comparison was between the enclave and supported employment models. Although the enclave was more beneficial, the authors suggested that fading support could make the supported employment model more beneficial (Coker et al., 1995). In 1996 Freedman & Fesko conducted focus groups with 29 consumers and families to determine the meaning of work in the lives of people with significant disabilities. Results

indicated that essential aspects of job satisfaction included feeling productive, keeping busy, socialization, and support, while obstacles included getting or keeping jobs, discrimination, and accommodations. When asked about their expectations, 50% of the consumers stated they wanted to continue in their present job, while the remainder expressed a desire to increase hours, upgrade skills, seek better jobs, and avoid becoming complacent (Freedman & Fesko, 1996). Also in 1996, Griffin, Rosenberg, Cheyney, and Greenberg compared job satisfaction and self-esteem of 100 supported employees and 100 sheltered workers labeled with mild mental retardation (IQ between 50 and 69). Analysis of results from an adapted version of the Vocational Program Evaluation Profile (VPEP; Rosenberg, Cheyney, & Greenberg, 1990) revealed that supported employees were significantly more satisfied (M = 95) than the sheltered workers (M = 63; p < .001). Further, those in supported employment had significantly higher self-esteem scores (M = 77) than sheltered workers (M = 61; p < .01), as measured by the Coopersmith Self-Esteem Inventory (SEI; Coopersmith, 1981). Griffin et al. (1996) concluded that the supported employment setting provided a wider variety of integrated job experiences than the sheltered workshop, which can enhance job satisfaction and self-esteem of people labeled with mild mental retardation. Finally, in 1996 Parent, Kregel, and Johnson evaluated consumer satisfaction of 110 first- time supported employees with severe disabilities. Using their own instrument, the Consumer Satisfaction Survey (CSS), researchers found that the majority of supported employees were satisfied with their pay (61%), benefits (81%), supervisor assistance (86%), treatment from coworker (82%), job duties (61%), schedule (85%), and transportation (86%). Overall, 90% of supported employees reported satisfaction with their job and 87% indicated they chose their job. Further, 84% of supported employees indicated their job coaches were very helpful and 96% were satisfied with their supported employment services. Parent and colleagues (1996) concluded that the overwhelmingly high level of consumer satisfaction might be a result of simply being employed; only 37% had previous work experience (versus, for example, sheltered workshop, day program, school, vocational training, or volunteering). It should also be noted that, as a criteria established during participant selection, none of the consumers had received prior supported employment services. Parent et al. (1996) purported enhanced quality of life for those consumers in supported employment, which was attributed to consumer involvement in job choice and, consequently, high levels job satisfaction.

In 1997, Melchiori and Church (1997) examined the applicability of the theory of work adjustment (postulated by Dawis and Lofquist in 1984) to 45 supported employees with disabilities and 45 coworkers without disabilities. They used modified versions of both the Minnesota Importance Questionnaire (by Lofquist , Dawis, & Weiss, 1970) and the Minnesota Satisfaction Questionnaire (Weiss, Dawis, England, & Lofquist, 1967). Results indicated that, overall, results of assessments did not indicate significant differences between the two groups. Further, supervisor knowledge of supported employees’ job satisfaction was considerably low, from which Melchiori and Church (1997) concluded success was being determined solely by how well supported employees’ met the needs of the job (rather than how well the job met the needs of the supported worker). In 1997, McAfee & McNaughton conducted a two-part study investigated the general job satisfaction, as well as satisfaction with promotion, pay, co-workers, supervision, and work conditions of 236 people with disabilities in competitive employment. Information from the personal data sheet and the Job Descriptive Index (by Smith et al., 1969) indicated that workers who had remained longest on the job and were integrated into general education during school years demonstrated the highest job satisfaction scores. Further, workers with disabilities derived a considerable amount of satisfaction from the social aspects of employment and were most dissatisfied with pay and promotion (McAfee & McNaughton, 1997a, 1997b). Also in 1997, Abrams, DonAroma, & Karan explored the relationship between employment choices and job satisfaction of 41 people with disabilities. Approximately 40% of the participants were hired as paid workers. The majority, however, were still in the “situational assessment” phase, which means they were participating in work-related activities at an actual job site while being evaluated on various work-related skills. Analysis of data from the JDI- Revised (Seltzer, 1984), person-centered situational assessments, the Supervisor Evaluation Form (by Moon, Goodall, Barcus, & Brooke, 1986), and a calculated percentage of job match, revealed that percentage of job match was positively correlated with job satisfaction (Percentage of job match was determined by identifying the most important aspects of job expressed by a person, and calculating the percentage to which they existed in the person’s present job). Abrams and colleagues (1997) cautioned limited interpretation of results, however, because of assessment challenges and complexities inherent in assessing job satisfaction and person- environment match of individuals with disabilities.

Finally, in 2000 Test, Carver, Ewers, Haddad, & Person explored the longitudinal job satisfaction of 32 supported employees labeled with mental retardation. Using their own instrument, once in 1992 and again in 1997, Test et al. questioned workers about satisfaction with current job, supported employment services, relationships with coworkers (level of fit and independence). Results indicated an increased percentage of consumers reporting a choice in current employment (from 43.8% in 1992 to 90.6% in 1997). Focus of the job coach changed from helping workers learn appropriate behaviors (46.9%) to helping them make friends (40.6%). Finally, supported employees’ primary reason for working expanded from simply wanting a job (59.4%) to include needing money (40.6%) and wanting a job (53.1%). Test et al. (2000) concluded that supported employment results in improved outcomes over time for workers with disabilities. Summary Although specific comparisons among the various studies on job satisfaction of workers with disabilities is confounded by the variety of measures and approaches used, some broad conclusions can be made. For example, sheltered workers typically expressed lower job satisfaction than people who were competitively employed. An exception was when sheltered workers had a considerably low intellectual ability (see Lam & Chan, 1988). Clearly, people with a variety of disabilities, as well as levels of IQs, functional ability, and communication skills were able to express how satisfied they were with their job. In general, studies indicated that the greatest satisfaction was with job aspects such as the work itself, supervision, and coworkers. Whereas, many people with disabilities were dissatisfied with compensation, such as pay. Finally, research examining the job satisfaction of workers with disabilities indicated that providing people with a choice in where they work was an important contributor to enhancing job satisfaction. Summary of Quality of Life and Job Satisfaction A review of the research available examining the quality of life and job satisfaction of people with disabilities revealed that comparisons across studies was complicated by the lack of consistency in the measures used. Further, few studies have explored the relationship between quality of life and job satisfaction using standardized, valid, and reliable instruments. Such efforts could add to existing literature, and ultimately enhance both satisfaction with, and quality of, life and employment for people with disabilities. The remainder of this chapter is devoted to a

review of the literature evaluating job performance and functional ability of workers with disabilities. Job Performance When examining issues surrounding employment and workers with disabilities, it is important to consider job performance. According to Rosenberg and Brady (2000b) employees with and without disabilities must demonstrate a variety of basic, yet essential employability skills for successful participation in competitive and integrated work settings. Studies examining the importance of various work-related behaviors have identified characteristics and skills that contribute to employment success of people with disabilities. As early as 1961, Kolstoe investigated factors impacting employability of 82 men labeled with mental retardation. After reviewing literature, which spanned from 1931 through 1960, Kolstoe identified various factors affecting employment of people with mental retardation. He categorized these characteristics as either status factors or dynamic factors. Status factors included: (a) home influence, (b) age, (c) sibling rank, (c) physical appearance and condition, (d) school experience, and (e) background (rural versus urban). Dynamic factors included: personality and work habits. Comparisons among employed versus unemployed men indicated no difference on status factors. However, the employed group was deemed superior to the unemployed group on both personality (t = 2.62, p < .05) and work efficiency (t = 2.19, p < .05) as judged by an employer rating scale. Kolstoe (1961) concluded that training programs for preparing people with mental retardation for work should emphasis social acceptability, personal independence, speech correction, grooming, and motor coordination. Further, opportunities to learn and practice these skills should begin in school and include experiences in actual work settings. In their pilot study, Song and Song (1961) investigated variables predictive of job efficiency for 45 people with mental retardation who held full-time community-based employment. Multiple regression analysis identified five cognitive predictor variables (subscale scores from intelligence tests): information, similarities, performance IQ, comprehension, and full-scale IQ and one work variable: work habits. Song and Song (1961) concluded that the multiple regression R of .66 suggested that job performance could be predicted by factors pertaining to work habit and intellect.

Warren (1961) examined personality ratings for 38 employed and unemployed men labeled with mental retardation. Results of Mann-Whitney U indicated that groups differed significantly (p < .05) on cheerfulness; cooperation and respect with supervisors; cooperation and socialization with coworkers; timeliness, quality, and understanding of work; safety and conscientiousness; self-confidence; and minding own business. Significant differences (p < .05) were also noted on global measures of work habit and efficiency, personality and social adjustment, and probability of permanent employment. Warren (1961) concluded that these significant factors could be instrumental in successful employment of men with mental retardation. In 1971, Krantz discussed numerous “critical vocational behaviors” that were originally identified by Walker in 1969. Walker examined and listed behaviors that were missing during observations of 60 clients participating in a rehabilitation program. The behaviors were grouped into one of three areas: job objective behaviors, job-getting behaviors, and job-keeping behaviors. Job objective behaviors included having a vocational goal and oriented toward employment. Job-getting behaviors referred to appropriate interview skills and enthusiasm about the job. Job-keeping behaviors included attendance, promptness, and ability to get along with coworkers and supervisor. Walker also identified behaviors that weren’t necessarily vocationally oriented, yet required for effective work adjustment. These behaviors were also grouped into one of three categories: social living competencies, community living competencies, and general and personal living competencies. Social living competencies included money management and grooming skills. Community living competencies included maintaining a house and securing adequate medical services. General and personal living competencies referred to behaviors such as coping with family and spouse, stability, and personal adjustment. Krantz (1971) suggested that successful rehabilitation and employment could result for people with disabilities, such as mental retardation, if professionals combined behavioral techniques with traditional vocational education that helps “…his client acquire goals consisting of work he can do, acceptable to him and available in his community” (p. 15). Berkson (1981) evaluated the job performance and social adjustment of people with mental retardation living with family, independently, and in sheltered-care facilities (n = 26 each). No significant differences were found among the three groups. Berkson suggested this could have resulted from matching groups according to age, IQ, gender, diagnosis, and sheltered

workshop placement. Berkson (1981) concluded that non-significant differences in among groups were most likely, because the work environment rather than residential setting determines social and work behaviors. Fraser and Shrey (1986) identified numerous barriers to job placement for people with developmental disabilities, as reported by 55 Northeast state vocational rehabilitation job placement specialists. Misconceptions about disabilities was the most frequently reported obstacle (85%), which was followed by negative employer attitudes (81%), transportation problems (74%), financial restraints (68%), large caseloads (65%), slow rehabilitation process (62%), environmental/access barriers (58%), high unemployment rates (56%), limited job placement time (54%), excessive paperwork (54%), no agency support for job placement activities (52%), complexity of job/client match (48%), emphasis on placing people with the most significant disabilities first (44%), and not enough time for employer/specialist coordination (40%). Shafer, Hill, Seyfarth, and Wehman (1987) explored employer perceptions of, and experiences with, supported and non-supported workers labeled with mental retardation. Results from 261 surveys revealed that employers reported more favorable ratings on work performance for supported employees who had a job coach when compared to workers with disabilities whose only support was job placement or to those who had no support at all. Employers identified four indicators of satisfactory job performance: arriving and leaving on time for work, timeliness of breaks, safety, and attendance. McCrea (1991) compared special educator and employer perceptions and identified four categories of 20 factors critical for job success, including: work-related behaviors (independence, follow instructions, understand routines, adaptability, appropriate response to correction), communication (initiate with supervisor, literate, express basic needs, respond appropriately, read and follow safety rules), personal behaviors (efficiency, job interest, maintain appearance, endurance and physical capability, neatness), and social behaviors (get along with others, control problem behaviors, sociability, and appropriate contacts). Nietupski, Hamre-Nietupski, Vanderhart, and & Fishback (1996) compared the perceptions of employers who had hired supported employees to employers who had not, and found common concerns for both regarding the need for extra training, increased demands for supervision, and need for increased work-related skills. Nietupski et al. (1996) suggested several

implications for supported employment practices, including the need for increased community- based work experience and assessments to assist in identifying and developing work-related skills for people with disabilities. Summary As indicated by the literature examining issues contributing to successful employment of people with disabilities, the nature and importance of work-related skills cannot be ignored. Perceptions of employers reveal that workers with disabilities are expected to learn and perform a variety of job tasks with a certain level of skill and precision. In addition to the ability to demonstrate skill in areas affecting quality and quantity of work, characteristics such as cheerfulness, and timeliness, capacity to follow basic rules of safety is also expected. Finally, it can be concluded that factors relating to job performance, such as work-related, personal, and social behaviors, as well as communication skills, are critical for attaining job success. Clearly, it is important to consider job performance when examining issues surrounding employment and workers with disabilities. Consequently, a method for assessing essential employability skills of people with and without disabilities can enhance participation in competitive and integrated work settings (Rosenberg and Brady, 2000b). Job Observation and Behavior Scale (JOBS) Developed by Rosenberg and Brady (2000a), the JOBS is an instrument for assessing both the job performance and level of support need of people participating in supported employment. The JOBS was designed to assist employers, employment consultants, and educators in evaluation, training, and employment of people with disabilities and entry-level workers. The JOBS assesses three patterns of job performance: (a) work-required daily activities, such as punctuality and communication; (b) work-required behaviors, such as social interactions; and (c) work-required job duties, such as quality and quantity of work. Further, the JOBS evaluates each of these three areas according to two criteria: quality of performance and type, or level of support. Rosenberg and Brady have encapsulated a wide array of factors in their instrument that have been identified in previous studies as critical to the employment success of people with disabilities. The JOBS is a relatively new instrument, which has the potential to provide details about the quality of performance, type of support, growth over time, evaluation data, modification needs, and effects of support and training of supported employees. Clearly, however, it would be

difficult to provide an accurate assessment of a person’s overall employment performance without considering the impact of a disability on his or her “…capacity for work or other productive activities” (Crewe & Athelstan, 1984). Functional Ability The final concept discussed in this literature review pertains to the functional ability of people with disabilities. In general, functional ability can be viewed in terms of behavioral capacities and limitations, while considering environmental factors (Crewe & Athelstan, 1984). Studies examining functional ability as it relates to vocational planning and success, personal history and counselor ratings, type of disability, rehabilitation services, employment model, quality of life, and its use as a means of dichotomizing groups are presented in the narrative that follows. Olney and Salomone (1992) described service system, professional, and personal barriers that impede vocational success of people with significant disabilities. Frequently, barriers to career development in service systems include professional overkill (intrusive, life-long involvement), professional problem solving (versus individual remediation), lack of real choice (limited decision making), and stereotypical views (associating specific problems with certain disabilities and, therefore, limiting options). Whereas obstacles imposed by professionals include teaching interventions (rigid behavioral training), which may impede problem-solving, spontaneity, and decision making; service provider dependency (decreased occupational motivation); and expectations within rehabilitation. Recommendations from mental health practitioners indicated that community-based assessments of functional ability, along with community-based training, support, and follow-up might lead to more successful employment of people with significant disabilities (Olney & Salomone, 1992). Bolton, Bellini, and Neath (1996) examined the influence of personal history on counselor ratings of functional limitations of two groups: physical disabilities (n = 3,167) and behavioral disabilities (n = 2,256). The physical disabilities group was composed of people with orthopedic and medical diagnoses, while the behavioral group consisted of people labeled with learning disabilities, mental illness, and mental retardation. Bolton et al. examined shared variance among groups and latent variables using canonical redundancy analysis. Results indicated that 13% of the variance in FAI scores was predicted by personal history for the behavioral disability group, whereas only 8.7% of FAI variance was predicted for the physical

disability group. Canonical analyses examined the relationship between various factors of the FAI and latent variables. Bolton et al. determined four latent variables or personal history (age, education, secondary disability, and coded severity) that determined counselors’ FAI ratings or judgments of a person’s cognition, physical condition, severity, and vocational qualification. Overall, the behavioral group demonstrated greater limitations in adaptive behavior, cognition, and vocational qualifications, while the physical disabilities groups were more limited in mobility and physical condition. Neath, Bellini, and Bolton (1997) explored the dimensionality of the FAI for five disability groups: chronic/physical condition (n = 834), learning disability (n = 732), mental illness (n = 981) mental retardation (n = 486), and orthopedic/amputation (n = 2,240). Principal factor analysis (PFA) on the overall sample revealed six factors: adaptive behavior, cognition, physical capacity, motor functioning/work history, communication, and vocational qualifications. These structures differed somewhat when PFA was conducted on individual groups. For example, Neath et al. found that a work history (versus motor functioning) factor emerged for the learning disability and mental retardation groups. This difference was attributed to intellectual differences for the learning disability and mental retardation groups, as opposed to physical and motor limitations emerging as individual factors among the chronic/physical, orthopedic/amputation, and mental illness groups. Examination of group means indicated that mental retardation group had the greatest limitation in cognition (12.42), adaptive behavior (8.02), and work history (3.64). The total FAI mean score for the mental retardation group, calculated by adding means across all six factors, was 32.46. The mental retardation group had the highest total mean score on the FAI, indicating the highest levels of functional limitations, when compared to the remaining five groups: orthopedic (21.91), chronic-physical (20.25), psychiatric (22.79), and learning disability (21.10). The total FAI mean score for mental retardation group was also higher than that calculated for the entire sample (22.76). Neath et al. (1997) concluded that the FAI (Crewe & Athelstan, 1981) was “…highly valid as a measure of functional limitations for a range of primary disabilities” (p. 206). Bellini, Bolton, and Neath (1998) evaluated the FAI’s (Crewe & Athelstan, 1981) ability to predict the type of rehabilitation services for five disability groups: chronic medical (n = 238), learning disability (n = 301), mental retardation (n = 272), psychiatric (n = 380), and orthopedic (n = 760). Results indicated different predictive patterns for the five groups. For example, Bellini

et al. determined that the FAI best predicted personal adjustment, placement services (R = .27 for both), and on-the-job-training (R = .28) for the mental retardation group. In comparison, the only service predicted by the FAI for the learning disability group was follow-up (R = .26). All multiple correlations were significant at .01 level. Bellini et al. determined that the FAI had poor predictive value for three groups: learning disability, mental retardation and psychiatric. However, the FAI was able to predict most services for the chronic and orthopedic groups. Bellini et al. (1998) concluded that, due to cognitive limitations, people in learning disability and mental retardation groups would, in all probability, receive more personal adjustment services than other groups. In contrast, people in the chronic and orthopedic groups could expect more restoration services than the other groups, because of physical capacity limitations. Heinemann, Crown, and McMahon (2000) evaluated the utility of the FAI (Crewe & Athelstan, 1981) for 100 post-stroke patients entering vocational rehabilitation. Identifying data from the FAI as ordinal, at best, a method called rating scale analysis was employed. Heinemann et al. concluded that, for the post-stroke patients in their study, the FAI: (a) provided a practical portrayal of vocational limitations; (b) reliably identified four levels of functional limitation; (c) identified subgroups (concurrent validity); (d) indicated vocational outcomes (predictive validity); and (e) indicated higher functional ability for people who had less severe strokes and whose pre-stroke employment was not service related (construct validity). Bolton, Bellini, and Brookings (2000) analyzed the ability of FAI (Crewe & Athelstan, 1981), along with personal history and type of rehabilitation services, to predict employment outcomes for individuals with disabilities. Participants were grouped into one of five disability categories: orthopedic (n = 1,602); psychiatric (n = 840); learning disability (n = 706); chronic medical (n = 635); and mental retardation (n = 428). Results specific to functional ability of participants in the mental retardation group revealed that adaptive behavior, physical capacity, and vocational qualifications were predictive of salary. In addition, participation in job training and job placement services was predictive of competitive employment for all five groups. Finally, Bolton et al. (2000) concluded that, although the FAI accounted for only 4% of the variance in salary and 0% of the variance in predicting competitive employment for the disability groups, the FAI (Crewe & Athelstan, 1981) remains a beneficial tool in planning for employment services.

A few researchers have evaluated group differences according to functional ability. In the study by Kober and Eggleton (2002) the FAI (Crewe & Athelstan, 1981) was used to create two independent samples. People with disabilities were assigned to either a low functional ability group (FAI > 22) or a high functional ability (FAI < 22). The higher the score on the FAI, the greater the limitations. Results indicated that the low functional ability group was comprised primarily of those people who attended a sheltered workshop. Conversely, the majority of people comprising the high functional ability group were competitively employed. Coker, Osgood, and Clouse (1995) used the FAI to establish the level of functional ability of workers with disabilities in four different employment models: affirmative industry, enclave, sheltered, and job coach. Functional ability and IQ scores varied somewhat among the four groups. As illustrated in Figure 2.1, the affirmative industry and sheltered employment groups demonstrated the lowest functional ability (FAI scores approached 44). While the highest level of functional ability was demonstrated by enclave and supported employment or job coach models (FAI = 39.6 and 39.73, respectively). (Note: the higher the FAI scores, the greater the functional limitations present).

80 70.48 70 58.15 59.61 60 56.67 50 43.81 43.93 39.61 39.73 Score 40 30 FAI IQ 20 10 0 Affirm Indust Enclave (n=90) Job Coach Sheltered (n=210) (n=140) (n=348) Employment Model

Figure 2.1. Mean FAI and IQ Scores for Employment Model Groups Before Matching

Also notable is that some groups demonstrated higher IQs than others, such as the affirmative industry and sheltered workshop, while also displaying the lowest functional ability. Clearly,

then, IQ scores can be of limited use when determining vocationally relevant strengths and limitations. Functional Ability and Quality of Life Results of the research reviewed previously suggest that functional ability has an impact on issues surrounding employment of people with disabilities, such vocational planning and success, counselor ratings, rehabilitation services, and type of employment model. But how does functional ability impact the quality of life of people with disabilities? This is a critical question. As pointed out by Crewe (1980), enhancing quality of life should be ultimate goal in efforts towards vocational rehabilitation. Before introducing the remaining research questions to be explored in the proposed study, however, a brief narrative describing the connection between functional ability and quality of life is provided. As discussed earlier, Crewe and Athelstan (1984) identified five factors of functional ability: adaptation, physical condition, communication, motor functioning, and cognition, which are assessed by their instrument, the FAI. Whereas, Schalock (1996) identified what he considered as core quality of life indicators, namely: emotional well-being, interpersonal relations, material well-being, personal development, physical well-being, self-determination, social inclusion, and rights. The QOL.Q (Schalock & Keith, 1993a) assesses four main areas purported to be reflective of a quality life: satisfaction, competence/productivity, empowerment/independence, and social belonging/integration. Schalock and Keith (1993b) found that the more significant a person’s disability was the more likely he or she was to have a lower QOL.Q score. As illustrated in Figure 2.2, people identified as having profound and severe disabilities demonstrated lower quality of life scores (all four subscale and total scores) when compared to people who were considered to have lower severity of disability (moderate and mild). The profound to severe levels used in this study actually refer to IQ scores. However, Coker et al. (1995) found IQ was not indicative of functional limitations. Perhaps these findings could be enhanced by using indications of functional capacities, instead of IQ scores alone.

100 90 80 70 60 50 40 30 QOL.QScore 20 10 0 Satisfaction Comp/Prod Emp/Indep Soc Bel/ Total Cmty Integ Level of Severity

Profound (n=22) Severe (n=65) Moderate (n=103) Mild (n=115)

Figure 2.2. Quality of Life Score by Level of Severity of Disability

Kober and Eggleton (2002) demonstrated that functional ability could have an impact on whether a person is competitively employed or attends a sheltered workshop. Others have repeatedly demonstrated that competitive employment contributes more favorably to quality of life than does employment in a sheltered workshop. Consequently, it could be postulated from the literature discussed previously that, as a person’s functional ability increases, the more likely that he or she will take part in the “normal” flow of life and hold a more socially valued role, as described by Wolfensberger (1972 and 1983, respectively). Clearly, functional abilities, such as the capacity to communicate effectively, move freely within the environment, read, and write, directly affects a person’s capability to express desires about and complete activities related to employment, community living, socialization, and other areas considered essential to a satisfying quality of life. It is also suggested that, as a person’s disability becomes more significant, a greater level or intensity of support will be required in order for basic needs to be met. As pointed out by Maslow (1954/1987), it is not until satisfaction of deficiency needs, such as physiological, safety, belongingness, love, and esteem, are met that one is apt to pursue being or growth needs, such as cognitive and aesthetic, and finally attain self-actualization. Consequently, the more

significant a person’s disability, the less opportunity he or she may have to pursue those needs typically associated with what many have theorized to be a quality life. Confounding the proposition of accurately evaluating quality of life (as well as job satisfaction, functional ability, and job performance) is the tendency of most researchers to group all people with disabilities into a single or a few categories. McAfee (1986) remarked: it is a gross generalization to lump all handicapped workers together as an entity for study. Yet because information is so severely limited and because samples often include individuals with multiple handicaps there appears, at this point, no other way to discuss the subject [job satisfaction] (p. 24). However, simply delineating categories of disabilities and reporting accordingly is still no guarantee that results will be meaningful for planning effective interventions. This inherently flawed approach to research assumes homogeneity among people for whom both research and “best practices” indicates quite the opposite is true. The special education and rehabilitation literature stresses an individualized approach to interventions, because of the heterogeneous nature of people within disability categories. A review of available research indicates that efforts at providing meaningful participant characteristics typically include IQ scores, usually without any reference to either level or intensity of support nor functional ability. Yet these two areas have the potential to provide meaningful information to guide planning, instruction, and services for people with varying levels of abilities. There are instruments available to make determinations on level of support and functional ability for people with disabilities. Further, these instruments have been standardized and deemed both reliable and valid for use with people who have disabilities. Consequently, and in addition to exploring the relationship between quality of life and job satisfaction, this study examined the impact of functional ability on job performance and level of support for people with disabilities working in competitive employment and receiving supported employment services. Such efforts have the potential to add to existing literature and, ultimately, enhance both services and outcomes, such as job satisfaction, for supported employees. Conclusion As previously illustrated, comparisons among studies investigating quality of life for people with disabilities are complicated by varying methods and instruments used. Further,

studies investigating the job satisfaction of people without disabilities have proliferated the literature over the past decade, while research exploring job satisfaction of people with disabilities remains markedly limited in comparison. Problems within existing studies on job satisfaction for people with disabilities include the predominant use of non-standardized measures rather than well-established and researched measures such as those provided by the Job Descriptive Index and Job In General scale (Smith et al., 1969). Only three of the studies reviewed used the JDI with people who have disabilities, while the majority of researchers opted to develop their own measures of job satisfaction. In addition to the limitations for generalization posed by a general lack of reliable, valid, and psychometrically sound job satisfaction measures, few studies explored how this construct relates to quality of life, which is purported by many to be the ultimate goal driving providers and services for people with disabilities. A review of available literature indicates that participant characteristics typically reported include disability category and IQ. These characteristics typically do not reflect the heterogeneity among people with disabilities, and are of limited use in planning and support efforts. Whereas, information pertaining to level of support and functional ability serves as a better indicator of what types of services people with disabilities may benefit from. Finally, few if any studies exist, which consider how functional ability impacts quality of life. Given the assumed relationships between quality of life and job satisfaction, the inherent role that functional ability may play in job performance and type of support, and the appearance that quality of life may vary according to level of functional ability, research exploring these connections is clearly justified. Beyond the theoretical interests, however, exists a group of people who participate daily in programs designed to provide them with quality supported employment services. It is for these people that this study has the most promise, because such individualized information can create a foundation for direct program and service enhancement. Such a program-wide effort is bound to improve the job satisfaction and, ultimately, the quality of life of the individuals they serve.

CHAPTER 3 METHODOLOGY

Go forth now. Go forth and question. Ask and listen. The world is just beginning to open up to you. Each person you question can take you into a new part of the world. For the person who is willing to ask and listen the world will always be new. Quoted by Michael Patton, 1990, p.279 From Halcolm’s Epistemological Parables

This study measured the quality of life, job satisfaction, functional ability, and job performance of 40 people with developmental disabilities receiving Phase II (follow-along) supported employment services from a north Florida community-based program focusing on employment, community living, and integration. Quality of life and job satisfaction were assessed via interviews with supported employees, using the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a) and the Job Descriptive Index (JDI; Smith, Kendall, & Hulin, 1997), including the Job in General (JIG) scale. Phase II employment consultants (ECs) assessed supported employees’ functional ability and job performance using the Functional Assessment Inventory (FAI; Crewe & Athelstan, 1981) and the Job Observation and Behavior Scale (JOBS; Rosenberg & Brady, 2000a). Research Questions The following research questions were addressed in this study: 1. What correlations exist between overall quality of life (as measured by the QOL.Q) and global job satisfaction (as measured by the JIG scale)? 2. What correlations exist between competence/productivity (as measured by the subscale of the QOL.Q) and various aspects of job satisfaction (as measured by the JDI)?

3. What differences exist in either quality of job performance or level of support (as measured by the JOBS subscales) between groups of supported employees assigned to one of two general categories of functional ability? 4. What difference exists in quality of life (as measured by the QOL.Q) between groups of supported employees assigned to one of two general categories of functional ability? Population The population of interest in this study was individuals with developmental disabilities employed in competitive work settings and receiving supported employment services. Program participants mirrored those characteristics identified previously by Menchetti & Garcia (2003), which are considered as typical of supported employees across the United States (Wehman & Kregel, 1995). These characteristics included a primary disability of mental retardation, with intelligence quotients (IQ) within the range of 70 to 50, and ages ranging from 22-60, for the majority of participants. Sample Participant Selection A purposeful selection process was used to identify the participating agency and study participants. The agency and participants were selected as the focus of this study primarily because they were believed to be reflective of what typically occurs in supported employment programs. Participant Characteristics The primary participants in this study were the supported employees with developmental disabilities. However, a description of the program in which they participated, as well as the employment consultants who served them is also provided. This enhances meaningful interpretations of outcomes of the study. Further, this information can assist with generalizability or extrapolations of study findings (Patton, 1997). Supported employment program. The participating agency is a regional provider of supported employment, community living, and integration for five north Florida counties. At the time of the study, the community-based employment program was serving approximately 90 people with developmental disabilities in a given month. Fifty-four of these individuals had been employed for 90 or more consecutive days. This 90-day benchmark is consistent with what is typically described by vocational rehabilitation and other funding agencies as point at which

“follow-along” services begin. During Phase II, five employment consultants provided ongoing support to assist the supported employees in maintaining his or her job. Supported employment process. Individuals seeking employment assistance through the participating agency participate in one of two employment models: employment services (ES) and supported employment (SE), which is generally provided in two phases. Typically, an individual is referred for either Phase I SE or ES by a vocational rehabilitation counselor (VRC). Phase I SE and ES are characterized by initial employment activities, including job search, attainment, and training. Phase II SE is used to describe long-term follow-along activities, including job maintenance and, occasionally, enhancement. Funding sources include Vocational Rehabilitation (VR), which pays for Phase I SE and ES, and Developmental Services Medicaid Waiver, which pays for Phase II SE or follow-along. For example, a VRC may refer an individual for either SE or ES. The primary distinction between SE and ES, as defined by VR, is that an individual referred for SE will need both Phase I and II support, whereas ES typically embodies those activities characterized by Phase I. This study focused on individuals who were employed for a minimum of 90 days and receiving Phase II SE services. The process experienced by most supported employees (SEs) at the participating agency is delineated as follows: 1. Referral for individual is made by VRC to participating agency for SE or ES, including recommendation of job type, job title, and minimum number of hours per week. The individual is assigned to an EC unless he/she has a preference. 2. EC facilitates the Personal Career Plan (Menchetti & Piland, 1998) with individual; form of person-centered career planning, which includes identification of preferences, action plan, and development of résumé. 3. EC supports individual as he/she perform job searches, complete/submit applications/ résumé, schedule/complete interviews, and select job. 4. Individual and EC attend employer orientation and training, when available. 5. EC conducts on-the-job situational assessment and task analysis specific to individual’s job. 6. EC provides on-the-job training and support’s individual’s independent job performance.

7. Individual completes VR benchmarks (e.g., job placement, stability) and case is either closed if ES or is transferred to Phase II if SE and requires follow-along. Occasionally, an individual will be referred for Phase II SE by his/her DS support coordinator. For example, an individual may already be employed and wish to change his/her SE provider. It should be noted that an individual is encouraged to participate in every step of the process and individuals vary in the amount of participation and training required to do so. For example, some individuals may need to learn how to perform job searches and complete applications, and may role-play with EC to hone their interview skills. Transportation, as well as appropriate grooming and dress are also critical issues to address. In summary, the frequency and intensity of EC support varies according to individual needs and employment phase. Typically, however, Phase I is characterized by more intense and frequent EC support. Whereas, during Phase II, EC support is reduced to one or two visits per week. Some individuals become so proficient that two visits per month (Medicaid Waiver minimum requirement for SE follow-along) are sufficient to maintain adequate job stability. Supported employees. Participants for this study were 40 people with developmental disabilities who were competitively employed. To be included in this study, participants had to (a) be employed for 90 or more days, (b) be receiving Phase II employment services from the participating agency, and (c) provide consent. Data collected on participant characteristics, which are presented in Tables 3.1 through 3.7, included age, gender, ethnicity, marital status, children, residence, education, IQ, primary disability, employment status, sheltered workshop history, job areas and titles, and benefits. Reported in Table 3.1 are participants’ age, ethnicity, and gender. Supported employees ranged in age from 22 to 60 (M = 34.5, SD = 8.7, Md = 33, Mo = 30). The majority of the participants were Caucasian (67.5%) and male (52.5%). Table 3.2 illustrates that most participants were single (36 or 90%), with the greater part (30 or 90%) having no children. The majority of participants resided with their family (18 or 45%) or in their own apartment with paid assistance (16 or 40%). Four individuals (10%) had their own home, three of which resided without paid assistance, while one person lived in an apartment without assistance and one person’s residence was a group home.

Table 3.1 Age, Ethnicity, and Gender Variable f % Age 21-24 yrs 4 10.0 25-29 yrs 8 20.0 30-34 yrs 11 27.5 35-39 yrs 7 17.5 40-44 yrs 2 5.0 45-49 yrs 7 17.5 50-54 yrs 0 0 55-59 yrs 0 0 60-64 yrs 1 2.5 Ethnicity African American 13 32.5 Caucasian 27 67.5 Gender Female 19 47.5 Male 21 52.5

Table 3.2 Marital Status, Children, and Residence Variable f % Marital status Divorced 1 2.5 Married 3 7.5 Single 36 90.0 Children 0 36 90.0 1 2 5.0 2 2 5.0 Residence Apartment w/assist 16 40.0 Apartment w/o assist 1 2.5 Family home 18 45.0 Group home 1 2.5 Own home w/assist 1 2.5 Own home w/o assist 3 7.5

As demonstrated in Table 3.3, the majority (75%) of supported employees graduated high school with either a special diploma or certificate of attendance; 15% obtained a standard diploma. Four individuals received either no high school credentials or their educational background was unknown. Records indicated that most participants had a full-scale IQ score of either 69 or below (14 or 35%) or 59 or below (12 or 30%). Table 3.3 also indicated that two participants’ IQ scores were 41 and 71, and for 30% of participants, IQ scores were not available. More readily available were participants’ primary disability: 72.5% (29) of supported employees were assigned a label of mental retardation. Another 12.5% (5) individuals’ primary disability could be categorized under autism spectrum disorder and two individuals had cerebral palsy. The remainder of the participants had a primary disability of mental illness (5%), learning disability (2.5%) or organic brain disorder (2.5%).

Table 3.3 Education, IQ, and Primary Disability Variable f % Education Standard diploma 6 15.0 Special diploma/certificate 30 75.0 None/unknown 4 10.0 Full Scale IQ Score 71 1 2.5 69 or below 14 35.0 59 or below 12 30.0 41 1 2.5 Not available 12 30.0 Primary Disability Autism spectrum d/o 5 12.5 Cerebral palsy 2 5.0 Learning disability 1 2.5 Mental illness 2 5.0 Mental retardation 29 72.5 Organic brain d/o 1 2.5 Note: d/o = disorder

Examination of employment status in Table 3.4 reveals that 50% of participants were employed for more than 60 months, working over 20 hours a week, and earning $6.39 or more per hour. Supported employees averaged 66.97 months of employment, 24.83 hours of work per week, and $6.69 per hour. Table 3.4 provides additional employment variable descriptives.

Table 3.4 Months Employed, Hours Worked per Week, and Wage Earned per Hour Variable M SD Md Mo Min-Max Months employed 66.97 50.94 60.5 7a 5-225 Hours worked per week 24.83 11.21 22 40 6--40 Wage earned per hour $6.69 $1.26 $6.39 $6.00 $5.15-$10.66 a. Multiple modes exist. Lowest value is reported.

Listed in Table 3.5 are data reported from ECs indicating that the majority of supported employees had been previously competitively employed (75%) and less than half (37.5%) had attended a sheltered workshop in the past.

Table 3.5 Employment/Workshop History and Company Tenure Variable f % Employment/Workshop History Previous competitive employment 30 75.0 Previous sheltered workshop 15 37.5 Company Tenure < 1 yr 7 17.5 2-5 yrs 17 42.5 6-10 yrs 10 25 11-15 yrs 5 12.5 16+ yrs 1 2.5

Some participants had both previous competitive employment and sheltered workshop experience (10 or 25%), accounting for combined percent exceeding 100. Approximately 42% of participants were employed with their company from two to five years, while 25% were employed from six to ten years with the same company. Seven participants were employed for

less than one year, five were employed from 11 to 15 years, and one person’s company tenure exceeded 16 years.

Table 3.6 Job Areas and Titles Job Areas f % Job Titles Cafeteria 3 7.5 Dishwasher, food service aid Day care 1 2.5 Attendant Dept store 4 10.0 Stockroom worker, customer service rep Fast food 1 2.5 Lobby attendant Grocery 11 27.5 Bagger, stock clerk, produce worker, maintenance worker Group home 1 2.5 Attendant Hospital 4 10.0 Equipment tech, maintenance worker, dietary aid, dining attendant Hotel 2 5.0 Housekeeper, laundry worker Medical supply 1 2.5 Assembly worker Office 3 7.5 Receptionist, clerical assistant, clerk Plant nursery 1 2.5 Nursery worker Residence hall 1 2.5 Maintenance worker Restaurant 4 10.0 Kitchen helper, silverware sorter, dishwasher, maintenance worker Stadium 1 2.5 Maintenance worker Theatre 2 5.0 Ticket taker, maintenance worker

Data in Table 3.6 revealed that the largest percentage of participants was employed in grocery stores (27.5%), followed by fast food/restaurant (12.5%). Not shown are the most common job titles, which were Bagger/Courtesy Clerks (n=8) and Custodial/Maintenance Workers (n=7).

Table 3.7 Employee Benefits Benefits f % Discount 15 37.5 Health insurance 15 37.5 Life insurance 2 5.0 Sick leave 23 57.5 Stock/retirement options 11 27.5 Uniforms 5 12.5 Vacation 21 52.5

The last demographics table (3.7) illustrates that the majority of supported employees were granted some form of sick leave (23 or 57.7%) and vacation (21 or 52.5%) benefits. Many participants received employee discounts (37.5%), enrolled in health insurance plans (37.5%), and partook in stock/retirement options (27.5%). A few participants were provided with uniforms (12.5%) and life insurance policies (5%). Employment consultants. Five employment consultants (ECs) assessed the functional ability and job performance of study participants. There were two females and three males, ages ranged from 25 to 59 years, and the average experience as an employment consultant was approximately 9 years (range = 4 –16 years). All five ECs had at least a four-year degree and were formally trained in both supported employment and person-centered planning methods. Procedures Data collection occurred during the spring of 2003. Five employment consultants (ECs) were asked to (a) identify all the supported employees on their caseload who were been employed for 90 or more days and receiving Phase II employment services, (b) obtain their consent for participation in the proposed study, (c) attend training sessions, and (d) complete surveys to determine the participating SEs’ functional ability and job performance. The researcher and a graduate research assistance conducted interviews with participating SEs using surveys to determine their quality of life and job satisfaction. Step 1: Gaining EC Cooperation To begin, the researcher met with Phase II ECs at the participating agency to describe the potential advantages of, nature of, and time required for their contribution to the study. For example, valuable information regarding functional ability and job performance of the SEs they work with could be used to develop implementation plans and training goals. ECs were provided with a description of the nature of their involvement and the time required for their participation, which included (a) identifying participants, (b) obtaining consent, (c) participating in a three- hour training, and (d) completing two instruments assessing functional ability and job performance for each participating SE on their caseload. In return for EC cooperation, the researcher completed the agencies yearly consumer satisfaction surveys (during Step 4) and compiled reports.

Step 2: Obtaining SE consent Next, the researcher provided instructions to Phase II ECs for obtaining SE consent. ECs were supplied with cover letters and consent forms and directed to approach everyone on their caseload that had been employed for a minimum of 90 days to recruit participants for the proposed study. Copies of letter and informed consent, which were approved by University Human Subjects Committee, are provided in Appendix A. Lastly, a time was scheduled for EC training on FAI and JOBS administration. Step 3: FAI and JOBS administration Phase II ECs attended a three-hour training session. During this training, the researcher instructed ECs on administration of the two surveys using the manuals for each instrument. ECs practiced by completing an FAI (Crewe & Athelstan, 1981) and JOBS (Rosenberg & Brady, 2000)a for one of their SEs who agreed to serve as a participant in the study. Individual follow- up meetings between the researcher and the ECs occurred to address any questions and ensure completion of FAI and JOBS measures for the remaining study participants. Step 4: FAI and JOBS inter-rater reliability Inter-rater reliability on 25% of the FAI and JOBS instruments was conducted using ratings from one of the five ECs who had also worked with the 10 randomly selected participants. Two calculations were used to determine inter-rater reliability for item scores on both the FAI and JOBS. Inter-rater reliability on item versus composite scores was conducted, and an overall result for each scale and/or subscale is reported. For example, the JOBS–quality of performance subscale is comprised of 30 items. ECs’ scores on each item (ranging from 1 to 5) were compared and a measure for inter-rater reliability was yielded for the particular subscale. Inter-rater reliability on item versus composite scores was used, because a major weakness of the latter is that composite scores can agree, regardless of agreement on individual items. First, an agreement rate (AR) or percentage of agreement was calculated by dividing number of agreements by number of agreements plus disagreements multiplied by 100. Using the same example, if the ECs agreed on all 30 scores, then an AR of 100% was assigned. Versus if they disagreed on five of 30 items, then an AR of 83.3% was assigned to the quality of performance scale of the JOBS for that measure of inter-rater reliability. Second, a Gamma or G statistic was used to determine agreement among raters. G statistics are calculated by dividing the number of agreements minus the number of

disagreements by the number of agreements plus the number of disagreements. A form of intra- class correlation, the G statistic accounts for variance among raters, as well as error. For example, the JOBS relies on a Likert scale response format. Consequently, one set of ratings (1 vs. 2) can be closer to each other than another (1 vs. 5). The G statistic accounts for this variance; the percentage correct does not. Using the same example, a G statistic is calculated for the same set of identical EC scores for the 30 items of the JOBS – quality of performance subscale and a perfect correlation results (G = 1.0). However, if ECs disagreed on five of 30 items, then a G statistic reflecting the amount of variation would result (G < 1.0). Results of inter-rater reliability calculations can be found in Tables 3.8 through 3.10. FAI and JOBS Inter-rater reliability on 25% of the FAI and JOBS instruments was conducted using ratings from an EC who had also worked with the 10 randomly selected participants. Two calculations, Gamma statistics and agreement rates, were used to determine inter-rater reliability for item scores on both the FAI and JOBS subscales. Suggested indexes for intra-class correlations, such as the Gamma statistic, have been reported by Cooper and Hedges (1994): (a) < .40 = poor, (b) .40 - .59 = fair, (c) .60 - .74 = good, and (d) > .75 = excellent. Siegel and Castellan (1988) indicated that a Gamma of .51 was considered representative of a moderate correlation between two measures.

Table 3.8 Inter-Rater Reliability for JOBS and FAI

JOBS Reliability Quality of Performance Type of Support FAI Check No. Gamma (sig) % Agree Gamma (sig) % Agree Gamma (sig) % Agree IRR01 0.884 (.001) 16.6 0.895 (.18) 60 0.500 (.058) 40 IRR02 0.964 (.000) 73.3 0.949 (.039) 73.3 0.225 (.474) 43.3 IRR03 0.815 (.000) 33.3 0.418 (.098) 43.3 0.591 (.146) 40 IRR04 0.767 (.000) 66.6 0.69 (.001) 56.6 0.871 (.029) 80 IRR05 0.824 (.002) 63.3 0.915 (.000) 40 0.594 (.015) 56.6 IRR06 0.467 (.034) 46.6 0.226 (.0474) 30 0.748 (.000) 63.3 IRR07 0.93 (.000) 73.3 0.935 (.000) 56.6 0.636 (.001) 46.6 IRR08 0.713 (.001) 53.3 0.888 (.000) 40 0.754 (.001) 60 IRR09 0.743 (.004) 26.6 0 (1.0) 56.6 1.00 (.000) 50 IRR10 0.623 (.004) 40 0.622 (.086) 30 1.00 (.005) 83.3

Inter-rater reliability for the JOBS – Quality of Performance subscale, as estimated by Gamma, ranged from .467 to .964 (M = .773, Md = .791). All Gamma statistics were in the good to excellent range, with exception of one statistic of .467. In contrast, agreement rates appeared less favorable, ranging from 16.6% to 73.3% (M = 49.29%, Md = 49.95%). Inter-rater reliability for the JOBS – Type of Support subscale, as estimated by Gamma, ranged from .000 to .94.9 (M = .6538, Md = .7890). All Gamma statistics were in the fair to good range, with exception of one statistic of .000. As was the case with the performance subscale, agreement rates for type of support ranged from 30% to 73.3% (M = 48.64%, Md = 49.95%). Inter-rater reliability for the FAI, as estimated by Gamma, ranged from .225 to 1.0 (M = .6919, Md = .692). All Gammas were in the fair to excellent range, with exception of one Gamma of .225. Percentages of FAI agreement ranged from 40% to 83.3% (M = 56.31%, Md = 53.3%). In summary, results indicated that for this study Gammas provided a more favorable and accurate estimate of inter-rater reliability on Likert-scale items, found in both the JOBS and FAI, than could be achieved from agreement rates. Step 5: Q.OLQ and JDI/JIG interviews The researcher and a trained graduate research assistant conducted interviews using instruments assessing participating SE quality of life and job satisfaction. The Q.OLQ (Schalock & Keith, 1993) and JDI/JIG (Smith et al., 1997), as well as the agency’s consumer satisfaction survey, were administered according to participant preference: either in person or over the telephone. Participants were instructed to respond to the best of their ability, informed that there were no right or wrong answers, and reminded that individual responses would be kept confidential. Interviews took from 30 to 60 minutes per SE to complete and the majority (approximately 75%) were conducted over the telephone. Step 6: Q.OLQ and JDI/JIG inter-rater reliability The researcher and the trained graduate research assistant (GRA) provided inter-rater reliability for 25% of the Q.OLQ and JDI/JIG instruments. During the researcher’s interviews, the GRA also complete the QOL.Q and JDI/JIG instruments (and visa versa); results of 10 interviews were compared. Separate interviews were not conducted, because of the time involved and the volunteer nature of participation. Again, two forms of inter-rater reliability were calculated for item scores. First, a percentage of agreement was calculated by dividing number of

agreements by number of agreements plus disagreements multiplied by 100. Second, the G statistic was used to determine agreement among raters. QOL.Q and JDI/JIG Inter-rater reliability calculations for the QOL.Q and JDI/JIG are presented in Tables 3.9 and 3.10 respectively. Inter-rater reliability for the QOL.Q subscales, as estimated by Gamma, ranged from .714 to 1.0, with 34 of 40 Gammas equaling 1.0. When all scores on a particular scale were constant (e.g., all 3s) a Gamma was not calculated (indicated by .a), however, this was also evidence of agreement between raters on these four occasions. For example, Gamma for IRR05 on empowerment/independence was not calculated, because at least one variable in each 2-way table upon which measures of association were computed was a constant. In this particular case, 9 of 10 item scores were identical (3s), with the exception of one disagreement: one item was given a score of 2 by one rater and 3 by the other. Consequently, Gamma does not calculate a statistic if there is little to no variation among scores. Again, it strength is its ability to account for variance among scores on Likert-scale items.

Table 3.9 Inter-Rater Reliability for QOL.Q

QOL.Q Competence/ Empowerment/ Social Belonging/ Reliability Satisfaction Productivity Independence Community Intg. Check No. Gamma % Agree Gamma % Agree Gamma % Agree Gamma % Agree IRR01 1.0 (.000) 100 1.0 (.000) 100 1.0 (.000) 100 1.0 (.000) 100 IRR02 1.0 (.236) 100 1.0 (.236) 100 1.0 (.035) 100 1.0 (.236) 100 IRR03 1.0 (.000) 100 1.0 (.000) 100 1.0 (.000) 90 1.0 (.000) 90 IRR04 1.0 (.000) 100 1.0 (.042) 90 .923 (.000) 80 1.0 (.065) 80 IRR05 1.0 (.000) 100 .a 100 .a 90 1.0 (.000) 90 IRR06 1.0 (.003) 100 1.0 (.236) 100 1.0 (.000) 90 1.0 (.000) 100 IRR07 1.0 (.000) 90 1.0 (.000) 100 .714 (.030) 90 1.0 (.000) 100 IRR08 .a 100 1.0 (.236) 100 1.0 (.240) 90 1.0 (.000) 90 IRR09 1.0 (.003) 100 1.0 (.000) 100 1.0 (.236) 100 1.0 (.003) 100 IRR10 1.0 (.000) 100 1.0 (.000) 100 .a 100 1.0 (.000) 100 Note: .a No statistics were computed because variable scores were constants; (significance).

Therefore, no measures of association were computed for the cross tabulation, because of the constant variable, in this case a score of 3. Further, percentages of agreement ranged from 80% to 100%, with 28 of 40 agreement rates equaling 100%.

Data in Table 3.10 indicate that inter-rater reliability on the JDI/JIG, as estimated by Gamma, ranged from .750 to 1.0, with 43 of 60 Gammas equaling 1.0. Again, when all scores on a particular scale were constant (e.g., all 3s) a Gamma was not calculated (indicated by .a), however, this was also evidence of agreement between raters on these four occasions. There was one instance of a negative 1 Gamma statistic, which occurred on the JDI/work subscale. Gammas of -1 can occur for one of two reasons. If one splits frequencies in a contingency table on the diagonal, beginning from upper right to lower left hand corners, and frequencies concentrate on this diagonal, a gamma of negative one will result. The other condition under which a -1 gamma results is if there are no agreements among scores. In the case of IRR02, agreements did occur for 80% (or 8 of 10) scores, consequently, it can be assumed that the negative value resulted from frequencies in the contingency table gathering on an upper right to lower left diagonal. Further, percentages of agreement ranged from 80% to 100%, with 44 of 60 agreement rates equaling 100%.

Table 3.10 Inter-Rater Reliability for JDI/JIG

JDI Work Pay Promotion Supervision Coworkers JIG

Reliability % % % % % % Check No. Gamma Agree Gamma Agree Gamma Agree Gamma Agree Gamma Agree Gamma Agree IRR01 1.0 (.000) 100 1.0 (.000) 100 1.0 (.000) 100 1.0 (.018) 100 1.0 (.018) 100 1.0 (.000) 100 IRR02 -1.0 (.453) 80 .a 100 1.0 (.025) 100 .a 100 1.0 (..275) 90 1.0 (.274) 100 IRR03 1.0 (.000) 100 1.0 (.050) 90 1.0 (.025) 90 1.0 (.000) 100 .857 (.005) 80 .818 (.000) 90 IRR04 1.0 (.001) 90 .750 (.257) 90 1.0 (.025) 100 1.0 (.026) 100 .913 (.001) 90 1.0 (.274) 100 IRR05 .938 (.105) 90 .a 100 1.0 (.001) 100 1.0 (.274) 90 1.0 (.000) 100 1.0 (.274) 90 IRR06 1.0 (.004) 100 1.0 (.000) 100 1.0 (.000) 100 1.0 (.004) 100 .a 100 1.0 (.274) 100 IRR07 1.0 (.018) 80 1.0 (.025) 100 1.0 (.025) 100 1.0 (.026) 100 .a 100 .a 100 IRR08 1.0 (.018) 100 .a 100 1.0 (.025) 100 .a 100 .a 100 .a 100 IRR09 1.0 (.000) 100 1.0 (.225) 100 1.0 (.001) 100 1.0 (.000) 90 1.0 (.018) 100 1.0 (.027) 90 IRR10 1.0 (.000) 90 1.0 (.045) 100 .a 100 1.0 (.000) 100 1.0 (.000) 100 1.0 (.005) 100 Note: .a No statistic was computed because variable score was constant; (significance).

Although Cooper and Hedges (1994) indicated that agreement rates were of limited evaluative use, they can be helpful in clarifying the conditions under which a + 1 gamma occurs. In summary, results indicated that for this study Gammas provided a more favorable and accurate

estimate of inter-rater reliability on Likert-scale items, found in both the QOL.Q and JDI/JIG, than could be achieved from agreement rates. Step 7: Data analyses and confidentiality Data analysis was conducted using the SPSS 10.1 version statistical package (SPSS, Inc., 1999). Confidentiality of information was achieved by assigning each SE a participant number, which was then used to code data entered into the computer. Until data entry was complete, all surveys were kept in portable, locked file cabinets. Once data entry was complete, all original documentation with identifying information on quality of life and job satisfaction was shredded, while functional and job ratings were returned to the participating agency, accordingly. Variables Independent Variables Several independent variables were reported on in this study, including (a) age, (b) ethnicity, (c) children, (d) company tenure, (e) education, (f) employment history, (g) employment status, (h) functional ability, (i) gender, (j) IQ score, (k) primary disability, (l) residence, and (m) sheltered workshop history. Operational definitions are provided as follows. Age: in years, reported in descriptives and range. Ethnicity: African American or Caucasian. Children: number of children participant has (0, 1, or 2). Company tenure: reported in range, determined by years with current employer. Education: determined by diploma type (special/certificate or standard). Employment history: previous competitive employment experience. Employment status: months employed, hours worked per week, and wages earned per hour. Functional ability: “…client’s behavioral capacities [and limitations] together with key environmental factors…” (Crewe & Athelstan, 1984, p. 1). Gender: male or female. IQ score: full-scale intelligence quotient previously assigned to participant, as indicated in records. Primary disability: predetermined disability assigned to participant, as indicated in records: autism, cerebral palsy, learning disability, mental illness, mental retardation, and organic brain disorder.

Residence: independent refers to living in own home or apartment without assistance; semi-independent refers to living in own home or apartment with assistance; and supervised refers to living in family home, a group home, or adult congregate living facility (ACLF). Sheltered workshop history: previous sheltered workshop experience. Dependent Variables Several dependent variables were evaluated in this study, including: (a) competence/ productivity, (b) job satisfaction – aspects (coworkers, pay, promotion, supervision, and work), (c) job satisfaction – global, (d) level/type of job support, (e) quality of job performance, and (f) quality of life. Operational definitions for dependent variables examined in this study are as follows. Competence/productivity: reflects personal assessment and satisfaction with employment or other daily activity, and the education and skills attained to perform them. Job satisfaction – global: “…overall feelings about the job….reactions to various aspects of the job in a single integrated response (Ironson et al., 1989, p.194). Job satisfactions – aspects: “…feelings or affective responses to facets of the situation” (Smith et al., 1969, p. 6). Also see satisfaction with coworkers, pay, promotion, supervision, and work. Level/type of job support: refers to the “…type of support which the employee receives during the entire work shift or work day” (Rosenberg & Brady, 2000b, p. 8) for work- required daily living activities, behaviors, and job duties. Quality of job performance: a comparison of “…the employee’s performance to workers not receiving supports who perform the same competitive job” (Rosenberg & Brady, 2000b, p. 8) on work-required daily living activities, behaviors, and job duties. Quality of life: “…a personal, subjective phenomenon that is a result of the following three levels of experience: personal characteristics and objective circumstances; the perceptions of significant persons; and one’s personal beliefs about what is important and how the world works” (Schalock & Keith, 1993b, p. 8). Satisfaction with coworkers: “…the level of employee satisfaction with his or her fellow employees” (Balzer et al., 2000, p. 36). Satisfaction with pay: “…attitude toward pay and is based on the perceived

difference between actual pay and expected pay” (Balzer et al., 2000, p. 36). Satisfaction with promotion: “…the employee’s satisfaction with the company’s promotion policy and the administration of that policy” (Balzer et al., 2000, p. 36). Satisfaction with supervision: “…reflects an employee’s satisfaction with his or her supervisor(s)” (Balzer et al., 2000, p. 36) regarding such behaviors as praise, recognition, interest, feedback, and listening. Satisfaction with work: “…various attributes of work that may be related to satisfaction, including opportunities for creativity and task variety, allowing an individual to increase his or her knowledge, and changes in responsibility, amount of work, autonomy, job enrichment, and job complexity” (Balzer et al., 2000, p. 36). Instrumentation Four instruments were used to gather information about the SEs’ quality of life, job satisfaction, functional ability, and job performance. In addition to these instruments, data were obtained via record review and social history, as needed, for verification of participant characteristics and employment information. Table 3.11 provides the types of instruments, sources of data, and description of content for data collection and analyses conducted in this study. Interviews The majority of participants had mental retardation as their primary disability, which can result in reading difficulties. Therefore, interviews were conducted to gather information necessary to complete the QOL.Q (Schalock & Keith, 1993a) and JDI/JIG (Smith et al., 1997) scales. Several studies have been undertaken to determine the best types of questions and methods of interviewing for use with people who have a cognitive disability. Following Table 3.11, a brief review of these studies and their implications for the instruments and strategies used in this study is provided. Sigelman, Schoenrock, Spanhel, Hromas, Winer, Budd, and Martin (1980) examined the responsiveness and response validity of people with mental retardation. Their sample was comprised of 52 children living in institutions (mean IQ = 42.02, SD = 13.81); 58 adults living in institutions (mean IQ = 39.76, SD = 13.12); and 57 children living in the community (mean IQ 47.53, SD = 12.12). Responsiveness was defined as the percentage of appropriate responses on 22 questions.

Table 3.11 Instruments, Sources of Data, Administration, and Description of Content

Instrument Source/Admin Description Satisfaction with: (a) life in general, (b) competence/ Quality of Life Questionnaire productivity, (c) empowerment/independence, and (d) (Schalock & Keith, 1993a) SE/GRA, RES social belonging/community integration.

Job Descriptive Index (Smith, Short-term satisfaction with: (a) coworkers, (b) pay, (c) Kendall, & Hulin, 1997) SE/GRA, RES promotion, (d) supervision, and (e) work.

Job in General (Smith, et al., Assessment of global, long-term feelings of job 1997) SE/GRA, RES satisfaction.

Functional Assessment Inventory Enumeration of: (a) vocational strengths, (b) limitations, (Crewe & Athelstan, 1981) EC (c) behavioral capacities, and (d) environmental factors.

Job Observation and Behavior Assessment of work-related: (a) daily living activities, Scale (Rosenberg & Brady, (b) behaviors, and (c) job duties for quality of 2000a) EC performance and type of support.

Record review DB/RES Verification of demographics and employment status.

Enumeration of: (a) employment history, (b) Social history SE, EC/RES employment status, and (c) services received. Note: DB = Agency database; EC = employment consultant; GRA = graduate research assistant; RES = researcher; SE = supported employee; SO = significant other.

Response validity was defined as percentage of agreement with family or caretaker on 22 questions. Acquiescence was defined as the tendency to agree during yes/no questioning, regardless of the content. Results of the Sigelman et al. (1980) study indicated that individuals with mild (IQ = 55- 69) or moderate (IQ = 40-54) mental retardation were more responsive (mean percentage = 89.15 and 90.19, respectively) than individuals with severe (IQ = 25-39) mental retardation (mean percentage = 70.45). For example, a significant difference in responsiveness existed between the mild and severe groups (t = 3.51, df = 21, p = .002). Examination of response validity revealed a similar pattern; as IQ increased, so did percentage of agreement with family or caregivers. For example, a significant difference in agreement was found, again, between the mild and severe groups (t = 2.56, df = 135, p = .02). Finally, Sigelman et al. (1980) concluded that, after analyses of individual items, respondents with lower IQs were more likely to acquiesce.

In continuation of the Sigelman et al. (1980) study, Sigelman, Budd, Winer, Schoenrock, and Martin (1982) tested several response formats in an effort to identify the best way to interview people with mental retardation. Their sample included the same children and adults used in the Sigelman et al. (1980) study. They examined several methods of questioning: open- ended questions with examples, open-ended questions with probes, yes-no checklists, multiple- choice with verbal response format, and multiple-choice with pictorial response format. Results indicated that yes/no response formats increased responsiveness and chance for acquiescence, while open-ended questions limited responsiveness but reduced chances of acquiescence. Sigelman et al. (1982) concluded that verbal and pictorial multiple-choice formats were best, because they increased responsiveness, reduced acquiescence or systematic response bias, and did not decrease agreement with family and caretakers. The QOL.Q (Schalock & Keith, 1993a) was designed such that respondents select from a verbal multiple-choice format. If individuals have limited communication, then a knowledgeable other can assist with completing the questionnaire. In contrast to the multiple-choice format of the QOL.Q, the JDI/JIG (Balzer et al., 2000) requires respondents to indicate their level of agreement with particular words or short phrases through a yes/no or don’t know response format. However, the JDI/JIG was designed with an equal number of favorable and unfavorable items, which serves as a control for acquiescing (Seltzer, 1984; Sigelman et al., 1982; Balzer, et al., 2000). Further, the JDI/JIG, with minor modifications, has been demonstrated as an appropriate method for determining job satisfaction of people with cognitive disabilities. For example, Seltzer (1984) used the JDI/JIG with 65 people who had mental retardation, however, she replaced the words or short phrases in the instruments with questions (to enhance understanding) and conducted interviews. McAffee and McNaughton (1997a & 1997b) used the JDI/JIG with the Seltzer (1984) modifications to determine the job satisfaction of 236 people with a variety of developmental disabilities. These researchers indicated that they chose the JDI/JIG, because it is considered to be the most reliable and valid measure of job satisfaction available, it is appropriate for people with a fourth grade and above reading level, and it was designed to control for acquiescing. It is for these reasons that the JIG/JDI by Smith et al., with modifications modeled after the Seltzer (1984) study, was used in this study. As indicated previously the majority of potential participants were expected to have reading difficulties, therefore both the QOL.Q and the JDI/JIG scales were completed via

interviews. To avoid an order or carry-over effect between instruments, half of the interviews were begun using the QOL.Q, while the remainder begun with the JDI/JIG (Wiersma, 2000). Finally, strategies identified by Biklen and Moseley (1988) were used to guide the interview process and to ensure that the information gathered was as meaningful and accurate as possible. For example, to correct for misunderstandings, questions focused on one concept at a time and repetition was used, as needed. Open-ended questions, when used, were minimal. Interviews occurred in the place and time most comfortable for the respondent. When respondents continued to give the same answer for different questions, the interviewer interpreted this as an indication the respondent may not: (a) understand the question, (b) not know the answer, or (c) not think it is important, and resolved with the respondent, accordingly. To avoid respondents’ attempts to please the interviewer, clarification of interviewer’s role outside of the participating agency or any other community agencies were made (such as explaining from a university, not working for agency, and just there to ask questions for a study versus report what was said to agency staff). When language difficulties were encountered, significant others were asked to serve as a translator, noting, however, they may also filter information. Finally, as recommended by Biklen & Moseley (1988), this study included an observational component using the Job Observation and Behavior Scale (JOBS; Rosenberg & Brady, 2000a), which was completed by the employment consultants. The following sections provide a detailed description of the instruments used in this study, including assumptions, format, scoring, reliability, validity, standardization, limitations, and modifications, as needed. Following descriptions of instruments used to assess participant quality of life and job satisfaction, methods of data analyses for these two constructs are described. Next, descriptions of the instruments used to measure participant functional ability and job performance, and related data analyses are provided. Finally, analyses conducted on The Quality of Life Questionnaire Schalock and Keith (1993a) designed the Quality of Life Questionnaire (Q.OLQ) for use with people who have cognitive disabilities. For people who have limited communication skills, the Q.OLQ should be completed by significant others who are familiar with the person’s current residential, leisure, and work situations. Assumptions: As stated by Schalock and Keith (1993b):

Quality of life is necessarily subjective and cannot be inferred from objective measures of life conditions; quality of life is essentially the same for persons with and without disabilities; quality of life is basically a social phenomenon and a product primarily of interactions with others; quality of life is the outcome of persons meeting basic needs and fulfilling basic responsibilities in community settings; and quality of life can be assessed on a standardized instrument through either subjective report or ratings made by persons who know the individual very well (p. 8). Format. The Q.OLQ provides scale scores on four areas: life satisfaction, competence/productivity, empowerment/independence, and social belonging/community integration. Each section is comprised of 10 items and respondents select from one of three words or phrases that best describe how the person feels about his or her life, home, work, friends, and family. For example, item 22 in Empowerment/Independence asks, “Who decides how you spend your money?” to which the respondent selects from “I do,” “I do, with assistance from others,” or “Someone else decides.” Scoring. Each item ranges in score from 1 to 3, and the total score for each of the four sections ranges from 10 to 30. Positive responses, which reflect evidence of the particular scale, are given a score of 3, while moderately positive responses are assigned a score of 2, and negative responses, reflecting no evidence of the scale, are assigned a score of 1. For example, item 35 in Social Belonging/Community Integration asks, “Do you have friends over to visit your home?” to which the respondent selects from “Fairly often” (3 points), “Sometimes” (2 points), and “Rarely or never” (1 point). Missing items can be completed by someone who knows the person well or, when a score cannot be obtained, the average of the items on the particular scale can be used. Reliability. An internal reliability coefficient of .90 was achieved for the total Q.OLQ score. Inter-rater reliability on the total Q.OLQ score was .73 between the respondent and a knowledgeable informant (n=374), while correlation coefficients for the four scales ranged from .46 (satisfaction) to .81 (competence/productivity). Inter-rater reliability between 173 pairs of informants was .83 on the total Q.OLQ score, while individual scale reliability scores ranged from .66 (satisfaction) to .83 (empowerment/independence). Test-retest reliability was established using 47 undergraduate students taking the Q.OLQ in a two-week interval (r=.87).

Validity. Face validity was achieved as scales and items were based upon an extensive review of the literature (from 1976-1988). Construct validity was accomplished by comparing scores to actual living situations. For example, evidence supported the assumption that people with more extensive disabilities are less independent in their environments and, as a result, score lower on this particular scale of the Q.OLQ. People in independent living (n=103) averaged 25.5 on the empowerment/independence scale, while people in supervised living (n=206) averaged a score of 17.8. Concurrent validity was achieved in a study by Harner and Heal in 1992 (Schalock & Keith, 1993); they reported a correlation of .57 between the Q.OLQ and their instrument, the Lifestyles Satisfaction Survey. Standardization. Q.OLQ norms are based on a sample of 552 people with disabilities who were participating in community-based programs providing employment, living, and integration services. Standard scores, based upon severity of cognitive disability, gender, employment status, and living environment were reported. For example, total scores based upon severity of disability were as follows: mild (M=90.9, SE=0.9, n=115); moderate (M=83.4, SE=1.1, n=103); severe (M=74.5, SE=1.5, n=65); and profound (M=62.6, SE=1.9, n=22). Limitations. According to a recent study conducted by Kober and Eggleton (2002), during which they tested the factor stability of the QOL.Q, the “satisfaction” factor was not congruent across heterogeneous populations and it lacked internal consistency (Cronbach’s alpha coefficient equaled .47). However, the overall reliability of the instrument was .81, which was deemed as “…very good…” by Kober and Eggleton (2002, p. 162). The Job Descriptive Index One of the most systematic and frequently used measures of job satisfaction is the Job Descriptive Index or JDI (Buckley, Carraher, & Cote, 1992; Roznowski, 1989; Schneider & Dachler, 1978). Since it’s first inception in 1959, the JDI has been revised several times (1969, 1975, 1985, 1997). The JDI was designed to measure short-term satisfaction among five main job facets: (a) work on the present job, (b) present pay, (c) opportunities for promotion, (d) supervision, and (e) coworkers. The JDI is considered a self-administered instrument for individuals with reading abilities at or above the fourth grade. Since 1985, the JDI has also included the Job in General scale, which is purported to provide an overall measure of long-term job satisfaction. The JIG is described in a later section.

Assumptions. Development of the JDI was based upon several assumptions: (a) studies on the relationship between job satisfaction and performance suggest that the more satisfied an employee is, the more willing he or she may be to perform those extra duties that foster an effective organization; (b) job facet satisfactions refers to how a person feels about the current aspects of his or her job; (c) global job satisfaction reflects a person’s overall evaluation of his or her job, based upon a unique consideration of all valued job aspects; (d) satisfaction level results from consideration of the job in relative (vs. absolute) terms, which reflects the influence of both work and personal characteristics; (e) facet satisfaction reflects evaluation of short-term (vs. long-term) job aspects; (f) facet satisfaction is more easily assessed through descriptive (vs. evaluative) characteristics of the job; and, (g) facets of job satisfaction are empirically supported by factor analysis (Balzer et al., 2000). Format. The JDI is designed such that respondents read a list of words or phrases for each of the five facets and are asked to select the response (Yes/No/?) that best reflects how they describe their current job. Half of the words or phrases are worded favorably while the remaining half are worded unfavorably. For example, a favorable item from the People at Work facet is “helpful,” for which a respondent described using “Yes” indicates satisfaction, whereas a “No” response indicates dissatisfaction. Conversely, an unfavorable item from the Pay facet is “underpaid,” for which a respondent described using “Yes” indicated dissatisfaction, whereas a “No” response indicates satisfaction. Finally, if a respondent is unsure, he or she can select the “?” response. Scoring. For favorable items, “Yes” responses are given a value of 3, “No” responses are assigned a value of 0, and “?” (cannot decide) is assigned a value of 1. The yes/no scores for unfavorable items are reversed (No=3 and Yes=0), while “?” remains a constant value of 1. Scores on each of the five facets range from 0 to 54. However, when scoring the Pay and Promotion scales it is necessary to double the scores; these two sections have nine items each, while the other three sections are comprised of 18 items each. Finally, missing responses are assigned a value of 1, provided they do not exceed a total of three or fewer for the 18 item scales or two or fewer for the 9 item scales. When the missing items exceed protocol, the authors recommend not scoring that particular scale. Reliability. According to the Buros Institute test reviewer, Parsons (1995), internal consistency of the JDI is consistently high, averaging .88 across five facet scales.

Validity. Discriminant validity of the JDI was evidenced through the results of four studies over a five-year period (1959-1965). For example, both factor and cluster analyses demonstrated that the five facets could be distinguished from one another across a variety of samples, settings, and employees. Convergent validity of the JDI was demonstrated by comparing the JDI scales with other methods measuring the same facets. For example, the JDI facet measures “…correlated highly with behavioral measures such as absenteeism, rated performance, and termination decisions” (Balzer et al., 2000, p. 39). Standardization. The JDI was standardized on approximately 1,600 employees in across several organizations within the U.S. workforce. Norms were developed for managerial status, job tenure, organization type, job level, educational level, full-v. part-time status, gender, age, and race. Limitations. Buros Institute test reviewers (Parsons 1995; Sundberg, 1995) indicated that the JDI is a well-documented, researched, and established instrument useful for studying organizational job satisfaction. No limitations in psychometric properties were noted. The Job Descriptive Index-Modified The Job Descriptive Index (Smith et al., 1969) was modified by Patricia Seltzer in 1984 and used as a method of assessing job satisfaction of 65 people with mental retardation in sheltered workshops. For the purposes of this study, this revised version by Seltzer in 1984 will from now on be referred to as the JDI-M (Seltzer, 1984). According to Seltzer (1984), the JDI (Smith et al., 1969) was selected for the following reasons: (a) appropriateness for workers with “limited abstract verbal ability” (p. 150), (b) instrument reliability, (c) control for acquiescent responses via balance of favorable and non- favorable items, and (d) established convergent and discriminant validity. Seltzer (1984) modified the JDI (Smith et al., 1969) format by replacing the short phrases or adjectives of the self-administered survey with questions, thus creating a structured interview. The same scoring procedure was used, which asked respondents to reply using “Yes,” “No,” or “Not Sure.” Items were omitted when they did not reflect an aspect of the employees’ work experience, i.e., profit sharing, or if a respondent did not comprehend the meaning of a word following provision of a pre-selected synonym. Finally, questions referring to intellectual abilities of the employee were also omitted.

Seltzer’s (1984) modifications reduced the JDI from 72 items to 61 items grouped within the original five subscales: work, coworkers, supervision, pay, and promotion. Additionally, Seltzer (1984) asked employees’ to rate their overall job satisfaction using a five-point scale of facial expressions (i.e., range from scowl to broad smile). Modifications. The original JDI was used in this study; all 72 items were retained. Questions for each item were used from the Seltzer study and developed in a similar fashion for items excluded in the Seltzer study. For example, the Seltzer study excluded item 13 from the Work on Present Job scale: Repetitive. This original item was retained in the present study and the question, “Do you have to do the same thing over and over again?” was added to the interview/survey for clarification. The Job In General Smith, et al. (1997) also developed an instrument assessing overall job satisfaction. The Job in General (JIG) scale, which is included in the JDI, provides a long-term measure of global job satisfaction. The JIG was designed to reflect both the importance of the five facets of job satisfaction and their interactions with personal and situational factors affecting job satisfaction. The JIG is considered a self-administered instrument for individuals with reading abilities at or above the fourth grade. Assumptions. Four main assumptions guided the development of the JIG: (a) facet satisfactions, as measured by the JDI, do not account for all of the areas that an employee may value when determining overall job satisfaction; (b) evaluative, rather than descriptive, items should be used to determine overall job satisfaction; (c) consideration of overall job satisfaction is a long-term evaluation, whereas facet satisfactions reflect short-term assessment; and (d) summation of facet scores may not reflect the unique combinations which comprise overall satisfaction for individual workers (Balzer et al., 2000). Format. The JIG is comprised of eighteen words or phrases, such as good, undesirable, and poor. As with the JDI, the JIG asks respondents to select a response (Yes/No/?), which best reflects how each word or phrase describes how the person feels most of the time about his or her job. Scoring. The JIG is scored in the same fashion as the JDI: positive ratings of either “Yes” or “No” responses are given a score of 3, negative ratings a score of 0, and all “?” are assigned a

score of 1. Scores on the JIG range from 0 to 54, with high scores reflecting greater overall satisfaction with the job. Reliability. The reliability of the JIG was established on 3,566 workers from a wide variety of educational, employment, and organizational levels. Reliability estimates from numerous data pools exceeded .90. Validity. Convergent validity of the JIG was accomplished through correlation with other instruments measuring global job satisfaction, and correlations ranged from .66 to .80. Construct validity was confirmed on a sample of 670 employees. The JIG demonstrated consistent correlation with global measures, such as intention to leave and life satisfaction, versus the specific facets of job satisfaction measured by the JDI. Standardization. As was the case for the JDI, the JIG norms considered in this study are Job level and education. Job level median scores are as follows: (1) 47, (2) 50, (3) 45, (4) 41, and (5) 49. Median scores for education levels include the following: (

Rank-Order Correlation Coefficient (rs), the association between job satisfaction and quality of life were examined in the present study. Tests of Significant Association The correlation between global measures of quality of life and job satisfaction were tested using the Quality of Life Questionnaire (QOL.Q) total score and the Job in General (JIG)

score. Correlations on aspect measures of job satisfaction and quality of life were tested using (a) Job Descriptive Index (JDI) work score and QOL.Q competence/productivity (cp) score, (b) JDI pay score and QOL.Qcp score, (c) JDI promotion score and QOL.Qcp score, (d) JDI supervisor score and QOL.Qcp score, and (e) JDI coworker score and QOL.Qcp score. Hypotheses The following null and alternative hypotheses were tested to determine if there was a relationship between global quality of life and global job satisfaction scores: