Learning Disabilities and Vocational Rehabilitation Carol A. Dowdy, Tom E.C. Smith, and Carl H. Nowell
Students with learning disabilities have received services in special education programs for many years. Unfortunately, many of these students continue to need services after they exit high schools. Vocational rehabilitation has begun to provide services for young adults with learning disabilities; however, there continues to be a discrepancy between the number of adults with learning disabilities who need vocational rehabilitation services and those who are receiving them. This article describes the definitions and eligibility criteria used by vocational rehabilitation agencies to serve adults with learning disabilities. By understanding the vocational rehabilitation system, teachers, it is hoped, will be better able to access these services for their students with learning disabilities.
S
tudents with learning disabilities (LD) have been served in special education programs for many years. Although this was one of the latest disabilities recognized, it is currently the largest single disability group that receives special education services in public schools. The 12th Annual Report to Congress (U.S. Department of Education, 1990) noted that in 1988-1989, 1.9 million students classified as learning disabled received special education services. This was 47.7% of the total number of students receiving special education services. Although the numbers of students in special education with learning disabilities have risen sharply over the past several years, adults with this disability still make up a small percentage of persons receiving services from vocational rehabilitation (VR) agencies. The number of clients with learning disabilities who were rehabilitated by vocational rehabilitation agencies increased from 1.3% to 4.9% between 1983 and 1988 (L.I. Mars, personal communication, April 9, 1990; Mars,
1986), but their number remains significantly smaller than the number of high school students with learning disabilities who are served in special education programs. In 1988-1989,1.3 million students with learning disabilities, ages 12 to 21, received special education services (U.S. Department of Education, 1990). Obviously, not all persons with learning disabilities need to be served by vocational rehabilitation agencies. However, the discrepancy between the number of adults who have learning disabilities and the number who receive vocational rehabilitation services suggests that some adults who are eligible for such services are not receiving them. Several reasons possibly explain the discrepancy between the number of teenagers with learning disabilities in special eduction programs and the number of adults with LD who receive vocational rehabilitation services. One of the most critical is the lack of information special education teachers possess about vocational rehabilitation services. Special education
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teachers, as well as young adults with learning disabilities, need to develop a better understanding of the vocational rehabilitation system in order to access services more efficiently. The purpose of this article is to present information that will explain how the vocational rehabilitation system deals with persons who have learning disabilities. The definition of LD used by the Rehabilitation Services Administration (RSA) will be presented, as well as diagnostic criteria and guidelines used for eligibility.
Definition Just as the field of special education has struggled to define learning disabilities, establish eligibility criteria, and provide appropriate services, the field of rehabilitation is currently faced with similar challenges (Szymanski, King, Parker, & Jenkins, 1989). Because of basic differences in the orientation of public school and VR programs, VR agencies have adopted their own definition and implemented separate diagnostic and eligibility criteria relating to providing services to persons with LD. Although the VR definitions and eligibility criteria better suit the needs of the adult service agency, the different approaches may have further limited the services provided to this group of individuals. One of the original roadblocks to providing VR services to persons with
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LD was that the RSA system recognized only mental or physical disabilities. States began to initiate the development and implementation of services to individuals with LD only after the Rehabilitation Services Administration's 1981 policy directive making specific learning disabilities a medically recognized disability (Gerber, 1981; Miller, Mulkey, & Kopp, 1984; Rehabilitation Services Administration, 1981). In 1985, RSA distributed a program policy directive to the state VR agencies that contained a definition recommended for adoption (Rehabilitation Services Administration, 1985). That definition stated the following:
ence to processing deficits involved in perceiving, understanding, and using spoken or written language concepts is similar to the statement in the Public Law 94-142 definition (Federal Register, 1977). All three definitions contain a list of manifestations of learning disabilities; although most of these overlap, the RSA definition exclusively lists attention, memory, coordination, social competence, and emotional maturity. These specific manifestations are extremely important in that they are used by vocational rehabilitation agencies as criteria for eligibility. The RSA definition does not include a clause excluding other primary handicapping conditions, as is in the NJCLD and P.L. 94-142 definitions, nor does it reference specific discrepancy criteria as found in the special education identification criteria issued in the Federal Register (1977). However, these two components of the definition and the identification criteria are inherent in the diagnostic criteria used by the majority of state vocational rehabilitation agencies.
A specific learning disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. This disorder manifests itself with a deficit in one or more of the following areas: attention, reasoning, processing memory, communication, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity, (p. 2) This definition is similar in many ways to the definitions of LD contained in Public Law 94-142 {Federal Register, 1977) and the definition of LD recommended by the National Joint Committee for Learning Disabilities (NJCLD) (National Joint Committee for Learning Disabilities, 1981). All three definitions attempt to describe persons who have learning difficulties that are not explained by other disabilities. Despite general similarities, the RSA definition differs from the other two in that it reflects the position that a learning disability is a lifelong (permanent) disability resulting from a central nervous system dysfunction as suggested in the definition recommended by the NJCLD for special education (National Joint Committee for Learning Disabilities, 1981). The definition of learning disabilities in Public Law 94-142 does not refer to the condition as a lifelong problem. The RSA definition's refer-
Diagnosis Most state vocational rehabilitation agencies require that a diagnosis of learning disabilities be made by a licensed physician or psychologist trained to identify persons with this condition. Because these professionals use the Diagnostic and Statistical Manual-3rd Edition Revised (DSM-III-R) (American Psychiatric Association, 1987) for diagnostic criteria, eligibility for vocational rehabilitation services is based on the DSM-III-R. The DSM-III-R does not include learning disabilities as a specific diagnostic category. The most logical categories used for persons with learning disabilities are Specific Delays in Developmental Disorders and Disruptive Behavior Disorders. These disorders generally begin in childhood or adolescence and persist in stable form (without remission or exacerbation) into adult life (American Psychiatric Association, 1987).
The Specific Developmental Disorders subclass in DSM-III-R includes disorders characterized by inadequate development of specific academic, language, speech, and motor skills. Part of the criteria requires that the inadequate development cannot be explained by demonstrable physical (including visual and hearing acuity) or neurological disorders, a pervasive developmental disorder, mental retardation, or deficient educational opportunities. Furthermore, the impairment must interfere significantly with school performance or activities of daily living. Achievement, measured by standardized, individually administered tests, must be markedly below expected levels, compared to the individual's intellectual capacity (measured by individually administered IQ tests). Areas included in Specific Developmental Disorders are arithmetic, reading, expressive writing, expressive (oral) language, receptive language, articulation, and motor skills. Examples of specific skills are listed for each area. For example, the area of expressive writing includes spelling, grammar, punctuation, and paragraph organization. The category Other Developmental Disorders is used as a diagnostic classification for additional developmental disorders that may be present but are not included in the Specific Developmental Disorder category. A final category that can be used for diagnosing individuals with learning disabilities is Disruptive Behavior Disorders. Under this category the two disorders applied to the LD population are Attention Dencit-Hyperactivity Disorder (ADHD) and Undifferentiated Attention Deficit Disorder (UADD). ADHD essentially refers to varying degrees of inattention, impulsiveness, and hyperactivity that are developmentally inappropriate. The disorder typically is manifested in most environments; however, the behaviors may be absent in novel, strictly controlled, individualized, or reinforcing situations. Behaviors are typically the most prevalent in situations requiring
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sustained attention. When signs of hyperactivity and impulsiveness are not present, the diagnosis Undifferentiated Attention Deficit Disorder is usually made. However, the validity of this diagnostic category is raised in DSM-IH-R (American Psychiatric Association, 1987).
Diagnosis and Referral Most state vocational rehabilitation agencies will not automatically accept a school's label of learning disabilities as an official diagnosis because of the additional diagnostic categories (attention, motor skills, and articulation) available to state vocational rehabilitation agencies and the requirement that persons making the diagnosis be licensed professionals. Thus, even in cases where a student has been served as learning disabled in schools for several years, the diagnostic process is usually repeated. Teachers must therefore be aware that their former students will not automatically receive vocational rehabilitation services simply because they were in special education. Any person can be referred to a state vocational rehabilitation agency for services. Referrals are frequently made by school special education programs, parents, and self-referrals. With the growing emphasis on the transition of students with learning disabilities from school to postschool environments, the likelihood increases that these students will be referred for vocational rehabilitation services. This fact alone makes it crucial that special education teachers understand how to access vocational rehabilitation services for their students. After referral, evaluation data are collected to determine if the individual is eligible for vocational rehabilitation services. The evaluation process begins with an initial intake interview conducted by an appropriate vocational rehabilitation counselor. Some states have designated counselors who work only with persons with learning disabilities;
however, general caseload counselors who work with persons with all disabilities are more common. The initial interview will focus on the individual's history, school records, and employment goals. During the interview, the counselor establishes the applicant's interest in the rehabilitation process and commitment to work. Throughout the interview the counselor will be noting the individual's characteristic that may be a handicap to employment or a strength in a job setting. With the applicant's permission, the counselor arranges to obtain information from a variety of relevant sources, including medical, previous psychological or vocational testing, and school records. Each individual will generally be referred for a current medical exam and a diagnostic assessment. This evaluation may include a comprehensive vocational assessment of career interests, functional limitations and capacities, as well as a test battery for diagnosis. For persons to receive appropriate vocational rehabilitation counseling and services, a thorough vocational evaluation is critical. Information obtained from the vocational evaluation enables vocational rehabilitation personnel to understand the person's strengths and weaknesses related to various jobs and necessary training. A comprehensive assessment and report from the persons conducting the evaluation is critical in providing the counselor with data to support eligibility for rehabilitation services (McCue, 1989; Vogel, 1989).
Eligibility Understanding the concept of eligibility is the key to understanding the vocational rehabilitation process. It is important to note that, unlike public schools, vocational rehabilitation programs are not an entitlement program. The diagnosis of learning disabilities by a licensed professional does not automatically entitle one to vocational rehabilitation services (Abbott, 1987). In
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other words, a person may be diagnosed as having a disability but may not be eligible for vocational rehabilitation services. Specific criteria are established and each case may potentially be monitored to assure that the eligibility criteria established at the federal level by RSA have been met. General criteria include the following: (a) the presence of a physical or mental disability that constitutes or results in a substantial handicap to employment; (b) a reasonable expectation that vocational rehabilitation services may benefit the individual in terms of employ ability. Many vocational rehabilitation counselors tend to think of a learning disability as primarily an academic disability that does not necessarily result in a vocational handicap. If the diagnostic process used has been modeled after a school battery, the assessment may be limited to measures of academic deficits and intelligence. This limited view of learning disabilities will not provide counselors with information about the impact of the LD characteristics, which can impede vocational success (National Joint Committee on Learning Disabilities, 1987). For example, an individual with only a reading, math, or expressive language deficit may be employed in an occupation that bypasses the disability (Simpson & Umbach, 1989)— for example, a job in landscaping would not necessarily require academic skills. Therefore, a counselor would not be able to document that the disability meets the requirements for eligibility or constitutes a vocational handicap requiring vocational rehabilitation services in order for the individual to obtain employment. With proper training, vocational rehabilitation counselors learn that rarely does an individual with a learning disability have isolated academic skill deficits. More frequently, he or she manifests a variety of behaviors that will limit vocational success just as they have created difficulties in aca-
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demic settings. In fact, a recent study showed that the problems and characteristics associated with learning disabilities persist, and even may worsen, into adulthood (Gerber et al., 1990). Characteristics frequently attributed to adults with learning disabilities include deficits in attention, reasoning, processing, memory, communication, coordination, social competence, and emotional maturity (Hawks et al., 1990; Johnson & Blalock, 1987; McCue, Shelly, & Goldstein, 1986; Newill, Goyette, & Fogarty, 1984; Patton & Polloway, 1982; Polloway, Smith, & Patton, 1984; Zwerlin, Smith, & Diffley, 1984). Vocational rehabilitation counselors are faced with the challenge of observing and documenting these characteristics during a relatively brief intake interview in order to appropriately determine eligibility. This process is complicated by the fact that learning disabilities are not as obvious as some other handicapping conditions, such as a major physical disability that leaves a person immobile. Rather than displaying characteristics that reveal an obvious disability, persons with learning disabilities are more likely to display indirect characteristics, such as arriving late for an appointment, limited eye contact, responding to questions in short, simple sentences, and providing limited background information. An individual who displays these kinds of behaviors may appear to the counselor to be an unmotivated, uncooperative applicant, when in fact he or she could have limitations in time management, organization, social skills, oral language, and long-term memory. It would require multiple services to address these limitations (Kopp, Miller, & Mulkey, 1984). Some aids have been developed to assist the vocational rehabilitation counselor in documenting the characteristics of learning disabilities. Comprehensive diagnostic batteries and vocational assessment can lead to a thorough investigation of the disability (Hawks et al., 1990; Hursh, 1984; McCue, 1989; Prickett, 1988). The LD Characteristics Checklist (Dowdy,
1990) and the Behavior Questionnaire and Rating Scale for the Learning Disabled (Koller, 1990) are also recommended as effective assessment tools. RSA has alerted the state vocational rehabilitation agencies to the importance of identifying the behaviors characteristic of learning disabilities. In the previously referenced RSA policy directive to state vocational rehabilitation agencies (Rehabilitation Services Administration, 1985), it was emphasized that characteristics such as problems with attention, memory, and social interaction may have greater implications for vocational planning and employment than those associated with poor academic performance. Therefore, a primary consideration for vocational rehabilitation professionals is documenting the manifestations of learning disabilities that can cause vocational problems.
Severe Handicap Determination Another important step in the vocational rehabilitation process is evaluating the individual to determine whether his or her specific learning disability constitutes a severe handicap. There has been resistance among some vocational rehabilitation counselors to coding an individual with learning disabilities as severely handicapped when the individual has no physical disabilities, has average to above-average intelligence, and manifests primarily academic deficiencies. Counselors are more likely to identify persons with paraplegia or quadriplegia as severely handicapped, even though a person with a learning disability may have a more difficult time experiencing job success than the person with the physical limitation. National data from RSA indicate that in 1988, only 50% of the rehabilitation clients with learning disabilities were determined to be severely handicapped, whereas approximately 70% of all other vocational rehabilitation clients were classified as severely handicapped (L.I.
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Mars, personal communication, April 9, 1990). An individual with a severe handicap is defined in the 1986 Amendments to the Rehabilitation Act of 1973 (Public Law 99-506) as an individual with handicaps who has a severe physical or mental disability that seriously limits one or more functional capacities (mobility, communication, self-care, selfdirection, work tolerance, work skills, or interpersonal skills) in terms of employ ability. Also, the vocational rehabilitation process must be expected to require multiple vocational rehabilitation services over an extended period of time. In 1990 RSA appointed a task force to study this and other critical issues raised in the application of the vocational rehabilitation process to clients with learning disabilities. The result was a comprehensive guide that assists counselors in understanding and accessing the severe vocational limitations imposed by learning disability characteristics, such as attention, memory, and social skill deficits (Rehabilitation Services Administration, 1990). This effort was critical, because many state vocational rehabilitation agencies are under an order of selection that requires them to provide services to persons with handicaps on a priority basis or exclusively. As vocational rehabilitation counselors become more aware of the severe limitations imposed by learning disabilities, more persons with this disability will be classified as severely handicapped.
Vocational Rehabilitation Services The focus of all services provided by VR agencies is on employment. These services are available to eligible individuals who are unemployed, at risk for losing their job, or underemployed. The comprehensive diagnostic assessment and intake process provides counselors with information about an applicant' s functional limitations, learning style, and functional capacities. After
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the person is determined to be eligible for VR services, the counselor utilizes the vocationally pertinent information to develop an Individualized Written Rehabilitation Program (IWRP). Following agreement of the plan by the client, rehabilitation services begin. Because IWRPs are individualized, there is no standard package of services for persons with learning disabilities. Counseling is at the core of the service program. Vocational rehabilitation counselors assist clients in career decisions and in identifying accommodations needed in postsecondary training sites and on the job. A key decision point is whether the client with a learning disability elects to go to college or some other form of postsecondary educational program. Many colleges and universities currently have programs specifically designed for students with learning disabilities. Vocational rehabilitation counselors should be able to help these students decide on an appropriate postsecondary education option. They also provide ongoing progress checks to monitor success and make adjustments as needed. Clients may be trained in a rehabilitation facility or receive partial or full support of college and/or technical school costs. Many times counselors will enlist the support of professionals in other agencies, such as mental health or special student services on a college campus, in an advocacy role for their client. However, all of these services must ultimately focus on the client obtaining and maintaining employment. Vocational rehabilitation services are not necessary for all adults with learning disabilities to reach their maximum vocational potential. However, when the need is present and eligibility can be supported, the vocational rehabilitation program can promote success in the life of the adult with a learning disability. Too often, young adults with learning disabilities who are eligible for vocational rehabilitation services, and who could benefit from such services, are not receiving them. Although this
could be the result of several factors, a primary reason is special education teachers' limited understanding of the vocational rehabilitation system. Limited understanding of special education services by vocational rehabilitation professionals also contributes to deficits in adult services. For young adults with learning disabilities to receive vocational rehabilitation services at appropriate levels, rehabilitation counselors and special educators must begin working together to better understand each other's systems. Agreeing on a common definition, characteristics, and nomenclature would be an excellent beginning in the development of a service delivery system that is a coordinated, lifelong system, rather than the series of services currently provided by different agencies. It is important for special education teachers and vocational rehabilitation counselors to continue to explore the vocational issues relating to individuals with learning disabilities and look for successful techniques in applying the education and rehabilitation process to such clients. It is just as important for adults with learning disabilities and their advocates to understand the vocational rehabilitation process and come to that agency as informed partners.
REFERENCES
Abbott, J. (1987, February). Accessing vocational education and vocational rehabilitation training and employment programs. Paper presented at the 1987 ACLD International Conference, San Antonio, TX. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author. Dowdy, C.A. (1990). Learning disability checklist. Assessment instrument submitted for publication. Federal Register. (1977, Thursday, December 29), 65082-65085. Washington, DC. Gerber, P.J. (1981). Learning disabilities and eligibility for vocational rehabilitation services: A chronology of events. Learning Disability Quarterly, 4, 423-425. Gerber, P.J., Schnieders, C.A., Paradise, L.V., Reiff, H.B., Ginsberg, R.J., & Popp, P.A. (1990). Persisting problems of adults with learning disabilities: Self-reported comparisons from their school-aged and adult years. Journal of Learning Disabilities, 23, 570-573. Hawks, R., Minkoff, E.H., Sautters, S., Sheldon, K.L., Steidle, E.F., & Hoffman, F.J. (1990). A model diagnostic battery for adults with learning disabilities in vocational rehabilitation. Learning Disabilities: A Multidisciplinary Journal, 1(3), 94-101. Hursh, N.C. (1984). Vocational evaluation of learning disabled adults. Journal of Rehabilitation, 45-52. Johnson, D.J., & Blalock, J.W. (1987). Adults with learning disabilities: Clinical studies. Orlando, FL: Grune & Stratton. Koller, J.R. (1990). Behavior questionnaire and ABOUT THE AUTHORS rating scale for the learning disabled. Unpublished assessment instrument, University Carol A. Dowdy is an associate professor at of Missouri, Columbia. the University of Alabama at Birmingham. She received her EdDfrom the University of Alabama Kopp, K.H., Miller, J.H., & Mulkey, S.W. and has worked closely with VR agencies to ex- (1984). The paradox of learning disabilipand services to young adults with LD. Tom ties: A stumbling block to rehabilitation. E.C. Smith is on the faculty in the Arkansas Journal of Rehabilitation, 50, 38-39. University Affiliated Program, University of Mars, L.I. (1986). Profile of learning disArkansas Medical Sciences campus, and has abled persons in the rehabilitation proworked extensively in the area of transition. He gram. American Rehabilitation, 12, 10-13. received his EdD from Texas Tech University. McCue, M. (1989). The role of assessment Carl H. No well received his MA from the in the vocational rehabilitation of adults University of Alabama. He is the rehabilitation with specific learning disabilities. Rehabilispecialist for the area of learning disabilities in tation Counseling Bulletin, 33(1), 18-37. the Division of Rehabilitation Services, AlabamaMcCue, P.M., Shelly, C , & Goldstein, G. Department of Education. Address: Carol A. (1986). Intellectual, academic, and neuroDowdy, Department of Special Education, Uni- psychological performance levels in learnversity of Alabama at Birmingham, Birminging disabled adults. Journal of Learning ham, AL 35294. Disabilities, 19, 233-236.
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Miller, J.H., Mulkey, S.W., & Kopp, K.H. velopment perspective. Journal of Learnservices for adults with specific learning (1984). Public rehabilitation services for ing Disabilities, 7, 179-186. disabilities. Journal of Rehabilitation, 9, individuals with specific learning disabil- Prickett, J.R. (1988). A statistical analysis of 49-55. ities. Journal of Rehabilitation, 50, 19-29. successful case closures in Iowa: Focus on Szymanski, E.M., King, J., Parker, R.M., learning disabilities. Journal of Job Place- & Jenkins, W.M. (1989). The state-federal National Joint Committee on Learning Disment, 10, 36-40. rehabilitation program: Interface with abilities. (1981). A position paper of the special education. Exceptional Children, 56, National Joint Committee on Learning Dis- Rehabilitation Services Administration. 70-77. (1981, July 27). Acceptance of specific abilities. Unpublished manuscript. learning disabilities as a medically rec- United States Department of Education. National Joint Committee on Learning Disognized disability program instruction. (1990). Twelfth annual report to Congress on abilities. (1987). Adults with learning disProgram Information Memorandum RSAthe implementation of the Education of the abilities: A call to action. Learning DisPI-81-22, pp. 1-7. Handicapped Act. Washington, DC: U.S. ability Quarterly, 9, 164-167. Office of Special Education and RehabiliRehabilitation Services Administration. Newill, B.H., Goyette, C.H., & Fogarty, (1985, January 24). Program policy directive. tation Services. T.W. (1984). Diagnosis and assessment of Washington, DC: U.S. Office of Special Vogel, S.A. (1989). Adults with language the adult with specific learning disabiliEducation and Rehabilitation Services. learning disorders: Definition, diagnosis, ties. Journal of Rehabilitation, 50, 34-39. and determination of eligibility for postRehabilitation Services Administration. Patton, J.R. & Polloway, E.A. (1982). The secondary and vocational rehabilitation (1990, September 28). Program assistance learning disabled: The adult years. Topics services. Rehabilitation Education, 3, 77-90. circular 90-7. Washington, DC: U.S. in Learning & Learning Disabilities, 2, Office of Special Education and Rehabili- Zwerlin, R.A., Smith, M., & Diffley, J. 79-88. tation Services. (1984). Vocational rehabilitation for learning disabled professionals. Albertson, NY: Polloway, E.E., Smith, J.D., & Patton, J.R. Simpson, R.G., & Umbach, B.T. (1989). Human Resources Center. Identifying and providing vocational (1984). Learning disabilities: An adult de-
(continued from p. 415) hensive curriculum for students with Vaillant, G.E. (1977). Adaptation to life. Ludlow, B., Luckasson, R., & Turnbull, A. (Eds.). (1988). Transitions to adult life for mild handicaps. Focus on Exceptional Chil- Boston: Little, Brown. persons with mental retardation: Principles dren, 21(8), 1-12. Wiederholt, J.L. (1974). Historical perspecand practices. Baltimore: Brookes. tives on the education of the learning disPolloway, E.A., Smith, J.D., & Patton, J.R. Patton, J.R., Cronin, M.E., Polloway, E.A., abled. In L. Mann & D.A. Sabatino (Eds.), (1984). Learning disabilities: An adult Robinson, G.A., & Hutchison, D. (1989). The second review of special education (pp. development perspective. Learning DisCurricular considerations: A life skills 103-152). Philadelphia: Journal of Special ability Quarterly, 7, 179-186. orientation. In G.A. Robinson, J.R. Patton, Education Press. E.A. Polloway, & L.R. Sargent (Eds.), Smith, J.D. (1991). Adult development models. Wiederholt, J.L., & Wolffe, K.E. (1990). Unpublished manuscript, Lynchburg Best practices in mental retardation (pp. Preparing problem learners for inde21-37). Reston, VA: Division on Mental College, Lynchburg, VA. pendent living. In D.D. Hammill & N.R. Retardation, Council for Exceptional Strauss, W., & Lehtinen, L. (1947). PsyBartel (Eds.), Teaching students with learnChildren. chopathology and education of the braining and behavior problems (5th ed., pp. Patton, J.R., & Polloway, E.A. (1982). The injured child. New York: Grune & 451-501). Boston: Allyn & Bacon. learning disabled: The adult years. Topics Stratton. Zigmond, N. (1990). Rethinking secondary in Learning & Learning Disabilities, 2(3), Trapani, C. (1990). Transition goals for adoles- school programs for students with learn79-88. cents with learning disabilities. Austin, TX: ing disabilities. Focus on Exceptional ChilPolloway, E.A., Patton, J.R., Epstein, dren, 23(1), 1-21. PRO-ED. M.H., & Smith, T.E.C. (1989). Compre-
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Students with learning disabilities have received services in special education programs for many years. Unfortunately, many of these students continue to need services after they exit high schools. Vocational rehabilitation has begun to provide services for young adults with learning disabilities; however, there continues to be a discrepancy between the number of adults with learning disabilities who need vocational rehabilitation services and those who are receiving them. This article describes the definitions and eligibility criteria used by vocational rehabilitation agencies to serve adults with learning disabilities. By understanding the vocational rehabilitation system, teachers, it is hoped, will be better able to access these services for their students with learning disabilities.
S
tudents with learning disabilities (LD) have been served in special education programs for many years. Although this was one of the latest disabilities recognized, it is currently the largest single disability group that receives special education services in public schools. The 12th Annual Report to Congress (U.S. Department of Education, 1990) noted that in 1988-1989, 1.9 million students classified as learning disabled received special education services. This was 47.7% of the total number of students receiving special education services. Although the numbers of students in special education with learning disabilities have risen sharply over the past several years, adults with this disability still make up a small percentage of persons receiving services from vocational rehabilitation (VR) agencies. The number of clients with learning disabilities who were rehabilitated by vocational rehabilitation agencies increased from 1.3% to 4.9% between 1983 and 1988 (L.I. Mars, personal communication, April 9, 1990; Mars,
1986), but their number remains significantly smaller than the number of high school students with learning disabilities who are served in special education programs. In 1988-1989,1.3 million students with learning disabilities, ages 12 to 21, received special education services (U.S. Department of Education, 1990). Obviously, not all persons with learning disabilities need to be served by vocational rehabilitation agencies. However, the discrepancy between the number of adults who have learning disabilities and the number who receive vocational rehabilitation services suggests that some adults who are eligible for such services are not receiving them. Several reasons possibly explain the discrepancy between the number of teenagers with learning disabilities in special eduction programs and the number of adults with LD who receive vocational rehabilitation services. One of the most critical is the lack of information special education teachers possess about vocational rehabilitation services. Special education
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teachers, as well as young adults with learning disabilities, need to develop a better understanding of the vocational rehabilitation system in order to access services more efficiently. The purpose of this article is to present information that will explain how the vocational rehabilitation system deals with persons who have learning disabilities. The definition of LD used by the Rehabilitation Services Administration (RSA) will be presented, as well as diagnostic criteria and guidelines used for eligibility.
Definition Just as the field of special education has struggled to define learning disabilities, establish eligibility criteria, and provide appropriate services, the field of rehabilitation is currently faced with similar challenges (Szymanski, King, Parker, & Jenkins, 1989). Because of basic differences in the orientation of public school and VR programs, VR agencies have adopted their own definition and implemented separate diagnostic and eligibility criteria relating to providing services to persons with LD. Although the VR definitions and eligibility criteria better suit the needs of the adult service agency, the different approaches may have further limited the services provided to this group of individuals. One of the original roadblocks to providing VR services to persons with
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LD was that the RSA system recognized only mental or physical disabilities. States began to initiate the development and implementation of services to individuals with LD only after the Rehabilitation Services Administration's 1981 policy directive making specific learning disabilities a medically recognized disability (Gerber, 1981; Miller, Mulkey, & Kopp, 1984; Rehabilitation Services Administration, 1981). In 1985, RSA distributed a program policy directive to the state VR agencies that contained a definition recommended for adoption (Rehabilitation Services Administration, 1985). That definition stated the following:
ence to processing deficits involved in perceiving, understanding, and using spoken or written language concepts is similar to the statement in the Public Law 94-142 definition (Federal Register, 1977). All three definitions contain a list of manifestations of learning disabilities; although most of these overlap, the RSA definition exclusively lists attention, memory, coordination, social competence, and emotional maturity. These specific manifestations are extremely important in that they are used by vocational rehabilitation agencies as criteria for eligibility. The RSA definition does not include a clause excluding other primary handicapping conditions, as is in the NJCLD and P.L. 94-142 definitions, nor does it reference specific discrepancy criteria as found in the special education identification criteria issued in the Federal Register (1977). However, these two components of the definition and the identification criteria are inherent in the diagnostic criteria used by the majority of state vocational rehabilitation agencies.
A specific learning disability is a disorder in one or more of the central nervous system processes involved in perceiving, understanding, and/or using concepts through verbal (spoken or written) language or nonverbal means. This disorder manifests itself with a deficit in one or more of the following areas: attention, reasoning, processing memory, communication, reading, writing, spelling, calculation, coordination, social competence, and emotional maturity, (p. 2) This definition is similar in many ways to the definitions of LD contained in Public Law 94-142 {Federal Register, 1977) and the definition of LD recommended by the National Joint Committee for Learning Disabilities (NJCLD) (National Joint Committee for Learning Disabilities, 1981). All three definitions attempt to describe persons who have learning difficulties that are not explained by other disabilities. Despite general similarities, the RSA definition differs from the other two in that it reflects the position that a learning disability is a lifelong (permanent) disability resulting from a central nervous system dysfunction as suggested in the definition recommended by the NJCLD for special education (National Joint Committee for Learning Disabilities, 1981). The definition of learning disabilities in Public Law 94-142 does not refer to the condition as a lifelong problem. The RSA definition's refer-
Diagnosis Most state vocational rehabilitation agencies require that a diagnosis of learning disabilities be made by a licensed physician or psychologist trained to identify persons with this condition. Because these professionals use the Diagnostic and Statistical Manual-3rd Edition Revised (DSM-III-R) (American Psychiatric Association, 1987) for diagnostic criteria, eligibility for vocational rehabilitation services is based on the DSM-III-R. The DSM-III-R does not include learning disabilities as a specific diagnostic category. The most logical categories used for persons with learning disabilities are Specific Delays in Developmental Disorders and Disruptive Behavior Disorders. These disorders generally begin in childhood or adolescence and persist in stable form (without remission or exacerbation) into adult life (American Psychiatric Association, 1987).
The Specific Developmental Disorders subclass in DSM-III-R includes disorders characterized by inadequate development of specific academic, language, speech, and motor skills. Part of the criteria requires that the inadequate development cannot be explained by demonstrable physical (including visual and hearing acuity) or neurological disorders, a pervasive developmental disorder, mental retardation, or deficient educational opportunities. Furthermore, the impairment must interfere significantly with school performance or activities of daily living. Achievement, measured by standardized, individually administered tests, must be markedly below expected levels, compared to the individual's intellectual capacity (measured by individually administered IQ tests). Areas included in Specific Developmental Disorders are arithmetic, reading, expressive writing, expressive (oral) language, receptive language, articulation, and motor skills. Examples of specific skills are listed for each area. For example, the area of expressive writing includes spelling, grammar, punctuation, and paragraph organization. The category Other Developmental Disorders is used as a diagnostic classification for additional developmental disorders that may be present but are not included in the Specific Developmental Disorder category. A final category that can be used for diagnosing individuals with learning disabilities is Disruptive Behavior Disorders. Under this category the two disorders applied to the LD population are Attention Dencit-Hyperactivity Disorder (ADHD) and Undifferentiated Attention Deficit Disorder (UADD). ADHD essentially refers to varying degrees of inattention, impulsiveness, and hyperactivity that are developmentally inappropriate. The disorder typically is manifested in most environments; however, the behaviors may be absent in novel, strictly controlled, individualized, or reinforcing situations. Behaviors are typically the most prevalent in situations requiring
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sustained attention. When signs of hyperactivity and impulsiveness are not present, the diagnosis Undifferentiated Attention Deficit Disorder is usually made. However, the validity of this diagnostic category is raised in DSM-IH-R (American Psychiatric Association, 1987).
Diagnosis and Referral Most state vocational rehabilitation agencies will not automatically accept a school's label of learning disabilities as an official diagnosis because of the additional diagnostic categories (attention, motor skills, and articulation) available to state vocational rehabilitation agencies and the requirement that persons making the diagnosis be licensed professionals. Thus, even in cases where a student has been served as learning disabled in schools for several years, the diagnostic process is usually repeated. Teachers must therefore be aware that their former students will not automatically receive vocational rehabilitation services simply because they were in special education. Any person can be referred to a state vocational rehabilitation agency for services. Referrals are frequently made by school special education programs, parents, and self-referrals. With the growing emphasis on the transition of students with learning disabilities from school to postschool environments, the likelihood increases that these students will be referred for vocational rehabilitation services. This fact alone makes it crucial that special education teachers understand how to access vocational rehabilitation services for their students. After referral, evaluation data are collected to determine if the individual is eligible for vocational rehabilitation services. The evaluation process begins with an initial intake interview conducted by an appropriate vocational rehabilitation counselor. Some states have designated counselors who work only with persons with learning disabilities;
however, general caseload counselors who work with persons with all disabilities are more common. The initial interview will focus on the individual's history, school records, and employment goals. During the interview, the counselor establishes the applicant's interest in the rehabilitation process and commitment to work. Throughout the interview the counselor will be noting the individual's characteristic that may be a handicap to employment or a strength in a job setting. With the applicant's permission, the counselor arranges to obtain information from a variety of relevant sources, including medical, previous psychological or vocational testing, and school records. Each individual will generally be referred for a current medical exam and a diagnostic assessment. This evaluation may include a comprehensive vocational assessment of career interests, functional limitations and capacities, as well as a test battery for diagnosis. For persons to receive appropriate vocational rehabilitation counseling and services, a thorough vocational evaluation is critical. Information obtained from the vocational evaluation enables vocational rehabilitation personnel to understand the person's strengths and weaknesses related to various jobs and necessary training. A comprehensive assessment and report from the persons conducting the evaluation is critical in providing the counselor with data to support eligibility for rehabilitation services (McCue, 1989; Vogel, 1989).
Eligibility Understanding the concept of eligibility is the key to understanding the vocational rehabilitation process. It is important to note that, unlike public schools, vocational rehabilitation programs are not an entitlement program. The diagnosis of learning disabilities by a licensed professional does not automatically entitle one to vocational rehabilitation services (Abbott, 1987). In
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other words, a person may be diagnosed as having a disability but may not be eligible for vocational rehabilitation services. Specific criteria are established and each case may potentially be monitored to assure that the eligibility criteria established at the federal level by RSA have been met. General criteria include the following: (a) the presence of a physical or mental disability that constitutes or results in a substantial handicap to employment; (b) a reasonable expectation that vocational rehabilitation services may benefit the individual in terms of employ ability. Many vocational rehabilitation counselors tend to think of a learning disability as primarily an academic disability that does not necessarily result in a vocational handicap. If the diagnostic process used has been modeled after a school battery, the assessment may be limited to measures of academic deficits and intelligence. This limited view of learning disabilities will not provide counselors with information about the impact of the LD characteristics, which can impede vocational success (National Joint Committee on Learning Disabilities, 1987). For example, an individual with only a reading, math, or expressive language deficit may be employed in an occupation that bypasses the disability (Simpson & Umbach, 1989)— for example, a job in landscaping would not necessarily require academic skills. Therefore, a counselor would not be able to document that the disability meets the requirements for eligibility or constitutes a vocational handicap requiring vocational rehabilitation services in order for the individual to obtain employment. With proper training, vocational rehabilitation counselors learn that rarely does an individual with a learning disability have isolated academic skill deficits. More frequently, he or she manifests a variety of behaviors that will limit vocational success just as they have created difficulties in aca-
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demic settings. In fact, a recent study showed that the problems and characteristics associated with learning disabilities persist, and even may worsen, into adulthood (Gerber et al., 1990). Characteristics frequently attributed to adults with learning disabilities include deficits in attention, reasoning, processing, memory, communication, coordination, social competence, and emotional maturity (Hawks et al., 1990; Johnson & Blalock, 1987; McCue, Shelly, & Goldstein, 1986; Newill, Goyette, & Fogarty, 1984; Patton & Polloway, 1982; Polloway, Smith, & Patton, 1984; Zwerlin, Smith, & Diffley, 1984). Vocational rehabilitation counselors are faced with the challenge of observing and documenting these characteristics during a relatively brief intake interview in order to appropriately determine eligibility. This process is complicated by the fact that learning disabilities are not as obvious as some other handicapping conditions, such as a major physical disability that leaves a person immobile. Rather than displaying characteristics that reveal an obvious disability, persons with learning disabilities are more likely to display indirect characteristics, such as arriving late for an appointment, limited eye contact, responding to questions in short, simple sentences, and providing limited background information. An individual who displays these kinds of behaviors may appear to the counselor to be an unmotivated, uncooperative applicant, when in fact he or she could have limitations in time management, organization, social skills, oral language, and long-term memory. It would require multiple services to address these limitations (Kopp, Miller, & Mulkey, 1984). Some aids have been developed to assist the vocational rehabilitation counselor in documenting the characteristics of learning disabilities. Comprehensive diagnostic batteries and vocational assessment can lead to a thorough investigation of the disability (Hawks et al., 1990; Hursh, 1984; McCue, 1989; Prickett, 1988). The LD Characteristics Checklist (Dowdy,
1990) and the Behavior Questionnaire and Rating Scale for the Learning Disabled (Koller, 1990) are also recommended as effective assessment tools. RSA has alerted the state vocational rehabilitation agencies to the importance of identifying the behaviors characteristic of learning disabilities. In the previously referenced RSA policy directive to state vocational rehabilitation agencies (Rehabilitation Services Administration, 1985), it was emphasized that characteristics such as problems with attention, memory, and social interaction may have greater implications for vocational planning and employment than those associated with poor academic performance. Therefore, a primary consideration for vocational rehabilitation professionals is documenting the manifestations of learning disabilities that can cause vocational problems.
Severe Handicap Determination Another important step in the vocational rehabilitation process is evaluating the individual to determine whether his or her specific learning disability constitutes a severe handicap. There has been resistance among some vocational rehabilitation counselors to coding an individual with learning disabilities as severely handicapped when the individual has no physical disabilities, has average to above-average intelligence, and manifests primarily academic deficiencies. Counselors are more likely to identify persons with paraplegia or quadriplegia as severely handicapped, even though a person with a learning disability may have a more difficult time experiencing job success than the person with the physical limitation. National data from RSA indicate that in 1988, only 50% of the rehabilitation clients with learning disabilities were determined to be severely handicapped, whereas approximately 70% of all other vocational rehabilitation clients were classified as severely handicapped (L.I.
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Mars, personal communication, April 9, 1990). An individual with a severe handicap is defined in the 1986 Amendments to the Rehabilitation Act of 1973 (Public Law 99-506) as an individual with handicaps who has a severe physical or mental disability that seriously limits one or more functional capacities (mobility, communication, self-care, selfdirection, work tolerance, work skills, or interpersonal skills) in terms of employ ability. Also, the vocational rehabilitation process must be expected to require multiple vocational rehabilitation services over an extended period of time. In 1990 RSA appointed a task force to study this and other critical issues raised in the application of the vocational rehabilitation process to clients with learning disabilities. The result was a comprehensive guide that assists counselors in understanding and accessing the severe vocational limitations imposed by learning disability characteristics, such as attention, memory, and social skill deficits (Rehabilitation Services Administration, 1990). This effort was critical, because many state vocational rehabilitation agencies are under an order of selection that requires them to provide services to persons with handicaps on a priority basis or exclusively. As vocational rehabilitation counselors become more aware of the severe limitations imposed by learning disabilities, more persons with this disability will be classified as severely handicapped.
Vocational Rehabilitation Services The focus of all services provided by VR agencies is on employment. These services are available to eligible individuals who are unemployed, at risk for losing their job, or underemployed. The comprehensive diagnostic assessment and intake process provides counselors with information about an applicant' s functional limitations, learning style, and functional capacities. After
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the person is determined to be eligible for VR services, the counselor utilizes the vocationally pertinent information to develop an Individualized Written Rehabilitation Program (IWRP). Following agreement of the plan by the client, rehabilitation services begin. Because IWRPs are individualized, there is no standard package of services for persons with learning disabilities. Counseling is at the core of the service program. Vocational rehabilitation counselors assist clients in career decisions and in identifying accommodations needed in postsecondary training sites and on the job. A key decision point is whether the client with a learning disability elects to go to college or some other form of postsecondary educational program. Many colleges and universities currently have programs specifically designed for students with learning disabilities. Vocational rehabilitation counselors should be able to help these students decide on an appropriate postsecondary education option. They also provide ongoing progress checks to monitor success and make adjustments as needed. Clients may be trained in a rehabilitation facility or receive partial or full support of college and/or technical school costs. Many times counselors will enlist the support of professionals in other agencies, such as mental health or special student services on a college campus, in an advocacy role for their client. However, all of these services must ultimately focus on the client obtaining and maintaining employment. Vocational rehabilitation services are not necessary for all adults with learning disabilities to reach their maximum vocational potential. However, when the need is present and eligibility can be supported, the vocational rehabilitation program can promote success in the life of the adult with a learning disability. Too often, young adults with learning disabilities who are eligible for vocational rehabilitation services, and who could benefit from such services, are not receiving them. Although this
could be the result of several factors, a primary reason is special education teachers' limited understanding of the vocational rehabilitation system. Limited understanding of special education services by vocational rehabilitation professionals also contributes to deficits in adult services. For young adults with learning disabilities to receive vocational rehabilitation services at appropriate levels, rehabilitation counselors and special educators must begin working together to better understand each other's systems. Agreeing on a common definition, characteristics, and nomenclature would be an excellent beginning in the development of a service delivery system that is a coordinated, lifelong system, rather than the series of services currently provided by different agencies. It is important for special education teachers and vocational rehabilitation counselors to continue to explore the vocational issues relating to individuals with learning disabilities and look for successful techniques in applying the education and rehabilitation process to such clients. It is just as important for adults with learning disabilities and their advocates to understand the vocational rehabilitation process and come to that agency as informed partners.
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Abbott, J. (1987, February). Accessing vocational education and vocational rehabilitation training and employment programs. Paper presented at the 1987 ACLD International Conference, San Antonio, TX. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author. Dowdy, C.A. (1990). Learning disability checklist. Assessment instrument submitted for publication. Federal Register. (1977, Thursday, December 29), 65082-65085. Washington, DC. Gerber, P.J. (1981). Learning disabilities and eligibility for vocational rehabilitation services: A chronology of events. Learning Disability Quarterly, 4, 423-425. Gerber, P.J., Schnieders, C.A., Paradise, L.V., Reiff, H.B., Ginsberg, R.J., & Popp, P.A. (1990). Persisting problems of adults with learning disabilities: Self-reported comparisons from their school-aged and adult years. Journal of Learning Disabilities, 23, 570-573. Hawks, R., Minkoff, E.H., Sautters, S., Sheldon, K.L., Steidle, E.F., & Hoffman, F.J. (1990). A model diagnostic battery for adults with learning disabilities in vocational rehabilitation. Learning Disabilities: A Multidisciplinary Journal, 1(3), 94-101. Hursh, N.C. (1984). Vocational evaluation of learning disabled adults. Journal of Rehabilitation, 45-52. Johnson, D.J., & Blalock, J.W. (1987). Adults with learning disabilities: Clinical studies. Orlando, FL: Grune & Stratton. Koller, J.R. (1990). Behavior questionnaire and ABOUT THE AUTHORS rating scale for the learning disabled. Unpublished assessment instrument, University Carol A. Dowdy is an associate professor at of Missouri, Columbia. the University of Alabama at Birmingham. She received her EdDfrom the University of Alabama Kopp, K.H., Miller, J.H., & Mulkey, S.W. and has worked closely with VR agencies to ex- (1984). The paradox of learning disabilipand services to young adults with LD. Tom ties: A stumbling block to rehabilitation. E.C. Smith is on the faculty in the Arkansas Journal of Rehabilitation, 50, 38-39. University Affiliated Program, University of Mars, L.I. (1986). Profile of learning disArkansas Medical Sciences campus, and has abled persons in the rehabilitation proworked extensively in the area of transition. He gram. American Rehabilitation, 12, 10-13. received his EdD from Texas Tech University. McCue, M. (1989). The role of assessment Carl H. No well received his MA from the in the vocational rehabilitation of adults University of Alabama. He is the rehabilitation with specific learning disabilities. Rehabilispecialist for the area of learning disabilities in tation Counseling Bulletin, 33(1), 18-37. the Division of Rehabilitation Services, AlabamaMcCue, P.M., Shelly, C , & Goldstein, G. Department of Education. Address: Carol A. (1986). Intellectual, academic, and neuroDowdy, Department of Special Education, Uni- psychological performance levels in learnversity of Alabama at Birmingham, Birminging disabled adults. Journal of Learning ham, AL 35294. Disabilities, 19, 233-236.
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