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Vocational Rehabilitation for Persons with Multiple Disabilities Presented by R. Narasimham Chairman, Expert Committee for Developing Courses in Vocational.

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Presentation on theme: "Vocational Rehabilitation for Persons with Multiple Disabilities Presented by R. Narasimham Chairman, Expert Committee for Developing Courses in Vocational."— Presentation transcript:


2 Vocational Rehabilitation for Persons with Multiple Disabilities Presented by R. Narasimham Chairman, Expert Committee for Developing Courses in Vocational Rehab & Allied subjects (Rehabilitation Council of India) Concept Paper on Vocational Rehabilitation at State level workshop on Needs & Deeds of adults with multiple disabilities 15 th September 2011

3 Types of Multiple Disabilities Difficult to categorize as all sorts of permutations and combinations of physical and intellectual disabilities are seen with varying possibilities and different residual abilities. Learning and teaching methodologies change accordingly. Capacity to acquire academic and daily living skills also differ Vocational skills therefore have to be designed to suit residual abilities. No authentic information is available on the incidence of Multiple Disabilities 2VR for MD - NIEPMD

4 I.L.O. Vocational Rehabilitation (Disabled) Recommendations ( 1955 & 1983) the term vocational rehabilitation means that part of the continuous and coordinated process of rehabilitation which involves the provision of vocational services, such as vocational guidance, vocational training and selective placement, designed to enable a disabled person to secure and retain suitable employment (UNCRPD implies Progress also) Vocational Rehabilitation is the most tangible of all rehab measures that result in psychological and social well being and an inclusive atmosphere. 3VR for MD - NIEPMD

5 Concept of Vocational Rehabilitation The Concept of Vocational training & rehabilitation itself has come in just about 40 – 45 years ago in India. Even among the Developed Nations the concept dates back to the end of Second World War (1945) Focus has always been on medical or surgical intervention and education While teaching and learning are disability oriented, do not forget that the jobs are not created for the disabled, nor are they designed to suit the disabled. 4VR for MD - NIEPMD

6 Paradigm Shift from disability to job While it is true that medical, therapeutic and learning is influenced by the impairment, jobs are not so. Any Voc Rehab worker has to understand the needs of the employer and the job requirements. Jobs have to be modified or job operations have to be identified to suit the abilities of the person & not the other way. Job analysis is fundamental to vocational rehab. 5VR for MD - NIEPMD Doctors & Rehab team – Shift from Medical Model Disabled Person – Shift to Social Model

7 What is Job analysis? Job analysis is a systematic approach to defining the job role, description, requirements, responsibilities, evaluation, etc. It helps in finding out required level of education, skills, knowledge, training, etc for the job position. It also depicts the job worth i.e. measurable effectiveness of the job and contribution of job to the organization. 6VR for MD - NIEPMD

8 7 Job Analysis – How? How do you stitch a button ? Mark, Hold a needle, Thread the needle, Hold the button, insert needle with thread into cloth & button, pull out, repeat for a few times, tie the end, cut the thread. Now that is job analysis. We talked of tasks, jobs of Assistant to tailor & Assistant to Domestic Wireman & occupation of Tailor & Wireman How do you fix a Switch Board ? Mark, Cut, place the Switches and screw them. In the process, use the saw to cut, hold the switches in place, put the screws, hold the Screw Driver and turn it clockwise till it is firm

9 VR for MD - NIEPMD8 Task Analysis We discussed in detail about the Job analysis. We saw different tasks performed to complete a job. What are different parameters required for performing each of the tasks efficiently? You need to have different qualities for Threading the needle and fixing the Board Each task calls for certain physical requirements, education, training, intelligence, psychomotor coordination, decision making (Intelligence & experience) and so on……. Analyzing & identifying the required parameters is task analysis. Task analysis is the natural concomitant to job analysis.

10 VR for MD - NIEPMD9 Job Analysis Job analysis is needed to decide on the exact work tasks on which a disabled could be optimally employed. Job Analysis is one of the basic techniques for job identification or job development or client-oriented job. A job may be defined as a collection of tasks performed by a worker in a single establishment. A task is defined as one activity that requires exertion of human effort - mental or physical - for a specific purpose. An occupation (as we find in the National Classification of Occupations – More than 2500 Occupations) is defined as a group of similar jobs found in various establishments. It may be pointed out that even though the jobs may be similar there are different variables, which affect placement effort.

11 VR for MD - NIEPMD10 Job Variables - 4 Ms & 4 Ss Methods - Sewing by Hand, Machine etc… Materials - Sewing m/c operator Silk Vs Canvas Machines - Printing m/c Platen Vs Large automated m/c Measurement- varied Speed accuracy Precision Specialization - One man Shop Vs Plant Surroundings - Carpenter Inside Vs Outside Special Assignments - Personal Assistant, Combination of jobs Selected tasks - Clerk-cum-Typist Combination of work tasks

12 Vocational Evaluation Functional ability despite impairment Capacity to withstand physical, mental and emotional strain associated with the occupation Identify areas where the possibilities to enhance vocational potential Identify the vocational needs of the pwmd Assess skills Assess potential for retraining for re- employment Assess work environmental modification to suit the individual 11VR for MD - NIEPMD

13 12 RANGE OF EVALUATION Every job has certain attributes and can be performed efficiently only when the person has abilities. This is assessed primarily through subjective-objective assessment techniques and procedures. S --- SKILL K --- KNOWLEDGE A --- ABILITY (to work) P --- PHYSICAL CAPACITY A --- APTITUDE T --- TRAITS(Personality) I --- INTERESTS

14 VR for MD - NIEPMD13 Job Selection Work tolerance Stress Aspirations Future Prospects Socioeconomic Status Status Experience Training Education Personality Traits Interpersonal relations Aptitude Intelligence Physical potential Physical Requirements Disabled personSkilled Semi-Skilled Un-Skilled IndividualJob

15 Issues in Vocational Training Major issue - educational attainment both for vocational training & economic rehabilitation For example : Only 484 Schools for the Deaf all over India. We do not have any facility for the pwmd other than NIEPMD Difference of opinion in teaching methodologies for different disabilities and inadequate training of regular teachers to deal with disabilities under SSA Communication – verbal, written and mobility to reach Institutions 14VR for MD - NIEPMD

16 Vocational Counseling & Adjustment Training Counseling on Employment Market Counseling on Employment Market Parent Counseling Behaviour modification Adjustment Training in operations to make the disabled employable for short periods Adjustment Training in operations to make the disabled employable for short periods Entrepreneurship Development Program Pre Recruitment Training Pre Recruitment Training Worker Education Custom made skill development as required by the employer or the pwmd Retraining of persons with recently acquired disabilities 15VR for MD - NIEPMD

17 16 Preparing for VR Job Training: Identify the job profile. Assess the capacity and match the job to the individual. Train them to suit the job. Training in Institute: Break down the job operations into simple work tasks, repeat the skill training constantly so that the person is able to recall the skill. On-the-job training: To provide job orientation, names, locations, hours and wages, supervisor, other employees, work uniform etc. Group Rehabilitation programs Development of basic skills for specific employer requirements Setting up supported employment services such as Cooperatives, Home bound employment and job specific sheltered employment involving the parents/guardians

18 Open employment Means an employment status where the person is not employed in protective atmosphere but is competing with others in securing and retaining a job on a full time basis. Right to opportunity for competent employment of the pwd Organized Sector/ Formal sector Only 7% of the Work Force covering Govt., PSU, Local Administration and registered under the Factories Act etc….. Unorganized Sector/ Informal Sector 93% all others. Most of our placement is in the unorganized sector As per National Commission on Unorganized Sector 79% of the 395 million get less than Rs 20 per day as wages. 17VR for MD - NIEPMD

19 Supported Employment The supported employment may at times be a final solution to the placement of the particular person Mainly to be a source of inculcating work behaviour, work environment & function towards attaining production targets. Function as a nursery to target regular employment Creating community awareness of abilities of the disabled & community participation Advocacy 18VR for MD - NIEPMD

20 Self Help Groups Identification of the persons with disabilities in the geographical area Meeting of the Persons with disabilities along with their parents/families. Assist in choosing a leader or a representative from among the pwd, His/her job would be to contact Employers, collect raw-materials, give back the finished products to the employers, collection and distribution of payment etc. Leader/representative may be rotated once in two years or three years as their group feels. Liabilities /Assets/ profits equally distributed among members 19VR for MD - NIEPMD

21 Cooperative Cooperative is a formal Self Help Group with an elected leader Accounts etc are to be maintained as per Rules Annual inspection by the Coop Authorities Allocate certain percentage of money for administration Job orders to be varied and equitable distribution among members Major part of remuneration to be paid to the members 20VR for MD - NIEPMD

22 21 Remedial programs Focus on diminishing or solving to a great extent the issues faced by the PWMD Evaluation & continuous evaluation basic to all remedial programs Programs should be individualized Depends on degree of disability/retardation Duration of inactivity, specific difficulties noticed first, speed of change, attitude of client, parents, fear of activity Should be within the clients capability but offer a challenge Activities to be graded to increase the clients capability Effort required and/ or the time spent on type of activity must increase. Check lists and records should be maintained for future guidance

23 Examples of Compensatory Strategies for Behavior Work BehaviourVocational Impact Compensations/accommodations/ modifications/strategies Has difficulty following through on instructions from others Completing job applications Job promotions Loss of job Low self-esteem Identify learning/working styles Provide instructions in preferred learning style mode (auditory/visual/tactile); Provide feedback/ supervision Provide special assistive aids, accommodations, etc. prescribed to meet individualized needs Has difficulty sustaining attention in tasks or play activities Difficulty following multi-step Instructions; Increases risk for accidents for certain jobs; Increases risks for mistakes on-the-job Break tasks into short segments Gradually extend activities into longer units; Schedule breaks between tasks; Arrange environment to block visual/auditory distractions; Use earphones to block sound 22VR for MD - NIEPMD

24 Has difficulty working independently Problems in jobs such as sales where you need to be a self-starter; Problems in helping professions; Problems in jobs requiring travel from supervised work setting Develop a structured and clearly defined task; Work close to peer or supervisor; Help the consumer identify and practice his/her preferred learning/work style Displays disorientation to time Impact job success if pwd is frequently late; Problems with professions where schedules and appointments are required Use pocket calendar Develop written schedule for daily work or independent living routines; Use watch alarm or beeper to cue Has difficulty using public transportation Frequent absences or tardiness increase risk of losing job Have pwd ride the bus with counselor or peer Teach specific transportation skills required Work BehaviourVocational ImpactCompensations/accommodations/ modifications/strategies 23VR for MD - NIEPMD

25 Takes longer to do job than others Rules out production jobs Rules out assembly jobs Irritates other co-workers who work faster; Problems with jobs having deadlines Allow extra lead time Gradually decrease practice time while maintaining or increasing job demands; Use a timer to set pace and cue Has difficulty following oral instructions Failure to complete work assignments, Problems with attendance/ punctuality Aggravates supervisor Safety may be a factor Develop a list of written instructions, Provide diagrammatic instructions Provide hands on task demonstrations Has difficulty following written instructions May fail to complete work assignments, Difficulty completing job applications Difficulty with jobs requiring interpretation of written material Tape instructions Give oral instructions Provide hands on task demonstration Work BehaviourVocational ImpactCompensations/accommodations/ modifications/strategies 24VR for MD - NIEPMD

26 25 Job Induction Prepare the pwmd for employment: Education Skill level Adjustment Training Prepare for interview Introduce employer Work Personality Job Selection Prepare the Employer Job Analysis Job Development Job Identification Job Engineering Job Tryout Follow up Adjustment Case closure

27 Skills of pwd Madhuri has challenged the world around her with her strength, passion for painting and her head-pointer. Having no control over her body except the head-pointer, which she uses strapped on her forehead ? Madhuri paints boldly and daringly. She has been awarded the Outstanding Calcuttan Award for her achievements which include a degree from the Spastics Society of Eastern India in Commerce and a diploma in Computer Application. 26VR for MD - NIEPMD

28 More skills Narasimhalu is severely Orthopedically impaired, and is also afflicted with un - suppressible enthusiasm. He is an accomplished painter with a unique sense of colour. He won the second prize in painting for his water colour on paper in the South Zone Region. He has also done a computer course in Basic Computer Applications and HTML. He uses his foot and toes to operate the mouse and key board 27VR for MD - NIEPMD

29 Seeing is believing!!!! Severely disabled person assembling Electronic components on a Printed Circuit Board 28VR for MD - NIEPMD

30 Severe disabilities Remember – Key to reducing inequality is not charity or philanthropy but innovation and empowerment Telework situation where fact – to – face contacts are minimal would suit some of those with severe disabilities. By eliminating obstacles to communication the disability may give rise to broader employment avenues and assimilation of the pwmd. The persons with severe disabilities could be helped to network with others in the community, country and the world for companionship and wage earning. Remember the National Commission on Unorganized Sector, which constitutes the major chunk of work force – 79% of the 395 millions get less than Twenty Rupees per day. If we can help the pwmd get at least this amount, we are doing some service 29VR for MD - NIEPMD

31 Community Based Vocational Training (CBVT) The Author had the opportunity to introduce Community Based Vocational Training in rural areas suited to the local employment markets as early as Hundreds of such training programs were carried out, in all sorts of occupations – electrical, mechanical, agricultural, floriculture, mushroom culture, garments, screen printing and so on for less educated rural pwd. We can design programs to suit a small group of persons with similar and multiple disabilities. 30VR for MD - NIEPMD

32 Suitable Occupations? All jobs are suitable and no job is suitable A few components of each job can be performed Analyze each job Identify operations List out simple to complex tasks Train the candidates 31VR for MD - NIEPMD

33 Rehab Programs - Goals Remember!!! The rehabilitation program is not designed to cope with emergencies; its goal is to assist persons with disabilities to attain the best possible vocational adjustment, not the most expedient – nor the most convenient. Vocational rehabilitation is not a quick – fix solution, where the persons with disabilities gets rehabilitated as soon as they arrive. Jobs are not readily available – jobs are not made for the disabled, and the persons with disabilities himself is not fully ready for placement. In a majority of pwd approaching institutions – almost 95%, do not possess any vocational or employable skill. Among the pwmd almost none has any vocational skill. The institution takes proactive role in creating suitable facilities for evaluating the individual and placement. 32VR for MD - NIEPMD

34 R. Narasimham Consultant (Vocational Rehabilitation) # 5, Gokulam Colony West Mambalam Chennai Phone: 044 – Mobile: r n s i m h a g m a i l. c o m Website: 33VR for MD - NIEPMD Thank You

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