Article Summary

The impact of competitive integrated employment on economic, psychological, and physical health outcomes for individuals with intellectual and developmental disabilities

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A quick look:

Competitive Integrated Employment (CIE) has been well established in research and policy as the preferred outcome for individuals with intellectual and developmental disabilities (IDD) in the United States. However, without greater documentation and accurate assessment of the impact of CIE to improve the lives of individuals with IDD, we risk greatly undervaluing this key life experience. Subsequently this miscalculates the public policy related to CIE by not more fully investigating in its promotion. Therefore, the purpose of this scoping review was not to describe CIE as an outcome, but rather to examine CIE as a vehicle for achieving other life benefits as determined by previous literature. Specifically, the authors reviewed research to identify the level of evidence demonstrating an association between CIE and (a) economic, (b) psychological health, and (c) physical health outcomes for individual with IDD.

Key Findings:

The review of the research literature identified 17 studies that met criteria for inclusion. Collectively, these studies indicated positive results supporting the association between CIE and various outcome constructs examined, although the level of evidence varied across studies, which incorporated a range of methodological designs, including retrospective review of records, secondary data analysis, analysis of survey data, and a variety of non- and pre-experimental measures. Findings include:

  • Economic outcomes of CIE were reported most frequently, and also presented the strongest level of research evidence.
  • All studies examining economic outcome benefits for CIE-service participants included some measure of earnings, wages, or salary.
  • Participants in CIE earned more than their peers in segregated settings.
  • SE in CIE settings proved to be less costly than a sheltered workshop and more efficient from a worker’s perspective in terms of the economic benefits received relative to cost.
  • All studies examining psychological and physical health outcomes reported positive findings related to those engaged in CIE
  • CIE was linked to improvements in locus of control, self-determination, personal independence, autonomy, maladaptive behaviours, and quality of life.
  • CIE led to increased levels of community integration.

Putting It into Practice:       
This review has demonstrated that there is credible evidence for the benefit of CIE extending beyond simply achieving employment in and of itself. However, more training and technical assistance is needed to provide support to practitioners aiming to launch new initiatives and sustain their implementation of CIE.

More about this Article
The current review was developed to understand the state of the research literature concerning the economic, psychological and physical health benefits associated with CIE. Research findings clearly show that CIE leads to more economic prosperity and with it, greater access to community activities and inclusion, higher quality of life, greater independence, and better overall health. While these findings unilaterally support CIE, there needs to be a greater commitment to future research directed at examining how these critical individual factors play a role in the lives of individuals when CIE is the primary employment goal.


Article Citation: Taylor, Joshua; Avellone, Lauren; Brooke, Valerie; Wehman, Paul; Inge, Katherine; Schall, Carol, & Iwanaga, Kanko (2021). The impact of competitive integrated employment on economic, psychological, and physical health outcomes for individuals with intellectual and developmental disabilities. Journal of Applied Research in Intellectual Disabilities, DOI: 10.1111/jar.12974.

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Virginia Commonwealth University, Rehabilitation Research and Training Center (VCU-RRTC) is an equal opportunity/affirmative action institution providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran’s status, political affiliation, or disability.  The VCU-RRTC is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant #90RTEM0003).  NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). If special accommodations are needed, please contact Vicki Brooke at (804) 828-1851 VOICE or (804) 828-2494 TTY.