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Vocational Rehabilitation for Persons with Multiple
Disabilities
Presented byR. Narasimham
Chairman, Expert Committee for Developing Courses in
Vocational Rehab & Allied subjects (Rehabilitation Council of India)
Concept Paper on Vocational Rehabilitation at Statelevel workshop on
“Needs & Deeds of adults with multiple disabilities”
15th September 2011
Types of Multiple DisabilitiesDifficult 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
I.L.O. Vocational Rehabilitation (Disabled)Recommendations ( 1955 & 1983)
A 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)
A 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
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.
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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.
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Doctors & Rehab team – Shift from Medical Model
Disabled Person – Shift to Social Model
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.
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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
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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.
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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.
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Job Variables - 4 Ms & 4 SsJob 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
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
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RANGE OF EVALUATIONRANGE OF EVALUATIONEvery 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 --- SKILLK --- KNOWLEDGEA --- ABILITY (to work)P --- PHYSICAL CAPACITYA --- APTITUDET --- TRAITS(Personality)I --- INTERESTS
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Job SelectionJob Selection
Work tolerance Stress
Aspirations Future Prospects
Socioeconomic Status Status
Experience Experience
Training Training
Education Education
Personality Traits Interpersonal relations
Aptitude Aptitude
Intelligence Intelligence
Physical potential Physical Requirements
Disabled personSkilled Semi-Skilled Un-Skilled
IndividualJob
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
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Vocational Counseling & Adjustment Training
Counseling on Employment MarketParent CounselingBehaviour modification Adjustment Training in operations to
make the disabled employable for short periods
Entrepreneurship Development ProgramPre Recruitment TrainingWorker Education Custom made skill development as
required by the employer or the pwmdRetraining of persons with recently acquired
disabilities 15VR for MD - NIEPMD
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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
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.
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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
Advocacy18VR for MD - NIEPMD
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
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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
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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
Examples of Compensatory Strategies for BehaviorWork Behaviour Vocational Impact Compensations/accommodations/
modifications/strategies
Has difficulty following through on instructions from others
Completing job applicationsJob promotionsLoss of jobLow self-esteem
Identify learning/working stylesProvide instructions in preferred learning style mode(auditory/visual/tactile); Provide feedback/ supervisionProvide special assistive aids, accommodations, etc. prescribed to meet individualized needs
Has difficulty sustaining attention in tasks or play activities
Difficulty following multi-stepInstructions; Increases risk for accidents for certain jobs; Increases risks for mistakes on-the-job
Break tasks into short segmentsGradually extend activities into longer units; Schedule breaks between tasks; Arrange environment to block visual/auditory distractions; Use earphones to block sound
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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 calendarDevelop 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 peerTeach specific transportation skills required
Work Behaviour Vocational Impact Compensations/accommodations/modifications/strategies
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Takes longer to do job than others
Rules out production jobsRules out assembly jobsIrritates other co-workers who work faster; Problems with jobs having deadlines
Allow extra lead timeGradually 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 supervisorSafety 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 applicationsDifficulty with jobs requiring interpretation of written material
Tape instructionsGive oral instructionsProvide hands on task demonstration
Work Behaviour Vocational Impact Compensations/accommodations/modifications/strategies
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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
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.
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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
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Seeing is believing!!!!
Severely disabled
person assembling
Electronic
components on a
Printed Circuit
Board
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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
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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 1988.
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
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
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.
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R. NarasimhamConsultant
(Vocational Rehabilitation)# 5, Gokulam Colony
West MambalamChennai - 600033
Phone: 044 – 42614181Mobile: 9840714181
Email- r n s i m h a m @ g m a i l. c o mWebsite: www.aidthedisabled.org
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Thank You