Women With Intellectual Disabilities: Finding a Place in the World: Finding a Place on the World

Other countries have targeted services, such as BizLink, Singapore More than employment service agencies for people with disabilities operate in China , where the Chinese Disabled Persons' Federation has a leading role in fostering employment. The aim is to find a match that will lead to viable longer term employment and a life-long career The idea is to employ people first, before they are trained, to help dispel beliefs that disabled people cannot perform a particular job — Several successful user-controlled disability employment services have been launched in recent years:.

In Rio de Janeiro, Brazil, the Centro de Vida Independiente serves as an employment broker and ongoing support agency for disabled people Owned by disabled people's organizations , it invests in and supports companies to promote disability employment equity targets , In India the National Centre for Promotion of Employment for Disabled People sensitizes the corporate world, campaigns for access, promotes education, and raises awareness.

These programmes suggest that disabled people's organizations could expand their range of activities for improving disability employment — such as job search and job matching, training in technology and other job skills, and in interview skills. Disability management refers to interventions applied to individuals in employment who develop a health condition or disability. The main elements of disability management are generally effective case management, education of supervisors, workplace accommodation, and an early return to work with appropriate supports The Canadian National Institute of Disability Management and Research is an international resource that promotes education, training, and research on workplace-based reintegration — the process that maintains workers' abilities while reducing costs of disability for employers and governments.

In the United Kingdom the Pathways to Work programme is an initiative providing support in the fields of employment and health for people claiming the Employment and Support Allowance. It consists of mandatory work-related interviews and a range of services to help disabled people and those with health conditions move into work.

Personal advisers offer help in finding jobs, work-related training, and assistance in managing disabilities or health conditions. Early research with a sample of beneficiaries found that the programme increased the probability of being employed by 7. People with disabilities are not a homogeneous group, and some subgroups require tailored approaches. The problems of impaired hearing, for instance, will differ from those of being blind , Particular issues arise for people who have intermittent or episodic problems, such those with mental health difficulties.

Organizations with established disability management programmes have improved the rates of return to work see Box 8. Returning to work in Malaysia. Social security programmes help people with disabilities engage in community and working life. Whether financed by social insurance or through tax-funded benefits, cash payments and in-kind benefits can provide a means of more Vocational rehabilitation services develop or restore the capabilities of people with disabilities so they can participate in the competitive labour market.

The services usually relate to job training, counselling, and placement. For example, in Thailand the Redemptorist Vocational School for the Disabled offers job placement as well as training in computer skills and business management Mainstream vocational guidance and training programmes are less segregating than dedicated vocational training programmes. In OECD countries there is insufficient investment in rehabilitation and employment measures, and take-up is low In developing countries, vocational services tend to consist of small rehabilitation and training programmes 9 , Because of their high costs, such programmes fail to reach a significant proportion of their target group Furthermore, traditional training programmes — focused on a limited range of specialized technical skills and provided in segregated centres — have not put many people with disabilities into jobs 38 , Such programmes are typically in urban areas, often distant from where people with disabilities live.

The trades they teach — such as carpentry and shoemaking — are frequently not responsive to changes in the labour market. In addition, an underlying assumption of these programmes tends to be that people with disabilities are capable of only a limited number of occupations.

Apart from imparting technical skills, recent programmes have also concentrated on improving the self-confidence of trainees and raising awareness of the wider business environment. The Persons with Disabilities' Self-Initiative to Development programme in Bangladesh helps people with disabilities form self-help organizations within the community In Soweto, South Africa, training in competencies forms part of an entrepreneurship training programme, and the survival rate of businesses has been high Trainers are local artisans who provide trainees with the skills to become self-reliant in the community.

In Nigeria participants are given training as well as help with microfinance, so that they can be self-employed when they have finished the programme In Cambodia a successful home-based peer-training programme encourages village entrepreneurs in rural villages to teach technical and business skills to people with disabilities In Australia a project providing computer training to people with recent spinal cord injuries — while still in hospital — has increased the rates of return to further education and training or work In the United States collaboration between the government and private enterprise provides summer internships to hundreds of young people with disabilities.

This mentoring project — raising career awareness and building skills — has in many cases led to permanent placements at the employers offering the internships Being able to keep in touch with rehabilitation centres, and to build on earlier training, is important. The Leprosy Mission in India sponsors associations of alumni from its vocational rehabilitation centres, enabling those trained to keep in touch with other graduates and with the training centres see Box 8.

Vocational training at the Leprosy Mission. The Leprosy Mission in India runs vocational training centres for young people affected by leprosy. Students are taught a wide range of technical skills — including car repairing, tailoring, welding, more Promoting employment and the development of livelihoods is often undertaken through community-based rehabilitation CBR , discussed throughout this Report. Interventions typically aim to:. CBR also seeks to create support in the community for including people with disabilities. A resource from the ILO offers examples of good practices on CBR and employment, together with practical suggestions for skills development, self-employment, and access to the job market Despite these promising initiatives, the evaluation of vocational rehabilitation is difficult and, in general, its effects are still largely unknown.

The evaluation is made more difficult by the fact that disability benefits often act as disincentives to work, and by the wide range of different services provided to individuals Funding to help start small businesses can provide an alternative to scarce formal employment , For self-employment programmes for people with disabilities to succeed, however, marketing skills, access to credit, and long-term support and follow-up are needed The International Study on Income Generation Strategies analysed 81 self-directed employment projects and highlighted four success factors:.

It identified successful examples of income generation schemes from Jamaica, the Philippines, and Thailand Many people with disabilities have few assets to secure loans, and may have lived in poverty for years.

Microfinance programmes are in principle open to all, including disabled people. But anecdotal evidence suggests that few people with disabilities benefit from such schemes. Some microfinance programmes have been set up by disability NGOs and others target people with disabilities, but more evidence is needed on their effectiveness.

Handicap International evaluated 43 projects and found that targeted microfinance schemes were beneficial and that almost two thirds of them were sustainable ;. A review of the literature found obstacles in mainstream microfinance, so provisional schemes run by NGOs and disabled people's organizations can help, because they give rise to social inclusion, participation , and empowerment. But both approaches are needed to achieve wider coverage and sustainability, given that microfinance has great social and economic impact for persons with disabilities Long-term disability benefits can provide disincentives for people to seek employment and return to work 2 , , This is especially the case for those who are less skilled or whose jobs, if they were seeking them, would be lower paying.

One reason is that the benefit provides a regular income — even though small — that the person can rely on. Loss of this regular payment and reliance on menial, low-paid work may result in no regular income and little sense of security But social assistance benefits can also have positive effects on employment for people with disabilities.

Returning to work after disability may involve a period of unemployment and income insecurity. Social assistance programmes therefore need to take this into account when planning the transitional phases away from and back onto benefits. Such transitions should be factored into the benefit programmes so that people feel an incentive to work, while at the same time being secure in the knowledge that a benefit is still available should they not succeed The growth in disability benefit costs and the low employment rates for people with disabilities are concerns for policy-makers in developing countries 2 , 7 , 35 , Disability benefits have become a benefit of last resort because: People with mental health difficulties make up the majority of claims in most countries.

People almost never leave disability benefits for a job 2. System reform to replace passive benefits with active labour market programmes can make a difference. Evidence from Hungary, Italy, the Netherlands, and Poland suggests that tighter obligations for employers to provide occupational health services and to support reintegration, together with stronger work incentives for workers and better employment supports, can help disability beneficiaries into work 2.

The work disincentives of benefit programmes, together with the common perception that disability is necessarily an obstacle to work, can be significant social problems So the status of disability should be independent of the work and income situation. Disability should be recognized as a health condition, interacting with contextual factors , and should be distinct from eligibility for and receipt of benefits, just as it should not automatically be treated as an obstacle to work 38 , Assessment should focus on the capacity for work, not disability.

Guidance for doctors should emphasize the value and possibility of work and keep sickness absence as short as possible 2. To ensure that social protection for people with disabilities does not operate as a disincentive to seeking employment, one policy option is to separate the income support element from the element to compensate for the extra costs incurred by people with disabilities. Temporary entitlements plus cost of disability components irrespective of work status, more flexible in-work payments, and options for putting benefits on hold while trying work are preferred options , Time-limited disability benefits may be another way to increase employment for disabled people, with particular importance for younger people 2.

Germany, the Netherlands, and Norway recently adopted such programmes to encourage the return to work These schemes accept the fact that some people have severe disabilities that will last for a longer period, but recognize that, with intervention, returning to work is possible. The limited duration of the benefit is in itself an incentive for people to return to work by the time benefits end. A critical factor in making the limited duration of the benefit an incentive to return to work, however, is the way in which the time-limited programme is linked to the permanent programme.

If the transition to the permanent programme is smooth and expected by recipients, the incentive to return to the labour force is reduced. But there is no firm evidence on the effectiveness of time-limited benefits in encouraging the return to work. Another priority is making sure it pays to be in work 2.

The United Kingdom has recently been experimenting with ways outside the traditional disability benefit system to encourage people with disabilities to work A Working Tax Credit is paid to a range of lower income employed and self-employed people, administered by the taxation authorities. A person qualifies for the disability element of the Working Tax Credit if he or she works at least 16 hours a week, has a disability that puts them at a disadvantage of finding a job, or receives a qualifying benefit such as the long-term disability pension.

The idea is to encourage work among low-income households with a member with disabilities. The credit, introduced in April , has proved complex to administer. But an early evaluation suggests that it is encouraging people to enter work and reducing previous disincentives for young people to seek work Many disabled people's organizations already attempt to change perceptions on disability at the community level.

Anecdotal evidence suggests that employing a disabled person in itself changes attitudes within that workplace 54 , In the United States, companies already employing a disabled person are more likely to employ other disabled people 1. Light is a public electricity utility in Rio de Janeiro, Brazil, employing disabled people and generating positive publicity for its actions On the reverse of the company's monthly electricity bill is a picture of a wheelchair, with the message:.

The reason is simple — for us, the most important thing is to have valuable people. In the United Kingdom the Employers' Forum on Disability has developed innovative approaches for changing perceptions of disability see Box 8. More data are needed to understand which interventions can shift embedded attitudes on disability and best promote positive attitudes about disability in the workplace.

The Employers' Forum on Disability. The Employers' Forum on Disability EFD was the world's first employers' organization to promote equality for people with disabilities. Pioneered by the business community in the United Kingdom in the late s, it more People with disabilities must also be enabled to progress up the career ladder Evidence suggests that people with disabilities may lack opportunities for promotion, because their employers are reluctant to place them in roles where they manage others In the United States greater knowledge about legislation on disability employment is associated with more positive attitudes towards the rights of disabled people in the workplace Trades unions also have a role in improving the employment conditions of people with disabilities , particularly in the public sector.

Trades unions have a record of concern about occupational health and safety, and more recently have started to make the prevention of disability and issues of accommodation part of their bargaining agenda Almost all jobs can be performed productively by someone with a disability , and given the right environment, most people with disabilities can be productive.

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But working age persons with disabilities experience significantly lower employment rates and much higher rates of unemployment than persons without disabilities. This is due to many factors, including lack of access to education and vocational rehabilitation and training , lack of access to financial resources, disincentives created by disability benefits, the inaccessibility of the workplace, and employers' perceptions of disability and disabled people.

In improving labour market opportunities for people with disabilities many stakeholders have a role, including government, employers, disabled people's organizations , and trade unions. The Report's recommendations to improve access to labour markets for people with disabilities are presented here by key actors. Ensure that public policies are harmonized to provide incentives and support for individuals with disabilities to seek employment, and for employers to hire them.

Promote awareness among employers of their duty not to discriminate, and of the means available to them to support the employment of people with disabilities. Instil a belief among the public that people with disabilities can work, given the proper support. As employers, lead by example in promoting the employment of disabled people in the public sector.

Make mainstream vocational guidance and training programmes accessible to people with disabilities. Make mainstream employment services available to persons with disabilities on an equal basis with other job seekers. Ensure that mainstream social protection programmes include people with disabilities, while at the same time supporting their return to work, and not creating disincentives to those seeking work or returning to work.

Design safety net interventions to promote labour market inclusion of disabled people by including assistance and support services or covering the additional costs incurred by those who enter employment — such as the cost of travel to work and of equipment. Adjust disability assessment systems so that they assess the positive aspects of functioning as opposed to disability and capacity to work. Monitor and evaluate labour market programmes aimed at facilitating and increasing employment of persons with disabilities and scale up those that deliver results with focus on inclusive, not segregated solutions.

Provide adequate and sustainable funding for training programmes, to build a skilled workforce of people with disabilities. Include persons with disabilities in labour market data collection activities, for instance labour force survey. Use internationally agreed for example ILO labour market indicators to measure and monitor the labour market status and livelihood experiences of people with disabilities.

Hire people with disabilities, making reasonable accommodations available where needed. Set up disability management programmes to support the return to work of employees who become disabled. Develop partnerships with local employment agencies, educational institutions, skill training programmes, and social enterprises to build a skilled workforce that includes people with disabilities.

Ensure that all supervisors and human resource personnel are acquainted with the requirements for accommodation and non-discrimination with regard to individuals with disabilities. For larger businesses, aim to become model employers of people with disabilities. For organizations providing mainstream training opportunities, include people with disabilities. Support community-based rehabilitation , to enhance the development of skills and enable people with disabilities to make a decent living.

Where the informal economy is predominant, promote micro-enterprises and self-employment for people with disabilities. For microfinance institutions, improve access to microfinance for persons with disabilities through better outreach, accessible information and customized credit conditions. Support the development of networks of people with disabilities that can campaign for the rights of people with disabilities.

For labour unions, make disability issues, including accommodations, part of their bargaining agendas.

Women with Intellectual Disabilities: Finding a Place in the World

Requests for permission to reproduce or translate WHO publications — whether for sale or for noncommercial distribution — should be addressed to WHO Press through the WHO web site http: Turn recording back on. National Center for Biotechnology Information , U. World Report on Disability World Health Organization; World Health Organization ; Understanding labour markets Participation in the labour market If people with disabilities and their households are to overcome exclusion, they must have access to work or livelihoods, breaking some of the circular links between disability and poverty 14 , 24 — The participation of people with disabilities in the labour force is important for other reasons: Employment rates In many countries data on the employment of people with disabilities are not systematically available.

Types of employment In many countries, labour markets are largely informal, with many self-employed workers. Wages If people with disabilities are employed, they commonly earn less than their counterparts without disabilities; women with disabilities commonly earn less than men with disabilities. Barriers to entering the labour market People with disabilities are disadvantaged in the labour market. Lack of access Education and training are central to good and productive work for a reasonable income 52 — Misconceptions about disability Misconceptions about the ability of people with disabilities to perform jobs are an important reason both for their continued unemployment and — if employed — for their exclusion from opportunities for promotion in their careers Discrimination Employers may discriminate against people with disabilities, because of misconceptions about their capabilities, or because they do not wish to include them in their workforce Overprotection in labour laws Several countries, particularly some in eastern Europe, retain a protective view towards workers with disabilities.

Addressing the barriers to work and employment A variety of mechanisms have been used around the world to address barriers to the labour market: Laws and regulations Laws and regulations affecting employment for people with disabilities, found in many places 71 , include anti-discrimination laws and affirmative action. Anti-discrimination laws Anti-discrimination laws make it illegal to make decisions about a person's employment on the basis of their disability , as in Australia , Canada , , New Zealand , and the United States Tailored interventions Quotas Many countries stipulate quotas for the employment of people with disabilities in the public and private sectors.

Incentives to employers If employers bear the cost of providing reasonable accommodations, they may be less likely to hire people with disabilities — to avoid additional costs of labour. To counter these obstacles, various financial incentives can be offered: Supported employment Special employment programmes can make an important contribution to the employment of people with severe disabilities, particularly those with intellectual impairments and mental health conditions Sheltered employment Sheltered work provides employment in separate facilities, either in a sheltered business or in a segregated part of a regular enterprise 73 , and is intended for those who are perceived as unable to compete in the open labour market.

Employment agencies General employment agencies have been encouraged — and in some cases required by law — to serve job seekers with disabilities in the same setting as other job seekers, rather than referring people with disabilities to special placement services. Thinking behind the provision of employment services for people with disabilities is changing: Several successful user-controlled disability employment services have been launched in recent years: Disability management Disability management refers to interventions applied to individuals in employment who develop a health condition or disability.

Vocational rehabilitation and training Vocational rehabilitation services develop or restore the capabilities of people with disabilities so they can participate in the competitive labour market. Traditional training and mainstream programmes In OECD countries there is insufficient investment in rehabilitation and employment measures, and take-up is low Alternative forms of training Apart from imparting technical skills, recent programmes have also concentrated on improving the self-confidence of trainees and raising awareness of the wider business environment.

Recent initiatives to provide alternative forms of training show promise: Self-employment and microfinance Funding to help start small businesses can provide an alternative to scarce formal employment , The International Study on Income Generation Strategies analysed 81 self-directed employment projects and highlighted four success factors: Social protection Long-term disability benefits can provide disincentives for people to seek employment and return to work 2 , , Working to change attitudes Many disabled people's organizations already attempt to change perceptions on disability at the community level.

Many awareness campaigns have targeted specific conditions: On the reverse of the company's monthly electricity bill is a picture of a wheelchair, with the message: Conclusion and recommendations Almost all jobs can be performed productively by someone with a disability , and given the right environment, most people with disabilities can be productive. Survey of employer perspectives on the employment of people with disabilities.

Sickness, disability and work: A synthesis of findings across OECD countries. Organisation for Economic Co-operation and Development; Counting working-age people with disabilities. What current data tell us and options for improvement. Houtenville AJ, et al. Disability and poverty in developing countries: Contreras DG, et al.

Socio-economic impact of disability in Latin America: Universidad de Chile, Departemento de Economia; Economic implications of chronic illness and disability in Eastern Europe and the Former Soviet Union. The recent decline in the employment of persons with disabilities in South Africa, — South African Journal of Economics. Mitra S, Sambamoorthi U. Employment of persons with disabilities: Economic and Political Weekly. People with disabilities in India: Scott K, Mete C.

Measurement of disability and linkages with welfare, employment, and schooling. Zaidi A, Burchardt T. Comparing incomes when needs differ: Review of Income and Wealth. Braitwaite J, Mont D. Haveman R, Wolfe B. The economic well being of the disabled: The Journal of Human Resources. Measuring welfare for small but vulnerable groups: Journal of African Economies. Long-term poverty and disability among working age adults.

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Verdonschot MM, et al. Community participation of people with an intellectual disability: Journal of Intellectual Disability Research: Government programmes to promote employment among persons with disabilities in India. Indian Journal of Social Development. The causes of contingent and part-time work among people with disabilities. Microfinance and people with disabilities. Disability and the rural labour market in India: Wage differential by disability status in an agrarian labour market in India.

Skills development through community-based rehabilitation. Vocational rehabilitation and employment of people with disabilities; Report of a European conference,Warsaw—Konstancin Jeziorna; Poland. Strategies for skills acquisition and work for people with disabilities: Education, employment and training policies and programmes for youth with disabilities in four European countries.

The education and employment of disabled young people. Joseph Rowntree Foundation; Eide AH, et al. Living conditions among people with activity limitations in Zimbabwe: Measuring Health and Disability in Europe; Roberts P, Babinard J. Transport strategy to improve accessibility in developing countries. Butler SE, et al. Barriers to employment as experienced by disabled people: Waghorn G, Lloyd C. The employment of people with mental illness. Australian e-Journal for the Advancement of Mental Health. Perceived and measured stigma among workers with serious mental illness. Psychiatric Services Washington, D.

Thornicroft G, et al. Acemoglu D, Angrist J. Consequences of employment protection? The case of the Americans with Disabilities Act. The Journal of Political Economy. Mitra S, Stapleton D. Disability, work and return to work. Contemporary issues in industrial relations, labor and employment relations. Cornell University Press; Did the employment of people with disabilities decline in the s, and was the ADA responsible? A replication and robustness check of Acemoglu and Angrist Cornell University, Employment and Disability Institute; Bell D, Heitmueller A. Lawson A, Gooding C, editors.

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