Abstracts

RATIONALE: While under-employment and increased unemployment rates have been frequently referenced in the literature for people of epilepsy, little is understood about the entry-level profile of the candidate for vocational rehabilitation(VR) services. The present study presents a comprehensive profile of VR clients with epilepsy at fixed points in time with varying unemployment rates across two decades. For the 2000-2001 service years, entry-level profiles for an epilepsy group are compared with groups having traumatic brain injury (TBI) or multiple sclerosis (MS) as a primary disability.
METHODS: In this retrospective study, 50 subjects were selected at random and intake data profiled for years of local high, medium, and low employment within the University of Washington Regional Epilepsy Center[ssquote]s Project With Industry. The retrospective years were 1982 (12% unemployment), 1992 (8%), and 2000/2001 (4%). Comparisons were made on key psychosocial variables to include age, sex, educational background, etc., but also on key socioeconomic data: federal subsidy (Social Security support), months unemployed in the last six months, months employed within the last 36 months, highest salary level, etc.. For the last project year, similar comparisons were made between the epilepsy sample and the samples of both TBI and MS as a primary disability.
RESULTS: Significant findings include changes in the profile of epilepsy VR candidates over the last two decades including a tripling of the percentage on Social Security or federal subsidy and significantly greater periods of unemployment over the six months prior to program entrance. Candidates with epilepsy presenting for services are significantly more vocationally impaired as compared to both the TBI and MS groups, their job history was poor-the MS group having the highest job skill level and pre-program job maintenance. Vocational outcome for the epilepsy group, however, appears significantly better than the other two.
CONCLUSIONS: It would appear that with a strong economy and perhaps the relaxing of Social Security regulations, a group more severely disabled by epilepsy is encouraged to attempt work. This is both encouraging and presents challenges which will be enumerated. Those with epilepsy were seen to be going to employment at a faster rate than the TBI or MS groups, although for different reasons-viz., the cognitive challenges presented by TBI and the financial disincentives impacting the MS sample. It appears that the epilepsy VR candidate can be among the most successful in neurologigical VR for diverse reasons.