Vocational Rehabilitation of Transition-Age Youth with Disabilities: A Propensity-Score Matched Study.

Objective To investigate the employment outcomes of vocational rehabilitation (VR) services for youth with disabilities in a targeted, enhanced, and contract-based secondary transition program as compared to the traditional VR transition services. Methods A population-based study was conducted on 4422 youth with physical, intellectual, learning, mental and hearing disabilities aged 14-21 at application and whose case was closed after receiving VR transition services in a Midwestern state. Selected youth were classified into either targeted secondary transition program (START) or non-START treatment group. The employment outcomes of the groups were compared using propensity-score matching procedures. Results 2211 youth with disabilities in each treatment group were successfully matched based on demographic characteristics, types of disabilities, existence of severe functional limitations, and year of referral. The overall rehabilitation rate was 57 % [95 % confidence interval (CI) 56-59 %], where the START group rate was 61 % (95 % CI 59-63 %) and the non-START group 53 % (95 % CI 51-55 %). The propensity-score matched odds ratio (OR) was 1.40 (95 % CI 1.24-1.58; p < 0.001). Subgroup analyses showed that the odds of rehabilitation in youth with disabilities were consistently higher when they were in START as compared to non-START (OR ranged from 1.27 to 1.92 with p < 0.05 except for the Hispanic subgroup). Conclusion The results suggest that VR services in a targeted, enhanced, and contract-based secondary transition program are more effective in transitioning youth with disabilities to employment than the regular VR transition services.