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All people deserve competitive, fulfilling employment (Lysaght, Cobigo, Hamilton, 2011). Many people with intellectual or developmental disabilities (I/DD) have difficulty obtaining competitive employment despite desiring to work (Lysaght, Ouellett-Kuntz, & Lin, 2010). In past years, people with I/DD have been employed in sheltered workshops; however, they are often paid below minimum wage, do not receive benefits, and are viewed as subordinates. Workers report the desire to work outside of sheltered employment. Competitive employment (integrated/supported employment), can lead to social justice, social inclusion, personal growth, and improved financial situations (Migliore, Mank, Grossi, & Rogan, 2007). Occupational therapists are suited to assist individuals with I/DD in obtaining and maintaining employment through development of skills and environmental supports. The purpose of this session is to present the results of an evidence based review on effective interventions to increase integrated/supported work engagement for individuals with I/DD, as well as discuss the significance in occupational therapy practice.

A comprehensive literature review was performed to identify best practice. CINAHL, PubMed, OT Search, Scopus, ERIC, and Cochrane databases were searched. Peer reviewed articles published between 2003-2013, relating to interventions regarding integrated/supported employment for adults with I/DD, and within the scope of occupational therapy were included in the literature review. The review examined 12 articles that investigated the most effective interventions to increase integrated/supported work engagement in adults with I/DD. Reviewers used Law and McDermid’s (2003) Appendix M+N and PRISMA Systematic Review Form to critique the articles. There was one primary and one secondary reviewer per article; discrepancies were resolved through peer discussion.

Upon review and synthesis of the articles, two main outcome themes, accuracy and quality of life were identified. Accuracy was typically related to the intervention of assistive technology. Interventions related to quality of life included choice-making, microenterprise, and peer support. In addition to expanding occupational therapy’s scope of practice, understanding the most effective interventions to promote employment for adults with I/DD allows occupational therapists to make informed decisions to increase the opportunities for integrated/supported work engagement for this population.


Law, M. & McDermid, J. (2003). Appendix M and N (pp 414-423). In Evidence-Based

Rehabilitation. Thorofare, NJ: SLACK, Inc.

Lysaght, R., Cobigo, V., & Hamilton, K. (2012). Inclusion as a focus of employment-related

research in intellectual disability from 2000 to 2010: A scoping review. Disability and rehabilitation, 34(16), 1339-1350.

Lysaght, R., Ouellette-Kuntz, H., & Lin, C. J. (2012). Untapped potential: Perspectives on

the employment of people with intellectual disability. Work: A Journal of Prevention, Assessment and Rehabilitation, 41(4), 409-422.

Migliore, A., Mank, D., Grossi, T., & Rogan, P. (2007). Integrated employment or sheltered

workshops: Preferences of adults with intellectual disabilities, their families, and staff. Journal of Vocational Rehabilitation, 26(1), 5-19.