Affiliations: Department of Health Psychology, School of Health
Professions, University of Missouri-Columbia, Columbia, MO, USA | Office for Citizens with Developmental Disabilities,
Louisiana Department of Health and Hospitals, LA, USA | Department of Elementary and Secondary Education
Jefferson City, MO, USA | Department of Physical Medicine and Rehabilitation,
School of Medicine, University of Missouri-Columbia, Columbia, MO, USA | Department of Biostatistics, Health Sciences Center,
University of Missouri-Columbia, Columbia, MO, USA
Note: [] Address for correspondence: Brick Johnstone, Ph.D., Department
of Health Psychology (DC116.88), One Hospital Drive, Columbia, MO 65212, USA.
Tel.: +1 573 882 6258; Fax: +1 573 884 4540; E-mail:
[email protected]
Abstract: Objective: To investigate the effect of traumatic brain injury (TBI)
and concomitant disabilities on vocational outcomes. Design: Non-experimental, prospective analysis of adults who
qualified for services with the Missouri Division of Vocational Rehabilitation
(MDVR) based on a history of TBI. Participants: 139 MDVR clients with non-acute TBI, followed from
enrollment until case closure, who were divided into 5 groups (TBI only; TBI
+ orthopedic injury; TBI + seizure; TBI + psychological
disorder; TBI + learning disability). Main outcome measures: Demographic characteristics; injury severity;
neuropsychological functioning; and employment status at case closure. Analyses: Multivariate analysis of variance and non-parametric
methods were used to evaluate differences in outcome variables between the TBI
Only and other 4 groups. Results: Statistically non-significant trends between the groups
suggested less successful employment outcomes for persons with TBI and
concomitant psychological disorders (11%) and learning disabilities (8%) vs.
persons with orthopedic injuries (23%), seizure disorders (32%), or TBI only
(26%). Conclusions: Concomitant psychological and learning disabilities,
compared to concomitant physical disabilities, are associated with greater
employment difficulties for persons with TBI. VR clients with psychological and
learning disorders may require additional services/interventions to enhance
their vocational outcomes.
