UNIVERSITY OF MEDICINE & DENTISTRY OF NEW JERSEY
SCHOOL OF HEALTH RELATED PROFESSIONS
Department of Psychiatric Rehabilitation &
Behavioral Health Care
Summer, 2006

Course Title: PSYCHOSOCIAL ASPECTS OF DISABILITY

Course Number: PSRT 4310

Credits: 3 Prerequisites: None

Instructor: Janice Oursler, Ph.D., CRC
Phone: (908) 889-2462
E-mail: ourslejd@umdnj.edu
Class Hours: Mon: 1:30-4:30 and 5:30-8:30 (and one Saturday)
Office Hours: Monday: 12:30-1:30 P.M. or by appointment

Course Description: This course examines the medical issues and psychological and social barriers experienced by people with disabilities and the dynamics of adjusting to disabling conditions for both individuals and families. Special emphasis is given to the following disabilities: psychiatric, development, substance-related disorders, and neurological disorders. Topics to be considered include:
1. Medical aspects and functional implications of selected disabilities.
2. The psychosocial impact of disabilities.
3. Societal attitudes towards individuals with disabilities from both historical and current perspectives.
4. Life stage development and the impact of disabilities including sexuality and disability.
5. The psychosocial impact of disabilities on families.
6. Theories and techniques to promote coping and adjustment including conflict resolution.

Course Goals:
The goals of the course are to:
1. Understand the medical aspects of a number of disabilities such as psychiatric, developmental, substance abuse and alcoholism, and neurological disorders, including functional capabilities and limitations.
2. Increase awareness of societal attitudes towards individuals with disabilities and the consequences of such attitudes for individuals, families and the larger society.
3. Be able to discuss various stages of development and describe the implications of disabilities in life stage development.
4. Understand the psychosocial influence of disabilities on family dynamics and identify methods families use to cope.
5. Describe stages of adjustment to disability including identifying key concepts related to adjustment and adaptation.
6. Have knowledge of wellness and recovery resources in the community.
7. Discuss multicultural issues in adjusting to disability.
8. Identify and discuss legal and ethical issues related to disabilities covered in the course.

Course Objectives:
By the end of this course, students will be able to:
1. Discuss medical aspects of several disabilities related to the brain including describing functional implications.
2. Discuss specific examples of societal reactions and attitudes toward individuals with disability including the use of language and stereotypes and political implications of these attitudes.
3. Apply information about life stage development to discuss the personal impact of disability for individuals.
4. Discuss several approaches to psychiatric rehabilitation.
5. Describe the psychosocial impact of disability on families and identify strategies to assist families in coping with that impact.
6. Be able to access wellness and recovery resources in the community and describe their use and benefits to individuals with disabilities.
7. Identify and discuss the effects of diversity issues in adjusting to disabilities.
8. Discuss legal issues and ethical practices in planning services for individuals with disabilities.

Required Texts:
American Psychiatric Association. (2001). Diagnostic and statistical manual of mental disorders. (4th ed. text revision). Washington, DC: Author.

Falvo, D. (2005). Medical and psychosocial aspects of chronic illness and disability (3rd
ed.). Sudbury, MA: Jones and Bartlett Publishers.

Chan, F., Leahy, M.J., & Saunders (Eds.) (2005). Case management for rehabilitation health professionals (2nd ed.). Osage Beach, MO: Aspen Professional Services.
(Information about ordering this text is at www.aspenprofessionalservices.com.)

Web site: www.healthyplace.com/index.asp
This web site has useful information related to mental illness. You should read about mental illness diagnoses on the web site as well as in the text and the DSM-IV TR as we discuss them in class.

Recommended Text:
It is recommended students obtain a medical dictionary. Example:
Stedman, T.L. (2000). Stedman’s medical dictionary. (27th ed.). New York: Lippincott,
Williams & Wilkins.
Other readings from other sources will be assigned during the semester.

Accommodations:
Students are encouraged to discuss their need for accommodations with the instructor. Information about supported education services is available from Michele Mullen at (908) 889-2513 or e-mail at mullenmi@umdnj.edu. You can also contact the Disability Compliance Coordinator, Karine Pierre-Pierre, at (973) 972-8594.
Course Evaluation:
The quality of this course is evaluated through student course evaluations completed at the end of the course and through the Department of Psychiatric Rehabilitation’s peer review process. As part of the peer review process, other faculty from the Department may attend class sessions to observe the course.

Grade Interpretation:
A = 92-100
B = 83-91
C = 75-82
D = 69-74
F = 68 or below
Note: This is a required course for the M.S. in Rehabilitation Counseling. Failure to pass the course will require retaking the course. This is an elective course for both tracks of the M.S. in Psychiatric Rehabilitation. Students enrolled in this degree who fail the course may retake the course or discuss with their advisor taking another elective. A grade of “C” or better is required to pass this course.

Course Requirements:
Classroom participation: 5%
Course Assignments:
Self Help Visits 15%
Article Reviews: 20%
Research Paper: 35%
Final Examination 25%

Additional Information about Course Requirements:
1. Classroom Participation: Taking part in class discussion and exercises is an important part of this course. Students are expected to complete assigned readings from the textbook and be prepared to discuss them in class. Students are also expected to read other assigned articles and readings in a timely manner and be prepared to present and discuss them in class as described under the projects section of the syllabus.

2. Course Assignments: There are three assignments. All written work is to be typed and free of errors in spelling, grammar and word usage. Assignments will be presented and discussed in class.

Self-help Meetings: Attend at least one meeting of two different types of self-help groups for individuals with substance abuse or alcoholism. One is a self-help group established to assist individuals to cope with or adjust to the disabling condition such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). The other is self-help for family members such as Al-Anon or Adult Children of Alcoholics (ACOA). Submit a written report of your experience with each group including the nature and goals of the group, a brief description of the meeting, your reaction to it, and the usefulness of self-help groups in rehabilitation counseling. If possible, attach literature about the group to your report. Your report should not exceed three pages for each type of group.
Article Reviews: In consultation with the instructor, select five journal articles addressing research about medical and psychosocial aspects of disability. Write a brief review of each article of about two to three pages. Your review should include both a summary of the article, and your comments on how the article might be applied in rehabilitation counseling. In your review, use headings including 1) purpose of the study or article, 2) disability and population studied, 3) methods, 4) results, and 5) your reaction to the article and your thoughts on applications of the article to rehabilitation counseling practice. Use APA format to reference each article. Reviews which do not incorporate correct APA reference format will not qualify for an “A.” It is recommended you hand in article reviews as you complete them so that you can receive feedback on your review. All reviews are due by June 12. Be prepared to present your article reviews in class.

Research Paper: Adapting to Disability: With permission from the instructor, select and read a book about a person with a disability discussed in this course. The person must be an adult. This book could be from either the person's or a family member's perspective. You will use this person as your “client” for the research paper. Your paper will address: 1) the person’s psychosocial adjustment and 2) possible vocational interventions for this person based on your research about vocational services relevant to persons with this disability. The paper should reflect your critical thinking about the issues for this person and the current state-of-the-art of interventions for persons with this disability. Be sure to include a specific rehabilitation plan for the person, based on your readings and your thinking about the issues.

Use APA format. While your paper may include both journal and Internet references, it must be based on academic references. Research must include at least five journal articles in addition to the three required references. If the person’s diagnosis is a psychiatric illness or a developmental disability, you must include the DSM-IV TR as an additional required reference. Full text journal articles may be accessed on-line through the UMDNJ library. Your reading should include articles on best practices and evidence-based practices for rehabilitation interventions for persons with that diagnosis. You should pay particular attention in the articles you read to the basis for conclusions and to potential applications to practice. Include your critical evaluation of the relevance of the articles’ conclusions to work as a rehabilitation counselor. Include all references in APA format in your list of references.

Your research paper should include the following:
1. Introduction: A brief description of the person’s background, disability and circumstances. Do NOT summarize the book in your report.
2. Using the articles listed below as a foundation, consider the person's reactions, family reactions, and how the person and family members attempted to cope with the disability. Comment on whether the required references offered useful information for understanding the reactions to the disability. The required references can be found on Academic Search Premier in the VALE database.
3. Select a particular point in time in the person’s life and identify the issues at that time facing the person. Be sure to include vocational issues.
4. Discuss what rehabilitation interventions you as a rehabilitation counselor would recommend to address the identified issues. Base your choice of interventions on your research about psychosocial adjustment and vocational interventions and your knowledge of the person from the book. Research vocation interventions currently used for individuals with this disability and discuss how useful such interventions might be for this person including your rationale for your conclusions. Your research must be based on academic resources such as journal articles with a minimum of five academic resources in addition to the required references. Identify specifics of the plan you would recommend for this person.
5. Summary of your report including your reactions to what you have learned in completing the assignment.

Required References:
Livneh, H., & Antonak, R. (2005). Psychosocial adaptation to chronic illness and disability: A primer for counselors. Journal of Counseling & Development, 83, 12-20.

Livneh, H. (2001). Psychosocial adaptation to chronic illness and disability: A conceptual framework. Rehabilitation Counseling Bulletin, 44, 151-160.

Livneh, H., Martz, E., & Wilson, L. (2001). Denial and perceived visibility as predictors of adaptation to disability among college students. Journal of Vocational Rehabilitation, 16, 227-234.

3. Final Examination: The final examination will reflect readings assigned in the class and class discussions. It will be a multiple-choice examination. Additional information about the final examination will be given in class.

COURSE SCHEDULE / TOPICAL OUTLINE
Summer, 2006

Date Topic
5/15 Part 1: Overview of course
6 hrs. Conceptual framework for study of psychosocial adaptation
Overview of DSM-IV TR and diagnosis

Part 2: Mental illness: Psychotic Disorders
Reading: Falvo, Ch. 1 (Psychosocial and functional aspects), Chan, Leahy & Saunders, Chs. 15 and 7
Review: DSM-IV TR, pp. 1-37 and Appendices A-I.

5/20 Mental illness: Approaches to psychiatric rehabilitation
6hrs Reading: Falvo, Ch. 6 (Psychiatric Disabilities), Chan, Leahy & Saunders,
(Saturday) Chs. 17 and 19
Review: DSM-IV TR, Schizophrenia and Other Psychotic Disorders, Mood Disorders, pp. 297-428.

5/22 Part 1: Substance abuse and addictions
6 hrs. Guest speaker: Norm Salt, Rehabilitation Counselor

Part 2: Mental Illness: Mood disorders
Reading: Falvo, Ch. 7 (Conditions related to substance use), Chan, Leahy & Saunders, Ch. 24
Review: DSM-IV TR, Substance Related Disorders, pp. 191-295.

5/29 Holiday: No class

6/5 Part 1: Multiple sclerosis
6 hrs. Guest Speaker: Pat Leavy – National Multiple Sclerosis Society

Part 2: Mental Illness: Anxiety Disorders and Personality Disorders
Reading: Falvo, Ch. 3, pp. 94-110 (Nervous system disorders)
Review: DSM-IV TR, Anxiety Disorders, pp. 429-484 and Personality Disorders, pp. 685-730.
Self Help Project Due

6/12 Part 1: Acquired brain injury
6 hrs. Guest speaker: Judi Weinberger, New Jersey Brain Injury Association
.
Part 2: Nervous system disorders: Seizure disorders
Guest Speaker: Epilepsy Foundation
Reading: : Falvo, Ch. 2 (Nervous system disorders), Chan, Leahy & Saunders, Ch. 18, The Acute Brain Injury Guide and Brain Injury: A Guide for Educators at www.bianj.org/hwch_pubs_order.php, Chan, Leahy & Saunders, Chs. 10, 11, and 14, Brain functioning and the Glasgow and Ranchos Los Amigos Scales at www.waiting.com/brainfunction.html
All article reviews due

6/19 Part 1: Case Conference: John Cecot, DVRS Counselor
6 hrs. Discussion of ethical issues

Part 2: Developmental Disorders
Guest Speaker: Nora Barrett, UMDNJ faculty
Reading: Chan, Leahy & Saunders, Chs. 3, 5, 6, 25 & 26
Review: DSM-IV TR, Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence, pp. 39-134.
Research Paper due

6/26 Part 1: Mental Illness and Substance Abuse
6 hrs. Guest Speaker: Peter Basto, UMDNJ faculty

Part 2: Final Exam
Review: DSM-IV TR, Delirium, Dementia, pp. 135-180, General Medical Conditions, pp. 181-190, and Somatoform Disorders, Factitious Disorders, Dissociative Disorders, Sexual and Gender Identity Disorders, Eating Disorders, Sleep Disorders, pp. 485-661.

Note: Dates for specific topics may change due to scheduling of class presentations. The instructor will advise the class of schedule changes.

Rev. Summer 2006

Journal Article Assignment
Summer, 2006

I. Developmental Disabilities:

Full Text Journal Articles at Ovid:

1. Sturmey, P. (2002). Mental retardation and concurrent psychiatric disorder: assessment and treatment. Current Opinion in Psychiatry, 15, 489-495.

Academic Search Premier:

2. Block, S R., Athens, K., & Brandenburg, G. (2002). Using performance-based contracts and incentive payments with managed care: Increasing supported employment opportunities for people with developmental disabilities. Journal of Vocational Rehabilitation, 17, 165-174.

3. Bolton, B. F., Bellini, J. L., & Brookings, J. B. (2000). Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services. Rehabilitation Counseling Bulletin, 44, 10-21.

4. Davies, D. K., Stock, S. E., & Wehmeyer, M. L. (2003). A palmtop computer-based intelligent aid for individuals with intellectual disabilities to increase independent decision making. Research & Practice for Persons with Severe Disabilities, 28, 182-193.

5. Dunham, M. D. (2000). Vocational rehabilitation outcomes of adults with co-morbid borderline IQ and specific learning disabilities. Journal of Rehabilitation, 66, 31-36.

6. Kilsby, M., Bennert, K., & Beyer, S. (2003). Measuring and reducing acquiescence in vocational profiling procedures for first time job-seekers with mental retardation. Journal of Vocational Rehabilitation, 17, 287-299.

7. Müller, E., Schuler, A., Burton, B. A., & Yates, G. B. (2003). Meeting the vocational support needs of individuals with Asperger Syndrome and other autism spectrum disabilities. Journal of Vocational Rehabilitation, 18, 163-175.

8. Olney, M.F. (2001). Communication strategies of adults with severe disabilities: Supporting self-determination. Rehabilitation Counseling Bulletin, 44, 87-94.

9. Revell, G., Brooks-Lane, N., & Hutcheson, S. (2005). Supporting consumer directed employment outcomes. Journal of Vocational Rehabilitation, 23, 123-134.

10. Taylor, S. J. (2004). Caught in the continuum: A critical analysis of the principle of the least restrictive environment. Research & Practice for Persons with Severe Disabilities, 29, 218-230.

11. VanderSchie-Bezyak, J. L. (2003). Service problems and solutions for individuals with mental retardation and mental illness. Journal of Rehabilitation, 69, 53-58.

12. West, M. D., Wehman, P. B., & Wehman, P. (2005). Competitive employment outcomes for persons with intellectual and developmental disabilities: The national impact of the Best Buddies Jobs Program. Journal of Vocational Rehabilitation, 23, 51-63.


II. Mental Illness:

Full Text Journal Articles at Ovid:

1. Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist. 59, 614-625.

2. Drake, R. E., Becker, D. R., & Bond, G. R. (2003). Recent research on vocational rehabilitation for persons with severe mental illness. Current Opinion in Psychiatry. 16, 451-455.

3. Goldberg, S., Killeen, M., & O'Day, B. (2005). The disclosure conundrum: How people with psychiatric disabilities navigate employment. Psychology, Public Policy, & Law. 11, 463-500.

4. Hogarty, G. E., Flesher, S., Ulrich, R., Carter, M., Greenwald, D., Pogue-Geile, M., Kechavan, M., Cooley, S., DiBarry, A. L., Garrett, A., Parepally, H., & Zoretich, R. (2004). Cognitive enhancement therapy for schizophrenia: Effects of a 2-year randomized trial on cognition and behavior. Archives of General Psychiatry. 61, 866-876.

5. Lehman, A. F., Goldberg, R., Dixon, L. B., McNary, S., Postrado, L., Hackman, A. & McDonnell, K. (2002). Improving employment outcomes for persons with severe mental illnesses. Archives of General Psychiatry. 59,165-172.

6. Mueser, K. T., Clark, R. E., Haines, M., Drake, R. E., McHugo, G. J., Bond, G. R., Essock, S. M. , Becker, D. R., Wolfe, R., & Swain, K. (2004). The Hartford study of supported employment for persons with severe mental illness. Journal of Consulting & Clinical Psychology. 72,:479-490.

7. Twamley, E., Padin, D., Bayne, K., Narvaez, J., Williams, R., & Jeste, D. (2005). Rehabilitation for middle-aged and older people with schizophrenia: A comparison of three approaches. Journal of Nervous & Mental Disease. 193,596-601.


Academic Search Premier:

8. Becker, D. R., Drake, R. E., & Naught on Jr., W. J. (2005). Supported employment for people with co-occurring disorders. Psychiatric Rehabilitation Journal, 28, 332-338.

9. Davis, L. W., Lysaker, P. H., Lancaster, R. S., Bryson, G. J., & Bell, M. D. (2005). The Indianapolis Vocational Intervention Program: A cognitive behavioral approach to addressing rehabilitation issues in schizophrenia. Journal of Rehabilitation Research & Development, 42, 35-45.

10. Krupa, T. (2004). Employment, recovery, and schizophrenia: Integrating health and disorder at work. Psychiatric Rehabilitation Journal, 28, 8-15.

11. Rogers, E. S., Drake, R. E., Becker, D. R., Bond, G. R., & Mueser, Kim T. (2003). A process analysis of integrated and non-integrated approaches to supported employment. Journal of Vocational Rehabilitation, 18, 51-58.

12. Spaniol, L., Wewiorski, N. J., Gagne, C., & Anthony, W. A. (2002). The process of recovery from schizophrenia. International Review of Psychiatry, 14, 327-336.


III. Substance-related Disorders:

Full Text Journal Articles at Ovid:

1. Krowchuk, H. (2005). Effectiveness of adolescent smoking prevention strategies. American Journal of Maternal Child Nursing. 30, 366-372.

2. Lockhart, P. J. (2001). Fetal alcohol spectrum disorders for mental health professionals - a brief review. Current Opinion in Psychiatry, 14, 463-469.

3. Maxwell, J. (2006). Emerging research on methamphetamine. International Drug Therapy Newsletter. 41, 17-24.

4. Pumariega, A. J., Rodriguez, L., & Kilgus, M. D. (2004). Substance abuse among adolescents: Current perspectives. Addictive Disorders & Their Treatment. 3,145-155.

5. Rychtarik, R. G., & McGillicuddy, N. B. (2005). Coping skills training and 12-step facilitation for women whose partner has alcoholism: Effects on depression, the partner's drinking, and partner physical violence. Journal of Consulting & Clinical Psychology. 73, 249-261.

Academic Search Premier:

6. Adrian, M. (2001). Do treatments and other interventions work? Some critical issues. Substance Use & Misuse, 36, 1759-1780.

7. Blankertz, L., Staines, G. L., Magura, S., Madison, E. M., Horowitz, E., Spinelli, M., McKenzie, A., Bali, P., Guarino, H., Grandy, A., Young, R., & Fong, C. (2003). The Customized Employment Supports (CES) model of vocational rehabilitation for methadone treatment patients. Journal of Vocational Rehabilitation, 19, 143-155.

8. Levy, D. T., Miller, T. R., Mallonee, S., Spicer, R. S., Romano, E. O., Fisher, D. A., & Smith, G. S. (2002). Social networks as mediators of the effect of Alcoholics Anonymous. Addiction, 97, 891-900.

9. Magura, S. (2003). The role of work in substance dependency treatment: A preliminary overview. Substance Use & Misuse, 38, 1865-1876.

10. Mueser, K. T. (2004). Clinical interventions for severe mental illness and co-occurring substance use disorder. Acta Neuropsychiatrica, 16, 26-35.

11. Nemes, S., Wish, E., Wraight, B., & Messina, N. (2002). Correlates of treatment follow-up difficulty. Substance Use & Misuse, 37, 19-46.

12. Sterling, R. C., Gottheil, E., Glassman, S. D., Weinstein, S. P., Serota, R. D., & Lundy, A. (2001). Correlates of employment: A cohort study. American Journal of Drug & Alcohol Abuse, 27, 137-146.


IV. Acquired Brain Injury:

Full Text Journal Articles at Ovid:

1. Armengol, C. G. (1999). A multimodal support group with Hispanic traumatic brain injury survivors. Journal of Head Trauma Rehabilitation. 14, 233-246.

2. Hart, T., Hawkey, K., & Whyte, J. (2002). Use of a portable voice organizer to remember therapy goals in traumatic brain injury rehabilitation: a within-subjects trial. Journal of Head Trauma Rehabilitation, 17, 556-570.

3. Mateer, C. A., Sira, C. S., & O'Connell, M. E. (2005). Putting Humpty Dumpty together again: The importance of integrating cognitive and emotional interventions. Journal of Head Trauma Rehabilitation. 20, 62-75.

4. Schultheis, M.T., Matheis, R. J., Nead, R., & DeLuca, J. (2002). Driving behaviors following brain injury: Self-report and motor vehicle records. Journal of Head Trauma Rehabilitation, 17, 38-47.

5. Simpson, G., & Long, E. (2004). An evaluation of sex education and information resources and their provision to adults with traumatic brain injury. Journal of Head Trauma Rehabilitation. Focus on Clinical Research and Practice,19, 413-428.

6. Wehman, P., Targett, P., West, M., & Kregel, J. (995). Productive work and employment for persons with traumatic brain injury: What have we learned after 20 years? Journal of Head Trauma Rehabilitation, 20,115-127.

7. Yasuda, S., Wehman, P., Targett, P., Cifu, D., & West, M. (2001). Return to work for persons with traumatic brain injury. Am J Phys Med Rehabil 80, 852–864.

Academic Search Premier:

8. Bounds, T. A., Schopp, L, Johnstone, B., Unger, C., & Goldman, H. (2003). Gender differences in a sample of vocational rehabilitation clients with TBI. NeuroRehabilitation, 18, 189-196.

9. Gartland, D. (2004). Considerations in the selection and use of technology with people who have cognitive deficits following acquired brain injury. Neuropsychological Rehabilitation, 14, 61-76.

10. Gorman, P., Dayle, R., Hood, C., & Rumrell, L. (2003). Effectiveness of the ISAAC cognitive prosthetic system for improving rehabilitation outcomes with neurofunctional impairment. NeuroRehabilitation, 18, 57-67.

11. Vandiver, V. L., Johnson, J., & Christofero-Snider, C. (2003). Supporting employment for adults with acquired brain injury. Journal of Head Trauma Rehabilitation, 18, 457-463.

12. Zasler, N. D., & Martelli, M. F. (2003). Mild traumatic brain injury: Impairment and disability assessment caveats. Neuropsychological Rehabilitation, 13, 31-41.


V. Nervous System Disorders:

Full Text Journal Articles at Ovid:

1. Engelberts, N. H. J., Klein, M., Ader, H. J,, Heimans, J. J., Trenite, D.G. A. K. van der Ploeg, H. M. (2002). The effectiveness of cognitive rehabilitation for attention deficits in focal seizures: A randomized controlled study. Epilepsia, 43, 587-595.

2. Ramsay, J. R., & Rostain, A. L. (2005). Adapting psychotherapy to meet the needs of adults with attention-deficit/hyperactivity disorder. Psychotherapy: Theory, Research, Practice, Training. 42, 72-84.

3. Shafer, P. O., & DiIorio, C. (2004). Managing life issues in epilepsy. Continuum: Lifelong Learning in Neurology. Epilepsy. 10,138-156.

4. Smout, S., Koudstaal, P.J., Ribbers, G.M., Janssen, W.G.M. & Passchier, J. (2001). Struck by stroke: A pilot study exploring quality of life and coping patterns in younger patients and spouses. International Journal of Rehabilitation Research, 24, 261-268.

Academic Search Premier:

5. Bishop, M. (2004). Determinants of employment status among a community-based sample of people with epilepsy: Implications for rehabilitation interventions. Rehabilitation Counseling Bulletin, 47, 112-121.

6. Elliott, H. (2002). Attention deficit hyperactivity disorder in adults: A guide for the primary care physician. Southern Medical Journal, 95, 736-742.

7. Heinemann, A. W., Crown, D., & McMahon, R. (2000). Utility of the Functional Assessment Inventory in a post-stroke sample. Rehabilitation Counseling Bulletin, 43, 165-177.

8. Johnson, K. L., Amtmann, D., Yorkston, K. M., Klasner, E. R., & Kuehn, C. M. (2004). Medical, psychological, social, and programmatic barriers to employment for people with multiple sclerosis. Journal of Rehabilitation, 70, 38-49.

9. McNaughton, D., Light, J., & Arnold, K. B. (2002). "Getting your wheel in the door": Successful full-time employment experiences of individuals with cerebral palsy who use augmentative and alternative communication. Augmentative and Alternative Communication, 18, 59-77.

10. Mpofu, E. & Watson, E. (1999). Learning disabilities in adults: Implications for rehabilitation intervention in work settings. Journal of Rehabilitation, 65, 33-42.

11. Rumrill, P., Roessler, R., Vierstra, C., Hennessey, M., & Staples, L. (2004). Workplace barriers and job satisfaction among employed people with multiple sclerosis: An empirical rationale for early intervention. Journal of Vocational Rehabilitation, 20, 177-183.

12. Schwiebert, V. L., Sealander, K. A., & Dennison, J. L. (2002). Strategies for counselors working with high school students with attention-deficit/hyperactivity disorder. Journal of Counseling & Development, 80, 3-10.