Social Integration and Vocational Adaptation of Adult Individuals Disabled since Childhood

Pilot program on vocational guidance and social integration of individuals disabled since childhood. Ninety disabled people selected to participate in the program, have received professional orientation at 15 organizations and businesses within Moscow, and taken psychological trainings dedicated to social adaptation in real working teams. Analysis of psychological testing prior to commencing the program and final or ‘exit’ testing, combined with the results of the participants employment (43% have been employed), are valid confirm effectiveness of the program. Analysis of psychological testing prior to commencing the program and final or ‘exit’ testing, combined with the results of the participants employment (43% have been employed), are valid confirm effectiveness of the program. Based on these results, replicative methodology that facilitates employment for individuals with different forms of disability may be designed and suggests further areas of work.

 Test to determine the destructive attitudes in interpersonal communication by V.Boyko -Identification of negative communicative attitudes towards other people.(http://azps.ru/tests/5/mihelson.html)  Measurement scale of self-esteem by T. Dembo -measuring scales of abilities, character, credibility, confidence, health, intelligence, beauty." The article's authors were invited by the Foundation as outside experts in the assessment (evaluation) of the program under development, analysis of data collected, and program modifications if necessary (intermediate test results and program adjustment are described in our previous article (Nikolskaya A.V., & Nazarov A.L., 2016, C. 156-170).
It is important to note that the mid-program cycle divides participants into 2 groups to facilitate the processing of the results.First subgroup is participants with different forms of intellectual disabilities (cerebral palsy, Down Syndrome, etc).The second subgroup is participants with intact intelligence.

Employers' Survey Results
Seventy eight percent of employers are willing or more willing to recruit program participants having passed their training to fill vacancies.Impaired fine motor skills and decreased intellectual functions are a serious obstacle to employment, but twenty percent of program participants with intellectual and memory impairment (the first subgroup) were employed in the enterprises where they were trained.
It is important to note that the range of specialties offered and companies participating in the program in this study were limited, therefore, it may be assumed that with the expansion of the range of specialties and consequently the required job skills, the range of disorders that do not impede employment can be expanded.

Analysis of Vocational and Social Adaptation of Program Participant's Data
Their mentors at each organization using the three-point scale assessed vocational and social adaptations of each program participant.Each participant was assessed with three scores of social adaptation: first score was obtained in a week after the start of the program.Second score was the average of the weekly ratings in the mid-cycle of the program (12 weeks).The third score was the final assessment of vocational guidance obtained upon completion of the program.Scores obtained as the result of professional adaptation were the final assessments of labor mentors at each facility where the program participants were trained.The individual's initial social adaptation score from the first subgroup was generally high (2-3 scores at three-point scale).However, the decision to slightly modify training was taken mid-cycle since the analysis of the data and characteristics of expert review showed predominance of motivation for social approval or game among those individuals.Correspondingly, reliance on originally selected assessment criteria of labor adaptation (reflexion, responsibility, and motivation) was transferred to the general performance of socialization, communicative skills, as well as cognitive functioning.This lead to a decision to dedicate a separate training unit to the development of memory performance and attention, and one more training unit to the mastery of self-confident behavior.
For this group of participants, the process of socialization at the enterprises was understood as the process of integration into the labor teams that forms the role behavior (the behavior of the employee performing a specific set of labor operations and comply with the rules adopted in the enterprise).Due to time limitation of the program, training of confident behavior skills led to ambivalent results.First, the program participants in this subgroup have become clearly aware of their needs with respect to work and interpersonal relationships with co-workers.Secondly, the acute shortage of time led their realization of needs was not set in the framework of socially acceptable behavioral manifestations.As a result, socialization scores of members of this subgroup began to decline.Considerable variation was observed regarding professional adaptation of the participants in this group associated with the peculiarities of labor operations necessary to acquire skills at each enterprise.
For program participants with preserved intellectual and mnemonic functions, we consider social adaptation as more complex.Compared to the first group, adaptation to the social environment of the enterprise included: • Ability to analyze the current social situation; • Awareness of their possibilities in the current social environment; • Ability to build and maintain the behavior in accordance with the objectives of the activity.
Social adaptation scores of certain intellectual and mnemonic intact participants in the program found a downward trend.As with the first subgroup, the training program was modified for this subgroup.It was decided to focus on the actual needs of the participants rather than to work with the theoretically important, but unclaimed adaptation mechanisms.New training topics focused on the displacement locus of control in the direction of internalization.Topics aimed at developing practical situational skills (the formation of patterns of behavior in the conditions of the interview with the employer); to strengthen the motivation for active independent life activity (increased personal responsibility and motivation of the participants with regard to the employment process) were introduced.
Additionally, we found that program participants had negative attitudes, often without any factual basis for them.These attitudes arise out of misinformation on the part of the parent family and the disabled community.Content of these attitudes associates with life in general and employment process in particular.These attitudes while not fully understood have a critical effect on lifestyle and behavior.Due to this fact, it was decided to use Rational Emotive behavioral therapy A. Ellis [1] and Reality therapy W. Glasser [2], which allows bringing negative attitudes in awareness and work with them.
In conclusion, work on the definition of a clear picture of the desired future was held.Since the majorities of participants' aspirations are limited exclusively momentary satisfaction of material needs and are not associated with the "big" goals, even in the medium term, it was decided to consolidate the structure of employment, based on obligatory actualization of goal (employment) and communication skills, and specific actions necessary to move towards the goal.
As in the case with the first subgroup of participants, the compressed timeframe limiting the possibility of further training work, led to the fact that the members of this subgroup (intellectual and mnemonic intact individuals) became more clearly aware of their goals and less fear of interaction with the world.This led to some behavioral emancipation, which affected the social adaptation scores.Subsequently, the motivation to succeed in the members of this subgroup increased, and will be described in the next section.
Concurrently, professional adaptation of this group of participants, showed considerable variation in scores.However, the spread was reduced in comparison with the scores obtained in the middle of the program cycle (1.1 to 3 -in the middle of the program cycle; 1.6 to 3 at the end of the cycle).
As previously mentioned, the degree of professional adaptation depends on the structure of the work performed.The results of the analysis showed that the participants in the first group (disturbed intellectual-mental functions) most successfully master the skills associated with the packing and sorting goods.Additionally, operations as data entry and scanning requiring high precision, care, and ability to use all the functions of the equipment (scanners, copiers), in conjunction with the required speed of operation, are almost impracticable for people with intellectual-mental dysfunction.The work seems to them complicated and their motivation declines.
Professional adaptation of the program participants belonging to the second group appears to be more successful and reaches the highest possible performance at the most.

Statistical Analysis of Data
Analysis was conducted by comparing the data of the intermediate and final testing of the program participants.As the H1 hypothesis advocated the assumption that as the participants progress through the program their psychological indicators (motivation, mental well-being, subjective control) will increase, self-esteem will be aligned approaching to the objective esteem and communication skills will improve.
Since program participants with mental disability are not able to undergo psychological testing, it was decided to evaluate this group based on expert opinion on the following criteria (see Table 1).

Degree of general socialization
No expressiveness 0 0 Low degree of expressiveness 31 0 Average degree of expressiveness 32 63 High degree of expressiveness 37 37

Degree of development of cognitive functioning
No expressiveness 0 0 Low degree of expressiveness 29 13 Average degree of expressiveness 53 59 High degree of expressiveness 18 28 Notably, a change in the training program gave a pronounced effect, which allowed not only increasing the level of general socialization, but also the level of development of cognitive functions of participants with intellectual dysfunction.
In general, it should be noted this subgroup of participants shows mostly playing motivation or the motivation for social approval, which makes the possibility of their long-term employment difficult, because they require individual labor mentor, expressing approval of their activity, and providing a game component.Otherwise, the loss of goal setting and a sharp decline in motivation to work becomes very high.
Group 2 was estimated by means of statistical tests based on interim and final psychological testing.The evaluation was conducted by t-test (Student's t-test).In this group, participants' motivation for success increased significantly: the average over the array in the intermediate testing -16.09, in the final test -18.9.
Changing the psychological training and continuing with the labor activity has led to an increase in motivation and appears very promising about future employment of this group in marketplace.Results of the communicative skills analysis show that dependent style of communication among participants provides a further downward trend (average at the beginning of the program 10.3, in the middle of the cycle -9.2,with final testing -8.9).
A decrease in the level of aggression in communication, which significantly increased in the middle of the program cycle, then dropped to previous levels (average of 14.6 in the primary array testing, 26.4 -in the intermediate test, 14.9 -in the final testing).This may indicate the adaptation stabilizing to the new lifestyle, including employment as its integral part.
There are no statistically significant differences in the level of internal control in comparison with the intermediate test except the scale in the field of industrial relations.Here, the level of internal control is reduced (the average over the array in the intermediate test -63, in the final testing -60.9).Notably, the above subgroups of participants' scores of social adaptation were decreased, in connection with the exhibited behavioral emancipation amid falling fears.This led to certain problems in industrial relations (tardiness, reluctance to implement uninteresting work, etc.).Consequently, these problems led to the strengthening of the external locus of control in this area.A further improvement on an index of mental well-being (a significant increase in levels of emotional well-being, reduced anxiety levels) was also revealed.
In the intermediate testing comparative analysis of the Dembo test conducted using factor analysis revealed differences in the perception of themselves between participants of the program in the Group 2 (intact intelligence) and the control group of "normal" respondents (individuals without disability in the same age range).Consequently, in both groups, two important components (according to the criterion of eigenvalues more than 1) were distinguished.These components explain about 64.9% of the variance of the original variables in the disabled individuals and 74.6% -in the control group ("normal" individuals).The analysis of the rotated component matrix showed that the first most important factor (explains 43.9% of the variance in the disabled individuals, and 58.4% of the variance in the control group) in both control and experimental groups includes virtually the same set of qualities -intelligence, ability, authority.
However, for people with disabilities the first factor includes beauty, while among respondents without disability the first factor includes character.Therefore, for people with disabilities compared to the individuals without disability, more important in assessing themselves are the beauty and health (included in the second factor, explaining about 20% of the variance), whereas the "normal" respondents assign priority character.In the both control and experimental groups, their assessment of self-confidence comes in the second most important factor, however, in the experimental group, it combines with health and in the control group, and it combines with beauty.
Taking into account that the average level of assessment of their own health in the experimental group is 51.3%, and in the control group, this level is 71.4% (the highest distinction among the components of the self-assessment).It was concluded that further training activity aimed at disabled individuals' awareness of their social value outside the context of their formal diagnosis is necessary.
It should be noted that among the members of this subgroup (intact intelligence) self-confidence (average of the array in the primary testing -53.4%, in the intermediate testing -57.0%, in the final testing -58.6%) significantly increased.In the test for the definition of destructive attitudes in interpersonal communication gain of covert cruelty (14.5 -in the intermediate test, 15.3 -in the final test) was identified that can be attributed to a better understanding of their goals and the need to achieve these goals.If there was the possibility of continuing work training this trend would be mitigated.

Conclusion
 Among disabled people in the group 2 (intact intelligence), the external locus of control, defining their world, dominates.Essence of this philosophy is reduced to the removal of the responsibility for their lives and the rearrangement of the responsibility to other people and circumstances.This hypothesis, in particular, is supported by including beauty as a priority factor of self-esteem.Beauty is the external factor that is usually inherited.While the character (or at least its external manifestations) can largely be controlled by the individual, and in this sense, character is an object of internal locus of control.To enhance the degree of internal control, continued training in the confronting style is required. Reducing the overall level of aggression and dependent style of communication are evident of normalization of relations "I -the world" and strengthening of adaptation to the new lifestyle to include employment as its integral part.This result is achieved through: (a) Training; (b) a large number of new contacts with the enterprises staff, where the program participants held practical training; (c) working with their parents, who were asked to adjust children to independent life. Overprotection, in conjunction with an external locus of control, leading to the withdrawal from responsibility for their own lives and the tendency to social parasitism, was reduced due to working with parents and the psychological training, resulting in a significant increase in the level of motivation to succeed. At the level of continued labor activity and psychological work improvement of mental well-being index (a significant increase in levels of emotional well-being, a significant reduction in the level of depression, reduced anxiety levels) is identified.Increased mental well-being index is closely linked to self-confidence, as evidenced by statistically significant increase in self-confidence (in Dembo test). Psychological factors influencing the social adaptation in disabled individuals with intact intelligence are the factor of health, as well as communicative aggressiveness, and covert and overt violence determining the behavior of these individuals in society.Further works training would make it possible to mitigate these factors. By modifying the training program for participants with intellectual disability, it was possible to increase the level of general socialization and the level of development of their cognitive functions.In general, it is noted that this group of program participants shows mostly playing motivation or the motivation for social approval making the possibility of their long-term employment difficult.The people with such kind of disability need special labor mentor expressing approval of their activities and providing a game component, otherwise, it leads to a probability of loss for goal-setting and abrupt decline in motivation to work. According to the results of the program 19 people from the subgroup 2 have a job with partner enterprises, while 3 more people in this subgroup were employed by Foundation "Quality of Life" to third-party companies.12 individuals found jobs due to the participation in the program independently. 5 more individuals from the subgroup 1 (intellectual disability) are employed in the partner companies.
Overall, 39 individuals were provided with employment, which 43% the total number of program participants.Correspondingly, this result affords discussing the proper selection of the chosen methods of work.

Further Areas of Opportunity
1).It is necessary to conduct explanatory conversations and workshops with parents, involving parents in work that promotes professional and social adaptation of working age children with disabilities, as well as taking responsibility for their lives and welfare of their parents when they are unable to provide support the children; 2).A more long-term work training (at least a full calendar year), is necessary for both categories of program participants (individuals with intact intelligence and individuals with intellectual disability); 3).The average level of assessment of their own health is 51.3% in disabled individuals with intact intelligence, while the average level of assessment of own health in individuals without disability is 71.4%.The highest distinction among all the components of the self-assessment in experimental and control groups indicates that further training is necessary for realization of their social value, which is not closely related to their formal diagnosis.
4).It is necessary to change the state policy aimed at the welfare of persons with disabilities, and appropriate coverage of this policy in the media.The core of the changes must ensure that employable people with disabilities are not just full members of society, but members of society, who are responsible to the public, including carrying out their work duties.In turn, the government must utilize its resources to provide people with disabilities the opportunity to work.