Persons with invisible disabilities and workplace accommodation: Findings from a scoping literature review

Autistic Perspectives on Employment: A Scoping Review

PURPOSE

Inclusive recruitment and employment of autistic adults has garnered recent attention in research and policy. To address a need to better understand the experiences of autistic adults in relation to paid employment, we asked the literature, what are the experiences of autistic individuals (from their perspectives) in competitive employment?

METHODS

A scoping review was conducted to summarize and consolidate the findings across research to date. A systematic search and screen of the literature resulted in 32 relevant studies.

FINDINGS

Key study characteristics, participant demographics, and thematic findings are shared, along with considerations and recommendations for future research and practice. Six key themes were described by autistic participants across the 32 studies: (1) accessibility of employment, (2) workplace relationships and communication, (3) role alignment, (4) sensory needs and/or mental health, (5) colleagues' knowledge and beliefs about autism, and (6) family and community context.

CONCLUSION

It is anticipated that the results of this review will be beneficial for stakeholders engaging in discussions and decision-making across research and employment contexts.

Exploring the employment experiences of young adults with multiple minoritized identities: A qualitative study focusing on race and non-apparent disabilities

Youth with disabilities often encounter many challenges in securing employment. Although the common barriers that youth face are well documented, little is known about the experiences of youth who have multiple minoritized identities in finding and maintaining employment. Youth with disabilities who belong to racial minoritized groups may encounter ableism and racism and other forms of discrimination at work. Exploring the experiences of racial minoritized youth with non-apparent disabilities is important given the growing concern about social inequities that are linked to disadvantage and differential access to resources such as employment. We used a qualitative design involving semi-structured interviews with 19 youth (13 women, 3 non-binary, 3 men), aged 17-30 (mean 23.5 years). An inductive thematic analysis was applied to analyze the data. We identified the following themes: (1) challenges finding and maintaining employment; (2) the extent of safety and comfort with disclosing minoritized identities in the workplace (i.e., comfortable disclosing; uncomfortable disclosing; did not need to disclose and/or hiding identities); (3) workplace discrimination based on minoritized identities (i.e., ableism, racism, ableist racism, gendered ableism, racist and gendered ableism); (4) impact of discrimination (i.e., negative affective outcomes, social and work adjustment, impact on professional development) and coping strategies (i.e., advocacy, networking, peer support); and (5) advice for youth and employers. Our study highlights the extent of racism and ableism that racial minoritized youth with non-apparent disabilities experience in the workplace and the importance of rehabilitation clinicians supporting their inclusion.

'They don't think I can do it': Experiences of self-advocates, employment specialists, and employers on employment of adults with intellectual disability

BACKGROUND

A multi-phase Canadian study was conducted as part of a large-scale community and academic research partnership focused on understanding and improving the employment experiences of people with intellectual disabilities.

METHOD

This multi-method study utilized a sequential approach, using findings from qualitative interviews (n = 28) to inform an online survey (n = 149). Participants were invited to share their experiences with paid employment or with persons with intellectual disabilities.

RESULTS

Thematic analysis of data across interview and survey findings resulted in six themes: (1) assumptions and attitudes, (2) knowledge and awareness, (3) accessibility of processes, (4) use of accommodations, (5) workplace relationships, and (6) supports and resources.

CONCLUSIONS

A holistic and systemic approach has the potential to improve inclusive employment experiences of people with intellectual disabilities. Action is needed mainly at the policy and employer level to reduce barriers and improve on facilitating measures reinforced by the themes shared in this study.

The Patient Generated Index (PGI) as an early-warning system for predicting brain health challenges: a prospective cohort study for people living with Human Immunodeficiency Virus (HIV)

PURPOSE

In research people are often asked to fill out questionnaires about their health and functioning and some of the questions refer to serious health concerns. Typically, these concerns are not identified until the statistician analyses the data. An alternative is to use an individualized measure, the Patient Generated Index (PGI) where people are asked to self-nominate areas of concern which can then be dealt with in real-time. This study estimates the extent to which self-nominated areas of concern related to mood, anxiety and cognition predict the presence or occurrence of brain health outcomes such as depression, anxiety, psychological distress, or cognitive impairment among people aging with HIV at study entry and for successive assessments over 27 months.

METHODS

The data comes from participants enrolled in the Positive Brain Health Now (+ BHN) cohort (n = 856). We analyzed the self-nominated areas that participants wrote on the PGI and classified them into seven sentiment groups according to the type of sentiment expressed: emotional, interpersonal, anxiety, depressogenic, somatic, cognitive and positive sentiments. Tokenization was used to convert qualitative data into quantifiable tokens. A longitudinal design was used to link these sentiment groups to the presence or emergence of brain health outcomes as assessed using standardized measures of these constructs: the Hospital Anxiety and Depression Scale (HADS), the Mental Health Index (MHI) of the RAND-36, the Communicating Cognitive Concerns Questionnaire (C3Q) and the Brief Cognitive Ability Measure (B-CAM). Logistic regressions were used to estimate the goodness of fit of each model using the c-statistic.

RESULTS

Emotional sentiments predicted all of the brain health outcomes at all visits with adjusted odds ratios (OR) ranging from 1.61 to 2.00 and c-statistics > 0.73 (good to excellent prediction). Nominating an anxiety sentiment was specific to predicting anxiety and psychological distress (OR 1.65 & 1.52); nominating a cognitive concern was specific to predicting self-reported cognitive ability (OR 4.78). Positive sentiments were predictive of good cognitive function (OR 0.36) and protective of depressive symptoms (OR 0.55).

CONCLUSIONS

This study indicates the value of using this semi-qualitative approach as an early-warning system in predicting brain health outcomes.

A Sensibility Assessment of the Job Demands and Accommodation Planning Tool (JDAPT): A Tool to Help Workers with an Episodic Disability Plan Workplace Support

Purpose Sensibility refers to a tool's comprehensiveness, understandability, relevance, feasibility, and length. It is used in the early development phase to begin assessing a new tool or intervention. This study examined the sensibility of the job demands and accommodation planning tool (JDAPT). The JDAPT identifies job demands related to physical, cognitive, interpersonal, and working conditions to better target strategies for workplace supports and accommodations aimed at assisting individuals with chronic health conditions. Methods Workers with a chronic health condition and workplace representatives were recruited from health charities, workplaces, and newsletters using convenience sampling. Cognitive interviews assessed the JDAPT's sensibility. A 70% endorsement rate was the minimum level of acceptability for sensibility concepts. A short screening tool also was administered, and answers compared to the complete JDAPT. Results Participants were 46 workers and 23 organizational representatives (n = 69). Endorsements highly exceeded the 70% cut-off for understandability, relevance, and length. Congruence between screening questions and the complete JDAPT suggested both workers and organizational representatives overlooked job demands when completing the screener. Participants provided additional examples and three new items to improve comprehensiveness. The JDAPT was rated highly relevant and useful, although not always easy to complete for someone with an episodic condition. Conclusions This study highlights the need for tools that facilitate accommodations for workers with episodic disabilities and provides early evidence for the sensibility of the JDAPT.

Workplace accommodations during the COVID-19 pandemic: A scoping review of the impacts and implications for people with disabilities

BACKGROUND

The COVID-19 pandemic has led to widespread changes in the way people work. Some of these changes represent the same kinds of work modifications or adjustments that have often been requested as workplace accommodations, and which may improve labour market and employment outcomes for people with disabilities.

OBJECTIVE

The aim of this scoping review was to examine the literature on workplace accommodations in the pandemic and their impacts and implications for people with disabilities.

METHODS

Following a search of six international databases, articles were selected by two reviewers, and data were abstracted in accordance with scoping review methodology. A thematic analysis was used to report the relevant findings.

RESULTS

Thirty-seven articles met the inclusion criteria, and three main themes were identified: positive impacts of pandemic-related workplace accommodations on people with disabilities (e.g., improved accessibility, reduced stigma around workplace accommodations, rapid implementation of workplace accommodations, opportunities for advocacy); negative impacts (e.g., worsened physical and mental health, new accommodation needs); and action needed and recommendations (e.g., revisit legislation and policy on accommodations, ensure representation of people with disabilities). Overall, our review identified a mixed assessment of the impacts of pandemic-related accommodations on people with disabilities. However, there was a broader consensus regarding the importance of learning from the experiences of the pandemic to improve workplace accommodation policies in the future.

CONCLUSIONS

The pandemic may present opportunities for improving workplace accommodation policies, but our review also highlights the need for more research examining how workplace changes due to the COVID-19 pandemic have impacted people with disabilities.

Unravelling the Complexities of Workplace Disclosure Among Persons with Non-Visible Disabilities and Illnesses: A Qualitative Meta-Ethnography

BACKGROUND

Deciding whether and how to disclose a disability at work for persons with non-visible disabilities and illnesses involve complex processes. Research has focused on antecedents and outcomes of disclosure. More research is needed to understand the lived experiences related to disclosure decision-making and actual navigation of disclosure and concealment at work.

PURPOSE

To understand the experiences of persons with non-visible disabilities and illnesses regarding workplace disclosure decision-making, navigating disclosure and/or concealment, and experiential differences across disability and illness types, ages, geographic locations, and genders.

METHODS

We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Searches were conducted via six databases. Studies were analyzed to develop conceptual categories, third-order constructs (themes), and a line-of-argument with comparisons drawn from the disclosure decision making model, disclosure process model, and consideration of disability and illness types, genders, ages, and geographic locations.

RESULTS

Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, focusing on one non-visible disability or illness, or multiple. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations.

CONCLUSIONS

Knowledge obtained could be used among professionals who support persons with non-visible disabilities and illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.

Effectiveness of interventions for improving livelihood outcomes for people with disabilities in low- and middle-income countries: A systematic review

Background

People with disabilities-more than a billion people worldwide-are frequently excluded from livelihood opportunities, including employment, social protection, and access to finance. Interventions are therefore needed to improve livelihood outcomes for people with disabilities, such as improving access to financial capital (e.g., social protection), human capital (e.g., health and education/training), social capital (e.g., support) or physical capital (e.g., accessible buildings). However, evidence is lacking as to which approaches should be promoted.

Objectives

This review examines whether interventions for people with disabilities result in improved livelihood outcomes in low- and middle-income countries (LMIC): acquisition of skills for the workplace, access to the job market, employment in formal and informal sectors, income and earnings from work, access to financial services such as grants and loans, and/or access to social protection programmes.

Search Methods

The search, up to date as of February 2020, comprised of: (1)an electronic search of databases (MEDLINE, Embase, PsychINFO, CAB Global Health, ERIC, PubMED and CINAHL),(2)screening of all included studies in the instances where reviews were identified,(3)screening reference lists and citations of identified recent papers and reviews, and(4)An electronic search of a range of organisational websites and databases (including ILO, R4D, UNESCO and WHO) using the keyword search for unpublished grey to ensure maximum coverage of unpublished literature, and reduce the potential for publication bias.

Selection Criteria

We included all studies which reported on impact evaluations of interventions to improve livelihood outcomes for people with disabilities in LMIC.

Data Collection and Analysis

We used review management software EPPI Reviewer to screen the search results. A total of 10 studies were identified as meeting the inclusion criteria. We searched for errata for our included publications and found none. Two review authors independently extracted the data from each study report, including for the confidence in study findings appraisal. Data and information were extracted regarding available characteristics of participants, intervention characteristics and control conditions, research design, sample size, risk of bias and outcomes, and results. We found that it was not possible to conduct a meta-analysis, and generate pooled results or compare effect sizes, given the diversity of designs, methodologies, measures, and rigour across studies in this area. As such, we presented out findings narratively.

Main Results

Only one of the nine interventions targeted children with disabilities alone, and only two included a mix of age groups (children and adults with disabilities. Most of the interventions targeted adults with disabilities only. Most single impairment group interventions targeted people with physical impairments alone. The research designs of the studies included one randomised controlled trial, one quasi-randomised controlled trial (a randomised, posttest only study using propensity score matching (PSM), one case-control study with PSM, four uncontrolled before and after studies, and three posttest only studies. Our confidence in the overall findings is low to medium on the basis of our appraisal of the studies. Two studies scored medium using our assessment tool, with the remaining eight scoring low on one or more item. All the included studies reported positive impacts on livelihoods outcomes. However, outcomes varied substantially by study, as did the methods used to establish intervention impact, and the quality and reporting of findings.

Authors' Conclusions

The findings of this review suggest that it may be possible for a variety of programming approaches to improve livelihood outcomes of people with disabilities in LMIC. However, given low confidence in study findings related to methodological limitations in all the included studies, positive findings must be interpreted with caution. Additional rigorous evaluations of livelihoods interventions for people with disabilities in LMIC are needed.

Hidden disability: a study of the psychosocial impact of living with pituitary conditions

BACKGROUND

Pituitary patients often experience psychosocial symptoms associated with their condition.

AIMS

To explore the condition management experiences of pituitary patients and their psychosocial symptoms and to explore the impact of these on quality of life.

METHODS

A sample of 748 individuals aged 18 to more than 65 years) completed a questionnaire relating to quality of life and the psychosocial impact of pituitary conditions.

FINDINGS

Analysis of the qualitative sections using content analysis identified four themes: social isolation, emotional and behavioural issues, appearance distress and physical and cognitive effects including fatigue and pain. An overarching theme of hidden disability emerged.

CONCLUSION

The study identified multiple biopsychosocial factors that impact quality of life, with symptoms not visible to others most likely to impact negatively. Nurses are well placed to provide support and information to patients about the possible psychosocial impact of pituitary conditions to enable positive adjustment.

Assessing Pain Research: A Narrative Review of Emerging Pain Methods, Their Technosocial Implications, and Opportunities for Multidisciplinary Approaches

Pain research traverses many disciplines and methodologies. Yet, despite our understanding and field-wide acceptance of the multifactorial essence of pain as a sensory perception, emotional experience, and biopsychosocial condition, pain scientists and practitioners often remain siloed within their domain expertise and associated techniques. The context in which the field finds itself today-with increasing reliance on digital technologies, an on-going pandemic, and continued disparities in pain care-requires new collaborations and different approaches to measuring pain. Here, we review the state-of-the-art in human pain research, summarizing emerging practices and cutting-edge techniques across multiple methods and technologies. For each, we outline foreseeable technosocial considerations, reflecting on implications for standards of care, pain management, research, and societal impact. Through overviewing alternative data sources and varied ways of measuring pain and by reflecting on the concerns, limitations, and challenges facing the field, we hope to create critical dialogues, inspire more collaborations, and foster new ideas for future pain research methods.

A balancing act: The employer perspective on disability disclosure in hiring

BACKGROUND: How to disclose an impairment during the hiring process is an important question for disabled people, yet the associated employer perspective remains overlooked in the literature. OBJECTIVE: The article investigates whether, when and how employers prefer jobseekers to disclose their impairment during the recruitment process. Stigma and impression management is used as a theoretical lens to interpret employer responses. METHODS: The article uses interview data from 38 Norwegian employers paired with behavioral data from a recruitment situation. Prior to the interviews, the employers were subjected to a field experiment wherein pairs of fictitious applications were submitted for real job listings. In these, one of the applicants disclosed either a mobility impairment or a mental health condition. RESULTS: The findings show that disability disclosure is a balancing act between appearing candid and demonstrating competence and that employers favor identity management strategies that present disability in a positive and unobtrusive manner and downplay the impairment. The employers favored disclosure but expected wheelchair users to disclose their impairment earlier than people with mental health conditions. Furthermore, employers with a relational view on disability were found to be more open to hiring disabled people. CONCLUSIONS: The article illustrates how disclosure expectations can represent a significant disability penalty, thus hampering employment advancement for disabled people.

Working with chronic health conditions and the disclosure decision-conflict: Development of a web-based interactive self-test to support an informed decision –A brief report

BACKGROUND: For employees with chronic health conditions the decision of whether or not to disclose their condition to colleagues or supervisors is both far reaching and hard to make. OBJECTIVE: In accordance with an expert panel, we developed a web-based self-test to provide easily accessible decision support for those who are not (yet) ready for personal counseling. METHODS: This report provides an overview of the web-based self-test for disclosure in the workplace. RESULTS: The self-test consists of a series of questions about the user’s personal situation. In order to reach a broad target-group it is applicable across health conditions and is made available online. CONCLUSION: Unlike other existing web-based offers the self-test is interactive, considers the personal situation of the user and provides individualized feedback that refers to additional resources (e.g., personal counselling).

Diversity and inclusion in the legal profession: disclosure of cancer and other health conditions by lawyers with disabilities and lawyers who identify as LGBTQ +

PURPOSE

Given the training and experience of lawyers, we assumed that a study of lawyers' willingness to disclose disability in the workplace would provide an example of the actions of a group knowledgeable about disability law. The current study accounts for the effect of visibility of disability, onset and type of disability, and whether the lawyer has made an accommodation request. We also investigate the role of other individual characteristics, such as sexual orientation, gender identity, race/ethnicity, age, and job-related characteristics, in willingness to disclose.

METHODS

We use data from the first phase of a longitudinal national survey of lawyers in the USA to estimate the odds of disclosing disability to co-workers, management, and clients using proportional odds models.

RESULTS

Lawyers with less visible disabilities, those with mental health disabilities, and those who work for smaller organizations have lower odds of disclosing to co-workers, management, and clients as compared to their counterparts. Attorneys who have requested accommodations are more willing to disclose as compared to those who have not, but only to co-workers and management. Women are less likely than men to disclose to management and clients. However, gender is not a significant determinant of disclosure to co-workers. Older attorneys are more likely to disclose to clients, whereas attorneys with children are less likely to disclose to co-workers. Lastly, lower perceived prejudice and the presence of co-workers with disabilities are associated with higher disclosure scores, but not for all groups.

CONCLUSIONS

Individuals who acquired a disability at a relatively early point in life and those with more visible disabilities are more likely to disclose. However, such willingness is affected by the intersection of disability with other individual and firm-level characteristics.

IMPLICATIONS FOR CANCER SURVIVORS

The findings imply that those with less visible disabilities and with health conditions acquired later in life are less likely to disclose. The relevance of the findings is heightened by the altered work conditions and demands imposed by the COVID-19 pandemic for cancer survivors.

Does it matter what your reasons are when deciding to disclose (or not disclose) a disability at work? The association of workers' approach and avoidance goals with perceived positive and negative workplace outcomes

Deciding whether to disclose a disability to others at work is complex. Many chronic mental and physical health conditions are associated with episodic disability and include times of relative wellness punctuated by intermittent periods of activity limitations. This research draws on the disclosure processes model to examine approach and avoidance disclosure and non-disclosure goals and their association with perceived positive and negative workplace outcomes. Participants were 896 employed individuals (57.7% women) living with a chronic physical or mental health/cognitive condition. They were recruited from an existing national panel and completed an online, cross-sectional survey. Participants were asked about disclosure decisions, reasons for disclosure/non-disclosure, demographic, work context and perceived positive and negative disclosure decision outcomes (e.g., support, stress, lost opportunities). About half the sample (51.2%) had disclosed a disability to their supervisor. Decisions included both approach and avoidance goals. Approach goals (e.g., desire support, want to build trust, maintain the status quo at work) were significantly associated with perceived positive work outcomes regardless of whether a participant disclosed or did not disclose a disability at work, while avoidance goals (e.g., concerns about losing one's job, feeling forced to disclose because others notice a problem) were associated with perceived negative work outcomes. The findings highlight benefits and challenges that workers perceive arise when they choose to disclose or not disclose personal health information. By better understanding disclosure decisions, we can inform organizational health privacy and support gaps to help sustain the employment of people living with disabilities.

PROTOCOL: Effectiveness of interventions for improving livelihood outcomes for people with disabilities in low- and middle-income countries: A systematic review

The objectives of this review are to answer the following research questions: (1) What is the effect size of the effectiveness of interventions to improve livelihood outcomes for people with disabilities in low- and middle-income countries (LMICs), and what is the quality of the evidence base? (2) What works to improve livelihood outcomes for people with disabilities in LMICs? (3) Which interventions appear most effective for different categories of disability? (4) What are the barriers and facilitators to the improvement of livelihood outcomes to people with disabilities?

A Qualitative Exploration of Addiction Disclosure and Stigma among Faculty Members in a Canadian University Context

Addiction is one of the most stigmatized public health issues, which serves to silence individuals who need help. Despite emerging global interest in workplace mental health and addiction, scholarship examining addiction among university faculty members (FMs) is lacking, particularly in a Canadian context. Using a Communication Privacy Management (CPM) framework and semi-structured interviews with key informants (deans and campus mental health professionals), this qualitative study aimed to answer the following research questions: (1) What is the experience of key informants who encounter FM addiction? (2) How may addiction stigma affect FM disclosure and help-seeking? and (3) What may help reduce addiction stigma for FMs? Thematic analysis was used to identify three main themes: (1) Disclosure was rare, and most often involved alcohol; (2) Addiction stigma and non-disclosure were reported to be affected by university alcohol and productivity cultures, faculty type, and gender; (3) Reducing addiction stigma may involve peer support, vulnerable leadership (e.g., openly sharing addiction-recovery stories), and non-discriminatory protective policies. This study offers novel insights into how addiction stigma may operate for FMs in relation to university-specific norms (e.g., drinking and productivity culture), and outlines some recommendations for creating more recovery-friendly campuses.

"It's like a ramp for a person in a wheelchair": Workplace accessibility for employees with autism

BACKGROUND, AIMS AND METHODS

Participation in employment by individuals with autism spectrum disorders (ASD) remains restricted despite their high motivation and evident abilities. Challenges to employment result from personal characteristics and environmental barriers. This phenomenological research explores the accessibility of a competitive work environment according to the perceptions of adults with ASD.

PROCEDURES AND OUTCOMES

We conducted in-depth interviews with 19 employees with ASD, followed by a thematic content analysis. Three themes emerged: (a) the employees' motivation for employment, (b) challenges and abilities at work, and (c) workplace accessibility (types of accommodations, implementation process).

RESULTS AND CONCLUSIONS

The findings contribute a classification of accommodations that addresses the core characteristics of autism-challenges as well as abilities and motivations for employment. Four types of accommodations were identified: job-performance communication, attitudes and interpersonal communication, daily workplace routines, and physical and sensory environments. Hence, this study supports the centrality of environmental factors in successful employment of individuals with ASD.

IMPLICATIONS

This study presents an evidence-based foundation for autism-related workplace accessibility. It offers an approach to enhance employees' abilities, strengths, and motivation for employment, as well as to decrease barriers and challenges. The findings may expand organizational policies regarding accessibility and thereby anchor workplace accommodations within organizations' corporate cultures.

Participatory design and qualitative evaluation of a decision guide for workplace human immunodeficiency virus self-disclosure: The importance of a socio-ecological perspective

Background

Disclosure of human immunodeficiency virus (HIV)‐positive status in a workplace can be a complex social decision for a person living with HIV.

Objective

To design a Decision Guide to support people living with HIV in assessing contexts, risks and benefits of workplace disclosure in choosing whether or not, or to what extent, to disclose. In this report, we review the participatory design of a Decision Guide prototype and focus on its evaluation.

Methods

We began with stakeholder input through an environmental scan and community consultation that informed the development of an online Decision Guide prototype. To evaluate the comprehensiveness, acceptability and usability of the prototype, we used qualitative methodology involving individual interviews and the think‐aloud technique. Interviews were transcribed and analysed qualitatively.

Results

Fourteen people, including people living with HIV and service providers, participated. We identified benefits of the Decision Guide related to comprehensiveness, acceptability and usability. Additional interview themes focused on disclosure concerns, mitigating risks associated with disclosure and additional considerations for the Decision Guide.

Conclusions

The Decision Guide was perceived to be acceptable, comprehensive and useful. The findings endorse the application of a socio‐ecological perspective when designing decision support aids for complex social decisions.

Patient or public contribution

People with lived experience of HIV were involved in the prototype design phases as research team members. They, along with community leaders and service providers, also participated in a community forum and were key informants for the evaluation of the Workplace Disclosure Decision Guide prototype.

Disclosure, Privacy and Workplace Accommodation of Episodic Disabilities: Organizational Perspectives on Disability Communication-Support Processes to Sustain Employment

Purpose Employers increasingly are asked to accommodate workers living with physical and mental health conditions that cause episodic disability, where periods of wellness are punctuated by intermittent and often unpredictable activity limitations (e.g., depression, anxiety, arthritis, colitis). Episodic disabilities may be challenging for workplaces which must comply with legislation protecting the privacy of health information while believing they would benefit from personal health details to meet a worker's accommodation needs. This research aimed to understand organizational perspectives on disability communication-support processes. Methods Twenty-seven participants from diverse employment sectors and who had responsibilities for supporting workers living with episodic disabilities (e.g., supervisors, disability managers, union representatives, occupational health representatives, labour lawyers) were interviewed. Five participants also had lived experience of a physical or mental health episodic disability. Participants were recruited through organizational associations, community networks and advertising. Semi-structured interviews and qualitative content analysis framed data collection and analyses, and mapped communication-support processes. Results Seven themes underpinned communication-support process: (1) similarities and differences among physical and mental health episodic disabilities; (2) cultures of workplace support, including contrasting medical and biopsychosocial perspectives; (3) misgivings about others and their role in communication-support processes; (4) that subjective perceptions matter; (5) the inherent complexity of the response process; (6) challenges arising when a worker denies a disability; and (7) casting disability as a performance problem. Conclusions This study identifies a conceptual framework and areas where workplace disability support processes could be enhanced to improve inclusion and the sustainability of employment among workers living with episodic disabilities.

Online resources supporting workers with chronic episodic disabilities: an environmental scan

Purpose

The purpose of this research was to conduct an environmental scan describing publicly available resources focussed on working with an episodic disability and providing information and advice about communication and accommodation to support working people living with episodic disabilities.

Design/methodology/approach

The authors conducted an environmental scan of English language, freely available, online resources relevant to episodic disabilities in the workplace. The authors used Google™ to conduct structured keyword searches. Resources were reviewed and data extracted about episodic health condition(s) addressed, intended audience(s), resource format and content about health, legal rights, workplace issues, and accommodation and communication needs.

Findings

Searches yielded 5,300 links to websites which was supplemented by 101 links identified by partners. Screening for relevance found 210 resources for which data were extracted. Of them, 158 addressed specific episodic disabilities or episodic disabilities generally. Most resources provided useful information addressing communication and accommodation of episodic disability. However, information specific to the episodic nature of disability was not consistently available. The resources generally lacked interactivity which could potentially limit users in applying the information to their personal circumstances.

Practical implications

The findings suggest there are good resources to help workers and managers/supervisors navigate accommodations for episodic disabilities. Research should aim to improve the interactivity of information to personalize resources to worker and workplace needs, as well as formally evaluate resources and their outcomes. Practitioners may wish to recommend resources that specifically address workplace challenges for their clients.

Originality/value

The authors believe this is one of few studies that examined publicly available resources relevant to working with episodic disabilities.

“What should I say to my employer… if anything?”- My disability disclosure dilemma

Purpose

The purpose of this paper is to explore the key issues surrounding teacher/staff disability disclosures in the UK's further education (FE) sector.

Design/methodology/approach

In total, 15 semi-structured interviews were conducted in a medium-sized FE college (case study) setting in the South East of England. To compare the experiences, views and perceptions of leaders, managers and teachers, interviews were carried out with leaders and managers who are accountable for ensuring disability legislation is adhered to, and with teachers who are responsible for complying with equality and disability legislation. The 15 interviewees who volunteered to take part in this research represent the various layers of the organisational structure and different academic departments in the college.

Findings

Two major themes discussed include: the desire for teaching staff to “come out” and make a disability disclosure and the perception of disability as a “deficit”. A number of staff that disclosed their hidden disabilities stated they would not do so again. To avoid the negative side effects, developing a “culture of disability disclosure” and providing long-term employer support are required.

Research limitations/implications

This is an exploratory qualitative case study that highlights some of the key issues from a teacher/staff perspective. It is not meant to be generalisable research, but the ideas therein should help to develop a wider (empirical) research agenda.

Originality/value

There is an abundance of critical and sociological research concerning disability disclosure in general; there are also a number of scholarly studies that focus on disability issues from the student perspective. However, this is the first scholarly study that explores the key issues involving FE staff.

Disability disclosure and workplace accommodations among youth with disabilities

Purpose: Many youths with disabilities find it challenging to disclose their medical condition and request workplace accommodations. Our objective was to explore when and how young people with disabilities disclose their condition and request workplace accommodations. Methods: We conducted 17 in-depth interviews (11 females, six males) with youth with disabilities aged 15-34 (mean age 26). We analyzed our data using an interpretive, qualitative, and thematic approach. Results: Our results showed the timing of when youth disclosed their disability to their employer depended on disability type and severity, comfort level, type of job, and industry. Youth's strategies and reasons for disclosure included advocating for their needs, being knowledgeable about workplace rights, and accommodation solutions. Facilitators for disclosure included job preparation, self-confidence, and self-advocacy skills, and having an inclusive work environment. Challenges to disability disclosure included the fear of stigma and discrimination, lack of employer's knowledge about disability and accommodations, negative past experiences of disclosing, and not disclosing on your own terms. Conclusions: Our findings highlight that youth encounter several challenges and barriers to disclosing their condition and requesting workplace accommodations. The timing and process for disclosing is complex and further work is needed to help support youth with disclosing their condition. Implications for rehabilitation Clinicians, educators, and employers should emphasize the importance of mentoring and leadership programs to give youth the confidence and self-advocacy skills needed to disclose and ask for accommodations in the workplace. Clinicians should advocate for the inclusion of youth with disabilities in the workforce and educate employers on the importance of doing so. Youth with disabilities need more opportunities for employment training and particularly how to disclose their disability and request workplace accommodations.