We investigated the extent to which employment consultants implemented job development practices recommended in the literature when assisting job seekers with intellectual or developmental disabilities. We contacted 83 employment consultants from 25 employment programs in Minnesota and Connecticut. Fifty-nine participants were eligible and completed surveys. We found inconsistencies between the employment consultants' practices and the job development literature in areas such as involvement of family members and acquaintances, observation of job seekers in work and nonwork environments, analyses of employers' needs, development of customized jobs, and assistance with work incentives planning. We recommend a system-wide effort for supporting employment consultants in implementing promising job development practices. This effort needs to involve funding agencies, employment programs, accreditation agencies, training programs, and researchers.
Most adults with intellectual and developmental disabilities (IDD) seek economic independence and self-sufficiency and include employment among their goals (Gray, McDermott, & Butkus, 2000; Migliore, Mank, Grossi, & Rogan, 2007). Federal and state legislation support these goals (Silverstein, 2003). However, only a minority of adults with IDD are employed in regular businesses, and the percentage has declined from 25% in 2001 to 20% in 2009 (Butterworth et al., 2011). In addition, when adults with disabilities work, they tend to be in entry-level jobs with limited hours and earnings (Boeltzig, Timmons, & Butterworth, 2008; Mank, Cioffi, & Yovanoff, 2003; Migliore & Butterworth, 2008). This problem is even greater for adults with the most significant disabilities (Gilmore, Schuster, Timmons, & Butterworth, 2000; West, 1995). The causes for this lack of participation of adults with disabilities in employment are complex. Some of the challenges include job seekers' support needs, families' or caregivers' concerns, the funding structures of day programs, employers' attitudes, and socioeconomic circumstances (Burke-Miller et al., 2006; Devlieger & Trach, 1999; Gilbride, Stensrud, Vandergoot, & Golden 2003; Kennedy & Olney, 2006; Luecking, 2008; Smith, 2007; U.S. Government Accountability Office, 2005).
To assist job seekers in negotiating these challenges, a system of services is in place across the nation. This system includes community rehabilitation programs, funding agencies, accreditation organizations, and employment consultants. We use the term employment consultant here to describe direct-support professionals who are responsible for supporting the job-placement process. Other terms used to describe this role include employment specialist, job developer, and job coach. Duties of this role include assessment and career planning, job development, and on-the-job supports. The scope of responsibilities varies from fairly narrow (e.g., only providing on-the-job training and support) to much broader (e.g., having responsibility for the full employment process, from intake to long-term follow-along supports). In this article, we emphasize responsibilities related to career planning and job development that support entry into individual integrated jobs.
An extensive literature has been published on promising employment practices. Beginning in the early 1980s, this research has drawn from the supported-employment model (Bellamy & Melia, 1991; Rusch, 1990; Wehman, Revell, & Kregel, 1998). Since the early 2000s, it has also drawn from customized-employment strategies (Callahan, 2003; Griffin, Hammis, Geary, & Sullivan, 2008; Office of Disability Employment Policy, 2005). Supported employment is intended to extend employment opportunities to individuals with a full range of support needs, and a key element of the model is the “place-then-train” approach to employment. This approach replaces a focus on prerequisites with an emphasis on learning on the job and access to long-term supports (Bellamy & Melia, 1991; Rusch, 1990; Wehman et al., 1998). Research conducted in the mental health field has established evidence for the effectiveness of a supported-employment model that includes individualized and rapid job search, focus on good job matches, emphasis on job seekers' preferences and needs, and building relationships with employers (Becker, Swanson, Bond, & Merrens, 2008). Promising supported-employment practices include involving family and friends in the job search, using job restructuring or job creation to expand employment opportunities, and using planning strategies, such as person-centered career planning, that emphasize choice, empowerment, and an effective job match. Butterworth et al. (2000) emphasized the importance of workplace culture and structure, including the value of developing a relationship with the employer and of understanding the work environment. Carlson, Smith, and Rapp (2008) identified the need to understand employer needs and to develop a strong relationship with the employer.
Building on this model, customized employment emphasizes negotiating an employment relationship that meets the needs of the job seeker and the employer and is not based on existing jobs that an employer has defined. This approach requires a detailed understanding of individual skills and interests and an exploratory approach to understanding the business and its culture and needs (Callahan, 2003; Griffin et al., 2008). Promising practices in supported and customized employment for career planning and assessment include developing a detailed understanding of the job seeker's strengths, skills, and preferences (Kluesner, Taylor, & Bordieri, 2005). The literature has recommended engaging in both formal and informal conversations with people who know the job seeker well and observing the job seeker in both work and nonwork settings. The process is often referred to as person-centered career planning or discovery (Callahan, Shumpert, & Condon, 2009; Griffin, Hammis, & Geary, 2007; Phillips et al., 2009). The next step is job development. Traditional job development has focused on targeting existing job openings by reviewing job advertisements, making cold calls to employers, and sending résumés to businesses. The literature has shown, however, that employers typically turn first to their networks of personal and professional acquaintances when looking for candidates. Only when this strategy is unsuccessful do employers advertise job openings or consider unsolicited résumés (Bissonette, 1994; Bolles, 2009; Hagner, Fesko, Cadigan, Kiernan, & Butterworth, 1996; Owens & Young, 2008). Therefore, a better job development strategy is reaching out to businesses through people who know the job seeker well, while also using the employment consultant's existing relationships with businesses. Long-term networking strategies also include participating in business events and building connections with key members of the community (Griffin et al., 2007; Levinson & Perry, 2009; Luecking, Fabian, & Tilson, 2004). The importance of networking has been confirmed by empirical studies that have found a strong relationship between using personal contacts and finding jobs (Fesko & Temelini, 1997; Gervey & Kowal, 1995; Granovetter, 1995; Silliker, 1993). Customized employment specifically uses an exploratory approach, with the goal of learning about business needs rather than identifying existing jobs. Exploring businesses without the pressure of hiring also has the advantage of allowing more opportunities for job negotiation (Callahan, 2003; Griffin et al., 2008). Job negotiation refers to practices such as job carving, job creation, or job sharing. Over time, employees often accumulate tasks that are not directly related to their job description. A negotiated position can free up an employee to spend more time performing more profitable tasks, offer a new service to customers, or address unmet needs in a company (Condon, Enein-Donovan, Gilmore, & Jordan, 2004; Griffin et al., 2007; Luecking et al., 2004; Nietupski & Hamre-Nietupski, 2000). After a job is found, strategies are needed to facilitate a smooth transition to employment. For instance, employment consultants need to demonstrate how job seekers will contribute to the business. One way to achieve this is by having job seekers complete job trials (Gilbride & Stensrud, 1999; Hagner et al., 1996; Hoff, Gandolfo, Gold, & Jordan, 2000). Employment consultants can also provide long-term assistance after hiring, which minimizes the risk that problems arising in the workplace will go unnoticed. This assistance can also prevent minor issues from growing into substantial problems that can jeopardize employment (Griffin et al., 2007; Hoff et al., 2000; Wehman, Revell, & Brooke, 2003). Transportation, work incentives planning, and building and ensuring natural supports are also critical for a smooth transition to employment (Becker & Drake, 2003; Test, Sollow, & Flowers, 1998). Work incentives planning refers to protecting disability benefits that might otherwise be reduced if the new income exceeds a federally set threshold (Becker & Drake, 2003; Revell, Kregel, Wehman, & Bond, 2000; Rogan, Held, & Rinne, 2001; Wehman et al., 2003). Natural support in the workplace, defined as support provided by coworkers, supervisors, and other readily available resources, correlates with greater social participation in the workplace, better outcomes, and lower support costs (Cimera, 2007; Mank, Cioffi, & Yovanoff, 1999; Novak, Rogan, Mank, & DiLeo, 2003). Strategies for promoting natural supports include facilitating relationships between workers with disabilities and their coworkers without disabilities, teaching workers with disabilities how to make requests of supervisors or coworkers, and teaching workers with disabilities how to market their skills in the workplace (Butterworth, Whitney-Thomas, & Shaw, 1997; Hagner, Rogan, & Murphy, 1992; Mank, Cioffi, & Yovanoff, 1999, 2000; Novak, Rogan, Mank, & DiLeo, 2003; Test et al., 1998).
We have shown that a well-established body of knowledge is available to guide employment consultants in assisting job seekers with disabilities. Limited research is available, however, about the extent to which these strategies are implemented and about the relationships between these promising practices and employment outcomes (Drake & Bond, 2008; Gervey & Kowal, 1995; Kluesner et al., 2005; Luecking et al., 2004). This limited research is troubling because evaluating the implementation of promising practices is critical for improving the outcomes of any organization (Fitzpatrick, Sanders, & Worthen, 2004; Fixsen, Naoom, Blasé, Friedman, & Wallace, 2005). Evaluating the implementation of promising practices is even more important for employment programs for job seekers with disabilities because of the challenges that this group faces. The current adverse economic conditions only amplify the need for closely monitoring that state-of-the-art employment supports are implemented. Our purpose in this article is to contribute to a better understanding of the extent to which job development practices are implemented. We address the following research question: To what extent do employment consultants implement the job development practices recommended in the literature?
This study was part of a larger experimental project designed to test the effectiveness of customized-employment training on employment consultants' outcomes. In this article, we focus on the findings from the baseline data (see Butterworth, Migliore, Nord, & Gelb, in press).
Eighty-three employment consultants from 25 employment programs were contacted for this study. Of the employment consultants, 45 were from 14 programs in Connecticut, and 38 were from 11 programs in Minnesota. To be eligible for this study, participants had to assist job seekers with IDD in gaining individual paid employment. We defined individual paid employment as work that paid at least minimum wage and that entailed working in environments in which most coworkers were people without disabilities. Eighty-one employment consultants returned completed surveys (97%). On the basis of data from these surveys, 59 employment consultants were eligible for this study. We excluded 22 for the following reasons: 18 did not report any placements during the year before data collection, three reported duplicate data, and one reported a number of placements that was an outlier (i.e., 3 standard deviations above average after transformation into a standard score).
We recruited employment consultants through programs that provided employment services. To be admitted as participants, these programs were asked to commit to (a) selecting as many as four employment consultants, (b) allowing these employment consultants release time to attend the study's training and mentoring components, (c) completing the data collection activities for 1.5 years after intervention, and (d) reimbursing employment consultants for study-related travel expenses. To maximize the potential for full cooperation on the part of the employment programs, we adapted the selection method to local circumstances. For instance, in Minnesota, the employment programs were selected through professional contacts established in past collaborations with the programs' directors. These professional relationships were critical to ensuring the directors' commitment throughout the duration of the project. Sixteen employment programs were contacted, and 11 submitted requests for proposals and agreed to participate in the study.
Employment programs in Connecticut were selected by means of a request for proposals process endorsed by the state's Department of Developmental Services, the funding agency of day and employment services in Connecticut. This endorsement was critical for ensuring collaboration because employment programs saw the research as an important component of their relationship with Department of Developmental Services. All 138 employment programs receiving funding from Connecticut's Department of Developmental Services were contacted. Fourteen programs submitted requests for proposals and were admitted into the study. Although two methods of selection may have increased the risks for bias in the findings, this recruitment strategy was necessary to maximize cooperation throughout the duration of the experimental study project in the two states.
The participating programs were diverse in their size and scope of services. The Minnesota programs were primarily located around the Minneapolis–St. Paul metropolitan area. The smallest program supported 62 people, the largest program supported 1,178 people, and the median program supported 299 people. Operational budgets also varied greatly, from $785,560 to $11,071,172. Ten of the Minnesota programs supported people with IDD either exclusively or primarily. On average, 22% of all people with IDD received services geared toward gaining individual paid employment. The programs used an average of seven employment consultants to provide these job-placement services.
In Connecticut, programs were from the southern, central, and northern regions of the state. The smallest program supported 26 people, the largest program supported 1,310 people, and the median program supported 150 people. Operational budgets ranged from $75,000 to $5 million. More than half of the programs supported primarily people with IDD, whereas this population represented fewer than half of the caseloads in three programs. On average, 42% of people with IDD served by the Connecticut programs received services geared toward gaining individual paid employment. The programs used an average of seven employment consultants to provide these job placement services.
We used a paper survey to investigate the employment consultants' professional background, demographics, outcomes, and activities performed to assist job seekers. The section on activities tested three domains: (a) career planning and assessment (seven items), (b) job development (15 items), and (c) job support (11 items). For each item, employment consultants were asked whether they performed the corresponding activity for all, most, half, a few, or none of the job seekers who gained employment during the year before the survey. The option of “not applicable” was available. These items were identified through an extensive review of the literature about assisting job seekers. The preliminary list of activities was then discussed within our team and then with six experts: three professionals who provided training to employment specialists, a coordinator of an employment program, an employment consultant, and the coordinator of a disability advocacy organization. The final version of the survey was piloted by seven employment consultants from three employment programs in three states—Idaho, Massachusetts, and Virginia. The pilot study participants suggested minimal changes.
Data Collection Procedures
Data collection began in mid-April 2009 and ended in mid-June 2009. The surveys were mailed in a packet to each employment consultant with return postage. After 2 weeks, employment consultants and their organizational leaders received reminder e-mails and phone calls. Survey packets were re-sent to all nonresponding participants after 4 weeks. A $25 gift certificate was used as an incentive for completing the survey.
After data cleaning, we recoded the 5-point Likert-type scale data—describing the job development activities—into dummy variables, with a value of 1 if a specific activity was performed for most or all job seekers who found jobs during the year before the survey and a value of 0 in all other cases. To be considered sufficiently implemented, an activity was to be put into practice by more than 50% of the employment consultants, for most or all job seekers assisted in the previous year. Data analyses included computing frequencies and cross-tabulation of the categorical variables and computing means-of-the-scale variables, such as number of placements, weekly earnings, and hourly wages.
In this section, we provide a summary of the employment consultants' characteristics, their outcomes, and the employment strategies that they used to assist job seekers.
Employment Consultants' Characteristics
As Table 1 shows, most employment consultants were female, more than one third were younger than age 35, and most were White. The level of education varied, with more than half of the employment consultants having earned at least a bachelor's degree. Nearly all employment consultants earned less than $45,000 annually, and they worked an average of 39.2 hr per week, SD = 4.1, minimum (min.) = 14.0, maximum (max.) = 47.0. A substantial percentage of participants had less than 2 years of experience as employment consultants. At some point during their professional careers, employment consultants had attended some type of training on general employment supports (25%), job development (25%), and other topics (25%). For 84% of employment consultants, job seekers with IDD represented most or all of the job placements they supported. As a group, employment consultants spent on average about half of their time assisting job seekers: 15% on career planning and assessment (SD = 15%, min. = 0%, max. = 57%), 21% on job development (SD = 17%, min. = 0%, max. = 64%), and 20% on job support (SD = 23%, min. = 0%, max. = 91%), which contrasted with the finding that almost half of employment consultants' time (45%) was invested in supports not directly related to assisting job seekers to gain employment.
Most employment consultants (73%) supported five or fewer job seekers in gaining employment during the 12 months preceding data collection (M = 4.7, SD = 3.9, min. = 1.0, max. = 18.0). The job seekers who gained employment earned on average $8.33 per hr (SD = $2.11, min. = $3.50, max. = $20.00), with only 11% of job seekers making more than $10 per hr. The average weekly work schedule was 16.8 hr (SD = 8.2, min. = 2.0, max. = 40.0), with only 16% of job seekers working more than 20 hr per week. Regarding job retention, 88% of employment consultants reported that at least half of the people they supported in gaining paid individual employment in the prior year were still employed at the time of data collection.
Table 2 shows the percentage of employment consultants who implemented specific employment strategies for most or all job seekers who gained paid individual employment during the year before data collection. Employment specialists used a variety of strategies to get to know job seekers. Most participated in person-centered planning meetings for most or all of the job seekers they worked with, and more than half talked to referral and funding agencies. Only a small number of employment specialists talked to job seekers' acquaintances or former employers. To find jobs, most employment consultants used classified ads, contacted employers with whom they had a record of success, or made cold calls. Fewer respondents involved family members or acquaintances or negotiated customized job descriptions. Conducting a formal analysis of employers' needs and offering job trials before hiring were also infrequently used as strategies to engage employers. For facilitating job seekers' transitions into employment, nearly all employment consultants discussed workplace expectations with job seekers, stayed in contact with employers after placing a job seeker, and actively listened to employers' concerns. Additionally, more than three quarters provided or facilitated follow-up assistance after a job seeker was hired. In these cases, employment consultants facilitated natural supports by teaching job seekers social skills and how to ask for help and training coworkers about how to support the new employee. Among the least-used strategies was assisting job seekers with work incentives planning.
Our purpose in this study was to investigate the extent to which employment consultants implemented employment practices recommended in the literature when assisting job seekers with IDD. The findings showed that some of the practices recommended in the literature were not consistently implemented. Discrepancies between the literature and practices emerged in regard to activities such as involving job seekers' family members and acquaintances, observing job seekers in work and nonwork settings, conducting analyses of employers' needs, negotiating job creation, and providing assistance with work-incentives planning. Fewer than 50% of the employment consultants surveyed adopted these strategies when assisting most or all of their job seekers in finding individual paid employment. For career planning and assessment, most employment consultants reported engaging in person-centered planning. This approach is effective, and it is consistent with the literature (Callahan et al., 2009; Griffin et al., 2007; Hoff et al., 2000; Phillips et al., 2009). However, fewer than half of the employment consultants used other strategies that the literature, especially the customized-employment literature, has recommended as part of an effective career planning approach. These strategies include talking to people who know the job seeker well, including family members, acquaintances, and former employers, and observing the job seeker in work and nonwork environments. As Callahan and colleagues (2009) emphasized, engaging in both formal and informal conversations with people who know the job seeker well and observing the job seeker in his or her home environment is important for obtaining accurate indications about skills, desires, and support needs. This information is critical for informing the next step of the job search, and especially for developing new jobs using strategies such as job creation or job negotiation. The findings around employer engagement showed some positive results but also showed evidence that improvement was needed. More than half of the employment consultants adopted job search strategies such as approaching employers with whom they had success in the past or asking employers about possible openings in related businesses. These strategies were consistent with the literature, which supports networking with employers as one of the most effective ways to find jobs (Bissonette, 1994; Bolles, 2009; Granovetter, 1995; Hagner et al., 1996; Levinson & Perry, 2009; Owens & Young, 2008).
However, our findings showed that progress was needed in several other areas. For example, most employment consultants browsed classified ads or made cold calls to employers to find job openings. Although these strategies may be included in a successful job search, more recent literature has recommended emphasizing other, more effective strategies, such as involving job seekers' family members or acquaintances in the job search. This approach is consistent with both the theoretical literature about the importance of networking in job development (Bolles, 2009; Bissonette, 1994; Hagner et al., 1996; Levinson & Perry, 2009; Owens & Young, 2008) and the empirical literature that has shown a correlation between networking and successful employment outcomes (Fesko & Temelini, 1997; Gervey & Kowal, 1995; Granovetter, 1995; Silliker, 1993). In addition, only a minority of employment consultants reported analyzing employers' needs or negotiating new job descriptions. The customized-employment literature has emphasized analyzing employers' needs and carving new job descriptions as a promising strategy for addressing job seekers' support needs. At the same time, this approach can help employers become more productive by better using their workforce's time (Callahan, 2003; Griffin et al., 2007; Luecking et al., 2004; Nietupski, Verstegen, Reilly, Hutson, & Hamre-Nietupski, 1997). After a job seeker finds employment, it is critical that an employment consultant ensure a smooth transition into the workplace. Our findings showed that employment consultants discussed work expectations with job seekers, provided assistance to employers after hire, and listened actively to employers' concerns—all practices recommended in the literature (Griffin et al., 2007; Hoff et al., 2000; Wehman et al., 2003). Employment consultants were also likely to facilitate natural supports by teaching job seekers how to ask for coworkers' assistance, teaching job seekers about social skills needed in the workplace, discussing workplace expectations with job seekers, and training coworkers and supervisors to support their coworkers with disabilities. These practices are all consistent with the literature (Butterworth et al., 1997; Hagner et al., 1992; Novak et al., 2003). However, employment consultants were less likely to assist job seekers with planning for work incentives, which is a concern. If work incentives planning is not addressed, job seekers may favor low-paying jobs to protect their overall income (Revell et al., 2000; Rogan et al., 2001; Wehman et al., 2003). Our findings showed that most job seekers worked fewer than 20 hr per week, and most of their jobs paid less than $10 per hr.
Various factors may explain why some of the promising practices described in the literature were not always implemented. Some employment consultants may simply be unfamiliar with these practices. Our findings support this hypothesis, considering that a substantial percentage of employment consultants had worked in this field for less than 2 years. Another factor influencing the implementation of promising practices might be the workload of employment consultants. Even assuming that employment consultants receive adequate training, they may neglect to implement some promising practices because of lack of time. This hypothesis is consistent with the finding that employment consultants as a group spent on average almost half of their time in activities that were not directly related to assisting job seekers in finding jobs. Finally, employment consultants' strategies may be constrained by potential conflicts with the priorities and guidelines set by their supervisors, their organizations' management, or the billing standards established by funding agencies.
Limitations and Strengths
A main limitation of this study was the self-reported nature of the data collected. Self-reported data do not control for participants' tendency to provide socially desirable responses or to report easier-to-remember activities as opposed to activities in fact implemented. A second limitation was that we did not collect information about job seekers' support needs. Although the study focused on people with IDD, support needs may vary even within this group, requiring different job development strategies. A third limitation was that employment consultants may have provided only a partial picture of the array of services that job seekers may have received from other employment consultants. A fourth limitation was that most promising practices investigated were based on theoretical literature as opposed to experimental literature. Readers should be aware that robust relationships between practices and outcomes can be demonstrated only through experimental research. Finally, this study involved a relatively small number of employment programs, and their participation was voluntary. Therefore, generalization of the findings beyond this sample should be done with caution.
Despite these limitations, this study had strengths. Although the data were self-reported, this study provided a tool for evaluating the extent to which certain practices were likely to be more or less implemented than others. For instance, the extent to which employment consultants browsed classified advertisements was substantially higher (64%) than the percentage of participants who networked with job seekers' acquaintances to find job openings (11%). Although the absolute precision of these two figures might be debated, these figures suggest that talking to job seekers' acquaintances is practiced substantially less often than browsing classified advertisements. Another strength of this study was that the response rate was very high at almost 100%, counterbalancing at least partially the limitations of the small sample size. Finally, the study drew attention to the need to invest more in research that assesses the extent to which promising practices in job development are implemented and which practices yield better outcomes. Investigating these areas is urgently needed because little is known about whether the promising practices are implemented and whether they are effective, based on experimental data.
On the basis of this study's findings—and assuming that adopting promising practices leads to better outcomes—we recommend that more employment consultants spend time observing job seekers in work and nonwork environments and talking to job seekers' family members and acquaintances. These activities are important because they allow employment consultants to familiarize themselves with job seekers' work skills, soft skills in interacting with others, and ability to problem solve. To find job openings, we recommend that more employment consultants involve people who know the job seekers well, including family members and acquaintances. These networks of people may be instrumental in facilitating informational interviews at places and types of industries that are of interest to the job seeker. This strategy can help reduce the need to make cold calls and browse generic job ads. Most employment consultants used these approaches, but experts consider them to be minimally effective as job-searching strategies. We also recommend that more employment consultants invest energy in analyzing employers' needs and in negotiating new job descriptions through job carving, job creation, and job sharing. These strategies can provide an opportunity to optimize the distribution of job tasks and increase productivity. To facilitate transition into employment, we recommend that job seekers have access to work incentives planning and assistance on a regular basis. Work incentives planning gives recipients of Social Security benefits an opportunity to have a specialist assess their personal financial situation, which helps the individual understand how working will affect his or her benefits and what incentives are currently available to make the transition to work more feasible.
For employment consultants to be able to implement these recommendations, a systemwide approach is needed. This process must start with governmental agencies and employment programs increasing their focus on promoting promising job development practices. In addition, funding mechanisms must be structured so that they facilitate the implementation of the promising practices recommended in the literature. Moreover, it is imperative that quality information, training, and development opportunities specifically related to job development and customized-employment strategies be available and easily accessible to employment consultants. Finally, it is necessary that research be expanded at two levels. First, descriptive research is needed to continually document and capture the employment practices adopted by employment consultants. This research is essential for policymakers and practitioners to align constantly evolving practices in the field with the promising practices identified in the literature. Experimental research is also needed to provide a more advanced evidence base that validates and advances our understanding of the relationships between employment outcomes of job seekers with disabilities and employment practices.
Implementing state-of-the-art practices is key for any program or organization that strives for better outcomes (Fitzpatrick et al., 2004; Fixsen et al., 2005). It is even more important for programs that assist job seekers with disabilities because of the additional challenges that this group faces in transitioning to employment and because of the recent difficult economic circumstances characterizing the labor market.
Editor-in-Charge: Steven J. Taylor
Alberto Migliore (e-mail: email@example.com), Institute for Community Inclusion/University Center for Excellence in Developmental Disabilities, University of Massachusetts Boston, 100 Morrissey Boulevard, Boston, MA 02125, USA; John Butterworth, University of Massachusetts Boston; Derek Nord, University of Minnesota; Monica Cox and Amy Gelb, University of Massachusetts Boston.