The vocational difficulties of persons with epilepsy include elevated rates of unemployment and historically low rates of movement into competitive employment through state rehabilitation agencies. Much of the current literature suggests that job development strategies, and not traditional skills-training programs, are most effective in assisting brain-impaired persons to secure competitive jobs. Initiating vocational habilitation work at the high school level is believed to be desirable because a) individuals with early onset of epilepsy are more likely to exhibit deficits in neuropsychological, intellectual, and social status than are individuals with post-adolescent onset; b) chronic unemployment as a life style may occur early in this population; c) there may be locus of control, or """"""""learned helplessness"""""""" factors present which are more amenable to early intervention. A prevocational intervention is proposed which is designed to assist epilepsy-impaired high school seniors to enter competitive employment at an early time. It is hypothesized that the treatment group, relative to placebo and no-treatment controls, will demonstrate a) a higher rate of entry into competitive employment, and b) a reduced rate of dependence on public subsidy. The treatment is presented in a group format, designed after successful group formats currently used in this center for adult outpatients with epilepsy. Pilot work is presented which suggests the feasibility of using neuropsychological testing results obtained from high school-age epileptics as an index of later vocational status. Pilot work also shows an early reliance on public subsidy for epileptics who were subjects in a post-high school vocational status study. Hypothesis testing will proceed by means of t tests, rank correlation coefficients, and distribution-free analyses of variance, and will be adjusted for multiple comparisons. Multiple rank regression methods will be used as an aid in identifying types of individuals who may be expected to benefit from extended or specialized services.
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