https://doi.org/10.1177/0034355220967109
Rehabilitation Counseling Bulletin
1–5
© Hammill Institute on Disabilities 2020
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DOI: 10.1177/0034355220967109
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Article
Traumatic brain injury (TBI) represents one of the largest
categories of disability in the United States. The Centers for
Disease Control and Prevention (CDC, 2019) estimated in
2014 that almost three million TBIs occurred in the United
States, with approximately 228,000 hospitalizations result-
ing in a TBI diagnosis. As the brain controls all areas of
human activity, TBI is a disability that can limit areas of
physical, cognitive, and emotional function. Beyond the
functional consequences of TBI, persons with TBI and their
family caregivers are challenged by a long-term care sys-
tem in the United States that is insufficiently funded (e.g.,
Friedman & VanPuymbrouck, 2018), lacks well-trained
professionals (e.g., Degeneffe & Bursnall, 2015), and lacks
a coordinated system of support from acute to long-term
care (Degeneffe, 2019).
Reflective of the public’s recognition of the growing
prevalence and functional consequences of TBI, it was
added as a qualifying disability for special education ser-
vices in the Individuals with Education Act (IDEA) in 1990
(University of Kansas, 2019). Also, TBI is now considered
as a qualifying disability for developmental disability ser-
vices in several states, provided the onset and functional
impairments of TBI meet Federal developmental disability
criteria (Vaughn, 2015). With the passage of the Workforce
Innovation and Opportunity Act (WIOA) on July 22, 2014
(U.S. Department of Labor, n.d.), State VR agencies are
tasked with providing targeted and enhanced employment
supports to transition-aged youth with TBI and other cate-
gories of disability (East & Wooderson, 2015).
Purpose of the Present Study
A focus on TBI is warranted given the commonality of this
disability among children, adolescents, and young adults in
the United States. In 2014, more than 837,000 of the
approximate 2.87 million TBI-related emergency room
visits involved children (CDC, 2019). Also, about 812,000
967109RCB XX X 10.1177/0034355220967109Rehabilitation Counseling BulletinDegenefe et al.
research-article 2020
1
San Diego State University, CA, USA
2
Mississippi State University, Starkville, USA
Corresponding Author:
Charles Edmund Degeneffe, Rehabilitation Counseling Program, San
Diego State University, Department of Administration, Rehabilitation,
and Postsecondary Education College of Education, 5500 Campanile
Drive, San Diego, CA 92182-1154, USA.
Email: cdegenef@sdsu.edu
Brief Report: Participation Among
Transition-Aged Youth With Traumatic
Brain Injury in the State/Federal
Vocational Rehabilitation System
Charles Edmund Degeneffe, PhD, MSSW, CRC
1
,
Mark Steven Tucker, PhD, CRC
1
, and Zaccheus James Ahonle, PhD, CRC
2
Abstract
This study aimed to understand the level of participation among transition-aged youth with traumatic brain injury (TBI)
in the State/Federal Vocational Rehabilitation (VR) System in the context of the Workforce Innovation and Opportunity Act
(WIOA). Case closures, case duration, and case expenditures in Federal fiscal years (FYs) 2014, 2015, and 2016 were
examined among transition-aged youth (i.e., State VR clients under the age of 22 years at application) with TBI, autism
spectrum order (ASD), and intellectual disability (ID), using a nonexperimental and descriptive design. A disproportionate
number of transition-aged youth with ASD and ID had closed State VR cases compared with transition-aged youth with
TBI. Alternatively, there were greater State VR case duration levels and case service expenditures for persons with TBI
compared with those with ASD or ID. The disproportionate participation with State VR was consistent among these
three groups via eligibility for services under the Individuals with Disabilities Education Act. This article highlights areas
of attention concerning transition-aged youth with TBI and will hopefully stimulate future dialogue, research, and policy
development concerning participation with State VR for this population.
Keywords
adolescents, transition, brain injury