Hiring People with Intellectual Disabilities

Employers are discovering that with a little help, workers with such disabilities can take on a wide array of jobs.

Last October, the Equal Employment Opportunity Commission (EEOC) issued guidelines on the employment of individuals with intellectual disabilities. It was just the latest sign that this long-overlooked group is starting to command the attention of the business community.

Although some specific challenges come with employing people who have intellectual disabilities, many companies are discovering that there can be a number of rewards. “Everybody recognizes that there’s an ethical argument for hiring persons with such disabilities, but what employers really want to know is whether it also makes financial sense,” says advocate Jim Runyon. The answer, he says, is a resounding yes.

Runyon is program coordinator for the Central Illinois Business Leadership Network. It is the Peoria chapter of a national, employer-led organization that promotes job opportunities for people with disabilities.

As with all employees, it’s important to make a good match between the person and the job, Runyon says. With careful matches and usually minor accommodations in the workplace, he continues, the businesses in his network have reported high attendance and retention as well as no increase in accident rates among employees with intellectual disabilities. Moreover, he says, “they have employees who are excited about coming to work every day.”

Some of those employees are bagging groceries, sweeping floors and raking leaves. But in Runyon’s network and around the country, others with intellectual disabilities are employed as office assistants, medical technicians, textile machine tenders, furniture refinishers, sales clerks, cashiers, building maintenance workers, messengers and cooks.

“In the last 10 years, we’ve seen a much wider range of jobs that people with intellectual disabilities go into,” says William Kiernan, director of the Institute for Community Inclusion at the University of Massachusetts in Boston. “We’ve moved away from the concept that people with these disabilities are only suited to dishwashing, cleaning and that sort of thing. At our institute, we have a couple of folks with intellectual disabilities who are doing data collection for us.”

What’s in a Name?

As defined by the EEOC, people are considered to have an intellectual disability if they meet all three of the following criteria:

• Their intellectual functioning level (IQ) is below 70-75.
• They have significant limitations in adaptive skills—the basic conceptual, social and practical skills needed for everyday life.
• Their disability began before age 18.

The same criteria have been used for years to define mental retardation, a term some professionals in the field still prefer because it’s more specific. The term intellectual disabilities, one could argue, sounds as if it should include learning disorders in people with an average or above-average IQ, but it doesn’t because learning disorders don’t fall within the EEOC’s definition.

Despite the potential for confusion, however, most organizations are moving away from the term mental retardation because many people now find it offensive and outdated. In this article, as at the EEOC, the term intellectual disabilities is used because it is less emotionally charged.

Based on the criteria above, it’s estimated that as many as 8 million Americans—approximately 3 percent of the population—have intellectual disabilities. “About 90 percent of these individuals have a mild level of functional impairment,” says George Bouthilet, research director at the President’s Committee for People with Intellectual Disabilities in Washington, D.C. While such individuals typically are a bit slower than average at learning information and acquiring skills, most are capable of holding a variety of jobs in the community.

As a result of improved educational and vocational rehabilitation opportunities, many of today’s young adults with intellectual disabilities are hitting the job market better prepared and more eager than ever to work. Yet nine out of 10 adults with intellectual disabilities are unemployed, Bouthilet says, which means they represent a vast but largely untapped labor pool. (For more information, see The Truth About the Coming Labor Shortage in the March 2005 issue of HR Magazine.)

The Cincinnati Solution

The underutilized potential of people with intellectual disabilities was recognized early on by nurse Erin Riehle of Cincinnati Children’s Hospital Medical Center. Eight years ago, as director of the emergency room, she faced a familiar problem: “We had a number of entry-level, high-turnover positions. We could fill the jobs, but people would only stay in them for three to five months because they didn’t see it as challenging work.”

The hospital was already providing care to people with intellectual disabilities, and it occurred to Riehle that the solution to her problem might be right in front of her.

Riehle began by training a young woman, Annie Sublett, to work in the emergency department. Sublett has Down syndrome, the most common genetic cause of mild to moderate intellectual disability. She proved to be so capable and focused that she was quickly promoted to the position of sterilization technician in the hospital’s large dental clinic, a job she has held ever since. “I take care of all the dental instruments,” says Sublett. “It gives me a chance to prove myself and do my work and do it right.”

Sublett’s boss, dentist Jim Steiner, director of the hospital’s Division of Pediatric Dentistry, says, “She knows every instrument by name, and she knows where everything is in our storage area. Our staff will come over the intercom and say, ‘I need an XYZ in Room 6.’ Sometimes I don’t even know what it is, but she knows, and she gets it there.” Sublett’s other duties include taking instruments to a central sterilization site, writing labels on sterilization packets and filling out forms.

Steiner acknowledges having “rocky times” with some staff members when Sublett first arrived. “There were hurtful things said, and we had to talk to some of our people,” he recalls. Over time, says Steiner, Sublett has earned her co-workers’ acceptance and respect. “Everybody supports her and understands that she’s just a person doing her job like anyone else.”

A Widening Influence

Riehle’s efforts grew into Project SEARCH, a multifaceted program based at the hospital that uses a business model to provide meaningful employment and educational opportunities to individuals with intellectual disabilities.

Since 1998, Project SEARCH has placed more than 150 employees at sites around the Cincinnati area, including two other hospitals and a bank. On average, participants in the adult employment program earn over $8 per hour, receive full benefits and work 33 hours per week.

The secret, says Riehle, is that “we don’t look for the easiest jobs to put people in. Instead, we look for complex jobs that are routine or systematic.” She has now placed 60 Project SEARCH employees into jobs at Cincinnati Children’s Hospital. They prepare trays for operating rooms, maintain incubators in the neonatal intensive care unit and stock equipment in the emergency department.

Another critical element, says Riehle, “is working with experts who know how to set up appropriate accommodations.” To this end, she has partnered with Great Oaks Institute of Technology and Career Development, a vocational rehabilitation provider based in Cincinnati. Most accommodations have been simple and inexpensive, such as using laminated photos instead of written signs to label supplies in a stockroom—a help for employees who have trouble reading.

The photo idea came from Great Oaks’ Jennifer Linnabary, who serves as a full-time employment coordinator at Cincinnati Children’s Hospital. She started using photos as an accommodation for a young woman who stocks hospital kitchens and cannot read.

Since then, Linnabary’s idea has spread throughout the hospital. “We find that the staff without disabilities like the picture signs better than the written signs and use them just as much as, if not more than, the people with disabilities,” she says.

Perhaps the biggest challenge as the program grew was making room for a large, ever-changing cast of job coaches—who help employees learn a job and become integrated into a workplace—and other support personnel from Great Oaks. Riehle solved the problem by hiring in-house job coaches and by getting Linnabary assigned to the hospital. A full-time support person becomes feasible, Linnabary says, when you have at least 20 employees with disabilities at a worksite.

Supermarket Experience

Throughout the country, companies of all sizes are creating their own success stories in helping people with intellectual disabilities get jobs. At Cub Foods, with three supermarkets in Peoria and Bloomington, Ill., four employees with intellectual disabilities have been hired as baggers. All have been with the company at least a year, and one has been there for a decade—much longer than the usual tenure of the teenagers who often fill such positions.

Sharon Riley, an HR specialist at Cub Foods, says all four have proved to be assets to the company: “They’ve been very open and friendly with the customers. They’re eager to work and learn different tasks, and their attendance for the most part has been very good.” A vocational rehabilitation agency coach helped each employee learn the ropes of their job.

One issue is transportation. When managers have had to schedule one of the four employees during hours when public buses are not running, Riley says, agency staff members or store employees have been able to provide a ride.

At the outset, “other employees were kind of standoffish,” says Riley, and some teenagers would tease one of the men about his slurred speech. But the teasing stopped, she says, when she told the offenders that it wasn’t acceptable. Employees have come to like and feel at ease with their co-workers who have intellectual disabilities, she adds, “and understand that they’re looking to make a living just like the rest of us.”

Manufacturing Success

While many companies have diversity initiatives that include hiring employees with various disabilities, a manufacturer in Tennessee has taken its commitment to a new level. At Habitat International, a privately owned firm in Chattanooga that makes indoor-outdoor rugs and artificial grass, at least 80 percent of the employees—who number 40 to 80, depending on the season—have some type of mental or physical challenge. About 15 of the current employees have intellectual disabilities, says co-founder and CEO David Morris.

In 1993, Morris began hiring individuals with intellectual disabilities. He also hired Connie Presnell, a job coach for the state, to coordinate the effort. Presnell cites the company principles guiding her work: “to believe in each other and not set limits for the people with disabilities.”

Morris notes the results of his approach: high profitability, frequent expansions, back order and return rates that are “almost zero,” little absenteeism, low turnover attributable to job dissatisfaction, and no accidents among employees with disabilities. Habitat International has since garnered several awards and is the subject of a new book, Able! How One Company’s Disabled Workforce Became the Key to Extraordinary Success, by Nancy Henderson Wurst (BenBella Books, 2005).

“We expect the best out of each person, and we challenge them to do things they have never done,” says Morris. Workers with intellectual disabilities are “doing everything from running a hundred-ton die-cutting press to rolling and cutting carpet,” he says. “No matter what the mental or physical disability, everyone is pretty much required to learn every job in the building.”

The company also encourages experienced workers to mentor newcomers with the same disability, which Morris says inspires self-confidence. One such mentor is Sharon Adams, who was hired a dozen years ago and is now considered an experienced hand. She’s known for her speed at the cutting table, and she gets a little frustrated when she trains newcomers because she can’t go as fast as she would like. But overall, she says of her job, “I love it. I make big money.”

Randy Hullender, another employee who previously worked in a state-funded workshop where his earning potential was limited, seconds that sentiment. When asked what his job means to him, he says, “More money. I’m able to go out, [pay] bills and eat.” Hullender’s job helps him provide financially not only for himself but also for his wife and his aging parents, with whom he lives.

Dealing with Differences

People with intellectual disabilities vary widely in their skills, limitations and lifestyle characteristics. Some can’t read or write, while others can. Some live with their parents or in group homes, while others have their own homes and families. And some—especially those with Down syndrome—have distinctive physical features, while most blend into a crowd.

The more severe the intellectual impairment, the more likely the person also will have coexisting conditions, such as cerebral palsy, attention deficit hyperactivity disorder, seizures, or hearing or vision loss.

The reasonable accommodations that may be required for the intellectual disabilities themselves are as individual as the employees who have them, and many are relatively low in cost. They may include, for example, providing spoken rather than written instructions for employees who can’t read, providing a counting device for those who have trouble with large numbers or demonstrating rather than describing what a job entails for those who learn more easily that way.

Keep in mind that, by law, employers have a responsibility to initiate a discussion about accommodations if they know that an employee has a disability, is experiencing workplace problems because of it and is prevented by the disability from asking for an accommodation. These circumstances might apply to many employees with intellectual disabilities.

“I think you have a heightened duty to communicate and to monitor whether accommodations are working,” says Rod Fliegel, a partner in the San Francisco office of Littler Mendelson, a national employment law firm.

The Personal Touch

“One thing that comes up frequently is social skills,” says Suzanne Gosden, a human factors consultant at the Job Accommodation Network, a government-funded free consulting service based at West Virginia University. “While most of us can pick up on social cues—when to say excuse me or what to do if you take the last cup of coffee—this is something that people [with intellectual disabilities] are never going to learn from their environment. Someone has to specifically teach them that.”

This is where job coaches can be invaluable. Gosden also recommends social skills training materials that are marketed by the Conover Co., Program Development Associates and other firms.

Moreover, it’s not only employees with intellectual disabilities who may need to brush up on their social skills. “There are a great number of people who, because of compassion or empathy, want to be overly protective and cautious around the employee” with an intellectual disability, says Gosden. “Then there are just as many people who still say ‘retard.’ ”

Although harassment has more-serious legal implications, both types of extreme behavior are counterproductive. Gosden recommends sending the message that “you don’t have to put on kid gloves to work with another adult just because that person has a disability, but you do need to show some sensitivity.” A disability awareness and sensitivity course might be a good preventive measure.

“For employees with intellectual disabilities, the biggest thing you need is a support network,” says Tammie McNaughton, director of corporate staffing and workforce initiatives at Highmark, a large insurer based in Pittsburgh. “That can mean anything from a mentor to a supervisor to co-workers who remind them, ‘It’s 10 o’clock. Time to take our break now.’ ” Highmark’s employees with intellectual disabilities hold positions such as insurance claims examiner and mail clerk.

Beyond social support, what individuals with intellectual disabilities frequently need most is a chance to show what they can do. “For people who are not disabled, oftentimes they’re overwhelmed by too many expectations. For people with disabilities, they’re not given a fair shake because people don’t expect enough of them,” says Wayne McMillan, president and CEO of Bobby Dodd Institute, a vocational rehabilitation provider in Atlanta. “We believe each individual has a contribution to make, and they can do that if given an opportunity.”

Contributing Editor Linda Wasmer Andrews is a freelance writer in Albuquerque, N.M., who has specialized in health and psychology issues for two decades.

Web Extras

• About Intellectual Disabilities
• Questions and Answers About Persons with Intellectual Disabilities in the Workplace and the Americans with Disabilities Act (Source: EEOC)
• A Charge We Have to Keep: A Road Map to Personal and Economic Freedom for Persons with Intellectual Disabilities in the 21st Century, 2004 (Source: President's Committee for People with Intellectual Disabilities)
• American Association on Mental Retardation
• Institute for Community Inclusion
• Job Accommodation Network
• National Down Syndrome Society

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Federal Guidelines At A Glance​

Following are highlights of the EEOC’s r​ecently released guidelines on employing people with intellectual disabilities: Reasonable accommodations. Examples of the kinds of accommodations that employees with intellectual disabilities may need include a job coach, training modifications, a modified work schedule, restructuring of nonessential functions, help in understanding job evaluations or disciplinary proceedings, or assistive devices (for instance, a phone with speed dial and large, clearly labeled buttons). Hiring process. “Even job applicants must be given reasonable accommodations,” says Jennifer Lutz, an employment attorney at the Klinedinst firm in San Diego. Examples include providing someone to read or interpret application material, or replacing a written test with an expanded interview in which applicants are allowed to demonstrate, rather than describe, their skills. Disciplinary matters. “Just because somebody has a disability doesn’t give them carte blanche to do whatever they want in a job,” says Lutz. An employer may discipline an employee with an intellectual disability for misconduct as long as the employer imposes the same discipline on employees without disabilities. Harassment. The Americans with Disabilities Act (ADA) prohibits offensive conduct, such as name-calling, that is severe or pervasive enough to create a hostile or abusive work environment. “Many ADA-based harassment claims involve employees with intellectual disabilities because they’re easy targets,” says Rod Fliegel, a partner in the San Francisco office of Littler Mendelson. “You have to be very vigilant because they may be more defenseless than the average person.”