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MAXIMIZING CAREER OUTCOMES:
A STUDY OF PROFESSIONALS WITH DISABILITIES
by
Diane K. King
BS, State University of New York at Buffalo, 1981
MBA, State University of New York at Buffalo, 1983
Submitted to Rush University in partial
fulfillment of the requirements for the
degree of Master of Science, Occupational Therapy
(c) Copyright by Diane Karen King, 1998
All Rights Reserved

UMI Number: 1392159
Copyright 1998 by
King, Diane Karen
All rights reserved.
UMI Microform 1392159
Copyright 1998, by UMI Company. All rights reserved.
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THESIS APPROVAL FORM
The undersigned have examined the thesis entitled: Maximizing Career Outcomes:
A Study of Professionals with Disabilities presented by: Diane K. King
a candidate for the degree of Master of Science in Occupational Therapy and hereby
certify that in their judgment it is worthy of acceptance.
Joyce B. Lan£, M.Ed., OTR, FAOTA (date)
Assistant Professor, Department of Occupational Therapy
Rush University
Thesis Committee Chair
> 7 ' ' ‘
(date)
(date)
Fatema T. Azhar, MS, OTR/L, CHT
Clinical Specialist, Hand and UE Rehabilitation
Rush Occupational Health
Thesis Committee Advisor ,
{ Pl/O ■Jonathan Dopkeen, Ph.D^
Risk Management Consultant
The Segal Company
Thesis Committee Advisor

ABSTRACT
Maximizing Career Outcomes A Study of Professionals with Disabilities.
Diane K. King, BS, 1981, MBA, 1983
Thesis directed by: Joyce B Lane, M.Ed., OTR, FAOTA
Assistant Professor
Department of Occupational Therapy
Rush University
Signa e omhesis Advisor
This study explored the career experiences of professionals who have a physical or sensory
disability. The goal was to identify the key factors that facilitate and inhibit an individual's ability
to maximize his or her career potential
Interviews were conducted with a sample ofthirty employed professionals who acquired a
disability prior to or early in their professional lives. The interview was based upon the Model of
Human Occupation which provides a framework for analyzing the effect that performance, habits,
volition, and the environment have on performance outcomes.
The results indicate that the ability to maximize career outcomes is affected by the
presence or absence of volition and environment factors. Specifically, individuals who perceive
that career outcomes are within their control and who are provided the opportunity to participate in
career enhancing training and development, reported more positive career outcomes. The roles
performance and habituation factors play are inconclusive

DEDICATION
I dedicate this thesis to my family and friends who have supported me throughout this
career change by providing their love and encouragement. I especially want to thank my
mom for expecting my sisters and me to reach for the stars, my sister Sandi for telling me
to shake up my life, my sister Anita and brother-in-law Howard for encouraging me to
“dig a new well”, my sister Abby for sharing her wisdom and editorial expertise, and Gene
for his analytical and ever-present emotional support. I would also like to thank Joyce,
Jonathan and Fatema for helping me to get done and get out.

V
ACKNOWLEDGEMENTS
I would like to acknowledge the following individuals and organizations for their help with
recruiting subjects for this study: Marca Bristo and the staff at Access Living, Diane
Coleman and the staffof the Progress Center, Pam Provost at the Guild for the Blind, the
National Federation of the Blind, Anne Feiler at the Chicago Public Library, Mercedes
Rauen and the staff of the National Spinal Cord Injury Association, Illinois Chapter, David
Hanson at the Chicago Mayor’s Office for People with Disabilities, the Rehabilitation
Institute of Chicago, Rush University, and the thirty individuals without whom this study
would not have been possible.

VI
Table of Contents
Preliminary Pages
Thesis Approval Form ii
Abstract iii
Dedication iv
Acknowledgments v
Table of Contents vi
Tables viii
Chapter I: Introductory Information 1
Introduction 1
Problem Statement 3
Purpose 4
Conceptual Assumptions 5
Theoretical Framework 6
Delineation of the Research Problem 8
Research Questions 10
Definition of Terms 10
Chapter II: Literature Review 13
Process Theories 13
Model of Human Occupation (MOHO) 13
Expectancy/Valence Theory 15
Equity Theory 17
Attribution Theory 21
The Environmental Context. Systemic & Workplace Factors 23
Systemic Factors 23
Workplace Factors 24
Individual Employee Factors 26
Career versus Job Orientation 26
Impact of Visible Difference on Career Outcomes 27
Impact of Gender on Career Outcomes 30
Impact of Type of Disability on Career Outcomes 33
Summary 35
Chapter III: Methodology 37
Overview 37
Statements of Hypotheses 37
Research Design 38
Human Subjects 39
Procedure 40
Characteristics of the Sample 43
Instrumentation 45
Measures 46

vii
Data Analyses 48
Chapter IV: Results 50
Introduction 50
Hypotheses 1,2,3, and 4: Correlation of MOHO factors with
Career Outcomes 51
Hypothesis 5: Impact of Gender on Career Outcomes 53
Hypothesis 6: Impact of Disability on Career Outcomes 55
Hypothesis 7: Impact of Demographics on Career Choice 57
Hypothesis 8: Impact of Career Choice on Career Outcomes 59
Workplace Accommodation 61
Recommendations to Employers and Healthcare Professionals 64
Chapter V: Discussion 66
Introduction 66
MOHO Factors and Career Outcomes 67
Performance 67
Habituation 68
Volition 69
Environment 69
Gender and Career Outcomes 70
Disability Category and Career Outcomes 71
Career Choice and Career Outcomes 72
Effect of Demographics on Career Choice 73
Implications for Employers 74
Implications for Occupational Therapists
and Other Healthcare Professionals 75
Implications for People With Disabilities 75
Limitations of the Study 76
Recommendations for Further Research 78
Summary 79
References 81
Appendices
A. Subject Pre-Screening Questions 89
B. Subject Information Sheet 91
C. Written Consent Form 93

viii
Tables
Tables
1. Characteristics ofthe Sample
2. Correlation ofMOHO Factors with Career Outcomes
3. Comparison Between Men and Women
4. Barriers to Career Advancement by Gender
5. Comparison Between Individuals with Physical, Visual,
and Speech/Hearing Disabilities
6. Barriers to Career Advancement by Disability
7. Impact ofGender on Career Choice
8. Impact ofDisability on Career Choice
9. Impact ofAge o f Onset o fDisability on Career Choice
10. Comparison Between Individuals in Disability-Related Careers
and Individuals Not in Disability-Related Careers
11. Barriers to Career Advancement by Career Choice
12. Workplace Accommodation Requests by Gender
13. Workplace Accommodation Requests by Disability
14. Workplace Accommodation Requests by Career Choice
15. Top Recommendations to Employers
16. Top Recommendations to Healthcare Professionals
44
51
54
54
55
57
57
58
58
60
61
62
63
63
64
65

1
Chapter I: Introductory Information
Introduction
A fundamental assumption about human kind lies at the core of the discipline
known as Occupational Therapy. The assumption is that men and women have an
occupational nature, within which there is an innate desire for mastery of their
environment. Mastering one’s environment requires the ability to continuously change
and adapt, not only for survival, but also for the purpose of self-actualization (Hopkins &
Smith, 1993). This occupational nature encompasses a wide range of purposeful
behaviors, typically grouped by occupational therapists into the broad domains of play,
leisure, activities of daily living, and work (Kielhofner, 1997; Kielhofiier, Burke, Igi,
1980). For many adults, the domain labeled “work” is a significant part of their
occupational lives, occupying more than 30 percent of their day, and spanning 5 decades
or more. It is no wonder that work, for many, takes on more meaning than payment in
exchange for services rendered. For these individuals work provides a means for
fulfillment and purpose, friendships and affiliations, status within the community, and is a
major contributor to their identity and self-esteem (Steers & Porter, 1979).
The above assumptions are no less true for people who, for whatever reason, are
living with a disability. Despite the passage of the Americans With Disabilities Act of
1990 (ADA) with its stipulation that employers provide reasonable accommodations for
employees who qualify as disabled under the act, full inclusion in the workplace is
extremely difficult. This is still the case, even with the removal of many of the physical
and architectural barriers previously encountered by workers with disabilities. There are

many reasons why this is so, including stereotypes and false beliefs held by employers,
workplace cultures and norms that reward “sameness” versus diversity, and self-limiting
behaviors adopted by the employees themselves (Braddock & Bachelder, 1994; Cox,
1993; Greenhaus, Parasuraman, & Wormley, 1990).
Specifically, many employers still maintain, despite evidence to the contrary, false
beliefs regarding people with disabilities including an expectation of higher costs,
absenteeism, turnover, and lower productivity levels. In addition, because these
employers expect less of employees with disabilities, the more challenging assignments
that could lead to advancement opportunities are not offered. This may also be due to the
false beliefthat career advancement is not as important to employees with disabilities as it
is to their able-bodied counterparts (Braddock & Bachelder, 1994).
In addition, organizational cultures generally reflect the values, beliefs, styles,
norms and traditions held by the employee group which dominates the upper echelons,
which is, in most major companies in the U.S., the able-bodied white male (Cox, 1993;
Thomas, 1990). This is still the case despite the changing demographics of the labor
market, which estimates that by the year 2000, the workforce will consist of over 25
percent racial and cultural minorities and close to 50 percent women (Jamieson &
O’Mara, 1991). American white males will comprise only 15 percent of new entrants into
the workforce. In spite of this, white men still hold most of the power in companies.
Coopers & Lybrand’s recent national survey o f267 companies found that, although the
numbers of women and minority directors had increased slightly in the past year,
boardroom representation for the survey sample was still 92 percent Caucasian and 89

3
percent male (“Women show gains,” 1997). New entrants into the workforce are
therefore expected to assimilate to a culture developed by and for white males, which is
not always easy, or even possible, for people who are different. Often the amount of
energy expended to try to “fit in” interferes with the ability ofthese employees to focus on
job performance and achieving their career goals. Individuals who are unable to adapt
may find it easier to limit their behavior by avoiding challenging assignments or
developmental opportunities (Greenhaus, et al.., 1990; Kielhofiier, 1997). For instance,
some may separate from the mainstream by cloistering themselves within a certain job
category or department, thus restricting their opportunities for career growth and
movement (Cox, 1993). Others, believing that certain opportunities are closed to them, or
that their efforts will not result in the desired outcomes, may lower or abandon their goals
all together, thus resigning themselves to a career that has plateaued or to a job that pays
the bills but is otherwise unfulfilling. (Cox, 1993; Kielhofiier, 1997; Steers & Porter,
1979).
Problem Statement
The focus of most employers with regard to people with disabilities has been
employment or re-employment after illness or injury. The goal is to provide a job, not a
career. This may be acceptable to some individuals, but for others, promise of a job with
no real opportunity for career development or advancement places limits on their ability to
master their environment, and to maximize their career outcomes. The result is diminished
opportunity to reap the intrinsic and extrinsic rewards that non-disabled members of
society have come to expect from work.

4
People with disabilities who would like the opportunity for a career face attitudinal
barriers and organizational biases in the workplace similar to those faced by minorities,
women, and other diverse groups. In effect, people with disabilities experience a glass
ceiling which prevents them from achieving their career potential (Braddock & Bachelder,
1994).
Purpose
Writings have suggested that issues regarding careers for the disabled are
important; however, most of these have been conceptual in nature. The majority of the
research has focused on jobs as opposed to career development. In addition, the studies
(Glass & Elliott, 1993; Johnson, 1993; Kanellos, 1985; Miller, 1991; Walter, 1993;
Welsh & Foster, 1991; Wiedman & Freehafer, 1981) that do exist have tended to focus
on one particular type of disability (e.g., hearing impaired employees). There is a need for
research that is empirical in nature, that focuses on careers for people with disabilities, and
that samples from a more diverse population.
The research proposed in this study will explore how individual and environmental
factors impact the ability ofprofessionals to maximize their career outcomes, leading to
fulfillment of career goals. The subjects of the study are men and women who have an
apparent disability (e.g., impaired sight, hearing, speech, or mobility) and who meet the
definition of having a disability as defined by the ADA. To be covered by the ADA, at
least one of the following conditions must be met: 1) the impairment substantially limits
one or more mayor life activities, 2) there is a record of such impairment, or 3) the

5
individual is regarded as having such an impairment (Braddock & Bachelder, 1994; U.S.
Equal Employment Opportunity Commission [EEOC], 1991).
The intent of this study is to examine how the process of maximizing one’s career
outcomes depends upon a number of factors that contribute to the career process. These
factors include: the performance skills and abilities held by the individuals; the
development of habits and internalized roles that allow them to establish routines; and to
fit in and be accepted into the workplace; the value they place on their goals; and, their
perception that their efforts will lead to desired outcomes. In addition, the impact of the
environment in which the process is taking place (e.g., workplace accessibility, job
accommodation, career support, and cultural diversity) will be explored.
Conceptual assumptions
Three assumptions will be considered as givens throughout this study. First, the
assumption that for many individuals work provides rewards in addition to income. These
rewards include status, self-worth, social interaction, opportunities to be creative,
problem-solving opportunities, power over others, new skills, security, and recognition
(Walter, 1993). Second, the assumption that a career is important to many people with
disabilities and in general, people with disabilities have the same need to master their
environment and fulfill their career potential as people without disabilities (Braddock &
Bachelder, 1994; Daly & Bound, 1996). Third, the assumption that individuals who are
unable to access a full range of opportunities will be limited in their ability to self-actualize
(Walter, 1993). In addition to the implicit assumptions imbedded in this study, it is

6
important to review some of the theories currently used to explain employee behavior in
the workplace.
Theoretical framework
Existing work theories tend to fall into two broad categories, content theories and
process theories. Content theories look at the specific correlates to worker satisfaction
and motivated behavior, (e.g., job content, work environment, and tangible rewards).
Process theories focus on the dynamic relationships among various variables in order to
explain how behavior is energized and sustained (e.g., an individual’s perception of his or
her progress relative to others) (Steers & Porter, 1979; Tremblay, Rogers, Toulouse,
1995; Thomas, 1990).
Content theories are still widely used by organizational psychologists and human
resources professionals, although their value is mostly in the realm of determining the
causes of worker satisfaction and dissatisfaction. Two typical content theories will be
discussed briefly. First, the Need Theory, originally put forth by Maslow (1979),
considers how an individual’s basic needs (e.g., hunger and safety) must be satisfied before
he or she will be motivated to strive for higher-level needs (e.g., love, esteem, and self-
actualization). This theory has been applied to the employee in the workplace, and has
been used by other theorists as a means of categorizing employees into affiliation,
achievement, or power need groups (Litwin & Stringer, 1979). Another widely
researched content theory, the Motivation/Hygiene Theory developed by Herzberg
(Hersey & Blanchard, 1993; Herzberg, 1987) identifies six factors that contribute to
worker satisfaction, termed “motivators”, and seven factors that contribute to worker

7
dissatisfaction, termed “hygiene factors”. The presence or absence of these factors allows
an employer to predict the level of satisfaction or dissatisfaction of his or her workforce.
Process theories, on the other hand, are more conducive to the study of career
mobility versus workplace satisfaction, because they consider how human behavior
operates within a dynamic open-system, continuously adjusting to environmental cues
(Steers & Porter, 1979). Process theories, in general, assume that the reason a person
embarks on a specific course of action is to reduce an inner state of disequilibrium (i.e.,
achieve homeostasis). He or she is energized to take a specific action in order to move
toward a valued goal or outcome. The outcome of this action, whether successful or
unsuccessful, provides feedback to the person, who then modifies his or her inner state,
resulting in an increased or decreased drive or expectation. Theorists who look at human
motivation from a process perspective believe that a major determinant of human behavior
is beliefs, expectations, and anticipation with regard to future events (Steers & Porter,
1979). According to Lewin, as cited by Steers & Porter (1979), people make conscious
decisions concerning their future behavior based upon cues received from their
environment. The emphasis here is on the anticipation that a specific outcome or goal can
be achieved. Thus, an individual’s skills and competence level, combined with perceptions
of his or her ability to achieve career goals, and moderated by feedback from the
environment, will determine what actions he or she may take (Kanter, 1977; Landeau &
Hammer, 1986; Tremblay, et al., 1995; Veiga, 1981).
The key process theory considered in this study will be one that is widely used by
occupational therapists in assessment and treatment of patients, the Model of Human

8
Occupation (MOHO). Because MOHO considers the interaction between an individual’s
skills, roles, habits, and volition, within the context of his or her environment, it provides
an intuitively appropriate framework to explain how and why an individual fulfills or fails
to fulfill his or her career potential. Three other related process theories that contribute to
our understanding of the volitional aspect of MOHO will also be used in this study. These
are the theories of Expectancy, Equity, and Attribution, and will be explained in greater
detail in Chapter II.
All four of these theories help to explain how individuals establish career goals,
whether or not they are able to achieve them, and how they evaluate the outcome of their
efforts. The following section describes how these theories will be applied in this study.
Delineation of the research problem
The research problem will be explored within the framework of the Model of
Human Occupation (MOHO) which provides a method for examining the career process.
The model allows individuals to identify factors in their environment, as well as personal
factors, that facilitate or inhibit their ability to sustain the effort required to maximize
career outcomes. While it is true that career success is individually perceived and
therefore subjective, patterns may exist among individuals who are career oriented but
face barriers due to their disability. Such patterns, once revealed, could provide valuable
information to employers, occupational therapists, vocational counselors, and individuals
with disabilities, who are working toward achieving the intentions of the ADA, i.e., full
inclusion for people with disabilities in the workplace.

9
A non-experimental research design will be used to collect data and analyze the
differences between individuals who feel satisfied with their career progress and those who
feel their careers are plateaued. Because of the small number of anticipated subjects,
consideration must be given to minimizing the number of confounding variables. This will
be accomplished as follows:
1. All subjects will be professionals who are currently employed in companies or
organizations.
2. All subjects will have an apparent disability versus a hidden disability. The assumption
is that people with hidden disabilities may find it easier to assimilate into the workforce, at
least on the surface, and can therefore access more opportunities than those who are
visibly different.
3. All subjects will have acquired their disabling condition either prior to, or early in their
careers.
4. The categories of disabilities studied will be limited to those that affect physical
mobility, vision, hearing and/or speech.
5. Both men and women will be selected for the study in order to compare the effect that
gender has in establishing career goals and maximizing career outcomes. Although,
gender discrimination for women regardless of ability has been well established, there is
evidence that disability-related discrimination is compounded by gender (Braddock &
Bachelder, 1994; Menz, Hansen, Smith, Brown, Ford, & McGrowey, 1989).
Other variables that may have an impact on results (e.g., age, race, job type) will
not be controlled for, but will be examined after the fact, to assess their contribution.

10
Research Questions
The data collected from participants in the study will be examined using the MOHO
framework in order to explain the following:
1. How and why do some individuals with disabilities achieve career success, while others
do not?
a. What environmental and individual circumstances allow for achievement of
maximum career outcomes for individuals with disabilities?
b. What environmental and individual circumstances interfere with or inhibit
achievement of maximum career outcomes for individuals with disabilities?
2. How does gender impact one’s ability to achieve maximum career outcomes?
3. How does type of disability impact one’s ability to achieve maximum career outcomes?
Definition of Terms
For the purpose of this study, key terms are defined as follows:
1. Professionals include individuals whose primary duties require knowledge of an
advanced type, customarily obtained through specialized education or certification. The
work performed by professionals is predominantly intellectual and varied, requiring use of
discretion and judgment, versus routine, manual, or mechanical duties (U.S. Department
of Labor, 1983).
2. Ajob, is static, provides financial rewards and is performed out of necessity
(Wrzesniewski, McCauley, Rozin, & Schwartz, 1997).

11
3. A disability-relatedjob is one where the primary customers and/or ultimate
benefactors of services are people with disabilities. All others are considered not
disability-related
4. Job discretion means having autonomy and decision-making authority within an
organization (Greenhaus, et al., 1990).
5. A career is dynamic and provides challenging and rewarding work, with opportunities
for personal and professional development, and/or advancement (Wrzesniewski, et al.,
1997). An individual is said to have a career when they have established a long term goal
which they plan to achieve by accumulating specified skills and experiences through
participation in intermittent assignments.
6. Careersupport consists of having a sponsor or a mentor who provides career guidance
and advice, opportunities for challenge, visibility, and advancement, and increased power
or influence. This individual may be a supervisor or another more experienced colleague,
who has higher status and influence in the organization than the employee. (Greenhaus, et
al., 1990; Igbaria & Wormley, 1992).
7. Careerstrategies are organizationally appropriate behaviors undertaken to enhance the
likelihood of achieving one’s career goals. These include making one’s goals and
aspirations known to supervisors and relevant others, seeking visible job assignments, and
taking advantage of networking opportunities (Greenhaus, et al., 1990).
8. Maximum career outcomes include favorable assessments of met expectations and
satisfactory attainment of desired career goals that are established by the individual
(Greenhaus, et al., 1990; Igbaria & Wormley, 1992).

1 2
For the purpose of this study, the phrase maximizing career outcomes is used
interchangeably with achieving careerpotential, achieving career success and reaching
one’s career goals.
9. Individualdescriptors include demographics (e.g., age, gender, race or ethnic origin),
job content, time in current job, type of business, and size of company.
10. Performancefactors describe the social, cognitive, and physical abilities which may
impact occupational performance (Kielhofiier, 1997). In this study the performance
factors considered will be type of disability, age of onset, education, and experience level.
11. Habituation implies the ability to organize, regulate and maintain behavior to meet
social norms, fulfill role expectations for behavior, and establish habits and routines
(Kielhofiier, 1997). In this study Habituationfactors will be defined as the degree of
perceived acceptance and inclusion by others into the workgroup, and the degree that job
performance feels routine.
12. Volition is defined as an individual’s feelings of efficacy and control over valued
outcomes (Kielhofiier, 1997). In this study, Volitionalfactors will include job power,
career orientation, implementation of career strategies, perceptions of equity in the
workplace, how he or she attributes results of efforts, and perceptions of advancement
prospects.
13. Environmental factors include the individual’s perception of physical accessibility,
available accommodations, career support, performance feedback, mentoring, training and
development, and corporate culture (e.g., expectations for conformity versus diversity).
(Greenhaus, et al., 1990; Herzberg, 1987; Igbaria & Wormley, 1992).

13
Chapter II: Literature Review
In seeking the answers to the aforementioned research questions, the literature
reviewed includes studies that explore the relevant applications of the process theories; the
environmental context of disability; and the effect of individual factors, specifically gender
and specific types of disability, on career outcomes.
Process Theories
Model of Human Occupation
The Model of Human Occupation (MOHO) is an open-system, occupational
therapy frame of reference, which attempts to explain how human beings interact with the
environment (Kielhofiier, 1980; Kielhofiier, Burke, Igi, 1980; O’Brien, 1993). MOHO
describes a generic process in which an individual receives input from the environment
urging him or her to take action (disequilibrium). The input is processed as throughput,
and a course of action is determined, resulting in an output (outcome), which elicits
feedback to the individual from the environment.
Within this open-system are three subsystems, that determine how effective the
individual will be in his or her attempts to achieve desired outcomes. The three
subsystems are organized hierarchically, each influencing the relative effectiveness of the
one above it (Kielhofiier, 1997; Mufioz, Lawlor, & Kielhofiier, 1993). The first
subsystem, performance, provides a foundation for the middle and top subsystems. Its
function is to perform an activity or behavior, and it consists of the individual’s social,
cognitive, and physical abilities, used to produce purposeful behavior. The middle
subsystem is habituation. It maintains the activity or behavior, and consists of the

14
individual’s internalized roles, habits, and routines. This subsystem allows an individual to
carry on an activity automatically, by incorporating skills into appropriate patterns, thus
meeting the expectations for behavior established by the organization or workgroup. The
top subsystem is volition. It describes an individual’s belief that he or she has the efficacy
and control needed for personal causation, i.e., the expectation that his or her specific
actions are likely to result in desired ends. In addition, the volitional subsystem considers
the individual’s valued goals and interests as keys to his or her willingness to commit to a
sustained activity.
The environment within which the individual must perform includes the physical
and psychosocial make-up of the community and its culture, the workplace and
workgroup, and required tasks. An environment may be perceived by the individual as
providing a supportive context for achievement, or containing physical and/or social
barriers that inhibit optimal performance (Kielhofiier, 1997; Munoz, et al., 1993).
By providing a framework for assessing the interaction of skills, habits, roles, and
volition, within a specific environment, MOHO provides a way to pinpoint where
obstacles to effective performance may arise, and helps to explain why an individual’s
career progress may stall. The model terms the successful achievement of performance
outcomes as a trajectory that supports adaptation, and unsatisfactory outcomes as a
trajectory that threatens adaptation. Both scenarios, once entered, can result in an
unending cycle of success or failures, dubbed as benign or vicious cycles (Kielhofiier,
1980).

15
Studies using MOHO have primarily focused on proving the soundness of the
model’s underlying premise, i.e., that human behavior is ordered and self-organizing, as
opposed to random and reactive (Kielhofner, 1997). Other research, in occupational
therapy literature, has focused on MOHO’s strength as an assessment tool. In a survey of
occupational therapists (Murioz, et al., 1993), respondents indicated that they routinely
used the model as a systematic framework for collecting and communicating information
on the occupational performance of specific clients. Participants in this study reported
that the model’s major limitations were its complex terminology, and inadequate
assessment instruments and application tools.
While these limitations must be considered when planning to apply the model in a
new way, the fact that MOHO has strong descriptive properties, and considers the holistic
nature of individuals and their environment as an integrated system, makes it an intuitively
appealing approach for this study.
Expectancy/Valence Theory
MOHO assumes that the benign and vicious cycles of an individual’s behavior are
greatly driven by his or her past experiences. If an individual’s efforts have proven to be
successful in the past, he or she is likely to expect that similar future efforts will result in
similar outcomes. If efforts have been unsuccessful, the expectation for future success is
likely to be reduced. Thus, the expectation for success or failure is a key factor in
predicting one’s motivation to exert the effort necessary to achieve desired goals (Burke,
1977). This notion of past experiences predicting future outcomes, and subsequently
influencing one’s motivation to persist, is the crux of the Expectancy/Valence theory, an

16
approach to human motivation and behavior utilized by organizational psychologists and
managers of people within organizations.
Expectancy/Valence theory (Hersey & Blanchard, 1993; Steers & Porter, 1979),
like MOHO, looks at performance as a function of motivation level; role perception and
role clarity; and skills. The theory focuses on two key concepts, valence and expectancy.
Valence refers to the assumption that individuals have preferences for, or place a value on,
a particular activity or outcome (Burke, 1977; Vroom, 1989; Steers & Porter, 1979).
Expectancy is the extent to which individuals believe that the outcomes they desire are
probable, and the expectation that a specific action or behavior will result in a particular
outcome.
The Expectancy/Valence theory attempts to measure the individual’s motivational
force mathematically by having him or her assign probability values to expectancy.
Expectancy equals the strength of the belief that effort will lead to desired performance,
(i.e., E—>P), and performance will be instrumental in producing desired outcomes, (i.e.,
P—>0), with 0 = absolutely no belief, and 1 = complete certainty. The resulting
expectancy measure is multiplied by outcome valance, which equals the degree of
desirability, with -1.0 being least desirable, and +1.0 being most desirable. The resulting
formula is as follows:
Motivational Force = (E—>P) (P-»0) (outcome valence)
The Expectation/Valence theory is primarily concerned with an individual’s ability
to make conscious choices about present and future behavior; however, as was noted
previously, the expectation for success is often based upon his or her own historical

17
experiences, or the vicarious experiences of relevant others. Thus, an individual who has
behaved in a specific way in the past and been rewarded, will believe there’s a high
probability that continued behaviors along the same lines will result in future rewards.
Conversely, an individual who has experienced a string of failures (or has seen others
similar to him or herselfwho have failed), will believe there’s a low probability for success
and will eventually lower his or her expectations, or completely give up on his or her goal.
This was evident, in a study ofblack and white Management Information Systems
(MIS) professionals (Igbaria & Wormley, 1992), where initial expectations for rate of
promotion, salary increases, career opportunities, and training and development
experiences were compared to later perceptions about whether these expectations were
actually met. The results showed that black employees indicated lower levels of met
expectations than whites. This in turn correlated significantly with lower career
satisfaction levels and organizational commitment for black employees. The study implies
that affective outcomes (i.e., satisfaction and commitment) were impacted by unmet
expectations, which could lead to a vicious cycle of lowered expectations for successful
career outcomes, followed by reduced motivational force, or turnover.
Equity Theory
Equity theory (Adams, 1979; Perry, 1993; Tremblay, et al., 1995), like Expectancy
theory, is used by organizational psychologists, human resource professionals, and
business managers, to help explain differences in employee motivation. It suggests that an
individual will accept his or her own individual success as the “right amount” by
comparing his or her progress to referent variables, usually other individuals. According

18
to Adams (1979), individuals perceive that they possess certain attributes or Inputs that
are relevant to the relationship with some significant other (e.g., employer). A person’s
Inputs are provided in exchange for certain Outcomes. In other words, employees may
perceive their relevant Inputs as education, skills, and experience, for which they should
receive the Outcomes of high pay, promotional opportunities, and status. They will then
compare their own Input/Outcome ratio to some referent person, in order to determine
equity. For comparison they may look at others with equivalent experience, education,
and job duties both inside and outside the company, their own past experiences of success,
or the expectations for success that are established by others (e.g., teachers or spouses)
(Lawrence, 1988; Sheridan, Slocum, Buda, & Thompson, 1990). What is considered
one’s just rewards, therefore, is relative, versus absolute.
In addition, when inequities are perceived, whether positive or negative,
individuals will strive to reduce feelings of distress and restore equity by taking some sort
of action or adjusting their own perceptions of the situation. This may be achieved by
altering Input levels or Outcomes, cognitively changing perceptions ofInputs or
Outcomes, or withdrawing from the situation or relationship (Adams, 1979; Huseman,
Hatfield, & Miles, 1985).
While certain studies have found that individuals will vary in the amount of distress
they feel when under or over-rewarded (Huseman, et al., 1985), equity has been shown by
many researchers to be a strong predictor ofjob-related attitudes and behaviors. For
example, Dubinsky and Levy (1989) used perceived organizational fairness as the equity
measure to predict overall job satisfaction, organizational commitment, motivation

19
(defined as valence, expectancy, and instrumentality), and performance levels for 238 retail
salespeople. In this quantitative study, organizational fairness was measured across seven
dimensions, pay rules, pay administration, pay level, work pace, rule administration,
distribution of tasks, and employee latitude. The authors found that perception of
organizational fairness positively impacted job satisfaction, organizational commitment,
and instrumentality (i.e., the beliefthat higher performance levels will lead to pay raises
and promotions, or the P-»0 part of the Expectancy/Valence equation). Organizational
fairness showed no perceptible influence on expectancy, valence, or worker performance.
The results were due, in part, to the definition of organizational fairness and how it
emphasized workplace processes associated with tangible outcomes. The study did not
measure the degree to which an individual valued these outcomes. In addition, employee
performance was defined using a single measure, which perhaps did not capture the many
facets of performance that may have been influenced by perceptions of fairness.
A subsequent study of the effect of equity perception on the specific job outcomes
ofjob satisfaction and intentions to stay with an organization conducted by Berg (1991),
found that professionals who worked at television stations were more satisfied in their jobs
when they perceived that outcomes (pay, seniority, benefits, promotion and advancement
opportunities, security, and job location) were equitable. Employee perceptions of equity
predicted both job satisfaction and intention to stay. An interesting finding of this study
was that perceptions of equity were related solely to tangible outcome measures that were
provided by the employer. Less tangible outcome variables such as job challenge,

20
responsibility, meaning, status, belonging, and recognition, did not appear to effect
employee perceptions of equity.
The phenomenon described by Equity theory has also been illustrated in several
studies that looked at subjects who were members of a specific demographic category.
Lawrence (1988) studied the effect that an employee’s age had on performance ratings.
The author found that an individual whose age deviated from what was considered the
average (or “normative”) age for a given job level was labeled by management as “ahead
of schedule”, “behind schedule”, or “on schedule”. Those labeled as “ahead” (i.e.,
employee with ages below the norm) received very high ratings, and were considered
“high potential employees”, while those labeled as “behind” (i.e., employees with ages
exceeding the norm) received very low ratings, and were considered as lacking future
potential. The likelihood for advancement for those individuals whose age exceeded the
average age for the job level was significantly reduced. In accordance with the Equity
theory, the affected workers attempted to reduce their distress by lowering their
aspirations, and resigning themselves to the fact that they were too old, or had been in
their jobs too long.
In a national survey of African-American workers, Perry (1993) examined the
relationship of Equity theory to job satisfaction, by looking at inequities in pay and status
as compared with data from the U.S. Census Bureau’s Current Population Survey, which
surveys a sample of households monthly. Perry’s findings supported the theory that
negative inequities (i.e. being underpaid) reduced job satisfaction. She also found that
while positive inequities (i.e., being overpaid) increased job satisfaction, the worker felt

21
the need to justify the inequity by increasing his or her cognitive estimation of his or her
skill level (Input), thereby reducing the distress.
Attribution Theory
The theory of Attribution (Tremblay, et al., 1995) is related to the theories of
Expectancy and Equity, in that it explores how individuals attribute their relative success
or non-success within an organization. Understanding attribution is important because it
provides a way to assess the relationship between the amount of power individuals feel
they have over their career outcomes and their career behaviors. According to Bandura,
as cited by Manz (1989), individuals who attribute career outcomes to self-efficacy are
more likely to persist in their goals. For instance, people who perceive themselves as
successful in their careers often attribute this to factors that they could control (e.g.,
performance, abilities, and training), and have correspondingly higher aspirations,
satisfaction, and performance levels. On the other hand, individuals who attribute
outcomes, such as a plateaued career, to external factors beyond their control (e.g.,
systemic bias, favoritism, and luck) may react by lowering aspirations, reducing on-the-job
effort, or leaving their company (Tremblay, et al., 1995; Veiga, 1981).
Consistent with the Attribution theory, Perry’s (1993) above-mentioned equity
study of African-American workers proposed that the individuals who were not injobs
that were commensurate with their skill level (i.e., the negative inequity group) may
attribute the cause of the inequity to racial bigotry. Similarly, the women subjects in the
study who indicated that sex discrimination was a problem, believed that they had the

2 2
skills for a betterjob (status inequity) and attributed their circumstances to sexism. In
both cases, subjects indicated low satisfaction with theirjobs.
Tremblay, et ai (1995) studied plateaued managers and career satisfaction, finding
that the perception ofbeing plateaued had a greater effect on the attitudes and intended
behaviors (e.g., intention to quit) oftheir sample than objective measures (e.g., tenure in
the job). Subjects who believed that their career had plateaued attributed their lack of
success to variables beyond their control including their age and their perception that
performance was not indicative of career advancement. These subjects also indicated
dissatisfaction with their work and their supervision.
The theories of MOHO, Expectancy, Equity and Attribution illustrate how
subjective perceptions about volition, expectancy of success or failure, beliefin one’s own
efficacy, and the valence or meaningfulness ofthe goal, will influence one’s motivation
and ability to maintain a productive career trajectory and result in a benign cycle of
positive career outcomes. These theories are important to this study in that they provide
insight into some ofthe factors that influence how individuals maintain their dedication to
achieving established career goals, hi other words, ifthey perceive that their efforts are
doomed to failure, they will lower their expectations and goals. Or ifothers whom they
deem to be equivalent to themselves are progressing farther and foster through the ranks,
they will perceive themselves to be in a state of inequity. Ifthey attribute the cause to a
biased system, they may feel that the most attainable way to balance the inequity is to
decrease their motivation and performance, alter their goals, or look for a job in another
organization.

23
As mentioned above in the discussion of process theories, particularly MOHO,
many of the individual’s perceptions are influenced and shaped by feedback he or she
receives from the environmental context in which he or she performs. Both systemic (i.e.,
factors that exist within the community as well as society at large) and workplace factors,
influence the ability of people with disabilities to maximize their career outcomes.
The Environmental Context: Systemic & Workplace Factors
Systemic Factors
The Americans With Disabilities Act of 1990 (ADA) is a landmark piece of
legislation with the potential to enforce substantive systemic change for people with
disabilities living in the United States. Bowman (1992) discusses how prior to the ADA,
the only law that even considered the Civil Rights of people with disabilities was the
Rehabilitation Act of 1973. She describes the results of a telephone survey conducted just
prior to enactment of the ADA, asking 1,000 non-institutionalized Americans with
disabilities, ages 16-64, to assess what being disabled meant to them. They said that
disability in this country meant less education, employment, money, and social life. The
majority of respondents said that they wanted to work outside their home, attend movies,
and do their own grocery shopping, but found these fundamental activities extremely
difficult to accomplish. More than half of respondents felt that they had been prevented
from achieving their potential, not because they were biologically or mentally impaired,
but because society had put up obstacles. National surveys indicate that 70-80 percent of
Americans would continue to work even if there wasn’t a financial need. For many
individuals, work provides status, self-worth, social interaction, opportunities to be

24
creative, problem-solving opportunities, power over others, new skills, security, and
recognition. Unemployment, low status jobs, or lack of advancement opportunities result
in low self-image (Walter, 1993).
People with disabilities are substantially underrepresented in the labor force, with
only one-third holding jobs. Seventy-nine percent of the remaining say they can work
and would like to work (Shapiro, 1994). A review of studies conducted with spinal cord-
injured individuals concluded that reports of successful employment outcomes varied from
20 percent to 85 percent, depending on the definition of “employment” (Wiedman &
Freehafer, 1982). For example, in one study by the National Spinal Cord Injury Data
Research Center, “vocation” was defined as worker, homemaker, or student. A 48.3
percent success rate was reported, but 68 percent of individuals were either homemakers
or students (Kanellos, 1985). In addition, people with disabilities who are working earn as
much as 15 to 30 percent less than their non-disabled colleagues and are less likely to be
promoted (Shapiro, 1994).
Workplace Factors
While the National Organization on Disability reports little improvement injob
rates for people with disabilities over the last four years (Kopelman, 1996), other studies
seem to indicate that since the ADA, employers are more likely to accommodate an
employee who is returning to work after a disability (Blanck, 1995b).
It is important to note that the writings in the area of people with disabilities and
work have typically focused on job entry, re-employment after injury or illness, and

25
physical access to the workplace. While many have alluded to the importance of careers
to people with disabilities, relatively few of these articles are empirically based.
A study by Blanck (1995) that examined workplace factors that have worked in
favor of successfully employing people with disabilities, looked at how Sears, Roebuck
and Co. (Sears), who has approximately 20,000 known disabled employees, implemented
the ADA. Sears, as a company, has long been committed to employing a diverse
workforce, and recognizes that providing a barrier-free environment is key. It is important
to note that Sears began accommodating employees with disabilities long before the ADA.
Blanck credits its success to three areas. (1) implementation of a universal work place
design versus trying to retrofit its environment; (2) education of all management and
employees on the ADA and (3) institution of an internal process for mediating employee
disputes. In addition, as part of its corporate culture, accommodations are considered a
routine part of doing business. Ninety-seven percent of the accommodations Sears made
required little to no cost (e.g., flex time, extended training, revised job descriptions, rest
periods, enhanced lighting, and altered work stations). Higher cost accommodations such
as voice synthesizers and Braille displays for visually impaired employees have also been
implemented. Sears clearly holds that the benefits to providing these accommodations
outweighs the costs. However, as Blanck points out, the implementation of the ADA in
the world of work, has been more of an evolution as opposed to a revolution since
corporate cultures, among other things, are not changed lightly. There needs to be a
strong commitment at the top, along with awareness education at all levels.

26
The need for strong commitment from management was supported by a survey of
deaf employees in the private sector. The study found that the work environment factors
that contributed most to employment success included management support, promotion
opportunity, access to training, access to meetings, and worksite accommodations
(Johnson, 1993).
In addition to environmental factors that effect the ability of people with disabilities
to maximize career outcomes, individual employee factors including attitudes towards
work, age, education, experience level, race and ethnic origin, gender, and type of
disability have an impact. As previously mentioned, this study will focus on how gender
and type of disability affect career outcomes. However, it is important to consider all of
the possible factors that may have an impact in order to make recommendations for future
research.
Individual Employee Factors
Career versus job orientation
In a recent study examining the subjective way that individuals experience their
work, Wrzesniewski, et al. (1997) surveyed 196 individuals in a variety of occupations
including professionals, technicians, and clerical employees. They found that employees
were able to easily classify whether they viewed their work as a job, a career, or a calling.
In addition, results revealed that within the occupations surveyed, it was possible for all
three of the dimensions to be represented. They also found that subjects who classified
their work as a calling had the highest work and life satisfaction. Those who classified
their work as a career tended to be younger, which, as other authors have found

27
(Lawrence, 1988; Tremblay, et al., 1995) implies an age-related expectation for
advancement, as well as perhaps a resignation by older employees that all they can hope
for is a job. A key question raised by the authors is what individual factors will cause one
person to view their work as a job, while another views the same work as a career or a
calling?
Career choice and vocational aspirations are influenced by many factors including
ability, gender, community, parental occupation, and self expectations. Common beliefs
and theories in the area of careers for individuals with and without disabilities emphasize
that it is important to introduce career awareness, and the exploration of skills and
interests, to all individuals at a young age (Jacobs, 1993). This notion was emphasized by
the American Foundation for the Blind’s Task Force on Upward Mobility, which found
that even the common question, “what do you want to be when you grow up?” is seldom
put to disabled children (Miller, 1991). As a result, disparate expectations for people with
disabilities are reinforced by not informing them of career options and career strategies.
Impact of visible difference on career outcomes
In addition to individual attributes, career outcomes for individuals have been
shown to be influenced by the degree of congruence or “fit” between the organization’s
values and the values of the individual. This has implications for people who stand out as
“different” from the organization’s traditional workforce (Cox, 1993). For instance, the
effect of race on organizational experiences and career outcomes was examined by
surveying 138 black and white MIS professionals and their supervisors (Igbaria &
Wormley, 1992). The study looked at the relationships between organizational experience

28
and career success variables. Organizational experience variables included acceptance, job
discretion, met expectations, career support from one’s supervisor (defined as providing
challenging and visible assignments, sponsorship, counseling, acceptance, and friendship),
participation in training and development programs, while career success variables
included job performance assessment, advancement prospects, career satisfaction, and
organizational commitment. The authors found that the variables most associated with
career satisfaction were feelings of acceptance into the organization’s informal social
networks, met expectations, career support, and advancement opportunities.
Advancement opportunities correlated strongly with supervisory performance
ratings (i.e., higher rated employees were expected to have greater opportunities for
advancement), and higher performance ratings correlated positively with participation in
training, job discretion, and career support. The survey data revealed that blacks
experienced less discretion in their jobs, had lower levels of met expectations, and received
less career support from supervisors. They also experienced lower performance ratings,
resulting in less favorable advancement expectations, and lower career satisfaction levels.
The fact that racial difference was shown to negatively influence organizational
experiences and career outcomes for black respondents has implications for other
categories of employee difference. Such disparate treatment may lead to under-utilization
of the individual talents, skills, and energy of affected employees, thus diminishing the
collective potential of the organization’s workforce.
It is important, therefore, to identify which career success factors can be affected
by individual employees, and which require the involvement of others (i.e., governments,

29
organizations, or supervisors). For instance, a study of people with disabilities and the
glass ceiling identified several career limiting factors, including lack of marketable business
skills and/or college education, vocational rehabilitation programs that do not counsel
clients on career development, and existing myths and stereotypes held by employers that
tend to preclude people with disabilities from employment or career development
(Braddock & Bachelder, 1994).
In a survey of deaf employees in the private sector (Johnson, 1993), worker
attributes was one of two factors identified as contributing to employment success, (the
other being work environment, as mentioned above). Successful worker attributes
included conforming to overt and covert worksite expectations, and exceeding co-workers
performance within the realms of task performance, teamwork, supervision, and
socializing.
These important individual success factors are routinely downplayed or ignored by
programs designed to help people with disabilities return to the workforce after illness or
injury. For example, in a qualitative review of vocational programs (Velozo, 1993), the
author found that the focus was mostly on physical accessibility, adaptation and
environmental accommodation, as opposed to the psychosocial aspects of work and its
meaning to individual employees. The author recommended that work evaluations which
consider the employee’s perception of his or her work environment and other psychosocial
factors may be more predictive of success in the workplace.
In a retrospective analytic study of 1,192 employees who had experienced onset of
a health limitation while they were employed, it was found that the majority of

30
respondents continued to work. This was particularly true of older, more educated
employees who worked for larger companies, especially ifthe company provided them
with specific accommodations (Daly & Bound, 1996). However, psychosocial aspects of
work, and its meaning to these employees, was not addressed.
Impact of Gender on Career Outcomes
While it has been shown that career outcomes are influenced by a wide range of
demographic characteristics such as race and age, gender-based job discrimination is the
most pervasive form of discrimination world-wide. Although women make up one-third
ofthe world’s labor force, two-thirds of the total hours worked and one-third of the
world’s heads of households, they still receive only one-tenth of the world’s income and
make up 70 percent of individuals living in poverty (Joel, 1994; Thompson, 1995;
Whaley & Hashim, 1995). When gender is combined with disability, the disparities in how
women are treated in the labor market are compounded. Studies have shown that while
employment of all women, including those with disabilities, has markedly increased over
the last 20 years, women tend to be clustered into less secure, lower paying occupations,
often with few or no health benefits (Braddock & Bachelder, 1994; Menz, et al., 1989;
Yelin, 1993). This was particularly illustrated in Baldwin, Johnson, & Watson’s report (as
cited in Braddock & Bachelder, 1994) which was based on data from national surveys
conducted in 1971 and 1983. The data showed several distinct differences between
treatment ofwomen with disabilities, women without disabilities, and men with
disabilities. The authors found that work experience, union membership, and education
had a positive impact on the salaries of women without disabilities, but had no effect on

31
the pay of women with disabilities. Furthermore, women with disabilities typically had
more education then men with disabilities, but still received less pay.
The greater disparities experienced by women with disabilities as opposed to
women in general may be partially a result of gender biases in the vocational rehabilitation
system. A 13-year study of rehabilitation outcomes for men and women who participated
in vocational rehabilitation programs throughout the midwest showed that society’s
viewpoint of careers for women as unnecessary is alive and well in the rehabilitation
system (Menz, et al., 1989). At the time of application for rehabilitation, no differences in
earnings for men and women were evident, yet at the time of exit, women’s earnings were
only 67 percent of men’s. Apparently, women were only directed into jobs considered
traditionally female, i.e., clerical, sales, and services positions. Also, a case closure option
that was acceptable for women was no employment, or “homemaker” status. Non-
traditional fields, defined as less than or equal to one-third female (Slappo and Katz,
1989), were not considered for women, thus limiting their potential for earnings growth
and benefits, even though more women were provided business school and college training
than men. Menz, et al., (1989) emphasized that these results prove a need for greater
education of women and rehabilitation counselors about opportunities in non-traditional
fields, role models of women with non-traditional careers, and overall career planning.
While providing more information and access to non-traditional careers for women
is needed, those with disabilities who currently have non-traditional careers still face
unique issues that are not faced by men or women without disabilities. Slappo and Katz’s
(1989) survey of 120 women with disabilities employed in non-traditional careers (e.g.,

32
attorneys, computer programmers, scientists, engineers, and physicians) highlighted the
success factors and obstacles encountered by these women. They found that while
disabled women often chose non-traditional careers for the same reasons as non-disabled
women, (i.e., personal interest and high motivation), had similar influences in their lives,
(i.e., their mothers), and attributed their success to similar forces, (i.e., dedication to the
job and career support from supervisors or other mentors), the obstacles they faced were
different. The problem cited most often was the negative attitudes of others towards
disability and the constant need to prove oneself. These women also reported that their
disability status and gender were equally problematic. For women with multiple
disabilities, insufficient support services was reported as the greatest obstacle to career
success, demonstrating how availability of such services overshadows the unfavorable
attitudes of others when it means the difference between being able to perform one’s job
duties or not. When asked how they overcame career problems and barriers, they
indicated work experience, education, and assistance from others most often. However,
the relative importance of these three factors varied according to differences in onset and
visibility of disability. Specifically, work experience was indicated as most important to
women who had later onset of disability, most likely because their education was far in the
past, and they were advanced in their careers. Education, on the other hand, was
indicated as most useful in overcoming barriers by women whose disability was acquired
early in life. For them, it was their education which played a large part in getting their
careers launched. For individuals with more visible disabilities, such as those with
amputations or visual impairments, assistance from others was considered most helpful.

33
This illustrates the notion that acceptance and support from others is important to
achieving satisfactory career outcomes, particularly when one visibly stands out as
different (Igbaria & Wormley, 1992).
Impact of Type of Disability on Career Outcomes
Studies (Braddock & Bachelder, 1994; Gething, 1992; Greenwood, et al., 1991)
have shown that it may be difficult to make broad generalizations about the experiences of
people with disabilities, as there are distinct differences among groups of individuals with
different types of disability, as well as the unique experiences of each individual.
However, these studies have found that people with specific types of disability share
common experiences, and like the shared experiences of other minority groups,
highlighting these commonalties can lead to higher levels of awareness among those who
are not living with a disability. One type of shared experience is the reactions of others to
various types of disability.
Gething (1992) conducted a study of health professionals’ reactions to people with
a visible physical disability. Respondents watched a video of an individual who was
interviewing for a bank position, and then completed an assessment of the applicant as if
they were the hiring manager in the scenario. Half of the respondents watched a version
of the video where the job candidate was in a wheel chair. The results showed that the
presence of the wheelchair corresponded with extremely negative assessments.
Specifically, the visibly disabled candidate was rated as less likable, trustworthy, sensitive,
pleasant, intelligent, attentive, ambitious, brave, socially adaptable, tenacious, confident
and religious, and more cruel, bad, selfish, shallow, dishonest, careless, passive, weak, self

34
pitying, dependent, submissive, incompetent, tense, anxious, mentally unstable, and
unfriendly.
In a study of employer receptivity to employees with different types of disability,
Projects With Industry (PWI) practitioners were surveyed as to the probable reactions of
typical employers with regard to recruitment and selection of people with disabilities,
willingness to assign them to various types of positions, workforce acceptance, and
expectations for work performance (Greenwood, et al., 1991). The respondents rated
these four areas while considering four broad categories of disability, physical (i.e.,
incoordination, limitations of stamina, seizures, impairments of upper extremities or lower
extremities), menial (i.e., difficulty in learning new tasks or interpreting information),
emotional (i.e., alcohol/drug dependency, irregular behavior, problems with interpersonal
relationships), and communication (i.e., sensory disabilities that limit hearing, sight, or
speech). The results indicated that employers would respond most positively to
employees with physical disabilities. In addition, employers were more likely to consider
employees with physical disabilities for manager and professional positions, than mental,
emotional, or communication impaired individuals. Employees with communication
impairments received the least favorable ratings as far as recruitment and selection
activities, and co-worker and customer acceptance.
Some of the unique difficulties experienced in the workplace by employees with
communication impairments are highlighted by several studies (Glass & Elliott, 1993;
Welsh & Foster, 1991) o f deaf employees’ experiences in the workplace. For instance, in
a study of the experiences of deaf employees with college degrees (Welsh & Foster, 1991)

35
it was shown that, similar to hearing individuals, a college education led to higher overall
employment levels, increased number of overall opportunities, greater likelihood of a
professional or managerial position, and considerably higher pay than deaf employees with
a high school diploma or sub-bachelors education. However, deaf employees, whether
college educated or not, still encountered barriers to achieving career goals due to reduced
ability to fully participate in meetings and exclusion from most of the informal social
interactions and information exchanges that allow individuals to test their ideas and stay in
the information loop. Deafemployees indicated that they were able to communicate with
their co-workers in one-to-one situations, but were otherwise isolated from the work
group. Employer accommodations such as TDD equipment, written meeting agendas and
notes, or interpreters were seldom provided. This decreased their ability to fully perform
on their jobs, as well as the likelihood for career advancement.
Similarly, in a study of workers who developed a hearing impairment later in their
careers (Glass & Elliott, 1993), the percent of respondents who reported receiving
workplace accommodations were extremely low. This group, however, did not indicate
that their work success or failure was affected by the presence or absence of adaptive
equipment. Rather, supervisor and co-worker support was indicated as the most critical
element to career success.
Summary
In summary, the literature explains the theoretical processes that individuals
engage in while attempting to master their environment. The specific theories described,

36
MOHO, Expectancy, Equity, and Attribution, consider the importance of individuals and
environmental factors which interact within an open, dynamic system.
It can be theorized, therefore, that in order for individuals to maximize their career
outcomes, they must possess the requisite skills, abilities, and work habits, as well as have
confidence that the actions they take will result in desired career outcomes. In addition, a
supportive environment which provides them with, and responds to, feedback is
important. Describing and explaining how all of these individual and environmental
factors come together to facilitate or inhibit maximum career outcomes for people with
disabilities is the goal of this study.

37
Chapter III: Methodology
Overview
This study applied an empirically based approach, in order to determine the
individual and environmental factors that enable professionals with visible disabilities to
maximize their career outcomes. The study considered the experiences of a sample of
employed professionals who are attempting to pursue their career goals with an apparent
physical disability. The career inhibiting and facilitating factors experienced by the
subjects were examined. In addition, the study considered the implications for employers
as well as occupational therapists and other health professionals who are working towards
employment of individuals with disabilities.
Statements of Hypotheses
Initially the study was designed to answer the following six hypotheses.
Hypothesis 1: The level of performance factors (i.e., ability, education and
experience) for an employee with a disability relates to his or her career outcomes.
Hypothesis 2: The degree of habituation (i.e., acceptance and inclusion in the
workplace, work routines and habits) for an employee with a disability relates to his or her
career outcomes.
Hypothesis 3: The degree of volition (i.e., job power, career orientation, career
strategies, perceptions of equity, attribution and advancement prospects) for an employee
with a disability relates to his or her career outcomes.

38
Hypothesis 4: The existence of supportive environmental factors (i.e., accessibility
and accommodation, career support, feedback, mentoring, T&D, and cultural diversity) as
reported by an employee with a disability, is related to his or her career outcomes.
Hypothesis 5 Women will encounter more obstacles to maximizing career
outcomes than men.
Hypothesis 6: Individuals with a speech or hearing related disability will encounter
more obstacles to maximizing career outcomes than individuals with a mobility or vision
related disability.
Upon examination of preliminary results of twenty subjects it was evident that
many of the subjects were working in fields where the primary customers or ultimate
beneficiaries of their services were people with disabilities. Since employment in such
disability-related areas as Independent Living Centers, Disability Studies departments, or
Government Agencies for the ADA may affect career outcomes, two additional
hypotheses were added.
Hypothesis 7: There will be a relationship between career choice and gender,
career choice and type of disability, and career choice and age of onset of disability.
Hypothesis 8: Professionals with disabilities in disability-related jobs will
encounter more obstacles to maximizing career outcomes than professionals with
disabilities in jobs that are not disability-related.
Research Design
The study followed a non-experimental, quantitative design, utilizing personal
interviews o f a sample of professionals with apparent disabilities. Interviews took place at

39
a location specified by the participant, and consisted of 71 multiple choice plus 2 open-
ended questions. Interviews were conducted utilizing adaptive technology as requested by
the respondent. Structured interview questions asked respondents to report on individual
and environmental factors, define their role within their organization, and identify the
factors that they believed were the most career-promoting, and the most career-inhibiting.
The interviews included questions regarding respondents’ expectations for achieving
satisfactory career outcomes and equity with relevant others. Participants were asked to
globally assess their overall satisfaction with their career success to-date. Finally,
participants were asked to comment on what they believed employers and healthcare
workers could do to help people with disabilities maximize their career outcomes.
Prior to data collection, the interview questionnaire (or instrument) was reviewed
and revised based upon input from the author’s thesis committee members. As a pilot, the
instrument was completed and critiqued by two professionals with physical disabilities in
order to obtain feedback and evaluate the effectiveness of the interview questions.
Because both were in remote locations the questionnaire was faxed for their completion
and responses and feedback was collected via the telephone. Some minor revisions to the
questionnaire were made based on suggestions of the two pilot subjects.
Human Subjects
Prior to proceeding with any research data collection involving human subjects,
approvals were obtained by the Human Investigation Committees of the sponsoring
organizations. Applications were submitted to the Human Investigation Committees at
Rush-Presbyterian-St. Luke’s Medical Center and Northwestern University/Rehabilitation

40
Institute of Chicago, in compliance with federal and state laws protecting the rights and
welfare of human research subjects. This important process mandates that participants are
informed of the purpose of the study, procedures, benefits, and any potential risks. In
addition, participants must be informed that their confidentiality will be protected, their
participation is voluntary, and that they may withdraw their consent to participate at any
time. To assure that this study was in compliance with these rules, each participant
received a subject information sheet and written consent form prior to their participation
(Appendices B and C).
Procedure
The target population for this study was employed professionals who have an
apparent disability. Since the author had limited access to the target population, a non
probability sampling technique was used. This involved collecting a core sample of
individuals through organizations who work with people with disabilities. Initial
organizations contacted included: Access Living, Guild for the Blind, Illinois Mayor’s
Office for People with Disabilities, National Association of the Deaf, National Federation
of the Blind, National Spinal Cord Injury Association, Progress Center for Independent
Living, Rehabilitation Institute of Chicago (RIC), and Rush University. Individuals whose
names were provided by these organizations were contacted by the researcher and asked
to provide the names of others who they believed would be interested in participating in
the study or who might provide additional referrals. This snowball process was used until
the targeted sample size of 30 individuals was reached.

41
The inclusion criteria for the study was that (1) subjects are managers or
professionals who are currently employed in companies or organizations, (2) subjects have
an apparent disability versus a hidden disability, and (3) subjects obtained their disabling
condition either prior to, or early in their careers. All potential subjects were asked six
screening questions to determine their eligibility (Appendix A). Answers to questions one,
two, three, and four determined ifthe potential participant met the inclusion criteria of the
study. In addition, questions five and six asked potential participants if they have career
goals and if so, what impact, if any, their disability had on these goals. Answers to these
questions did not disqualify participants, but provided additional information which was
used during the analysis of the interview data as potentially explanatory.
Both men and women were selected for the study in order to examine the effect
that gender has in establishing career goals and maximizing career outcomes. Although,
gender discrimination for women regardless of ability has been well established, there is
evidence that disability-related discrimination is compounded by gender (Braddock &
Bachelder, 1994; Menz,etal., 1989).
Disability types were initially categorized as physical (primarily affects mobility) or
sensory (primarily affects vision, hearing, or speech). After examining preliminary data,
disability types were re-categorized as physical, vision-related, or speech/hearing-related.
No controls were included for other variables that may have had an impact on the
results. These included demographic variables (e.g., age, race, and ethnic origin) and job-
related descriptors (e.g., type of industry, business sector, and company size).

42
Once the subjects were selected, an appointment for a personal interview was
arranged. The participants were informed that the interview process would take
approximately one hour. The data collection procedures were modified slightly to
accommodate the needs of the individual subjects. For example, during the interview all
respondent received the aforementioned subject information sheet explaining the purpose
of the study, as well as the written consent form to read and sign. In the case of subjects
with vision-related disabilities, the consent form was presented orally to them by the
researcher, with the exception of one individual who asked that the form be emailed to
him so that he could review it using voice technology. A copy of the interview
questionnaire was offered to all sighted respondents so that they could follow along as
each question was read out loud by the researcher. The researcher then recorded the
responses on her copy of the questionnaire.
There were several additional procedural modifications required for subjects with
hearing-related disabilities. Interpreters, because of their expense, were used only when
they were made available by the subject’s organization. This occurred in two cases.
These two interviews were, for the most part, conducted in the same manner as the
interviews with hearing subjects, i.e., the researcher read each question, the interpreters
used American Sign Language (ASL) to relay their meaning, the subjects answered in
ASL, and the interpreter explained their response. In the cases of the other five deaf
subjects, a combination of fax, email, TTY and/or relay operator were used to collect the
data. The information sheet, consent form and questionnaire were faxed, mailed or

43
emailed prior to the scheduled interview. The interview itselfwas conducted live via TTY
or relay operator, with the researcher asking the questions and the subjects typing their
responses. In two cases subjects completed the short answer items on the questionnaire
upon receiving the FAX instead of waiting for the scheduled interview. One of these
individuals returned the questionnaire by FAX prior to the “live” TTY interview. Since
most of the questions were already completed, the researcher focused solely on any
skipped or unclear questions plus the two open-ended questions. The other individual
returned the completed questionnaire to the researcher by mail, so at the time of the
scheduled TTY interview neither the researcher nor the subject had a copy of the
responses. For this individual the researcher focused solely on the two open-ended
questions and then followed up with the subject on any skipped or unclear questions after
the mailed responses were received one week later.
Characteristics of the Sample
The total sample size was 30 individuals. As shown in Table 1, 16 (53.3 percent)
had a mobility-related physical disability, 6 (20.0 percent) had a vision-related disability,
and 8 (26.7 percent) had a speech and/or hearing-related disability. Fifteen (50.0
percent) were men and 15 (50.0 percent) were women. Twenty-six (86.7 percent) were
white, 3 (10.0 percent) were black, and 1 (3.3 percent) was Latino. Twenty-three (76.6
percent) acquired their disability before the age of 20, and of these, 13 (56.5 percent)
were disabled from infancy. Years of professional experience ranged from 1 year to over
20 years, with 13 (43.3 percent) having 10-19 years and 11 (36.7 percent) with 20 or
more years. All individuals (100 percent) had attended some college with 10 (33.3

44
percent) holding an undergraduate degree, and 19 (63.3 percent) holding a graduate
degree.
A varied representation of industries was reflected in the sample including
Advertising/Public Relations, Arts & Architecture, Disability Advocacy, Education,
Government, Health Services, Information Technology, Law and Manufacturing. Sixteen
subjects (53.3 percent) reported that the work that they do is disability-related and
twenty-three subjects (76.7 percent) reported they worked in the not-for-profit sector.
Table I
Characteristics of the Sample (N=30)
Personal
Demographics
Total % Professional
Demographics
Total %
GENDER YRS PROFL EXPERIENCE.
Male 15 50.0 <5 1 3.3
Female 15 50.0 5 to <10 5 16.7
10 to <20 13 43.3
RACE 20+ 11 36.7
White 26 86.7
Black 3 10.0 JOBTYPE
Latino 1 3.3 Disability-Related 16 53.3
Not Related 14 46.7
DISABILITY
Physical 16 53.3 BUSINESS SECTOR
Vision 6 20.0 Not for Profit 23 76.6
Speech/Hearing (S/H) 8 26.7 For Profit 7 23.3
AGE OF ONSET INDUSTRY
Birth-Infancy 13 43.3 Advertising/P.R. 2 6.7
Childhood 5 16.7 Arts and Architecture 2 6.7
Adolescence 5 16.7 Disability Advocacy 8 26.7
Early Adulthood 2 6.7 Education 5 16.7
Adulthood 5 16.7 Government 6 20.0
Health Services 2 6.7
EDUCATION Information TechnoL 2 6.7
Some College 1 3.3 Law Practice I 3.3
Baccalaureate 10 33.3 Manufacturing. 2 6.7
Masters 14 46.7
Ph.D., JD 5 16.7

45
Instrumentation
Interview questions were adapted from Gould & Penley’s Career Strategies
Inventory (1984), and original survey questions on sponsorship, supervisory support, and
career satisfaction, developed by Greenhaus, et al. (1990). It should be noted that these
instruments were used in studies that examined the effects of race on career outcomes for
black professionals.
In addition, the author developed specific questions to address issues unique to
people with disabilities, e.g., workplace accessibility and accommodation.
The resulting questionnaire consisted of 71 structured interview questions, which
use both nominal and ordinal levels of measurement, plus 2 open-ended questions, to
provide additional information regarding the underlying research questions. The
questionnaire took an average of 30-45 minutes to complete. The questionnaire examined
the following key variables:
Dependent variable:
Career Outcomes: subjects’ perceptions of met expectations with regard to
promotions, salary increases, career opportunities, and opportunities for continued
development; progress toward meeting career goals; and overall career success.
Independent variables:
IndividualDescriptors: include gender, race or ethnic origin, job content, and
type of business.
Performance Factors: include type of disability, age of onset, education, and
experience level.

46
Habituation Factors: defined as the degree of acceptance and inclusion of the
employee into the workgroup.
VolitionalFactors: include degree of career orientation, implementation of career
strategies, perceptions of equity in the workplace, attribution, and perceptions of
advancement prospects.
EnvironmentalFactors: include physical accessibility, available accommodations,
career support, performance feedback, mentoring, training and development, and
workplace diversity.
Measures
As mentioned earlier the Model Of Human Occupation (MOHO) was used as a
framework to establish measures for the critical factors, Performance, Habituation,
Volition, Environment, and Career Outcomes.
Performance was measured by four items, category of disability, age of onset,
education, and years of professional experience. Responses to age of onset, education,
and experience were averaged to produce a global performance score. The affect of
category of disability was considered separately.
Habituation was measured with two subscales, workhabits and acceptance and
inclusion. For most items in this section as well as the sections to follow, subjects
indicated their agreement or disagreement on a four-point scale. Work habits was
measured with three items (e.g., “I am able to perform the majority of my job duties
comfortably”) and acceptance and inclusion with four items (e.g., “There is a feeling of
camaraderie between me and my work associates”). Means were calculated for all items

47
to produce a global habituation score as well as a sub-score for work habits and a sub
score for acceptance and inclusion.
Volition was measured with five subscales,job power, career orientation, career
strategies, perceptiom ofequity, and attribution. Jobpower was measured with three
items (e.g., “there is an opportunity for independent thought and action in myjob”),
career orientation with five items (e.g., “My work means more to me than just a means of
financial support”). Career strategies was measured with five items (e.g., “In the past
year I have made my supervisor aware of the assignments I want”) adapted from Gould
and Penley’s (1984) Career Strategies Inventory. Perceptions ofequity consisted of six
items (e.g., “The amount of effort I put into my work is than others” [much less,
less, about the same, more, much more] ) and attribution with three items (e.g., “I control
my own career success”). Means were calculated for all items to produce a global volition
score as well as sub-scores for each of the five subscales.
Environment was measured with seven subscales, physicalaccessibility,
accommodation, career support, performancefeedback, mentoring, training and
development, and workplace diversity. Accessibility was measured with one item (“My
workplace is accessible to people with a disability like mine). Accommodation was
measured with a descriptive checklist. Career support was measured with five items (e.g.,
“My supervisor keeps me informed about different career opportunities for me in the
organization”) adapted from a longer survey developed by Greenhaus, et al. (1990).
Feedback was measured with two items (e.g., “I feel my performance appraisal provides
an accurate assessment of my performance”)- Mentoring consisted of four items (e.g.,

48
“People who get ahead in this profession generally have a mentor”), trainingand
development with three items (e.g., “In this organization, people with disabilities have the
same opportunities for training and development as other employees), and workplace
diversity with three items (e.g., “This organization has a formal diversity program which
includes persons with disabilities”). Means were calculated for all items accept
accommodation, to produce a global environment score as well as sub-scores for the
subscales. Frequencies were calculated for the accommodation checklist.
Career Outcomes was measured with three subscales, met expectations,
aspiratiotis, andsatisfaction. Met expectations was measured with four items (e.g., “1
feel my rate of promotions are than what I expected when 1started with this
organization”, [much less than, less than, about the same as, more than, much more than]),
aspirations, with one item (“I feel I’m schedule when it comes to my career goals”,
[behind, right on, ahead of]). Careersatisfaction was measured with three items (e.g., “I
am satisfied with the success I have achieved in my career”) adapted from Greenhaus, et
al. (1990). Means were calculated for all items to produce a global career outcomes
score, as well as sub-scores for the two subscales.
Data Analysis
After all the interviews were completed the researcher worked with a bio
statistician to analyze the data and explore the relationships among the variables. Because
of the non-probability sampling technique used only non-parametric tests were selected.
Spearman’s rho, a measure of correlation computed for ranked data, was used to
determine the extent of agreement or disagreement between the independent variables and

49
the dependent variables. For example, in the case of volition, Spearman’s rho ranks the
mean scores for volition and the mean scores for career outcomes for each subject and
assesses the extent that individuals who rank high on volition also rank high on career
outcomes and vice versa. If the two sets of ranks are in agreement then there is a positive
correlation. The Mann-Whitney U test was performed to compare the responses of men
with women, and of physically disabled and visually disabled with speech/hearing disabled
subjects. The Mann-Whitney U compares the mean ranks of responses between two
groups (e.g., men’s mean rank volition score and women’s mean rank volition score) to
determine if there is a significant difference. The Pearson Chi-Square test was used to
determine if there was a significant relationship between career choice and gender, career
choice and type of disability, and/or career choice and age of onset of disability.

50
Chapter IV: Results
Introduction
This section presents the results ofthe statistical analyses that were performed in
order to address each of the research hypotheses. The first four hypotheses stated that a
relationship would be found between the MOHO factors (independent variables) o f
performance, habituation, volition, and environment and career outcomes (dependent
variable). Hypothesis 5, 6 and 8 predicted that women encounter more obstacles to
maximizing career outcomes then men, that individual's with a speech and/or hearing
related disability encounter more obstacles to maximizing career outcomes then
individual's with a physical or vision related disability, and that individuals who choose a
disability-related career path encounter more obstacle to maximizing career outcomes,
respectively. Hypothesis 7 predicted that career choice is affected by gender, type of
disability, and age of disability onset.
For all analytical test, results are considered significant at g < .05, representing a
95% confidence level that statistical findings did not occur by chance. This p score level
was set by the researcher in accordance with conventional norms of research. However,
in the case of a small sample which was selected using non-probability techniques, it is
reasonable to assume that the data may be less representative than data drawn from a
larger, more random sample ofthe population (Depoy & Gitlin, 1994). For this reason,
scores ofg < .10 will be discussed as a potential area for further research.
Mean scores < 3.0 indicate that the average response to a question or group o f
questions was below the satisfied leveL While this in and ofitselfmay not be significant ft

51
will also be examined further where other corroborating evidence of dissatisfaction is
provided.
Hypotheses 1 .2 .3 and 4: Correlation of MOHO Factors with Career Outcomes
A statistically significant relationship was not found between performance factor
scores and career outcomes or habituation factor scores and career outcomes, thus
hypotheses 1 and 2 were not confirmed (Table 2).
Table 2
Correlation of MOHO factors with Career Outcomes (N=30)
FACTORS M SD Zm D
PERFORMANCE (global score) 3.41 0.73 0.266 0.156
HABITUATION (global score) 3.20 0.44 0.162 0.392
VOLITION (global score)
Career Strategies
Equity
Attribution
3.00
2.94
2.72
2.94
0.28
0.43
0.34
0.71
0.442
0.100
0.224
0.404
0.014**
0.600
0.234
0.027**
ENVIRONMENT (global score)
Career Support
Performance Feedback
Training & Development
Workplace Diversity
2.54
2.83
2.58
3.21
2.91
0.42
0.53
0.47
0.60
0.82
0.327
0.214
0.156
0.353
0.080
0.077*
0.257
0.411
0.055*
0.676
*2 < .10, potential area for further research.
~ E < .OS, significant.
Hypothesis 3 which states that a professional with a disability’s degree ofvolition
is related to his or her career outcomes is supported by Spearman’s rho which indicated
significant correlation between the volition factor score and the career outcomes score
(r,= 442, p= 014). In addition, several relationships among volition subscale scores were

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