Research Article
Issue Date: March/April 2019
Published Online: March 01, 2019
Updated: April 30, 2020
Cognitive, Emotional, and Physical Functioning as Predictors of Paid Employment in People With Stroke, Traumatic Brain Injury, and Spinal Cord Injury
Alex W. K. Wong; Cynthia Chen; M. Carolyn Baum; Robert K. Heaton; Berrit Goodman; Allen W. Heinemann
Author Affiliations
  • Alex W. K. Wong, PhD, DPhil, is Assistant Professor, Program in Occupational Therapy and Department of Neurology, Washington University School of Medicine, St. Louis, MO; wongal@wustl.edu
  • Cynthia Chen, PhD, is Assistant Professor, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
  • M. Carolyn Baum, PhD, OTR/L, FAOTA, is Professor and Elias Michael Executive Director, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
  • Robert K. Heaton, PhD, is Professor, Department of Psychiatry, University of California, San Diego.
  • Berrit Goodman, BA, is Master of Science in Occupational Therapy Student, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO.
  • Allen W. Heinemann, PhD, ABPP-RP, FACRM, is Professor, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, and Director, Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago.
Article Information
Neurologic Conditions / Spinal Cord Injury / Stroke / Research Articles
Research Article   |   March 01, 2019
Cognitive, Emotional, and Physical Functioning as Predictors of Paid Employment in People With Stroke, Traumatic Brain Injury, and Spinal Cord Injury
American Journal of Occupational Therapy, March 2019, Vol. 73, 7302205010. https://doi.org/10.5014/ajot.2019.031203
American Journal of Occupational Therapy, March 2019, Vol. 73, 7302205010. https://doi.org/10.5014/ajot.2019.031203
Abstract

OBJECTIVE. Our objective was to examine demographic, cognitive, emotional, and physical factors that predict return to paid employment for people after neurological injury.

METHOD. Four hundred eighty adults with stroke (n = 149), traumatic brain injury (n = 155), and spinal cord injury (n = 176) completed an occupational outcome questionnaire and physical, emotional, and cognitive assessments at three rehabilitation facilities.

RESULTS. Odds of employment were predicted by being married or partnered, having more education, requiring fewer prompts for task sequencing, and having higher inhibitory control (but were not predicted by specific type of injury). Participants who returned to work within 3 mo were more likely to work with the same employer and to take a full-time position than those who returned later.

CONCLUSION. Executive functioning, in particular sequencing and inhibitory control, strongly predicts employment and highlights the importance of cognitive strategy training during occupational therapy with people who have sustained neurological injuries.