7. Job placement and training methods

In general, people with severe brain injury require more intensive assistance in job seeking, job placement, job-training and longer-term support than other disability groups. The required level of support is often under-estimated by the client, employer and provider, contributing to job failure.

Training techniques commonly used in brain injury:

Errorless learning

The client is taught information in a way that does not allow him/her to make mistakes. Using this approach, the trainer demonstrates a task to be performed in the correct way and closely observes the client, preventing him or her from straying from the instructed technique in order to prevent errors.

This is useful for those with more severe cognitive impairments impacting on memory and planning/problem solving abilities on the grounds that it prevents the inadvertent consolidation of the incorrect response

Scaffold learning

Focus on the core, underlying knowledge or skills prior to layering on a new task

Cues and prompts

Visual cues are pictures that trigger learning (e.g., flowcharts) and can be used in conjunction with verbal prompts (e.g., single word reminders).

The least restrictive (i.e. minimal) amount of cues and prompts should be used to maximise independence, monitored and reduced over time where possible.

Chaining:

Step-by-step instruction following a task analysis, via either forward or backward task instruction.  With forward chaining, the client performs the first step of the task with gradual addition of further steps as each successive step is mastered.

With backwards chaining, the trainer provides substantial assistance with the initial steps and allows the client to independently complete the final steps of the task

Provide lots of repetition

Depending on the individual they may need different levels of repetition to assist them to learn over time and embed their work practices into everyday routines. Variables to be repeated can include: instructions, routines, work tasks and any new or changed activities.

Using written instructions, checklists, phone reminders and other strategies can assist with repetition.

Make training specific

Train in the actual task environment using the actual task resources needed.