In setting the methodological parameters for the research, it was determined that it should be restricted to research that has been published since the inception of the NDIS, with a focus on disability employment practice with particular reference to Customised Employment. Customised Employment, in particular the Discovery element is recorded in NDIS documentation as a billable item. This provides a clear link to the potential for the NDIS to influence the use of Customised Employment. A literature search was undertaken using the EBSCO database using the keywords customised, employment and disability. Limited to peer-reviewed papers from the past ten years (overlapping the NDIS), it produced two hundred and forty-six papers. Removing the peer-reviewed limit increased the outcome to three hundred and seventeen papers. Examining the abstracts for a specific focus on Customised Employment reduced the total to thirty-eight papers (Fig 1). Following this process, a literature search was undertaken of peer-reviewed journals focusing on disability and employment known to the reviewer (Fig 2).

Fig 1. Ebsco Data Base Search.

A search of the Journal of Vocational Rehabilitation found one hundred and sixty-five papers that mentioned CE.

The removal of duplicates and a review of the abstracts reduced the total to 25 papers. Other journals, such as Intellectual and Developmental Disabilities, produced four hundred and sixty-four papers on employment but none when using the word "customised" in the search parameters. Inclusion journal produced ninety-two papers, again none focusing on Customised employment.

The American Journal on Intellectual and Developmental Disabilities produced one hundred and ninety-nine papers, but none specifically focused on Customised Employment. Additional searches of Research and Practice for Persons with Severe Disabilities found twenty-one papers, which, following an abstract review, included four papers.

A literature search of journals produced in Australia, specifically those under the direction of the Australian Society for Intellectual Disability (ASID), produced no results for inclusion. The Journal of Intellectual and Developmental Disability produced nine hundred and sixty-seven papers on disability employment; this was reduced to twelve by adding the word "customised", and following an abstract review, all were eliminated due to the absence of any mention or focus on customised employment.

Disability and Society produced one thousand seven hundred and ninety-eight papers using “disability and employment. The addition of the word Customised reduced the total to thirty-one.

Following an abstract review, all papers were eliminated as none focused on customised employment or practice, with most focusing on rights, accommodations, marginalised groups and education. Research and Practice in Intellectual and Developmental Disabilities produced one hundred and five results using disability and employment. Adding Customised eliminated all papers. Journal of Mental Health Research in Intellectual Disabilities produced one hundred and twenty-five papers; adding the word Customised reduced it to three papers, all eliminated after an abstract reading. A total of 67 papers were deemed to meet the criteria for inclusion.

Against this background, it is worth noting a recently updated paper by Riesen et al. (2023) that built on their 2015 paper examining the literature for Customised Employment as an evidence-based practice. Measured against Leahy's 2018 model for levels of evidence, they reported that much of the research into Customised Employment is descriptive and illustrates that CE produces quality outcomes for people with disabilities. They noted that the gold standard for research is random control trials; however, conducting such trials on people with a disability ethically is problematic. They made several suggestions, including using correlational studies using robust indicators to move CE from a promising practice to an evidence-based one.

Fig 2. Review of known disability journals.

The literature supporting Customised Employment and Discovery highlights the work of academics and practitioners who share common knowledge and seek employment projects to remedy employment barriers in specific areas and opportunities while building an evidence base for practice. Harvey et al. (2013) sought to develop a competency model for Customised Employment. Their work highlighted the elements of Discovery and Customised Employment, which illustrated the need for tools to maintain the integrity of Discovery. At the same time, it was recommended that an objective measure of CE outcomes be developed to show the relationship between the competency model and employment outcomes. Inge et al. (2022) continued this theme by surveying disability employment service providers to understand what Discovery activities were being used. They found that while CE produced successful outcomes, there needed to be a more consistent application of the critical elements of CE, Discovery and Job development. It highlighted the need for CE professionals to be appropriately trained and fidelity scales to consistently apply essential evidence-based elements (Jones et al., 2020). Research by Smith et al. (2019) further supports the benefits of support and training as a crucial factor in provider transformation, illustrating the dual benefits of investing in this area.

Jorgensen-Smith et al. (2017) examined the settings for implanting CE in service systems, specifically Vocational Rehabilitation (VR) services. VR serves a similar role to disability employment service providers in Australia. While concluding that systems change requires extensive effort beyond training, it was essential to consider pragmatism when introducing change strategies to practices where systems are underfunded and have high caseloads and staff turnover. Murphy et al. (2014) noted the demand for competitive integrated employment (CIE) due to the increasing support for the Employment First initiative. This fed off the back of the Workforce Innovation and Opportunities Act (2014) that defined CIE, with Customised Employment included in that definition. While service providers supported the idea of integrated employment, most were reluctant to move beyond day services and socialisation outings.

Reisen et al. (2015) reviewed the literature to identify the conceptual and empirical evidence for Customised Employment. They identified a small number (n=25) of primarily descriptive papers, with a few having some data regarding aspects of Customised Employment. An examination of those articles highlights that they are primarily the work of a handful of CIE pioneers, such as Luecking (Transcen Worklink), Inge & Wehman (VCU), Griffin & Hammis (GHA), Callahan and Condon (MGA) in the main with others in the listing associated in some way with the mentioned authors. Riesen et al. (2015) noted the need for interventions using fidelity measures or replication studies to confirm the effectiveness of CE as an intervention. While the descriptive studies highlighted the effectiveness of CE, they failed to meet the threshold for empirical evidence, concluding that CE was an emerging practice. It highlights the need for a random control trial or correlation studies. They recommended developing a fidelity scale like the IPS Fidelity Scale to ensure quality service provision. The IPS or Individual Place and Support Fidelity Scale is used in mental health recovery programs with employment as an intervention goal. Individual Place and Support has been used extensively as an employment support program since the 1960s.

Wehman et al. (2016) conducted a study into participants with ASD who engaged in their program from 2009 to 2014 utilising Customised Employment finding that 63 of 64 participants found employment using CE and maintained their employment with appropriate post-placement supports. Their research and program highlighted how the customising of employment while taking more time, was more cost-effective over the long term as support needs reduce and young people with a disability started paying taxes. Further study was recommended into this aspect of CE. Similar studies by Brooke et al. (2018) using ASD cohorts supported the role of job customisation in promoting long-term employment outcomes, noting that support needs to be reduced to less than four hours per month. It supports the cost-effectiveness of Customised Employment, notably because 93% of participants in their study had reported no or intermittent employment before engaging with customised support.

Currently, most employment outcome measures focus on process outcomes, i.e., compliance against a policy that effectively measures provider compliance. Smith & Parmenter (2023) proposed a personal outcome measure that focuses on the impact of employment across the domains of social inclusion, social cohesion, socio-economic security and self-determination. This measure proposes shifting the focus to the impact of employment on the individual to shift employment practice away from compliance and any job to a practice approach that focuses on the right job. This is consistent with the approach of Customised Employment, which is about the right job and meaningful employment. Cost-benefit analysis and personal employment outcomes measures would provide evidence to support the efficacy of employment practices such as customised employment (Riesen et al., 2022).

An adaptation of this that departs from conventional wisdom is the use of Discovery as a component of self-employment or social entrepreneurship. Heath et al. (2013) showed a link between Discovery and successful self-employment. Research has demonstrated a link between Customised Employment entrepreneurship via self-employment and micro-enterprise, noting that they are a subset of Customised Employment that offers significant advantages such as accommodation of the needs of the individual, a sense of achievement and transport accommodations, among other benefits (Ouimette & Rammler, 2017; Parker-Harris et al., 2013). It has been explored in Australia with varying degrees of success and is the subject of a US Federal Government grant-funded project in the USA. Further research is needed to validate the components that underpin successful self-employment and social entrepreneurship.

With the passing of Discovery into the US Federal Register effective July 2015 as a defined practice, Hall et al. (2016) developed the Discovery Fidelity Scale to bring some rigour and fidelity to the emerging evidence for the process of Discovery. The Discovery Fidelity Scale divided the process into Systems Fidelity and Services Fidelity. The Systems Fidelity component focuses on funding and service providers. The Services Fidelity component focuses on practice delivery (Discovery) and is time-limited, consistent with the fidelity scale focus on US service provision and funding. It was noted that Discovery is not a stand-alone service and is an integral part of Customised Employment. Developing the Discovery Fidelity Scale is essential to ensure that Customised Employment does not fall victim to the issues that have diluted the effectiveness of person-centred planning.

Research has shown that "customisation" was regularly misunderstood to mean service activity, something more in line with process outcomes (Smith et al., 2018, p 63a). The identified gaps in applying Customised Employment principles by employment specialists highlight the importance of having a fidelity scale (Inge et al.,2022; Kim et al., 2022; Riesen et al., 2019). Inge et al. (2018) conducted research to define the characteristics of customised employment by surveying twenty-eight subject matter experts. Their analysis distilled twelve practices that define Customised Employment.

These were recorded as follows:

1. Physically meet at a location of the individual’s choice.

2. Build rapport and get to know the individual.

3. Mindfully listen to the person.

4. Identify the individual’s interests, skills, and abilities.

5. Conduct in-depth interviews with family and friends concerning the person’s interests, skills, and abilities.

6. Observe the person in daily activities in several different community settings.

7. Arrange for the job seeker to observe local businesses that match the job seeker's interests, skills, and abilities.

8. Conduct informational interviews with employers at local businesses that are representative of the job seeker’s interests,

skills, and abilities.

9. Observe the job seeker engaging in job-related tasks.

10. Assist the job seeker in identifying a work experience(s) to refine/identify job interests, skills, and abilities.

11. Collaborate with the job seeker, family, and friends in confirming the job seeker’s interests, job interests, skills, and abilities.

12. Negotiate a customised job description.

During their analysis, they found several CE practices aligned with qualitative research methods, such as the researcher going to places where the research subject is engaged. The twelve practices evolve the elements defined by Harvey et al. (2013).

Building on Inge et al. (2018), Riesen & Morgan (2018) examined employer perspectives on Customised Employment. Reciprocity and mutuality (Luecking et al., 2004; Wehman et al., 2018) are vital ingredients to successful Discovery outcomes that meet the needs of employers and job seekers. Engaging with a small cohort of business owners, they found that employment specialists need to develop specific business-related knowledge about finance, risk management, and hiring processes and take a needs-based approach to working with the business. These skill sets are not readily seen in disability employment, with specific job development such as task analysis and job analysis rarely seen, highlighting the need to ensure that employment staff are supported by research, policy and training that supports good practice (Migliore et al., 2018; Remund et al.,2022; Riesen et al.,2022).

Riesen et al. (2019) reviewed the Discovery Fidelity Scale using an online modified Delphi study to obtain consensus from a panel of experts. Conducted over three rounds, they found consensus on 55 of 60 Discovery tenets and agreement that a fidelity scale is essential to ensure that Discovery is implemented consistently. At the same time, CDERP and the University of Melbourne convened a panel of experts in Australia and the USA to review the Discovery Fidelity Scale for application in Australia. While preliminary, the findings suggest that the US model of fidelity requires a change to reflect our funding model and cultural context. This is not unexpected, given that one of the drivers for Discovery has been to ensure adequate funding for CIE services in the USA.

Funding has remained a contentious issue within the USA (Murphy et al., 2014; Jones et al., 2020), with significant efforts being made to blend Customised Employment with programs such as school transition to enable funding to be available. One example is using Group Guided Discovery (a form of peer work) with Pre-Employment Transition Services (Pre-ETS) to improve employment transition outcomes. Salon et al. (2018) found that students undertaking Group Guided Discovery could utilise the information gained in developing IEPs that advocate for real work experiences. The Utah School to Work Initiative used a similar approach by blending or braiding funding to successfully support students using Customised Employment to demonstrate the impact of work experience and internships on students with disabilities (Jones-Parkin et al., 2021).

The issue of students with a disability obtaining access to significant work experiences is not unique to the USA, with experience in Australia highlighting a lack of funding and opportunities for children with disabilities to access work experiences and planning (Discovery) in sufficient volume to create meaningful pathways post-school. In 2018, a pilot study was undertaken by Koomarri (Canberra), Wanniassa High School and the Centre for Disability Employment Research and Practice (CDERP). Funded by the Prosser Foundation, a contextualised version of Group Guided Discovery (GGD) was delivered to students at Wanniassa High School. CDERP trained Koomarri staff in Customised Employment and, with their support, delivered the GGD program to the students. Koomarri staff provided work experience and facilitated post-course support. The program highlighted the benefits of starting early and using multiple work experiences to dispel any misgivings parents and participants had about work potential (Smith & Stephen, 2018). Importantly it aligned with the O'Brien & Callahan (2010) position that Discovery is a knowledge-creation process regarding a person's employment interests and conditions for success. Despite this, the ongoing lack of funding for schools to offer significant transition support and planning hinders employment pathways for children with disabilities.

Research by Taylor et al. (2021) into the cost-benefit of competitive integrated employment about CE compared to sheltered employment found that while CIE front-loads the cost of extensive employment support, costs diminish over time as supports reduce. Sheltered employment was found to be a constant cost and not cost-effective in comparison. Based on data from twenty-six research papers that examined the cost-effectiveness of employment support types, they found that when examining individual outcomes, the cost-benefit ratio for those supported into employment using a customised approach was even more significant. They concluded that while reform to segregated employment may be costly, inaction on this would come at a cost to the hidden talent lost to the community. Wehman et al. (2018) reported that research on the cost-benefit of outcomes would send a clear message to policymakers that CIE and CE should be extended.

The findings of this paper concerning peer-reviewed research are consistent with the work of Riesen et al. (2023), whose updated paper found few new research papers. However, inclusion criteria may have been a limiting factor, given the insistence on research papers with objective fidelity measures.

A small number of grey literature reports have been produced in Australia highlighting the utility of Customised Employment and the small number of trials. Customised Employment has a long history, with many service providers claiming to use the process. However, very few service providers have undertaken training in Customised Employment that meets the standards acknowledged as the minimum undertaking in the USA. This suggests that only some use it with fidelity to the evidence. This parallels the uptake of person-centred planning in Australia, which saw many adopt the name for marketing but not the processes with any fidelity.

An environmental scan undertaken by the Brotherhood of St Laurence (Brown & Mallett, 2021) examined current employment interventions and research in Australia. They identified current work by CDERP in developing outcome measures and the CDERP, University of Melbourne, Scope partnership evaluating Scope's Customised Employment project as the only active research in this area. At the same time, CDERP's Work First Employment program and Brite's Pathway program are noted as the only active CE interventions. Brite's program was initiated with support and training by CDERP. The University of Melbourne, Future of Work Lab examined employment literature from the perspective of people with intellectual disabilities, finding that few studies in Australia directly addressed barriers to employment. Examining open, sheltered and social entreprise models of employment, they concluded that the choices were imperfect and created systematic barriers to employment. It was recommended that investment be made into customised person-centred approaches such as Customised Employment that promote successful employment strategies referencing CDERP's Work First and Glide In programs. The report specifically recommended CDERP's Work First as a blueprint for the NDIA and the Department of Social Services (Taylor, 2022).

Smith et al. (2018b) reported the NDIS Funded Innovative Workforce Fund grant project findings that examined Customised Employment as a workforce capacity-building instrument. Using the Work First CE training curriculum, staff at four service providers were trained in delivering Discovery and Customised Employment, along with supporting twenty-nine people with a disability. The project highlighted how Discovery increased support staff knowledge and skills in support of people with a disability requiring assistance in employment / vocational support. At the same time, evidence showed that people with disability (and their family/support networks) gained knowledge and understanding of the Discovery process and how it could be used to facilitate employment outcomes. People with disability exercised choice and control throughout the implementation of the Discovery program. People with disability and their families valued the process. Where they had previously been involved with employment support services, they saw this as something distinctly different and providing a more holistic and person-centred approach. This project was built on the evidence produced by the Koomarri Career Discovery High School Project (Smith & Stephen, 2018).

The Jobs Victoria Innovation Fund supported a pilot project to evaluate the Customised Employment model of employment practice by supporting people with disability in two Victorian regions (Broadmeadows and Warrnambool). Established in 2019, it sought to evaluate CE in two social enterprises. Despite the restrictions imposed by the pandemic, the project demonstrated promising outcomes and the potential benefits of Customised Employment (Smith, 2021).

Micro-enterprise is another area where Customised Employment and Discovery create employment opportunities in Australia. The Community Living Project in South Australia has supported a small number of people with a disability to create employment opportunities. The project also highlighted the benefits of exploring micro-enterprise in creating awareness among families of the broader range of employment support available while educating the broader community about the benefits of employing a person with a disability (Smith & Alexander, 2022). Similar projects have been undertaken in other states, illustrating the utility of Discovery in supporting employment outcomes, consistent with the evidence reported by Heath et al. (2013).