Introduction
Employment is important to an individual as it offers income, forges social relationships, elevates social status, and ultimately provides meaning in life (van Campen & Cardol 2009). Evidence shows that employment is linked with the general population’s better physical and mental well-being (Hintikka et al. 2009; Meltzer et al. 2009). Employment also enhances the quality of life by providing a sense of identity, contribution, and belonging (Emerson et al. 2011). Moreover, individuals with disabilities were found to be able to contribute to economic growth as they expanded the job recruitment pool and improved employees’ tenure (Houtenville & Kalargyrou 2012).
However, despite the importance of employment on well-being, people with disabilities remain the largest untapped source of the labour force (Green & Brooke 2001). Similarly, people with disabilities in Malaysia were reported to have significantly higher unemployment rates than the general population (Ang 2017). Being unemployed could hinder their efforts to become independent and continue to rely on their parents, family, or the government for support (Harun et al. 2019). Ultimately, their exclusion from the workforce would cost 3–7% of the total national gross domestic product (Buckup 2009). This proves to be an issue of economic loss to the nation if the barriers to their integration into the workforce are not remedied. Therefore, this study aims to identify intervention strategies that would promote and drive positive employment attitudes among employers and nurture the culture of acceptance within society.
Employment and individuals with Down syndrome
With the advancement of medical care and improved quality of life, the life expectancy for individuals with Down syndrome has increased drastically, from only 12 years in the 1950s to 60 years over the past decades (Englund et al. 2013). Therefore, the importance of addressing employment issues for individuals with Down syndrome cannot be overstated as it directly impacts their overall socioeconomic status and quality of life.
Down syndrome is the most commonly identifiable cause of intellectual disabilities, accounting for around 15–20% of the population (Rutter 2002; Schalock et al. 2009). Down syndrome is characterised by specific traits that distinguish it from other neurogenetic disorders associated with intellectual disability (Channell et al. 2021; Tomaszewski et al. 2018). These traits include difficulties in expressive language fine motor skills, and social functioning. Effective communication is crucial in workplaces, and challenges in this area may affect their ability to convey ideas, understand instructions, or collaborate with colleagues. Additionally, employers and colleagues may hold misconceptions about individuals with Down syndrome’s abilities, limiting their opportunities for professional growth. Thus, high unemployment or part-time paid employment and unpaid volunteer work are typical for individuals with Down syndrome (Kumin & Schoenbrodt 2016). Studies have shown that individuals with Down syndrome have a wide range of functional abilities and skill asynchrony, which could affect their job qualifications. Therefore, although Down syndrome is often grouped with other conditions of cognitive limitations, it is important to examine their socioeconomic issues separately from the others.
Individuals who have Down syndrome possess the capability and desire to attain self-sufficiency and make valuable contributions to the betterment of their community and society (Foley et al. 2013; Foley et al. 2014; Kumin & Schoenbrodt 2016; Scott et al. 2013). However, the literature usually discusses the barriers and hindrances to employment for people with disabilities in general, and evidence on the benefits of work participation, especially for individuals with Down syndrome, is limited. Therefore, this study will explore the positive impact of employment for individuals with Down syndrome, and the results from the analysis can guide policy makers and organisations in promoting their integration into the workforce.
Employment policies and legislations in Malaysia
In Malaysia, despite establishing various policies and legislations, the employment statistics for people with disabilities still show no significant improvement. As of 2018, data indicated that around 4,500 individuals with disabilities were employed in the public and private sectors. This constituted roughly 1.4% of the working-age adult population with disabilities, which was documented as 320,870 individuals in the Social Welfare Department’s national disability register for the same year (Kementerian Pembangunan Wanita Keluarga Dan Masyaraka 2018). However, by 2021, reports showed that the representation of persons with disabilities in the civil service was only 0.35% of the total workforce (Ministry of Human Resource 2021), significantly below the government’s target of 1% quota for employment of persons with disabilities in the public sector (Jamil & Saidin 2018).
Additionally, in 2008, Malaysia was one of the signatories to the United Nation Convention on the Rights of Persons with Disabilities (UN CRPD) and ratified it on July 19, 2010 (United Nations 2022). However, Malaysia did not sign the Optional Protocol and had put forward interpretive declarations and reservations with regard to some of the Articles within the Convention. (Human Rights Commission of Malaysia 2015).
To show the ongoing readiness and effort to protect the rights of individuals with disabilities, Malaysia signed the Persons with Disability (PWD) Act into effect in 2008. The Act aims ‘to provide for the registration, protection, rehabilitation, development and well-being of persons with disabilities, the establishment of the National Council for Persons with Disabilities, and for matters connected therewith’ (‘Persons with Disabilities Act 2008’ 2008: 7). In ensuring individuals with disabilities are treated equally, most provisions state that they must be treated based on equality and impose obligations on the government, private sector, and non-government organisations. Matters pertaining to the employment of individuals with disabilities are stated under Part IV (Section 29) of the Act, where they ‘shall have the right to access to employment on an equal basis with persons without disabilities’ (‘Persons with Disabilities Act 2008’ 2008: 26). Despite that, with the persuasive approach towards the employer and the absence of punitive or sanction imposition in the PWD Act 2008, a promise for equal rights in employment remains doubtful (Hisham 2013).
Theories and framework for employing persons with disabilities
Various theories and frameworks concerning the employment of people with disabilities focus on understanding the complex relationship between individual abilities and societal barriers, especially in relation to employabilities. While the traditional medical model of disability (Jammaers & Hardonk 2023; Smith-Merry 2023) tend to isolate disabilities as a medical issue, overlooking social obstacles, a more inclusive model like the Social Model of Disability (Mauksch & Dey 2023) emphasises the removal of these barriers and the creation of inclusive environments, aligning with the need for workplaces to accommodate individuals with diverse abilities, including those with Down syndrome. The Capability Approach (Bonvin & Laruffa 2023) and Human Capital Theory (Maalaoui et al. 2023) focus on enhancing individual abilities through education and training, albeit criticised for overlooking social challenges. Overall, these theories underscore the necessity of considering individual and social dynamics to foster inclusivity in the labour market for PWD.
Maltreatment of persons with disabilities in the workplace
In the context of maltreatment in the workplace, these theories and frameworks highlight the urgent need to combat discrimination, harassment, and exploitation faced by PWD, including those with Down syndrome. Individuals with disabilities often face discrimination during the hiring process and in promotions (Khoo et al. 2013). Employers may hold biases against disabled individuals, perceiving them as less productive and requiring expensive accommodations, which can limit their career advancement opportunities (Hyseni et al. 2023). Studies have shown that employees with disabilities have lower perceptions of organisational citizenship behaviour (OCB), indicating a culture of exclusion in the workplace (Bennett 2022). Employees with disabilities may face harassment and bullying in the workplace, including mocking their disability, making insensitive comments, and engaging in subtle forms of exclusion and marginalisation (Hyseni et al. 2023; Li & Valerievna 2023). Workplace cultures lacking co-workers’ support and effective diversity, equity, and inclusion policies contribute to lower perceptions of organisational citizenship behaviour (OCB) among disabled employees (Petasis 2003). PWD frequently encounter limited career progression as employers may undervalue their abilities and neglect to offer necessary training or avenues for advancement (Tinta et al. 2020). The nature and application of maltreatment in the workplace in Malaysia among PWD, including PDS, remains unclear, particularly in addressing cultural factors. Cultural issues such as societal attitudes towards disabilities, traditional beliefs, and norms may pose additional challenges for individuals with disabilities, necessitating a holistic approach that considers cultural sensitivities and promotes inclusivity across various facets of society.
Examining benefits of employment through the social ecological framework
To understand the intricacies of employment issues for individuals with Down syndrome, we have drawn from the Social Ecological Model (Burge et al. 2007) to help inform our study. This model was developed as a conceptual framework to understand human development in the 1970s and was formalised as a theory in the 1980s (Bronfenbrenner 1986; Vasta 1992). It helps to understand how personal and environmental factors, such as intra- and interpersonal relationships, community, and policies, shape individual behaviours (Ingram et al. 2021; Kilanowski 2017). The theory was illustrated by nesting circles that place the individual in the centre surrounded by various system levels (Vasta 1992). These levels encompassed various interactions between the individuals and the environment housed within the larger socio-cultural contexts (Golden & Earp 2012; Kilanowski 2017; Lindsay et al. 2014). This model also presumes those multi-level factors are synergistic and reinforcing (Golden & Earp 2012).
Through SEM, we can explore the perception of employment opportunities as it results from the complex interactions between individuals with Down syndrome and their social environment (Lindsay 2011). Furthermore, besides understanding how behaviour develops, SEM can also identify behavioural and organisational leverage points and intermediaries for interventional strategies and policymaking (Centre for Disease Control and Prevention 2021; Kilanowski 2017).
The employment for individuals with disabilities in Malaysia can be generalised into open employment (i.e., working in the mainstream market, often with training and financial support from the government or NGOs) or sheltered employment (i.e., segregated work settings for individuals with disabilities, with training and financial support fully provided). Therefore, the focus of this research would include both employment courses for individuals with Down syndrome.
Aims
This study aims to explore the benefits and opportunities of employment for individuals with Down syndrome from the views of the various stakeholders by addressing these research questions:
What are the benefits of employment for individuals with Down syndrome?
What influences others to hire or support their employment?
Method
Study design
The researchers adopted the social constructivism paradigm to align with the exploratory nature of the research questions. It is anchored on the ontological assumption that ‘reality is socially constructed and fluid,’ and reality is always ‘negotiated within cultures, social settings, and relationships with other people’ (Cohen & Crabtree 2006). This philosophical approach valued the meanings individuals with Down syndrome gave to employment issues based on their interpretation. This method is well-suited for identifying patterns in the dataset and is adaptable to different theoretical perspectives (Braun & Clarke 2021). We utilised the Social-Ecological Model as a basis for their analysis, recognising that employment concerns are influenced by various factors within the broader social context. Individual interviews were conducted through an in-depth online video conference to collect data. The interviews addressed the research questions and provided valuable perspectives. The interviewer used a semi-structured approach to guide the conversation.
Ethics and consent
The study proposal received approval from the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak ethics committee (Ref # FME/21/12). The researchers emailed the Informed Consent Form and Participants Information Sheet to each participant after confirming their participation. Prior to the interview, the researchers reiterated the study’s details to each participant, ensuring confidentiality and their rights as participants. A recorded verbal consent was obtained before beginning the interview.
Participants and recruitment
As a result of the movement restrictions implemented during the COVID-19 pandemic, we conducted our study in Malaysia through online video conference interviews across different states. We recruited participants using purposive (Patton 2014) and snowball sampling to ensure we did not overlook anyone (Naderifar et al. 2017). We acquired participants’ details from the Department of Social Welfare. All participants were adults who had experience working with, employing, or caring for people with Down syndrome and community members who worked closely with them, such as special needs teachers, trainers in rehabilitation centres, or NGOs. We excluded individuals who could not understand the structure of the questions, converse in Bahasa Malaysia or English, and provide consent from our study. In our study, no one was excluded due to the exclusion criteria set. We contacted all potential participants via phone call and emailed them all relevant documents once they confirmed their participation.
In total, 45 respondents were interviewed, including six individuals with Down syndrome, ten family members, six employers and co-workers, 22 community members, and a policy maker (Table 1). Due to the great reach of participants via online interviewing, the participants in this study hailed from states all over Malaysia (Sarawak, n = 30; Kuala Lumpur, n = 8; Johor, n = 2; Melaka, n = 1; Pahang, n = 1; Penang, n = 1; and Selangor, n = 1). Most of the respondents were urban dwellers (n = 43, 95.56%), with only two participants (4.44%) coming from rural areas. Two-thirds of the participants were female (n = 30, 66.67%), with a mean age of 33.84 (SD = 12.85) years old. Most of them had tertiary education (n = 31, 68.89%), and all participants had some form of formal education. Almost all participants were employed (n = 43, 95.56%), while two (4.44%) were unemployed. Of those in employment, one-third worked in the private sector (n = 15, 33.33%), while seven were in civil services (15.56%). The other two were business owners (4.44%), and one was self-employed (2.22%). Of the unemployed participants, a large majority of them were university students (n = 8, 17.78%), while one of them was pensioner (2.22%), and two were unemployed (4.44%).
Table 1
Participants’ socio-demographic characteristics (N = 45).
| NO | CATEGORY (n) | AGE GROUP (n) | GENDER (n) | OCCUPATION (n) | EDUCATION LEVEL (n) |
|---|---|---|---|---|---|
| 1 | Individual, i.e., PDS (6) | 18–29 (6) | Male (1) Female (5) | Unemployed (2) Private sector (3) | Certificate (2) Secondary school (4) |
| 2 | Family members (10) | 18–29 (4) 30–39 (1) 50–59 (1) 60–69 (3) ≥70 (1) | Male (3) Female (7) | Homemaker (5) University student (2) Pensioner (1) Private sector (1) Civil servant (1) | Secondary school (5) Tertiary education (3) |
| 3 | Employer (3) Co-worker (3) | 18–29 (1) 30–39 (1) 40–49 (1) 50–59 (2) 60–69 (1) | Male (1) Female (5) | Business owner (2) NGO (4) | Secondary school (1) Tertiary education (5) |
| 4 | Community (22) | 18–29 (17) 30–39 (5) | Male (11) Female (11) | University student (6) Self-employed (1) Private sector (9) Civil servant (6) | Secondary school (1) Tertiary education (21) |
| 5 | Policymaking (1) | 18–29 (1) | Female (1) | NGO (1) | Tertiary education (1) |
[i] NGO: Non-governmental organisation.
Data collection
We conducted all the interview sessions online and collected data using an in-depth semi-structured interview. We developed an interview protocol and pilot-tested it following the Interview Protocol Refinement Framework (Castillo-Montoya 2016). There were two main sections to the interview protocol: (1) participants’ socio-demographic profile and (2) the benefit of employment for individuals with Down syndrome. The central question during the interview was, ‘From your view, what are the benefits of employment for a person with Down syndrome?’
Consent was obtained before video recording the sessions, which were conducted one-to-one except for the six sessions with individuals with Down syndrome who were accompanied by their respective proxies, comprising of job coaches and parents. We actively encouraged participants to seek clarification if any question was unclear or if they needed additional information. This open communication ensured that participants felt comfortable and empowered to express their thoughts. In cases where participants had difficulty understanding the questions, we recognised the importance of inclusivity by inviting proxies, such as family members or caregivers, to participate in the interview session. By engaging proxies in a respectful and collaborative manner, we aimed to enhance the depth and accuracy of our research findings while ensuring that participants with varying communication abilities could express themselves through a trusted representative. The sessions were conducted in both English and Bahasa Malaysia by the first author, who is bilingual, with assistance from the second author. The first author was a medical doctor with clinical experience in managing individuals with Down syndrome and was trained in qualitative research methodology, while the second author was a public health physician and a social medicine expert. He has expertise in both quantitative and qualitative research. Each session lasted between 30 to 120 minutes. Interviews were conducted from June 2021 to April 2022.
Data analysis
Data analysis followed the iterative six-step reflexive thematic analysis (RTA) by Braun and Clarke (2006). The first step is data familiarisation, where interview recordings were reviewed, transcribed verbatim, translated (if necessary), and re-read. For interviews conducted in Bahasa Malaysia, translations into English were made. The two main authors undertook the transcription and translation process independently to minimise data loss (Edwardraj et al. 2010). Final transcripts were stripped of personal identifiers before being returned to the participants for review. All participants had no further amendments to the transcripts, and the returned transcripts were uploaded to Atlas Ti software. Initial views and observations of the interviews were recorded in the software. Next, data items were coded independently by the two main authors, according to both the semantic and latent coding process. The entire coding process were inductive in nature, whereby no prior codebook or coding frame were established (Braun & Clarke 2021). Coding decisions were also recorded in Atlas Ti. After the initial coding of the entire dataset was done, codes were sorted into initial groups according to their respective themes or subthemes based on their unifying concepts. Subsequently, the themes and subthemes were reviewed, reconstructed, merged, or split into a more coherent group. At this stage, a thematic map was generated and refined. A detailed analysis and explanation of each theme and subtheme were presented, as well as their relationship with each other.
The current analysis adopts the Social Model of Disability over the Medical Model. This choice reflects our focus on understanding disability as a result of societal barriers and attitudes rather than solely as a medical condition. The analysis highlights how employment contributes to personal growth, independence, and improved self-image for individuals with Down syndrome and provides incentives for employers, such as financial benefits, enhanced corporate image, and access to a reliable workforce. Furthermore, the current study emphasises the role of employment in fostering social acceptance, increasing awareness, and instilling empathy within the community, aligning with the principles of inclusivity and empowerment advocated by the Social Model of Disability. As a reflection, for example, we have a medical background; before researching the Social Model of Disability, the researchers admit to viewing Down syndrome primarily as a medical condition. However, by interviewing parents of Down syndrome and cases of Down syndrome, we revealed the daily societal hurdles their families confront. It shifted our focus from an individual’s limitations to the lack of accessible spaces, outdated attitudes, and inadequate support systems that truly create the experience of disability. This has sparked our commitment to advocate for systemic change beyond just awareness campaigns. Finally, a report was produced with examples from the dataset, as presented in the Results and Discussion. All researchers were entirely engaged in the analysis, and the findings were rigorously discussed.
Trustworthiness
We followed the 15-point criteria for good practice in RTA (Braun et al. 2016) to ensure the quality of our study. In addition, other qualitative validation techniques were implemented, including data source triangulation, member check, and a thick description of the overall research process. Furthermore, we engaged in a researcher’s triangulation, where coding was done independently by the two main researchers, and both engaged in discussions to reflect on their perspectives on the data analysis. This practice allowed us to think deeply about the data (D’Souza et al., 2020). Researchers recorded the impact of their assumptions, pre-conceptions, and values on research decisions and analysis by documenting their reflexive accounts.
Findings
As mentioned above, our analysis of employment opportunities and benefits for individuals with Down syndrome in Malaysia could be effectively explained and understood through the lens of the Social Model of Disability (SMD) theory. The Social Model of Disability is a theoretical framework that shifts the focus from the individual’s impairments to the barriers and societal structures that create disability.
From the analysis, three major themes were constructed: (1) ‘I can learn to help myself’: personal growth, (2) ‘Is there something for us?’: employers’ incentive, and (3) ‘Accepting differences and instilling empathy’: Social acceptance. The themes and sub-themes constructed represent participants’ views on employment benefits for individuals with Down syndrome. The thematic concept generated is outlined in Table 2. The sample quotes were taken from the participants, and they were identified by their respective groups and an identifier to ensure anonymity.
Table 2
Generated themes and sub-themes.
| THEMES | SUB-THEMES | |
|---|---|---|
| 1. | Personal growth | 1. Improving soft skills 2. Building positive self-image 3. Striving for independence 4. Monetary benefit |
| 2. | Employer’s incentives | 1. Financial incentives 2. Enhanced corporate image 3. PDS as a reliable workforce |
| 3. | Social acceptance | 1. Improve awareness 2. Increased understanding |
“I can learn to help myself”: Personal growth and independence
In the context of the Social Model of Disability emphasises that disability is not solely a result of impairments but is also caused by social, attitudinal, and environmental barriers. The findings reflect how employment opportunities contribute to personal growth, improved self-image, and striving for independence among individuals with Down syndrome. This aligns with the Social Model’s focus on empowering individuals with disabilities to lead independent lives by addressing societal barriers such as limited access to employment and negative stereotypes.
From the analytic point of view, personal growth was one of the overarching aspects of employment benefits reported across all participant groups. This theme discussed how employment would contribute to the personal well-being of individuals with Down syndrome. Under this theme, four subthemes were constructed.
Subtheme 1.1 Improving soft skills
Employment was perceived to allow individuals with Down syndrome to interact with others in the workplace. They also met new people and forged new relationships, which widened their social network and improved their interpersonal skills.
Plus, this is good for himself, as he is working and seeing a lot of people, perhaps he can develop his communication and other skills. (Family member, 05)
Employment was also perceived to be therapeutic for them as it helped to manage their behaviour and emotion through the established routine and the nature of the work.
Sometimes, there’s a cash machine. Like, pushing the buttons, sometimes, that can be a therapy for them. Like, pushing the buttons, they can control themselves. (Physical therapist, 30)
It was thought to help them cope and develop emotional maturity, as they could learn skills to handle themselves better. Employers and job coaches alike have observed their growth through employment.
[…] emotionally, when they go [to work], they are better, much better. They’ll be better. Able to cope easily. So, barriers are not permanent barriers. The barriers can be reduced by certain, what do you call that, inclusion? Yeah, inclusion. (Job coach, 11)
Additionally, PDS could also gain new experience and skills during their employment. This and their improved communication and social skills would aid in their transition towards independence.
From their perspective, of course, they will gain new experiences, and they can try new things […]. Try to blend in the new environment. (Community, 21)
I can learn some more to help myself. (Individual, 39)
Subtheme 1.2 Building positive self-image
Employment was also perceived to improve their sense of self-image. The supportive work environment was viewed to improve their confidence, as they were given the responsibility of handling their tasks.
Yeah, if they’re given proper training and all that, if they are given confidence that they are capable in doing it, what they can do, you see. (Family member, 08)
Employers had also reported that they were also able to gain leadership roles at their workplace. Hence, this would create a sense of belonging within their peers, while also potentially improving their social skills.
So, he [individual with Down syndrome] was appointed as the leader of the whole pack. And he’s very proud that he’s the leader. Yeah, he’s very proud, and the rest of the kids surprisingly actually respect him as their leader. (Employer, 15)
Ultimately, improved confidence and a sense of cooperation between them would improve their work proficiency and productivity as they become more comfortable with their work.
So, they feel good, you know. So, it’s like they feel very proud and, ‘I know how to do this already. I know how to do that already.’ (Employer, 15)
Subtheme 1.3 Striving for independence
Their transition towards independence was perceived to be aided by their employment. As discussed earlier, individuals with Down syndrome were able to lead an independent life through the skills gained during employment. Moreover, they were also viewed as striving to become self-sustaining and contribute to the community.
These children may take in what they know; ‘In future, I have to do this, and I have to do that, I have to take care of myself, and serve people’ and all that. (Family member, 08)
The benefits are that they are able to make a living, they’re able to be self-sustaining. And also, the fact that they can contribute back to the community. I don’t think there was a choice. The PWD [people with disabilities] community would not want to ask for donations all the time. (Policy maker, 06)
Employment would also assure family members that they could make ends meet, providing relief, especially for their parents.
For now, in my mind, we, the parents, are not going to live long, right. […] She needs to take care of herself, her spending. That’s all. (Family member, 13)
Subtheme 1.4 Monetary benefit
Employment provides significant monetary benefits to individuals with Down syndrome, contributing to their enhanced independence and overall well-being. Earning a salary supports their financial stability and plays a crucial role in improving their quality of life.
Of course, they got a chance to earn for themselves. Sustainable indeed, living. […] improve their livelihood. (Job coach, 11)
If I get job, I can get a lot of money (Individual, F, ND)
The participants also stressed the various financial aid schemes that were in place. Consequently, this additional income would encourage people with disabilities to work and attract employers to employ them.
It’s like this, the employer pays their salary, for example, RM200. And then they can… or the job coach can bring them to Welfare Department to register… to receive the allowance for working PWDs. (Rehabilitation centre supervisor, 16)
Additionally, having a source of income would relieve the financial burden on their family, as they were able to also contribute financially.
I think they would be able to help their family. For example, especially financially. (Community, 21)
Like the others, Down syndrome individuals also have goals and dreams. Through their earnings, they were perceived to be able to fulfil their aspiration of leading life like others.
Yeah, they can get married. They can have a life partner. And because they’re able to work, they’re able to earn for themselves. With the earning – of course, not having children, they can pay for their rent. Pay when they want to go out, you know. Would they be able to pay for themselves? Go for movies. Yeah, and some of my Down syndrome trainees, one lady, she’s 33 years old this year. That day, after lunch, we had a chat. So, I ask her, ‘What’s your goal in life?’ She told me she wanted to buy a car. ‘What kind of car do you want to buy?’ ‘I want to buy “Vellfire”.’ So, they also have dreams and goals in life. (Job coach, 11)
“Is there something for us?”: Employer’s incentives
The analysis highlights the benefits and incentives for employers to hire individuals with Down syndrome, such as financial incentives, enhanced corporate image, and a reliable workforce. The Social Model emphasises the importance of inclusive practices within organisations and how accommodating diverse abilities can benefit employers by tapping into a pool of capable workers. It also stresses the role of public perception and corporate social responsibility in promoting inclusion and diversity. We found that participants emphasised the profits of employing individuals with Down syndrome for the organisations. Under this theme, three subthemes were generated.
Subtheme 2.1 Financial incentives
Cited across the groups, one of the major benefits of hiring individuals with Down syndrome was the financial incentives. This includes tax exemptions, financial aid, and grants from the government.
And for these employees, companies can apply for tax exemption. Not many people know that, but you can apply for tax exemption. So, basically, you’re making money hiring PWDs. (Policy maker, 06)
This would further boost their finance and corporate image, and employers were perceived to be more encouraged to hire and retain them. Therefore, the incentives would also drive employment for individuals with Down syndrome.
There must be something for them also. Say if I take in someone with special needs, do I get tax exemption? […] Must be some perks to make an employer want to employ someone with special needs. Otherwise, why should I bother? (Employer, 07)
Subtheme 2.2 Enhanced corporate image
As mentioned, employing people with Down syndrome was perceived to enhance the company’s corporate image. This was apparent from the good public impression towards them, as they would be seen as an organisation that is diverse and concerned about employment equality.
The benefits for the employers. For me, the employers who employ people with Down syndrome would reflect that the company as being concerned [on their well-being]. And it would reflect that the company as being ‘observant’ with the current [social] situation, where not many people are exposed to [PDS] in the workforce. (Community, 29)
As a result, an enhanced corporate image would benefit the employer financially and attract more business opportunities. This is seen to be related to the previous subtheme on fiscal incentives.
I don’t see it as a bad thing for employers specifically. If anything, you’ll get more customers and more clients because you’re tapping into the PWD community. (Policy maker, 06)
Subtheme 2.3 PDS as reliable workforce
The issue of workforce drought was a recurring concern for the employers. Therefore, employing individuals with Down syndrome was perceived to address these shortages. Employees with Down syndrome were perceived as able to work with others, thus providing the labour market with a large pool of capable workforce.
Well, the benefit of hiring them is that I get an employee. I think they are a good workforce. So, they can address the workforce shortage, you know, stuffs like that. They can work, which is already great if you are looking for an employee. (Employer, 03)
Moreover, they were also perceived to be a superior workforce compared to their peers without disabilities. They were reported to be more focused and were able to achieve better performance after receiving proper training. Therefore, this amplified the argument that they would need proper training to unlock their true potential.
From my opinion, they can be a workforce for our economy. Because sometimes, their work is more efficient for a certain non-disabled person. They would be the ones that would give their utmost focus. (Family member, 05)
If I get the job, I want to sweep the floor, and it is easy to do. (Individual, F, 20)
I saw a KFC, they hire mute individual. I can do the packaging cutleries. That’s what I saw. (Individual, F)
Additionally, PDS are often viewed as highly loyal employees, which can lead to lower turnover rates and better retention in organisations. They seek employment in environments where teamwork is valued, fostering a sense of collaboration and community.
From my knowledge, people with Down syndrome, I think, [they] are very loyal, and they’re hardworking. I think that’s [something] positive. I think [they] will show loyalty to the company. (Community, 27)
I want friends and want work with my friends. It is fun. (Individual, F, 20)
“Accepting differences and instilling empathy”: Social acceptance
The findings show how employment opportunities can contribute to improved social acceptance and understanding of individuals with Down syndrome within the community. This resonates with the Social Model’s emphasis on changing societal attitudes and promoting inclusivity to create a more accepting and accessible environment for people with disabilities. Employment provides economic benefits and fosters greater awareness, empathy, and integration within society. For example, participants also viewed that work participation for individuals with Down syndrome would contribute to improved acceptance within the community. They viewed employment as an opportunity for the community to understand and become more accepting of individuals with Down syndrome. Under this theme, two subthemes were constructed.
Subtheme 3.1 Improve awareness
Improving awareness towards PDS had been cited across all groups. Employment was perceived as a tool for advocacy to increase their visibility, as society would be more aware of their capabilities and potential in the workforce.
[…] I felt that if they make that step to employ these special needs, they are also advocating for them. Advocating for the special needs. Yeah, because people won’t know if they don’t see them out there. (Job coach, 11)
Furthermore, this would also improve awareness among family members and individuals with Down syndrome. Those who were employed would be able to become a role models for others to integrate into the workforce. Ultimately, this would assure others of their ability to work and become independent.
And then for the community, perhaps if they have a child with Down syndrome themselves, they would allow their child to go about their days like any other person. Perhaps this will open their eyes to allow their children to work. To improve their skills. So, I think the benefit is that they can become a role model. (Family member, 05)
Subsequently, increased visibility and awareness towards individuals with Down syndrome would also enhance employers’ confidence in hiring them. Other organisations were perceived to be more ready to employ them when they could work.
And then they [employers] can be a good example to other companies as well. (Community, 35)
Subtheme 3.2 Increased understanding
Similarly, employing individuals with Down syndrome would enhance understanding towards them. At the workplace, employers and co-workers would learn to interact with them. This would increase their knowledge and awareness regarding Down syndrome and improve their understanding of them.
[Employers] also can learn how to handle them. All this time, we always have ‘regular’, ‘healthy’ workers. So, this time we got Down Syndrome employee. How do they handle [them]? How do they divide the tasks? So, that is a new experience for [employers] to learn. (Community, 21)
Moreover, with improved understanding, employers could properly accommodate them and effectively implement strategies such as segmentation of tasks to delegate work to employees with Down syndrome. This would benefit the employers by increasing productivity and profits from having a skilled worker.
I think that is important so that they can do their job well, and we can guide them effectively. For example, don’t give them too much job that they might lose focus and can’t do well. Instead, I would give them one task at a time and then proceed to other tasks after that. So, to me, this kind of understanding is not special treatment. It’s just how I try to understand and cater to their needs because each person would have different needs. So, that’s how I see it. (Employer, 03)
Improved understanding would also dispel any misperception towards them. This would not only be limited to understanding the disability per se, but also on how to interact with and integrate them into society.
[Society] will gain more understanding into what it is like. And I think understanding is very important. It will pave a way for many other things to fall into place because once you don’t understand something […] there’s a lot of fear, fear can lead to anger, and anger leads to hatred. (Employer, 07).
Overall, the Social Model of Disability theory and Social Ecological Framework provide a comprehensive framework for understanding the multifaceted benefits of employment for individuals with Down syndrome. It highlights the interconnectedness of personal empowerment, organisational practices, and societal attitudes in shaping inclusive employment opportunities and promoting full participation and acceptance of individuals with disabilities in Malaysia.
Discussion
This study is the first to explore employment advantages for individuals with Down syndrome in Malaysia. The findings suggest that participating in work can positively impact their employment opportunities, overall well-being, and social acceptance. The factors are also interrelated and housed within the larger social environment, which could be explained by the Social Model of Disability theory (Mauksch & Dey 2023) and Social Ecological Framework (Burge et al. 2007). Therefore, recognising these relationships is critical in implementing strategies to facilitate and advocate for their employment, and the SEM provides a framework of leverage points for these action plans.
Personal growth
The inclusion of PDS in the workforce is beneficial not only to people but also to organisations. Employers increasingly appreciate the unique contributions that disabled individuals, including those with Down syndrome, bring to the workplace. Employers acknowledge the diverse skills that contribute a thriving and inclusive work environment by emphasising PDS’s working abilities and strengths. Intercultural interactions between people with and without disabilities can help modulate implicit and emotional attitudes towards disability, promoting a more inclusive work environment (Peate 2023). Organisations are important in providing specific resources to help individuals with Down syndrome and their families be ready for significant job opportunities. These resources aim to empower and prepare both of them, creating a work environment that values diversity and recognises the potential of every team member.
Our analysis revealed that improving soft skills enhances employment opportunities for individuals with intellectual disabilities, such as Down syndrome. These skills, including teamwork, following instructions, and taking initiative, are often prioritised over hard skills like reading and math (National Down Syndrome Society 2024; Young & Rooney 2023). Personal attributes such as flexibility, punctuality, and good hygiene are crucial in employment, along with social communication skills for effective interaction and maintaining professional relationships (Iqbal et al. 2022). Despite their abilities and eagerness to work, many individuals with Down syndrome often experience underemployment because of challenges in education and training (Kumin & Schoenbrodt 2016; Wilson et al. 2018). In Malaysia, there are few companies that provide opportunities for people with disabilities (Specialjobs.com.my 2024). However, resources are available to support their career development, including employment planning workbooks and job preparation tools (Baratta 2022; Canadian Down Syndrome Society 2024). Building a positive self-image in PDS is the key finding in our analysis. Strategies include understanding and accepting their condition, focusing on abilities, and encouraging social interactions and friendships for self-esteem and happiness (Saha et al. 2014; Skotko et al. 2011). Supportive workplace cultures, such as effective diversity, equity, and inclusion (DEI) policies and co-worker support, can help mitigate the negative impact of disability on perceptions of engagement (Beaton & Léger 2012). Self-care and life skills development, supported by techniques like task analysis and occupational therapy, foster their independence and confidence (Baumeister et al. 2003; Abaoğlu et al. 2017). Hiring individuals with Down syndrome benefits companies economically through increased profitability, competitive advantage, and inclusive culture (Fisher & Connelly 2020; Katuruni et al. 2022). It also enhances the employees’ quality of life, income, self-confidence, and social network (Grosse 2010; Lindsay et al. 2018; VanZant & Vellody 2023). Overall, these efforts contribute significantly to the societal integration and personal growth of PDS.
Employer’s incentive
Our analysis found that the incentives for employers to hire PDS extend beyond simply fulfilling corporate social responsibility. These incentives include tangible financial benefits, improved public perception, and the acquisition of a dedicated and reliable workforce, all of which contribute to a business’s overall success and sustainability. Financial incentives such as tax credits, subsidies, or grants help offset training and accommodation costs (Zain & Malek 2022). Employees with disabilities often exhibit lower turnover rates, enhancing workforce stability and reducing recurrent hiring and training expenses (Wu et al. 2023). Such inclusive hiring practices improve a company’s image by demonstrating commitment to diversity, a value increasingly important to consumers and stakeholders (Chajduga & Ingaldi 2021; Dauth et al. 2023). This leads to enhanced customer loyalty and brand strength, positively impacting profitability and competitive advantage. Furthermore, PDS add unique perspectives and skills to the workforce, contributing to a dynamic and inclusive work environment. Studies indicate that these employees show high dedication, lower absenteeism, and strong loyalty, benefiting day-to-day business operations and fostering a vibrant corporate culture (Carreño-León et al. 2022; Emaliana et al. 2022). Therefore, employing PWD including PDS is a socially responsible choice and a strategic business decision that promotes sustainability and success.
Social acceptance
The study found that employment is a tool for increasing visibility and awareness of the capabilities and potential of PDS in the workforce. The journey to greater social acceptance of PDS hinges on improved public awareness and greater understanding. Educational efforts and inclusive activities can guide society toward a more welcoming and embracing environment where people with Down syndrome are acknowledged and fully incorporated as important contributors to the community (Schwab et al. 2016). Increased public awareness is fundamental for the social acceptance of PDS (Hodapp & Fidler 2021). Awareness campaigns and educational programmes play a vital role in dispelling myths and misconceptions about Down syndrome. As awareness increases, it fosters a more inclusive society where PDS are acknowledged and appreciated for their distinct contributions (Magnuson et al. 2007). Alongside awareness, there is a need for deeper understanding and empathy toward individuals with Down syndrome. Educational programmes in schools and communities that include interactions with PDS have been shown to foster greater understanding and empathy (Carbone et al. 2023). Such programmes educate and allow meaningful interactions, breaking down barriers and stereotypes. This better understanding is the key to a more welcoming and inclusive society, where we celebrate differences instead of seeing them as negative.
Conclusion
This study acknowledges a significant gap in the literature by investigating employment benefits and opportunities for PWD including PDS. The analysis reveals that employing individuals with Down syndrome offers multifaceted benefits, encompassing improved personal growth, financial incentives for employers, and enhanced social acceptance. Key advantages include the development of soft skills, building a positive self-image, and fostering independence for individuals with Down syndrome. Employers benefit from financial incentives, an enhanced corporate image, and a reliable workforce. Moreover, employment is critical for raising awareness and understanding of Down syndrome promoting inclusivity and empathy in society. This holistic approach empowers individuals with Down syndrome and enriches their communities and workplaces.
Limitations and Recommendations
One limitation of this research is that individuals with restricted access to technology were not included in the virtual interview session. However, in the context of the current pandemic, we believe that protecting the safety of both participants and researchers is crucial. Furthermore, the employers and co-workers recruited for this study have extensive experience working with individuals with Down syndrome. Therefore, the perspectives of employers without experience hiring them are unknown.
Based on our findings, we recommend better tax incentives and financial aid to employers to support work inclusion for individuals with Down syndrome. Affirmative action policies aimed at mandating quotas for the community within the private sector would also be beneficial to increase awareness and improve hiring attitudes among employers. We would also like to recommend strategies to increase the visibility of employees with Down syndrome and promote their ability to work to entice public support and attract more employment opportunities. This can be achieved by using mass and social media to advertise organisations that have successfully integrated employees with Down syndrome into their business. Stress the importance of promoting awareness and disability literacy among the general community and employers to ensure they understand the disability-specific needs of individuals with Down syndrome, particularly in the workplace. Moreover, implement support and in-job training programs as suggested by the Capability Approach (Bonvin & Laruffa 2023) and Human Capital Theory (Maalaoui et al. 2023) to enhance their skills and communication. Individuals with Down syndrome who aspire to become self-employed may also benefit from skills programs.
More research should be done to explore the breadth of available employment policies to discern their impact and effectiveness on employment for individuals with Down syndrome, especially within the Malaysian context. Future research looking into the relationship between autonomy and decision-making for individuals with Down syndrome would also provide insight into possible interventional strategies. Apart from that, research should also explore their ability to venture into online businesses and services as an alternative to being employed.
Implications
The employment rate is one of the yardsticks that reflects the government’s capabilities in providing opportunities and closing the employment gap between people with disabilities and those without disabilities. Therefore, this study has several policy implications, especially concerning the context of Malaysia.
From a policy perspective, Malaysian lawmakers should consider amending the PWD Act 2008 to include remedial provisions to firmly enshrine the protection of equality towards individuals with disabilities in general. In any legislation protecting civil rights, there is a need to adopt anti-discrimination measures to express the implementation and enforcement of the rights. One of the important measures is the existence of remedial provisions to address any breach. The provision may address the need for individuals with disabilities to launch any complaints against authorities should any breach of their rights occur, and punitive actions should be imposed against the persecutor.
We also pointed out the benefits of developing skills for individuals with Down syndrome. Therefore, the relevant bodies should revisit the delivery of current policies to ensure that training and skill programs are provided to individuals with Down syndrome as early as possible. This can include providing vocational training and supervised in-job placement in the national curriculum for special education. Apart from that, as discussed earlier, fiscal support to employers who employ individuals with disabilities can also be considered. This can include better tax incentives and support payments for employees with disabilities. We believe that this research finding could help establish new policies and legislation that aid in abolishing any discrimination and barriers to employment in Malaysia.
Data Accessibility Statement
The datasets used and or analysed during the current study are available from the corresponding author upon reasonable request.
Ethics and Consent
Verbal informed consent was obtained before the interview, and all participants consented to anonymously publishing their data in academic journals.
Acknowledgements
The researchers would like to extend their heartfelt gratitude to all the individuals who participated in this study. We greatly appreciate the Ethics Committee of our Faculty for their authorization of this investigation. We are also indebted to the Ministry of Higher Education Malaysia for their financial contribution, as well as Universiti Malaysia Sarawak for the crucial support they provided for this research.
Funding Information
The Ministry of Higher Education, Malaysia, funded this research (Ref. no.: FRGS/1/2020/SS0/UNIMAS/01/2).
Competing Interests
The authors have no competing interests to declare.
Author Contributions
ASA, MMR, and SEWP participated in the concept and design of the study. ASA and MMR have full access to all of the study data and are responsible for data integrity acquisition, data analysis accuracy, data interpretation, and manuscript drafting. RSS, RS, YYC, and CHT validated critical data revision of the manuscript for important intellectual content. The authors read and approved the final manuscript.