Vocational outcomes following assistive technology and digital workplace supports for people with disabilities: a systematic review

BACKGROUND: Employment is a key social determinant of health, yet people with disabilities face persistent barriers to labour-market participation and job retention. Assistive technology (AT) and technology-enabled supports may reduce functional limitations; however, empirical evidence linking these interventions to vocational outcomes remains heterogeneous. Objective: This study systematically reviewed quantitative evidence on the impact of assistive technology and technology-enabled supports on vocational outcomes among people with disabilities. METHODS: A systematic review was conducted following PROSPERO registration (CRD420251270554). Electronic databases (EBSCOhost, Web of Science Core Collection, Scopus, and ScienceDirect) were searched from inception to 30 November 2025. Eligible studies examined vocational outcomes including employment retention, competitive employment attainment, job quality, work functioning, workplace independence/support needs, and task performance. Due to substantial clinical and methodological heterogeneity, meta-analysis was not performed. Instead, findings were synthesised using SWiM (Synthesis Without Meta-analysis) direction-of-effect coding with risk-of-bias weighting. RESULTS: Ten studies (2013-2025) met inclusion criteria (United States n = 8; Netherlands n = 1; Israel n = 1), comprising longitudinal panels/surveys (n = 3), an administrative cohort (n = 1), randomised controlled trials (n = 2), cross-sectional studies (n = 3), and a single-case design (n = 1). Overall, direction-of-effect coding favoured assistive technology across most outcome domains. The strongest evidence was observed for employment retention, with assistive support significantly increasing the likelihood of continued employment following disability onset (β = 0.124, p < .05). Competitive employment outcomes were also significantly improved among vocational rehabilitation recipients receiving AT services (OR = 2.09, p < .001). Job quality effects were positive but varied across disability subgroups (OR ≈ 6.62-17.43). Evidence for work functioning (MD = -5.3 on WSAS, p < .0001), reduced support needs (p = .013), and improved task performance (p < .001) was consistently favourable, although based on a limited number of studies. CONCLUSION: Assistive technology and technology-enabled supports demonstrate potential to improve vocational outcomes, particularly employment retention, among people with disabilities. However, the evidence base remains limited, heterogeneous, and context-dependent. Future research should prioritise contemporary, standardised evaluations using objective employment outcomes across diverse labour-market settings.