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We must be willing to get rid of the life we planned, so as to have the life that is waiting for us.

We must be willing to get rid of the life we planned, so as to have the life that is waiting for us. Joseph Campbell. TRANSITION INTO ADULTHOOD FOR STUDENTS WITH TBI. Bonnie Todis, Ph.D. Center on Brain Injury Research & Training. Our Questions:.

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We must be willing to get rid of the life we planned, so as to have the life that is waiting for us.

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  1. We must be willing to get rid of the life we planned, so as to have the life that is waiting for us. Joseph Campbell

  2. TRANSITION INTO ADULTHOOD FOR STUDENTS WITH TBI Bonnie Todis, Ph.D. Center on Brain Injury Research & Training

  3. Our Questions: • What are the transition experiences of students with TBI? • What are their transition outcomes? • What factors are associated with positive outcomes? • What factors are associated with negative outcomes? • What is transition like for students and families?

  4. Transition Services IDEA • Mandated, but not fully funded • Students with TBI are under-identified for special ed and transition services • Transition services are highly variable • district to district • disability to disability • severity of disability

  5. POST-SECONDARY OUTCOMESPROJECT(PSO)

  6. Project PSO • 8-year study of transition outcomes • Funded by OSEP and NIDRR • 90 students in Oregon and Washington • Recruited at exit from high school • Rolling recruitment over 2-3 years • School districts • VR

  7. PSO Participants • 77% had severe injuries • 2/3 were identified for special education • Half were injured while in high school • Mean time since injury 7.7 yrs (range: 0-19) • 2/3 male

  8. Project PSO Purpose: • Systematic tracking of quantitative data on transition outcomes Methodology: • In-person/phone interviews with young adult, parent • 6-12-month intervals

  9. PSO Survey Domains • Education and training • Education accommodations • Satisfaction ratings • Employment history & plans • Type of work, pay, hours • Employment supports & accommodations • Living/rent arrangements • Sources of community support • Satisfaction ratings • Community integration & activities • Social relationships • Health issues • Life satisfaction

  10. RESULTS

  11. Life Transition Planning At initial interview

  12. Written Transition Plan At initial interview Bonnie Todis, Ph.D. Center on Brain Injury Research and Training

  13. Person Who Helped Plan Transition At initial interview

  14. TRANSITION OUTCOMES

  15. Employment Outcomes Ages 19-25

  16. Post-Secondary Employment Outcomes 19-25

  17. Closer Look:Employment at Age 25 • 60% employed • 74% of males, • 35% of females • Hours per week • Mean 21-30 • No one worked more than 30 hrs per week

  18. Employment Outcomes by Gender

  19. Employment at Age 25 • Wages • Mean $8.22 per hour • No difference between males and females • Type of Job • 81.3% in menial, unskilled, or semi-skilled categories • The rest in skilled (11.3%) clerical/sales (5%) or technicians (2.5%) • None in the top 3 categories

  20. Comparison with Typical Peers • Bureau of Labor Statistics of the U.S. Department of Labor, January 19, 2007

  21. Factors Predicting Employment • Hierarchical Linear Modeling Results • Family SES: Those with higher SES were less likely to be employed at the beginning of the study, more likely to be employed over time • For every unit change in SES there was a 3.3% increase in the odds of employment and a .7% increase in the rate of change in employment over time.

  22. Factors That Impact Employment Work Category by Sex and Age at Injury Over Time Job Category by Sex and Age at Injury Clerical, sales Later age) Skilled manual labor Earlier age Avg age Females Later age Semi-skilled Earlier age Avg age Males Unskilled work Menial service Bonnie Todis, Ph.D. Center on Brain Injury Research and Training

  23. Factors That Impact Employment Wages Over Time by Age at Injury and Severity Later injury Severe Mild/Moderate Early injury Later injury Bonnie Todis, Ph.D. Center on Brain Injury Research and Training Early injury

  24. Factors That Impact Employment Hours Worked per Week Severity: M/M work > # Hrs. Gender: Males> #hrs. For both genders: Earlier age at injury = work fewer hours/week 21 – 30hr later Bonnie Todis, Ph.D. Center on Brain Injury Research and Training later Hours Per Week 16-20hr Injured earlier Injured earlier Males Males Females 11-15hr Females Mild/Mod Severe Severity

  25. Factors That Impact Employment Job Happiness by Severity and Age at Injury Very Happy Early age Severe Avgage Later age Happy Early age Mild/ Moderate Avgage Later age Unhappy

  26. POST SECONDARY EDUCATION

  27. Post-SecondaryEducation OutcomesAges 19-25 n (%)

  28. Post-Secondary Education Outcomes Ages 19-25

  29. Comparison with Peers • Non disabled young adults 18-25 46% enrollment (Pew 2007) 54% female (200?) • NLTS2 45% reported continuing to postsecondary ed within 4 years of leaving high school. • 32% community colleges • 23% vocational/tech • 14% 4-year

  30. Factors That Affect Enrollment • Higher family SES, shorter time to enrollment • Females more likely to enroll • Those injured later were more likely to enroll. For every year increase in age at injury there was a 12.3% increase in likelihood of enrollment.

  31. Independent Living Outcomes Ages 19-25 Bonnie Todis, Ph.D. Center on Brain Injury Research and Training n (%)

  32. Post-SecondaryIndependent Living OutcomesAges 19-25

  33. Comparison with Peers • Non-disabled peers 18-25 40% live with parents (Pew) • NLTS2 ages 17-21 25% have lived independently at some time since high school (65% of these lived in a college dorm or military housing).

  34. Factors That Affect Ind. Living • Age at injury: Those injured earlier take longer to achieve independent living status. • For each year older at injury, there is a 12.7% increase in odds of achieving independent living.

  35. Qualitative Component

  36. Qualitative Component Purpose: • Access perspectives of youth with TBI and their parents on the transition experience • Identify specific factors that promote positive outcomes • Investigate the details of transition services

  37. Qualitative Methodology Methodology: • Unstructured recursive interviews • Participant observations with young adult • Interviews with knowledgeable others 1-to-6-month intervals

  38. Selection of Respondents • Selective sampling for factors of interest • Resilience factors • Family support • Access to/use of agency supports • Community/social support • Range of high school experiences, severity, age at injury, disabilities, SES, urban/rural

  39. Qualitative Findings

  40. Thematic Categories • High School Experiences • Employment • Post-Secondary Education • Community Integration

  41. High School Experiences

  42. Themes: High School Services • Students not identified for special education: • Tested at or above grade level (didn’t qualify) • Injured junior or senior year, “helped” to graduate on time

  43. Helped to Graduate: Academic “My mom worked at the school and all the teachers loved me, so I didn’t have to do anything, they just passed me. All I had to do was come to class. They knew what had happened to me and they felt sorry for me. They thought I was a great kid. Did they do me a favor? Yes and no. I don’t think it was that great for going to [college], but yes, because I don’t think I would’ve graduated.” ~Kristi

  44. Themes: Not identified for SpEd • No transition services • No IEP • Graduated • No access to disability services post-graduation • Usually tried to follow pre-injury plan

  45. High School Services • Students identified for special education: • Not identified TBI • Two-track system • Rarely received good transition services

  46. Not identified TBI All of the transition services I got were through the school for the deaf, because I had a hearing impairment before the TBI. So one summer I went to camp there, and I got some cooking lessons. That was it. ~Tanya

  47. Themes: Two-track System College Prep • Focus on graduation requirements • Learning problems not like those of LD • Often need social and life skills training • Minimal transition services

  48. Identification Issues Because he presents well and isn’t a behavior problem, everybody thought I was nuts when I asked for so much support. But then at the very end of the year, a teacher called me, furious because Mike “belonged in a special class.” Every year I would tell staff this. They’d say, “Ok, ok.” and then mid-year, “Your kid’s got problems!” Then they would spend the last half of the year trying to get something in place, when he’s already missed the first half. ~Mike’s mom

  49. Identified for SpEd: Academic He has these gaps. He can do math that he learned before the TBI, but I’m not sure he’s really learned anything since the injury, because his teachers don’t know how to deal with his learning problems. ~Jed’s mother

  50. Identified for SpEd: Academic “I graduated with a B average. I can’t really read or write, though.” ~Jed

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