Transition into Adulthood and Community

1. Transition into Adulthood and Community Bonnie Todis, Ph.D. Teaching Research Institute - Eugene

2. Adult Transition Goals Road through Adulthood Sustains TBI Employment Independence Relationships Quality of Life • Return to • previous or • optimal or • acceptable lifestyle

3. Youth Transition Goals Childhood Sustains TBI • School • Activities • Relationships • Quality of Life Return to previous or optimal childhood TRANSITION to Adulthood Adult Identity Employment Independence Relationships Quality of Life

4. Transition outcomes for students with TBI • Post-secondary Outcomes Study • National Transition Longitudinal Study

5. Transition Services IDEA A coordinated set of activities for a child with a disability: • Within a results-oriented process • Focused on improving academic and functional achievement • To facilitate movement from school to post school activities

6. Transition Services IDEA Post school activities include: • Postsecondary education • Vocational education • Integrated employment • Including supported employment • Continuing and adult education • Adult services • Independent living or community participation

7. Transition Services IDEA Based on the individual child’s needs strengths preferences interests

8. Transition Services IDEA Includes • Instruction • Related services • Community experiences • Development of employment and other adult living objectives • When appropriate • Acquisition of living skills • Functional vocational evaluation

9. Transition Services IDEA • Begin no later than age 16 • Students on IEPs are eligible to receive special education services through age 21 • Once a student graduates with a regular diploma, he is no longer eligible for transition services

10. Transition Services IDEA Mandated, but not funded Students with TBI are under-identified for special ed and transition services Focus is often on graduation Transition services are highly variable from district to district, disability to disability, severity of disability

11. Transition Services IDEA Examples of transition services • Academic track • Write a resume • Take an aptitude test • College visitation and meeting with disability services coordinator

12. Transition Services IDEA • Life Skills Track • In-school work experience • 3 to 4 years of • supported employment, • independent living skills, • bus training, • self-advocacy, • social skills, • money management, • experience in independent living

13. PSOTransition Experiences

14. Post-Secondary Outcomes 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 • Interviews with Parent and Youth every 6 months

15. PSO Participants • 77% had severe injuries • only 2/3 were on IEPs • Half were injured while in high school • 2/3 male

16. PSO Measures • Interview Domains • Employment • Post-secondary training • Living situation • Cognitive/emotional functioning • Social relationships • Services, supports • Life satisfaction

17. Life Transition Planning At initial interview

18. Written Transition Plan At initial interview

19. Person Who Helped Plan Transition At initial interview

20. National Transition Longitudinal Study (NTLS) • 10-year study of transition outcomes • Funded by OSEP • 11,000 students • 12 disability categories • NTLS1 did not include students with TBI • NTLS2 included youth who were 13-19 in 2000 • Data collected in 2003 on 28% out of school

21. NTLS: Employment %

22. NTLS: Post-secondary Education %

23. NTLS: Living with Parents %

24. Summary of Findings • Students with disabilities are working and going to school at lower rates than peers in general population • Higher rate than adults with TBI • Students with TBI do average or better than average compared with other students with disabilities on employment and post-secondary training

25. Summary of Findings • What parents say about what their students with TBI need after leaving high school

26. NTLS: Needs Life Skills %

27. NTLS: Needs vocational services %

28. NTLS: Needs additional services %

29. Summary of Post-Secondary Needs • When the structure and services of school are no longer available, young adults with TBI are not as well-served by the social service systems as young adults with other types of disabilities.

30. Other PSO Findings • Receipt of special education services had no impact on transition outcomes • Those who received rehabilitation services were more likely to live at home • Severity of injury was not a factor

31. Other PSO Findings • Those with higher ratings on emotional adjustment were more likely to live independently • Those with higher ratings on executive function were more likely to be enrolled in post-secondary training/education

32. Both NTLS2 and PSO • Females and individuals from higher SES households are more likely to be enrolled in post secondary training/education

33. Implications for Practice • Special education interventions for students with TBI should • Target emotional adjustment and executive functioning • Work with male students to address barriers to post-secondary enrollment

34. Implications for Practice Transition services should recognize the role of family support • Connect families with community based resources • Provide information on financial assistance for post-secondary training • Connect youth and family with post-secondary disability services

35. Implications for Practice • Young adults with TBI need improved post-secondary community supports • Vocational training, placement, supports • Life skills training and supports • Integrated support systems

36. Points to Consider • Transition continues well beyond high school graduation • The service system youth enter is the same one that produces 40% employment for adults with TBI

37. Points to Consider • Positive work outcomes in early adulthood maintain at least to middle age (Nybo, Sainio, & Muller, 2004) • Paid employment is associated with higher life satisfaction (Corrigan, Bogner, Mysiw, Clincot, & Fugate, 2001)

38. Family Agencies Friends Young Adult Life Path Transition engagement in work & education Adult Life High School Support Skills Training

39. Discussion Topics What can rehabilitation research contribute to special education and vice versa? • Connecting with community supports • Supporting families • Building social networks • Specific interventions

40. Discussion Topics What can we learn from research on adults with TBI re: best practices? • Employment • Independent living • Quality of life • Community services