Jan Evans

Planning Successful Transitions From School to Adult Roles for Youth With Disabilities

This article provides a conceptual model and review of the effectiveness of approaches for providing transition education and planning services for youth with disabilities. The model incorporates four approaches: skills training, prevocational/ vocational guidance, a client-centered approach, and an ecological/experiential approach. The model links these approaches to commonly used transition strategies, which reflect the personal, person-environment, and environmental levels of intervention. The model specifies the short-term goals addressed by the approaches and strategies and links these to the long-term outcome of multifaceted role engagement. Evidence for the effectiveness and utility of the identified approaches is reviewed. Recommendations are made for best practices in the delivery of transition education and planning services, for research, and for clinical practice.

The Importance of Self-Determination to Perceived Quality of Life for Youth and Young Adults With Chronic Conditions and Disabilities:

This study examined the relationship between self-determination and perceived quality of life for youth and young adults with chronic conditions and disabilities over time. A total of 34 individuals completed the Life Satisfaction Index—Adolescents and the Arc’s Self-Determination Scale at study baseline and again 1 year later. Controlling for perceived quality of life at baseline and other relevant health and demographic variables, linear regression analysis was performed to examine the longitudinal relationship between self-determination and perceived quality of life. Self-determination was significantly associated with two subdomains of quality of life over time. Those individuals with higher self-determination at baseline reported higher perceptions of satisfaction with both personal development and personal fulfillment 1 year later. Findings suggest that there may be a relationship between self-determination and specific subdomains of perceived quality of life for youth and young adults with chronic conditions and disabilities that extends over time. Studies using larger international samples followed over a longer period of time are required to substantiate these findings.

Solution-Focused Coaching in Pediatric Rehabilitation: An Integrated Model for Practice

ABSTRACT This article describes the conceptual basis and key elements of a transdisciplinary model for solution-focused coaching in pediatric rehabilitation (SFC-peds). The model exemplifies a strengths-based, relational, and goal-oriented approach to clinical practice. It provides a distinct shift from a problem-oriented, therapist-directed approach to a possibilities-oriented approach where client empowerment takes precedence. The model facilitates client change through a method of working with client strengths and resources that involves the use of strategic questions to co-construct therapy intervention. Through client–therapist collaboration, therapy goals and plans are developed that align with client hopes, priorities, and readiness for change. SFC supports client self-determination and capacity for change through customized therapy goals and plans that are meaningful for the child and family. Implications for therapists include the need for relational expertise, practical coaching skills, and expertise in facilitating change. The need for research on the effectiveness of this approach in pediatric rehabilitation is discussed.

The Effectiveness of Transition Strategies for Youth With Disabilities

This article reviews the effectiveness of the 10 main strategies used to provide transition education and planning services for youth with disabilities. The review suggests that multifaceted interventions are most effective. Integrated and comprehensive transition services should address skill instruction and self-awareness; provide customized informational, emotional, and instrumental supports to meet the needs of youth and families; provide direct opportunities and experiences for skill development; and address the welcoming nature of community activities and settings. The information can be used by rehabilitation managers and therapists in the design and delivery of transition services. Recommendations are made for future research with respect to strategies to facilitate youth transitions.

If I knew then what I know now: parents' reflections on raising a child with cerebral palsy.

ABSTRACT In this study we investigated experiences of parents of children with cerebral palsy (CP) to identify areas in which health care providers and educators could improve practice. A second objective was to create educational material for parents of young children newly diagnosed with CP. A purposive sample of nine parents, who previously participated in the Adolescent Study of Quality of Life, Mobility, and Exercise, was recruited through phone. During an interview, parents reflected on the experience of raising a child with CP from birth to young adulthood. These interviews were audiotaped, transcribed, and coded using the International Classification of Functioning, Disability and Health-informed model and analyzed to identify major themes. Parents elaborated upon what was helpful and what could be changed to improve their childrens and families’ experiences through supports, advocacy, and education at different levels. The results informed the development of tips for parents and children with CP to enhance their families’ experiences and interactions with health care providers, educators, and others.

An Evaluation of the “Youth En Route” Program

Youth En Route (YER) is a transition program for youth and young adults with multiple disabilities. It offers a multifaceted approach that includes self-discovery, skill development, and community experience. Underlying the service delivery model is a philosophy of self-determination. This program evaluation measured the self-determination skills, sense of personal control over life choices, and community participation of 34 youth prior to and one year following their involvement with YER. Youth reported statistically and clinically significant improvement from pretest to posttest with respect to both self-determination and sense of personal control. Moreover, youth reported spending significantly more time at posttest than at pretest engaged in volunteer/work activities and community leisure activities. On average, youth reported high satisfaction with YER services. Practical and research implications are discussed.

A Checklist to Determine the Methods of Intervention Used in School-Based Therapy

Research is needed with respect to the types of intervention methods therapists use when providing school-based therapy to children with special needs. This article describes the development of a checklist by which to identify the intervention methods used by occupational therapists, physical therapists, and speech-language pathologists in the school setting. The checklist was pilot tested on a group of 15 therapists working in a school-based therapy services program. Content validity of the checklist was estimated through a peer review process and by examining frequency distributions. Reliability was estimated using a test-retest approach. Five categories of methods are included in the checklist: teaching/learning techniques, cognitive strategies, handling/physical interventions, environmental/task modifications, and information sharing. Initial findings demonstrate the reliability of three of the five categories and the content validity of the checklist. Among both the occupational therapists and the speech-language pathologists, the most commonly used methods across therapy sessions were teaching/ learning techniques, followed by cognitive strategies. Among the physical therapists, teaching/learning techniques also were used most commonly across therapy sessions, followed by handling/physical interventions. Future research directions are discussed.