Interviewing Time Awareness/Scheduling Job Skills Task Completion Social Interaction Safety

Adolescence and Transition Flashcards by Jen Ludwig

Who are students in Transition?

Ages 12-22 (begins middle school)
School districts responsible for students with disabilities until 22.
Focus shifts from remediation of skills to occupation-based adaptation/functional skill building for max indep.
Services designated/covered by IDEA

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Individuals with Disabilities in Education Act (IDEA)

Federal Law that explains/funds service delivery in public schools
Continues evolving as needs of students/parents/school districts change
Designates OT/COTA as “RELATED SERVICES” to support students in educational environment

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IDEA’s Law on Transition

PART A, 20 U.S.C. Section 1401, part 34 – Transition Services
• Includes provisions for movement to post-school, incl. secondary ed., voc. ed., adult ed./services, indep living, community participation
• Incl instruction, related services, community experiences, dev of employment, post adult living objectives, acquisition of daily living skills, and functional vocational ed.

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What IDEA/Transition Means

Schools must prep students w/disabilities for adult life
Incl any student with IEP: students w/physical disabilities, learning disabilities, mental retardation, and mental illness
Schools must come up with transition plan before student’s 16th bday.

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Brief History of Independent Living Movement

• 1975, Education for All Handicapped Children Act (EHA) (nothing prior to this)
• Most districts not compliant until 1980s
• 1990, becomes IDEA
• Revised many times, and continues
• Never has been fully funded!
• Indep Living mvmt started Berkeley 1970s (part of Civil Rights mvmt)
• Philosophy that every person with a disability is expert on their own needs/has right to meaningful, indep life
** Original students from 80s/90s now adults! Must have transition plan!

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People First Language

Always put the PERSON first!
• Not “disabled student,” but better “student who has disability”, but best “NAME”
• Respect indiv who happens to have disability
• Notable exceptions: Deaf, Autism, Blind

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Office of Special Education and Rehabilitative Services (OSERS)

Federal govt office to provide leadership to achieve full integration/participation in society of ppl with disabilities by ensuring equal opp, access to, excellence in educ, employment, community living.
Sets federal policy and guidance around IDEA/IEPs etc.

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What Skills OT Brings to Transition

Task analysis
Task skill leveling
Problem solving
Outside vantage
Observational skills
Point person (informational clearing house); “on student’s team” along w/parent(s)

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OT Provided in Transition

Functional life skill support
Independent living skill support (ADL)
Job skill support
Self-regulation support
Adaptations for independence

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Functional Life Skill Support

Community Mobility (ie:bus riding)
Shopping (clothing, groceries)
Family and Friends
Recreation and Leisure

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Independent Living Skill Support

Grooming/Self-Care
Cooking
House Cleaning (dust, sweep, mop, etc.)
Laundry
Safety

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Job Skill Support

Interviewing
Time Awareness/Scheduling
Job Skills
Task Completion
Social Interaction
Safety

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Self-Regulation Support

• Skills must be functional/socially appropriate
• Must be able to be done in community (as adult)
• Wide variety of interventions:
-	Breathing techniques
-	Sunglasses/ear plugs
-	Water bottles in backpack for weight
-	Socially approp fidgets (keychains)
-	Incorp workout/gym routines
-	Chewing gum/crunchy granola bars

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Adaptations for Independence

Goal of OT intervention at this stage is to assist in becoming indep as possible
ANY adaptation that achieves that end can be successful
Get creative
As OT in this setting, you will find yourself stretched to creative limits!

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Role of OTP in Transition

Support in previous areas in community
Services must be provided in “natural environment”
Bring expertise of task analysis/problem solving—can be new eyes on situation!
Must also bring respect for knowledge of job coach/parent/rec therapist/etc. - primary caregiver in natural environment (they will share with you!)

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Age Range of Adolescence

10-19 yo (10-24 for OT)

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Self-Efficacy

One’s view of his/her own physical performance. Belief that they possess abilities to participate/perform adequately.

Middle Adolescence

Most intense period of development; peers replace parents as primary influence; conformity is desirable.

“Contradictory Typical Behavior”

When behaviors, thoughts, emotions seem contradictory, particulary ages 13-15. Example: 14 yo who breaks rules and pierced nose, but holds a job after school. Becoming a vegetarian/healthy but smoking.

Identity Achievement

Exploration of possibilities and the healthy resolution of the quest. Usually final years of high school, college. Commitment to interests, values, gender`, political views, career, moral stance. Ex: earning money to pay for chosen major in college.

Feedback Strategy for Adolescents

Give specific feedback with concrete examples. Describe incorrect skill/behavior demonstrated. Do not say just “good.”

Physical Changes in Adolescence

Gain 50% of adult weight and 20% of height
Growth and sex-related hormones released
Average growth period lasts 4 years
Begins as early as 9, to around 17 yo
Average peak of growth: girls age 11, boys age 13
Girls reach full height within 2 yr of start of menstruation
Head, hands and feet reach adult size first
Bones calcify, become stronger
Muscles increase in size/strength
Strength greatest 12 mo after peak of growth
Boys’ performance peaks around 17-18 yo
Girls increase motor performance around 14

Cognitive Changes in Adolescence

Increased capacity for abstract/logical thinking
Advanced hypothetical/deductive reasoning
Impulse control/self-regulation
Increased ability to risk-assess and problem-solve
Improved working memory
Improved language skills (esp girls)
Future planning/goal-setting
Moral reasoning/morality
Ability to perceive others’ perspectives
Focus on role obligations/how perceived by others
Questioning values of parents/institutions

Psychosocial Issues in Stages of Adolescence

Phase 1: early/middle school (age 10-13)
Phase 2: middle/high school (14-17)
Phase 3: late/first years of work/college (17-21)
• Emotional separation from parents
• Exploration of interests, ideas, roles
• Experimentation w/interests/preferences
• Formation of personal identity
• Identification with peer group
• Exploring romantic relationships
• Sense of one’s sexuality/orientation
• Establishing occupational identity for future worker role

How Self-Identity Develops

Achieving stable self-identity is a critical task of adolescence. • 2 components: Individual “Who am I;” and contextual “Where do I fit in my world” • Visible in values, beliefs, interests, commitments to work, and social role • Includes gender orientation, identification to culture/ethnicity, and perceptions of one’s personality traits (ie: introverted, open, etc.)

What OT can do to develop positive identity

Those with disabilities may be marginalized/stereotyped, which becomes a barrier to others seeing their qualities. OT can assist with not internalizing these labels as integral to their identity; help define interests, values, competencies in social/occupational roles.

How teens develop body image

* Compare themselves with ideal images * Shapes attitude of one’s body * Many struggle with image and are critical of body * Poor body image can lead to depression, anxiety, eating disorders * 40-70% of girls dissatisfied with 2+ aspects

Strategies for Teens with Cognitive Impairment

* ID how teen works best * ID strengths * Offer choices * Match abilities * Break down to simple steps * Use many methods of instruction * Learn in familiar setting first * Give specific feedback with concrete examples * Be consistent, use repetition * Do not introduce variety without reason

Behavioral Indicators of Positive/Neg Self-Esteem

``` POSITIVE: • Expresses opinions • Interacts with other teens • Makes eye contact/faces others • Volunteers for tasks ``` ``` NEGATIVE: • Avoids eye contact • Overly confident/brags • Class clown • Self-critical (humor) • Submissive/overly agreeable • Puts others down ```

Play/Leisure in Adolescence

* Adolescents spend over half waking hours in free time/leisure activities * Choices made important to development * Can use to assess strengths, values, interests, social positions * Recommended to have 1 hour physical activity/day * Contributes to participation in age-related groups and self-efficacy

Issues Teens with Special Needs Face

* Fewer opportunities to engage in typical adolescent experiences * Fewer chances to make own choices/explore * May have negative self-perceptions, lower expectations, social isolation * Some confront stigma/discrimination * Struggle with social acceptance * Barriers to making friends * Typical access points for inclusion are limited * Problems with accepting their bodies

Interventions/Therapy for Adolescents

OT interventions may address: • decreased participation in leisure/hobbies • poor time management • poor coping skills (self-regulation of anger/stress/unhealthy lifestyle) • Goal of OT is to optimize each adolescent’s functioning at his/her full capacity.

Portion of Population that are Adolescent

1/6 of world population; 13.2% of U.S.

Adolescents in families below poverty

Almost 16%

Number of high school students who are working

1/3

Identity Foreclosure

When adolescent chooses to avoid experiencing an identity crisis by prematurely committing to an identity experience.

Identity Moratorium

State when adolescent openly explores alternatives, strives for autonomy, tries out different interests, and pursues sense of individuality. (Early/Mid adolescence)

Identity Diffusion

Least defined sense of personal identity; adolescent avoids/ignores task of exploring identity and has little interest in exploring options. Seldom think about the future. (Early adolescence)

Identity Achievement

Follows moratorium; exploration of possibilities and healthy resolution of the quest. Commitment to interests, values, gender, sexual orientation, politics, career, moral stance. Autonomous, mature moral reasoning, independent. (Final years of high school/college/work)

Sleep recommended for adolescents

8.5-9.25 hours daily