Adolescence and Transition Flashcards
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
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
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.
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.
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!
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
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.
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)
OT Provided in Transition
- Functional life skill support
- Independent living skill support (ADL)
- Job skill support
- Self-regulation support
- Adaptations for independence
Functional Life Skill Support
- Community Mobility (ie:bus riding)
- Shopping (clothing, groceries)
- Family and Friends
- Recreation and Leisure
Independent Living Skill Support
- Grooming/Self-Care
- Cooking
- House Cleaning (dust, sweep, mop, etc.)
- Laundry
- Safety
Job Skill Support
- Interviewing
- Time Awareness/Scheduling
- Job Skills
- Task Completion
- Social Interaction
- Safety
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
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!
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!)
Age Range of Adolescence
10-19 yo (10-24 for OT)
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
