Work & Education

• Adolescence is a major phase of life when individuals establish identity, norms, and lifestyle

• Occupations, interests, habits, roles, & routines shift & change

Early Adolescence 

• Middle school - 10-13 yrs old

• self-evaluate, compare themselves to others

• preoccupied with self

Middle Adolescence

• High school - 14-17 yrs old

• developing acceptance of self

Late Adolescence 

• Work or college - 17-21 yrs old

Adolescent Development

• cognitive 

  • executive functioning is developing and highly tested by daily demands

  • for lower functioning individuals, the cognitive & academic demands of HS may far exceed their projected abilities and so their education may shift away from academics to prevocational or life skills programming to better align with their needs/performance

• psychosocial 

  • establishment of identity

  • sexual orientation

  • gender identity

  • self-esteem - can be at-risk 

    • risk is no different between individuals with and without disabilities

• mental health

  • many disorders/conditions are identified during this age

  • when brain chemistry changes, anxiety, pre-schizophrenia, eating disorders can emerge

• health behaviors

  • can be positive, e.g. increased physical activity due to joining sports teams

  • alcohol & substance abuse

  • injury, violence, and suicide prevention for at-risk students

  • nutrition tends to be poor when guided by the adolescent vs. parent

  • reduced physical activity - becomes at risk

  • risky sexual behaviors

Teenagers with Disabilities

• the development experiences of a teenager are universal (whether the individual has or doesn't have a disability)

• it's importance to explore inclusive activities to help teens develop as any typically developing teen would

• the literature shows no difference between adolescents with and without disabilities in self-esteem and satisfaction in physical appearance

• adolescents have fewer opportunities to engage in typical teen experiences, make own choices, interact with peers, and explore ideas & values outside of their family

  • ex. unified sports/fitness, special camps, after school programs

Considerations for OTPs Working with Adolescents

• as the child grows into a teenager, new aspects of their occupational roles emerge - need to be explored & evaluated

• may need to involve the teen in the process of interviews, review of results, goal-planning, and service recommendations

• occupation identification and development can help improve self-efficacy, peer acceptance, social status, and self-esteem

Occupation of Adolescences

• work & volunteering

  • further develops IADLs, such as money management, time management, organization, interpersonal skills, new routines

  • some school programs focus on this as part of a child's education so if it is difficult, the OT needs to be part of this part of their learning

  • OT's need to help adolescents with disabilities explore what strengths and interests they have to build on work and volunteering opportunities

• IADLs

  • driving & community mobility/transportation

  • health management & health behaviors

  • money management

  • safety & emergency procedures

  • social networks & social media

• play & leisure

  • develops self-efficacy, autonomy, social inclusion

• social participation & peer relationships

  • making & keeping friendships is really hard for individuals with disabilities

Life Skills Curriculum

• as the child enters into HS, the team needs to begin to make decisions as to whether they will follow the traditional academic course and/or follow a life skills track

• life skills curriculum includes instruction on:

  • ADLs

  • community mobility/transportation

  • work skills

  • social skills

  • self-determination

  • functional academics

    • writing - signing name, filling out an application, personal information

    • math - paying with money & making change

    • reading - reading community and/or warning signs & labels

  • independent living skills

• individuals with more moderate to severe disabilities, may need to deviate from the regular academic track for their education and maximize the time life in school to focus on skills for living beyond high school (post-secondary)

• **Be sure that the skills focused on are functional and relevant to current practices (e.g. less likely to write checks/using cash, more likely to have credit/debit cards & bank accounts)

• as the child progresses through adolescence & ransitions into adulthood, they become the most important decision-maker in program meetings

• students need to have established skills in:

  • self-awareness & self-advocacy

  • decision-making

  • problem-solving

  • goal-setting

Legislation under IDEA (for those with an IEP)

• transition teams

  • transition planning should begin at 16 yrs old or earlier (maybe 12 or 14) for individuals with special needs

• IDEA and IEPs only go through age 21 -- educational funding & supports stop after this point!

  • students can opt to graduate at 18 and go onto college/work (receiving a diploma, if have sufficient credits) or

    • pros: get a diploma, graduate w/ peers, maybe move onto a specialized program for individuals with special needs at a college

    • cons: lose publicly funded specialized services (no more IEP)

  • can go to school through 21 (receiving a certificate of completion)

    • pros: can get 3 more years of services focused on life skills, pre-vocation/vocation skills, leisure, independence, social skills, etc. -- all things needed to transfer to adulthood 

Legislation under 504 & ADA

• individuals who transition to work or post-secondary schooling may require "reasonable accommodations"

• "reasonable" is important term - law says that it will need to accommodate, as long as it doesn't exceed the employer or university's resources

  • e.g. a student may have received accommodations in HS and can go to college and are no longer deemed reasonable under ADA because viewing the accommodation differs based on the two pieces of legislation

  • as the OT, it's important to know and prepare the student to determine how they can receive the necessary resources even after they leave HS and enter college or identify ways to support without accommodations or identify alternative, more reasonable ones

Interagency Teams

• as the child transitions to adulthood, the school district begins to invite other agencies who may eventually take over the care upon leaving the school's domain including

  • state vocational rehab agency

  • state departments of mental health

  • developmental disabilities agencies (DDS)

  • post-secondary education or training programs

Main Pathways

1. Post-secondary education

   • inclusive post-secondary education programs (IPSE)

   • career & technical education (CTE)

   • comprehensive transition program (CTP) - thinkcollege.net 

2. Day program

   • community based supports that focus on social participation, life skills, community participation, possible vocational exploration/sheltered workshop

3. Employment

   • job coaching

Post-Secondary Considerations

• continued education

  • 2 yr or community college

  • vocational/technical schools

  • 4-yr colleges

• employment

  • transportation

  • social participation & communication

• community participation & inclusion

• helps with the development of:

  • identity

  • self-worth

  • socio-economic status

  • health

  • quality of life

  • social engagement & social competence

  • self-efficacy

• vocational education may be utilzied during transition programming

Intervention Session Ideas

• Researching community internship opportunities that she may be interested in (ex: music store)

• Role playing workplace scenarios

• Practice social situations she might encounter at work

• Practicing transitions from preferred to non preferred tasks

• Use visual schedules / checklists to help help with multi-step tasks

• Red, yellow, green light when navigating on the street/community/work

• Have a list of activities that may have different time frames and have her list them from shortest to longest in order to prioritize tasks

• Play games that would work on her inhibition

• Social boundaries with a hula hoop 

• Creating a visual plan for the day to work on time management and planning/organizing skills

• Identifying personal stress signs and preferred coping strategies 

• Use a typing game that is music oriented to help her type for longer periods which may be used in a work setting

• Social stories to practice social boundaries in different scenarios

• Sensory, social boundaries with kids, even if a kid comes up to you and wants a hug, give a high five, interested in learning kids songs; Demands of working with kids

• Using a pomodoro timer to get a better understanding of switching between tasks and how to prioritize them 

• Have Marla use a computer to create a playlist, to work on typing and computer skills but motivated by music.