TBI Transition, Research and the Oregon TBI Team. Bonnie Todis , PhD Center on Brain Injury Research and Training. Overview. What we know about the transition experiences of students with TBI. What we know about transition in general. What do we do with this knowledge? - PowerPoint PPT Presentation
TBI Training for Pre-Service Teachers
TBI Transition, Research and the Oregon TBI Team
Bonnie Todis, PhDCenter on Brain Injury Research and Trainingcbirt.orgOverviewWhat we know about the transition experiences of students with TBI.What we know about transition in general.What do we do with this knowledge? What does this have to do with you? What do you think? cbirt.orgResearch on Outcomes after Childhood TBIMost of this research has been conducted by doctors and neuropsychologists.Why would they do this research? cbirt.orgWhat these studies look likeParticipants recruited from medical filesUsually one follow up data point in adulthoodRarely look at school factorscbirt.orgWhat these studies didnt tell usWhat are the transition experiences of young adults with TBI?How do employment, etc. fluctuate over time?What factors lead to different outcomes?Special ed?Family support?Community SupportsDemographics (age, severity, sex)cbirt.orgNational Transition Longitudinal Study (NTLS)10-year study of transition outcomesFunded by OSEP11,000 students 12 disability categoriesNTLS1 did not include students with TBINTLS2 included youth who were 13-19 in 2000Data collected in 2003 on 28% out of schoolcbirt.org6NTLS: Employment%cbirt.org7NTLS: Post-secondary Education%cbirt.org8NTLS: Living with Parents%cbirt.org9POST-SECONDARY OUTCOMESPROJECT(PSO)cbirt.orgProject PSO8-year study of transition outcomesFunded by OSEP and NIDRR90 students in Oregon and Washington Recruited at exit from high schoolRolling recruitment over 2-3 yearsSchool districtsVRcbirt.org11Employment Outcomes Ages 19-25Age 19(n = 54)20(n = 74)21(n = 85)22(n = 86)23(n = 84)24(n = 75)25(n = 55)Employment20 (37)36 (49)44 (52)42 (49)37 (44)35 (47)33 (60)Male17 (46)23 (49)34 (60)34 (59)29 (52)26 (54)26 (74)Female3 (18)13 (48)10 (36)8 (29)8 (29)9 (33)7 (35) # Hrs.
Gender: Males> #hrs.
For both genders: Earlier age at injury = work fewer hours/weekFemalesMalesFemalesMalesInjured earlierlaterSevereMild/Mod21 30hr11-15hr
Hours Per Week16-20hrcbirt.org21
Factors That Impact EmploymentLater age Later ageEarly age Avg ageEarly ageSevereMild/ModerateJob Happiness by Severity and Age at InjuryAvg ageHappyVery Happy Unhappy
cbirt.orgSeverity diffs: Severe injury -> similar initial level , stable over time M/M -> reported happiness level drops off over time toward mid-twentiesDiffs age at injury: higher job happiness assoc with earlier age at injuryHappiest with job? Those with severe injuries, earliestLeast happy with job? Those with mild/moderate injury , latest age injury22POST SECONDARY EDUCATION cbirt.orgPost-SecondaryEducation OutcomesAges 19-25 n(%)Age 19(n = 54)20(n = 74)21(n = 85)22(n = 86)23(n = 84)24(n = 75)25(n = 55)Education 15 (28)26 (35)34 (40)22 (26)26 (31)18 (24)14 (25)Male7 (19)17 (36)20 (35)11 (19)15 (27)7 (15)6 (17)Female8 (47)9 (33)14 (50)11 (39)11 (39)11 (41)8 (40)cbirt.org.Maximum enrollment at age 21 40%Females generally had higher rate of enrollment (except age 20)Females stayed in school longermuch higher rates after age 2324Post-Secondary Education Outcomes Ages 19-25cbirt.orgPSO sample enrollment 19-25 compared with mean enrollment of typicals 18-24 of 46% Pew sampleCheck typical enrollmentCATHy: Change Chart Title to Comparison with Typical Young Adults25Comparison with PeersNon disabled young adults 18-25 46% enrollment (Pew 2007) 54% female (2005) NLTS2 45% reported continuing to postsecondary ed within 4 years of leaving high school. 32% community colleges 23% vocational/tech14% 4-year
cbirt.org26Factors That Affect EnrollmentHigher family SES, shorter time to enrollmentFemales more likely to enrollThose injured later were more likely to enroll. For every year increase in age at injury there was a 12.3% increase in likelihood of enrollment. cbirt.orgIndependent Living Outcomes Ages 19-25 n(%)Age 19(n = 54)20(n = 74)21(n = 85)22(n = 86)23(n = 84)24(n = 75)25(n = 55)Independent Living12 (23)26 (36)28 (35)37 (44)35 (41)37 (49)29 (53)Male7 (20)13 (28)18 (33)22 (39)22 (39)24 (49)20 (57)Female5 (29)13 (48)10 (37)15 (54)13 (45)13 (48)9 (45)cbirt.org53% at age 2528Post-SecondaryIndependent Living OutcomesAges 19-25cbirt.orgCross-section percent of sample at each age 19-25 snapshot.e.g. 40% of all 23 year olds (in sample at time of survey) in survey reported living independentlyTime period 1998-2006 29Comparison with PeersNon-disabled peers 18-25 40% live with parents (Pew)NLTS2 ages 17-21 25% have lived independently at some time since high school (65% of these lived in a college dorm or military housing). cbirt.orgBased on last year of data collection. 30Factors That Affect Ind. LivingAge at injury: Those injured earlier take longer to achieve independent living status. For each year older at injury, there is a 12.7% increase in odds of achieving independent living. cbirt.orgTransition Practices cbirt.orgWhat We Know about Transition PracticesTransition has been mandated since the 80sLots of programs have been developedSome programs have been evaluatedUSDoE provided funding to identify and disseminate research-based transition practices NSTTACcbirt.orgHow E-B Practices Are IdentifiedEstablish criteria for evidence of effectivenessClassify practices as Look at what you end up with cbirt.orgTaxonomy of Evidence-Based Practices Student-focused planningInvolving student in IEP processSelf-Advocacy StrategySelf-Directed IEPStudent developmentLife skillsSelf-advocacyEmployment skillsreading, mathSelf-determinationcbirt.orgTaxonomy of Evidence-Based Practices Family InvolvementTraining for parents about transitionProgram structureCommunity-based instructionExtending services beyond high schoolCheck and ConnectInteragency collaborationcbirt.orgCaution!Evidence is not strongEffectiveness have not been established for students with TBI Not included in most of the studies that were reviewedWhy? (Top secret story that you cant tell anyone!)cbirt.orgWhat does this mean?Knowing about transition outcomes for students with TBIKnowing what transition practices are most effectiveWhat is your next step as an educator? cbirt.orgWhat does this all mean?We have a pretty good idea what kids with disabilities need to prepare for transitionWere pretty sure kids with TBI need these things, tooThe things that work for other kids may need to be tweaked for kids with TBIcbirt.orgOutcomes so far.Transition toolkitTransition Web Project IES Proposal
cbirt.org40Transition Website ProjectHistoryNIDRR Development Project 2011-2014Three stagesDevelopment Pilot testingEvaluationcbirt.orgTransition Web Project
cbirt.orgWhat does this have to do with you?Participatory Action ResearchInvolve the people who are the stakeholder in the research in every phase of the research processStakeholdersStudents with TBIEducatorsFamily memberscbirt.orgPAR ActivitiesPredevelopmentQualitative findings from PSOWhat were transition services like?What was difficult for educators? Parents? Kids?What worked? Where were the gaps in knowledge? Practice?
cbirt.org44PAR ActivitiesDevelopmentFocus groupsInterviewsParticipant observationscbirt.orgPAR ActivitiesPilot test phaseUsability testsAdvisory board cbirt.orgPAR ActivitiesEvaluationField test interventionComplete pre-post measuresFocus groupsDisseminationPresentationsHelp with articlesImplementing evidence-based practices*******cbirt.orgPAR Activities for Team Memberson T-WebPredevelopmentFocus groupDevelopmentusabilityEvaluationTreatment/Non-treatment
cbirt.orgFocus-Group/Discussioncbirt.orgSpeaking of Research OpportunitiescbiRtCurrent projectsTATESTEP***Family WebTransition Web ***MCH ***TEAM ***cbirt.orgData on Team ActivitiesODE reporting requirements
MCH reporting requirements
WOU reporting requirementscbirt.org
cbirt.orgCan you move or delete the black title? 52Other ways we use these dataDissemination extending the team modelPresentationsArticlesGrant proposalsSOS ProjectBack to School/TOPSTEPTransition Web - mentioned 5 times
cbirt.orgTransition Web and the Team18 years of working with educators on the TBI team provides knowledge about what p. 9 students and educators need and want.Team members will participate in development and evaluation pp. 19, 25Prior research and development on which the new project is based p. 20Transition pilot project (toolkit) p. 20cbirt.orgData we currently collectNumber of contactDemographicsConcernsActionsOutcomes cbirt.orgData we would like to haveMore specific information about ActionInservice training?Consultation? InformationNumber of people touchedEducators, students, family membersMore specific information about OutcomesDid the training/information get used? How? What was the outcome for the educator?What was the outcome for the student? Parent?
cbirt.orgWhy we need these dataIn order to be accountable to ODEIn order to be accountable to WOU, OSHE
cbirt.orgWhy we would like these dataWe could establish an evidence base for the team modelIncreased/stable funding for team activities and other TBI servicesWe could disseminate the model to other statesWe could improve educational services nationally
cbirt.orgWhat do you think? How can we help you send us more data?On ActivitiesOn People ServedOn OutcomesAction Plan cbirt.org