Bilateral visual acuity decline in males with choroideremia: a pooled, cross-sectional meta-analysis

Background Choroideremia is a rare inherited retinal disease that leads to blindness. Visual acuity (VA) is a key outcome measure in choroideremia treatment studies, but VA decline rates change with age. An accurate understanding of the natural deterioration of VA in choroideremia is important to assess the treatment effect of new therapies in which VA is the primary outcome measure. We conducted a meta-analysis of data on individuals with choroideremia to determine the rate of VA deterioration between the better- and worse-seeing eye (BSE and WSE, respectively). Methods Data were collected from the prospective Natural History of the Progression of Choroideremia (NIGHT) study (613 eyes, baseline data only), studies included in a recent meta-analysis, and studies identified in a targeted literature search performed on March 25, 2020, including individual best-corrected VA (BCVA) and age data in male individuals with choroideremia. Best-corrected VA decline rates (measured by logMAR units) by age and trends in BCVA decline rates in the BSE and WSE were evaluated. Results Data from 1037 males (1602 eyes; mean age, 41.8 years) were included. Before and after an age cutoff of 33.8 years, BCVA decline rates for the WSE were 0.0086 and 0.0219 logMAR per year, respectively. Before and after an age cutoff of 39.1 years, BCVA decline rates for the BSE were 0.00001 and 0.0203 logMAR per year, respectively. Differences in absolute BCVA and decline rates increased between the 2 eyes until age ~ 40; thereafter, differences in absolute BCVA and decline rates were similar between eyes. Conclusions Using the largest choroideremia data set to date, this analysis demonstrates accelerated BCVA decline beginning between 30 and 40 years of age. Disparate interocular progression rates were observed before the transition age, with similar interocular progression rates after the transition age.

Empowering Transition-Age Students to Use Self-Determination Assessment to Lead IEP Goal Development

Self-determination is a predictor of positive in- and post-school outcomes, including access to general education, competitive employment, and community participation. Emerging research has focused on promoting self-determination for all students given alignments with college and career readiness frameworks and equity-based education. However, it is also important to enhance self-determination as students participate in the Individualized Education Program (IEP) goal development process. Empowering transition-age students to lead the IEP goal development process with support from school personnel has the potential to enhance the alignment of IEP goals based on students’ strengths, preferences, values, and needs and enhance transition planning and college and career readiness. In this article, we provide an example of how to use a self-determination assessment, the Self-Determination Inventory: Student Report (SDI:SR), and an intervention, the Self-Determined Learning Model of Instruction (SDLMI), in the IEP goal development and implementation process to enhance transition planning and college and career readiness.

Employability Social Skills Interventions in Transition-Age Youth with Intellectual Disabilities: A Literature Review

Employability skills are necessary for youth with Intellectual Disabilities (IDs) to successfully navigate their transition from educational settings to autonomous adult life. Most importantly, research evidence has shown that individuals with IDs appear to perform adequately on job tasks, yet they frequently face inadequacies in the social aspects of work life. Although much of the existing employability research has focused on social skills training related to employability for individuals with other disabilities, people with IDs are underrepresented in the literature. Thus, this review aimed to provide insight into the existing social skills interventions that promote employability in transition-age youth with IDs. Results indicated that although there is a limited number of studies regarding intervention programs on improving social skills related to employment for individuals with IDs, the majority of them positively impacted target behaviors, thus highlighting the need for further empirical research.

Service needs assessment of employment-related soft skills for transition age youth with disabilities

BACKGROUND: Work-related soft skills can be an important factor for successful employment outcomes, particularly for individuals with disabilities. OBJECTIVE: This study conducted a survey on the needs of important work-related soft skills for employment success of transition age youth with disabilities. METHODS: 183 participants included 27 individuals with disabilities, 32 family members of individuals with disabilities,35 disability service providers, 47 disability advocates and 42 employers, completed surveys to identify a list of soft skills by importance for transition age youth with disabilities to succeed at work. RESULTS: All five groups noted the top two skills: asking for help and responding to feedback, as most important. Employers also rated interview skills as third most important skills, while the other four groups advocated requesting for accommodations and negotiating conflicts as the third and fourth most important skills. CONCLUSIONS: Findings indicated soft skills being critical to work success for transition age youth with disabilities, with some skills potentially being more important. Vocational counseling implications were discussed.

Determinants of employment outcomes of transition-age youth with depressive disorders

BACKGROUND: Transition-age youth (TAY) with depressive disorders struggle with finding and retaining gainful employment. Thousands of these youth enroll in the state-federal vocational rehabilitation (VR) program each year to improve their employment outcomes. However, there is a dearth of information on the factors that facilitate or impede their success in the program. OBJECTIVE: The study aims to shed light on the demographic characteristics and vocational rehabilitation services and their association with successful employment and earnings of TAY with depressive disorders in the state-federal VR program. METHOD: The sample comprised of 4,772 participants drawn from the Rehabilitation Services Administration dataset. Regression analyses were employed to examine the effects of demographic characteristics and vocational rehabilitation services on successful employment and earnings. RESULTS: Results indicated that employment outcomes varied by demographic characteristics such as race/ethnicity, severity of disability and level of education. Also, certain VR services had significant positive or negative relationships with successful employment and earnings. CONCLUSIONS: Highlighting the promise of the state-federal programs for supporting TAY with depressive disorders to successfully participate in the labor market, findings from this study expand upon the literature by suggesting practices and services for optimizing employment potentials of this population.

Job-Search Activities, Job-Seeking Barriers, and Work Experiences of Transition-Age Youths With Visual Impairments

Introduction: The purpose of this study was to describe the job-seeking and work experiences of transition-age youths with visual impairments. Methods: We analyzed follow-up data from a quasi-experimental study of a job-search intervention conducted from 2016 to 2019. Participants were 88 youths with visual impairments from three states; approximately half received the job-search intervention, and the other half served as a comparison group. Measures included job-search activities and outcomes, job-seeking barriers, volunteer and work experiences, and parental support for job-seeking. Results: Commonly reported job-search activities were preparing or revising resumes, talking to people about jobs, submitting applications, and submitting resumes, but most participants performed these activities infrequently. Many job-seekers encountered barriers during their job search, and few searches resulted in paid employment. Participants generally reported moderate levels of preparation to handle job-seeking barriers and parental support for job-seeking. Intervention and comparison participants had similar results on most measures, with few exceptions. Discussion: When youths actively search for a job but do not find one, their motivation to continue job-seeking may be reduced, particularly if their preparedness to overcome job-seeking barriers is low. Although many participants had some engagement in volunteer or work activities, short-term work experiences were the most common—and perhaps most misunderstood—work activity. Implications for practitioners: Youths with visual impairments may benefit from feedback on their job-seeking approach, application materials, and interview skills so they can make changes and determine how to focus or refocus their efforts. In addition to offering feedback, service providers can provide ongoing support to youth job-seekers and encourage them to persist in their job search. Explicit discussions about different types of work activities may help transition-age youths understand how short-term work experiences differ from paid jobs.

Estimation of age of transition from children's to adult healthcare for young people with long term conditions using linked routinely collected healthcare data

IntroductionHealthcare transitions, including from paediatric to adult services, can be disruptive and cause a lack of continuity in care. Existing research on the paediatric-adult healthcare transition often uses a simple age cut-off to assign transition status. This risks misclassification bias, reducing observed changes at transition (adults are included in the paediatric group and vice versa) possibly to differing extents between groups that transition at different ages. ObjectiveTo develop and assess methods for estimating the transition point from paediatric to adult healthcare from routine healthcare records. MethodsA retrospective cohort of young people (12 to 23 years) with long term conditions was constructed from linked primary and secondary care data in England. Inpatient and outpatient records were classified as paediatric or adult based on treatment and clinician specialities. Transition point was estimated using three methods based on record classification (First Adult: the date of first adult record; Last Paediatric: date of last paediatric record; Fitted: a date determined by statistical fitting). Estimated transition age was compared between methods. A simulation explored impacts of estimation approaches compared to a simple age cut-off when assessing associations between transition status and healthcare events. ResultsSimulations showed using an age-based cut-off at 16 or 18 years as transition point, common in research on transition, may underestimate transition-associated changes. Many health records for those aged 14 years were classified as adult, limiting utility of the First Adult approach. The Last Paediatric approach is least sensitive to this possible misclassification and may best reflect experience of the transition. ConclusionsEstimating transition point from routine healthcare data is possible and offers advantages over a simple age cut-off. These methods, adapted as necessary for data from other countries, should be used to reduce risk of misclassification bias in studies of transition in nationally representative data.