Transitions

The Doctor Switch- Shane's Story from CanChild on Vimeo.

Any transition is a developmental stage that involves significant cultural milestones (Stewart et al., 2001). Some examples of significant transitions are: the transition to elementary school, the transition to high school, the transition to postsecondary education, gaining more autonomy from parents, transition to the workforce, transition to independent living, and the transition from institutional setting (e.g. a hospital) to community life.

Research has shown that children and youth with disabilities have complex journeys, as they often have to navigate new environments with limited guidance, feel pressure to be independent, and lack the resources and supports that make it difficult to prepare for transitions. Research on transition has shown that social support is a critical success factor for any transition. Social support includes family, of course, but also peers, community members and service providers.

Some of the key concepts that need to be studied and considered by anyone working with children and youth with chronic disabilities who are transitioning to a new stage of life includes: the emphasis on a person's lifecourse and the network of relationships, changing roles and expectations over time; building a person's capacity to participate in meaningful activities in their community; helping a person "get ready" for the next stage in life by giving them the "tools" they need; being "interdependent" versus "independent" because person and environment are transactional. These concepts recognized that life is a journey with many transitions.

Historically, therapeutic focus has been oriented on transitioning a person toward adult services and individual independence, but our research advocates a change in direction (Stewart et al., 2001). A lifecourse approach to transition places the emphasis on the natural, developmental transitions that all people experience in life. Furthermore with this approach, there is less focus on individual skills of independence (for example, with dressing or cooking), and more on the term 'interdependence' among many people. This concept recognizes that everyone relies on supports at different stages and transitions in their life.

We have learned a great deal in the past decade or so about some transitions (for example, the transition to adulthood for youth with disabilities) but we still have much more to learn as we adopt a lifecourse approach to services and research in this area. For a synthesis of the current literature on the transition to adulthood for youth with disabilities, please click here to view the article that is posted on the International Encyclopedia of Rehabilitation.

  • Click here for list of references

    Claassen, A. A., Gorter, J. W., Stewart, D., Verschuren, O., Galuppi, B. E., & Shimmell, L. J. (2011). Becoming and staying physically active in adolescents with cerebral palsy: Protocol of a qualitative study of facilitators and barriers to physical activity. BMC Pediatrics, 11, 1.

    Gorter, JW (2011). Build our youth for the future in paediatrics and beyond. Acta Paediatrica, Aug 28, doi: 10.1111/j.1651-2227.2011.02455.x



    Gorter, J.W., Stewart, D., Woodbury-Smith, M. (2011). Youth in transition: Care, health and development. Child: Care, Health and Development, 37(6):757-763.



    Wiegerink, D. J., Stam, H. J., Gorter, J. W., Cohen-Kettenis, P. T., Roebroeck, M. E., & Transition Research Group Southwest Netherlands. (2010). Development of romantic relationships and sexual activity in young adults with cerebral palsy: A longitudinal study. Archives of Physical Medicine and Rehabilitation, 91(9), 1423-1428.



    Young N, Barden W, Mills W, Law M, Boydell K. (2009). Transition to Adult-Oriented Health Care: Key Messages from Youth and Adults with Chronic and Complex Physical Disabilities of Childhood. Journal of Physical and Occupational Therapy in Pediatrics, 29( 4), 345-361.



    Stewart, D. (2006). Transition to adulthood. Physical and Occupational Therapy in Pediatrics, 26(4), 1-103.



    Stewart, D. (2006). Evidence to support a positive transition into adulthood for youth with disabilities. Physical and Occupational Therapy in Pediatrics, 26(4), 1-4.



    Wynn, K., Stewart, D., Law, M., BurkeGaffney, J., & Moning, T. (2006). Creating connections: A community capacity-building project with parents and youth with disabilities in transition to adulthood. Physical and Occupational Therapy in Pediatrics, 26(4), 89-103.



    Young, N., McCormick, A., Mills, W., Barden, W., Boydell, K., Law, M., et al. (2006). The transition study: A look at youth and adults with cerebral palsy, spina bifida and acquired brain injury. Physical and Occupational Therapy in Pediatrics, 26(4), 25-45.



    Stewart, D., Law, M., Rosenbaum, P. & Willms, D. (2001). A qualitative study of the transition to adulthood for youth with physical disabilities. Physical and Occuaptional Therapy in Paediatrics. 2001, 21, 3 - 21


Read more about a Lifecourse Approach
Read more about Best Practice Guidelines