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Promoting Successful Transitions for Youth with Serious Mental Health Conditions

Learn about the post-high school employment and education patterns of youth with mental health conditions based on the National Longitudinal Transition Study-2. Discover factors influencing their outcomes and effective interventions.

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Promoting Successful Transitions for Youth with Serious Mental Health Conditions

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  1. Promoting Successful Transitions for Youth with Serious Mental Health Conditions Findings from the National Longitudinal Transition Study-2 (NLTS2) Mary Wagner, Ph.D. Lynn Newman, Ed.D. Webinar sponsored by the • Transitions Research and Training Center, University of Massachusetts Medical School • Worcester, MA May 14, 2014

  2. Today’s Agenda • Provide a national picture of youth who received special education services in high school in the category of emotional disturbance regarding: • Post-high school employment • Participation in postsecondary education • Longitudinal patterns of productive engagement in employment and/or postsecondary education 6 years post high school • Factors related to an increased likelihood of employment and postsecondary education up to 8 years after high school, and productive engagement 4 years after high school

  3. NLTS2 overview

  4. Data sources • NLTS2 • Parent telephone interview (Wave 1, 2001) • Parent and youth telephone interview/survey (Waves 2-5, 2003-2009) • Surveys of school staff (2002 and 2004) • Direct assessments of academic achievement (Woodcock-Johnson III, 2002 and 2004) • High school transcripts (2002 through 2009) • NLTS comparison (comparable sample and data items from1985)

  5. Characteristics of high school students with ED • 77% male • 61% white, 25% African American, 10% Hispanic • 49% lived in two-parent household • 60% of heads of households with high school degree or less • 44% with incomes < $25,000; 30% in poverty • Parent-reported secondary disabilities:63% ADD/ADHD; 30% learning disability; 20% “other” • 46% take medication to affect behavior, mood, or emotions

  6. When youth with ED left high school • 58% had a goal of obtaining competitive employment. • 24% had any school contacts made with potential employers and 29% had contacts made with job placement agencies. • 44% had a goal of attending a 2- or 4-year college or vocational/technical/business school or program. • 18% had any school contacts made with representatives of such schools/program. • 44% had not completed their high school program.

  7. Employment After High School

  8. Employment of young adults with ED up to 8 years out of high school **p < .01; *** p < .001

  9. Employment of young adults with ED by time out of high school *** p < .001 NOTE: Analyses include young adults with ED out of high school up to 8 years.

  10. Outcomes assessed • Achieving full time employment • In the first 2 years after high school • 2 up to 8 years after high school • Hypothesizing that interventions in high school will have the greatest impactin the early post-highschool years

  11. What promotes early employment after high school? • Tested the effects of • Transition planning activities (e.g., contacting potential employers, youth had leadership role) • Career/technical education course-taking • Any CTE courses in general education setting • A concentration of CTE courses in a general education setting (4 or more credits earned in an occupationally-specific area). • Post-high school goals • Employment-related high school services (e.g., job search instruction) • Having a job in high school • Receiving behavioral/mental health services • High school graduation

  12. Methods • Propensity scoring methods strive to create balance on observed covariates between treatment and comparison groups using statistical methods instead of randomization. • Baseline equivalence tests assess how well balanced adjusted treatment and comparison groups are. • Multiple imputation was used on missing covariates, but not on intervention or outcome variables. • Results are the average population effect of treatment on the treated (PTT), not the analysis sample.

  13. Predicting employment outcomes • Used propensity score modeling techniques to create comparison groups statistically similar on: • Demographics—age, gender, mother’s education, household income, race/ethnicity, two-parent household • Disability—diagnosed with ADD/ADHD • Scores on scales measuring skills related to cognitive functioning, social assertion, self-control, social cooperation • Scores on scale of family support for education at home and family involvement at school • Experiences during school—GPA, number of absences, ever arrested, ever held back a grade, number of school changes

  14. Effects on full-time employment of providing transition planning instruction Youth received transition planning instruction in high school = 78.4% ** p < .01

  15. Effects on full-time employment of any general education CTE and CTE concentration CTE = Career and technical education Concentration = earning 4 or more credits in an occupationally specific CTE subject *p < .05; ** p < .01

  16. CTE enrollment of youth with ED NOTE: Analyses include young adults with disabilities out of high school up to 8 years. Young adults who had enrolled in more than one type of postsecondary school were included in each type of school they had attended. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), high school transcripts.

  17. Effects of HS graduation on full-time employment High school graduation rate for youth with ED = 74.2%. * p < .05

  18. Postsecondary School Enrollment

  19. Postsecondary school enrollment of young adults with ED up to 8 years post-high-school Ever enrolled in: NOTE: Young adults who had enrolled in more than one type of postsecondary school were included in each type of school they had attended. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Waves 2-5 parent interviews and youth interviews/surveys, 2003-2009; U.S. Department of Labor, Bureau of Labor Statistics, National Longitudinal Survey of Youth 1998 (NLSY 97), 2005 youth survey. Responses for 21- to 25-year-olds.

  20. Postsecondary school completion at the time of final interview/survey Earned degree or completed program at: SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 2 - 5 parent interviews and youth interviews/surveys, 2003 - 2009.

  21. What promotes postsecondary school enrollment for young adults with ED? • Tested the effects of • Course taking • Behavioral/mental health services • Learning strategies • Transition planning activities • Post-high school goals • Youth expectations • Parent involvement • Parent expectations • Graduation status

  22. Effects of course taking and performance on postsecondary enrollment: * p < .05;*** p < .001; Empty cell = No significant relationship; OR = odds ratio; CTE = Career and Technical Education.

  23. Average number of credits earned in high school, by course type Average number of credits earned: *** p < .001. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), high school transcripts; U.S. Department of Education, National Center for Education Statistics, Education Longitudinal Study of 2002 (ELS:2002), High School Transcript Study.

  24. Grade performance *** p < .001. SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), high school transcripts; U.S. Department of Education, National Center for Education Statistics, Education Longitudinal Study of 2002 (ELS:2002), High School Transcript Study.

  25. Effects of transition planning experiences on postsecondaryenrollment: *p< .05;*** p < .001; Empty cell = No significant relationship; ; OR = odds ratio; CTE = Career and Technical Education

  26. Student participation in transition planning meetings by youth with ED Role in meeting of studentswho attended: Percent SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 student’s school program survey, 2002.

  27. Contacts with postsecondary schools in transition planning for youth with ED Percent SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 student’s school program survey, 2002.

  28. Effects of goals and expectations on postsecondaryenrollment: **p< .01;*** p < .001; Empty cell = No significant relationship; ; OR = odds ratio; CTE = Career and Technical Education.

  29. Transition plan goals of youth with ED Primary transition goal: SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 student’s school program survey, 2002.

  30. Youth expectations Expects to attend postsecondary school SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 interview/survey.

  31. Parent expectations for youth with ED Expects student will attend postsecondary school SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 interview/survey.

  32. Effects of parent involvement on postsecondaryenrollment: * p < .05; Empty cell = No significant relationship; ; OR = odds ratio; CTE = Career and Technical Education.

  33. Involvement of parents of youth with ED Participated in school-based activities: SOURCE: U.S. Department of Education, Institute of Education Sciences, National Center for Special Education Research, National Longitudinal Transition Study-2 (NLTS2), Wave 1 interview/survey.

  34. Effects of high school completion on postsecondaryenrollment • Comparing NLTS (1987) and NLTS2 (2001), the high school completion rate of students with ED had increased 16 percentage points. • Up to 8 years post high school, 74% of young adults with ED had completed high school. *** p < .001; Empty cell = No significant relationship; ; OR = odds ratio; CTE = Career and Technical Education.

  35. Putting It all Together: Engagement Over Time

  36. Going the next step • The most common post-high school experience of youth with ED combines employment and postsecondary education participation. • The combinations fluctuate over time. • Examining the patterns of engagement in these activities over time paints a more complete picture of youth experiences than most outcome-oriented research can provide. • NLTS2 data support examining these patterns over a 6-year period for young adults with three waves of data after leaving high school.

  37. Patterns of engagement • Engagement is participating after high school in: • Full-time paid employment, • Part-time paid employment, and/or • Any form of postsecondary education • Calculated six combinations of engagement at each of three time periods after high school: • Full-time job, in school • Full time job, not in school • Part-time job, in school • Part-time job, not in school • Not employed, in school • Not employed, not in school

  38. Patterns of engagement by time out of high school

  39. Patterns of engagementover time • Combined patterns of engagement over time to form three sequences of engagement: • Fully or primarily disengaged—no engagement at 2 or 3 time points, e.g.: • No work, no school; No work, no school; No work, no school • No work, no school; PT work, in school; No work, no school • Primarily engaged at 2 times points, e.g.: • No work, no school; PT work, in school; PT work, no school • PT work, in school; PT work, no school; No work, no school • Steadily engaged over time—evidence of work and/or school at all 3 time points, e.g.: • FT work, no school; PT work, in school; PT work, no school • No work, in school; No work, in school; FT work, no school

  40. Prevalence of three patterns of engagement over 6 years post high school

  41. Demographic factors associated with disengagement and steady engagement * p < .05, ** p < .01. Empty cell = No significant relationship

  42. Experiences associated with disengagement and steady engagement ** p < .01; *** p < .001; Empty cell = No significant relationship.

  43. Other factors associated with disengagement and steady engagement * p < .05, ** p < .01; Empty cell = No significant relationship.

  44. Taking the next step • Goal: Identify school practicesand interventions during high school that protect against disengagement and/or promote engagement using propensity score modeling • Obstacle: Too few youth with 3 waves of data to identify “statistical twins” needed for this analysis technique • Solution: Redefine patterns to require two waves of data—i.e., what is the pattern of engagement/ disengagement over the first 4 post-high school years?

  45. Prevalence of patterns of engagementover 4 years after high school

  46. Association between CTE course takingand engagement ** p < .01

  47. Association between engagement and transition planning goals and instruction * p < .05, ** p < .01.

  48. Association between engagement and parents involvement and expectations * p < .05, ** p < .01. Empty cell = No significant relationship

  49. Association between high school graduation and engagement * p < .05

  50. Implications • Transition planning could • Encourage active student and parent participation in goal setting • Encourage a concentration of CTE for those with a primary transition goal of employment • Include both academic and CTE teachers in transition plan for a holistic view of a student’s program • More actively reach out to potential employers • Supports for success in academic courses • GPA powerfully predicts high school graduation • Youth with ED fail more courses than any other students with disabilities, largely academic courses • Analyses show providing learning supports significantly improves odds of graduating

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