Life-Course Transitions Among Adolescents With and Without Disabilities: A Longitudinal Examination of Expectations and Outcomes

The Long-Term Impact of Childhood Disability on Mental Health Trajectories in Mid- to Late-Life

OBJECTIVES

We draw from the life course and stress process frameworks to examine how experiencing disability in early life influences mental health in adulthood.

METHODS

Data come from the Health and Retirement Study Cross-Wave Childhood Health and Family Aggregated Data file (2008-2018, n = 15,289). Childhood disability status is a retrospective self-report of whether respondents were disabled for six months or more because of a health problem before the age of 16 (n = 581). We used age-based growth curve models to construct trajectories of depressive symptoms by childhood disability status.

RESULTS

Respondents who experienced childhood disability exhibit more depressive symptoms at age 50 compared to those who did not experience this stressor. However, there is no difference in the growth of depressive symptoms with age between these groups, suggesting maintained inequality over the late adulthood life course.

DISCUSSION

Findings suggest that childhood disability has long-term implications for life course mental health.

Understanding the Disability Dynamics of Youth: Health Condition and Limitation Changes for Youth and Their Influence on Longitudinal Survey Attrition

Disability status-experiencing a functional limitation caused by a health condition-is dynamic throughout the life cycle, even during adolescence and young adulthood. We use data from the 1997 cohort of the National Longitudinal Survey of Youth to better understand these dynamics, examining how health condition and limitation statuses evolve during adolescence and young adulthood as well as how changes in these characteristics are related to survey nonresponse and attrition. Health condition and limitation dynamics are evident in our data: the proportion of sample members who reported having a limitation in their activities for any interview increased from approximately 12 % during the initial interview (when sample members were 12 to 17 years old) to almost 25 % 13 years later. Multivariate analyses revealed that women are more likely than men to report changes in health condition or limitation status. Those with mild limitations were relatively less likely than those without limitations or with severe limitations to experience changes in limitation status. Somewhat surprisingly, a survival analysis of survey participation outcomes found limited correlation among health conditions, limitations, and either missing a survey interview for the first time or permanently leaving the survey sample.

Disability and the Context of Boys' First Sexual Intercourse

PURPOSE

The context in which first sexual intercourse takes place has lasting implications for subsequent sexual behavior. This study examines how adolescent disability associates with boys' age of sexual debut, relationship at first sexual intercourse, degree of discussion about birth control before first sexual intercourse, and contraceptive use at first sexual intercourse.

METHODS

Data were used from the National Longitudinal Survey of Youth 1997, a nationally representative survey collected annually in the United States. Multinomial logistic regression of a base sample of 2,737 boys examines the likelihood of (1) sexual debut at ages 12-14, 15-17, or ≥18 years; (2) first intercourse with a stranger, casual acquaintance, dating partner, in a committed relationship, or in an undefined relationship; (3) level of discussion about birth control; (4) contraception; and (5) condom use among those who contracept.

RESULTS

Compared to boys without disability, those with learning or emotional conditions are more likely-and those with sensory conditions are less likely-to report very early sexual debut. Boys with chronic illness are both more likely to have sex in a committed relationship and in an undefined relationship and also more likely to contracept at first intercourse. Boys with learning or emotional conditions are more likely to discuss birth control but less likely to use condoms if they do contracept.

CONCLUSIONS

Boys with and without disabilities-and boys with different types of disabilities-vary significantly in multiple aspects of their first sexual experiences. It is pertinent that sexual health interventions are tailored to address this diversity.

Planning for motherhood: fertility attitudes, desires and intentions among women with disabilities

CONTEXT

An estimated 10% of U.S. women of reproductive age report a current disability; however, the relationship between disability, motherhood attitudes and fertility intentions among these women is largely unknown.

METHODS

Data from the 2006-2010 National Survey of Family Growth were used to examine attitudes toward motherhood and fertility intentions among 10,782 U.S. women aged 15-44. A series of regression models assessed, separately for mothers and childless women, associations between disability status and women's attitudes and intentions.

RESULTS

Women with and without disabilities held similar attitudes toward motherhood. Among women without children, women with and without disabilities were equally likely to want a child and equally likely to intend to have one. However, childless women with disabilities who wanted and intended to have a child were more likely to report uncertainty about those intentions than were childless women without disabilities (odds ratio, 1.7). Mothers with disabilities were more likely to want another child (1.5), but less likely to intend to have a child (0.5), than were mothers without disabilities.

CONCLUSIONS

Deepening understanding of the reproductive health desires, needs and challenges of women with disabilities is essential if the highest quality reproductive health services are to be provided for all.

Experiences with pregnancy of adolescents with disabilities from the perspectives of the school social workers who serve them

Adolescents with disabilities are more likely than adolescents without disabilities to become pregnant, although very little is known about the lived contexts of their sexual and pregnancy experiences. Such youths are often deprived of sexual health information across a range of potential sources, although school social workers are in a unique position to provide them services. Thirteen school social workers working primarily with adolescents with disabilities were interviewed using a phenomenological study design to offer their perspectives concerning the sexual and pregnancy experiences of such youths. Inductive content analysis revealed that school social workers provided services for pregnant and parenting adolescents with a range of disabilities in areas that included making decisions about sex, deciphering whether they were pregnant, and making decisions once they were pregnant. These experiences were complicated by cognitive impairments; emotional struggles; desires to fit in with peers; histories of sexual abuse; and issues with communication, self-esteem, and impulsivity. School social workers play an integral role in preventing pregnancy and supporting adolescents with disabilities who are pregnant. Recommendations pertaining to the provision of sexual health services for adolescents with disabilities are provided.