The impact of transition to adulthood on health and wellbeing in young people with intellectual disabilities

Young-Southward, Genevieve (2018) The impact of transition to adulthood on health and wellbeing in young people with intellectual disabilities. PhD thesis, University of Glasgow.

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Abstract

Background: Transition to adulthood is recognised to be a difficult period for young people with intellectual disabilities, and there is evidence to suggest that outcomes across vocational and social domains may be worse for this population compared to the typically developing population. It is possible that the turbulence of the organisational transition to adulthood, including leaving school and entering adult services, combined with the social aspects of becoming an ‘adult’ may conspire to result in negative health outcomes during transition. Despite significant concern being attached to the transition period in both the scientific literature and governmental policy, there is little evidence on health outcomes during this period in the population with intellectual disabilities. Aims: (1) To investigate whether transition to adulthood affects health and wellbeing in young people with intellectual disabilities, and in what particular ways; (2) to investigate whether the impact of transition on health and wellbeing is similar or different for young people with intellectual disabilities compared to those without intellectual disabilities; (3) to investigate whether the impact of transition on health and wellbeing is similar or different for young people with profound and multiple intellectual disabilities, compared with those with mild to moderate intellectual disabilities; (4) to identify what supports are helpful for families undergoing transition. Method: A systematic review of the literature on health and wellbeing during transition to adulthood for young people with intellectual disabilities, and a mixed methods project, utilising both quantitative and qualitative methodologies. Secondary analysis of Scotland’s Census (2011) was conducted in order to compare health outcomes between the populations with and without intellectual disabilities undergoing transition. The Census data was then further analysed to compare health in young people with intellectual disabilities who were still in school (aged 13-18 years) with that of those who had transitioned from school (aged 19-24 years). Additionally, semi-structured interviews were conducted with young people with intellectual disabilities (n = 17) aged 16-27 years, and with parents of young people with intellectual disabilities (n = 23) aged 16-26 years, in order to uncover insights into the experience of transition from multiple perspectives. Additionally, an ethnographic study of a service for young adults with intellectual disabilities undergoing transition was completed. Interview transcripts and the ethnographic field diary were analysed using thematic analysis, deploying both emic and etic coding categories. Results: Across all of the health outcomes investigated through the Census (2011) analysis, those with intellectual disabilities fared worse compared to those without intellectual disabilities. Mental health was significantly worse in the population with intellectual disabilities who had left school compared to those who were still in school. The qualitative studies revealed transition to be an anxious time for young people with intellectual disabilities, with many experiencing significantly increased anxiety during the period prior to and following school exit. This phenomenon was attributed to a lack of post-school meaningful activity; inadequate organised support during the transition to adulthood; and complex issues associated with ‘growing up’ with intellectual disabilities. Additionally, parents raised concerns regarding their children’s post-school weight gain, which was also attributed to a lack of post-school daytime activity, contributing to a more sedentary lifestyle. Conclusions: Health in the population with intellectual disabilities undergoing transition to adulthood is poor, and significantly worse than in the typically developing population. Mental health especially may be negatively affected by the experience of transitioning to adulthood, and changes in lifestyle following school exit may result in weight gain leading to obesity and secondary health conditions. Improving support during transition to adulthood, as well as increasing the availability of post-school opportunities for meaningful activity, may help to combat these negative health and wellbeing phenomena. Future research should include a longitudinal study following a representative sample of young people with intellectual disabilities throughout the course of transition to adulthood in order to clarify the ways in which this important life period affects health and wellbeing.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Intellectual disabilities, transition, health, wellbeing.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Funder's Name: UNSPECIFIED
Supervisor's Name: Cooper, Professor Sally-Ann
Date of Award: 2018
Depositing User: Dr Genevieve Young-Southward
Unique ID: glathesis:2018-8675
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 17 Jan 2018 14:23
Last Modified: 02 Mar 2018 13:13
URI: http://theses.gla.ac.uk/id/eprint/8675
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