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3 Health and Functioning Outcomes for Children with Disabilities
Pages 73-90

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From page 73...
... However, it is important to note that many children with severe disabilities will never achieve optimal outcomes: their health may improve, but they may never be considered healthy; they may meet their daily needs or engage in competitive employment only with significant supports; and they may never fully act as the causal agent in their lives, even with a great deal of support. Therefore, positive health and functioning outcomes should not simply be equated with the absence of disability or elimination of the need for services and programs aimed at improving the lives of those with disabilities.
From page 74...
... Social and human capital development outcomes encompass seven outcome domains spanning the child's life from school entry through the transition to adulthood: education, skills for daily living, communication and social skills, employment and earnings, community participation, self-determination, and independent living. Optimal outcomes in the health domain and the social and human capital domain and potential indicators for measuring progress are described in turn in the next two sections.
From page 75...
... Successful long-term health outcomes are achieved when a child is able to reach her or his optimal health potential. Optimal outcomes in this domain include increased emotional and behavioral strengths, the ability to regulate emotional and cognitive states, the development of healthy eating habits, regular engagement in physical activity, and resilience.
From page 76...
... • Health potential - Emotional and behavioral strengths - Nutritional habits - Physical fitness activity levels - Resilience - Health-related quality of life severity of acute illnesses,1 limiting secondary and tertiary impairments that may occur as complications of the original impairment, mitigating the accumulation of disability related to the impairment, improving gross and fine motor skills, meeting recommended weight and body mass, and improving psychological and cognitive functioning. In addition to outcomes related directly to body structures and their functions, outcomes in this domain are also often discussed in relation to their impact on daily life.
From page 77...
... The Building Blocks of Childhood: Education, Daily Living Skills, and Communication and Social Skills A primary goal of childhood is to develop the skills required to be healthy and active, independent, and engaged in one's community to the extent desired and to serve as the causal agent in one's life (Heckhausen et al., 2010; NASEM, 2016)
From page 78...
... . In addition to these discrete skills, daily living skills include the ability to organize a relevant set of activities into a routine and to problemsolve and adapt to unexpected circumstances (Kao et al., 2015)
From page 79...
... Optimal long-term outcomes include developing social competence, being able to build leadership skills, working productively with others (McHolm et al., 2005) , forming positive relationships, and engaging in effective conflict resolution.
From page 80...
... • Enrollment and persistence in postsecondary education • Postsecondary degree Daily Living Skills • Mastery of self-care activities • Ability to organize activities • Ability to develop and maintain a daily routine • Ability to adapt to unexpected or changing circumstances Communication and Social Skills • Speech perception and production • Semantic and pragmatic language skills • Relationship development and maintenance skills •  onflict resolution C • Leadership • Teamwork The Transition to Adulthood: Self-Determination, Employment and Earnings, Community Participation, and Independent Living During adolescence, children with disabilities reach a particularly salient period of life as they prepare to transition to adulthood. "Transition" as it relates to youth with disabilities has been defined as "a significant change or set of changes in a person's life circumstances during a relatively limited time period rather than over the life span" (IOM, 2007, p.
From page 81...
... The four primary outcome domains during this period identified above -- self-determination, employment and earnings, community participation, and independent living -- are discussed in turn below. Self-Determination Self-determination is increasingly understood to be an important individual-level, long-term goal, particularly in the context of the transition from high school to the workplace or higher education.
From page 82...
... found that autonomy, a construct of self-determination, was linked to greater financial independence, employment, social relationships, housing, and positive postsecondary education outcomes among children with high-incidence disabilities (learning disabilities, emotional disturbances, speech or language impairments, and other health impairments) , and to higher levels of independent living for people with intellectual and sensory disabilities.
From page 83...
... . Not all adults with disabilities will fully achieve independent living; enabling them to rely on adult disability services and vocational and professional/communication skills gained through education and job training programs can develop personal characteristics (e.g., confidence, competence)
From page 84...
... As noted previously, community participation is also an important outcome for adults with disabilities, and thus should be considered a long-term outcome for children to achieve as well. In the field of psychiatric disabilities, Kaplan and colleagues (2012)
From page 85...
... The latter domain encompasses education, skills for daily living, communication and social skills, self-determination, employment and earnings, community participation, 7  is important to acknowledge that for many young adults with severe disabilities, fully It independent living, as opposed to assisted community living, is not a reasonable goal.
From page 86...
... The transition to adulthood presents special challenges for youth with disabilities, and near-term outcomes during this period can greatly impact these youth's long-term health outcomes. Based on its examination of optimal health and functioning outcomes for children with disabilities, the committee drew the following conclusions: 3-1.
From page 87...
... In the ensuing chapters, this report examines a variety of services and programs focused on health care and social and human capital development that are designed to help children with disabilities achieve the optimal health and functioning outcomes and avoid the negative outcomes discussed in this chapter. REFERENCES Baron-Cohen, S
From page 88...
... 2012. Community participation as a predictor of recovery-oriented outcomes among emerging and mature adults with mental illnesses.
From page 89...
... samhsa.gov/Docs/Literatures/NREPP%20Learning%20Center%20Literature%20%20 Review_Transition-age%20Youth.pdf (accessed January 10, 2018)
From page 90...
... 90 IMPROVING SERVICES FOR CHILDREN WITH DISABILITIES Wimmer, H., and J Perner.


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