Time in childhood extracurricular activity and mental health of young adults with developmental disability.

BACKGROUND: People with developmental disability have higher rates of mental health problems such as anxiety, depression, psychological distress, or a limited sense of belonging to a community. Extracurricular activity can help children and adolescents build social connections beyond family, increasing social capital, which may promote mental health in the transition into adulthood. Little is known about such associations among people with developmental disability. OBJECTIVE: To examine associations of childhood extracurricular activity with mental health in young adulthood among people with and without developmental disability. METHODS: Data: Panel Study of Income Dynamics (PSID, 1968-2017), its Child Development Supplement (1997, 2002, 2007) and its Transition into Adulthood Supplement (2005-2019) (n = 2801). Time diaries measured time in activity. Outcomes were psychological distress (Kessler K6) and flourishing (Mental Health Continuum-Short Form). Adjusted linear regressions modeled associations. RESULTS: In nationally representative results, 9.6 % (95 % confidence interval, CI 7.8, 11.4) had a disability. Children without disability reported more average weekly time in group activity, 125.1 min (CI 113.2, 136.9) vs. 93.6 (CI 55.1, 132.0; not significant at conventional levels). In adjusted results, "some" group activity (0-180 weekly minutes) was associated with greater flourishing for those with developmental disability (0.89; CI 0.16, 1.61). CONCLUSIONS: Among people with developmental disability, group activity in childhood was associated with greater flourishing in young adulthood. More research is needed to understand the complex nature of activity participation for children with developmental disabilities.

"Eventually I'm gonna need people": Social capital among college students with developmental disability.

BACKGROUND AND AIMS: About 18% of college students have disabilities. Social capital, resources we can tap from relationships, may be particularly valuable for students with disabilities. Yet, disabilities often limit the individual's ability to develop or use social capital. We studied how college students with developmental disabilities understand, develop, and use social capital. METHODS AND PROCEDURES: We conducted in-depth semi-structured Zoom interviews with 10 women with developmental disabilities enrolled at a public university in the southeastern United States early in 2021. We examined the qualitative data with thematic analysis. OUTCOMES AND RESULTS: Participants averaged age 20; 70% reported attention deficit disorder or attention deficit hyperactivity disorder; 90% reported multiple diagnoses. Most participants described COVID-19 pandemic-related isolation and stress, which magnified both the need for relationships and awareness of that need, prompting participants to become proactive in forming and maintaining relationships despite anxiety about them. Themes were: foundational relationships, reciprocity, expanding horizons, a need for new relationships, focus on the future and relationship barriers. CONCLUSIONS AND IMPLICATIONS: Results highlight the importance of social relationships and the resources they provide to students with disabilities, particularly in stressful times. Colleges can help students by connecting them with others and providing strategies for building and maintaining social capital. WHAT THIS PAPER ADDS: College students with developmental disabilities often face challenges developing and maintaining social capital, resources derived from relationships with other people. These resources are key to success in school and after graduation, as students continue into adulthood. We studied how students with developmental disabilities build social capital. The students described their relationships with others and the types of support they contributed to and received from those relationships. We also extended previous research by examining pandemic-related effects, interviewing participants nearly one year into the COVID-19 pandemic. We provide recommendations for further research and ways colleges and universities can encourage social capital development among all students.

Identifying developmental disability in national surveys: Addressing the knowledge gap with special education histories.

BACKGROUND: In the United States nearly 20% of children ages 12-17 have developmental disorders. Some attain population-based developmental milestones after a delay, or increase functioning through special education, medication, technology, or therapy. Others have severe lasting impairments. An indicator identifying those groups in surveys of adults could help shape policies to improve lives. HYPOTHESES: We hypothesized that survey histories of special education could indicate functional status levels. METHODS: Data were from the nationally representative Panel Study of Income Dynamics (1997-2017, n = 2745). With measures of diagnoses, behaviors, functional status, service use, and adult outcomes, we tested three special education groups as indicators of: (1) no impairment (no special education), (2) disorders, developmental diagnoses that adversely affect educational performance, but with development after a period of delay or only moderate disability, indicated by transfer from special education; and (3) severe lasting disability, the diagnoses combined with life-long needs for supports or services, with limitations in areas including self-care, mobility, and capacity for independent living, indicated by special education in the individual's final year of school. RESULTS: Across the special education groups, from no impairment to severe lasting disability, there were trends of: increasing severe and lasting disability (respectively 4.8%, 35.6%, 76.4%); increasing special services use (13.5%, 43.1%, 83.7%); increasing severe emotional disorders (2.3%, 11.3%, 17.9%); lower percentages attaining at least an associate's degree by age 25 (42.1%, 20.7%, and 8.9%); and more chronic diseases. CONCLUSIONS: Special education histories provide a useful indicator of developmental disability impairment levels in adults.

Disability in Childhood, Special Education Histories, and Lifetime Health Outcomes in the United States.

Objectives: We evaluated special education as an indicator of childhood disability and used that indicator to estimate lifetime dependency and life expectancy. Methods: Data: Panel Study of Income Dynamics and Health and Retirement Study (n = 20,563). Dependency: Nursing home care or equivalent. Analysis: We first analyzed special education as an indicator of childhood disability; multinomial logistic Markov models and microsimulation then compared populations with and without childhood disability. Results: Special education history was a valid indicator of childhood disability. For example, with parents who did not complete high school, 3.8% with no special education history were dependent at least 5 years of adult life; that result with special education was 15.2%. Life expectancy from age 20 was 58.3 years without special education, 46.0 years with special education (both p < .05). Discussion: Special education history can indicate childhood disability. People with that history had significantly a more dependency than others and significantly shorter lives.

Mental health risks of parents of children with developmental disabilities: A nationally representative study in the United States.

BACKGROUND: Caring for a child with a developmental disability may affect parents' mental health. There are few longitudinal or nationally representative studies, none on new mental health problems. Studies have few young children, and few adult children. OBJECTIVE/HYPOTHESES: We hypothesized that parents of children with developmental disability would be more likely to develop mental health problems than other parents. METHODS: We used the Panel Study of Income Dynamics (PSID, 1997-2017) and its Child Development Supplements, defining developmental disability by diagnoses such as autism spectrum disorder or intellectual disability, and requiring additional evidence of lasting impairment. We linked children's and parents' data spanning 20 years, including 44,264 mental health measurements for 4024 parents of 7030 children. Discrete-time hazard analysis controlled for child and parent characteristics. RESULTS: About 9.4% of children had developmental disability. Parents of children with developmental disability were more likely to develop mental health problems than other parents. The odds of developing anxiety or depression were higher when an adult child with developmental disability lived independently, nearly 3 times higher for mothers (OR 2.89, CI 2.33-3.59) and more than twice as large for fathers (OR 2.35, CI 1.70-3.26). Compared to fathers whose children did not have developmental disability and challenging behaviors, the odds of psychological distress were over 7 times larger (odds ratio, OR 7.18, 95% confidence interval, CI, 5.37-9.61) for those whose children had developmental disability and challenging behaviors. CONCLUSIONS: Parents of children with developmental disability may benefit from increased emotional support, respite, and interventions addressing challenging behaviors.

Work-related asthma in the USA: nationally representative estimates with extended follow-up.

OBJECTIVE: We studied the associations of working in occupations with high asthma trigger exposures with the prevalence and incidence of asthma, and with ever reporting an asthma diagnosis throughout working life. METHODS: We used the nationally representative Panel Study of Income Dynamics (1968-2015; n=13 957; 205 498 person-years), with annual reports of occupation and asthma diagnoses across 48 years. We compared asthma outcomes in occupations likely to have asthma trigger exposures with those in occupations with limited trigger exposures. We estimated the prevalence ratios and the incidence risk ratios using log-binomial regression adjusted for age, sex, race/ethnicity, education, and current and past atopy and smoking, and accounting for the survey design and sampling weights. We calculated the attributable risk fractions and population attributable risks, and used multinomial logistic Markov models and microsimulation to estimate the percentage of people ever diagnosed with asthma during working life. RESULTS: The adjusted prevalence ratio comparing high-risk occupations with low-risk was 4.1 (95% CI 3.5 to 4.8); the adjusted risk ratio was 2.6 (CI 1.8 to 3.9). The attributable risk was 16.7% (CI 8.5 to 23.6); the population attributable risk was 11.3% (CI 5.0 to 17.2). In microsimulations, 14.9% (CI 13.4 to 16.3) with low trigger exposure risk reported asthma at least once, ages 18-65, compared with 23.9% (CI 22.3 to 26.0) with high exposure risk. CONCLUSION: Adults were more than twice as likely to report a new asthma diagnosis if their occupation involved asthma triggers. Work exposures to asthma triggers may cause or aggravate about 11% of all adult asthma and increase the risk of work-life asthma by 60%.

Severe developmental disability and the transition to adulthood.

BACKGROUND: Developmental disabilities are serious and long-lasting. There are few studies of developmental disability in the transition to adulthood, when the programs that provided support in childhood may no longer be available. OBJECTIVE: We studied associations of long-lasting developmental disabilities with health, behaviors, and well-being in adulthood. METHODS: We used the Panel Study of Income Dynamics (1968-2017), its Child Development Supplement (CDS, 1997, 2002, 2007), and its Transition into Adulthood Supplement (TAS, every-other year, 2005-2017) (n = 2702) following a national sample from childhood through age 28, defining serious developmental disabilities using diagnoses and reports from parents, teachers, schools, children, and young adults. We tested differences in proportions using Chi-square tests, estimated differences in least squares means, and used logistic regression to compare results for those with and without developmental disabilities. We adjusted results for age, sex, race, immigrant status, family income, region, metropolitan statistical area, educational attainment, and employment status, accounting for sampling weights and survey design. RESULTS: At ages 18-21, 8.2% had serious developmental disability (95% confidence interval, CI 6.6-9.8). They were more likely to report: no high school graduation (19.3% vs. 4.3%), being assaulted physically (32.1% vs. 20.4%) or sexually (14.4% vs. 6.6%), serious criminal arrests (25.7% vs. 13.2%), smoking (30.8% vs. 12.8%), sedentariness (5.8% vs. 1.1%), obesity (39.2% vs. 23.4%), diabetes (9.1% vs. 2.1%), and work disability (18.7% vs. 4.3%) (all p < 0.01) compared to peers without developmental disability. CONCLUSIONS: Results indicate opportunities to promote education, self-direction, safety, and well-being for people transitioning to adulthood with serious developmental disabilities.