Abstract

Objective: In Australia, the National Disability Strategy provides a framework to guide actions and investment to achieve equity in social inclusion and economic participation for people with disability. We investigated the social outcomes of school leavers with cerebral palsy (CP) in Victoria, Australia and explored the determinants of desirable outcomes.Methods: We used the Victorian CP Register to invite all adults with CP aged 18–25 years (n = 649). On-line and/or paper-based surveys explored participation in education, employment, community activities, living situation, relationships and life satisfaction. Functional and health status data were collected. Social outcomes were summarized descriptively and compared between individuals with CP and non-disabled peers aged 18–25 years from the Household Income and Labor Dynamics in Australia dataset. Within the CP cohort we explored whether physical and mental health and level of functioning were associated with social outcomes. In addition, a descriptive comparison was undertaken between the social outcomes of the current CP cohort with that of a previously reported 2007 cohort.Results: Ninety participants (57% male; mean age 22.4 years (SD: 2.2) in 2020; 61.1% self-reported) provided data for analyses; response rate 16.9%. CP characteristics were similar between respondents and non-respondents. In comparison to similar aged peers, 79.8% had completed secondary school (compared to 83.2%); 32.6% (compared to 75.8%) were in paid work; 87.5% (compared to 48.2%) were living in their parental home; and 3.4% (compared to 31.6%) were married or partnered. Individuals with CP and higher levels of functional capacity and better physical health were more likely to undertake post-secondary education. Higher levels of functional capacity and physical health, as well as lower mental health status were associated with being employed.Conclusions: While foundational education completion rates were similar to non-disabled peers, significant gaps in social outcomes remain, including residence in the parental home and single status. While addressing these issues is challenging, substantial efforts are needed to reduce these disparities—work that needs to be done in collaboration with people with CP and their families.

Highlights

  • Adults with cerebral palsy (CP) experience social and economic inequalities and challenges [1,2,3], related to impairments associated with CP [4], societal barriers such as discrimination, and a lack of accommodations they require to cater for their needs [5, 6]

  • We investigated the social outcomes of school leavers with cerebral palsy (CP) in Victoria, Australia and explored the determinants of desirable outcomes

  • Within the CP cohort we explored whether physical and mental health and level of functioning were associated with social outcomes

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Summary

Introduction

Adults with cerebral palsy (CP) experience social and economic inequalities and challenges [1,2,3], related to impairments associated with CP [4], societal barriers such as discrimination, and a lack of accommodations they require to cater for their needs [5, 6]. There is evidence that participation in life situations becomes more challenging as children with CP transition to adulthood. As their social roles change, they expect and desire to participate in common adult activities such as employment, further education, independent living and intimate relationships [7]. While prognostic data is most commonly found in studies of children, more recent research that has focused on adults, confirms the epidemiology of ongoing functional impacts of CP into adulthood [10]. Given that in Australia over 75% of the estimated 35,500 individuals who have CP are adults [11], evidence of outcomes for Australian adults with CP is needed

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