Transition Planning Activities Research Articles

An Intervention to Promote Healthcare Transition Planning Among Pediatric Residents

PurposePoorly planned healthcare transition (HCT) from pediatric to adult-based care for adolescents and young adults with special healthcare needs (AYASHCN) is associated with increased morbidity and mortality. Most pediatricians and pediatric residents are not trained to assist AYASHCN with HCT planning. An electronic medical record-based Transition Planning Tool (TPT) was developed at a large children’s hospital to guide provider-patient interactions around HCT planning. The purpose of this study was to evaluate an educational intervention to promote residents’ use of the TPT. MethodsA multimodal (TPT training, demonstrations, use prompts, and case discussions) curriculum promoting the use of the TPT was developed and implemented within a one-month Adolescent Medicine Rotation. A prospective, nonrandomized, quasi-experimental design with Intervention and Historical Control groups was used. Forty-two residents received the intervention. Twenty-three Historical Control residents received minimal formal training in the TPT. Intervention Group residents completed prerotation/postrotation assessments measuring perceived importance of/comfort with HCT planning and self-reported HCT planning activities. TPT use was compared between the two groups. ResultsCompared to the Historical Control Group, Intervention Group residents were significantly more likely to use the TPT (98% vs. 37%, p < .001) and had a higher mean number of uses (5.5 ± 3.0 vs. 2.6 ± 1.2, p < .001). Residents reported greater perceived importance of (p < .001) and engagement in (p < .001) transition planning activities after completing the intervention. Nearly all (91%) reported that their training increased their comfort in HCT planning. ConclusionsA targeted intervention improved pediatric residents’ use of the TPT and HCT planning activities.

Transition Planning: Voices of Chinese and Vietnamese Parents of Youth With Autism and Intellectual Disabilities

Lack of family engagement in transition planning continues to be a challenge in special education. This study examined the experiences of Chinese and Vietnamese families of youth with disabilities toward transition planning. Results suggested that participants were eager to be engaged in the transition planning and valued the importance of transition planning activities. They wanted to ensure that their youth were equipped with skills, so they could lead a successful and independent adult life. However, schools provided little to no information regarding the transition planning process. This lack of information prevented them from being actively involved. Implications for future research and practice to enhance partnership between schools and diverse families in the development of transition planning are discussed.

Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction

An electronic medical record (EMR)-based transition planning tool (TPT) designed to facilitate transition from pediatric to adult-based health care for youth (16-25 years) with special health care needs was introduced at a large children's hospital. Activities to increase provider use were implemented in five plan-do-study-act cycles. Overall, 22 of 25 (88%) consenting providers in four pediatric subspecialty services used the TPT during 303 patient encounters, with nurses and case-managers the top users and physicians the least likely users. Use was highest with intensive technical assistance and following the introduction of an upgraded tool. Provider satisfaction with the TPT and self-reported transition planning activities notably increased across the PDSA cycles.

Parent Involvement in the Transition Process of Children With Intellectual Disabilities: The Influence of Inclusion on Parent Desires and Expectations for Postsecondary Education

AbstractStudents with disabilities and their families across the globe are increasingly setting postsecondary education (PSE) as a future goal, a relatively recent phenomenon. To supplement current knowledge on this goal, we studied parents' means of accessing information and the impact of K‐12 inclusive general education experiences on parents' desires and expectations for PSE. Key findings indicated that parents did not fully understand the transition process and had a low degree of knowledge and access to information about PSE. The data showed that levels of student inclusion related to parental desire and expectation for PSE and to parental involvement in transition planning activities. Implications for theory, measurement, practice, and public policy include a clear need for improved information and dissemination practices regarding PSE as a transition option. The data also imply that teacher education programs would be strengthened by the inclusion of information about PSE options.

Factors Influencing Physical Therapists' Involvement in Preschool Transitions

Families and children receiving early intervention services benefit from service provider involvement during the transition to preschool special education services. This study sought to determine the factors that physical therapists working in early intervention services and/or preschools identified as supportive of their involvement, and associated with their perceived involvement, in transition planning for young children with disabilities moving from early intervention to preschool services. A cross-sectional survey was used. A survey was mailed to a random sample of 600 members of the American Physical Therapy Association's Section on Pediatrics. Physical therapists working with children transitioning out of early intervention and into preschool participated. Data from physical therapists providing services in preschools were included in this study. The response rate was 56.3%. The highest- and lowest-ranked facilitators of transition planning were: "Staff at my preschool program value my participation in transition planning activities" (highest ranked) (X=5.02, SD=1.36, n=142) and "I am encouraged to participate in transition planning activities by the early intervention service coordinator" (lowest ranked) (X=1.91, SD=3.50, n=143). Multivariate regression models demonstrated that physical therapists' perceived value and expertise in providing transition planning services were significantly associated with collaboration with professionals from early intervention programs (F(1,129)=207) and support of families during the transition process (F(1,134)=48). Physical therapists who identified implementing practices that supported communication, collaboration, and strong, positive relationships between early intervention and preschool programs had greater involvement in the transition planning process.

Mandates and Effective Transition Planning Practices Reflected in IEPs

In this study, the researchers analyzed the transition components of 399 Individualized Education Programs (IEPs). In many cases, transition goal areas mandated by the 1997 amendments to the Individuals with Disabilities Education Act (IDEA) either were not addressed or were inadequately detailed. Effective practices, such as career planning and self-determination enhancement, were not incorporated within most plans, and the study indicated that students frequently were solely responsible for carrying out action steps to achieve their transition goals. Race and gender were not significant determinants of plan quality; however, disability type, projected diploma type, and district residence were associated with variations in transition planning activities. The authors discuss the implications of the findings relative to enhancing student preparation for adult life as envisioned by the 2004 reauthorization of IDEA.

The Role of Assessment in the Transition to Adult Life Process for Students With Disabilities

Students with disabilities must have a statement of transition service needs in their individualized education programs (IEPs) by age 14. Transition service needs must be based on students' needs, preferences, and interests. Transition assessment is an ongoing process that can help students with disabilities gain an understanding of their needs, interests, and preferences in relation to educational, vocational, and postschool environments. In addition, it can provide secondary personnel with a framework to meet the mandates for transition services in the Individuals with Disabilities Education Act Amendments of 1997. The legislative foundation, purposes, and uses of transition assessment in the middle and high school years are discussed in relation to transition planning. In addition, the competencies needed by personnel involved in this assessment process are highlighted along with IEP team members who may be involved in transition planning activities.

TAKE CHARGE for the Future: A Controlled Field-Test of a Model to Promote Student Involvement in Transition Planning

This study investigated the efficacy of an intervention model to promote student involvement in transition planning. The intervention included the coaching of youths in the application of student-directed planning skills to achieve transition goals, peer-based mentorship and parent support, and in-service education for school transition staff. An independent groups, repeated measures design was used to evaluate the impact of the intervention with 43 youth who experienced diverse disabilities. Results indicated that students in the treatment group demonstrated significant increases in their involvement in transition planning activities, empowerment, transition awareness, and level of participation in transition planning meetings compared with youths in the wait-list or control group. Implications of these findings are discussed and the need for additional research emphasized.

Multicultural Aspects of Parent Involvement in Transition Planning

This study surveyed 308 African-American, Hispanic-American, Native-American and European-American parents to assess their level of participation in various transition planning activities and how important each activity was to them. In addition, 52 school professionals completed a parallel survey of their perceptions toward parent participation. Analyses indicate that culturally and linguistically diverse parents are active in the transition process and, in some instances, their level of reported participation surpassed that of European-American parents. In contrast, professionals described culturally and linguistically diverse parents as less involved than European-American parents in the majority of transition activities. The results are discussed in terms of how the participation of culturally and linguistically diverse parents can be better supported and the importance of transition planning extending beyond school to include other life domains.

Enterprise architecture: agile transition and implementation

In our previous articles, we made the case for having an enterprise architecture and discussed the first phases of an architecture development process. The second article concentrated on describing the baseline architecture and defining the target architecture. We complete our discussion of the methodology by focusing on transition and implementation planning. Transition planning focuses on deriving a time-phased set of actions to achieve a given goal-in this case, implementation of the target architecture. Large organizations will remediate, renovate, or replace many systems concurrently. In doing so, they must recognize interdependencies among systems and accommodate them in activity scheduling. Implementation planning has a different time frame and a different audience. It maps resources (people, places, things, and funding) to transition planning activities.