Stability of transition to adulthood among individuals with pediatric-onset spinal cord injuries

Background/Objective: Cross-sectional studies have provided information about the outcomes of adults with pediatric-onset spinal cord injuries (SCIs), but there has been no information about the stability of those outcomes over time. The purpose of this study was to assess the stability of independent living, employment, and life satisfaction and to determine factors associated with stable, successful outcomes. Methods: Structured interviews of individuals who had sustained an SCI at age 18 years or younger and were 24 years or older at first interview. The primary standardized measures used include the Functional Independence Measure, Craig Handicap Assessment and Recording Technique (CHART), Short-Form 12 measure of perceived health, and the Satisfaction with Life Scale. Results: One hundred sixty-six individuals had 3 consecutive annual interviews. Mean age at interview was 29 years (range, 24-36 years). Of this group, 64% lived independently at the first interview, and 90% of those continued to live independently; 64% were employed at first interview, of which 83% continued to be employed; and 48% reported life satisfaction at the first interview, and 84% of these continued to be satisfied. Factors most closely associated with stable independent living were CHART subscales of physical independence, mobility, and occupation. Factors associated with stable employment were sex, race, independent living, CHART mobility, and cognitive independence. Factors associated with stable life satisfaction were CHART occupation subscale and fewer pressure ulcers. Conclusions: Many individuals with pediatric-onset SCI achieve successful, stable adult outcomes. The factors associated with that success can help us improve rehabilitation for future patients.