Employment outcomes of adults who sustained spinal cord injuries as children or adolescents

Objectives: To determine employment outcomes of adults with pediatric-onset spinal cord injury (SCI) and factors associated with those outcomes. Design: Structured interview. including standardized measures. Setting: Community. Participants: Individuals who sustained an SCI at age 18 years or younger, were 24 years or older at follow-up. did not have a significant brain injury, and were living in the United States or Canada. A total of 195 subjects were interviewed. Mean age at injury was 14 years (0-18y), mean age at interview was 29 years (24-37y), and mean duration of injury was 15 years (7-28y). All participants had been enrolled in SCI programs. Interventions: Not applicable. Main Outcome Measures: A structured interview, the FIM(TM) instrument, the Craig Handicap Assessment and Recording Technique, the Medical Outcomes Study 12-Item Short-Form Health Survey, and the Satisfaction with Life Scale. Results: Of the participants, 99 (51%) were employed. 78 (40%) were unemployed, 12 (6%) were students, and 6 (3%) were homemakers. A predictive model of employment identified 4 factors associated with employment: education, community mobility, functional independence, and decreased medical complications. Other variables significantly associated with employment included community integration, independent driving, independent living, higher income, and life satisfaction. Conclusions: Compared with the general population. the high rate of unemployment among adults with pediatric-onset SCI is a cause for concern. Risk factors associated with adult unemployment provide guidelines for targeting rehabilitation resources and strategies.