NADD U.S. Policy Update (from the NADD Bulletin Volume XII Number 6)

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School to Adult Transitions at Vanderbilt Program Description


Bruce E. Davis, Ph.D., LPC, SrLPE, BCBA, School to Adult Transitions at Vanderbilt


The transition from adolescence to adulthood is a difficult process under the best of circumstances.  Decisions have to be made and responsibilities have to be taken that may dramatically alter the course of a person's life.  The difficulty is magnified when the person experiencing the transition has multiple or severe disabilities.  The failure to properly plan for and address transition issues sets the stage for more intense difficulties later in life.


Educational services for persons with intellectual disabilities end between the ages of 18 and 22.  The Individuals with Disabilities Education Improvement Act (IDEA) 2004 requires transition planning for persons with intellectual disabilities, but many individuals leave school with no particular planning for the future.  When parents are unaware of their rights or the consequences of their decisions, they allow students to graduate early only to be relegated to an inactive and unstructured life at home.  This type of sedentary lifestyle fosters difficulties including those associated with behavioral health problems and mental illness.


In the School to Adult Transitions at Vanderbilt (SAT-V) program, 93% of persons aged 17 to 25 who enter services have significant problems with self-esteem and few psychological strengths.  When this type of discouragement is projected into the future, it is no wonder that people tend to develop difficult or unmanageable behavior.  One of the crucial needs for every adolescent with a disability is the belief that they can have a meaningful life.  Early adulthood is the precise time of life when many people begin to lose hope that many of their dreams will ever be fulfilled. 


At the basis of any service structure must be some process by which kids get the encouragement they need during this critical period.  Families are generally the source of this type of encouragement, but they frequently don't have the information they need to help their child be successful.  Unfortunately, they too are often discouraged about what their child can accomplish. In the SAT-V program we address this issue through consultation with the family.  By meeting with them on a regular basis, we can make them aware of the resources that exist for their child and help them set a course for the future. 


Another of the central issues faced by persons in transition is that after the school years they are left without any productive daily activity.  Over 70% of the individuals coming to SAT-V have difficulties with obtaining employment or even a structured day activity.  The question here should not be "whether" a person with a disability can have a meaningful day, but rather "how" a person can have a meaningful day.  Families frequently need assistance to know how their loved one can be successful in a work setting.  Competent professionals who know the employment landscape for people with disabilities are an essential component to identifying job opportunities and providing job training. 


Mental health services are also important for many persons in transition.  It is equally important that the services be appropriate to the person's need.  Most service systems still do not have enough mental health practitioners who are skilled in providing services to persons with intellectual disabilities.  The problem stems not just from failures of state agencies, but also the failures of universities to provide adequate training.  Psychiatrists, psychologists, social workers, and professional counselors often complete their courses of study with little or no exposure to the problems of people with intellectual disabilities.  SAT-V has begun to address the problem by offering internship opportunities for graduate students in psychology and special education.  This is a good start, but more must be done to ensure that coursework and experience in intellectual disabilities become more ubiquitous in university training.


Persons with disabilities experience gaps in services across the developmental spectrum, but those experienced by persons in post-secondary transition are some of the most glaring.  The movement from the educational system to other systems of support is anything but seamless.  As we set out to improve the service system we must ensure that transition needs are addressed in thoughtful and effective manner. 


The School to Adult Transitions at Vanderbilt program is a joint project between the Vanderbilt Kennedy Center and the Vanderbilt University Department of Psychiatry.  The program is funded by a grant from the John Merck Fund.


For further information, contact Dr. Davis at


The "U.S. Public Policy Update" is an ongoing column in The NADD Bulletin.  We welcome your comments and submissions for this column.  To learn more or to contribute to this column you may contact Joan Beasley, Editor of the U.S. Public Policy Update at