Book Review “Disability in Adolescence”

Although not a quick or leisurely read, Disability in Adolescence is a helpful resource for those looking to understand the human experience of disability in the period before the implementation of the Americans with Disabilities Act in 1990 and similar international legislation. First published in 1982, Disability in Adolescence follows 150 teens with spina bifida, cerebral palsy, and hydrocephalus through the transition from their school-age years to adulthood. It is part of a 19-book series entitled Routledge Library Editions: The Adolescent. Notably, the study from which the book was written was performed in England between 1976 and 1979, which limits the generalizability of some of the findings noted, though not all. Fifty years after the study began, many of the frustrations related to transitioning from the school system to the graduate education system or employment remain the same. Another factor that may limit the applications of this work to the difficulties faced by today's adolescents with disabilities is the fact that the study only included adolescents whose intelligence quotient (IQ) was estimated to be 70 or above, thus excluding the voices of patients with comorbid intellectual disabilities. The text itself is well-written but dense, predominantly presenting findings from the authors' qualitative research on the transition to adulthood for their cohort of patients with predominantly physical disabilities. The book is divided into 3 sections: (1) the last years at school, (2) the transition from school to adult life, and (3) support from society and the family. This book provides insight into adolescents' worries about the future, their ability to find love, and their ability to start families of their own in the form of direct quotations. These quotes from adolescents and their parents are perhaps the most valuable part of the book for clinicians. They serve as reminders that adolescents with disabilities often have big questions that they are too afraid to ask and reinforce the idea that health care providers can facilitate discussions around these bigger life questions. In general, although initially published over 40 years ago, Disability in Adolescence provides an in-depth look at the unique experience of becoming an adult with a disability and the critical role that an individual's social network and the larger societal infrastructure play in enhancing independence and quality of life. The text reinforces the importance of concepts with which many of today's practitioners are familiar. The authors found that those adolescents with "typical" school placements or more socially inclusive postgraduate positions often were more satisfied than their peers who were placed in "special schools" or more isolating postgraduate positions. Accessibility, inclusion, degree of social contact, and level of independence remain the largest factors contributing to mental well-being for adolescents with disabilities in this work. Thus, this text is a good addition for those physicians, nurse practitioners, social workers, therapists, and psychologists interested in understanding the history and importance of accessibility and inclusion in schools and in the community. However, one who is searching for tangible practice changes related to the transition care for their adolescent patients with disabilities should consider turning to a different, more recent publication.