Young people with physical disabilities such as cerebral palsy, spina bifida, traumatic brain injury, or degenerative neuromuscular disease often have difficulty attaining independence in adult life--consequently they often need lifelong support from parents and from health-care and social-care services; however there is a lack of evidence comparing the impact and cost-effectiveness of these various support services.
Alan Tennant from the University of Leeds, UK, and colleagues compared the effect of a young adult team (YAT) approach with the ad hoc service approach in four locations in England--Leeds, Birmingham, Stoke on Trent, and Leicester--in terms of their ability to enhance the participation of young disabled people in society. A YAT approach involves multidisciplinary specialist teams developed specifically to help in the transition from childhood to adulthood disability services, typically including a consultant in rehabilitation medicine, a psychologist, therapists, and a social worker.
Around 250 young disabled people (average age 20 years) were interviewed to establish the type of transitional service received (YAT or ad hoc), and to assess their degree of participation in society. Young disabled people given YAT services were 2.5 times more likely to participate in a range of activities than those given ad hoc support services--and cost-effectiveness analysis showed no difference between these two forms of support.
Alan Tennant comments: "The implication of these findings is that the way in which services are organised can make a difference to the participation of young adults with physical disabilities. Introducing multidisciplinary teams who offer a coordinated response to the needs of these young people can, at no extra cost, make a difference to their everyday lives."
In an accompanying Commentary (p 1264), Gunnar Grimby from Göteborg University, Sweden, concludes: "In the UK, and most likely in other countries, there is a lack of coordinated multidisciplinary teams for young adults with physical disabilities...The report by Bent and colleagues should be used to stimulate having YAT teams available for all young adults with disability, either with continuous responsibility for certain patients or as a resource with the family physician for other patients with less need of a specialised team."
Contact: Professor Alan Tennant, Academic Unit of Musculoskeletal and Rehabilitation Medicine,
University of Leeds, 36 Clarendon Road, Leeds LS2 9NZ, UK;
Professor Gunnar Grimby, Department of Rehabilitation Medicine,
Sahlgrenska Academy at Göteborg University, SE-413 45 Göteborg, Sweden;