In this issue of Topics in Language Disorders, the authors are responding to a question that those involved with the education of children with disabilities must continually ask "What is next for these children as they grow into adulthood?" Children with language and social communication disorders in the United States receive special services and accommodations that support many to graduate from high school with the fundamental abilities in place needed for success in postsecondary education. Gone are the days when a language-related disorder necessitated scaling back plans for college, and in many populations affected by language impairments, sights are set on achieving a college degree.
Navigating the transition to adulthood is a challenge for both those with and without disabilities. As Frink, Whitmire, and Bogdan (2015) in their overview article in this issue point out, there is a changing landscape of young adulthood in industrialized societies; evolving economic and social factors have resulted in a reassessment of developmental stages. A stage now termed "emerging adulthood" encompasses those in the 18-29 years age demographic because the length of time it takes to establish economic independence has lengthened. If adulthood poses great challenges for individuals with no history of language and learning challenges, the obstacles faced by those with such impairments are even more daunting. The aim of this issue is to add to the emerging literature on supports for young adults with language disorders, with a specific emphasis on autism spectrum disorders (ASD), and on the transition to college.
Language impairments have a broad-ranging impact on an individual, and many individuals with language disorders and language learning disabilities have comorbid psychiatric disorders, including attention-deficit disorder as well as mood disorders. They may struggle more than their peers with independence and complex problem solving because of their history of language disorders, leaving them with fewer resources to draw on and/or because of these concomitant psychological disorders.
As discussed by Frink et al., there is a sharp drop-off in access to support services post-high school; in the United States, there is also a major change in the legal environment. Because of this, Frink et al. advocate for enhanced curricula and services targeted at developing critical prerequisite abilities not only for fundamental abilities such as language and literacy but also for the broader skill sets of self-advocacy and real-world problem solving. Hewitt references these aspects in her suggestions for assessment, and both the transition programming described by Retherford and Schreiber and the college supports reported by Weiss and Rohland emphasize the importance of considering more than just language and social communication in assisting individuals with language disorders and autism in college success.
Three of this issue's articles focus on ASD in particular. The literature on the outcomes for individuals with ASD is particularly concerning. Many young adults with ASD earn high school diplomas and seek to further their educations in colleges and universities. Yet, despite high attainments and relative independence (i.e., classifiable as Level 1 in DSM-V, least need for supports; American Psychiatric Association, 2013), students on the spectrum are less likely than their peers to be either employed or in college. Research on outcomes for adults with ASD shows continuing struggles, with low levels of educational and vocational success coupled with significant psychological disabilities (Farley et al., 2009; Howlin & Moss, 2012; Howlin, Moss, Savage, & Rutter, 2013; Howlin, Savage, Moss, Tempier, & Rutter, 2014; Levy & Perry, 2011; Roux et al., 2013; Shattuck, Wagner, Narendorf, Sterzing, & Hensley, 2011; Shattuck et al., 2012). Howlin and Moss's (2012) systematic review showed that across studies the mean proportion of adults sampled who had living situations and outcomes rated as good to very good was just 20%. Without question, many adults on the spectrum have a good quality of life, but the unfortunate fact is that a substantial number of adults with ASD are not living independently and/or are experiencing substantial dissatisfaction with their social, educational, and vocational success. Outcomes for individuals with less severe disorders such as developmental language impairments may be somewhat better but still below that of typically developing peers.
Speech-language pathologists have the knowledge and skills to assist individuals with persisting developmental language and related disorders, but current practices tend to result in a steep drop-off in services available post-high school. Readers of this issue of Topics in Language Disorders will notice that all the authors have extensive clinical experience serving the population of students with language learning impairments, ASD, and related disabilities; thus all bring a strong sense of mission to the topic, based on encounters with those who are not being well served by the current system.
Frink et al. describe how the requirement of equal access for persons with disabilities under federal law is insufficient for many and advocate for wider access to services critical to student success. They also advocate for changes in awareness of the needs of students with language learning disabilities among professionals in higher education. They argue that an evolution that might enhance learning for all would be to implement the ideals of Universal Design for Learning in the higher education environment. Richards tackles the topic of college-age literacy; clearly, difficulty in higher order literacy may pose insurmountable barriers to college success in any population. Although the normative clinical literature on this population is sparse, Richards pulls together a range of materials that can direct clinicians who seek to support literacy in young adults with language impairments. Hewitt describes the elements of a comprehensive assessment in designing effective interventions and supports, based on the scientific and clinical literature and understanding of fundamental challenges experienced by individuals on the autism spectrum. Retherford and Schreiber describe an innovative transition to college program that is a collaboration among various university departments and programs, as well as local agencies and businesses. Weiss and Rohland describe one university's response to the challenge of serving individuals on the autism spectrum by setting up specialized programming in collaboration between the university's communication sciences and disorders department and the office of disabilities services.
The common theme to all these articles is that effective supports for individuals with language-related disabilities who attend college are possible but often are not available to many or even most who need them. For the individuals concerned, their families, and indeed for society at large, successful outcomes in educational attainment and ultimate vocational success are more than just a desirable goal. Without independence and economic self-determination, the individuals' quality of life will suffer, families' resources will be taxed, and society will feel the added strain of having to provide financial and other resources to persons not able to live independently. There are many with severe, lifelong disorders who cannot aspire to such independence, but for the many others affected by language disorders who could be thriving and independent citizens, given the right supports at the right times, we are challenged as a society to develop innovations that will enable these optimal outcomes. The articles in this issue aspire to provide information that will guide us toward models of service delivery that address these needs and bring us some way closer to a future where services do not decrease abruptly at high school graduation. The contributors to this issue advocate for society and our profession to find a way to provide individualized assistance to help every student able and willing to attend college to realize their educational aspirations and achieve their life goals.
-Lynne E. Hewitt, PhD
Bowling Green State University
Bowling Green, Ohio
-Amy L. Weiss, PhD
University of Rhode Island
Kingston, Rhode Island
Issue Co-Editors
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