Abstract
This article reviews studies that depict the developmental transition from adolescence to young adulthood of persons who have experienced serious emotional disturbance (SED) as children or adolescents. The literature demonstrates that their plight in young adulthood is grave. Youth with SED enter the transition phase delayed in their developmental maturation and face additional challenges relative to their nondisabled peers. As a group, they are undereducated, underemployed, and have limited social supports. Homelessness, criminal activity, and drug use are prevalent. This article defines the transitional youth population, describes the developmental tasks of transition, and summarizes the results of longitudinal studies that have tracked functional outcomes of transitional youth into young adulthood. The discussion focuses on the relevance of these findings to service provision.
Similar content being viewed by others
References
Davis M, Vander Stoep A:The Transition to Adulthood Among Adolescents Who Have Serious Emotional Disturbances: At Risk for Homelessness. Delmar, NY: National Resource Center on Homelessness and Mental Illness, 1996.
Clark H, Unger K, Stewart E: Transition of youth and young adults with emotional/behavioral disorders into employment, education and independent living.Community Alternatives International Journal of Family Care 1993; 5:21–46.
Wagner M: Outcomes for youths with serious emotional disturbance in secondary school and early adulthood.The Future of Children: Critical Issues for Children and Youths 1995; 5:90–112.
Mallory B: The role of social policy in life-cycle transition.Exceptional Children 1995; 62:213–233.
Bazelon Center for Mental Health Law.Federal Definitions of Children With Emotional Disorders. Washington, DC: Bazelon Center for Mental Health Law, 1993.
Clarizio H: Social maladjustment and emotional disturbance: Problems and positions I.Psychology in the Schools 1992; 29:131–140.
Forness S, Kavale K, Lopez M: Conduct disorders in school: Special education eligibility and comorbidity.Journal of Emotional and Behavioral Disorders 1993; 1:101–108.
Davis M, Yelton S, Katz-Leavy J, et al.: “Unclaimed Children” revisited: The status of state children's mental health service systems.Journal of Mental Health Administration 1995; 22:147–166.
Friedman B, Katz-Leavy J, Manderscheid R, et al.: Prevalence of serious emotional disturbance in children and adolescents. Unpublished manuscript, 1996.
U.S. Department of Commerce, Bureau of Census:Statistical Abstract of the United States: 1994. 114th ed. Washington, DC: U.S. Department of Commerce, 1994.
Costello EJ, Janieszewski S: Who gets treated? Factors associated with referral in children with psychiatric disorders.Acta Psychiatrica Scandinavica 1990; 81:523–529.
Knitzer J:Unclaimed Children: The Failure of Public Responsibility to Children and Adolescents in Need of Mental Health Services. Washington, DC: Children's Defense Fund, 1983.
Koot H, Verhulst F: Predication of children's referral to mental health and special education services from earlier adjustment.Journal of Child Psychology and Psychiatry and Allied Disciplines 1992; 33:717–729.
Offord D, Boyle M, Szatmari P, et al.: Ontario child health study: II. Six-month prevalence of disorder and rates of service utilization.Archives of General Psychiatry 1987; 44:832–836.
Realmuto G, Bernstein G, Maglothin M, et al.: Patterns of utilization of outpatient mental health services by children and adolescents.Hospital and Community Psychiatry 1992; 43:1218–1223.
Halfon N, Simms M: The health care needs of children in foster care: A research agenda.Child Welfare 1994; 73(5):505–524.
McIntyre A, Keesler, T: Psychological disorders among foster children.Journal of Clinical Child Psychology 1986; 15:297–303.
Thompson A, Fuhr D: Emotional disturbance in fifty children in the care of a child welfare system.Journal of Social Service Research 1992; 15:95–112.
Trupin E, Tarico V, Low B, et al.: Children on child protective service caseloads: Prevalence and nature of serious emotional disturbance.Child Abuse and Neglect 1993; 17:345–355.
U.S. Department of Education:To Assure the Free Appropriate Public Education of All Children With Disabilities: Annual Report to Congress on the Implementation of the Individuals With Disabilities Education Act. 16th ed. Washington, DC: U.S. Department of Education, 1994.
Office of Juvenile Justice and Delinquency Prevention:Juvenile Court Statistics, 1992. Pittsburgh, PA: National Center for Juvenile Justice, 1995.
Commons M, Armon C, Kohlberg L, et al. (Eds.):Adult Development: Vol. 2. Models and Methods in the Study of Adolescent and Adult Thought. New York: Praeger, 1990.
Damon W:Social and Personality Development. New York: Norton, 1983.
Feldman SS, Elliott GR (Eds.)At the Threshold: The Developing Adolescent. Cambridge, MA: Harvard University Press, 1990.
Kastner LK, Wyatt JF:The Seven Year Stretch: How Families Work Together to Grow Through Adolescence. New York: Houghton-Mifflin, 1997.
Keating D: Adolescent thinking. In: Feldman SS, Elliott GR (Eds.):At the Threshold: The Developing Adolescent. Cambridge, MA: Harvard University Press, 1990, pp. 54–89.
Klineberg S: Changes in outlook on the future between childhood and adolescence.Journal of Personality and Social Psychology 1967; 7:185–193.
Gilligan C:In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press, 1982.
Kohlberg L: The child as moral philosopher.Psychology Today 1968; 4:25–30.
Hoffman ML: Affect and moral development.New Directions for Child Development 1982; 16:83–103.
Selman RL:The Growth of Interpersonal Understanding. New York: Academic Press, 1980.
Youniss J:Parents and Peers in Social Development: A Sullivan-Piaget Perspective. Chicago: University of Chicago Press, 1980.
Karpel M, Strauss E:Family Evaluation. New York: Gardner, 1983.
Erikson E:Identity: Youth and Crisis. New York: Norton, 1968.
Josselson R: Ego development in adolescence. In: Adelson J (Ed.):Handbook of Adolescent Psychology. New York: John Wiley, 1980.
Marcia JE: Identity in adolescence. In: Adelson J (Ed.).Handbook of Adolescent Psychology. New York: John Wiley, 1980, pp. 159–177.
Bunt M: Ego identity: Its relationship to the discrepancy between how in adolescent views himself and how he perceives that others view him.Psychology 1968;5:14–25.
Offer D, Marcus D, Offer JL: A longitudinal study of normal adolescent boys.American Journal of Psychiatry 1970; 126:917–924.
Stark PA, Traxler AJ: Empirical validation of Erikson's theory of identity crises in late adolescence.Journal of Psychology 1974; 86:25–33.
Wagner M, Newman L, D'Amico R, et al.:Youth With Disabilities: How Are They Doing? Menlo Park, CA: SRI International, 1991.
Vander Stoep A: Through the cracks: Transition to adulthood for severely psychiatrically impaired youth. Paper presented at the fifth annual meeting of the Research & Training Center for Children's Mental Health, FMHI, University of South Florida, March 2–4, 1992, Tampa, FL.
Canino G, Bird H, Rubio-Stipec M, et al.: Child psychiatric epidemiology: What we have learned and what we need to learn.International Journal of Methods in Psychiatric Research 1995; 5:79–92.
McGree R, Feehan M, Williams S, et al.:DSM-II disorders from age 11 to age 15 years.Journal of the American Academy of Child and Adolescent Psychiatry 1992; 31:50–59.
Costello E, Burns B, Angold A, et al.: How can epidemiology improve mental health services for children and adolescents?Journal of the American Academy of Child and Adolescent Psychiatry 1993; 32:1106–1114.
Meinhardt KVW: A method for estimating underutilization of mental health services by ethnic groups.Hospital and Community Psychiatry 1987; 38(11):1186–1190.
Kelly T, Bullock L, Dykes M: Behavioral disorders: Teachers' perceptions.Exceptional Children 1977; 43:440–444.
Silver S, Unger K, Friedman R:Transition to Young Adulthood Among Youth With Emotional Disturbance. Report #839. Tampa: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health, 1994.
Valdes K, Williamson C, Wagner M:The National Longitudinal Transition Study of Special Education Students: Statistical Almanac: Vol. 3. Youth Categorized as Emotionally Disturbed. Menlo Park, CA: SRI International, 1990.
Berlin N: Prevention of emotional disorders among Native American children: Overview of developmental issues.Journal of Preventive Psychiatry 1982; 1:319–330.
Silver S, Duchnowski A, Kutash K, et al.: A comparison of children with serious emotional disturbance served in residential and school settings.Journal of Child and Family Studies 1992; 1:43–59.
Hu T, Snowden L, Jerrell J, et al.: Ethnic populations in public mental health: Services choice and level of use.American Journal of Public Health 1991; 81:1429.
O'Sullivan M, Peterson P, Cox G, et al.: Ethnic populations: Community mental health services ten years later.American. Journal of Community Psychology 1989; 17(1):17–30.
Sue S, Fujino D, Hu L, Takeuchi D, et al.: Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis.Journal of Consulting and Clinical Psychology 1991; 59:533–540.
Bernard R, Clarizio H: Socioeconomic bias in special education placement decision.Psychology in the Schools 1981; 18:178–183.
Costello EJ: Developments in child psychiatric epidemiology.Journal of the American Academy of Child and Adolescent Psychiatry 1989; 28:836–841.
Frazier D, DeBlassie R: Diagnosing behavior disordered early adolescents as a function of cultural differences.Adolescence 1984; 19:381–390.
Touliatos J, Lindholm B: Relationship of children's grade in school, sex and social class to teachers' ratings on the behavior problem checklist.Journal of Abnormal Psychology 1980; 3:115–126.
Wagner M, D'Amico R, Marder C, et al.:What Happens Next? Trends in Postsecondary Outcomes of Youth With Disabilities. Menlo Park, CA: SRI International, 1992.
Goldschmid ML: The relation of conservation to emotional and environmental aspects of development.Child Development 1968; 39(2):579–589.
Jurkovic G, Prentice NM: Relation of moral and cognitive development to dimensions of juvenile delinquency.Journal of Abnormal Psychology 1977; 86:414–420.
Hirschi T, Hindelang MJ: Intelligence and delinquency: A revisionist view.American Sociological Review 1977; 42:571–587.
Marder C:Secondary School Students Classified as Seriously Emotionally Disturbed: How Are They Being Served? Menlo Park, CA: SRI International, 1992.
Longman RS, Inglis J, Lawson JS: WISC-R patterns of cognitive abilities in behavior disordered and learning disabled children.Psychological Assessment 1991; 3:239–246.
Mack AE, Warr-Leeper GA: Language abilities in boys with chronic behavior disorders.Language, Speech, and Hearing Services in Schools 1992; 23:214–223.
Schonfeld IS, Shaffer D, O'Connor P, et al.: Conduct disorder and cognitive functioning: Testing three causal hypotheses.Child Development 1988; 59:993–1007.
Sanvitale D, Saltzstein HD, Fish MC: Moral judgments by normal and conduct-disordered preadolescent and adolescent boys.Merrill-Palmer Quarterly 1989; 35:463–481.
Schonert KA, Cantor GN: Moral reasoning in behaviorally disordered adolescents from alternative and traditional high schools.Behavioral Disorders 1991; 17:23–35.
Keasey CB: Implicators of cognitive development for moral reasoning. In: De Palma DJ, Foley JM (Eds.):Moral Development: Current Theory and Research Hillsdale, NJ: Lawrence, Erlbaum, 1975, pp. 39–56.
Kohlberg L: The development of children's orientations toward a moral order.Vita Humana 1964; 6:11–33.
Lee LC: The concomitant development of cognitive and moral modes of thought: A test, of selected deduction for Piaget's theory.Genetic Psychology Monographs 1971; 83:93–146.
Piaget J:The Moral Judgment of the Child. New York: Free Press, 1965.
Sigman M, Erdynast A: Interpersonal understanding and moral judgment in adolescents with emotional and cognitive disorders.Child Psychiatry and Human Development 1988; 19:36–44.
Walker LJ: Cognitive and perspective-taking prerequisites for moral development.Child Development 1980; 51:131–139.
Gurucharri C, Phelps E, Selman R: Development of interpersonal understanding: A longitudinal and comparative study of normal and disturbed youths.Journal of Consulting and Clinical Psychology 1984;52:26–36.
Matthys W, Walterbos W, Van Engeland H: Conduct-disordered boys' perceptions of their like peers.Cognitive Therapy and Research 1995; 19:357–372.
Joffe R, Dobson K, Fine S, et al.: Social problem-solving in depressed, conduct-disordered, and normal adolescents.Journal of Abnormal Child Psychology 1990; 18:565–575.
Gresham FM, Elliott SN, Black FL: Teacher-rated social skills of mainstreamed mildly handicapped and nonhandicapped children.School Psychology Review 1987; 16:78–88.
Merrell K, Merz J, Johnson E, et al.: Social competence of students with mild handicaps and low achiievement: A comparative study.School Psychology Review 1992; 21:125–137.
Sabornie EJ, Cullinan D, Epstein MH: Patterns and correlates of learning, behavior, and emotional problems of adolescents with and without serious emotional disturbance.Journal of Child and Family Studies 1993; 2:159–175.
Claes M: Frendship characteristics of adolescents referred for psychiatric treatment.Journal of Adolescent Research 1994; 9:180–192.
Schonert-Reicht K. Empathy and social relationships in adolescents with behavioral disorders.Behavioral Disorders 1993; 18:189–204.
Patterson GR:Coercive Family Process. Eugene, OR: Castalia, 1982.
Prange M, Greenbaum P, Silver S, et al.: Family functioning and psychopathology among adolescents with severe emotional disturbances.Journal of Abnormal Child Psychology 1992; 20:83–102.
Bonforte S, Davis M, Ziven H: A follow-up study of hospitalized adolescents. In: Liberton C, Kutash K, Friedman R (Eds.),The 7th Annual Research Conference Proceedings: A System of Cure for Children's Mental Health: Expanding the Research Base (February 28 to March 2, 1994), Tampa: University of South Florida, Florida Mental Health Institute, Research and Training Center for Children's Mental Health, 1995, pp. 215–222.
Ball L, Chandler M: Identity formation in suicidal and nonsuicidal youth: The role of self-continuity.Development & Psychopathology 1989; 1:257–275.
Koenig L: Self-image of emotionally disturbed adolescents.Journal of Abnormal Child Psychology 1988; 16:111–126.
Koenig L, Howard K, Offer D, Cremerius M: Psychopathology and adolescent self-image.New Directions for Mental Health Services 1984; 22:57–71.
Edwall G, Hoffman N, Harrison P: Psychological correlates of sexual abuse in adolescent girls in chemical dependency treatment.Adolescence 1989; 24:279–288.
Mattison R, Morales J, Bauer M: Elementary and secondary socially and/or emotionally disturbed girls: Characteristics and identification.Journal of School Psychology 1991; 29:121–134.
Vander Stoep A, Taub J, Holcomb L: Follow-up of adolescents with severe psychiatric impairment into young adulthood. In: Liberton C, Kutash K, Friedman R (Eds.):The 6th Annual Research Conference Proceedings: A System of Care for Children's Mental Health: Expanding the Research Base (March 1–3, 1993), Tampa: Florida Mental Health Institute, Research and Training Center for Children's Mental Health, 1994, pp. 373–379.
Whitebeck L, Simons R. Life on the streets: The victimization of runaway and homeless adolescents.Youth and Society 1990; 22(1):108–125.
Deykin E, Alpert J, McNamera J: A pilot study of the effect of exposure to child abuse or neglect on adolescent suicidal behavior.American Journal of Psychiatry 1985; 142:1299–1303.
Stone N: Parental abuse as a precursor to childhood onset depression and suicidality.Child Psychiatry and Human Development 1993; 24:13–24.
Greenbaum P, Prange M, Friedman R, et al.: Substance abuse prevalence and comorbidity with other psychiatric disorders among adolescents with severe emotional disturbances.Journal of the American Academy of Child and Adolescent Psychiatry 1991; 30:575–583.
Kaplan HI, Sadock BJ, Grebb JA:Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences, Psychiatry, Baltimore, MD: Williams & Wilkins, 1994.
Harrington R, Fudge H, Rutter M, et al.: Adult outcomes of childhood and adolescent depression: I. Psychiatric status.Archives of General Psychiatry 1990; 47: 465–473.
Harrington R, Fudge H, Rutter M, et al.: Adult outcomes of childhood and adolescent depression: II. Risk for antisocial disorders.Journal of the American Academy of Child Psychiatry 1991; 30:434–439.
Strober M, Carlson G: Bipolar illness in adolescents with major depression: Clinical, genetic and psychopharmacologic predictors in a three to four-year prospective follow-up investigation.Archives of General Psychiatry 1982; 39:549–555.
Halpern A: Transition: A lool at foundations.Exceptional Children 1996; 51:479–486.
Blackorby J, Wagner M: Longitudinal postschool outcomes of youth with disabilities: Findings from the National Longitudinal Transition Study.Exceptional Children 1996; 62:399–413.
Heal LW, Rusch FR: Predicting employment for students who leave special education high school programs.Exceptional Children 1995; 61:472–487.
Marder C, D'Amico R:How Well Are Youth With Disabilities Really Doing? A Comparison of Youth With Disabilities and Youth in General, Menlo Park, CA: SPI International, 1992.
Wagner M, Blackorby J, Hebbeler K:Beyond the Report Card: The Multiple Dimensions of Secondary School Performance for Students With Disabilities. Menlo Park, CA: SRI International, 1993.
Greenbaum PE, Dedrick RF, Friedman RM, et al.: National adolescent and child treatment study (NACTS): Outcomes for children with serious emotional and behavioral disturbance.Journal of Emotional and Behavioral Disorders 1996; 4:130–146.
Silver S: Who fares best? Comparing outcomes for young adults served in special education and residential settings. Paper presented at the 6th Annual Research Conference, A System of Care for Children's Mental Health: Expanding the Research Base, University of South Florida, Research and Training Center for Children's Mental Health, March 1–3, 1993, Tampa, FL.
Silver S: How to promote (and not interfere with) effective transition. Paper presented at the 5th annual conference of the National Association of State Mental Health Program Directors Research Institute, January 28–31, 1995, San Antonio, TX.
Silver S: How to promote (and not interfere with) effective transition. Paper presented at the 8th Annual Research Conference, A System of Care for Children's Mental Health: Expanding the Research Base, University of South Florida, Research and Training Center for Children's Mental Health, March 3–5, 1995, Tampa, FL.
Carson R, Sitlington P, Frank A: Young adulthood for individuals with behavioral disorders: What does it hold?Behavioral Disorders 1995; 20(2):127–135.
Frank A, Sitlington PL, Carson R: Transition of Adolescents with behavioral disorders—Is it successful?Behavioral Disorders 1991; 16(3):180–191.
Malmgren K, Edgar E, Neel R: Post-school status of youth with behavioral disorders. Manuscript submitted for publication, 1996.
Neel R, Meadows N, Levine P, et al.: What happens after special education: A statewide follow-up study of secondary students who have behavioral disorders.Behavioral Disorders 1988; 13:209–216.
Vander Stoep A: Transition to adulthood: Issues of youth with mental illness. Paper presented at the meeting of the American Public Health Association, November, 1995, Washington, DC.
Vander Stoep A: Risk factors for homelessness after discharge from residential treatment. Paper presented at the 10th annual meeting of the Research & Training Center for Children's Mental Health, FMHI, University of South Florida, February 23–26, 1997, Tampa, FL.
Vander Stoep A, Taub J: Predictors of level of functioning within diagnostic groups for transition aged youth with affective, thought, and conduct disorders. In: Liberton C, Kutash K, Friedman R (Eds.),The 7th Annual Research Conference Proceedings: A System of Care for Children's Mental Health: Expanding the Research Base (February 28th–March 2, 1994). Tampa: Florida Mental Health Institute, Research and Training Center for Children's Mental Health, 1994, pp. 323–327.
U.S. Bureau of Census:School Enrollment: Social and Economic Characteristics of Students, Oct. 1993, Washington DC: U.S. Bureau of Census, 1993.
Brown E: School dropouts from the National Adolescent Child Treatment Study. Paper presented at the 8th Annual Research Conference, A System of Care for Children's Mental Health: Expanding the Research Base, University of South Florida, March 3–6, 1995, Tampa, FL.
U.S. Department of Commerce, U.S. Bureau of Census:Statistical Abstract of the United States: 1992. 112th ed. Washington, DC: U.S. Department of Commerce, 1992.
U.S. Department of Commerce, U.S. Bureau of Census:Stastical Abstract of the United States: 1990. 110th ed. Washington, DC: U.S. Department of Commerce, 1990.
U.S. Department of Commerce, U.S. Bureau of Census:Statistical Abstract of the United States: 1993. 113th ed. Washington, DC: U.S. Department of Commerce, 1993.
Brown E, Greenbaum P: Recent findings from the National Adolescent and Child Treatment Study: Research related to juvenile justice and incarceration. Unpublished manuscript, 1994.
Davis M, Cooper DK: Adult corrections involvement and court outcomes of adolescents with serious emotional disturbance. Paper presented at the 8th annual research meeting of the National Association of State Mental Health Program Directors, February 2–4, 1997, Washington, DC.
Farrington DP: Early precursors of frequent offending. In: Wilson J, Loury G (Eds.):Development of Antisocial and Prosocial Behavior New York: Academic Press, 1987, pp. 359–384.
Farrington D, Loeber R, Van Kammen W: Long-term criminal outcomes of hyperactivity-impulsivity-attention deficit and conduct problems in childhood. In: Robins L, Rutter M (Eds.):Straight and Devious Pathways From Childhood to Adulthood (Cambridge, UK, Cambridge University Press, 1990, pp. 62–81.
U.S. Department of Commerce, U.S. Bureau of Census,Statistical Abstract of the United States: 1995. 115th ed. Washington, DC: U.S. Department of Commerce, 1995.
Lammert M, Timberlake E: Termination of foster care for the older adolescent: Issues of emancipation and individuation.Child and Adolescent Social Work Journal 1986; 3:26–37.
National Institute of Mental Health.Proceedings of the Conference on Mental Health Care: The Severely Mentally Ill and HIV Infection, Rockville, MD: National Institute of Mental Health, 1990.
Sacks M, Dermatis H, Looser-Ott S, et al.: Undetected HIV infections among acutely ill psychiatric inpatients.American Journal of Psychiatry 1992; 149:544–545.
Pritchard C, Cotton A, Godson D, et al.: Mental illness, drug and alcohol misuse and HIV risk behaviour in 214 young adult (18–35 year) probation clients: Implications for policy, practice and training.Social Work and Social Sciences Review 1991–1992; 3:227–242.
Vander Stoep A:Report on Birthing and Parenting of Discharged McGraw Center Residents, Seattle, WA: Seattle Children's Home, 1988.
Brooks-Gunn J, Chase-Lansdaale PL: Adolescent parenthood. In: Bornstein MH (Ed.):Status and Social Conditions of Parenting, Mahwah, NJ: Lawrence Erlbaum, 1995, pp. 113–149.
Contreras P:Compendium of Resource Materials in Adolescent Health. DHHS Publication No. (HSA) 81-5246. Rockville, MD: Department of Health and Human Services, 1981.
Hillard J, Slomowitz M, Levi L: Aretrospective study of adolescents' visits to a general hospital psychiatric emergency service.American Journal of Psychiatry 1987; 144:432–436.
Carlson G, Rich C, Grayson P, et al.: Secular trends in psychiatric diagnoses of suicide victims.Journal of Affective Disorders 1991; 21:127–132.
Swanson JW: Alcohol abuse, mental disorder, and violent behavior: An epidemiologic inquiry.Hospital and Community Psychiatry 1993; 41:761–770.
Kaplan HB (Ed.):Drugs, Crime and Other Deviant Adaptations: Longitudinal Studies New York: Plenum, 1995.
Stroul B, Friedman R:A System of Care for Severely Emotionally Disturbed Children and Youth. Washington, DC: CASSP Technical Assistance Center, 1986.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Davis, M., Vander Stoep, A. The transition to adulthood for youth who have serious emotional disturbance: Developmental transition and young adult outcomes. J Behav Health Serv Res 24, 400–427 (1997). https://doi.org/10.1007/BF02790503
Issue Date:
DOI: https://doi.org/10.1007/BF02790503