Expanding horizons: a model academic and vocational training program for out-of-school youth with disabilities. (Program for Out-of-School Youth with Disabilities).

Youth with learning disabilities (LD), emotional and behavioral disorders (EBD), or psychiatric disabilities face many barriers to success in school and work. Compared with peers without disabilities, youth with LD, EBD, or psychiatric disabilities are at greater risk for a variety of poor outcomes including academic failure, school drop out, limited post secondary education, living in single parent households, and poor socioeconomic status related to high unemployment rates (Blackorby & Wagner, 1996; Bullis & Cheney, 1999; Maag & Katsiyannis, 1998; Malian & Love, 1998; US Department of Education, 1995). The support and intervention needs for youth with such disabilities are substantial. Programs for helping in-school youth with special education needs to transition to work and post-secondary education, vocational training, and integrated employment have been described (Bullis & Cheney, 1999). The purpose of this paper is to describe a program designed to improve academic and vocational outcomes for youth with disabilities who have dropped out of or who have been removed from high school.

Youth with disabilities are at risk for poor school-related outcomes and those who are unable to achieve success in and graduate from school are more likely to have poor employment outcomes as well (Bullis & Cheney, 1999). Data from the National Longitudinal Transition Study (NLTS) conducted from 1987 through 1993, demonstrated that absenteeism, lower grades than non-disabled students, and course failure were problems for students with all types of disabilities including learning, emotional, speech, mental retardation, vision, hearing, physical, and mental disabilities, and strong predictors of school drop out (SRI International, 1997). Data indicated that 38% of students with all types of disabilities dropped out of school compared with 25% of students without disabilities during the study time period. Thirty percent of these youth enrolled in high school but did not complete it and 8% dropped out before entering high school. Sixtyeight percent of students with LD ultimately left school by graduating but for youth with emotional disturbance, this figure was only 48.4%. Thus, nearly one-half of all students who were identified as emotionally disturbed did not complete high school (SRI International, 1997). Other estimates also support an increased risk for school-related problems for students with all types of disabilities. According to 1995 Census Bureau estimates, youth with disabilities dropped out-of-school at a greater rate than their non-disabled peers (14.6% versus 11.8%) (National Center for Education Statistics, 1995). In 1998, only 33.1% of youth with specific LDs graduated with a diploma and even fewer (15.6%) of those with serious emotional disturbance exited the educational system with a diploma. During the same period, 4.5% of youth with specific LDs graduated with a certificate (GED) while just 2.2% of those with emotional disturbance received their GED (US Department of Education, 2000).

Employment is a significant outcome for adults in the U.S. and as such is an important marker for success (Bullis & Cheney, 1999). Youth with LD and EBD face a variety of obstacles in finding and maintaining employment. Such youth often have poor communication skills, difficulty in accepting feedback, and inadequate work and social skills. Findings also have suggested that youth with disabilities tend to avoid risk-taking in areas that would promote advancement, such as job and promotion seeking (Schelly & Koethe, 1995). Not surprisingly, youth with disabilities fare worse than youth in the general population in their rate of competitive employment. According to data from the NLTS, youth with disabilities were significantly less likely to be employed than non-disabled youth at both two years and three to five years after leaving school. Youth with EBD were less likely to be employed two years after secondary school (40.7%) compared with youth with LD (59.2%), speech impairment (50.1%), and hearing loss (48.8%) (SRI International, 1997). Overall, while youth with all types of disabilities demonstrated an increase in competitive employment three to five years after leaving school, youth with EBD continued to have lower rates of competitive employment (47%) than both the general population of youth (69%), and those with LD (70.8%). Correspondingly, youth with EBD had lower wage earning potential, a risk factor for economic failure (Blackorby & Wagner, 1996).

Comorbidity further increased these adolescents' risk for poor outcomes. Approximately one-half of youth with LD have a psychiatric diagnosis that confounds their treatment (American Academy of Child and Adolescent Psychiatry, 1998). Even without this comorbidity, such youth are at increased risk for social skills deficits, decreased self-esteem (Kaufman, 1997; Kavale & Forness, 1995), performance anxiety, family disruption, and poor peer relationships (American Academy of Child and Adolescent Psychiatry, 1998), all factors that increase risk for poor school and work outcomes. Emotional distress, suicide attempts, and violent behavior occur more often among adolescents with LDs (Svetaz, Ireland & Blum, 2000). Youth with EBD are more likely to engage in antisocial behavior (Wagner, D'Amico, Marder, Newman & Blackorby, 1992) thus increasing the likelihood of poor academic and vocational outcome. Consistent with their poor employment and economic status, youth with EBD commit crimes and are arrested and incarcerated at a disproportionate rate (Maag & Katsiyannis, 1998). One study found that youth with emotional disturbance were 13.3 times more likely to have been arrested while still in school compared to students with other disabilities and that at one year after leaving school, those with EBD who had been previously arrested were almost 17 times more likely to be arrested again compared to all other participants (Doren, Bullis, & Benz, 1996).

Overall, research has suggested that without intervention, the outlook for youth with learning and emotional disabilities is bleak due to increased risk for negative emotional, educational, and employment outcomes. As a result, such youth have `multisystem' needs requiring interagency collaboration and services (Rosenblatt & Rosenblatt, 1999). Transition services are mandated by law by the 1992 Amendments to the Individuals with Disabilities Education Act (IDEA: P.L. 101-476). These services provide a coordinated set of outcome-focused interventions to facilitate movement from school to post-secondary education, vocational training, integrated employment, continuing and adult education, adult services, independent living, or community participation (US Department of Education, 2000). Coordinated education and transition services provided to in-school youth is termed `wraparound'. The wraparound approach is comprehensive, addresses all aspects of the student's life, and focuses on the strengths versus the deficits of the individual student and his or her family (Bullis & Cheney, 1999; Eber, Nelson & Miles, 1997). In the past decade, model demonstration programs have been developed and implemented to provide services addressing the multiple, complex needs of in-school youth with EBD (Bullis & Cheney, 1999; Cheney, Hagner, Malloy, Cormier, & Bernstein, 1998). Such projects have reported positive outcomes suggesting that many youth can become successful and productive members of society (Bullis & Cheney, 1999). Essential components of these programs include interagency cooperation and collaboration, a maximum staff to participant ratio of 1:12 to 1:15, planned criteria for evaluation, and long term intervention (Bullis & Cheney, 1999).

In order to meet the transition needs of out-of-school youth with disabilities, Alliance established a program designated as Expanding Horizons within its Youth Services Division. The purpose of this study is to describe the Program and its collaborative development within the community, the Program components and operation, and the success of first group of participants. Figure 1 shows the Program's flow of service from participant referral to establishment of follow-along services. Implications for rehabilitation programs providing academic and vocational training services are discussed.

[FIGURE 1 OMITTED]

Method

Target Population

To participate in a Workforce Investment Act (WIA) funded program, youth must meet one or more of the following criteria for being "economically disadvantaged." A participant must be: a member of a family whose income meets the poverty guidelines for the state of Maryland or whose family receives cash welfare payments or food stamps; a homeless or a foster child; a youth with a verified physical or mental disability that presents a substantial barrier to employment and whose own income meets the poverty guidelines, even if the family income exceeds the guidelines. Participants also must meet one or more of the following additional criteria: they must be deficient in basic literacy skills (reading or math skills below 9th grade level), have dropped out of school, be homeless, be a runaway or foster child, be pregnant or parenting, be an offender, or be an individual (including a youth with a disability) who requires additional assistance to complete an educational program or to secure and hold employment. Consistent with these criteria, the Expanding Horizons target population includes adolescents ages 16 through 18 who have dropped out of high school. Each participant meets the poverty guidelines and has a verifiable disability that presents a substantial barrier to completing an educational program or to securing and maintaining employment.

Participants

Thirty-nine out-of-school youth, ages 16 to 18, were referred to the Program. Twenty-one applicants were determined to be ineligible due to lack of verification of disability, income above the poverty guideline, placement within the court system and subsequent incarceration, active drug use and refusal to enter a drug treatment program, or refusal to sign up for selective service making them ineligible for federally funded services. The 18 remaining applicants were assessed as eligible and willing to participate. All participants completed an intake and evaluation process with one enrollee withdrawing before the start of service. At the time of intake, all participants were 16 to 17 years old, with the exception of one 15 year old who became 16 three weeks after intake. Seventeen participants began receiving services immediately upon intake. Of the 17, 13 (76.5%) were male, all but one was Caucasian, and all were residents of the implementation county. Of the seventeen participants receiving services, 8 (47.1%) had completed 8th grade, 5 (31.3%) had completed 9th grade, and 4 (23.5%) had completed 10th grade. Nine (53%) participants had been arrested or were referred because of legal difficulties. All participants had at least one disability as shown in Table 1. Learning disability and affective disorders (major depression, bipolar, or dysthymic disorder) were reported most frequently. More than one-half (53%) of participants had a LD, 47% had an affective disorder, and 41% had a substance abuse disorder. Nearly one-third (29.4%) of participants had oppositional defiant or conduct disorder, or attention deficit disorder.

Program Description

Alliance, Inc., is a private, not-for-profit, community-based rehabilitation agency, accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), licensed by the Maryland Department of Health and Mental Hygiene, the Maryland Department of Alcohol and Drug Abuse, and the Developmental Disability Administration. Alliance offers rehabilitation services to individuals with disabilities throughout the state of Maryland. The Expanding Horizons Program, within the Youth Services Division of Alliance, seeks to provide academic and career assessment, skills training, and employment opportunities for out-of-school youth. The two-year Program consists of two phases. Phase I provides services for one year from referral to academic engagement and/or vocational retention. Phase II provides follow-along services for an additional year that include monitoring, supporting, and/or referring participants to appropriate agencies as needed.

Community Collaboration

During Program development, Expanding Horizons developed three primary referral sources, including the Department of Juvenile Justice (DJJ), the county public schools (CPS), and Alliance's Targeted Case Management (TCM). Other potential referral sources are listed in Figure 1. The referral agencies identified potential candidates for enrollment in the Program. Each agency afforded the Expanding Horizon's coordinator an opportunity to speak to their extended teams and to identify an agency representative as a specific point of contact. Enrollment in the Expanding Horizons Program is voluntary. At the initial meeting, both the Program and viable alternatives to the Program are discussed with the candidate and, when applicable, candidates are informed that the services of their selected provider, Alliance or another agency, will become a part of their court ordered probation. All three referral sources collaborated effectively with Alliance in identifying and referring potential candidates.

Academic Services

Expanding Horizons, working with the local community college, conducted an academic assessment of each of the participants. The Program then assisted the participants to improve their academic skills and to register for the GED examination. Participants lacking sufficient academic skills to pass the GED examination were enrolled in Adult Basic Education (ABE) classes for three months, with Program staff monitoring and ensuring attendance. Participants who were qualified to take the GED, but who needed to review content material, either were enrolled in 3-month GED preparation classes or assisted with home study for three months prior to registering for the examination. Participants who had sufficient academic skills and knowledge of the subject material needed to pass the GED without prior classroom preparation were assisted in registering for the examination.

Vocational Training Services

Alliance offers two vocational training classes. The Youth Services "Job Search System" and "Success Express". The Job Search System, designed by the Expanding Horizons Program coordinator, focuses on `job seeking' skills and is designed for teaching three or fewer students simultaneously. The curriculum is usually completed in three, two-hour sessions and emphasizes skills needed to obtain employment such as locating job openings, writing resumes, interviewing, and completing job applications. Classes are conducted within the community to enhance the participant's knowledge of and comfort in accessing community-based resources, with the expectation that participants will continue to use these resources after completing the Program. Community facilities used as training sites include local libraries, a privately funded learning center, the Regional Workforce Network, and the Maryland Employment Development office. Success Express provides training for "job keeping". It was developed by and is taught in partnership with the Active Citizens Coalition for Employment of Persons with Mental Illness (A.C.C.E.P.M.I.). Content is taught in a classroom environment in six, two-hour modules, providing students with the skills needed to become successful in today's workplace. Participants receive content designed to assist them to value employment and maintain a positive attitude. The importance of punctuality is emphasized and students receive content on communication and interpersonal relationships as well as the importance of following employer policies and procedures. Pre- and post-testing is conducted for the Job Search System and Success Express programs to measure the participant's baseline skill and skill achievement level, respectively, and to provide the instructor with a greater understanding of the student's needs.

The Intake Process

The Expanding Horizons Program began intake of students on November 1, 2000. Potential candidates and their families received information and were encouraged to explore all available options before selecting Alliance as their service provider. Expanding Horizon staff arranged an intake with new applicants and, if under 18, their parent or guardian. In most cases, the intake was conducted at the student's home, with families rejecting other intake location options, which included Alliance offices, public libraries, and the DJJ office.

Goal Setting

After determining diagnostic status, psychosocial and environmental factors, and job seeking/keeping skills, Expanding Horizons arranged an individual meeting with each participant to discuss academic and vocational interests and to assess individual strengths, needs, and preferences. Data from these assessments was used to develop goals and objectives for the participant's Individual Service Plan (ISP). The ISP served both as a contract between the participant and the Program and as a plan for intervention to assist the participant to successfully achieve his or her desired goals. Components of the ISP include goals, objectives, and methods to achieve established goals, the person responsible for goal attainment, the frequency of goal monitoring, and a timeline for meeting goals and objectives. Each goal is broken down into objectives that must be accomplished to assist the participant in reaching the overall goal. Each objective has an individual assigned to it and designates the steps that need to be taken to achieve that objective. For example, the goal for "securing a driver's license", might have as an objective "register for driver's education class" and the person responsible designated as the participant. If, for example, the objective is "to obtain a driver's rule booklet," the Program coordinator might be the responsible party.

Results

Academic Progress

All 17 participants were assessed and three qualified for the GED program. One of the three participants completed home study with Alliance assistance and the other two attended GED classes for three months. All three completed their GED test and received their Maryland State Diploma. The other 14 students were placed in Adult Basic Education classes to improve their skills. Of the 14, all but 2 made academic improvements, with 6 of the 14 advancing to the GED class approximately 6 months after entrance into the program. Two students enrolled for part-time fall classes at a community college.

Vocational Progress

Most participants attended the vocational classes (see Table 1). In two situations, when class times conflicted with student work schedules, class content was provided on a 1 to 1 basis. The mean pre-test score for the "Job Search System" was 72% and the post-test mean score was 93%, demonstrating an increase of 21% following instruction. The mean pre-test score for "Success Express" was 79% and the mean for the post-test was 94%, an increase of 15% following participation in the "Success Express" component of the program.

Psychosocial and Environmental Barriers and Resources

Family support was a problem for the majority of participants. Of the 17 participants, only three had two parents involved in their daily life. Even those parents who were interested in their child's success were limited in their time, knowledge, and resources to independently assist their adolescent. Case management services assisted participants to meet their goals and helped both participants and parents recognize the Program's importance in helping participants achieve success.

Transportation was difficult and a potential barrier to success for this group of youth. Many participants lived in rural areas, and even those living in more populated areas were faced with a public transportation system that provided only weekday service between the hours of 8:00 a.m. and 5:00 p.m., with most Program activities and academic classes taking place in the evening hours. To address this problem, Alliance provided transportation reimbursement to encourage the participants to creatively solve their transportation difficulties. They could use the money to pay for mass transit costs (i.e. bus fare), taxi fare, or to reimburse parents, family members, or friends for mileage costs, or to purchase bicycles. The Program provided information on how to use the public transportation system for those students who were able to take advantage of this mode of transportation. Since the county had a limited public transportation system and, depending on where the students resided, it may or may not have been available as a viable means of transportation, Alliance also assisted participants to develop ride share arrangements with co-workers, classmates, and fellow Program participants.

Employment

Initially, the Program budget contained $8000 to match 50% of participant's salaries during a six-week training internship. However, the participant consensus to begin earning as much money as possible and employer's willingness to employ without matching funds, resulted in participants being assisted to obtain employment versus internships.

Sixteen of the 17 participants expressed an interest in working, and one participant and his mother strongly preferred that the youth concentrate on obtaining his GED, before seeking employment. Another participant's goal was to become a fire fighter. Expanding Horizons intervened by paying for equipment fees so he could become a volunteer fire fighter. The youth plans to concentrate on this position until he earns his GED, at which time he will apply for a paid fire fighter position. Of the remaining 15 participants seeking work, all were placed in competitive employment with an average job search time of 17 days. Six students had multiple job placements during the study period as shown in Table 1. Overall, participants worked an average of 30 hours per week and earned salaries ranging from $5.15 to $9.00 per hour with an average hourly salary of $6.73. Participants were employed in a variety of settings and positions including video store clerk, supermarket cashier, small retail store cashier, electrician's apprentice, landscaper, fast food restaurant crew-member, and masonry laborer.

More than Vocational Services

Recognizing the importance of a comprehensive approach to helping adolescents realize their goals, the Program provided a variety of other support services shown in Table 2. Expanding Horizons assisted students to obtain the following: Boys and Girls Club membership, photo identification, social security cards, birth certificates, library cards, driver's education classes, and appropriate clothing for job interviews. Expanding Horizons also enabled two participants to serve their court ordered community service hours with Alliance by helping with setting up before and cleaning up after class and by preparing a report on the teen drug culture. The Program also sent a group of 14 participants to a local restaurant for a dinner theater "Murder Mystery" and provided a tour of the local detention center for eight participants to increase their awareness of potential consequences of illegal behavior.

Summary

Of the 39 referred candidates, 18 were deemed eligible and entered the program. Two participants were incarcerated, one of whom was discharged from the Program. The other will resume services when released. One participant withdrew from the Program prior to his case being opened with the Regional Workforce Network. Thus, 15 students were receiving services at the time of this writing and 13 were employed. Four participants quit their jobs, one was terminated, and none were work-ready but unemployed.

Discussion

The Future: Follow-up and Beyond

After completion of Phase I, Alliance will continue monthly contact with all participants, educational programs, employers, and families for a minimum of one year as required by the WIA. During this one-year follow-along period (Phase II), Alliance will monitor participants and provide support and/or referral services on an as-needed basis to promote continued success and independence. Follow-up is planned to evaluate academic and vocational outcomes as well as participant perceptions of their functional abilities, employment, and satisfaction with the Program.

Expanding Horizons demonstrated the important contribution of community partnerships and interagency cooperation and collaboration in assisting youth with multiple and complex needs. By providing academic and vocational training to out-of-school youth with disabilities who would otherwise be "lost" in the community and by connecting them to resources, the Program sought to assist participants to live productively in the community and to become contributing members of society. Early results from the Expanding Horizons Program demonstrated that despite significant barriers to academic and vocational success, youth with disabilities could be successfully engaged in services to improve their academic and vocational outcomes. Program participants obtained or are currently working toward obtaining their GED. Participants seeking employment were placed or located employment independently and most maintained initial or subsequent employment. Of note was the need for multiple placements in order for some participants to maintain employment. Thus, agencies wishing to provide this service should plan for sufficient numbers of staff, resources, and potential employment situations to maximize participant's opportunities to achieve success in competitive employment.

Recommendations

Depending on funding requirements and guidelines, agencies wishing to establish a similar program could employ various modifications. Potentially, such programs could include students not yet identified as disabled but who are at risk for poor academic and vocational outcomes based on poor past school performance or involvement in the juvenile justice system. In addition, the age of the target population could potentially be decreased to 14 years and services focused on academic and social skills, both of which are necessary for success in school and work. Employment skills training might be introduced to a younger group of participants at a preliminary level and include work and career exploration. Counseling services to assist participants to cope with individual and family difficulties would also be a valuable addition to such a program. Expanding Horizons currently has 4 staff including a coordinator and 3 adolescent specialists. When operating at full capacity, the program serves 50 youth, representing an overall staff to participant ratio of 1 to 12.5. Adequate staffing and planning are essential to provide the intensity of services needed to assist participants to meet their academic and vocational goals.

Table 1
Participant's Referral Sources, Disabilities, Class Attendance,
Wages, and Employment Status

ID   Referral   Disabilities     % Class      Wages/Employment Status
 #   Source                      Attendance

1    DJJ        ODD; CD, ADHD,    44%         $5.15 + tips; terminated
                poly SA, LD                   for not reporting to work
                                              or calling in

2    CPS        Depression,       89%         $6.50; resigned without
                ADHD, LD                      notifying counselor;
                                              re-employed

3    CPS        LD                89%         $6.65; 30 hr/wk

4    Relative   Depression,      100%         $7.00; 35 hr/wk
                ODD; r/o
                bipolar
                disorder

5    RWN        ADD              100%         $5.25; resigned;
                                              Re-employed ($6.75);
                                              30 hr/wk

6    CPS        LD               100%         $9.00; Developed own
                                              position; 40 hr/wk

7    TCM        Depression; LD   100%         $5.15; Began 20 hr/wk;
                                              now 40 hr/wk

8    DJJ        Depression;      100%         $7.50; Developed own
                SA; migraine                  position; 32 hr/wk

9    DJJ        Depression;       89%         $6.00; 25 hr/wk; wanted
                ODD; LD; poly                 to increase earnings;
                SA                            re-employed ($8.00);
                                              40 hr/wk

10   DJJ        CD; dysthymic    100%         Worked 1 day only;
                disorder; SA                  refused job development;
                                              found own position;
                                              ($6.50)

11   CPS        LD               100%         Volunteer

12   CPS        LD                44% (a)     With assistance, changed
                                              employment due to
                                              schedule conflict;
                                              ($6.00); 24 hr/wk

13   DJJ        LD               100%         $9.00; 40 hours per week

14   CPS        LD                89%         Family preferred
                                              participant to obtain
                                              GED prior to employment

15   CPS        ADHD; poly SA    100%         $5.50; 25 hr/wk prior to
                                              incarceration

16   DJJ        Bipolar          100%         Job offer received
                disorder; ODD;                following arrest; now
                CD; ADHD; SA                  awaiting trial

17   DJJ        Depression; SA   100%         Employed 3 times;
                                              relocated out of county
                                              and withdrew from program

Note: DJJ (Department of Juvenile Justice), CPS (County Public
Schools), TCM (Targeted Case Management), RWN (Regional Workforce
Network), ODD (oppositional defiant disorder), CD (conduct disorder),
LD (learning disability), ADHD (attention deficit hyperactivity
disorder), SA (substance abuse), ADD (attention deficit disorder).

(a) Participant missed classes due to schedule conflict but had
competent test scores.
Table 2
Support and Other Ancillary Services Provided to Participants

Support/Service Provided                         n    (%)

Photo identification card obtained               10   (56)
Social security card obtained                    10   (56)
Detention center tour                             8   (44)
Birth certificate obtained                        5   (28)
Library card obtained                             4   (22)
Membership in boys or girls club                  4   (22)
Bicycle purchase                                  3   (17)
Students with seat on youth advisory committee    3   (17)

Author Note

The authors acknowledge the funding provided by the Susquehanna Workforce Network and appreciate the cooperation and collaboration of referral agencies and partnership groups. In addition, the authors acknowledge the contributions of Alvo Antonelli who helped with the collection of data for this paper.

References

American Academy of Child and Adolescent Psychiatry (1998). Practice parameters for the assessment and treatment of children and adolescents with language and learning disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 37 (supplement), 46S-62S.

Blackorby, J., & Wagner, M. (1996). Longitudinal postschool outcomes of youth with disabilities: Findings from the National Longitudinal Transition Study. Exceptional Children, 62, 399-413.

Bullis, M. & Cheney, D. (1999). Vocational and transition interventions for adolescents and young adults with emotional or behavioral disorders. Focus on Exceptional Children, 31 (7), 1-24.

Cheney, D., Hagner, D., Malloy, J., Cormier, G.M., & Bernstein, S. (1998). Transition services for youth and young adults with emotional disturbance: Description and initial results of project RENEW. Career Development for Exceptional Individuals, 21 (1), 17-32.

Doren, B., Bullis, M., & Benz, M.R. (1996). Predicting the arrest status of adolescents with disabilities in transition. The Journal of Special Education, 29, 363-380.

Eber, L., Nelson, C.M., & Miles, P. (1997). School-based wraparound for students with emotional and behavioral challenges. Exceptional Children, 63, 539-555.

Kauffman, J. M. (1997). Characteristics of emotional and behavioral disorders of children and youth (6th Ed.). Englewood Cliffs, New Jersey: Prentice Hall.

Kavale, K. A., & Forness, S. R. (1995). The nature of learning disabilities: Critical elements of diagnosis and classification. Mahwah, Jew Jersey: Erlbaum.

Maag, J.W., & Katsiyannis, A. (1998). Challenges facing successful transition of youths with EB/D. Behavioral Disorders, 23, 209-221.

Malian, I.M., & Love, L.L. (1998). Leaving high school. An ongoing transition study. Teaching Exceptional Children, 1, 4-10.

National Center for Education Statistics. (1995). Dropping out and disabilities. Summary: Dropout Rates in the United States: 1995, (1972-1995).

Rosenblatt, J., & Rosenblatt, A. (1999). Youth functional status and academic achievement in collaborative mental health and education programs: Two California care systems. Journal of Emotional & Behavioral Disorders, 7, 21-31.

Schelly, C., & Kothe, J. (1995). Vocational support strategies for students with emotional disorders. Reston, VA: ERIC Clearinghouse on Disabilities and Gifted children. (ERIC Document Reproduction Service No. ED 383152).

SRI International. (1997). The National Longitudinal Study. A summary of findings. Menlo Park, CA: SRI International. Retrieved July 13, 2001, from http://www.sri.com/policy/ cehs/publications/dispub/nlts/nltssum.html

Svetaz, M. V., Ireland, M., & Blum, R. (2000). Adolescents with learning disabilities: Risk and protective factors associated with emotional well-being: Findings from the National Longitudinal Study of Adolescent Health. Journal of Adolescent Health, 27, 340-348.

US Department of Education. (1995). Seventeenth Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act. Washington, D. C. US Office of Special Education Programs.

US Department of Education. (2000). Annual Report to Congress on the Implementation of the Individuals with Disabilities Act. Office of Special Education and Rehabilitative Services.

Wagner, M., D'Amico, R., Marder, C., Newman, L., & Blackorby, J. (Eds.). (1992). What happens next? Trends in postschool outcomes of youth with disabilities. The second comprehensive report from the National Longitudinal Transition Study of Special Education Students. Menlo Park, CA: SRI International.

Gail Schoen Lemaire, Ph.D., RN, CS-P, University of Maryland School of Nursing, Department of Behavioral and Community Health, 655 West Lombard Street, Baltimore, Maryland 21201. Email: [e-mail].