title: Longitudinal employment outcomes in adults with pediatric-onset spinal cord injury.
abstract: METHODS
  Longitudinal survey.
  
  
  OBJECTIVE
  To determine in adults with pediatric-onset spinal cord injury (SCI) employment outcomes, longitudinal changes in employment over time and changes in psychosocial outcomes associated with employment status.
  
  
  METHODS
  Community setting.
  
  
  METHODS
  Adults who had sustained a SCI before 19 years of age and had completed at least three consecutive annual interviews were included in the study. Generalized estimating equation models were formulated to obtain odds ratio (OR) of change in employment status and outcomes over time.
  
  
  RESULTS
  Total 1691 interviews were conducted in 283 participants, 182 men and 101 women (88% Caucasian; age at baseline, 27.3±3.7 years; duration at baseline, 12.7±5.0 years). At the last interview (age, 34.4±5.2 years; duration, 19.9±6.1 years), 49.5% were employed and 47.0% had a baccalaureate or post-baccalaureate degree. There was no significant change in employment status over time (OR 1.01, confidence interval (CI) 0.98-1.04). Odds of employment increased over time in participants who were women (1.04, CI 1.00-1.08), married (1.05, CI 1.02-1.08) and attained baccalaureate (1.03, CI 1.00-1.07) or post-baccalaureate (1.05, CI 1.02-1.08) degree. Employment odds decreased with occurrence of autonomic dysreflexia (0.80, CI 0.65-0.99), spasticity (0.80, CI 0.59-0.99) or chronic medical condition (0.83, CI 0.71-0.98). Life satisfaction scores increased over time in those who remained employed (1.11, CI 1.01-1.22); odds of depression increased over time in those who remained unemployed (1.13, CI 1.04-1.23).
  
  
  CONCLUSIONS
  Employment status remained relatively stable in adults with pediatric-onset SCI; however, changes in employment were associated with education, secondary health conditions and psychosocial well-being.
authors.affiliation: 1] Orthopaedic Rehabilitation and Engineering Center, Marquette University, Milwaukee, WI, USA [2] Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hwang
authors.affiliation: 1] Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA [2] Department of Psychology, Loyola University Chicago, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Zebracki
authors.affiliation: Department of Clinical Research, Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: Chlan
authors.affiliation: 1] Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA [2] Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D010549:Personal Satisfaction; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult