Development and Transitions for Individuals and Families

Across the life course, people experience a wide range of planned and unanticipated transitions. There is a critical need for interventions to support people, families, and communities as they experience these transitions. Example transitions may include disability onset/identification/diagnosis, starting and ending educational and training programs, transitions across systems of care, retirement, aging in place, and end of life. 

• Many topics in Healthy People 2030 emphasize the unique developmental needs of different age groups (early and middle childhood, adolescent health, older adults), populations (disability and health, lesbian, gay, bisexual, and transgender health), and conditions.¹ 

• There are a variety of types of transitions that people experience throughout their lifespan. They range from developmental transitions (e.g., puberty), transition in roles and environments (e.g., school to work, retirement), transition in service settings (e.g., pediatric to adult health services) and others. Transitions can pose particular challenges during specific periods of development or populations, especially those with disabilities and chronic health conditions.² 

• There are 61 million people (26%) living in the United States with a disability including over three million children (4.3%). Across the lifespan, the highest rates of disability are within minority groups.³ 

• The transition from adolescence to adulthood can be particularly challenging for individuals with disabilities because of unique needs related to securing appropriate healthcare and education services, vocational planning, living environments, and community participation.2 

• Performance of many activities may change with aging (e.g., driving, work, physical activity). Evidence-based interventions are needed to support the health and safety of older adults. ⁴ 

• Care transitions are the end of life are common, although there is a paucity of research and understanding on best supports and practices during these critical transitions.⁵ 

Need and Relevance to Occupational Therapy 

Development and transitions have been identified as 

• a critical issue requiring attention across the lifespan to promote health and well-being. 

• an area in which evidence-based measures and interventions are needed 

• an area where application of the unique expertise of occupational therapy would be highly beneficial. 

Development and transitions require mastering the “doing of everyday activities” that support participation in daily life, health and well-being. Occupational therapy understanding of daily occupations and of the ways in which person and environment factors may serve as supports and barriers to function may guide development of better measures and interventions to support performance and participation.   

Current knowledge, research training, measures and interventions are inadequate for addressing the developmental and transition needs of individuals and populations. AOTF is committed to the development of a scientific network and body of evidence to achieve effective and efficient advances in this area across the lifespan. 

Many occupational therapy scientists are building knowledge related to development and transitions.  However, there is no coordinated network for occupational therapy research in this area, nor sufficient resources to train more occupational therapy researchers.  We believe a significant investment is needed in order to address developmental and transition needs across the lifespan in order to achieve better outcomes and improve quality of life. 

1. Office of Disease Prevention and Health Promotion. (2022). Objectives and Data. Retrieved from https://health.gov/healthypeople/objectives-and-data 

2. Centers for Disease Control and Prevention. (2021). Disability and health promotion.  Retrieved from https://www.cdc.gov/ncbddd/disabilityandhealth/people.html 

3. Centers for Disease Control and Prevention. (2020). Disability impacts all of us. Retrieved from https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html#:~:text=61%20million%20adults%20in%20the,have%20some%20type%20of%20disability. 

4. Centers for Disease Control and Prevention. (2022). Alzheimer’s Disease and Healthy Aging. Retrieved from[Text Wrapping Break]http://www.cdc.gov/aging/index.html 

5. Abraham, S. & Menec, V. (2016). Transitions between care settings at the end of life among older homecare recipients: A population-based study. Gerontology Geriatric Medicine, doi: 10.1177/2333721416684400