Late adolescent & young adult functioning and participation outcomes after prematurity

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There has been an increased emphasis on optimizing health, developmental, and behavioral outcomes over the life course after prematurity. An important framework for examining adolescent and young adult outcomes is the International Classification of Functioning Disability and Health Children (ICF) developed by the World Health Organization (WHO) in 2001 and expanded to children and youth (ICF-CY) under age 19 years in 2007. The ICF and the ICF-CY can be used as a statistical tool in population studies, a research tool to measure outcomes, quality of life, and environmental factors, a clinical tool for outcomes of rehabilitation and vocation training, and as a social policy-educational tool to raise awareness and promote social action for equity. In this review we describe how functioning and participation can help inform transitional outcomes at age 17 years and emerging adult independence at 23 years. We highlight outcomes in adolescence and adulthood of former preterm infants using the ICF domains of functioning and participation. We include current standardized adaptive assessments (Vineland Adaptive Behavior Scales-3rd Edition; VABS3) and Adaptive Behavior Assessment Scale-3; ABAS3) that measure self-care daily living skills, applied learning, and social functioning. We also emphasize that participation involves life activities of higher education attainment, completing vocational training, experiencing employment, living independently, and relationship experiences with partners as well as family formation.

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Seminars in Fetal and Neonatal Medicine