Adolescents with spinal cord injury: Indications and suggestions for recreation therapy practice

cases of traumatic spinal cord injury (SCI) are reported each year, with the average age at injury being 37.6 years. The age group with the greatest frequency of injury comprises individuals between 16 and 30 years old, and 51.8 percent are single when injured. The majority of SCIs (79.6 percent) have occurred in males. Counting nontraumatic causes of SCI, the injured population consists of about 1 million people. Since 2000, about half (47.5 percent) of reported SCI cases have been due to motor vehicle crashes, followed by falls, acts of violence (primarily gunshot wounds), and recreational sporting activities. The incidence rate of SCI due to acts of violence is six to nine times higher among minorities, and there has been a large increase in severe SCIs in minority groups in the United States. Of those injured by any means since 2000, 67.5 percent are Caucasian, 19 percent are African American, 10.4 percent are Hispanic, and 3.1 percent are from other racial/ethnic groups. Today, about 6.6 percent of all persons with SCI who are discharged from initial treatment are sent to hospitals and group living situations, and 5.3 percent are discharged to nursing homes. The average length of stay in the acute care unit for those with SCI is 19 days, and on average they spent 45 days in a rehab unit in 2003.1 For adolescents who have an SCI, there are unique considerations. Adolescence is regarded as one of the most important developmental periods of life, characterized by significant biological, intellectual, and psychosocial changes.2,3 It is also a time when individuals are in the process of giving up the world of childhood in favor of the world of adulthood. While wrestling with numerous important developmental issues is challenging for most adolescents, it would be more so for adolescents who experience life-changing traumatic events such as SCI. The injury not only results in dramatic life changes during this critical stage but also disrupts the normal process of transitioning into adulthood. Therefore, adolescents with