True Grit residential program helps injured youth navigate adult life

Transitioning from high school to adult life is a challenge for anyone, but for young people living with spinal cord injuries, the path forward is less clear.

A Rutgers Health study, published in Topics in Spinal Cord Injury Rehabilitation, evaluated the outcomes of participants in True Grit, a residential program offered by Rutgers School of Health Professions and RWJBarnabas Health's Children's Specialized Hospital, designed to give youth ages 14 to 21 with spinal cord injuries the tools to confidently enter adulthood.

According to the U.S. Department of Health and Human Services, about 18,000 new spinal cord injuries are reported each year.

"There is a high incidence of traumatic spinal cord injuries, specifically in young males, in adolescence," said Keara McNair, a lecturer in the school's Department of Rehabilitation and Movement Sciences who co-directs the program with Kassandra Boyd, an occupational therapist at Children's Specialized Hospital. "People with spinal cord injuries are getting discharged into the community sooner. While there are services to help adults return to work, there are no programs in the nation that specifically target the transition to adulthood for young adults. True Grit is designed to bridge that gap."

Each summer since 2024, True Grit, a week-long, sleep-away program based in dorms at Rutgers University-New Brunswick's Livingston Campus in Piscataway, N.J., has brought together occupational therapists, physical therapists and recreational therapists with clinical experience in spinal cord injury rehabilitation along with peer mentors to provide therapeutic, recreational, social and independence-building experiences designed to teach life skills and build independence.

In addition to individualized occupational and physical therapy sessions, participants engage in adapted recreational activities like wheelchair basketball, community outings and workshops that address vocational planning, sexuality, adapted driving and psychosocial adjustment to injury.

The study evaluated the short-term outcomes for the six participants in the 2024 cohort. Participants completed surveys on goals, resilience and how they participated at home, school and in the community with their injury at the start of the program and three months after. They also were evaluated through specialized outcome measures used in rehabilitation to track personalized goal progress, emotional resilience after spinal cord injury and social and community involvement in children with spinal cord injuries.

All participants demonstrated progress toward their individual goals. Participation scores increased overall, with the largest gains seen among youth with lower participation at the beginning of the program. The study also revealed how barriers such as transportation and limited peer access after returning home influenced participation and resilience.

After the program the participants described significant shifts in how they viewed their futures, which included higher education, employment, independent living and serving as peer mentors. Each year the program grows in size. We have enrolled 12 participants for 2026 and since this program is unique, participants continue to come from across the nation."

Keara McNair, study author

The study was co-authored by Aaron Dallman, Rutgers School of Health Professions, and Kassandra Boyd and Corinne Calvanico (Rutgers OTD '25 Alum), Children's Specialized Hospital.