Date Presented 3/30/2017
Students with intellectual or developmental disabilities are entering postsecondary programs. Persisting adaptive behavior needs affect performance and participation. This research served to better understand student needs and potential roles of occupational therapy in postsecondary settings.
Primary Author and Speaker: Lucretia Berg
Contributing Authors: Tracy Jirikowic, Ginger MacDonald, Katie Haerling
PURPOSE: Since the reauthorization of the Higher Education Opportunity of 2008 (Public Law 110–315), the choice to attend college is possible for students with intellectual disabilities (Grigal & Hart, 2010). Yet, students demonstrate challenges with adaptive behavior skills and performance expectations, impacting outcomes for school, employment, and independent living (Garrison-Wade, 2012). Research indicates that independence in adaptive behaviors is more critical for outcome than IQ (Foley, Dyke, Girdler, Bourke, & Leonard, 2012). While occupational therapy (OT) fosters adaptive behavior skill acquisition, it is infrequently used in secondary settings (Gangl, Neufeld, & Berg, 2011; Kertcher, 2014).
This research addressed two primary questions—(1) What are the needs of postsecondary students with intellectual and/or developmental disabilities to participate in and complete program requirements? and (2) How are the identified needs currently supported?—and two subquestions—(1) How are the identified needs of young adults with intellectual and/or developmental disabilities falling under the purview of the profession of OT? and (2) What are the perceptions of young adults with intellectual and/or developmental disabilities and their parents regarding OT intervention to prepare for postsecondary education?
DESIGN: A qualitative instrumental, exploratory case study was conducted of a college educating students with intellectual and/or developmental disabilities regarding adaptive behavior needs in relation to the scope of OT. The 32 participants secured through purposive and snowball sampling included college administrators (n = 4) and instructors (n = 8), occupational therapists (n = 5), parents or guardians (n = 5), and students with intellectual and/or developmental disabilities (n = 10).
METHOD: In-depth interviews were supported by a demographic survey, class observations, document review, adaptive behavior skill assessment, and researcher reflection. Data were organized, coded, analyzed, and interpreted relative to analytic categories derived from the literature and research questions. Categories included persisting needs, current supports promoting student success, whether needs fell under the scope of OT, and participant perception of OT.
RESULTS: The five primary outcomes were as follows: (1) All participants indicated persisting challenges in adaptive behavior skills. (2) A majority of participants reported that faculty naturally support students at their need level. (3) Nearly all areas of occupation were represented. (4) While half of the participants were unfamiliar with OT, a majority stated uncertainty regarding OT for the students. (5) All participants desired students to attain optimal independence, employment, relationships, and community acceptance.
CONCLUSION: This study identified persisting adaptive behavior needs of postsecondary young adults with intellectual disabilities, supports and accommodations to promote student success, and how needs fell within the scope of OT. All 10 students demonstrated low adaptive behavior skills that fall within the OT scope of practice yet are inconsistently addressed at the secondary or postsecondary levels. Uncertainty persists regarding how OT may benefit postsecondary students.
IMPACT STATEMENT: OT needs to close the gap in service provision for postsecondary young adults with intellectual disabilities. Practitioners must promote OT to serve students in adaptive behavior skill development as well as in employment and life skill development. This requires systems change for school and clinic-based services. Advocating on behalf of students for continued OT service provision up through young adulthood is necessary. No longer should this be considered an emerging practice area. Young adults with disabilities are precipitously enrolling in postsecondary education. A call to action is warranted.
References
Foley, K.-R., Dyke, P., Girdler, S., Bourke, J., & Leonard, H. (2012). Young adults with intellectual disability transitioning from school to post-school: A literature review framed with the ICF. Disability and Rehabilitation, 34, 1747–1764. https://doi.org/10.3109/09638288.2012.660603
Gangl, C., Neufeld, P. S., & Berg, C. (2011). A qualitative study of occupational therapy’s role in adolescent transition in a Midwestern coalition of many school districts. Journal of Occupational Therapy, Schools, and Early Intervention, 4, 154–167.
https://doi.org/10.1080/19411243.2011.595313
Garrison-Wade, D. F. (2012). Listening to their voices: Factors that inhibit or enhance postsecondary outcomes for students with disabilities. Journal of Special Education, 27, 113–125.
Grigal, M., & Hart, D. (2010). Think college! Postsecondary education options for students with intellectual disabilities. Baltimore: Paul H. Brookes.
Kertcher, E. (2014). Postsecondary education in students with intellectual disabilities. Developmental Disabilities Special Interest Section Quarterly, 37(2), 1–4.
