Environmental and Technology Needs of Persons With Developmental Disabilities: A Preliminary Descriptive Study

PURPOSE AND BACKGROUND: Older individuals diagnosed with developmental disability (DD) display significant deficits in performing activities of daily living (ADLs; Totsika, Felce, Kerr, & Hastings, 2010). Everyday technologies such as tablets and iPads and specialized apps have potential to provide structure and coaching in task performance, thus improving the functional independence of individuals (Arvidsson, Granlund, & Thyberg, 2007; Kagohara et al., 2013). However, there is not sufficient evidence on how to assess the common use of technology devices or on how to assess ADL performance among individuals with DD. This study aimed to establish a comprehensive assessment process for independent living skills and use of technology among adults with DD.

DESIGN AND METHODS: This descriptive study explored the feasibility of an assessment battery. Participants were four adults ages 32, 33, 55, and 61 diagnosed with DD. Inclusion criteria were (1) residents in a supported living setting; (2) experiencing functional limitations in ADLs; (3) ability to communicate consistently in English by either verbal, written, or communication device; (4) ability to follow one-step directions and attend to a task for a minimum of 15 min; and (5) motor function in one upper extremity to perform individually selected task. Exclusion criteria were (1) significant sensory disability and (2) active psychiatric or behavioral issues. Consent and assent were obtained with adherence to preapproved institutional review board criteria.

An assessment battery was assembled based on an extensive literature review to examine (1) client’s cognitive performance, using the Behavioral Rating Inventory of Executive Function Adult Informant Version (BRIEF–A); (2) client’s environment and performance, using a background questionnaire, the Canadian Occupational Performance Measure (COPM), the Independent Living Scales (ILS), the Waisman Activities of Daily Living client and caregiver versions (W–ADL), and a macroanalysis of ADL performance; and (3) use of technology, by means of a technology survey, client and caregiver versions.

RESULTS: The data gathered were analyzed using descriptive statistics (IBM SPSS Statistics Version 23) and macroanalysis of transcribed video footage to detect frequency of occurring behaviors. The BRIEF–A and ILS displayed a floor effect, while the COPM was found to be challenging with respect to individuals’ communication skills and ability to comprehend a numeric scale.

The researchers found the following battery to be sensitive to individuals’ characteristics and reflective of their performance in their everyday environment: W–ADL client and caregiver versions, macroanalysis of ADL performance, and technology survey client and caregiver versions. Preliminary data analysis indicated similar averages for both clients’ and caregivers’ ratings of ADL performance (client M = 2.32, SD = 0.23; caregiver M = 2.52, SD = 0.21). However, their perspectives differed regarding the use of technology, with caregivers indicating more positive attitudes toward its potential support and implementation (client M = 2.52, SD = 0.21; caregiver M = 3.40, SD = 0.09).

CONCLUSION: Initial findings lend support to the feasibility of implementing the above-mentioned comprehensive and population-sensitive assessment battery. Furthermore, these results indicate the importance of incorporating both clients’ and caregivers’ perspectives into the assessment process.

IMPACT STATEMENT: This preliminary study of baseline measures can inform occupational therapy practice with a new arena and set of tools that can further promote clinical intervention with this understudied population.

References

Arvidsson, P., Granlund, M., & Thyberg, M. (2007). Factors related to self-rated participation in adolescents and adults with mild intellectual disability—A systematic literature review. Journal of Applied Research in Intellectual Disabilities, 21, 277–291. https://doi.org/10.1111/j.1468-3148.2007.00405.x

Kagohara, D. M., van der Meer, L., Ramdoss, S., O’Reilly, M. F., Lancioni, G. E., Davis, T. N., . . . Sigafoos, J. (2013). Using iPods and iPads in teaching programs for individuals with developmental disabilities: A systematic review. Research in Developmental Disabilities, 34, 147–156. https://doi.org/10.1016/j.ridd.2012.07.027

Totsika, V., Felce, D., Kerr, M., & Hastings, R. P. (2010). Behavior problems, psychiatric symptoms, and quality of life for older adults with intellectual disability with and without autism. Journal of Autism and Developmental Disorders, 40, 1171–1178. https://doi.org/10.1007/s10803-010-0975-1