Date Presented 03/28/20
The B.E.E. Program was a three-phase project that was completed to develop a community- and occupation-based program for adults with I/DD. The study examined the feasibility and acceptability of implementing this program in an established community facility. The program involved two individuals who participated in an eight-week program that targeted occupational exposure through a community volunteer experience and education sessions aimed at increasing independence with activities of daily living and instrumental activities of daily living.
Primary Author and Speaker: Kelsey Voltz
PURPOSE: The purpose of this study was to examine the feasibility and acceptability of a community and occupation-based day program for adults with disabilities. There has been a shift of care for individuals with intellectual and developmental disabilities (I/DD) that has been occurring over the past 20+ years. This shift has moved care from institutionalized settings and into the community. Due to this, there is a growing need for community-based services for this population and a focus on community participation. Additionally, individuals with I/DD are widely underrepresented in integrated competitive community employment. To address needs and overcome barriers, solutions that promote independence and integrate individuals with I/DD in community participation are needed. It is hypothesized that occupational therapy has a role and can effectively develop and implement client-centered programs to meet the needs of the population and the community.
DESIGN: This study was a qualitative three-phase (exploratory, development, and implementation) process completed to develop a community and occupation-based program for adults with I/DD. A convenience sampling of individuals who already utilize an existing community service was completed which matched the following inclusion criteria: 1) age 21 and over, 2) mild to moderate developmental disability, 3) ambulatory or independent with the use of a device, 4) verbal or minimally verbal to express wants and needs, and 5) independent with restroom self-care tasks.
METHOD: The program involved two participants who participated in an 8-week program that targeted occupational exposure through a community volunteer experience at a community partner and education sessions aimed at increasing independence with ADLs and IADLs. The program used established benchmarks to determine the feasibility and acceptability and gauged the participants’ and the community partner’s confidence and satisfaction throughout the program through weekly Likert scaling to see changes in perception over time. Goal Attainment Scaling (GAS) was used to gauge the participants’ responses and to track the progress of each participant at the end of the program. The occupational therapist tracked the level of assistance required for task completion, scoring both physical and verbal assistance. These served as additional indications of the response to the volunteer work. To measure response towards the education sessions, the Pittsburgh Rehabilitation Participation scale was used to measure each participant’s participation in the program.
RESULTS: Both participants and community partners displayed confidence and satisfaction in the program through results in Likert scaling. Both participants met goals on the GAS and displayed increased independence and participation in tasks completed over the course of the program. 100% of the feasibility benchmarks were met and 100% of the participant’s goals were achieved.
CONCLUSIONS: There is a need for new and innovative programs to support individuals with I/DD in the community, specifically in integrated and competitive employment. This need for services is ideal for occupational therapy to be a leader in the field, offering client-driven, occupation-based services in the community as evident by the successful implementation of the pilot program. The integration of the program was feasible and accepted by the participants, community partner and the facility in which it was implemented. The occupation and community-based focus led to positive and favorable results from the three constituents of the project. The results of this study contribute to the body of evidence that occupational therapists have unique skills, that can make a profound effect on services for adults with I/DD.
References
Bathje, M., Lannoye, M., Mercier, A., & Panter, K. (2018). A Review of Occupation-Based Life Skills Interventions for Adults with Neurodevelopmental Disorders. Occupational Therapy in Mental Health, 34(2), 165-180. doi:10.1080/0164212x.2017.1360168
Engquist, G., Johnson, C., & Johnson, W. C. (2012). Systems of care for individuals with intellectual and developmental disabilities: A survey of states. Hamilton: Center for Health Care Strategies Policy Brief.
Holwerda, A., van der Klink, J. J., de Boer, M. R., Groothoff, J. W., & Brouwer, S. (2013). Predictors of work participation of young adults with mild intellectual disabilities. Research in developmental disabilities, 34(6), 1982-1990.
Lindsay, S., Cagliostro, E., Albarico, M., Mortaji, N., & Karon, L. (2018). A systematic review of the benefits of hiring people with disabilities. Journal of occupational rehabilitation, 28(4), 634-655.
