Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Adolescents with autism spectrum disorder (ASD) show poor independence in daily activities. The self-report Daily Routine and Autonomy Questionnaire (DRA) identifies adolescents' actual versus desired independence in daily routines and promotes setting and achieving goals. This research assesses the DRA with adolescents with ASD. Results indicate moderate to high internal reliability and significantly higher desire for independence than independence level, indicating potential goals they can set.
Primary Author and Speaker: Liron Lamash
Additional Authors and Speakers: Naomi Josman
INTRODUCTION: Adolescents with autism spectrum disorder (ASD) show poor independence in daily activities (Wehmeyer & Garner, 2003). Occupational therapists lack suitable assessments to help adolescents develop resilience in setting and meeting independence goals and transitioning into independent adults (Hodgetts & Park, 2017). Unlike existing instruments, the innovative self-report Daily Routine and Autonomy questionnaire (DRA; Lamash & Josman, 2020) addresses their level of and desire for independence in activities throughout a full daily routine and promotes their involvement in setting and achieving independence goals. This study describes the DRA development, explores its psychometric properties and internal consistency reliability using full-information factor analysis (FIFA; Bock et al., 1988), and identifies levels of and desire for independence among adolescents with ASD.
DESIGN: This cross-sectional study included 72 adolescents with ASD (58 boys and 14 girls) aged 11 to 19 years (M = 14.59 years, SD = 1.61) recruited through a convenience sample. All participants attended special education classes at mainstream schools. Inclusion criteria required participants to have normal IQs and basic skills (e.g., read, write, and understand instructions) to respond to the DRA. The sample excluded adolescents with significant physical or mental conditions that limited their movements, senses, or activities.
METHOD: To describe DRA development and implementation with adolescents with ASD, advanced statistical analyses were performed using SPSS and R. Internal consistency reliability, FIFA, Spearman’s correlations, t tests, and Wilcoxon signed-rank tests were conducted to assess relationships and differences between the DRA parts.
RESULTS: The FIFA revealed three factors with high sum of squared loadings (4.09–5.13). Of the 31 DRA items, 28 had factor loadings higher than .35 and were retained in the study questionnaire. The DRA had moderate-to-high internal reliability for factors (α = .65–.84) and total scores ((α = .86–.90). Participants showed partial independence in most daily activities, with high desire for independence in social and leisure activities. Significant gaps in half of the DRA items indicate the participants’ desire for independence was significantly higher than their independence level.
CONCLUSION: The DRA provides crucial information about levels of and desire for autonomy that can be used to promote participation of adolescents with ASD in setting their own goals for independent living.
IMPACT STATEMENT: The DRA is a short, targeted questionnaire that can enrich knowledge regarding the independence status of adolescents with ASD and offers an option to involve the adolescents. Unlike other instruments to assess independence in adolescents with ASD, the DRA focuses on the adolescent’s (rather than the caregiver’s) perspective and reflects a typical routine of daily activities rather than specific activities. As such, it can provide a good solution in interventions that focus on everyday life functioning and allow the adolescents to set their own goals.
References
Bock, R. D., Gibbons, R., & Muraki, E. (1988). Full-information item factor analysis. Applied Psychological Measurement, 12, 261–280. https://doi.org/10.1177%2F014662168801200305
Hodgetts, S., & Park, E. (2017). Preparing for the future: A review of tools and strategies to support autonomous goal setting for children and youth with autism spectrum disorders. Disability and Rehabilitation, 39, 535–543. https://doi.org/10.3109/09638288.2016.1161084
Lamash, L., & Josman, N. (2020). Full-information factor analysis of the Daily Routine and Autonomy (DRA) questionnaire among adolescents with autism spectrum disorder. Journal of Adolescence, 79, 221–231. https://doi.org/10.1016/j.adolescence.2020.01.011
Wehmeyer, M. L., & Garner, N. W. (2003). The impact of personal characteristics of people with intellectual and developmental disability on self-determination and autonomous functioning. Journal of Applied Research in Intellectual Disabilities, 16, 255–265. https://doi.org/10.1046/j.1468-3148.2003.00161.x
