Date Presented 04/04/19
This study investigated the effects of the Alert Program® sensory strategies on communication, social interaction skills, and occupational performance of adults with intellectual and developmental disabilities (IDD). Significant positive pre- to postchanges were found: communication and interaction skills improved (p = .043) and demonstrated improvements in occupational performance (p = .046).
Primary Author and Speaker: Jennifer Allison
Additional Authors and Speakers: Mary Shotwell, Benjamin Keeling, Robert Simon
PURPOSE: The purpose of this study was to investigate the effects of the Alert Program® sensory strategies on communication, social interaction skills, and occupational performance of adults with developmental and intellectual disabilities (DD/ID). Over two million adults with DD/ID live in the United States. These individuals demonstrate less community participation, fewer interpersonal and social relationships, lower leisure participation and decreased employment opportunities. Occupational therapists work with individuals with DD/ID and organizations serving individuals with DD/ID to enable occupational participation. Currently, there is very limited research on the effects of sensory based strategies and their possible use as interventions to help improve the lives of individuals with DD/ID. The overwhelming majority of the sensory based research literature currently available pertains to children with a DD/ID diagnosis.
DESIGN: A quasi-experimental, repeated measures design was completed with 7 adults with DD/ID at a community-based facility using a convenience sampling method. Four participants had a primary diagnosis of a moderate ID, one reported Autism spectrum disorder (ASD), and two participants reported a mild ID with their ages ranging from 24 years to 57 years. The participants attended programs at the facility three to five days per week. Consent was obtained from the day program and from the participants and/or their legal guardian. The study received approval from the university IRB.
METHOD: The researchers implemented a 12 module adapted protocol based on the Alert Program®, delivered in group sessions, with the 7 adult participants. The modules focused on teaching self-regulation strategies to improve participation in group activities and communication and social skills. The Assessment of Communication and Interaction Skills (ACIS), which assesses communication and interactions skills of an individual while completing an occupation. The Comprehensive Occupational Therapy Evaluation (COTE) was used to assess interaction skills and occupational behaviors. The ACIS and COTE were used before and after each of the 14 sessions to observe skills during a group activity over 7 weeks. The Alert Program® was not administered during session 1 (baseline) and session 14 (post intervention). Data was analyzed using the SPSS software. T-tests, where appropriate, and Wilcoxon signed-ranks tests were used to determine group differences. T-tests and an ANOVA, followed by post hoc analyses, were employed to explore individual differences.
RESULTS: Significant pre to post change was found for all participants in communication and interaction skills on ACIS (p = .043) and occupational performance on the COTE (p = .046); Significant change in occupational performance was found within session 7 (p = .02) for all participants on COTE; significant change in communication and interaction skills was found for all participants within sessions 6 (p = .03), 7 (p = .05), 10 (p = .01), 12 (p = .05), 14 (p = .02) on ACIS.
CONCLUSION: The hypotheses were accepted that (a) the use of the sensory strategies with adults with DD/ID will affect communication and interaction skills during group activities as measured by the ACIS; and (b) the use of the Alert Program® sensory strategies with adults with DD/ID will affect occupational performance during group activities as measured by the COTE.
IMPACT STATEMENT: The Alert Program® is an effective program occupational therapists can use to address self-regulation to positively impact communication, interaction skills, and occupational performance in adults with DD/ID.
References
Verdonschot, M., deWitte, L., Reichrath, W., Buntinx, W., & Curfs, L. (2009). Community participation of people with an intellectual disability: A review of empirical findings. Journal of Intellectual Disability Research, 53(4), 303–318.
Haertl, K. (2014). Adults with intellectual and developmental disabilities: Strategies for occupational therapy. Bethesda, MD.: AOTA Press.
Williams, M. S., & Shellenberger, S. (1996) How does your engine run? A leader’s guide to the alert program for self-regulation. Albuquerque, NM: The Therapy Works, Inc.
Allison, J. L., & Shotwell, M. (in press). The comprehensive occupational therapy evaluation. In B. J. Hemphill-Pearson & C. K. Urish (Eds.). Assessments in Occupational Therapy Mental Health: An Integrative Approach (3rd Edition). Thorofare, NJ: Slack Incorporated.
