Date Presented 03/27/20
Individuals with intellectual or developmental disabilities have unmet transportation needs, which limits their community mobility. Access to transportation is linked to community participation and independence in adult outcomes. The purpose of this study was to examine the implementation feasibility of Community Mobility Plans, an individualized OT intervention.
Primary Author and Speaker: Beth Pfeiffer
PURPOSE: Individuals with intellectual and/or developmental disabilities (IDD) have unmet transportation needs, which limits their community mobility (Durbin, Sirotich, Lunsky, and Durbin, 2015). Community mobility is considered an instrumental activity of daily living according the AOTA Practice Framework (AOTA, 2014), which provides practitioners a guide for holistic intervention by summarizing multiple constructs related to meaningful activity (AOTA, 2014). Limited access to transportation is linked to poor adult outcomes and reduces an individual’s ability to participate in the community and achieve independence. Travel training for public transportation enables independent mobility and is linked to the outcomes of quality of life and social inclusion (Bührmann & Fiedler, 2010). The purpose of this study is to examine the implementation feasibility of an individualized intervention, Community Mobility Plans (CMP), for transitional age youth and young adults with IDD.
DESIGN: A pre-test post-test one group design was used to determine the feasibility of the intervention, to target appropriate outcome measures for subsequent phases, and to manualize the intervention based on feedback from key stakeholders.
METHODS: Participants were 6 transition age youth and young adults with IDD who received the CMP intervention over a period of 3 to 8 sessions. CMP use a cyclical process where the individual first develops self-determined community mobility goals followed by a comprehensive assessment process and individualized environmental and person-centered travel interventions. Pre-test and post-test measures (e.g., Progressive Evaluation of Travel Skills [PETS], Goal Attainment Scaling [GAS], TU Participation Scale [TUPS]) were administered by researchers prior to and at the end of the intervention sessions. Additionally, data were collected during the study to assess feasibility of the intervention (e.g., number/reason for drop outs, sessions to goal attainment) and to determine appropriate outcome measures for subsequent phases (e.g., time to administer, understandability of items). Descriptive statistics were calculated to evaluate feasibility data and paired sample t-tests to determine any significant differences in pre-test post-test measures.
RESULTS: Data suggested that CMP are a feasible intervention for implementation with individuals with IDD. There were no drop outs and all participants met their goals in 3 to 8 sessions. Administration of measures ranged from 30-60 minutes. Participants demonstrated significant improvement between pre- and post-test scores on the measures of the Progressive Evaluation of Travel Skills (t(5) = -4.481, p = .007) and Goal Attainment Scaling (t(5) = -7.457, p =.001), but there were no significant changes on the TUCP.
CONCLUSION: CMP may provide a feasible option to improve community mobility for individuals with IDD, although further research is needed to determine effectiveness. CMP have the potential to help individuals with IDD meet their self-determined community goals and improve travel skills.
References
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1– S48. http://dx.doi.org/10.5014/ajot.2014.682006
Bührmann, S., & Fiedler, M. (2010). Guidelines for implementers of travel training for public transport. Niches+. Retrieved from https://www.polisnetwork.eu/publicdocuments/download/118/document/21582_policynotesWG1_1.indd_low.pdf (no doi)
Durbin, A., Sirotich, F., Lunsky, Y., & Durbin, J. (2015). Unmet needs of adults in community mental health care with and without intellectual and developmental disabilities: A cross-sectional study. Community and Mental Health Journal, 53(1), 15-26. doi: 10.1007/s10597-015-9961-6
