Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
This project brings to our attention OT's important role in meeting the ever-changing service needs of individuals with autism spectrum disorder (ASD) as they transition into adulthood. Comparative analysis of pretest, posttest, and maintenance assessment scores offers insight into changes and begins an important discussion of how we can improve and sustain adaptive life skills in adolescents with ASD for the long-term goal of changing their trajectory for greater independence.
Primary Author and Speaker: Elizabeth Grant
Additional Authors and Speakers: Shirley O'Brien, Geela Spira
Contributing Authors: Scott Tomchek
BACKGROUND: This pilot project brings to our attention the importance of occupational therapy's role in meeting the continued and ever changing service needs of individuals with ASD as they transition into adulthood. Adaptive life skill groups fill a gap in services for adolescents and support learning and performance of everyday occupations necessary for independent living.
PURPOSE: The purpose of this pilot project is to determine if occupational therapy adaptive life skill groups are an effective method for improving adaptive life skill performance and if performance gains are maintained for five months in a group of adolescents with ASD. This study answers the following research questions: Are there differences in General Adaptive Composite (GAC) and three domain scores on the Adaptive Behavior Assessment System—Third Edition (ABAS-3; Harrison & Oakland, 2015) and Percent of Maximum Possible Score (POMP; Keller et al., 2014) scores on the Child Occupational Self-Assessment (COSA; Keller et al., 2014) for participants when comparing between pre- and post-group scores and when comparing between post-group and five months post-group scores? Are differences noted statistically significant?
DESIGN: This is a quantitative research study examining the effectiveness of group interventions on adaptive life skill performance of adolescents with ASD. Part one is a retrospective design, utilizing a pretest/posttest analysis of assessment scores. Part two is a prospective design measuring maintenance of skills at five months post intervention for the same six participants chosen in part one of this study. OT adaptive life skill groups were held at a university-based autism center for adolescents with ASD. Groups offered structured supports and strategies fostering greater adaptive life skill performance. Participants attended group up to nine sessions (offered one time per week) for 60 min each session, following best practice in group use (Tanner et al., 2015).
METHOD: Retrospective and prospective data was collected by the study Primary Investigator (PI). Data collection included age, gender, attendance, and pre, post and maintenance measures. The ABAS-3 GAC and domain scores were collected along with COSA POMP and report of independence were collected and entered into Statistical Package for Social Sciences (SPSS) on individuals that attended the adaptive life skills groups. Additionally, prompting (level of and frequency) metrics in daily treatment notes were collected by task focus in the group by session. Group differences were analyzed using a paired t-test for ABAS-3 GAC and domain scores while the Wilcoxon signed-ranks test investigated differences with COSA POMP scores. Session treatment notes were reviewed in the retrospective portion of the study, to add depth in understanding about session participation.
RESULTS: The results of the pilot study show no statistical significance in assessment scores, but would also be considered inconclusive given the small sample size (n = 6). There was indication of individual improvement of assessment scores from pretest to posttest and posttest to the five month maintenance, but not enough to demonstrate statistical significance. Through visual analysis of the assessment scores, a pattern of improvement emerged with participants maintaining improvement over the five month time period. Individual achievement of goals identified through group was achieved for all participants.
CONCLUSIONS: Exploring the sustaining value of group participation is important within occupational therapy practice. The data in this pilot study begins an important discussion of how we can improve adaptive life skills in adolescents with ASD for the long term goal of changing their trajectory for greater independence.
References
Harrison, P., & Oakland, T. (2015). Adaptive Behavior Assessment System, Third Edition (ABAS–3). Torrance, CA: Western Psychological Services.
Keller, J., Velden, M., Kafkes, A., Basu, S., Federico, J., & Kielhofner, G. (2014). A user’s manual for Child Occupational Self-Assessment (COSA) (Version 2.2). Chicago, IL: Model of Human Occupation Clearinghouse.
Tanner, K., Hand, B. N., O’Toole, G., Lane, A. E. (2015). Effectiveness of interventions to improve social participation, play, leisure and restricted and repetitive behaviors in people with autism spectrum disorder: A systematic review. American Journal of Occupational Therapy, 69(5), 6905180010. http://dx.doi.org/10.5014/ajot.2015.017806
Tomchek, S.D. & Koenig, K. P. (2016). Occupational Therapy Practice Guidelines for Individuals with Autism Spectrum Disorder. Bethesda, MD: AOTA Press.
