Date Presented 04/8/21
People with developmental disabilities (DD) often face transportation challenges that impede community participation. The purpose of this study was to examine the impact of a comprehensive intervention program on the travel skills of individuals with DD to increase community mobility.
Primary Author and Speaker: Elizabeth Pfeiffer
Contributing Authors: Allison Smith
INTRODUCTION: People with developmental disabilities (DD) often face serious transportation challenges that impede healthcare access, community participation, and employment opportunities (Risser et al., 2015). Interventions to support travel skills, which makes use of one-on-one instruction, may help people with DD overcome transportation barriers and increase community mobility. The purpose of this study was to examine the impact of a comprehensive intervention program on the travel skills of individuals with DD and the effects of diagnosis on outcomes.
DESIGN: Data that included pre-test and post-test scores on the Progressive Evaluation of Travel Skills (PETS), as well as mode(s) of public transportation used, purpose of use, and number of training sessions were collected and inputted in a secure database by a large travel intervention provider.
METHODS: Participants were 87 individuals diagnosed with one or more DD between the ages of 15-77 years who completed the travel intervention program. The travel intervention program was developed by the Kennedy Center (2012) and uses an eight-step plan for teaching independent travel on public transit. The program was designed so that it could be modified to fit different locations and address individualized needs. Pre and post-test data was collected on travel skills and public transportation use. Data was de-identified and a secondary analysis completed to test the effect of the travel intervention on transportation skill acquisition by fitting a multilevel model to the data. The effects of condition (Intellectual Disability (ID) without Autism Spectrum Disorder (ASD), ID and ASD, ASD without ID), time (pre-intervention, post-intervention), and condition x time interactions on transportation skill T-scores were analyzed.
RESULTS: Participants made very substantial (> 2 standard deviation) gains on the competencies needed for independent travel. At baseline (prior to the start of the transportation intervention), participants' scores on the transportation competency measures were: M = 40.20; SD = 6.4; range = 20.0 – 59.0. After completing training, scores were: M = 58.5; SD = 2.3; range = 40.2 – 59.0. A significant condition x time (intervention) interaction was observed. Prior to intervention, people with ID (with and without ASD) had less developed travel skills than those with ASD (and no ID). Those with ID made larger gains (t = 16.69, p = .00) in travel skills than those ASD/no ID (t = -2.53, p = .01), such that upon completion of the intervention, both groups had comparable skill levels.
CONCLUSIONS: The results of this study provide preliminary support for the use of a structured and comprehensive travel intervention program to improve overall travel skills needed for public transportation. As community mobility is considered an instrumental activity of daily living (AOTA, 2014), an effective travel intervention program to support the use of public transportation for community mobility serves as an important resource for practitioners. Further research is needed using experimental designs, larger sample sizes, and broader outcomes.
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
Kennedy Center, Inc. (2012). Travel training guide. Trumbull, CT: Kennedy Center, Inc. (no doi)
Risser, R., Lexell, E. M., Bell, D., Iwarsson, S., Ståhl, A. (2015). Use of local public transport among people with cognitive impairments: A literature review. Transportation Research Part F: Psychology and Behavior, 29, 83-97. https://doi.org/10.1016/j.trf.2015.01.002
