Date Presented 04/02/2022
Transitional-age youth and young adults with autism spectrum disorder (ASD) often face transportation challenges that impede community participation. The purpose of this study was to examine the impact of a comprehensive peer support OT intervention program on the travel skills of individuals with ASD to increase community mobility.
Primary Author and Speaker: Elizabeth Pfeiffer
INTRODUCTION: Transitional age youth and young adults with Autism Spectrum Disorders (ASD) 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 ASD overcome transportation barriers and increase community mobility. Peer support is identified as an effective mediator when implementing interventions for people with ASD (Chan et al., 2009). Peer support interventions are founded on the concept that someone with lived experience can best understand the unique perspective of the individual while increasing the acceptability and feasibility of an intervention. The purpose of this study was to examine the impact of a comprehensive OT intervention program provided through peer support on the travel skills of individuals with ASD.
DESIGN: A quasi-experimental pre-test post-test design was used to evaluated travel skills before and after an OT developed travel intervention delivered through peer support. Thirty-eight transitional age youth and young adults with ASD aged 16-27 were recruited through local service agencies to participate in an eight-step plan for teaching independent travel on public transit (Kennedy Center, 2021). The program was delivered using certified Peer Support Specialists who were individuals with ASD and supervised by OTs.
METHOD: Pre- and post-test data were collected 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 collected. Qualitative and quantitative data was collected on feasibility and acceptability of the intervention. Quantitative analysis included both descriptive statistics and paired sample t-tests using SPSS (version 27). Qualitative data was coded into themes using a grounded theory approach.
RESULTS: Participants made substantial gains on the competencies needed for independent travel. Post-test scores were significantly higher (M = 107.65; SD = 4.25) than pre-test scores (M = 91.09; SD = 11.8) on the PETS. Paired sample t-tests identified a significant difference with a very large effect size in scores on the PETS before and after the intervention, t(33) = 11.30, p = .000, Cohen’s d (based on differences) with Hedges correction = 1.92. Feasibility data identified that 98% of all data was collected and there were no drop-outs in the study. Qualitative themes identified strong acceptability for peer support and individualized community mobility goals.
CONCLUSIONS: The results of this study provide preliminary support for the use of a structured and comprehensive travel intervention program delivered using peer support 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
Chan, J. M., Lang, R., & Rispoli, M. (2009). Use of peer-mediated interventions in the treatment of autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 3, 876-889.
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.2015.0
