Date Presented 04/21/2023

The transition to adulthood is challenging for adolescents with disabilities. This study evaluated the efficacy of a transitions–instrumental activities of daily living (IADL) program for adolescents with disabilities to improve client-centered goals and executive functioning.

Primary Author and Speaker: Katherine S. Ryan-Bloomer

Additional Authors and Speakers: Kalvin Hudson, Katherine Mathias, Annalise Mergen, Macey Mick, Grace Mitchell, Katherine Hill

PURPOSE: Research suggests a need for self-directed Transitions-IADL programs that ease the transition into adulthood for adolescents with disabilities (Anaby et al., 2018; King et al., 2006; Seong et al., 2014; Ullenhag et al., 2020). Limited research exists investigating the efficacy of IADL programs. The purpose of this study was to measure the efficacy of a Transitions-IADL program for adolescents with various disabilities. Research questions asked, Was a Transitions-I-ADL Program effective for improving 1) client-centered IADL goals and 2) executive functioning skills?

METHOD:

DESIGN: Pre-post study Participants: N= 9, ages 13-21 with varying disabilities purposively recruited Instruments: COPM, Demographic survey, daily documentation notes Intervention: 4 wk group program: 3 hrs/day x 5 days/ wk x 4 wks. OT present each hour with co-treatments with SLP and neuropsychology. Interventions focused on IADLs of meal preparation, home management, hobby exploration, job skills training, & transportation Data Analysis: Wilcoxon signed ranks, descriptive statistics, qualitative thematic analysis of daily notes

RESULTS: IADL Client-Centered Goals: statistically significant improvements in COPM performance, Z (4,5) = -2.023, p = .043 and COPM satisfaction, Z (4,5) = -2.023, p = .043 Executive Functioning: staying on topic and problem solving were the most notable executive function improvements

CONCLUSION/IMPACT: The findings suggest that the Transitions-IADL program was effective to improve client-centered goals and executive functioning for adolescents within this sample which supports previous literature. This Transitions-IADL program was more varied in its range of activities than in those found in previous literature, which may have led to broader improvements. Though this study yielded positive results, it was limited by sampling and measurement bias. More research is needed to build the evidence base for Transitions-IADL group programming.

References

Anaby, D. R., Avery, L., Feldman, D., Law, M. and Majnemer, A. (2018). The effectiveness of the Pathways and Resources for Engagement and Participation (PREP) intervention: Improving participation of adolescents with physical disabilities. Developmental Medicine & Child Neurology, 60(5), 513–519. https://doi.org/10.1111/dmcn.13682

King, G. A., Baldwin, P. J., Currie, M., & Evans, J. (2006). The effectiveness of transition strategies for youth with disabilities. Children’s Health Care, 35(2), 155–178. https://doi.org/10.1207/s15326888chc3502_4

Seong, Y., Wehmeyer, M.L., Palmer, S.B., & Little, T.D. (2014). Effects of the self-directed individualized education program on self-determination and transition of adolescents with disabilities. Career Development and Transition for Exceptional Individuals, 38(3), 132–141. https://doi.org/10.1177/2165143414544359

Ullenhag, A., Granlund, M., Almqvist, L., & Krumlinde-Sundholm, L. (2020). A strength-based intervention to increase participation in leisure activities in children with neuropsychiatric disabilities: A pilot study. Occupational Therapy International, 2020, 1–11. https://doi.org/10.1155/2020/1358707