Date Presented 04/01/2022
High school Individualized Education Program (IEP) goals of 44 diploma-track autistic youth were coded for content. Most goals addressed social-emotional, executive function, and self-advocacy. Sensory processing, daily living skills, and postschool occupations were least addressed but are known challenges for this population. Although OTs rarely provided school services for these youth, these areas are aligned with the scope of OT practice. There is a need to advocate for OT’s role in transition services for this population.
Primary Author and Speaker: Sharada Krishnan
Contributing Authors: Deborah Greene, Jennifer Chen, Ellen Cohn, Wendy Coster, Gael Orsmond
A significant and growing number of autistic transition-age youth enroll in post-secondary education (PSE) programs (Roux et al., 2015). Autistic PSE students experience challenges in academic and non-academic areas (e.g., social-emotional, executive function, self-advocacy, sensory processing, daily living skills; Anderson et al., 2017). While school-based services play a key factor in promoting positive transitions (AOTA, 2018), little is known about what high school services are provided for diploma-track autistic youth or the extent to which provided services align with their PSE needs. The purpose of this study is to 1) describe the focus of school services, indicated by Individualized Education Plan (IEP) goal content, for this population and 2) identify the school service providers working with this population. By understanding the focus of school-based services for diploma-track autistic youth during transition years, occupational therapists (OTs)—who are often under-represented providers in transition services (Pierce et al., 2020)—will be able to advocate for our role in transitions and better support these students’ PSE visions. In this descriptive study, we analyzed the IEPs of 44 autistic high schoolers aged 14-18. Participants were recruited from community organizations and social media throughout the USA. All participants received special education services through an autism classification, expected to graduate with a regular diploma, and did not have intellectual disability. We coded the goals and objectives of 44 IEPs using directed content analysis, according to whether goals addressed 13 domains. A codebook was initially developed through literature review and iteratively refined. Domains included academic, study strategies, technology, language and communication, sensory/motor, social/emotional/behavioral, executive function (EF), self-determination/advocacy (SA), independent living skills, employment, PSE, leisure, and transition (other). Service providers listed in IEPs were recorded. At least 2 raters coded each IEP; discrepancies were resolved through team meetings. All raters achieved good interrater reliability (Cohen’s kappa >.80). Descriptive statistics were calculated for the total number of goal domains per IEP; frequencies were calculated for goal domains and service providers. On average, IEPs included goals in 5.23 domains (SD = 1.95). Most IEPs included goals addressing social/emotional/behavioral skills (n = 41, 93%), EF (n = 39, 89%), SA (n = 33, 80%), and academic content (n = 28, 64%). Less than half had goals on study strategies (n = 21, 48%), technology use (n = 10, 23%), independent living (n = 10, 23%), employment (n = 19, 43%), PSE preparation (n = 19, 41%), and other transition (n = 7, 16%). The least addressed areas were basic language (n = 3, 7%), sensory/motor (n = 1, 2%), and leisure (n = 1, 2%). The most common personnel responsible for goals were special educators (n = 40, 91%), SLPs (n = 21, 48%), and school counselors (n = 12, 27%). Fewer than 25% of IEPs included psychologists, general education teachers, and behavior staff. Only 9% of IEPs (n = 4) included an OT. There was considerable variability in the focus of goals and service personnel included in IEPs. Few IEPs addressed several known challenges for this population that persist in PSE, such as daily living skills and managing sensory challenges. There were also few IEP goals related to leisure, PSE, and employment. OTs, who were rarely included as service providers in IEPs, are well-equipped to support these goal domains (AOTA, 2018). Thus, findings suggest a unique role for OTs in high school transition services for diploma-track autistic youth. OT advocacy and service provision changes are needed to better prepare these youth for PSE.
Roux, A.M., Shattuck, P.T., Rast, J.E., Rava, J.A., & Anderson, K.A. (2015). National autism indicators report: Transition into young adulthood. Philadelphia, PA: Life Course Outcomes Research Program, A.J. Drexel Autism Institute, Drexel University.
Anderson, A. H., Stephenson, J., & Carter, M. (2017). A systematic literature review of the experiences and supports of students with autism spectrum disorder in post-secondary education. Research in Autism Spectrum Disorders, 39, 33–53. https://doi.org/10.1016/j.rasd.2017.04.002
Pierce, D., Sakemiller, L., Spence, A., & LoBianco, T. (2020). Effectiveness of transition readiness interventions by school-based occupational therapy personnel. OTJR: Occupation, Participation and Health, 40(1), 27–35. https://doi.org/10.1177/1539449219850129
American Occupational Therapy Association. (2018). Transitions for children and youth: How occupational therapy can help [Fact sheet]. https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/CY/Fact-Sheets/Transitions.pdf