top of page

Capstone Project

Literature Review​

​

Individuals with intellectual and developmental disabilities (IDD) generally have difficulties with their intellectual ability, physical ability, and/or adaptive behavior skills, or daily living skills (e.g., ADLs, IADLs, socialization, communication, etc.) that allow an individual to engage in their environment successfully; intellectual ability, physical ability, and adaptive behavior skills can influence how individuals participate and perform in the things they want and/or need to do (Berg et al., 2017). For young adults with IDD, graduating high school and transitioning to adulthood is often a complex process that relies heavily on advanced planning (Anderson et al., 2016; Francis et al., 2018). While there are processes in place during high school to promote successful transition amongst youth with IDD, stakeholders such as parents and the youth themselves feel more can be done to encourage positive transition experiences; despite the Individuals with Disabilities Education Act (IDEA) and its mandate regarding postsecondary preparedness through an emphasis on transition planning and skills related to transition while still in high school, this population leaves high-school at-risk, with a decreased likelihood of success (Francis et al. 2018; Lipscomb et al., 2018).

 

Helping young adults with IDD plan for transition, as well as planning programs for transition-related needs, is within occupational therapy's scope of practice and aligns with the "Occupational Therapy Practice Framework," and this framework aligns with the IDEA, but this population is not receiving occupational therapy as accessibly as it should be; occupational therapy research related to the transition needs of young adults with IDD must be undertaken and disseminated to promote the value and role of occupational therapy in this setting (Abbott & Provident, 2016; Benson et al., 2021; Berg et al., 2017; Kardos & White, 2005; Trujillo et al., 2019). The community of occupational therapists working with transition-aged youth with IDD is small, and on top of that, the therapists who do work with the population report minimal participation in transition planning assessment and intervention and believe their contributions to the transition planning process do not maximize their skills (Kardos & White, 2005; Benson et al., 2021).

 

Occupational therapists have the expertise to provide interventions related to ADLs, employment, leisure, social interaction, and community participation, which are the primary focuses of existing transition programming (Blaskowitz et al., 2021). In addition, specific occupational therapy intervention amongst this population has shown significant improvement in adaptive behavior and self-care skills (Kirby et al., 2021). Occupational therapy-related assessment tools can monitor the progress of young adults and offer insight into how to improve programming by looking at occupational performance and participation, person factors, and environmental factors. (Mahoney et al., 2021). Incorporating an OT lens when addressing these areas can offer better outcomes in transition programming.

 

To help young adults with IDD plan to transition to adulthood, it is essential to consider each individual's perspective, desires, and goals; while young adults with IDD have desires that are not so different from that of their typically developing peers, each has a unique idea of what adulthood means and looks like to them, framing the roles they hope to fill and the goals they set when considering transition (Anderson et al., 2016). Occupational therapists can take a client-centered approach to transition programming and meet the individual needs of participants.

​

Summary of Needs Assessment

​

I used the PEOP Framework to construct my approach to collecting data to inform my learning needs for my capstone assignment. I examined my professional person factors, those of young adults with IDD, the environment of St. Louis transition programming, the St. Louis Arc specifically, the roles of individuals with IDD, and my OT role in transition programming. I utilized the following methods:

​

  • Personal Assessments and Professional Feedback 

    • Strengths and Areas for Growth​​

  • Community Stakeholder Interview

    • Overview of existing transition programming in St. Louis, identification of gaps/needs

  • Mentored Scholarship Project

    • Process of 3-semester collaboration with St. Louis Arc developing an independent living skills curriculum for young adults with IDD

  • St. Louis Arc Interview with Manager of Transition Services

    • Current needs of St. Louis Arc transition programming, as well as role/experiences available for capstone project​

  • Analysis of Secondary Transition OT Goals

    • Organization of transition goals identified during Level IIA fieldwork into themes​​​

​

The methods I chose were advantageous because most were specific to the site I will be working with or can otherwise be applied to this site. These methods will allow me to form better learning objectives to match that of the experience I can expect with community programming at St. Louis Arc while giving me a chance to have the same hands-on experience with educational programming. The disadvantage of these methods is that they were mainly qualitative. There are no quantitative results to support my objectives. Occupational therapy's work in transition services for young adults with IDD is an emerging area of practice. I hope to add to the existing research, but I feel there is much to learn about OT's role with this population.

​

A summary of the results per method is as follows:

  • Personal Assessments and Professional Feedback

    • Strengths: empathy, creativity, collaboration, previous experience with population, communication, and flexibility​

    • Areas for Growth: initiative, resiliency, giving constructive feedback, conflict resolution, confidence

  • Community Stakeholder Interview

    • What programming exists:​ St. Louis Arc, Easterseals, Special School District (SSD), UMSL Succeed Program

    • What are the gaps or needs: Community transportation, SSD needs increased inclusion, UMSL Succeed programming – "expectation v. reality," vocational training

  • Mentored Scholarship Project

    • Product of 3-semester collaboration with St. Louis Arc developing an independent living skills curriculum for young adults with IDD​

  • St. Louis Arc Interview

    • Current Needs: NextEd Summer program development and implementation (1 session of a 1-week residential independent living program and two sessions of a 1-week day program)

    • Experiences Available: Transition program development and implementation; collaboration with community partners and organization programs (e.g., UMSL Succeed; Launch)

    • Roles to Serve: Transition Service Provider; OT Lens for program development

  • Analysis of Secondary Transition OT Goals - Themes

    • ​Task Completion

    • Self-Regulation

    • Self-Management

    • Compliance

    • Employment

    • Independent Living

    • Self-Awareness

    • Executive Function

    • Problem-Solving

​

There are many service providers and programs for transition-aged youth in St. Louis, Missouri. While the population has options for continued support after high school, there are still gaps in programming. Community stakeholders see needs in this area. Occupational therapists can work with organizations to improve the quality and content of community and postsecondary education transition programming. The St. Louis Arc is a reputable disability service provider in St. Louis. Even with its reputation, St. Louis Arc would benefit from an OT lens to help develop its transition programming, specifically for the residential independent living programs they aim to implement this summer.

 

Independent living skills go hand in hand with OT's scope of practice. Occupational therapists are well-prepared to provide intervention focused on content areas of self-determination, cooking and nutrition, money management, connection to community resources, routines, managing living spaces, personal safety skills, leisure and wellness, and communication as ADLs and IADLs at the foundation of the profession. Beyond that, themes of transition programming (e.g., self-regulation, self-management, student roles and responsibilities, employment, and executive function) align with the expertise of occupational therapists.

​

Person factors that are beneficial to me as an aspiring occupational therapist pursuing a Capstone project in this area of practice include empathy for the population, creativity for program development and implementation, collaborative nature when working with other transition providers, previous experience with the population, ability to communicate with the population and other providers, and flexibility when changes arise in planning and implementation. Finding the initiative to take creative liberties and leads, and having the confidence to do so, will be areas of growth that this project will facilitate me to address. It will be refreshing to work in person with the population and be a part of such an umbrella organization as the St. Louis Arc, allowing for collaboration and exposure to various programs. The role I will take on with these organizations is one of autonomy and leadership as one of the select few students of Washington University's occupational therapy program collaborating with the organization and contributing an OT lens to transition program development and implementation.

​

Purpose Statement

My proposed capstone aims to highlight occupational therapy's role in transition programming and identify where occupational therapists can fill a need in this programming, addressing person factors, environmental factors, and roles of independent living specifically for young adults with IDD. The capstone promotes utilizing my OT lens, practice in leadership and collaboration, and advocacy for the OT role in transition programming for young adults with IDD.

​

Project Description

My priorities for this capstone experience and project include exploring the role of occupational therapy in postsecondary transition programming and using my OT lens to develop and implement quality programming for transition-aged youth with IDD. The St. Louis Arc's robust programming and access to mentored leadership opportunities will allow me to have a well-rounded experience in this area of practice. My capstone project aims to contribute to the current understanding of occupational therapy's role in transition programming by identifying where occupational therapy can fill a need and expand its role in transition programming. 

 

My proposed learning objectives are as follows:

  • Advocate for OT role in Transition Programming and Leadership Working with Individuals with IDD

  • Utilize the OT-lens to Consult on Transition Program Development

  • Acquire Appropriate Tools and Skills to Engage with Transition-Aged Young Adults with IDD

  • Utilize the OT-lens to Consult on Transition Program Implementation

  • Collaborate with Transition Program Providers for Leadership Development

 

These learning objectives will give me the capacity to confidently advocate for the role of our profession amongst this population and pursue a position that aligns with my career goals in this field. I will culminate my experience with a pitch presentation to the St. Louis Arc for an occupational therapy position in the organization, as well as forms of dissemination directed towards fellow occupational therapists and students to better understand OT's role in this area of practice. Through this, I can impact the occupational therapy and IDD worlds. Students and providers can benefit from being able to advocate for their roles amongst young adults with IDD transitioning from high school who can benefit from increased quality programming that considers their needs and desires and allows them to achieve their personal goals.

​

References

Abbott, B. L., & Provident, I. (2016). Changing occupational therapists' knowledge of their role in secondary transition planning. Journal of Occupational Therapy, Schools & Early Intervention, 9(4), 382- 396. https://doi.org/10.1080/19411243.2016.1227760

​

Anderson, K. A., McDonald, T. A., Edsall, D., Smith, L. E., & Taylor, J. L. (2016). Postsecondary expectations of high-school 
students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 31(1), 16–26. https://doi.org/10.1177/108 8357615610107

 

Benson, J. D., Tokarski, R., Blaskowitz, M. G., & Geubtner, A. (2021). Phenomenological study of the transition process for adolescents with intellectual and developmental disabilities. American Journal of Occupational Therapy, 75(3), 7503180040. https://doi.org/10.5014/ajot .2021.044289

​

Berg, L. A., Jirikowic, T., & Haerling, K. (2017). Navigating the hidden curriculum of higher education for postsecondary students with intellectual disabilities. American Journal of Occupational Therapy, 71(3), 1–9. https://doi.org/10.5014/ajot .2017.024703

 

Blaskowitz, M. G., Johnson, K. R., Bergfelt, T., & Mahoney, W. J. (2021). Evidence to inform occupational therapy intervention with adults with intellectual disability: A scoping review. American Journal of Occupational Therapy, 75(3), 7503180010.

https://doi.org/10.5014/ajot .2020.043562

 

Francis, G. L., Stride, A., & Reed, S. (2018). Transition strategies and recommendations: Perspectives of parents of young adults with disabilities. British Journal of Special Education, 45(3), 277–301. https://doi.org/10.1111/146 7-8578.12232

 

Kardos, M.R., & White, B. P. (2005). The role of the school-based occupational therapist in secondary education transition planning: A pilot survey study. American Journal of Occupational Therapy, 59(2), 173-180. https://doi.org/10.5014/ajot.59.2.173

 

Kirby, A. V., Cottle Feldman, K. J., Himle, M. B., Diener, M. L., Wright, C. A., & Hoffman, J. M. (2021). Pilot test of the Maximizing Adolescent Post-Secondary Success (MAPSS) intervention: Supporting parents of autistic youth. American Journal of Occupational Therapy, 75(3), 7503180070. https://doi.org/10.5014/ajot.2021.045815

 

Lipscomb, S., Lacoe, J., Liu, A. Y., & Hamison, J. (2018). I was preparing for life after high school: The characteristics and experiences of youth in special education. A summary of key findings from The National Longitudinal Transition Study 2012. NCEE Evaluation Brief. National Center for Education Evaluation and Regional Assistance.

​

Mahoney, W. J., Blaskowitz, M. G., & Johnson, K. R. (2021). Occupational therapy-related assessments for adults with intellectual disability: A scoping review. American Journal of Occupational Therapy, 75(3), 75031800100. https://doi.org/10.5014/ajot .2021.046342

​

Trujillo, C., Poach, M., & Carr, M. (2019). Exploring the applicability of occupational therapy transition assessments for students with disabilities. WFOT Bulletin, 75(1), 71–77. https://doi.org /10.1080/14473828.2018.1 556961

​

White, S. W., Elias, R., Salinas, C. E., Capriola, N., Conner, C. M., Asselin, S. B., Miyazaki, Y., Mazefsky, C. A., Howlin, P., & Getzel, E. E. (2016). Students with autism spectrum disorder in college: Results from a preliminary mixed methods needs analysis. Research in Developmental Disabilities, 56, 29–40. https://doi.org/10.1016/j.ri dd.2016.05.010

bottom of page