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Occupational Therapy Intervention for Project Search Interns with Autism Spectrum Disorder: Potential for Improved Transition Outcomes

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Occupational Therapy Intervention for Project Search Interns with Autism Spectrum Disorder: Potential for Improved Transition Outcomes Eastern Kentucky University Encompass Occupational Therapy Doctorate Capstone Occupational Science and Occupational Projects Therapy 2018 Occupational Therapy Intervention for Project Search Interns With Autism Spectrum Disorder: Potential for Improved Transition Outcomes Jessie L. Bricker Eastern Kentucky University, [email protected] Follow this and additional works at: https://encompass.eku.edu/otdcapstones Part of the Education Commons, Occupational Therapy Commons, and the Social and Behavioral Sciences Commons Recommended Citation Bricker, Jessie L., "Occupational Therapy Intervention for Project Search Interns With Autism Spectrum Disorder: Potential for Improved Transition Outcomes" (2018). Occupational Therapy Doctorate Capstone Projects. 39. https://encompass.eku.edu/otdcapstones/39 This Open Access Capstone is brought to you for free and open access by the Occupational Science and Occupational Therapy at Encompass. It has been accepted for inclusion in Occupational Therapy Doctorate Capstone Projects by an authorized administrator of Encompass. For more information, please contact [email protected]. OCCUPATIONAL THERAPY INTERVENTION FOR PROJECT SEARCH INTERNS WITH AUTISM SPECTRUM DISORDER: POTENTIAL FOR IMPROVED TRANSITION OUTCOMES Presented in Partial Fulfillment of the Requirements for the Degree of Doctor of Occupational Therapy Eastern Kentucky University College of Health Sciences Department of Occupational Science and Occupational Therapy Jessie L. Bricker 2018 Copyright by Jessie L. Bricker, 2018 All Rights Reserved Executive Summary Background. As the prevalence of autism spectrum disorders (ASD) continues to rise, the individual and societal costs associated with disconnected adults with ASD in our communities also continues to rise. Thus, it has become vitally important to address the needs of adults with ASD as they transition from secondary education into the work world. Project SEARCH, an internationally recognized service delivery model, has one of the best success rates in assisting individuals with disabilities in attaining competitive employment in the community; yet, even in this program model, individuals with ASD have comparatively lower success rates in sustaining meaningful employment than individuals in other disability categories. Purpose. The purpose of this action research study was to explore the needs of individuals with high functioning autism spectrum disorder (HFASD) within the Project SEARCH program from their own perspectives, and to utilize the knowledge gained to examine the potential for occupational therapy interventions within the Project SEARCH program aimed specifically towards improving employment outcomes for interns with HFASD. Method. Utilizing ethnographic qualitative methodology within an action research framework, the study examined the experiences of three interns with HFASD at various points within the Project SEARCH program, as well as the experiences of their support staff, mentors, coworkers, and employers. Data collected from initial phases of the project was analyzed using open coding procedures, and then used to plan and implement occupational therapy interventions, before gathering qualitative data regarding the value of the occupational therapy interventions implemented. Results. Thematic analysis first two phases of the project seemed to suggest that the needs of interns with HFASD were distinctly different than the needs of interns within other disability categories. Further, the current service delivery model, which focuses primarily on job skill development, was ineffective in addressing some of the unique differences noted for interns with HFASD, specifically environmental modifications and adaptations, addressing sociocultural differences in the workplace and basic psychological needs to support self-determined behavior (Deci & Ryan, 2001). Theoretical Framework. Utilizing a Person, Environment, Occupational Performance (PEOP) framework (Baum, Christiansen, & Bass-Haugen, 2015), the investigator collaborated with stakeholders to utilize the information gathered in initial data collection phases to implement specific educational, consultative, and direct occupational therapy interventions to specifically address the needs of interns with HFASD as a cultural difference, and to promote autonomy, perceived competence, and relatedness within the context of work (Deci & Ryan, 2001). Conclusions. Initial findings during suggested that while specific occupational therapy interventions that included direct treatment and consultation with stakeholders were reported as effective and valued among stakeholders and interns, education and training services alone were not felt to be effective in addressing the needs of interns with HFASD. The findings suggest there may be a unique and valuable role for occupational therapists to play within the Project SEARCH model in addressing the unique needs of interns with HFASD. Acknowledgements First, I would like to express my utmost gratitude to the Project SEARCH intern participants who allowed me a glimpse into their lives during a very tumultuous time. This project could not have been completed without their wholehearted support and willingness to share their stories. I am also thankful for the many Project SEARCH stakeholders that I was blessed to know and work with over the course of this project. Your passion and dedication for the work you do is an inspiration to me, and it was a joy to partner with you in this endeavor. I am also indebted to several mentors and partners who have helped along the way: To Jamie Easley, a true friend and formidable advocate – thank you for being both my listening ear, and my megaphone. To Doris Pierce, an amazing teacher and researcher – thank you for championing my transition into academics. To Dennis Cleary, thank you for always being open to having your brain picked by a novice researcher. Last, but certainly not least, I want to thank my family. Words cannot adequately express the love and support they have shown me over the last two years. Jeff, thank you for being my constant encouragement, personal assistant, housekeeper, handyman, cook, and nanny. I could not have done this without you. To my sons James and Noel, and to my daughter, Annabel, thank you for your unending patience, hugs, and smiles - you will never know how much I needed them. I love you guys. And to my son, Sean, I dedicate this work to you, and to the young man you will become. I have learned far more from you than I will ever learn from a book. Thank you for helping me to understand that when it comes to becoming who you want to be, working hard is not nearly as important as being accepted for who you already are. I love you, and I hope you are proud of me. EASTERN KENTUCKY UNIVERSITY COLLEGE OF HEALTH SCIENCES DEPARTMENT OF OCCUPATIONAL SCIENCE AND OCCUPATIONAL THERAPY CERTIFICATION OF AUTHORSHIP Submitted to (Faculty Mentor’s Name): ____Doris Pierce, PhD ____________________ Student's Name: __Jessie Bricker____________________________________________ Title of Submission: _Occupational Therapy for Project SEARCH Interns with Autism Spectrum Disorder: Potential form Improved Transition Outcomes ________________ _______________________________________________________________________ Certification of Authorship: I hereby certify that I am the author of this document and that any assistance I received in its preparation is fully acknowledged and disclosed in the document. I have also cited all sources from which I obtained data, ideas, or words that are copied directly or paraphrased in the document. Sources are properly credited according to accepted standards for professional publications. I also certify that this paper was prepared by me for this purpose. Student's Signature: ____________________________________________________ Date of Submission: _______11-27-18_____________________________________________ Table of Contents Background ................................................................................................................................ 1 Outcomes in HFASD .................................................................................................................. 2 Role of Occupational Therapy .................................................................................................... 4 A Window for Change ................................................................................................................ 5 Project SEARCH ......................................................................................................................... 6 Problem Identification ................................................................................................................. 7 Capstone Project Purpose ............................................................................................................ 7 Theoretical Underpinnings .......................................................................................................... 8 Project Significance..................................................................................................................... 9 Summary ................................................................................................................................... 11 Review of the Literature ...................................................................................................... 12 Characteristics of High Functioning Autism Spectrum Disorder (HFASD)............................
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