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A Systematic Review of Teaching Daily Living Skills to Adolescents and Adults with Autism Spectrum Disorder

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We examined the peer-reviewed literature on teaching daily living skills to secondary students (ages 12–22 years) with Autism Spectrum Disorder (ASD) and Intellectual Disabilities (ID). A systematic search of the literature spanning January 2000–October 2012 was conducted, and 14 studies meeting the inclusion criteria were identified. Overall, there is limited research examining instructional tactics for teaching daily living skills to this population. Features of the studies are presented, and a classification of the studies’ results (i.e., positive, negative, mixed) and certainty of evidence (i.e., suggestive, preponderance, conclusive) are discussed.
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REVIEW PAPER
A Systematic Review of Teaching Daily Living Skills
to Adolescents and Adults with Autism Spectrum Disorder
Kyle D. Bennett &Charles Dukes
Received: 3 July 2013 / Accepted: 13 July 2013 / Published online: 24 October 2013
#Springer Science+Business Media New York 2013
Abstract We examined the peer-reviewed literature on
teaching daily living skills to secondary students (ages
1222 years) with Autism Spectrum Disorder (ASD) and
Intellectual Disabilities (ID). A systematic search of the
literature spanning January 2000October 2012 was conducted,
and 14 studies meeting the inclusion criteria were identified.
Overall, there is limited research examining instructional tactics
for teaching daily living skills to this population. Features of
the studies are presented, and a classification of the studies
results (i.e., positive, negative, mixed) and certainty of evidence
(i.e., suggestive, preponderance, conclusive) are discussed.
Keywords Autism Spectrum Disorder .Adolescents .
Daily living skills .Functional skills .Instruction
For decades, professionals have recognized the importance of
teaching functional skills to individuals with disabilities (e.g.,
Ayer s e t a l. 2011; Brown et al., 1979; Siegel 1996). Daily
living skills are among the functional skills needed for success
in current and future environments, and they consist of those
activities needed in domestic, employment, and community
settings that allow a person to be as independent as possible
(Brown et al. 1979;Testetal.2006; Volkmar and Wiesner
2009).
Individuals with Autism Spectrum Disorder (ASD) should
acquire a variety of daily living skills if they are to be
successful in post-school environments (Carothers and Taylor
2004). Ideally, such skills are taught during an individuals
formative years in school starting well before graduation,
irrespective of a students post-graduation plans (Ayers
et al. 2011; Smith and Targett 2009). Unfortunately, many
adolescents and adults with ASD experience challenges
acquiring the skills needed for independent functioning,
including those needed for home life, employment, and
participation in community events (Hendricks and Wehman
2009). Consequently, integration into post-school settings can
be hindered resulting in dependence on others (Hendricks and
Wehm an 2009; Targett and Smith 2009).
Recognizing the importance of teaching daily living skills
to students with ASD, several researchers have conducted
reviews of the literature on this topic. These reviews included
studies that: (a) investigated specific categories of daily living
skills (e.g., social skills), (b) evaluated specific treatments to
develop these skills (e.g., applied behavior analysis), or (c)
examined the development of daily living skills among
specific populations (e.g., individuals with ASD with an
IQ above 70). For instance, Flynn and Healy (2012)
examined the literature on improving social skills and
self-help skills among this population. Twenty-two studies
were identified with the majority being related to social skills
development (n= 16), and many of these studies had younger
children as participants. A variety of interventions was
discussed showing varying degrees of effectiveness. Matson,
Hattier, and Belva (2012) provided an examination of the
literature on teaching adaptive living skills among individuals
with ASD using Applied Behavior Analysis (ABA) tactics as
the teaching approach and concluded that it was effective for
teaching these skills to this population. Although the Matson
et al. (2012) review summarized the literature well, it was not
a systematic review, and thus, it is possible that other studies
might have been included (Palmen et al. 2012). In another
review, Palmen et al. (2012) examined the literature on the use
of behavioral interventions to teach adaptive skills to young
K. D. Bennett (*)
College of Education, Florida International University,
11200S.W.8thStreet,Miami,FL33199,USA
e-mail: kyle.bennett@fiu.edu
C. Dukes
Florida Atlantic University, Boca Raton, FL, USA
Rev J Autism Dev Disord (2014) 1:210
DOI 10.1007/s40489-013-0004-3
adults with ASD considered high functioning. To be included
in this review, studies had to have at least one participant with
ASD 16 years or older with a full scale IQ, or verbal IQ, of 70
or above, or be described as high functioning. An additional
feature of the Palmen et al. review included the categorization
of the study results (i.e., positive, negative, or mixed) and the
certainty of evidence (i.e., suggestive, preponderance, or
conclusive) based on a heuristic evaluating the design features
of each study. This provided a detailed analysis, beyond
a qualitative review, allowing greater insight into the
design features of the reviewed studies, revealing many
with positive results, but with varying degrees of certainty of
evidence.
The reviews outlined provide important summaries of the
literature. Such work guides future research as well as practice
in home, school, and community settings. Nevertheless, there
appears to be a gap related to examining the literature on
instructional strategies to teach daily living skills to secondary
students (ages 1222 years) with ASD with reported IQ scores
in the intellectual disabilities range. This group of individuals
with ASD represents an important constituency, and an
understanding of developing daily living skills among this
population can guide the work of researchers, practitioners,
and caregivers. Furthermore, federal education law requires
evidenced-based practices be implemented, as well as
emphasizes the results of special education service in post-
school settings (Ayers et al., 2011). Thus, the purpose of this
study was to extend that of Matson et al. (2012) and Palmen
et al. (2012) by systematically reviewing research that
examined daily living skills instruction among secondary
students (ages 1222 years) with ASD, including those with
and without intellectual disabilities.
Method
Definitions
We examined the peer-reviewed literature on teaching daily
living skills to adolescents with ASD spanning the years
January 2000October 2012. For this review, autismspectrum
disorder included autistic disorder, Asperger Syndrome, and
pervasive developmental disorder-not otherwise specified.
Participants of the studies meeting the inclusion criteria could
have had comorbid diagnoses, as well. Daily living skills
included those described by the Life Centered Career
Education-Modified Curriculum (LCCE-M; Loyd and
Brolin 1997) including: (a) managing money, (b) selecting
and maintaining living environments, (c) caring for personal
health, (d) developing and maintaining appropriate intimate
relationships, (e) eating at home and in the community, (f)
cleaning and purchasing clothing, (g) participating in leisure/
recreational activities, and (h) getting around in the community.
We chose to guide our review by using the Daily Living Skills
Curriculum Area of the LCCE-M Curriculum as it provided a
finite scope of daily living skills with each competency broad
enough to encompass a variety of behaviors.
Search Procedures
We completed a systematic review of the literature by
conducting journal hand searches, electronic database
searches, and a bibliographic search (Wolery and Lane 2010).
Hand searches were conducted in the following journals: Focus
on Autism and Other Developmental Disabilities,Education
and Training in Autism and Developmental Disabilities ,
Journal of Applied Behavior Analysis,andResearch in Autism
Spectrum Disorders. Additionally, electronic database searches
were completed using the following databases: Education
Resources Information Center (ERIC), Education Full
Text, Psych Info, and PsychArticles. Keywords used for
the database searchesincluded the population terms: (a) autism
spectrum disorder, (b) autism, (c) Asperger syndrome, and (d)
pervasive developmental disorder-not otherwise. Each of these
terms was paired with the keywords: (a) daily living skills, (b)
self-care skills, (c) self-help skills, (d) life skills, (e) functional
skills, (f) leisure skills, and (g) recreation skills. Following the
hand and database searches, we conducted a bibliographic
search of the studies meeting the inclusion criteria.
Inclusion Criteria
Articles had to meet several criteria to be included in this
review.First,studieshadtobepublishedinthepeer-
reviewed literature between January 2000 and October 2012.
Next, at least half of the participants in a study had to have a
diagnosis as previously described. We selected this criterion to
ensure at least a balanced representation of participants with
ASD. Further, limits were not placed on participantsIQ
scores to extend the research of Palmen et al. (2012). At least
half of the participants in a study had to be between the ages
1222 years. We selected this criterion to allow for an equal
representation of students at the secondary level of instruction.
Additionally, the studies had to use a single-subject research
design. This criterion was chosen to focus our examination of
the contributions of the single-subject research literature
pertaining to daily living skill instruction. The independent
variable had to be an intervention or intervention package,
while the dependent variable(s) had to meet the definition of a
daily living skill as previously described. Finally, studies
aimed at examining vocational and employment skill
development were not included in this review, as recent
researchers have presented that information (see Bennett
and Dukes 2013; Hendricks and Wehman 2009).
Rev J Autism Dev Disord (2014) 1:210 3
Reliability of Inclusion Criteria
The first and second authors screened studies from the hand,
database, and bibliographic searches for potential inclusion in
this review. From this initial screening, we identified 17
studies for further examination using the inclusion criteria.
Of these 17 studies, there was 100 % agreement to include
14 and exclude three. We excluded a study by Myles,
Ferguson, and Hagiwara (2007) due to its focus on homework
assignments. We also excluded a study by Chezan, Drasgow,
and Marshall (2012) because the dependent variable was
collateral academic skills. Neither of these studies met the
definition of daily living skills we employed from the
LCCE-M Curriculum. Finally, we excluded a study by
Copeland and Hughes (2000). Although the skills under
investigation in that study were daily living skills, the
purpose was to develop employment skills needed in
faculty dining rooms and hotels.
Data Extraction and Coding
Data were extracted and coded using similar procedures
as Palmen et al. (2012). The first and second authors
independently summarized the studies to include information
regarding (a) participantsdiagnoses, (b) participantsages,
(c) targeted skills, (d) the intervention, (e) the setting,
and (f) the LCCE-M competency matching the targeted
skills.
After summarizing the studies, the authors independently
classified the results as positive, negative, or mixed. A rating
of positive results was given if all the participants and/or all
skills improved as compared to baseline measures. A rating of
negative results was given if all the participants and/or skills
remained unchanged from baseline or declined. A rating of
mixed results was given if some of the participants and/or
targeted skills improved, while others either remained
unchanged or declined relative to baseline (Machalicek
et al., 2008;Palmenetal.,2012).
Following the classification of the results of the studies, the
authors independently used a modified heuristic evaluating
the certainty of evidence (i.e., suggestive, preponderance, or
conclusive evidence) based on each studysdesignfeatures
(Lang et al. 2010; Palmen et al., 2012; Ramdoss et al., 2011).
Studies were classified as conclusive evidence if they met the
following criteria including, (a) an experimental design, (b)
interobserver agreement (IOA) collected at least 20 % of the
sessions with agreement coefficients at 80 % or better, (c)
clearly defined dependent variables, (d) detailed descriptions
of the independent variable sufficient for replication, and (e)
design features that provided at least some controls for
alternative explanations of the results. Studies were classified
as preponderance of evidence if they met criteria (a) through
(d) presented above, but had limitations in their control for
potential alternative explanations for the results. Studies were
classified as suggestive of evidence if a pre-experimental
design (A-B design) was used, or if any one of the criteria
(a) through (d) were not met. A plus (+) was recorded if a
design feature was present and a minus () if it was not
present.
Other investigators (Palmen et al., 2012; Ramdoss et al.,
2011) included treatment fidelity (procedural reliability) as
part of their decision model when categorizing a study using
the certainty of evidence heuristic. However, Palmen et al.
(2012) indicated that few studies in their review included
treatment fidelity procedures, and they relied upon other
characteristics of a study to evaluate the potential for
treatment fidelity (e.g., video recorded sessions, the use of a
flowchart, the use of self-management tools). Ramdoss et al.
(2011) relied on other features of studies to evaluate the
potential for treatment fidelity as well (e.g., replication of an
experiment, presence of researchers). This has the potential to
incorrectly classify a studys certainty of evidence according
to this heuristic, which includes treatment fidelity used as a
feature against which a study is evaluated. Potentially, this
limits the utility of the heuristic, but more extensive use will
better address such issues. Although the topic of treatment
fidelity was discussed at least three decades ago by
Billingsley, White, and Munson (1980), it appears that the
wide scale acceptance of this measure has only emerged in
recent years, potentially leaving older studies vulnerable to
misclassification using this heuristic. Therefore, we decided to
report whether a study detailed treatment fidelity procedures
and the results of such measures, but not to include the
measure as part of the decision when categorizing a study
based on its certainty of evidence. A plus (+) was recorded if
treatment fidelity data were collected at least 20 % of the
sessions with a treatment fidelity coefficient of at least 80 %.
A minus () was recorded if treatment fidelity data were
collected less than 20 % of the sessions or if the treatment
fidelity coefficient was below 80 %. A not reported(NR)
was recorded if information pertaining to treatment fidelity
was absent.
Reliability of Data Extraction and Coding
The first and second authors independently coded the items
presented in Tables 1and 2. Items used to evaluate IOA
included: (a) number of participants with ASD; (b) age range
of participants with ASD; (c) target behavior; (d) intervention;
(e) setting(s); (f) LCCE-M competency; (g) results of the
study; (h) experimental design; (i) IOA, (j) TF; (k) operational
definition(s) of the dependent variable(s); (l) independent
variable detailed for replication; and (m) control for alternative
explanations of the results. A total of 182 items were scored
across the 14 studies. The only item not used in evaluating
IOA was the level of certainty since it was an overall score
4 Rev J Autism Dev Disord (2014) 1:210
Tab l e 1 Details of studies meeting inclusion criteria
Study No. of participants
(ASD/total participants)
No. of participants
(1222/total participants)
DV IV Setting LCCE-M competency
Ahearn (2003) 1/1 1/1 Eating vegetables Pairing non-preferred foods
with preferred condiments
Unspecified room Eating at home and in the
community
Anglesea et al. (2008) 3/3 3/3 Pace of eating food Tactile prompting; physical
guidance, response blocking,
verbal praise
Classroom Eating at home and in the
community
Bereznak et al. (2012) 3/3 3/3 Using a washing machine,
making noodles, using
a copy machine
Video self-prompting for two
students; video prompting
for one student
School living center (daily
living skills) and teacher
workroom (vocational skills)
Selecting and maintaining
living environments;
eating at home and in
the community
Cihak and Grim (2008) 4/4 4/4 Purchasing skills Next dollar and count on
strategy instructed via
verbal instruction, modeling,
reinforcement, time delay,
and least-to-most prompting
Classroom; school bookstore;
local department store
Managing money
DeLeon et al. (2008) 3/4 (one with autism
was under 12 years old)
3/4 (One between
the ages 1222 years
did not have autism)
Wearing glasses; removal
of glasses; attempts to
remove glasses
NCR for one participant;
treatment package for the
remaining with component
analysis
Treatment room for all;
general purpose room in
later conditions
Caring for personal health
Ferguson, Myles,
Hagiwara (2005)
1/1 1/1 Independent morning,
evening, and school
activities
Use of a Personal Digital
Assistant (PDA) calendar
and alarm function
Home; resource and general
education classes
Selecting and maintaining
living environments;
Caring for personal health;
Eating at home and in the
community
Mechling et al. (2009) 3/3 3/3 Cooking Use of a PDA with choice of
picture, auditory, and video
prompts with voice over
High school home living room Eating at home and in the
community
Mechling and Gustafson
(2008)
6/6 6/6 Cooking Static picture prompts versus
video prompts
High school home living room Eating at home and in the
community
Shabani and Fisher (2006) 1/1 1/1 Keeping arm still while
testing blood glucose
levels with needles
Stimulus fading and differential
reinforcement of other behavior
Room in treatment center;
nurses station for
generalization
Caring for personal health
Taylor et al. (2004) 3/3 3/3 Using a card to communicate
to an adult when lost in
the community
Treatment consisting of
instruction, verbal modeling,
tactile prompts, manual
guidance, prompt fading,
and reinforcement
School and community sites Caring for personal health
Todd and Reid (2006) 3/3 3/3 Increase physical activity
(Snowshoeing and
walking/jogging)
Self-monitoring, verbal
encouragement/directions,
reinforcement
Outdoors and inside a school Caring for personal health;
Participate in leisure/
recreational activities
Van Laarhoven et al.
(2010)
2/2 2/2 Folding laundry and
meal preparation
Picture prompts versus video
prompts
Faculty lounge of a school;
other school areas for
generalization
Cleaning and purchasing
clothes; Eating at home
andinthecommunity
Vuran (2007) 2/2 1/2 Leisure skills (making
clay pottery baskets)
Chaining, most-to-least
prompting
Clay studio of private special
education center
Participating in leisure/
recreational activities
Wat er s an d Bo on ( 2011) 2/3 3/3 Solve money math problems Touch Math ©, modeling, verbal
cues, feedback
Self-contained special education
classroom
Managing money
Rev J Autism Dev Disord (2014) 1:210 5
based on the previous ratings and duplicative. A plus (+)
was scored for agreements and a minus () was scored for
disagreements. Initial IOA was calculated by dividing the
number of agreements by the number of agreements plus
disagreements, and multiplying by 100. The initial IOA was
90.7 %. In the case of disagreements, the authors discussed the
discrepancies and came to consensus to accurately present the
studies meeting the inclusion criteria.
Results
We identified 14 studies meeting the inclusion criteria. With
the exception of 2008, there were 02 studies identified
per year throughout this timeframe. Further, there was
only one publication meeting the inclusion criteria each
of the last 4 years with no trend in publication frequency (see
Fig. 1).
Characteristics of the Included Studies
The total participants in the reviewed studies was n=39.
Thirty-seven participants were identified as having ASD as
Tabl e 2 Results of studies and certainty of evidence
Study Results Design IOA TF Operationally
defined dependent
variable
Detailed
intervention
for replication
Control for
alternative
explanations
Level of
certainty
Ahearn (2003) Positive Multiple baseline design
with reversals
+ NR + + + Conclusive
Anglesea et al. (2008) Positive Reversal NR + + Suggestive
Bereznak et al. (2012) Positive Multiple probe design
across behaviors and
replicated across
participants
+ + + + + Conclusive
Cihak and Grim (2008) Positive Multiple probe design
across behaviors and
settings
+ + + + + Conclusive
DeLeon et al. (2008) Positive Reversal design with an
added component
analysis
+ NR + + + Conclusive
Ferguson et al. (2005) Mixed Multiple baseline design
across settings
+NR+ −−Suggestive
Mechling et al. (2009) Positive Multiple probe design
across behaviors and
replicated across
participants
+ + + + + Conclusive
Mechling and
Gustafson (2008)
Positive Adapted Alternating
Treatments Design
+ + + + + Conclusive
Shabani and Fisher (2006) Positive Reversal Design + NR + + + Conclusive
Taylor et al. (2004) Positive Multiple baseline design
across participants
+NR+ + Preponderance
Tod d an d Re id ( 2006) Positive Changing conditions
design
−−++Suggestive
Van Laarhoven et al. (2010) Positive Adapted Alternating
Treatments Design
+++ + Preponderance
Vuran (2007) Positive Multiple probe design
across participants
+++ + Preponderance
Waters and Boon (2011) Positive Multiple probe design
across participants
+ + + + + Conclusive
2000
2002
2004
2006
2008
2010
2012
0
1
2
3
4
5
Years
Frequency of Publications
Fig. 1 Frequency of publications meeting inclusion criteria January
2000October 2012
6 Rev J Autism Dev Disord (2014) 1:210
well as between the ages 1222. Additionally, the majority of
the participants in 13 of the studies were either identified as
having an IQ score below 70, were identified as having an
intellectual disability without specifying the IQ score, or they
were described as attending separate day schools. A
variety of dependent variables were examined including
behaviors related to eating, domestic skills, purchasing and
solving money related math problems, safety and health
skills, independent routines, leisure skills, and cooking.
Furthermore, the teaching strategies used in each study were
based on ABA, including chaining, prompting and fading,
video-based instruction, pairing, self-monitoring, and
differential reinforcement, to name a few. The research studies
were conducted in several different types of settings, including
therapy rooms, classrooms, school facilities (e.g., bookstore),
homes, outdoors, and community sites (see Table 1for details
from each study).
Evaluation of the Results
We evaluated the results of each of the reviewed studies using
procedures similar to Machalicek et al., 2008 and Palmen
et al., 2012. The results from 13 studies demonstrated positive
results. Only one study, Ferguson, Myles, and Hagiwara
(2005), demonstrated mixed results, and none of the reviewed
studies showed negative results (see Table 2).
Evaluation of the Certainty of Evidence
We also evaluated the certainty of evidence of each study
using a modified heuristic (see Table 2). Eight studies were
identified as having conclusive evidence. Three studies were
classified as demonstrating a preponderance of evidence. The
study by Taylor, Hughes, Richard, Hoch, and Rodriguez-
Coello (2004) included different teaching procedures that
were used during the school and community sessions.
Although the results of the interventions were positive,
the differences in the teaching strategies precluded this
study from meeting the criteria for conclusive evidence since
the relative contribution of each set of teaching procedures is
unknown. We also classified the study by Van Laarhoven,
Kraus, Karpman, Nizzi, and Valentino (2010) as meeting the
criteria for preponderance of evidence. There were minimal
baseline data, as well as no discernable control condition to
examine the influence of maturation or multiple treatment
interference. Finally, the study by Vuran (2007) was classified
as meeting a preponderance of evidence as only two tiers of a
multiple baseline design were examined, rather than at least
three tiers (Kratochwill et al., 2010). Finally, we classified the
certainty of evidence of three studies as suggestive.
Angelesea, Hoch, and Taylor (2008) reported that IOA data
were collected below the 20 % criteria. The study by
Ferguson, Myles, and Hagiwara (2005) was also classified
as suggestive. Although IOA data were collected at school, it
was unclear if it was collected at home. Furthermore, we did
not rate the description of the independent variable as being
detailed enough to permit replication, particularly the prompts
needed for corrections. Moreover, there were ascending trends
evident in two out of the three baselines, which may indicate
difficulty with experimental control. The last study classified
as suggestive of evidence was by Todd and Reid (2006). It
was unclear if Todd and Reid collected IOA data on the
dependent variable. Additionally, they used a changing
conditions design, and this design limits the ability to
determine a functional relationship (Richards et al. 2014).
Discussion
The purpose of this review was to examine the research on
teaching daily living skills to secondary students with ASD
and ID. Through a systematic search of the literature, we
identified and reviewed 14 intervention studies on the
development of a variety of daily living skills. We classified
most of the results as positive, but with varying degrees of
certainty of evidence.
This paper contributes to the literature in several ways.
First, there was very little overlap between the findings
presented in this review and the three recent reviews
previously identified. Specifically, there was one study that
overlapped with Flynn and Healy (2012), three that overlapped
with Matson et al. (2012), and one that overlapped with
Palmen et al. (2012). Thus, additional studies were identified
in the current review that might guide researchers with future
studies, as well as practitioners designing and implementing
instructional procedures with this population. Second, 13 of
the identified studies were comprised of participants described
as experiencing an intellectual disability, or were identified as
students in center-based school programs. This extends
the findings of Palmen et al. (2012) who identified 20
studies on daily living skills development among young
adults considered high functioning. Third, although we
identified additional research on developing daily living skills
among individuals with ASD, we concur with Matson et al.
(2012) and Palmen et al. (2012) in that overall, there is a
scarcity of research on this topic. This shortage of research
seems even more pronounced considering individuals with
ASD functioning in the range of intellectual disabilities.
Indeed, the frequency of publications spanning the last 12 years
has been exceedingly low with no trend. Furthermore, given
that single-subject research design requires multiple replications
to increase the external validity of an intervention (Horner
et al., 2005), this issue is compounded since none of the
studies examined the same dependent variables using similar
Rev J Autism Dev Disord (2014) 1:210 7
procedures. Perhaps through additional research, including
replication studies, future researchers will identify efficient
teaching procedures to assist adolescents and adults with
ASD achieving independence in post-school environments
(Bennett and Dukes 2013), an issue known to be problematic
and with deleterious effects for the individual, their family,
and society (Cimera and Cowan 2009; Hendricks and
Wehm an, 2009; Lawer et al. 2009; Targett and Smith 2009).
Moreover, additional studies can assist educators in meeting
the requirements set forth by federal education legislation that
requires evidence-based practices that lead to positive results
in post-school settings.
Similar to Palmen et al. (2012), and others who have
conducted systematic reviews of the literature (e.g.,
Ramdoss et al., 2011), we evaluated the certainty of evidence
of studies using a heuristic. Among the criteria evaluated in
determining a studys certainty of evidence was treatment
fidelity. Collecting and reporting on the consistency with
which an independent variable is delivered as intended in-
creases both the internal and external validity of a study
(Billingsley et al., 1980). Although the importance of proce-
dural fidelity has been discussed for some time, and it is an
important feature of intervention studies (Gast, 2010), we
speculate that its wide-scale use may have only recently
emerged given the criteria of what constitutes evidence-
based instruction via entities such as the What Works
Clearinghouse. For instance, some studies reviewed by
Palmen et al. (2012) and Ramdoss et al. (2011) did not report
treatment fidelity data, and this was found in the current
review even among recent publications. If the heuristic were
followed as designed, these studies would have been classified
as suggestiveof evidence. However, Palmen et al. and
Ramdoss et al. used other features of the studiesdesigns that
might have indicated treatment fidelity, and thus, rated the
studies as having a higher certainty of evidence (i.e., prepon-
derance or conclusive). This practice has the potential of
misclassifying some studies, as well as limits the consistency
with which studies are evaluated using the heuristic. As an
alternative, we listed whether a study reported treatment fidel-
ity as well as evaluated the quality of the measure reported
(e.g., data collected at least 20 % of the sessions with coeffi-
cients of 80 % or better). However, we did not use the
presence or absence of treatment fidelity in categorizing
studies as suggestive, preponderance, or conclusive, rec-
ognizing that some studies, including recent studies, might
have demonstrated clear experimental control but did not
collect and report treatment fidelity data (e.g., Ahearn 2003;
DeLeon et al. 2008). This provides a reader with information
on the presence or absence of treatment fidelity without po-
tentially misclassifying studies in either direction (i.e., giving
a higher or lower certainty of evidence rating).
An additional issue discovered using this heuristic was the
IOA on the item, some controls for alternative explanations.
Although our overall initial IOAwas 90.7 %, on that specific
item, it was 57.1 % before correction and consensus between
the authors. The notion of some controlsintroduced a
degree of subjectivity, and this item was among the more
subjective in the heuristic, which may have contributed to
the low IOA observed for this category. Future investigators
may consider modifying this criterion to be more objective
(e.g., number of potential limitations or number of potential
confounds). Adding these measures may assist researchers in
rating this item, although eliminating judgment, and thus
subjectivity, may be difficult.
The results of this study should be considered in the presence
of several limitations. The timeframe of the review, the
keywords used, the journals selected for hand searches,
and the databases used to identify articles meeting the
inclusion criteria represent limitations of this study.
Other studies not meeting our inclusion criteria might
exist that could have contributed to this investigation.
Additionally, limiting studies that used single-subject
research methodology could have also restricted the
scope of this review. Anecdotally, however, very few
studies using group design were identified. Using the
LCCE-M Curriculum as a guide might have reduced the
amount of articles we identified as well. However, we
only excluded three studies from the review using the
LCCE-M Curriculum as a guide. Finally, the low IOA
found on the item that rated the degree of control of the
studies reviewed is another limitation of this study.
Considering the results of this review, as well as those
conducted by other investigators (Matson et al., 2012;
Palmen et al., 2012), additional research is clearly needed
investigating the strategies to develop and maintain daily
living skills among adolescents and adults with ASD. This
population has the potential to live, work, and recreate in
integrated community settings (Wehman et al. 2009). Many
individuals with ASD can likely achieve greater independence
provided families, teachers, and related service professionals
have a variety of evidence-based procedures to use.
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... There are a range of evidence-based strategies that have been identified for targeting adaptive behavior, including DLS, in adolescents with ASD utilizing various behavioral strategies (e.g., direct instruction, reinforcement, chaining, task analysis, prompting) and technology, visual supports, and video modeling (Bennett & Dukes, 2014;Flynn & Healy, 2012;Hume & Reynolds, 2010;Matson et al., 2012;Mechling et al., 2009;National Autism Center, 2015;Palmen et al., 2012;Wong et al., 2015). The literature has often focused more on supports and interventions that target DLS in children and younger adolescents with ASD or individuals with ASD with a comorbid ID (Bennett & Dukes, 2014). ...
... There are a range of evidence-based strategies that have been identified for targeting adaptive behavior, including DLS, in adolescents with ASD utilizing various behavioral strategies (e.g., direct instruction, reinforcement, chaining, task analysis, prompting) and technology, visual supports, and video modeling (Bennett & Dukes, 2014;Flynn & Healy, 2012;Hume & Reynolds, 2010;Matson et al., 2012;Mechling et al., 2009;National Autism Center, 2015;Palmen et al., 2012;Wong et al., 2015). The literature has often focused more on supports and interventions that target DLS in children and younger adolescents with ASD or individuals with ASD with a comorbid ID (Bennett & Dukes, 2014). Thus, there is a clear gap for how best to build pivotal DLS in adolescents with ASD without an ID (i.e., IQ ≥ 70) to facilitate successful outcomes in college, employment, and independent living. ...
... These DLS areas were chosen because they are easy to teach (e.g., the steps of laundry using a task analysis), allow for the adolescent to practice evidence-based strategies during the learning process, provide opportunities for the adolescent to achieve success and witness their own growth, initially require few social-communication skills, and are critical to independence in adolescence and adulthood. When determining how to foster acquisition, mastery, and generalization of the DLS areas, it was clear that evidencebased behavioral principles such as task analysis, prompting, modeling, scaffolding, and reinforcing would be likely be most successful because it is well established that a range of DLS can be successfully taught to adolescents with ASD using behavioral strategies (Bennett & Dukes, 2014;Palmen et al., 2012;Steinbrenner et al., 2020;Wong et al., 2015). Thus, our team sought to expose adolescents and their parents to a range of evidence-based behavioral strategies that could be used to build DLS both during and after the STRW intervention (see below section on 'Evidence-Based Strategies'). ...
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Daily living skill deficits commonly co-occur in individuals with autism spectrum disorder (ASD). These deficits in adolescence are associated with poor outcomes, in both employment and independent living skills as adults. Currently, there are no interventions that directly target daily living skill acquisition in adolescents with ASD without an intellectual disability to facilitate a successful transition to adulthood. In this paper, we discuss the development, refinement, and initial efficacy studies of Surviving and Thriving in the Real World (STRW), a 14-session group treatment for both adolescents with ASD and their parent/caregiver that promotes attainment of critical daily living skills. We summarize initial feasibility studies that have been instrumental in the iterative development of STRW. The structure, core treatment elements, and content of STRW are described in detail. Lastly, we discuss the transition of the in-person STRW intervention to STRW-telehealth, which allows for adolescents with ASD to work on daily living skills in their own home with support from a therapist.
... They refer to a wide range of abilities needed for an individual to perform daily living abilities at home, school, and work. In addition, functional living skills encompass a variety of skills including social, vocational, behavior management, and academic skills (Bennett and Dukes 2014). Ayres et al. (2011) found that there is a connection between functional living skills and independent living for individuals with ASD, since independence of functional skills affects the way they act in environment. ...
... Identifying effective educational interventions directed towards the acquisition of functional living skills by individuals with ASD continues to be a critical task for researchers, teachers and health practitioners (Delano 2007). In recent decades, technology-based approaches and methods have been used in educational and therapeutic interventions for individuals with ASD in order to improve a variety of their skills, including social impairments, communication, recognizing emotions, maintaining social relationships, academic, daily living, and vocational skills (Bennett and Dukes 2014). Studies have shown that individuals with ASD often show an intense interest in technology, both in using it and learning with it (Lin et al. 2013). ...
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Individuals with Autism Spectrum Disorder (ASD) deal with impairments in functional living skills. Video-based instruction (VBI) has been used for teaching and enhancing functional living skills for adolescents and young adults with ASD. This literature review of 19 relevant reports investigates various different types of VBI used in the studies. It explores the utilization and efficacy of VBI in enhancing the functional living capabilities of adolescents and young adults with ASD. Social skills were taught in most of the included studies. Only two studies focused on workplace social skills, three on vocational skills, and one on academic skills. The findings demonstrate that video modeling (VM) alone or in conjunction with other methods or strategies, is the method most often used in enhancement of functional living skills in adolescents and young adults with ASD.
... More specifically, despite their importance, multiplicative Cartesian product problems have not been addressed in any of the COMPS-based studies of which the present authors are aware. Lastly, the progress of students with ASD must be assessed not only in academic terms, but also in connection with the skills acquired to conduct their everyday lives independently (Bennett & Dukes, 2014;Kasap & Ergenekon, 2017). Learning to handle multiplication problems is particularly useful to enable ASD-diagnosed students understand frequently encountered mathematical concepts such as rate, proportion or slope (Bouck et al., 2018). ...
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Conceptual model-based problem solving (COMPS) was tested for its efficacy in teaching a student diagnosed with autism spectrum disorder to solve word problems involving multiplication and division. A single-case, multiple-baseline across behaviors design was conducted. The ability to solve each of three types of multiplication problems examined (equal groups, multiplicative comparison and Cartesian product) was addressed separately. The student’s performance improved in all three, and it was maintained five weeks after the intervention. The student also generalized the effects of instruction to two-step (addition and multiplication) word problems. Knowledge transfer to an everyday situation was also assessed. The implications of these findings for teaching multiplicative word problems to students diagnosed with autism spectrum disorder are discussed.
... To address these barriers to employment for individuals with IDD, researchers have often focused on promoting the development of daily living skills (Bennet & Dukes, 2013), training vocational skills (e.g., how to complete specific employment tasks such as food preparation, sorting, packing; Seaman & Canella-Malone, 2016), and academic skill supports (Hua et al., 2019;Spooner et al., 2018). Within these domains, interventions such as prompting, video modeling, self-monitoring, and explicit instruction have been found to be useful in promoting improvements in daily living skills, vocational tasks, and academic performance. ...
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Social deficits often impede the ability of individuals with intellectual and developmental disabilities (IDD) to obtain and maintain employment (Barnard et al., Barnard et al., Inclusion and autism: Is it working? 1000 examples of inclusion in education and adult life from the National Autistic Society’s members, National Autistic Society, 2000; Elksnin & Elksnin, Elksnin and Elksnin, Exceptionality 9:91–105, 2001). The purpose of the present study was to evaluate a social skills intervention including behavioral skills training, video modeling, and self-monitoring on the acquisition of discrete vocational social skills in young adults with IDD. Participants included high school students in special education that were part of a work internship program. A multiple baseline design across skills with concurrent replication across participants was used to evaluate the effects of the packaged intervention on target skill accuracy. Results indicate that the packaged intervention was effective in promoting social skill acquisition for all participants. Further, high levels of skill acquisition were observed during the maintenance phase.
... Another approach to improving adaptive skills is Naturalistic Teaching Strategies, which utilize materials in the environment and naturally-occurring activities as opportunities to increase adaptive skills (National Autism Center, 2015). Evidence from single-case design studies targeting adaptive behaviors show promising outcomes in individuals with ASD, both with ID (Bennett & Dukes, 2014) and without ID (Palmen, Didden, & Lang, 2012). Results ranged from employment attainment to cooking skills. ...
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... 12,13 In addition, DLS can be taught and systematically supported in youths with autism across a range of abilities. 14,15 Given the positive correlation between DLS and better outcomes in ASD and the accessibility of DLS to youths of varying intellectual ability, an in-depth understanding of DLS developmental trajectories could shed light on strategies for improving adult outcomes in ASD. 9,16 Longitudinal research on DLS in ASD is relatively rare. ...
Article
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A disproportionate number of individuals with autism spectrum are unable to transition into independent living during adulthood, compromising the ability to experience autonomy and exert self-determination. Over the past 30 years, there has been an increasing trend to incorporate technology into educational and behavioral interventions, including those to target daily living skills. In order to inform practice and identify needs for future research, we conducted a systematic review of peer-reviewed published research evaluating the effectiveness of an intervention incorporating electronic technology to improve daily living skills among adults with autism spectrum. We extracted data regarding participants, daily living skills targeted, intervention characteristics, and outcomes. Additionally, we evaluated each case against What Works Clearinghouse single-case design standards. Through a systematic database search and ancillary searches, we identified 27 studies with 49 participants. Interventions supported by electronic technology were most commonly used to improve meal preparation and housekeeping tasks. Across most applications, technology was utilized within the antecedent portion of an intervention, most commonly used with video modeling or video prompting interventions. Surprisingly, few studies took place in the participants’ place of residence. Evidence suggests there is great potential for incorporating technology into daily living skill interventions; however, more research is warranted to realize the full benefits of this approach.
Chapter
Employment is considered to have a great impact on people's quality of life. However, it is thought to be one of the major problems adolescents and young adults have to face during their transition to the adulthood. Given their impairments, individuals with ASD face several barriers to their vocational rehabilitation. Yet many of them are capable of being independent and working effectively when they are well supported. Since they deal with several challenges due to their condition, high rates of unemployment or underemployment are very common among them. This chapter provides a view of the barriers that can affect the employment outcomes of this population and strategies (e.g., supported employment programs and technology-based interventions) for overcoming those barriers. In particular, the social deficits that characterize ASD may result in difficulty in developing and maintaining high-quality social skills and competence in communication, which are important for finding employment and staying in a work position.
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