Doctoral Capstone Project Description
Down syndrome is a congenital condition that affects one's physical characteristics, health, cognition, social experiences, and learning experiences. Individuals with Down syndrome often have trouble with communication as they process information slower than adults without disabilities (Kumin & Schoenbrodt, 2016; Krell, K., Haugen, K., Torres, A., & Santoro, S. L., 2021). Due to difficulties with communication, some adults with Down syndrome may not get the same learning and employment opportunities because others may misinterpret their abilities (Kumin & Schoenbrodt, 2015). As a result, employment rates for adults with Down syndrome are low. In 2022, just over twenty percent of individuals with disabilities were employed in the United States, while in 2021, less than twenty percent of individuals with disabilities were employed (U.S. Bureau of Labor Statistics, 2023). Bush and Tassé (2017) found an employment rate of roughly sixteen percent for adults with Down syndrome. This doctoral capstone aimed to assess local businesses that hire individuals with intellectual and developmental disabilities to determine the essential skills for successful and sustained employment. This project was designed to develop an adult career-focused curriculum for GiGi's Playhouse, a Down syndrome achievement center. The curriculum was designed to include community experiences, vocational training, and classroom learning, accommodating various learning styles and differences. The program was created to bring an occupational therapy perspective to prepare adults with Down syndrome for future employment, volunteer, and internship opportunities.
Mission Statement
To assess and enhance a career program at GiGi's Playhouse in Charlotte, NC to improve employability and independence of adults with Down syndrome.
Vision Statement
To advocate for more employment opportunities and promote an inclusive workplace culture for individuals with disabilities.
Project Site
This project was in collaboration with GiGi's Playhouse of Charlotte, North Carolina, a Down syndrome achievement center.
GiGi's Playhouse is a non-profit organization that offers free therapeutic, educational, and career programs for individuals with Down syndrome across the lifespan and their families.
Literature Review
- While there is a high unemployment rate for individuals with Down syndrome, there are strategies and experiences that can be used that correlate with a higher chance of obtaining employment. These strategies and experiences begin at a young age. Loveall, Channell, Burke, & Rodgers (2022) discovered that adults with Down syndrome that had family support had higher chances of getting jobs than those who did not.
- Education has a significant impact on future employment opportunities. Adults with previous training in vocational skills are more likely to have higher-paying jobs than those who did not have vocational training (Carter, Austin, & Trainor, 2011).
- Self-esteem, self-confidence, and adaptive skills can influence employment (Jackson, Cabenagh, & Clibbens, 2014; Chan, Smith, Hong, Greenberg, Taylor, Mailick, 2018). Employment chances may be negatively affected if an individual has low self-esteem, as it can cause difficulties with communication (Jackson et al., 2014). Adaptive skills that can positively influence the employment experience include instrumental activities of daily living like money management, home maintenance, meal preparation, and community mobility. Adaptive skills also include completing activities of daily living like bathing, dressing, eating, and oral hygiene (Chan et al., 2018).
- Occupational therapists can provide adults with Down syndrome with the resources and skills needed to find and sustain employment. Occupational therapists may evaluate an individual's cognitive, physical, and social abilities and determine how they affect work performance. They can use this information to provide individualized interventions to promote meaningful employment outcomes (American Occupational Therapy Association, 2015).
Needs Assessment
- GiGi's Playhouse co-founder verbalized the need for participants to learn and develop career skills to increase employment rates among GiGi's Playhouse adult participants (Roy Courtney, personal communication, November 23, 2021)
- Service providers and employers have low expectations for individuals with disabilities, leading to decreased employment pursuits by adults with disabilities. (Sandy Jordan, personal communication, March 22, 2021).
- Current adult programs at GiGi's Playhouse do not include direct career-related curricula. Current programs focus on nutrition, health, wellness, social development, and opportunities to give back to the community.
- Roughly 11.2% of adults with Down syndrome have jobs (Kumin & Schoenbrodt, 2016).
- Adults with Down syndrome get paid less on average than individuals with other intellectual disabilities (Bush & Tassé, 2017).
- Occupational therapists have the duty to consider work-related issues for people of all abilities (WFOT, 2012).
Deliverables
Outcome Measure 1
To develop an in-depth knowledge in policy and program development, the student will demonstrate the creation of a job skills program for the purpose of increasing employability of individuals with Down syndrome at a Down syndrome achievement center.
Learning Objective 1: Student will demonstrate increased knowledge in program development/ enhancement as measured by the completion of employment guidelines and inventories at community businesses and a program curriculum at a Down syndrome achievement center.
Learning Objective 2: Student will demonstrate increased knowledge in occupational therapy's role in facilitating positive employment outcomes as measured by the completion of an educational course.
Outcome Measure 2
To develop an in-depth knowledge in work and industry for individuals with disabilities, the student will demonstrate increased competency, as measured through the presentation of the essential vocational skills needed for sustained employment to the community and inclusive employment opportunities.
Learning Objective 1: Student will demonstrate increased knowledge in the essential job skills for successful employment through implementing survey(s) within community organizations to help determine occupations most desired by clientele.
Continuing Education
To learn more about supporting positive employment outcomes for adults with intellectual and developmental disabilities, continuing education courses were completed.
Certificates of Completion
- Persch, A. & Cleary, D. (2022). Occupational therapy and the transition to adulthood and employment podcast. OccupationalTherapy.com, Article 5507. Available at http://occupationaltherapy.com
- Lape, J. (2019). Teambuilding for practitioners and leaders. OccupationalTherapy.com, Article 4911. Available at http://occupationaltherapy.com
- Berthiaume, D. M. (n.d.). Best practice in the use of sensory integration in school-based occupational therapy- Combining research and practical strategies. Allied Health Education. Available at http://alliedhealthed.com
Job Assessments and Interviews
To gather data for the foundation of the adult curriculum, assessments and interviews were administered to determine the essential components needed for a successful curriculum supporting positive learning and employment outcomes. First, four parents of adults with Down syndrome were interviewed about their child's job, internship, volunteer experiences, and their wishes for a career-focused curriculum. A student-made survey was created and provided to local businesses to gather information on crucial job skills and demands to sustain employment and on workplace hiring processes and accommodations. Lastly, the Vocational Fit Assessment (VocFit) was administered to gather objective data across multiple businesses on job skills and demands needed for employment.
Skills Inventory and Employment Guidelines
After gathering data from the assessments and interviews, the skills inventory and employment guidelines were created to guide the teaching and learning process of adults with Down syndrome and other intellectual and developmental disabilities to promote positive employment outcomes. The information from the skills inventory and employment guidelines may also be used as a guideline for employers during the hiring process.
Adult Curriculum
The curriculum was designed as a twelve-week program at GiGi’s Playhouse. The timeline for the program was based on current GiGi’s Playhouse career and specialty programs at various locations. The curriculum was designed as the EPIC (empowerment, participation, independence, community) program, which focuses on vocational skills, social and communication skills, and community involvement opportunities to promote independence and empower participants.
Program Description
EPIC is a program aimed to increase independence and empower individuals with Down syndrome through community involvement. This program will have a large focus on building career and self-determination skills through group activities, classroom learning, and community outings to prepare participants for future employment opportunities.
- 12 weeks
- 2x per week classroom learning
- 1x per week rotational internship experience
- Adults 18+
Program Goals
- Promote positive employment outcomes through career training and community involvement.
- Increase self-determination and self-confidence through group participation in activities, community involvement, and vocational opportunities.
- Provide opportunities for participants to discover jobs and work environments that are meaningful to them.
Curriculum Outcome Measures
Outcome measures were created as GiGi’s Playhouse verbalized the need to make program efficacy measurable.
- Parent/ Guardian Questionnaire
- Participant Self-Determination Questionnaire
- Money Management Outcome Measure
- Social Skills and Communication Outcome Measure
- Career Skills and Activities Outcome Measure
- Vocational Skills Portfolio Outcome Measure
Volunteer and Staff Training Modules
Training modules were created for GiGi’s Playhouse staff, volunteers, and program leads to provide education on curriculum materials and teaching strategies to provide positive learning outcomes. Training Module 1 provides an overview of EPIC and the common laws and regulations that affect inclusive hiring. Training Module 2 covers the Down syndrome learning profile, errorless learning, and additional teaching strategies for positive learning outcomes. Lastly, training Module 3 covers the curriculum topics, teaching strategies using VARK(®), and a guide to score and analyze the outcome measures.
Artifacts
Case Studies: Inclusive Employment
Community Flyer
Sensory Strategies to Promote Positive Learning Outcomes
Future Implications
Occupational Therapy
Occupational therapists play various roles in supporting individuals with disabilities in the workforce. Occupational therapists can help individuals of all abilities by developing therapeutic job skills programs, assessing jobs and the workplace, and recommending supports and equipment to support the employment process (AOTA, 2015).
The program curriculum includes occupational therapy principles and was designed to fit various learning styles and needs to ensure positive learning outcomes. The training modules and activity instructions include tips to guide program volunteers and leads through the implementation and teaching process. In addition, the curriculum contains ideas on how to tailor and grade the activities for all abilities and ensure activities are meaningful to each participant, increasing occupational engagement.
Career
The doctoral capstone experience contributed to personal and professional development. This doctoral capstone encouraged leadership, networking, and program development experiences that will contribute to success as a clinician and future educator.
Emily Sweetman, OTDS
School: sweetmane@huntington.edu
Personal: sweetmanemily@outlook.com
References
American Occupational Therapy Association. (2015). The role of occupational therapy in facilitating employment of individuals with developmental disabilities [Fact sheet]. https://www.aota.org/-/media/corporate/files/aboutot/professionals/whatisot/wi/facts/workers%20with%20dd%20fact%20sheet.pdf
Bush, K. L., & Tassé M. J. (2017). Employment and choice-making for adults with intellectual disability, autism, and down syndrome. Research in Developmental Disabilities, 65, 23-34. https://doi.org/10.1016/j.ridd.2017.04.004
Carter, E. W., Austin, D., & Trainor, A. A. (2011). Factors associated with the early work experiences of adolescents with severe disabilities. Intellectual and Developmental Disabilities, 49, 233-247. https://doi.org/10.1352/1934-9556-49.4.233
Chan, W., Smith, L. E., Hong, J., Greenberg, J. S., Taylor, J. L., & Mailick, M. R. (2018). Factors associated with sustained community employment among adults with autism and co-occurring intellectual disability. Autism, 22(7), 794-803. https://doi.org/10.1177/1362361317703760
Jackson, C., Cabenagh, P., & Clibbens, J. (2014). Communication and self-esteem in adults with Down syndrome. International Journal of Language & Communication Disorders, 49(3), 275-287. https://doi.org/10.1111/1460-6984.12060
Krell, K., Haugen, K., Torres, A., & Santoro, S. L. (2021). Description of daily living skills and independence: A cohort from a multidisciplinary Down syndrome clinic. Brain Sciences, 11(8), 1-13. https://doi.org/10.3390/brainsci11081012
Kumin, L., & Schoenbrodt, L. (2016) Employment in adults with down syndrome in the United States: Results from a national survey. Journal of Applied Research in Intellectual Disabilities, 29(4), 330-345. https://doi.org/10.1111/jar.12182
Loveall, A. J., Channell, M. M., Burke, M. M., & Rodgers, D. B. (2022). Post-high school transition outcomes for young adults with down syndrome. American Journal on Intellectual and Developmental Disabilities, 127(2), 135-148. https://doi.org/10.1352/1944-7558-127.2.135
U.S. Bureau of Labor Statistics. (2023). Persons with a disability: Labor force characteristics summary. Retrieved February 28, 2023, from https://www.bls.gov/news.release/disabl.nr0.htm