Evidence based practice symposium occupational therapy class of 2019

Children with Autism Spectrum Disorder (ASD) often experience difficulty managing self-care skills. Independence in self-care skills is related to an increase in self-efficacy and participation for children with ASD and eases caregiver burden. Video-based modelling is an intervention approach used to teach self-care skills to children with ASD. The objectives of this study are to: 1) Review current literature on video-based interventions for use in children with ASD; 2) Complete a program evaluation of the video-based modelling program at CDRP; 3) Evaluate the effectiveness of video-based modelling for use in children with ASD at Children’s Developmental Rehabilitation Program (CDRP). The current body of literature revealed moderate-to-low quality evidence. The results from the literature review and preliminary results from the program evaluation indicate the video-based modelling is an effective intervention at teaching self-care skills to children with ASD. Introduction ASD is a neuro-developmental disorder that affects the development of social and communication abilities, as well as aspects of behaviour such as restricted interests and repetitive behaviours1. The term “autism spectrum disorder” reflects the current view that the impact of ASD on development, learning and behaviour can range from relatively mild to severe in any or all of these areas of development1. The severity of these impairments may lead to deficits in the development of activities of daily living such as personal care skills, such as dressing, toileting and hand washing. Personal care skills and the completion of activities of daily living represents a foundational set of skills needed for individuals with ASD to achieve independence and maintain a desired quality of life. Video modelling has been used successfully to teach children with a variety of diagnoses a diverse set of skills including language, classroom behaviour expectations, play, self-care and social skills2. Video modelling involves watching a video of a model engaging in target behaviours, with the goal that the observer will later imitate those behaviours. There are several types of video models including adult modelling, peer modelling, selfmodelling and point-of-view modelling and each of these model types have been used effectively to teach target behaviours to children with ASD3. Methods Literature Review: The search process consisted of an electronic search of six academic databases (OVID Medline, CINAHL, Cochrane Library, ERIC via ProQuest, PubMed and OTSeeker) following the 6S pyramid and included the following keywords: video model*ing combined with the terms youth OR adolescent OR pediatric combined with the terms autism, ASD. The following inclusion criteria determines which studies qualified for review: (a) at least one participant identified as having ASD that was between the ages of 5 15; (b) target acquisition of self-care skills as a dependent measure; and (c) published in a peer-reviewed journal past the date of January 1, 2014. The authors excluded articles containing (a) children outside the age range of 5 – 15; (b) a population of participants that did not include autism or ASD; and (c) did not include the acquisition of a self-care task as a dependent variable. Both authors independently screened all articles included in the related literature reviews4,5 against the inclusion criteria and removed any duplicates of articles that were included in the reviews. As a result of the search procedures, 21 articles were identified for possible inclusion in review. These articles were then assessed to determine whether they met the inclusion criteria. Ultimately, a total of 5 articles qualified for the review. Program Evaluation: A before-and-after design was used to determine the following research question: Is the video-based modelling program at CDRP effective in teaching self-care skills to children, aged 5-15, diagnosed with Autism Spectrum Disorder (ASD)? Five participants (n=5) participated in the program evaluation. An occupational therapist administered the the Adapted Behavior Assessment System Third Edition (ABAS-3) during the initial assessment period to determine the child’s current level of performance in everyday skills. The Canadian Occupational Performance Measure (COPM) was used as an outcome measure to identify participants’ selfcare goals. YouTube accounts were created for each participant and based on their age and self-care goal, videos were uploaded to the each individual account. Fidelity checklists were given to parents of the participants to track the viewing frequency. The participants were instructed to watch the video twice per day for three-weeks. After threeweeks, the COPM was re-administered. Parent satisfaction and clinician satisfaction questionnaires were administered to parents and participating OTs. Results Literature Review: Overall, the literature on video-based modelling for children and adolescents with ASD to teach self-care skills is limited. All articles included in the review concluded that video-based modelling was effective at improving self-care skills in children and adolescents with ASD. Limitations of the literature include a small sample size across all articles. The authors in one article noted the challenges in recruiting a homogenous sample in individuals with ASD due to the variability in cognitive, social and motor skills5. Despite these challenges, future research should include studies including a larger number of participants. There is also a low quality of evidence on this topic area. Future research should include research utilizing higher levels of evidence, such as Evaluating the Use of Video-Based Modelling to Teach SelfCare Skills to Children with ASD A Program Evaluation Authors: Alyssa Corcoran, MSc(OT) Candidate & Kailey Gruber MSc(OT)