Importance: Youth with intellectual disabilities (ID) have persistently poor work outcomes. Occupational therapy can support school-to-work transition but is underrepresented in transition practice. Objective: To identify and describe interventions within the scope of occupational therapy for youth with ID who are transitioning from school to work. Data Sources: MEDLINE, ERIC, PsycINFO, and CINAHL were searched, and hand searching was performed in relevant peer-reviewed journals. Study Selection and Data Collection: Included were peer-reviewed, English-language articles published from 2004 to 2017 describing studies focused on youth with ID with no significant co-occurring physical diagnoses who were transitioning from U.S.-based school settings to paid employment. Data extraction was managed using Google Drive. Data were organized on extraction sheets by trained reviewers. The quality of each study was assessed using questions adapted from the Critical Appraisal Skills Program checklist. Findings: A total of 35 articles were included, 7 of which used randomized controlled designs. All articles described interventions aligned with the Occupational Therapy Practice Framework: Domain and Process (3rd ed.), but specific mention of occupational therapy was notably absent from the literature. Interventions had little and generally low-level evidence supporting their use. Conclusions and Relevance: Significant and concerning gaps exist in the literature on school-to-work transition for youth with ID, likely impeding evidence-based practice. No included article mentioned occupational therapy or had a contributor who was an occupational therapy practitioner. Practitioners should advocate for occupational therapy’s role in transition and contribute reports of occupational therapy transition services for youth with ID to the literature. What This Article Adds: This study demonstrates that occupational therapy is poorly represented in literature describing transition services for youth with ID. Although the articles described interventions within the occupational therapy domain, these interventions were not provided by occupational therapy practitioners and did not have a strong evidence base.

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Importance: Engaging and pulling up a zipper is a functional skill needed by young children. Objective: To compare the efficacy of a standard zippering teaching vest presented with general verbal prompts to a modified zippering teaching vest presented with a related story and vocabulary among typically developing preschoolers. Design: An experimental, two-group, pre–post design. Setting: A local preschool. Participants: Fifty preschoolers ages 3 yr, 6 mo to 4 yr, 11 mo were recruited. Intervention: Eligible children received three zippering practice sessions from occupational therapy and speech-language pathology graduate students supervised by faculty; either a standard (control group) or modified (comparison group) zippering teaching vest was used. Outcomes and Measures: Individual sessions were video recorded. We coded data using a score of 2, 1, or 0, indicating degree of success through seven zippering steps. Using IBM SPSS Statistics (Version 26) for analysis, we conducted independent t tests to compare measures between the two groups. Results: Each cohort consisted of 14 preschoolers (N = 28); 252 separate zippering trials were analyzed. Pretrial zippering ability demonstrated no initial differences. Results indicate that both groups advanced their skills with added practice; however, the comparison group performed statistically significantly better than the control group, beginning with the second set of interventions. Conclusions and Relevance: Beginning with a second exposure to a novel instructional method, preschoolers increased their success by completing more of the seven identified steps of zippering than those receiving traditional input. This study demonstrates the ability of occupational therapy–speech-language pathology partnerships to create innovative treatments that facilitate occupationally based skill acquisition. What This Article Adds: This article adds evidence supporting the use of a modified practice zippering vest with added visual and language cues to teach zippering skills to occupational therapy clients.

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Date Presented 03/27/20 This pilot research compared the efficacy of a standard teaching zippering vest to a specially designed teaching zippering vest with a related story in the acquisition of zippering skills among 28 preschoolers. The study used a two-group (control/comparison) pre–post test experimental design. Results indicate that both groups developed their skills further with added practice; however, children in the comparison group did statistically significantly better than those in the control group. Primary Author and Speaker: Fern Silverman Additional Authors and Speakers: Carrie Knight, Anna Grasso, Stephanie DeFazio, Gina Inglese, Sophie Swallow, Jessica Lesnoy