Leadership Education in Neurodevelopmental and related Disabilities (LEND) Program

Division of Developmental and Behavioral Pediatrics

Cincinnati Children's Hospital Medical Center
University of Cincinnati University Center for Excellence in Developmental Disabilities

Development and Evaluation of a Daily Living Skills Assessment for Adolescents and
Young Adults with Developmental Disabilities
Ann Donnelly, OTR/L, Megan Kelly, BSW, Carla Luevano, M.Ed., & Amie Duncan, Ph.D.

Young people with developmental disabilities (DD) are not developing the critical daily
living skills (DLS) needed to successfully make the transition from adolescence to
postsecondary education, employment, and independent living (Newman et al., 2011). The
mastery of DLS in the domains of self-care (e.g., waking up, personal hygiene, taking
medications), domestic (e.g., laundry, cooking, cleaning), and community (e.g., grocery
shopping, paying bills) are critical for achieving certain milestones in adulthood. Further, DLS
have been linked to a more successful adult outcome and a positive quality of life (e.g., Farley
et al., 2009). Interestingly, there are few direct assessments of DLS for adolescents with DD,
which make it difficult to understand which skills need targeted and to determine whether
progress is being made in regards to skill acquisition, mastery, and generalization.
While assessments of DLS exist, they are often self or proxy reported measures, require
training to administer, or are unstandardized observational assessments. For example, the
Vineland Adaptive Behavior Scales, 3rd Edition is our gold standard measure of DLS, but does
not have a self report and the majority of items focus on skills attained in childhood and early
adolescence. The primary aim of the current study was to develop and refine a direct behavioral
observation assessment of DLS for youth with DD that is easy to administer, has a standardized
scoring system, and assesses critical DLS.
The DLS Behavioral Observation Measure (DLS-BOM) consists of tasks assessing
cooking in the microwave, cooking on the stove, doing laundry, and budgeting for purchases at
a store. In Phase 1, the DLS-BOM was piloted with 12 students with DD participating in a
postsecondary education program and enrolled in a DLS class. Using qualitative methods, the
students’ responses, behaviors, and scores were analyzed in order to refine and adapt the task
components, instructions, and scoring rubric. In Phase 2, the adapted DLS-BOM was given to 5
adolescents with a diagnosis of autism spectrum disorder (ASD) who were enrolling in a study
to evaluate the efficacy of a DLS intervention. Similar qualitative methods were used to then
further refine the measure using participants’ responses, behaviors, and scores.
Results from piloting the DLS-BOM indicated the need for clear, standardized scoring for
each item assessed. Detailed behavioral observations and an analysis of responses from a total
of 17 individuals allowed for the research team to create a detailed scoring rubric using a Likert
scale based on the ability to independently complete a task (i.e., ratings of 0-2). The DLS-BOM
will be used as an outcome measure in a randomized clinical trial that is comparing the
effectiveness of a DLS intervention vs. a social skills intervention for adolescents with ASD. The
development of a direct behavioral assessment of DLS fills a gap in the literature that will allow
for an understanding of individual change in DLS over time in adolescents with DD.