Tier Level of Support

Functional Skills Training for Individuals with Autism Spectrum Disorders

By: Robert H. LaRue, PhD, BCBA-D James C. Maraventano, EdM, BCBA Jenna Budge, MSW Douglass Developmental Disabilities Center at Rutgers University, April 1st, 2016.

The acquisition and maintenance of functional skills are among the most important educational targets for individuals with intellectual disabilities. Functional skills are the skills we possess that allow us to take care of ourselves and function independently in our natural environment. For most of us, these skills are readily acquired through daily life experiences. For individuals with cognitive impairments, these skills may need to be explicitly taught. The acquisition of functional skills results in several favorable outcomes, including increased opportunities for community integration and better overall quality of life (Ayres, Lowrey, Douglas, & Sievers, 2011). In addition, functional skills allow individuals with disabilities to have more opportunities to access reinforcers and make choices in their daily lives, which has been shown to have positive effects on work completion and inappropriate behavior (e.g., Watanabe and Sturmey, 2003).

The goal of any educational program should be to prepare individuals to function as independently in their environment as their abilities will allow. Experts have noted that individuals with intellectual disabilities encounter a myriad of challenges as they transition out of school placements, including unemployment and placement in more restrictive programs (Ayers et al., 2011; Courtade, Spooner, Browder, & Jimenez, 2012). Consequently, researchers have argued that functional skills should be incorporated into students’ individualized educational programming and practiced on a daily basis. Ideally, each educational goal should be linked to a terminal skill that will be useful to the individual in the natural environment (Bannerman, Sheldon, Sherman, & Harchik, 1990; Favell, Favell, Riddle, & Risley, 1984). This should be accomplished through systematic assessment and planning which allows parents and practitioners to produce the best outcomes for this population.

What Are Functional Skills?

Functional skills refer to a broad range of abilities needed to navigate the demands of everyday life. Functional skills are often referred to by a variety of names, such as self-help skills, life skills, or activities of daily life (ADLs). Functional skills, simply put, are those skills that are practical in nature and helpful for fostering independence.

All too often, practitioners implement academic goals that have little or no functional outcome. For example, an instructor may teach an adolescent to put plastic shapes into a shape sorter while they are unable to place coins in a vending machine. Students may be taught to identify the pictures of lesser-known U.S. Presidents (e.g., James K. Polk) or list the characteristics of sedimentary rock as a part of their academic programming. These kinds of goals can be a concern as they do not translate in any meaningful way to activities the individual is likely to encounter in their daily life. From this perspective, instructional time that is devoted to teaching non-functional skills is a waste of valuable educational resources and highlights the need for appropriate educational curricula with a focus on functional skills (Conderman & Katsiyannis, 2002).

Functional Skills Assessments

In order to evaluate an individual’s current level of functioning and identify skills to target for intervention, it is important for caregivers to conduct assessments of an individual’s capacity to perform various functional skills. Specifically, functional skills assessments may be valuable in the identification of meaningful instructional targets, in determining the level and type of support that an individual may need. Some commonly used instruments for identifying functional skill targets include the Vineland Adaptive Behavior Scales II (Sparrow, Cicchetti, & Balla, 2008), the Scales of Independent Behavior-Revised (Bruininks, Woodcock, Weatherman, & Hill, 1996), and the Assessment of Functional Living Skills (Partington & Mueller, 2012). These measures can be a useful guide for parents and practitioners when selecting curricular targets and can be used to determine socially-significant short and long-term goals.

Types of Functional Skills

The spectrum of functional skills is quite diverse, encompassing multiple domains of performance, such as self-care, domestic, recreational, community safety, prevocational/vocational, social and behavior management skills.

Self-Care Skills – Self-care skills are among the most important and basic kinds of functional skills in that they contribute to the maintenance of well-being and are necessary to sustain one’s health. Self-care skills include a number of important targets, such as the ability to bathe oneself, self-grooming (e.g., teeth brushing, shaving, hair brushing, putting on deodorant), washing (e.g., hand and face washing, showering), self-toileting, and getting dressed (e.g., choosing clothes, tying shoes, dressing independently).

Domestic Skills – Domestic skills encompass the skills related to household affairs. These skills involve maintaining one’s home as well as providing necessary daily sustenance. Domestic skills may include food preparation and safety (e.g., using a microwave or an oven to cook food), meal planning, sweeping/vacuuming the floor, doing dishes (e.g., loading a dishwasher), making a bed, and doing laundry (e.g. washing, drying, folding and sorting clothing),

Community Skills – Community skills include those abilities that are required to navigate and access resources within one’s specific locality. Important community skill targets may include the ability to cross a street safely (e.g., using a crosswalk, observing “Walk/Don’t Walk” signs), the ability to recognize stores (e.g., grocery store, pharmacy, laundromat), the use of public transit (e.g., using the bus or train), or locating and purchasing items in a store (e.g., paying for items, counting change).

Vocational Skills – A common goal for many individuals with intellectual disabilities and their families is obtaining employment. Vocational skills include those skills that involve the production aspects of jobs, such as busing tables at a restaurant or filing paperwork at a doctor’s office. Vocational targets often depend on several factors, such as opportunities in the community, individual levels of challenging behavior, individual skill level, and parent/student preference. Such instruction may begin with prevocational skills to teach the prerequisite skills (e.g., sorting tasks, discrimination tasks) that are components of more complex skills (e.g., delivering inter-office mail).

Recreational Skills – Recreational skills typically involve an individual’s engagement with activities or items that they find interesting, rewarding, relaxing, or enjoyable. For most individuals, recreational activities are acquired without specific training as a part of typical development. Exercising (e.g., running), playing games/sports (e.g., bowling, soccer, playing “Tag”), or interacting with preferred items (e.g., playing video games or reading a book) are learned by most without any specific teaching. Alternatively, individuals with intellectual disabilities may require formal teaching strategies to develop repertoires of appropriate leisure-time activities.

Social Skills – An individual’s ability to participate in their community is, to a large extent, dependent upon their ability to interact with others. Social skills are the skills necessary that facilitate interaction and communication with others. Under normal circumstances, social rules and relations are developed without specific teaching. However, for individuals with intellectual disabilities, specific teaching strategies may be necessary to develop appropriate social behavior, such as respecting personal space, perspective-taking, conversation skills, turn taking, sharing with others, asking for or offering to help, giving an appropriate greeting, and giving/accepting compliments.

Behavior Management Skills – The ability to be integrated into the community is often directly dependent on the absence of maladaptive behavior. Specifically, the presence of problem behavior significantly limits an individual’s ability to participate in functional activities. Effective, function-based behavioral intervention is imperative for improving outcomes in individuals with intellectual disabilities. Behavioral intervention should involve a systematic plan that includes antecedent strategies to prevent the occurrence of problem behavior, the reinforcement of appropriate alternative behavior, and strategies for responding to problem behavior (e.g., extinction). In terms of functional behavior management skills, individuals should be taught to make choices and state their preferences, functional communication skills (e.g., appropriate ways to ask for a break, attention, preferred items and activities), in addition to various strategies for managing their own behavior (i.e., self-management techniques).

It is important to note that this list of functional skills is not all encompassing. In fact, functional skills span a wide variety of domains, are specific to an individual’s natural environment, and are more than just what an individual needs to survive. These skills are essential to achieving independence and can significantly affect quality of life for both an individual and their caregivers. More specifically, if an individual is unable to perform these skills on their own, they will require more restrictive environments with fewer opportunities for choice and produce greater strain for caregivers.

Conclusion

The development of functional skills for individuals with ASD is, arguably, one of the most important goals for any parent or practitioner, leading to immense benefits for the individual. Individuals who have learned functional skills have the ability to be more self-sufficient than those who have not. The acquisition of functional skills affords more choices in life and lessens the need for intensive support. Functional skill development allows the individual to be more integrated with his or her community and increases opportunities for gainful employment and volunteer work. Sound functional programming can lead to the development of adaptive hobbies and leisure activities. Actively participating in the community and maintaining gainful employment can lead to a more rewarding lifestyle.

The benefit of sound functional skills programming extends beyond the individual. Benefits can be seen among friends and family members through the establishment of more meaningful relationships with others. Family members can spend less time providing intervention and more time enjoying interactions with their loved ones. In addition, the more functional and independent an individual is, the less need there is for support. In short, individuals who do not require intensive support and services require less financial support than those who are unable to function on their own, so costs may be reduced for family members and taxpayers.

These factors underscore the importance of selecting sound functional goals for individuals with intellectual disabilities. The acquisition of self-care, domestic, recreational, community safety, pre-vocational/vocational, social, and behavior management skills are of paramount importance for improving outcomes for this population. To aid in the selection of appropriate goals, tools like the Vineland Adaptive Behavior Scales II, the Scales of Independent Behavior-Revised, and the Assessment of Functional Living Skills can provide a roadmap for practitioners to target necessary skill areas.

We should always be focused on the acquisition of skills that are immediately useful, practical, helpful, and beneficial. As parents and practitioners, we should question the need for each goal being addressed. Is this skill important? Is this skill a component of a larger, important skill? Is this goal going to make a meaningful difference in 10 years? Will this skill make the individual more independent at some point in the future? If the answer to any of these questions is “no,” then we need to seriously consider why the goals are being targeted. All too often, goals are selected for the wrong reasons (e.g., because other students in a classroom are working on similar goals), which can lead to wasted time and frustration on the part of the individual. As a general rule, if a program is not promoting independence, parents and practitioners should be doing something else. Everything that we target as educators should prepare individuals with intellectual disabilities for the post-school environment that they will be living in.

Robert H. LaRue, PhD, BCBA-D, is Director of Behavioral and Research Services, James C. Maraventano, EdM, BCBA, is a Behavior Analyst, and Jenna Budge, MSW, is a Program Coordinator at the Douglass Developmental Disabilities Center at Rutgers, The State University of New Jersey. For more information, please contact Robert LaRue, PhD, BCBA-D, at (848) 932-4500 or larue@scarletmail.rutgers.edu.

References

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