Occupational Therapy Practice with Adults with Intellectual Disability: What More Can We Do?

Sep 28, 2020

With recent celebrations to commemorate the 25th anniversary of the Americans with Disabilities Act (ADA) and the centennial of the American Occupational Therapy Association (AOTA),
it is timely to take stock of the profession’s involvement in the intellectual disability (ID) community. There are observable deficiencies in occupational therapy practice with adults with ID; however, occupational therapists are well positioned to assist members of the ID community by enhancing, enabling, and advocating for participation in daily life (Bathje, Lannoye, Mercier, & Panter, 2017). Individuals with ID are a disadvantaged group who have not come to their circumstances by chance. They have endured a history of isolation in state-operated facilities with limited supports and services and have confronted policies and professional practices that have, at times, reproduced their
marginalization by perpetuating custodial care (Johnson & Bagatell, 2017). Although access to community-based services has increased since the passing of the ADA and the Olmstead Decision (Dean, Dunn, & Tomchek, 2015), barriers that restrict the spectrum of opportunities for occupational participation continue to put adults with ID at significant risk for occupational alienation and a decreased sense of occupational competence (Mahoney, Roberts, Bryze, & Kent-Parker, 2016). This has resulted in disparities in health care, community housing, transportation, secondary education, gainful employment, and social inclusion, to name a few.  In this Opinions in the Profession paper, we explore how occupational therapists can better address the occupational needs of adults with ID. We describe the facilitators and barriers to occupational therapists’ work with this population, and we provide recommendations that align with broader efforts of national, state, and community-based organizations aimed at improving the lives of adults with ID.