You could say it’s been Beth Pfeiffer’s year. In addition to teaching courses and maintaining a clinical pediatric practice, the associate professor is involved in several funded research projects, received the highest honor of the American Occupational Therapy Foundation, and was recently named a fellow of the American Occupational Therapy Association. Her latest project: a program to get more young adults with autism on the move. For Beth Pfeiffer, occupational therapy is holistic and intersectional: Research is rooted in the real world, and practice informs study.
Now the associate professor of occupational therapy will implement a peer-mediated transit training program that will ask an important question: If two therapeutic methods are known to work, are they even more effective when put together? The program, “Enhancing Community Participation and Utilization of Employment and Health Services through Peer-Mediated and Occupational Therapy Transportation Interventions,” starts with a curriculum developed by the Kennedy Center that coaches people with disabilities to use public transportation effectively. Then it goes a step further, training people on the autism spectrum to take their peers through the curriculum themselves.
Pfeiffer, an associate professor of occupational therapy, and her co-investigator, Assistant Professor of Occupational Therapy Susan Santalucia, anticipate that if travel training with OTs is effective, travel training with peers who have been through the process can be even more effective. “Peers model skills and facilitate social interactions,” Pfeiffer says. Further, she says, “If a person is learning a skill from someone with similar challenges, this can enhance self-efficacy, their belief that they can perform the task, which may enhance learning and strengthen their social network.”
Transit Trouble
For many disabled folks, transportation poses a tremendous obstacle. They often don’t drive, and so depend on parents and others for some of the most important activities of daily living. A 2015 study found that 72 percent of individuals with disabilities missed at least some of their desired activities because they didn’t have transportation and that over 70 percent of their parents and caregivers also missed out on activities because they were transporting their adult child. Meanwhile, getting around with public paratransit services, while a welcome and necessary service, can be time-consuming and burdensome, requiring users to request rides and set aside large blocks of time for pickups and drop-offs. Travel training provides a solution.
City Connection
To facilitate the program, the researchers will collaborate with SEPTA, Philadelphia’s public transit authority. Many of the peer-mediators will have completed SEPTA’s own travel training program, which is overseen by staff occupational therapists Amy Raphael and Catherine Fleming (MOT 2012). Both the Chance to Ride and the peer-mediated programs guide young adults with intellectual, developmental, and physical disabilities through the A to Z of public transit: responding in an emergency; crossing the street; interacting with transit operators and others; mapping a commute; physically navigating the buses, turnstiles, and train platforms; and solving the problems that can arise during a trip, such as missing a bus or coping with delays. “Most of the students love it,” Fleming says of SEPTA’s program. They establish routines, develop independence, and begin to participate in the community.
Defining Success
“There’s no one-size-fits-all in terms of success,” says Cassandra West, manager of Program Eligibility & Regulatory Compliance for Customized Community Transportation, SEPTA’s paratransit service. “Each user will define independence differently.” One way SEPTA measures success, of course, is by looking at the numbers, and from that perspective, travel training has been a boon. Each graduate of the SEPTA’s travel training program saves the system $1 million per year compared with that same person using paratransit services – and as they gain independence they become paying SEPTA riders, many of whom commute to jobs that further contribute to the local economy. “Even with a minimum wage job, that’s another $12 per hour we’re able to help individuals earn and then put back into the community,” West says.
Moving Forward
Pfeiffer’s pilot program will start with 20 young adults ages 16 to 21; a larger study to evaluate the pilot will recruit up to 100. At this point, the project is focusing on individuals with ASD, and will eventually include people with intellectual and developmental disabilities as well. The study will recruit through local community organizations such as Temple's Institute on Disabilities, the Philadelphia Independence Network and the School District of Philadelphia. “Our goal is to help as many individuals with ASD and other developmental disabilities to access meaningful participation in their communities to improve outcomes in employment, healthcare, and community inclusion. We hope to reduce one of the biggest barriers to access, which is transportation,” Pfeiffer says