Occupational Therapy Lens on Independent Living Skills for College

As adulthood arrives, so does additional responsibility and independence. For young adults with disabilities, gaining independent living skills can increase opportunities and improve their quality of life. Independent living skills consist of a wide variety of activities. If a student has an intellectual or physical disability, how they complete activities may need to be adapted. The following list is not exhaustive but covers many skills that will be important to develop to prepare for college, with consideration given to young adults with disabilities.

From an occupational therapy perspective, many of the skills are within the scope of occupational therapy according to the Occupational Therapy Practice Framework (American Occupational Therapy Association, 2020). Occupational therapists can bring additional thoughts and strategies to the conversation of supporting young adults with disabilities to develop independent living skills based on their knowledge of activity analysis and other factors impacting function. When considering strategies for students to learn how to complete activities more independently, occupational therapists reflect on how much instruction they provide and slowly decrease the amount of help provided so students can learn to process activities more independently.

Activities of Daily Living (ADLs)

Bathing and showering 

The above picture is the shower set up in the dorm room at Huntington University, Roush Hall. Students in the Achieving Balance in Life through Education.

Considerations for this ADL may include coordination of a shower schedule or time to shower, grab bars or a shower chair, supplies needed for showering, and safety.

If a student has a disability that impacts their mobility or balance, a shower bench or chair can help provide stability and safety if there is not one already present. A handheld shower head can allow students to wash themselves while sitting. Some students may need reminders to process through the steps of showering to ensure they maintain good hygiene. An occupational therapist can analyze the showering activity specific to the student and determine what steps they need to include on a laminated page that can be placed on the wall outside the shower or even within the shower if possible so the student can follow along and complete each step appropriately.

Toileting

Some considerations for toileting could be if the student needs a raised toilet seat to more easily get on and off the toilet. Grab bars can also be next to the toilet or a heavy piece of furniture that the student could use as leverage. In a dorm, a student may only be able to retrieve a certain amount of toilet paper at a time that is provided by the university, or they may have to purchase their own. Either way, students must remember to have enough toilet paper and to use the correct amount. 

Dressing

As students are attending various classes or events on campus or even off campus, they may consider what types of clothes they have available with them in their dorm, or if they do not live on campus, they must consider what clothing is most appropriate to wear for the occasion. Students in a dorm could plan what they will wear the night before so they are not running out of time in the morning. Or, they could organize their closet to know what clothing types can be found where. Determining the best method for staying organized depends on the student’s personal factors and environment.

Eating 

Considerations for eating are what time to obtain meals, social and communication skills to navigate the dining commons, standing in lines or sitting with others, and processing through steps of obtaining food in different locations. Many students have to work on skills such as picking healthy meal choices and balancing different food groups. With more independence with food choices and the amount of food available, students may need more support to maintain a healthy lifestyle. Students may benefit from looking at the menu at the college dining commons before they arrive. They may have assistance to create a template or list of food groups to obtain at each meal, or a list of foods to buy at the grocery store.

The above picture is outside of the dining commons at Huntington University.

Functional Mobility 

Students must assess how they navigate campus, especially when paths are slippery in winter. Leaving class earlier may be wise to ensure arrival at the proper time. Learning where all the buildings are located on campus can also be overwhelming for some students. Creating a visual map of the buildings could be helpful if the student is familiar with reading maps. Processing through directions or walking the campus before a student arrives for classes could ease concerns.

Walking on campus at Huntington University in the winter.

Hygiene and Grooming

Considerations include toiletries, medications, towels, soaps, and other items. A cleaning schedule must be established with a roommate. A student may need visuals or steps for completing tasks found at the sink, such as washing hands (i.e. turn the water on, use 3 pumps of soap, scrub hands, rinse hands, dry hands) or brushing teeth (i.e. open toothpaste and apply 1 inch of toothpaste on the toothbrush, wash front teeth then back teeth, etc., rinse mouth with water, wipe mouth, dry the area around the sink, place materials away). If a student has a visual impairment, an occupational therapist is trained to recognize different factors to adapt to make the task more attainable. Ideas may include decluttering the countertop, having a large mirror to see the task, having bright-colored items on a dull surface to locate items easier, and other ideas pertaining to a student’s specific needs.

Instrumental Activities of Daily Living 

Communication Management 

Students must communicate with professors, students, or other people involved while in college. If they live on campus, they may communicate with family or friends who are not with them. Does the student have a cell phone? Do they know how to write professional emails? What support may they need in this area?

Driving and community mobility

Students must get to and from campus if they are commuting from home. Or if they are on campus, will they need to go to the grocery store? They may want to explore the city around campus with friends. Is the student able to drive? Are they aware of safety or how to fill the car with gas? Students may need to work on driving skills earlier in high school to develop the ability to drive. A student may need a schedule to keep track of who will drive them to different places as they need it.

Financial Management 

Most stores take credit or debit cards to purchase items. On college campuses, students may often have a student card with money prepaid to order food or other items. For students with intellectual disabilities, some factors to contemplate are whether the student prefers to use a credit or debit card for purchases rather than counting cash. Cash could prevent overspending and give students a visual way of recognizing how much money they have left.

Home Establishment and Management (your dorm)

Many items are needed for a dorm room, such as bedding, pillows, desk supplies, decorations, or even extra storage bins. Check with your college campus to see what items have already been provided. There are responsibilities in keeping the space clean and maintaining boundaries with a roommate. Will items be shared, and can the student properly communicate their needs with a roommate? Has the student lived in close proximity to someone before and if not, can they practice this before arriving to college? Can they practice sleeping at another family member’s house or a friend’s house away from their routine?

Meal preparation and clean up

Shared space in Rousch Hall of Huntington University. Consider the safety procedures involved and how to operate each appliance. What appliances might you want to use? How many have you used before college on your own?

Religious and spiritual expression

The prayer room at Huntington University dorm.

Students may want to attend church outside campus. At Huntington University, students are required to obtain chapel credits by attending chapel services throughout each week of the semester. Church or religious activities may provide opportunities for social interaction, managing stress, and encouragement during the transition to college.

Safety and emergency maintenance

 Standard fire alarm on campus.

Standard fire extinguisher on campus.

Safety procedures and equipment are essential skills for students with disabilities to live more independently. Visuals or pictures of items to remember their purpose may be conducive to learning before arriving at college. Practicing a fire drill or another scenario can help the student be more prepared if a situation arises. Speaking to staff at a student’s university, such as the program director or a mentor involved in supporting students living on campus, can help families determine what supports may already be in place.

Laundry

Standard washer on college campus.

Standard dryer on college campus.

Laundry is an important task that students will need to complete. Becoming familiar with the materials such as liquid detergent, pods, dryer sheets, and others as well as the steps to laundry including sorting clothes will be useful to increase independence. Students will need to learn how to share the laundry space with others and to remember to remove their clothes at the appropriate time. These skills can be learned by participating in related tasks at home or at a laundry mat.

Health Management 

Symptom and Condition Management; Medication management

For students with a medical condition or those who take daily medications, a system must be in place to continue tasks that may be part of a student’s routine. A pill organizer with customized labels or a list of steps to manage a task can be helpful. If a student will require assistance, consider who may be available to help, and if no one, consider if a student would benefit from commuting to and from college if they still need extra support.

Rest and Sleep

Without a parent or guardian to remind a student when to get up or get to bed if this is part of their routine, students must identify how to manage their schedule independently. Different apps or types of alarm clocks can be chosen depending on what a student needs to get out of bed on time. Would a roommate need to ensure the student is up at a certain time? Can someone initially keep the student accountable for getting to bed on time? 

Education

Formal educational participation

Students attend classes with other students with disabilities within their program or may be auditing or completing courses with students without disabilities on campus.

ABLE students at Huntington University attend classes in Loew-Brenn Hall.

The second floor of the library at Huntington University.

Finding a quiet space for working on school-related tasks may be helpful for students who are easily distracted or overwhelmed by noise.

Social Participation

Community participation:

Chapel, dorm lobbies, campus events, and more!

Huntington University Roush Hall shared space.

Huntington University Roush Hall shared space.

Family participation, Friendships, Intimate Partner Relationships, Peer Groups

In college, students can engage with a wide variety of people, leading to them making new friends and even pursuing romantic relationships. College allows students to grow and learn more about themselves and their abilities. For all students, regardless of disability, college has exciting victories and many challenges. It is a privilege to attend college, and students with disabilities can be present on campuses to achieve goals that are meaningful to them.

Reference

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2).