Barbara Abbott, PhD, OTR/L is a school-based occupational therapist currently working with students grades K-12 in four schools in Kent, WA. The purpose of our project was to identify the most effective service delivery models and/or components of interventions for young adults with complex communication needs to understand their health information. We conducted a systematic review to critically appraise literature published between the years of 1990-2018 to address our research question. Our research yielded a total of seven qualitative and 12 quantitative studies to address our research question. Qualitative data found that individuals with complex communication needs (CCN) experience significant challenges in adulthood with managing and communicating their health needs. Quantitative research identified seven evidence-based interventions that improved health knowledge, health literacy, and health advocacy skills for improving participation in the adult healthcare system. The overarching recommendation from the studies highlighted the importance of promoting self-advocacy and self-determination to navigate the system and manage individual health needs. There is a need for professionals to help prepare these young adults throughout the transition phase from pediatric to the adult healthcare system.

Our subsequent knowledge translation product entailed developing a tri-fold pamphlet intended for school administrators and school-based occupational therapists. It includes qualitative data and evidence based interventions to improve health literacy and self-advocacy skills for young adults with communication challenges in the school setting. Outcomes data collected from school based occupational therapists indicated that the research findings in the pamphlet were widely new information for them. Additionally, they reported positive reactions to the pamphlet. Occupational therapists surveyed agreed that teaching health education is within their scope of practice in the school setting, and reported an interest in incorporating a health education intervention for students with disabilities into their services. Future research is recommended for developing additional evidence-based interventions for preparing these young adults to advocate for their health needs. Recommendations for future translation of knowledge include catering the information in the pamphlets to specific audiences, such as one pamphlet for occupational therapists and a separate pamphlet for school administrators, with suggestions regarding support for families and educators.

Publication Place

Tacoma, Washington


University of Puget Sound

Project Chairperson

Renee Watling, PhD, OTR/L, FAOTA

Project Chairperson

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound