Teaching the Calendar Application on a Mobile Device to Young Adults With Intellectual and Developmental Disabilities

Self-Management

In order for students with IDD to succeed in postsecondary settings, self-management skills have been deemed essential as they permeate all areas of learning, living, and working (Getzel & McManus, 2005; Getzel & Thoma, 2008; Schulze, 2016). Douglas and Uphold (2014) described self-management as the ability to “self-monitor, self-evaluate, and self-instruct” (p. 1). As such, learners who possess self-management skills to regulate their behavior can independently complete a series of tasks, transition between tasks, or stay on-task without prompts or reliance and assistance from adults (van Dijk & Gage, 2019). Among the self-management skills, organizing and scheduling may be particularly important as they can assist postsecondary learners with IDD to attend and complete various educational, vocational, and leisure tasks (Lancioni & Singh, 2014). Keeping appointments and schedules is essential to fulfill required academic responsibilities and may even foster personal and professional relationships in a college setting. Despite the importance of these self-management skills, postsecondary students with IDD often struggle with organizing and scheduling activities (Freedman, 2010; Lancioni & Singh, 2014; Lang et al., 2014) such as coping with schedules, arranging classroom materials, recording assignment details and due dates, meeting deadlines, and overall time management. Problems with organizing information, planning, and programming activities can affect academic performance and contribute to stress and anxiety for college students with IDD (Kuder & Accardo, 2018). Therefore, youth with IDD would benefit from specific research-based strategies that improve self-management of tasks, which could potentially lead to an enhanced quality of life in the postschool areas of living, learning, and working (Freedman, 2010; Schulze, 2016; Wood et al., 2005).

Self-Management Support Strategies

Individuals with IDD benefit from cuing supports to manage daily tasks independently. Graphic organizers, video modeling, video prompting, and scheduling tools such as visual activity schedules (VAS) are frequently employed support strategies to increase autonomy (Spriggs et al., 2017). In particular, activity schedules can provide the learner with visual cues, auditory, and/or tactile prompts to complete a series of tasks independently. Once taught how to use these schedules, individuals become less dependent on adults because the activity schedules provide the cues of the tasks they need to perform (van Dijk & Gage, 2019). Numerous studies have validated the effectiveness of activity schedules to teach a variety of skills including daily living, vocational, leisure, academic, and navigation to children, young adults, and adults with intellectual disabilities (Spriggs et al., 2017). Further, when combined with technology, scheduling tools can be a particularly effective means to teach students to self-manage their daily activities independently (Kagohara et al., 2013; Stromer et al., 2006). In particular, electronic mobile devices, such as iPods, iPads, and smartphones, can deliver prompts for individuals to complete tasks, which in turn could enhance their organization and self-management and, therefore, decrease their reliance on others.

Given the availability, as well as recent advances of technology, the use of mobile platforms and devices as assistive technologies to improve functioning and independent completion of daily tasks has evoked recent investigations. For example, Douglas and Uphold (2014) taught five high school students with IDD to take pictures with the camera function on the iPad and iPod touches of daily tasks in the classroom and the lunchroom (e.g., erase board, count money, throw away trash, wipe off table) and use the pictures as photographic activity schedules on these mobile platforms. Results indicated that all participants learned to create their own picture schedules and consequently increased their daily task completion. Similarly, Uphold et al. (2016) taught six young adults with IDD in a postsecondary setting to take pictures using the camera on their personal iPod touch to create picture schedules of exercises (e.g., jump rope, lunges, walk laps). These participants also subsequently increased their independent completion of exercises in a recreational facility.

Calendar App as a Scheduling Tool

The plethora of available applications (apps) on mobile platforms, such as the Calendar app on iOS devices, could serve as an assistive technology (AT) tool to augment young individuals’ abilities to manage one’s behavior and task completion. In fact, the Americans with Disabilities Education Act (2004) and Section 504 of the Rehabilitation Act (1973) ensure that college students with disabilities are entitled to AT to receive the same educational benefits as students without disabilities (Office of Civil Rights, 2020). AT is described as “any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability” (Individuals with Disabilities Education Act [IDEA], 2004, 602.1A). Given the broad definition of AT, apps on mobile devices can help with a variety of skills (e.g., reading, writing, organization) to enhance learning, working, and living for persons with disabilities. As to the Calendar app, and with the ultimate goal of increased independence, teaching youth with IDD to use it may be an efficient means of staying organized, remembering where and when they are supposed to be at all times, decreasing reliance on adults, and improving overall self-management. Few researchers investigated the possibility of using a calendar app to increase independent scheduling skills. Specifically, Myles et al. (2007) taught the calendar function of a personal digital assistant (PDA) to a high school student with autism to record and keep track of homework assignments. Prior to the intervention, the student solely relied on his teacher to record his homework assignments in a daily paper and pencil planner. Without teacher prompts, the student either would not record the classroom tasks or would record them with missing details and due dates. Following a training session on how to use the PDA’s calendar, the student was able to record his homework tasks in the PDA. Results indicated that he recorded his homework with 75% accuracy for history, 75% for English, and 33% for science classes, indicating an overall increase in independent homework recording from baseline. The authors concluded that the use of the PDA’s calendar function may be a promising tool for improving student organization and overall self-management and called for further research.

The participants in previous activity schedule studies had to regularly check and look at their schedule/to-do list to complete various tasks. However, the available notification feature of modern calendar apps can provide additional cuing support that could assist with self-management. Specifically, the notifications on the iOS Calendar app would alert its users to attend upcoming events and tasks via tactile, auditory, and/or visual prompts (Apple, 2019). As a result, teaching young adults with IDD to use a Calendar app and set up notifications on mobile devices may further help them keep track of daily activities.

Participants, Setting, and Materials

Three young adults with IDD, Jessica, Arnold, and Joe participated in this study. They attended a 2-year on-campus postsecondary education program designed for students with intellectual and cognitive disabilities in a Midwestern 4-year public research university at the time of participation. The goal of the program is to foster independence and community integration by focusing on career and independent life skills, as well as academic instruction in reading, mathematics, and writing. Students in this program are required to live on-campus; attend various college activities, including classes, program meetings, and advising sessions; and participate in on- and off-campus internships. Prior to the study, participants were nominated by their program coordinator based on the following inclusion criteria: (a) past history of not attending required college events/activities, including classes and advising meetings and (b) ability to read at second-grade level. The participants lacked the skills related to scheduling. Their program coordinators and peers had to remind them to attend different events.

Jessica was a 20-year-old female with an intellectual disability (IQ 58, Wechsler Adult Intelligence Scale-Fourth Edition [WAIS-IV]; Wechsler, 2008). Arnold was an 18-year-old male with an intellectual disability (IQ 50, WAIS-IV) and a diagnosis of autism spectrum disorder. Joe was a 20-year-old male with an intellectual disability (IQ 65, WAIS-IV). Their program coordinator provided the participants’ reading level based on Curriculum-Based Measurement in Reading (Hasbrouck et al., 1999), on which they were screened prior to their enrollment in the postsecondary program. All three participants read at second-grade level. In addition, all three participants owned mobile devices and were able to operate basic functions on their mobile platforms. While their devices were frequently used for communication (e.g., texting and calling), they never used the calendar function before to schedule various tasks and events and set reminders.

Two instructors conducted a total of 24 one on one sessions (including baseline, instruction, and postinstruction) with the participants twice a week in a private office on campus. Both instructors had at least 3 years of teaching experience working with young adults with IDD.

Materials

Cue card with mnemonic device

Before the study, we task analyzed the steps needed to schedule and set reminders for events on the Calendar app. We created a keyword mnemonic device, “CALENDAR,” based on these steps and made a 5 × 7 cue card with the acronym. Mnemonics refers to the use of cues to help students learn and remember information (Therrien et al., 2014). Therefore, the purpose of the CALENDAR mnemonic was to assist our students recall the necessary steps to enter events into the Calendar app. See Table 1 for CALENDAR steps.

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Table 1.

CALENDAR Steps and Corresponding Definitions to Schedule Events and Reminders.

CALENDAR Steps	Definitions
Step 1—Calendar app	Locate and press the Calendar app.
Step 2—Add event	Locate and press the “+” on top right corner of the Calendar app.
Step 3—Log title	Enter event title where it says “Title.”
Step 4—Enter location	Enter location where it says “Location.”
Step 5—Note the start	Locate and press “Starts.”
Step 6—Date and time	Scroll and enter date and time of event.
Step 7—Alert	Locate and press “Alert.”
Step 8—Remind 30 min and save	Locate and press “30 min before,” click on “New Event” on top left corner, and press “Add” to save the event.

Dependent Variables

The primary dependent variable was the number of independently completed steps according to the task analysis. A correct step included the participant performing the step independently and accurately. If the participant completed another step or completed steps in a different order, we marked all the independently completed steps as correct. If the participant completed a step incorrectly (e.g., pressed the wrong button, entered wrong location), that step was recorded as incorrect. If the participant did not initiate any step within 5 s, we scored that step as incorrect and terminated the task.

We also probed for attendance during the postinstruction phase for each of our participants after they have programmed the events in their phones. This attendance probe was considered successful if the participant actually showed up to the scheduled event on time (see “Generalization and Attendance Probes” section).

Experimental Design

We used a multiple probe across participant design through which the functional relation is demonstrated via the staggered application of the intervention across different participants at different times (Kazdin, 2011). As such, when the target behavior only changes when the intervention is implemented, we can conclude an experimental effect of the intervention. We selected this design as the use of noncontinuous probes during baseline helps to minimize the aversiveness of repeated assessment due to the participants’ continuous contact with errors.

After examining the first three data points, the participant with the most stable baseline (little or no variability) received the intervention first (i.e., Arnold). During Arnold’s CTD instruction condition, we continued to collect baseline data for Joe and Jessica. Once the first participant entered the postinstruction phase, we initiated the instruction with our second participant, Jessica. It should be noted that while both Joe and Jessica exhibited some variability in their baseline, both participants’ performance stabilized as more data were collected. Because Jessica consistently completed fewer steps than Joe (five and six, respectively), and Joe was not available to start intervention at that time due to a scheduling conflict, we began the CTD instruction with Jessica. Joe remained in baseline. Similarly, we continued baseline collection with Joe while we provided CTD instruction to Jessica. Once Jessica entered postinstruction, we began the intervention with Joe.

Data Analysis

Using Figure 1, we conducted the within- and between-condition visual analyses based on the steps outlined by Lane and Gast (2014). Specifically, we evaluated level, trend, and stability (i.e., variability) of data for within-condition examination. The mean was used to report the level. The split-middle line of progress was used to evaluate the trend. We used the stability criterion of 80% of data points within 25% of the median to determine stability of data. Immediacy of change (effect) and overlap of data were used for between-condition examination, while consistency of data patterns across participants was examined to establish replicability of our intervention effects (Barton et al., 2018). To assess overlap of data, we calculated the percentage of nonoverlapping data (PND; Scruggs et al., 1987).

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Figure 1.

CALENDAR steps performed by each participant in baseline and postinstruction phases. Note. □ represents step missed or performed incorrectly, ▪ represents step performed correctly, and ◂ represents step performed correctly in a generalization probe using their own personal device.

Procedures

Generalization and Attendance Probes

We conducted one generalization probe during postinstruction sessions to gauge if treatment effects generalized to personal devices. Both Arnold and Joe had iPhones, while Jessica had an Android phone. During the generalization probe, we requested their program coordinator to ask the participants to schedule and set a reminder for an additional advising meeting using their personal phones. We also asked the coordinator to notify us whether the participants had actually arrived for the advising session and whether their attendance was on time (i.e., attendance probe). If the participants showed up, he would proceed with advising. In order to assess whether the participants had indeed scheduled the meeting and set a reminder on their phone for this event, we later checked the Calendar app on the participants’ phones regardless of their attendance. The generalization and attendance probes were used to determine whether the participants could independently schedule and set a reminder for the meeting using their own devices (i.e., generalization probe) and whether they actually attend it (i.e., attendance probe).

Procedural Integrity and Interobserver Agreement

A graduate student in special education served as the second observer. He was responsible for collecting procedural integrity and participant data independently. At the start of each session, we gave him a copy of the procedural integrity (PI) checklist and the data collection sheet. He sat behind the participants so that he could remain nonintrusive but also observe the instructor and participant performance. We developed the PI checklists across baseline, CTD instruction, postinstruction, and generalization probes. Each PI checklist contained the essential steps as outlined in the procedures above, such as the presentation of materials and instruction, delivery of prompts, timing of prompt delivery, and provision of praise during CTD instruction. The second observer monitored a minimum of 66.7% of sessions in each phase and 100% of CTD instructional sessions. Procedural integrity was 100% across baseline, CTD instruction, postinstruction, and generalization, respectively. The second observer also collected participant data for at least 78.6% of the sessions during each phase. We calculated interobserver agreement (IOA) using step-by-step agreement (Kazdin, 2011). Mean IOA was 100% for both Jessica and Joe, and 98% (range, 87.5–100%) for Arnold.

Limitations and Future Research

This study has some discernable limitations. First, we used a mnemonic device, “CALENDAR,” to help with recall of steps. While all our participants were able to read and remember letters and corresponding steps, the mnemonic device may not be effective for students who do not have sufficient skills to read and maintain information (Roediger, 1980). In this case, educators and researchers should consider strategies that may achieve the similar effects of mnemonic devices such as electronic photographic activity schedules (e.g., Douglas & Uphold, 2014). Relatedly, we introduced our mnemonic device, “CALENDAR,” with CTD instruction. Thus, it may be difficult to isolate the effects of the CTD. Future studies can present the mnemonic device during baseline, so that the effects of CTD instruction can be separated.

Second, even though Arnold’s performance increased from 0 steps correct during baseline to a mean of 7.43 steps correct during postinstruction phase, only half of his data points during postinstruction reached 8 steps (100% correct), while the other two participants consistently performed all 8 steps. This may indicate that some young adults with IDD may require additional instruction to achieve mastery of skills. Therefore, we recommend individual instructional programming to address student ongoing performance. Third, we only collected three data points during the baseline phase for Arnold and during the postinstruction phase for Joe. Even though Arnold performed 0 correct steps throughout baseline, and Joe’s performance was stable at 8 correct steps (100% correct) across postinstruction, a minimum of five data points per phase have been recommended for a multiple baseline design (Kratochwill et al., 2013). Five data points allow for a better demonstration of responding pattern within the phase. Relatedly, we did not set a specific criterion to terminate the postinstruction sessions. Having an established criterion to end the post-CTD instruction condition (e.g., correct performance on all steps for five consecutive data points) may assist with consistency of the study procedures.

Fourth, due to time constraints, we only collected one generalization and one attendance probe for our participants, while no generalization probes were conducted during baseline. Additional generalization and attendance probes during baseline and postinstruction conditions would have demonstrated a consistent pattern of effects and strengthened our study results. We recommend that future studies include more attendance probes in baseline and postinstruction conditions to establish a pattern of independent attendance behavior as a result of programming appointments in the Calendar app. In addition, an iPad was used for our participants to better attend to the features of the app owing to the larger screen. However, researchers and practitioners could consider training the participants using their own personal devices (i.e., instead of a designated instructional device). This direct modus could remove the need for, or reduce potential issues with, generalization to a new device.

Last, we did not assess how long our participants maintained their skills to schedule events and set reminders. Because individuals with IDD often have difficulties in maintaining learned skills over time (e.g., Richards et al., 2014), it is crucial that future researchers systematically program for maintenance of learned skills to attain long-lasting behavioral changes. With regard to the Calendar app, educators could create numerous opportunities for students to demonstrate the learned steps to schedule a variety of class, internship, and leisure tasks and prompting them to frequently use these skills in real life (Brown & Odom, 1994). Relatedly, the social validity of an intervention is an important factor to consider when examining the acceptability of and satisfaction with intervention procedures (Wolfe, 1978). Additional social validity measures would provide information on treatment outcome, procedural acceptance, and incorporation of AT by our participants and their program coordinator when training postsecondary students to schedule tasks and events.

While the current study holds promise that postsecondary students with IDD can learn to program daily tasks and events into the Calendar app after being systematically taught how, it is necessary to replicate this study with other groups and students in the future, including those of diverse cultural, age, and disability background. In addition, we recommend researchers to further investigate the actual functional use of the Calendar app on independent event attendance in real-life situations. The use of the Calendar app and other time planner tools on mobile devices to improve independent scheduling, organization, keeping appointments, and overall self-management skills for young adults with IDD is worth investigating. Managing daily tasks is a critical first step toward increased independence for youth with IDD, including those living semi-independently who do not have access to or have chosen not to attend postsecondary education.

Implications for Practice

Our study indicates that young adults with IDD can learn to use a scheduling app to schedule appointments on a mobile device. In addition, two participants attended the programmed events they scheduled themselves on their personal devices without further reminders from adults. This is particularly important given that postsecondary instruction should focus on reducing adult supports and fostering independence for young adults with IDD during their transition into postschool life. Young adults with IDD should learn to self-manage various daily tasks and events as this skill is critical for college success and an enhanced autonomy in the postsecondary settings of living, learning, and working.

Results of the study highlight the use of mobile devices as AT to facilitate self-management skills for young adults with IDD. With a wide array of technological platforms available, educators, in collaboration with students, should select the most appropriate and sustainable product that would decrease reliance on adults and family members. In our study, two of the three participants successfully attended the event they scheduled themselves into their Calendar app without further reminders from adults. This finding is promising and underscores the need to consider self-management instruction for youth with IDD.

However, simply choosing an iPhone or Android with embedded features and apps without further instruction may not be effective. Our study along with previous literature (e.g., Douglas & Uphold, 2014; Uphold et al., 2016; Yuan et al., 2019) show that individuals with IDD may need to be explicitly taught to use these devices and apps with effective research-based instructional methods such as CTD as demonstrated in the current study. Further, when learning to schedule and plan via a self-management tool does not result in independent completion of tasks, instruction on responding to self-management prompts is warranted. As more students with IDD access postsecondary education programs, equipping them with strategies and skills to effectively self-manage their activities can be one-step closer to achieving more independent and self-determined lives for these young adults with IDD.