Date Presented 03/22/24
This pilot study explores the relationship between OT strategies and child engagement levels during routine OT sessions. Our results offer preliminary evidence for optimizing active engagement of autistic children during therapy.
Primary Author and Speaker: Amy Watson-Grace
Additional Authors and Speakers: Jewel Elias Crasta
Contributing Authors: Joseph E. Martis, Lauren Wengerd
PURPOSE: For children on the autism spectrum, active engagement is suggested as a key to maximizing outcomes (Ruble & Robson, 2007). However, there is limited research examining the relationship between occupational therapy (OT) strategies and child engagement levels (D’Arrigo et al., 2020). Given steadily increasing autism prevalence, rising healthcare costs, and inconsistent evidence, there is a critical need to examine OT practice patterns in this population (Holland et al., 2021; Thompson-Hodgetts & Magill-Evans, 2018). Our research questions included: 1) Is it feasible to identify OT strategies using codes developed via the Delphi method; and 2) Which OT strategies most consistently relate to active engagement in autistic children?
DESIGN: We completed a pilot study using video analysis of 8 routine OT sessions with one 8-year-old male on the autism spectrum. Convenience sampling inclusion criteria included: autism diagnosis, 8-13 years old, verbal, and normal/corrected vision/hearing.
METHOD: Videos of 8 school-based OT sessions were analyzed using Mangold INTERACT. Treatment strategies were coded for duration (minutes) and frequency (times observed), and child engagement levels were coded for type and duration to calculate descriptive statistics.
RESULTS: Video coding OT sessions based on Delphi-identified codes is feasible. Child-led activities were associated with active engagement 99% of the time. Therapist-led fine motor activities were used most often (57% of total time), followed by communication (20%) and sensory (19%). Sensory activities were most often associated with active engagement (98%), followed by fine motor (71%) and communication (57%).
CONCLUSIONS: Our results offer preliminary evidence to guide interventions for actively engaging children on the autism spectrum during OT sessions. Determining OT strategies that are most effective in facilitating engagement during therapy has the potential to enhance the clinical management of autism.
References
D’Arrigo, R. G., Copley, J. A., Poulsen, A. A., & Ziviani, J. (2020). The Engaged Child in Occupational Therapy. Canadian Journal of Occupational Therapy. Revue Canadienne D’ergotherapie, 87(2), 127–136. https://doi.org/10.1177/0008417420905708
Holland, C. M., Blanche, E. I., & Thompson, B. L. (2021). Quantifying Therapists’ Activities during Sensory Integration Treatment for Young Children with Autism. Physical & Occupational Therapy in Pediatrics, 41(3), 284–299. https://doi.org/10.1080/01942638.2020.1847235
Ruble, L., & Robson, D. (2007). Individual and Environmental Determinants of Engagement in Autism. Journal of Autism and Developmental Disorders, 37, 1457–1468. https://doi.org/10.1007/s10803-006-0222-y
Thompson-Hodgetts, S., & Magill-Evans, J. (2018). Sensory-Based Approaches in Intervention for Children With Autism Spectrum Disorder: Influences on Occupational Therapists’ Recommendations and Perceived Benefits. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 72(3), 7203205020p1–7203205020p8. https://doi.org/10.5014/ajot.2018.024729
