Date Presented 04/03/2025
This session presents the results of a national survey of OTs delivering services for autistic children and their families. Alignment of current practices with contemporary guidelines and barriers that affect service delivery will be discussed.
Primary Author and Speaker: Renee Watling
Additional Authors and Speakers: Kylie Darby, Natalie Daughton
PURPOSE: Autistic individuals have expressed dissatisfaction with services dictated by imposed systems of care at the same time that various agencies have published professional practice guidelines. Knowing what occupational therapists are doing in their practices allows for assessing alignment with published guidelines and with requests coming from autistic self-advocates.
DESIGN: This study used online survey methodology to query occupational therapy practitioners from across the United States who were providing services to autistic clients in clinic-based practices.
METHOD: The custom-designed questionnaire was created by bringing forward questions used by Watling and colleagues (1992) and incorporating contemporary issues as identified in current literature and AOTA Practice Guidelines (2016). Forced choice, open-ended, and ordered choice question types were asked. Participant recruitment used a structured approach to websearching to identify clinical practices in each state that were providing OT services for autistic clients which was supplemented with recruiting at a national conference, posting on social media sites, and using professional networks. 92 respondents participated. Descriptive and thematic analyses were conducted.
RESULTS: Current practitces are consistent with 2016 guidelines to use ASI and multisensory strategies, highlight strengths vs. deficits, and support family coping, and are also consistent with 2024 guidelines for clinic-based service for children 3-12 years old to provide parents with education and coaching, use multifacted approaches to child social interaction skills, and support parent-child dyads through direct service provision.
CONCLUSION: A majority of clinic-based practitioners are providing services for autistic children and their parents that align with current practice guidelines. Caregivers report that institutionalized service delivery and reimbursement structures continue to impede best practice in many cases.
References
Patten, K. K., Murthi, K., Onwumere, D. D., Skaletski, E. C., Little, L. M., & Tomchek, S. D. (2024). Practice Guidelines—Occupational therapy practice guidelines for autistic people across the lifespan. American Journal of Occupational Therapy, 78, 7803397010. https://doi.org/10.5014/ajot.2024.078301
Tomchek, S. D., & Patten Koenig, K. (2016). Occupational therapy practice guidelines for individuals with autism spectrum disorder. AOTA Press.
Watling, R., Deitz, J., Kanny, E., & McLaughlin, J. (1999). Current practice of occupational therapy for children with autism. American Journal of Occupational Therapy, 53, 498–505. https://doi.org/10.5014/ajot.53.5.498
