Abstract
This case study examines an autistic child’s experience in the outpatient therapy waiting room and examines the utility of the Person–Environment–Occupation (PEO) model to identify facilitators and barriers of this environment to inform supportive and inclusive waiting room design
Primary Author and Speaker: Maria J. Vetter
Contributing Authors: Kathryn Williams, Ashley Mason
Autistic children can experience sensory and self-regulation difficulties in unsupportive environments (Schaaf et al., 2011). The outpatient therapy waiting room is frequented by this population and can often be dysregulating. This case study aims to 1) understand the child’s experience in the outpatient waiting room and 2) examine the utility of the Person-Environment-Occupation (PEO) Model (Law et al., 1996) to guide the identification of facilitators and barriers to inform waiting room design. The participant was initially recruited for a larger study investigating pediatric waiting room design using purposeful, convenience sampling at a suburban children’s hospital. MG (8 years 6 months) met inclusion criteria including: a diagnosis of autism spectrum disorder, attendance in outpatient therapy for two or more months, and no other medical issues. Qualitative methods were used including participant observation in the waiting room, a family interview, a parent survey, and the Sensory Processing Measure, 2nd Edition. Data analysis followed a recursive process to arrive at themes (Kiger & Varpio, 2020). The PEO Model guided data collection procedures and interpretation of results. Three themes emerged: waiting room triggers, facilitating regulation, and supported inclusion. Themes spoke to how design of the waiting room did or did not support MG’s ability to stay regulated before his therapy session. The PEO model revealed specific design elements that accounted for the interconnectedness between MG, the waiting room environment, and his occupation of waiting for services. Outpatient therapy waiting rooms are frequented by autistic children, but their design may not support their needs as experienced by MG. This study is important to occupational therapy because it provides an example of how the PEO Model can be a useful tool for practitioners to assess an environment’s design and identify modifications that can support the unique needs of their patients.
Kiger, M. E., & Varpio, L. (2020). Thematic analysis of qualitative data: AMEE guide no. 131. Medical Teacher, 42(8), 846–854, https://doi.org/10.1080/0142159X.2020.1755030
Law, M., Cooper, B., Strong, S., Stwart, D., Rigsby, P., & Letts, L. (1996). The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9–23.
Schaaf, R. C., Toth-Cohen, S., Johnson, S. L., Outten, G., & Benevides, T. W. (2011). The everyday routines of children with autism. Autism, 15(3), 373–389. https://doi.org/10.1177/136231310386505