Practice Models to Facilitate Participation of Children with ASD in Home, School & Community Activities

Background: The conceptual practice models in occupational therapy guides clinical practice because they provide a framework to understand a client’s participation in home, school and community activities. Evidence suggests that successful childhood participation requires a dynamic interaction between the child and the environment.   There is a need to develop practice models for children with autism spectrum disorder (ASD) that reflects on the impact of the person factors (such as their cognitive, sensori-motor, psychological and spiritual development) and the environmental factors (physical, social & cultural) on the participation of the child. The International Classification of Functioning, disability and health (ICF) as well as the Person- Environment and Occupational Performance (PEOP) model highlight the importance of a child’s engagement in meaningful activities. This presentation aims to present three conceptual practice models for children with ASD. Objectives: 1.Understand the need to develop conceptual practice models for children with ASD. 2.Explore the importance of practice models in guiding evaluation and intervention in children with ASD. 3.Analyze the interaction between meaningful participation of children with ASD and the person and environmental factors. Methods: The three conceptual practice models were individually built on theory, the contemporary practice models that guide the profession of occupational therapy and the evidence from the biological, psychological, social and occupational science. It involved an extensive review of the literature as well as the classification and synthesis of the evidence from the literature. Each of the three models also identified the measurement strategies to ensure sound evaluation and planning of the interventions for children with ASD. Results: A critical analysis of the evidence facilitated in the understanding of the dynamic interface between theory, research, and clinical practice. The first practice model emphasizes on the role of the physical, social and cultural environmental factors on the development and the participation of children with ASD. The second practice model focuses on the impact of the sensory processing system on children’s development and participation. The third practice model emphasizes the contribution of motor and cognitive functions to participation and development of children with ASD. Conclusions: Overall, the three practice models provide a systematic approach to address the impact of the environmental factors as well as the cognitive, behavioral, and sensorimotor factors on the participation of children with ASD.  These practice models may help clinicians to guide practice and defend clinical decision making in both evaluation and intervention for children with ASD.