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Importance: The coronavirus disease 2019 (COVID-19) pandemic highlighted unique neurodiversity-affirming practices that may support autistic people’s mental health, many of which run contrary to typical notions of autism. These insights are critical for occupational therapists working with this population. Objective: To (1) understand the self-reported mental health experiences of autistic adults during the COVID-19 pandemic and (2) identify ways that occupational therapy practitioners and other clinicians can help autistic adults during unexpected and challenging times. Design: This qualitative interpretative phenomenological study used surveys and interviews to collect data between August 15, 2020, and May 1, 2021. Two researchers independently coded interview transcripts. Any disagreements were resolved through consensus. Setting: Qualtrics survey and Zoom interviews. Participants: Participants (N = 34) met the following inclusion criteria: self-reported diagnosis of autism spectrum disorder or Asperger’s syndrome, ages 18 to 35 yr, residing in the Eastern United States, able to understand English, and able to participate in a one-on-one interview using verbal or written communication. Recruitment was conducted via snowball sampling through local agencies serving autistic people. Results: Two themes emerged from the data: (1) autistic adults’ social experiences during the COVID-19 pandemic paradoxically supported and hindered their mental health and (2) during the COVID-19 pandemic, mental health was tied to daily activity among autistic adults. Conclusions and Relevance: Participants reported feelings of anxiety and depression, as well as a need for social interaction on their own terms. Clinical recommendations are provided. What This Article Adds: This article includes suggestions generated from autistic people’s input on how clinicians can support this population. The suggested supports and alteration to occupations can be both applied in the case of another unexpected event (e.g., another pandemic) and incorporated to promote the participation and well-being of autistic adults. Positionality Statement: We use identity-first language (e.g., autistic person) throughout this article because disability advocates and scholars assert that person-first language (e.g., person with autism) contributes to disability stigma (Collier, 2012; Gernsbacher, 2017).

Behavioral inflexibility (BI) has been highlighted to occur across genetic and neurodevelopmental disorders. This study characterized BI in two common neurogenetic conditions: Fragile X syndrome (FXS) and Down syndrome (DS). Caregivers of children with FXS (N = 56; with ASD = 28; FXS only = 28) and DS (N = 146) completed the Behavioral Inflexibility Scale (BIS) via an online survey. Total BIS scores were higher in FXS+ASD than both FXS only and DS (p

For individuals with autism spectrum disorder (ASD), behavioral inflexibility can affect multiple domains of functioning and family life. The objective of this study was to develop and validate a clinical interview version of the Behavioral Inflexibility Scale. Trained interviewers conducted interviews with parents of 144 children with ASD and 70 typically developing children (ages: 3–17 years). Using exploratory factor analysis, the Behavioral Inflexibility Scale-Clinical Interview (BIS-CI) was found to be unidimensional. Reliability data indicated the measure was internally consistent (α = 0.80), achieved excellent inter-rater reliability (ICC = 0.97) and test–retest reliability (ICC = 0.87). These findings demonstrate that the BIS-CI is a reliable and valid measure to determine the functional impact of behavioral inflexibility.

Individuals with autism spectrum disorder (ASD) often benefit from allied health services such as occupational therapy, speech and language pathology, and applied behavioral analysis. While there is consistent evidence of disparities in access and use of medical services (e.g. dentistry), no such systematic review has examined disparities and differences in allied health use amongst children with ASD. In this systematic review, we examine disparities and differences in service access and use for children with ASD. Our findings suggest that children who are older, have less severe ASD symptoms, are from minority groups, and those from particular geographic regions are less likely to receive allied health services. Limitations and future directions are discussed.

This article reports a review of the research and scholarship investigating the concepts of affectus and emotion within occupational science. A scoping study method was used to explore how ...

PURPOSE To evaluate postural symmetry in sitting and standing for children with hemiplegic cerebral palsy (hCP) following the Combined Approach to Treatment for Children with Hemiplegia (CATCH) protocol, an intervention combining Constraint Induced Movement Therapy, Bimanual Intensive Therapy and Neuro-Developmental Treatment. METHODS The study included 10 children with a diagnosis of hCP and 10 typically developing age-matched peers. Subjects participated in a CATCH camp for six hours daily for eight consecutive days. Postural symmetry measurements in quiet sitting and standing were obtained using a Boditrak pressure-mapping system at four time points: prior to start of camp (T1), first day of camp (T2), last day of camp (T3), and one month post-camp (T4). RESULTS Significant differences (p< 0.05) were found in quiet sitting when comparing postural symmetry pre-intervention and one-month post camp. In quiet standing, significant differences (p< 0.05) were found when pre-intervention was compared to one-month post-intervention. One month post-intervention, the intervention group showed no significant difference from the comparison group. CONCLUSIONS Children with hCP demonstrate improvement in postural symmetry in sitting and standing following participation in a CATCH camp. Following the intervention, children with hCP continued to improve postural symmetry and approach age-matched peers.

This study evaluates the feasibility of the NIH Toolbox Cognition Battery (NIH-TCB) for use in autism spectrum disorder (ASD). 116 autistic children and adolescents and 80 typically developing (TD) controls, ages 3–17 years, completed four NIH-TCB tasks related to inhibitory control, cognitive flexibility, processing speed, and episodic memory. While the majority of autistic and TD children completed all four tasks, autistic children experienced greater difficulties with task completion. Across autistic and TD children, performance on NIH-TCB tasks was highly dependent on IQ, but significant performance differences related to ASD diagnosis were found for two of four tasks. These findings highlight the potential strengths and limitations of the NIH-TCB for use with autistic children.

Depression is a common comorbidity in autism spectrum disorder (ASD). Little is known about risk factors for depression and depressive symptoms in this population. Ecological momentary assessment (EMA) has been used in the typically developing population to identify risk factors for depression, but has been rarely applied in ASD populations. In this exploratory study, 17 autistic adolescents participated in an EMA protocol in which they reported on their current activities and emotions six times per day for seven consecutive days. Results suggested that negative affect is predicted by momentary quality of social interaction and enjoyment of the current activity (p

Individuals with autism spectrum disorder (ASD) often benefit from allied health services such as occupational therapy, speech and language pathology, and applied behavioral analysis. While there is consistent evidence of disparities in access and use of medical services (e.g. dentistry), no such systematic review has examined disparities and differences in allied health use amongst children with ASD. In this systematic review, we examine disparities and differences in service access and use for children with ASD. Our findings suggest that children who are older, have less severe ASD symptoms, are from minority groups, and those from particular geographic regions are less likely to receive allied health services. Limitations and future directions are discussed.

Since the time of Descartes, western science has tended to separate and prioritize the mind over the body when studying human behavior. Consequently, the corporeal dimension of human activity is often overlooked in studies of participation in meaningful occupation. The purpose of this paper is to highlight the body's fundamental and active role in sensory perception and to encourage occupational scientists to consider the body as an intelligent and intentional repository of experiential knowledge that is predisposed to draw an actor towards particular behaviors at a pre-reflective level. To achieve this end, we present a focused discussion on Merleau-Ponty's concepts of the corporeality of perception, grip, coupling, ecart, and reversibility. These concepts enable occupational scientists to consider perception and action as phenomena that are predicated on an active body that incorporates experiences of participation in occupation. Merleau-Ponty's philosophy portrays the body as a sediment of past...

Background. The Canadian Association of Occupational Therapists (CAOT) and the American Occupational Therapy Association (AOTA) state that occupational justice is part of the domain of occupational therapy and that occupational justice is “an aspect of contexts and environments and an outcome of intervention” (AOTA, 2014, p. S9). Key Issues. Despite the increasing focus on justice in the occupational therapy and the occupational science literature, many practitioners in traditional settings do not see its relevance to their everyday practice (Galvin, Wilding, & Whiteford, 2011) or have difficulty envisioning how to enact a justice-informed practice. Purpose. This paper demonstrates how occupational justice is germane to all settings of occupational therapy, and how it can be enacted at micro, meso, and macro levels of occupational therapy practice. Implications. We argue that occupational therapy is a justice-oriented profession at its core and will discuss how occupational justice can be enacted at all levels of practice.

Cutchin’s commentary on Bailliard, Carroll, and Dallman (2018) posed the question “how can/should the micro and macro be related so that they are viewed as part of the same processes of occupation and life?” (p. 238). This response engages Cutchin’s question by focusing on aspects of Merleau-Ponty’s philosophy which enfold micro and macro processes into everyday action. Through his concepts of reversibility, ecart, and coupling, Merleau-Ponty portrays micro and macro processes as co-constitutive and mutually transformative such that they encroach upon each other and cannot be understood separately. We believe Merleau-Ponty offers valuable insight into how these relationships function at all levels of occupational participation.

Date Presented 03/28/20 This study examined attentional inflexibility for children at elevated likelihood (EL) for autism spectrum disorder (ASD) through use of eye tracking. The results indicate that the EL-ASD group had significantly fewer attention shifts from an area of interest to the rest of the screen. While we only assessed a static activity, we believe attentional inflexibilities are also present during occupational engagement, which has implications for OT practice. OT strategies to address this will also be discussed. Primary Author and Speaker: Stephanie Bristol Additional Authors and Speakers: Susan Agostine Contributing Authors: Aaron Dallman, Clare Harrop, Elizabeth Crais, Grace Baranek, Linda Watson

Date Presented 03/28/20 Sensory-processing challenges are measured by caregiver report and clinician observation and affect many people with autism spectrum disorder and their caregivers. It is unclear how caregiver stress influences the correlation between scores on caregiver reports and observational measures. The present analysis explored correlations between two formats of tools to assess sensory processing and indicated that caregiver stress moderates the association between sensory-seeking scores on the measures. Primary Author and Speaker: Emily Campi Additional Authors and Speakers: Cristin Holland, Susan Agostine, Stephanie Bristol Contributing Authors: John Sideris, Emily Sopkin, Yun-Ju Chen, Elizabeth Choi, Aaron Dallman, Amanda Wiles, Linda Watson, Elizabeth Crais, Grace Baranek

Date Presented 04/06/19 This research explores how an eight-day CIMT camp improves postural symmetry in children with cerebral palsy. A pressure mapping system was used while participants engaged in functional static and dynamic tasks to assess how improvements in postural symmetry related to functional task performance. Improvements were found in both static sitting and standing tasks. The uses and feasibility of pressure mapping systems within clinical applications will also be explored. Primary Author and Speaker: Aaron Dallman Contributing Authors: Holly Holland, Margo Haynes, Kerry Blazek