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Play in children with autism spectrum disorder (ASD) is often atypical, yet consensus regarding effective occupational therapy strategies for improving play is not established. To examine the efficacy of strategies used in occupational therapy to improve play in ASD, authors completed a systematic review of papers from January 1980 through January 2019. Search terms included autism, Asperger’s, ASD, autistic in combination with play, playfulness, pretend, imagination, praxis, creativity, and generativity. Twenty papers met inclusion criteria and were reviewed. Reviewed interventions included parent education, modified play materials or environments, imitation of the child, and modeling by an adult, a peer, or video. Moderate to strong support exists for the specific strategies of imitation of the child and modeling for the child, with lesser or mixed support for other strategies. Certain strategies commonly used in occupational therapy may be effective in improving the occupation of play in ASD.

The Classroom Sensory Environment Assessment (CSEA) is a tool that provides a format for examining the sensory environment of a classroom and considering its impact on student behavior and performa...

The American Occupational Therapy Association (AOTA) asserts that occupational therapists and occupational therapy assistants, through the use of occupations and activities, facilitate clients’ cognitive functioning to enhance occupational performance, self-efficacy, participation, and perceived quality of life. Cognitive processes are integral to effective performance across the broad range of daily occupations such as work, educational pursuits, home management, and play and leisure. Cognition plays an integral role in human development and in the ability to learn, retain, and use new information to enable occupational performance across the lifespan.This statement defines the role of occupational therapy in evaluating and addressing cognitive functioning to help clients maintain and improve occupational performance. The intended primary audience is practitioners1 within the profession of occupational therapy. The statement also may be used to inform recipients of occupational therapy services, practitioners in other disciplines, and the wider community regarding occupational therapy theory and methods and to articulate the expertise of occupational therapy practitioners in addressing cognition and challenges in adapting to cognitive dysfunction.

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration that incorporates multiple evidence-based approaches. To best meet the needs of the children and families seeking occupational therapy services, interventions must be focused on participation and should be multifaceted.

School-based and early intervention occupational therapy evaluation is influenced by federal policy and prevailing ideas regarding best practice. Current best practice considers a child's performance in appropriate contexts and natural environments, as well as the impact of the environment on occupational functioning and participation across settings. As a recent report suggested 3.4% to 15.6% of children in a community sample of 4-year-olds may demonstrate sensory processing difficulties, occupational therapists should be familiar with multiple methods of assessment to address these concerns. One such assessment tool, the Sensory Processing Measure–Preschool (SPM-P) for children 2- to 5-years old, provides 8 scaled scores: Vision, Hearing, Touch, Body Awareness, Balance and Motion, Total Sensory System Score, Planning and Ideas, and Social Participation. Through discussion on the development, usage, and implementation of both Home and School forms, this article illustrates how the SPM-P provides a mechan...

A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers' perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified that included coping strategies such as "me time," planning, knowledge is power, sharing the load, lifting the restraints of labels, and recognizing the joys. The information from this study may benefit mothers of children with ASD and inform pediatric therapists providing services to children with ASD and their families.

Changes in federal legislation guiding occupational therapy practice in educational environments have required modifications in the way therapists evaluate children in these settings. New methods in turn require new tools. This article will describe one new tool designed to assist school-based practitioners in their assessment of the impact of sensory processing and praxis difficulties on educational performance. The Sensory Processing Measure is an assessment tool that promotes team collaboration by examining performance across multiple natural environments and also considers the relationship between sensory processing, praxis and social participation. Part One of this paper provides a description of the assessment tool and its proposed uses while in Part Two, examples of the use of the measure will be presented.

As a follow-up to The Sensory Processing Measure (SPM), Part One: Description and Background, this case illustrates how a student with poor peer interactions can be helped by the entire school and home team using the Sensory Processing Measure after identifying that sensory processing (praxis and sensory modulation) issues are contributing to difficulties with social participation.

This qualitative study investigated the perceptions of play experiences and rationales for play choices of 6 boys and 4 girls between the ages of 7 and 11 years. Individual in-depth interviews were completed and then transcribed, and the transcripts were coded and analyzed using grounded theory methodology. Fun emerged from the data as the core category explaining the choice of specific play activities for children, and 4 additional categories of characteristics surfaced as contributors to the children’s perception of fun: relational, activity, child, and contextual. The relationships among the core category, the 4 characteristics categories, and the development of play preference and meaningfulness are illustrated in the Dynamic Model for Play Choice. Included is a discussion of the usefulness of the model in supporting the careful consideration of factors that will increase the perception of fun during therapeutic activities and facilitate client-centered pediatric practice.

This cross-sectional survey research investigated play preferences of children with and without developmental delays who were between 3 and 7 years old. Parents completed questionnaires regarding their child's play activity and context preferences. Valid results were obtained for 166 children, 83 of whom had developmental delays. Preference ratings were compared by gender, age, and delay status. Play preference did not differ by gender. Rough-and-tumble play and computer/video game play increased with age, whereas object exploration decreased. Children with developmental delays had higher preferences for rough-and-tumble play and object exploration and lower preferences for drawing and coloring, construction, and doll and action figurine play than typically developing children. This comparison of children's play preferences across ages, gender, and developmental status enhances our understanding of how these variables influence children's play.

OBJECTIVE. The history and development of the Sensory Processing Measure–School are detailed, and findings of initial pilot studies are reported. METHOD. Multiple reviews, focus groups, case studies, and two pilot studies were used to develop the early versions of the tool. Internal consistency and discriminatory ability were examined. RESULTS. Internal consistency measured with Cronbach’s alphas ranged from .93 to .99 in the first pilot study and .70 to .99 in the second pilot study. Children who were typically developing were correctly classified 92.3% of the time, and children with sensory issues were correctly classified 72% of the time. CONCLUSION. Initial results suggest that the tool is reliable and valid and discriminates children with and without sensory processing issues. Further research is under way with larger samples.

The Classroom Sensory Environment Assessment (CSEA) is a tool that provides a means of understanding the impact of a classroom’s sensory environment on student behavior. The purpose of the CSEA is to promote collaboration between occupational therapists and elementary education teachers. In particular, students with autism spectrum disorder included in general education classrooms may benefit from a suitable match created through this collaborative process between the sensory environment and their unique sensory preferences. The development of the CSEA has occurred in multiple stages over 2 yr. This article reports on descriptive results for 152 classrooms and initial reliability results. Descriptive information suggests that classrooms are environments with an enormous variety of sensory experiences that can be quantified. Visual experiences are most frequent. The tool has adequate internal consistency but requires further investigation of interrater reliability and validity.

This systematic review examined the literature published from January 2006 to April 2013 related to the effectiveness of occupational therapy interventions for children with autism spectrum disorder (ASD) and their parents to improve parental stress and self-efficacy, coping, and resilience and family participation in daily life and routines. From the 4,457 abstracts, 34 articles were selected that matched the inclusion criteria. The results were mixed and somewhat inconclusive because this body of literature is in its infancy. Studies of children with ASD do not routinely measure parental and family outcomes. Recommendations include an emphasis on family measures other than parental stress and a greater focus on measures of parental and family functioning in all future studies of pediatric interventions to more fully understand the impact of interventions in a wider context.

Occupational therapy has much to offer to families of people with autism spectrum disorder (ASD). However, people outside the profession may be unaware of occupational therapy’s breadth and scope. It is our responsibility and our duty to express the full range of occupational therapy services through research, clinical practice, advocacy, and consumer education. This special issue of the American Journal of Occupational Therapy, with its focus on autism, embarks on this endeavor by highlighting research and theoretical articles that address the various aspects of occupational therapy practice that can help to fully meet the needs of people with ASD and their families.

This systematic review examines the literature published from January 2007 through May 2015 related to the effectiveness of occupational therapy interventions using parental or teacher education and coaching with children with challenges in sensory processing and sensory integration (SP–SI). Of more than 11,000 abstracts and 86 articles that were considered, only 4 met the criteria and were included in this review. Studies of parental training and coaching for children with challenges in SP–SI and comorbid autism spectrum disorder have suggested that educational or coaching programs could result in positive outcomes for both parents and children, often in a relatively short time period. Recommendations include a greater focus on providing educational interventions for parents and teachers and including specific assessment of SP–SI before implementing interventions meant to address those issues. Specific recommendations for future research are provided.

Scientific theory evolves through phases. Scientists observe phenomena, classify their observations, examine and explain causation, and attempt to understand their results in varied circumstances. If anomalies are found that do not mesh with the theory, revision occurs, and the theory is improved (Christensen, Carlile, & Sundahl, 2001). Each stage requires accurate and precise measurement and, therefore, appropriate measurement tools. The body of scientific inquiry developed byA. JeanAyres is deeply rooted in systematic and methodical measurement, and her work marked the first effort by an occupational therapist to build a theory for clinical application with an evidence-based approach. The trajectory of the growth of Ayres Sensory Integration (ASI), beginning in the 1950s with continual advancements from the ongoing contributions of the researchers who have built on her seminal work since that time, has occurred simultaneously with the widespread use of more rigorous research methods, attention to measurement of fidelity, greater usage of exploratory and factor analysis, and more routine practice of examining multivariate research problems with computer statistical programs (Century, Rudnick, & Freeman, 2010; Elmore & Woehlke, 1988; Keselman et al., 1998; Ottenbacher & Peterson, 1985; Press, 2013; Tukey, 1980; West, Carmody, & Stallings, 1983). This special issue of the American Journal of Occupational Therapy consists of an impressive compilation of the widereaching application of the concepts that have evolved from those early efforts in measurement and that now continue to serve as a model for the profession, in line with the American Occupational Therapy Association’s (2007) Centennial Vision aiming toward “a powerful, widely recognized, science-driven, and evidence-based profession” (p. 613). This issue provides multiple examples of the improvements in methodological rigor that occupational scientists have brought to the study of ASI theory. The articles includemeasurement in sensory integration across age spans and diagnostic categories, with implications for theory and practice ranging fromassessment to intervention. In “The Issue Is” article by Schaaf et al. (2014), the current state of measurement in sensory integration is thoughtfully analyzed and articulated. In this editorial, we highlight the ways in which the foundations in measurement established by Ayres have evolved and how this earlier work connects with current and future trends.

There are well-documented play deficits in autism beginning with infant object and social play. To create effective interventions, the predictors of play deficits in autism must be established. Individuals with autism spectrum disorder (ASD) frequently report sensory processing difficulties including poor praxis; however, these are potential predictors of play that have not been well studied. Using a data set of 162 individuals with ASD, this study examined the direct and indirect relationships between sensory processing and social play performance via structural equation modeling. The best fitting model suggested that sensory system functions predict praxis and play in combination, providing preliminary evidence that sensory functions are related to social play in combination with praxis in children with ASD. The findings suggest future avenues for research. [OTJR: Occupation, Participation and Health 2013;33(3):159-167.].

The increasing prevalence of autism spectrum disorder (ASD) suggests that dental practices will be seeing patients with this diagnosis more frequently. Although patients with ASD have similar dental needs to other patients, the symptoms of the disorder may influence the ability of dental practitioners to provide necessary care. Dental professionals may be unaware of the difficulties with sensory processing common to patients with ASD. However, awareness of sensory processing issues and knowledge of strategies to improve the sensory experience for individuals with ASD may improve dental visits for these patients and allow for enhanced dental care provision.

This systematic review describes the published evidence related to the effectiveness of frequency modulation (FM) devices in improving academic outcomes in children with auditory processing difficulties. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were used to identify articles published between January 2003 and March 2014. The Cochrane Population, Intervention, Control, Outcome, Study Design approach and the American Occupational Therapy Association process forms were used to guide the article selection and evaluation process. Of the 83 articles screened, 7 matched the systematic review inclusion criteria. Findings were consistently positive, although limitations were identified. Results of this review indicate moderate support for the use of FM devices to improve children’s ability to listen and attend in the classroom and mixed evidence to improve specific academic performance areas. FM technology should be considered for school-age children with auditory processing impairments who are receiving occupational therapy services to improve functioning in the school setting.

Initial reliability and validity studies were completed for a newly created assessment tool called the Preschool Occupational Therapy Assessment (POTA). The POTA was designed to examine fine motor and sensory motor skills relevant to preschool academic function. Forty-five children, both typically developing and developmentally delayed, participated in the initial research. Results of data analysis support further development of this tool.