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Background: Concepts such as participation and environment may differ across cultures. Consequently, cultural equivalence must be assured when using a measure like the Young Children Participation and Environment Measure (YC-PEM) in other settings than the original English-speaking contexts. This study aimed to cross-culturally translate and adapt the YC-PEM into German as it is used in Germany, Austria, and Switzerland. Methods: Following international guidelines, two translations were compared, and the research and expert team made the first adaptations. Twelve caregivers of children with and without disabilities from three German-speaking countries participated in two rounds of think-aloud interviews. Data were analyzed by content analysis to look for item, semantic, operational, conceptual, and measurement equivalence to reach a cultural equivalence version in German. Results: Adaptations were needed in all fields but prominently in item, operational, and conceptual equivalence. Operational equivalence resulted in graphical adaptations in the instructions and questions to make the German version of YC-PEM, YC-PEM (G), more user-friendly. Conclusion: This study presents a cross-cultural translation and adaptation process to develop a German version of the YC-PEM suitable for Germany, Austria, and Switzerland. A culturally adapted YC-PEM (G) is now available for research, practice, and further validation.

The influence of a person’s environment and its modifying potential on participation (at home, at school or in the community) is well recognized for most childhood disabilities, but scarcely studied for adolescents with autism spectrum disorder (ASD). The aim of this dissertation was to deepen the understanding of the role of environment on the participation of adolescents with ASD. Within a mixed method methodology, five consecutive studies were conducted. The empirical parts were performed in the German-speaking part of Switzerland. Results highlight the importance of the parental and family environment and adolescents’ need for company during participation. They further point to the special role that information and knowledge play for adolescents with ASD, the effect of physical aspects of the environment, and adolescents’ need for motivation and nudges to connect and engage socially. Combatting negative attitudes is another important characteristic of an engaged, active, and supportive environment. The main role of environments is to make adolescents feel secure and help them to connect.

Die Zahl von Kindern und Jugendlichen mit einer Autismus-Spektrum-Störung (ASS) nimmt weiter zu. Die Wartelisten für eine Abklärung sind lang: Diagnostische Möglichkeiten werden differenzierter, aber auch komplexer. Müssen die Massnahmen im Gleichschritt immer weiter anwachsen? Zweifel sind angebracht, wie der Beitrag argumentiert. Anhand der sechs Leitprinzipien der «National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders in Australia» und eines Fallbeispiels leiten wir Empfehlungen für den Umgang mit der Diagnose Autismus-Spektrum ab.

Freundschaften sind zentraler Bestandteil der sozio-emotionalen Entwicklung und spielen auch für die Persönlichkeitsentwicklung des Kindes eine wesentliche Rolle. Am Beispiel von Nick und seinem besten Freund zeigt sich, wie Freundschaften auch unter schwierigen Umständen funktionieren können.

Background: Low participation in youth with autism spectrum disorder (ASD) has been reported, but age-related and contextual information is rare. Objective: This study aimed to describe, from parental perspectives, two patterns of participation and parental desires for change of children (age: 5–11) and adolescents (age: 12–17) with ASD in Switzerland. Method: A cross-sectional design used the German version of the Participation and Environment Measure-Child and Youth to describe and juxtapose the participation results of 60 children and 55 adolescents with ASD in 45 activities at home, school and in the community and parental desires for change. Results: Participation patterns differed between settings and age groups. Both groups were found to participate most at home, followed by school, whereas community participation was either low or nonexistent. Children were more involved at home than adolescents, while school involvement was higher than participation frequency in both age groups. Community participation frequency was generally low but higher in children than in adolescents, while involvement was similarly low in both groups. Half the parents expressed desire for change with three tendencies: (1) widespread desire for change at home due to high support needs, (2) parents of adolescents expressed more desire for change in all settings than those of children and (3) all parents mainly desired to increase participation frequency and involvement. Conclusions: This study informs research and social, health and community service providers to further reshape their programmes to meet parental needs and increase the participation of youth with ASD.

Einleitung: Kinder mit einer Autismus-Spektrum-Störung (ASS) sind oft in ihrer sozialen Partizipation eingeschränkt. Peer- Interventionen, die Kinder mit ASS bei Interaktionen unterstützen, werden in der Literatur oft thematisiert. Deren Umsetzung im Alltag ist jedoch in der Ergotherapie im deutschsprachigen Raum kaum verankert. Die vorliegende Arbeit zeigt auf, wie Peers einbezogen werden können, um die soziale Partizipation von Kindern mit ASS zwischen 3 und 12 Jahren zu fördern, und wie Ergotherapeut*innen die Zusammenarbeit zwischen Kindern, Lehrpersonen und Eltern unterstützen können. Methode: Mit einer Literaturrecherche wurden sechs Hauptstudien systematisch ausgewählt und kritisch gewürdigt. Relevante Ergebnisse wurden einander gegenübergestellt und in das Modell «Partnering for Change» eingebettet, das einen Universal Design-Ansatz im inklusiven Schulsetting repräsentiert. Ergebnisse: Peer-Interventionen bei Kindern mit ASS sind vielfältig. Die Auswahlkriterien für die Peers unterscheiden sich bei den verschiedenen Programmen ebenso wie die Schulungsarten der Peers und die Umsetzung in den Alltag. Gemeinsamkeiten aller evaluierten Programme bestehen in der engen Kollaboration verschiedener Anspruchsgruppen im Schulsetting. Außerhalb des Schulsettings findet diese Kollaboration kaum statt. Schlussfolgerung: Die Arbeit zeigt detailliert auf, wie Peer-Interventionen geplant und durchgeführt werden können. Ergotherapeut*innen können, vor allem, wenn sie schulbasiert arbeiten, eine wichtige Rolle bei der Koordination, Schulung und Implementierung übernehmen.

Partizipation (Teilhabe) ist neben Wohlbefinden eines der wichtigsten Outcomeparameter für die die medizinische, pädagogische und therapeutische Unterstützung von Menschen mit ASS. Trotzdem gibt es im Deutschsprachigen Raum wenig Daten zur aktuellen Partizipation von Kindern und Jugendlichen aus dem autistischen Spektrum. Ziel der vorliegenden Querschnittstudie war es, die Partizipationsmuster von Kindern und Jugendlichen mit ASS mit der neuen, für den deutschsprachigen Raum adaptierten PEM-CY (Participation and Environment Measure - Child and Youth Version), zu beschreiben. 115 in der Schweiz lebende Eltern von Kindern (5-11 Jahren) und Jugendlichen (12-17 Jahren) mit ASS füllten eine online Version des PEM-CY (G) (deutschsprachige Version) aus. Die Daten wurden deskriptiv analysiert und lieferten damit einen detailreichen Einblick zur Partizipation der Kinder und Jugendlichen mit ASS in drei lebensrelevanten Settings (zuhause, in der Schule und der Gesellschaft). Der Vortrag zeigt neben den Partizipationsmustern, das die Diversität, die Häufigkeit und das Engagement in Alltagsaktivitäten in den drei Settings umfasst, auch die von den Eltern genannten Veränderungswünsche auf. Zusätzlich werden auch Unterschiede zwischen den beiden Altersgruppen deutlich. Die vorliegende Studie zeigt eine räumlich zwar begrenztes, aber in ihrem Muster auch auf andere deutschsprachige Regionen übertragbare Zustand der Partizipation von Kindern und Jugendlichen mit ASS. Daraus lassen sich die Bedürfnisse der Betroffenen und ihre Familien und Hinweise für die Veränderungen der Versorgungschwerpunkte ableiten.

Spätestens seit Einführung der an Kinder und Jugendlichen angepassten Version der internationalen Klassifikation Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF-CY) (WHO, 2007) gehören Aktivitäten und Partizipation von Kindern und Jugendlichen zu den wichtigen Parametern für erfolgreiche Rehabilitation und Unterstützung von Kindern und Jugendlichen mit herausfordernden Lebensumständen wie körperliche Beeinträchtigungen, psychischen Belastungen oder sozio-öekonomisch schwierigen Bedingungen. Die ICF beschreibt zusätzlich Umweltfaktorenfaktoren, die Partizipation unterstützen oder behindern. Die Begrifflichkeiten der ICF haben bereits Eingang in das SGB V "Gesetzliche Krankenversicherung" und das SGB IX "Rehabilitation und Teilhabe behinderter Menschen" gefunden. Auch die "Rehabilitations-Richtlinie" des Gemeinsamen Bundesausschusses ist bereits auf der Grundlage der ICF konzipiert worden. Um Rehabilitationsziele, unterstützende Massnahmen und die erreichten Veränderungen klinisch erfassen zu können, sind partizipationsbasierte Assessments unumgänglich. Sie müssen leicht anwendbar sein, optimalerweise auch die Umwelt und das Umfeld erfassen und die wichtigen Bezugspersonen von Kindern und Jugendlichen, meistens Eltern, mit in den Erfassungs- und Zielprozess einbeziehen. In den letzten Jahren wurde im anglikanischen Kontext mehrere dafür geeignete Assessments entwickelt, aber um diese im Deutschsprachigen Raum anwenden zu können, benötigt es neben Übersetzung auch eine kulturelle Adaptation, da sowohl Partizipation als auch Umfeld kulturell bedingt sind. Der Vortrag stellt zwei Assessments vor, die von CanChild an der McMaster Universität in Toronto entwickelt und vertrieben werden. Der PEM-CY (Participation and Environment Measure – Child and Youth Version) erfasst Partizipation und Umfeld im Alter von 5-17 Jahren in den Bereichen zu Hause, Schule und Gesellschaft. Analog dazu erfasst der YC-PEM (Young Children Participation and

Gemäss der ICF (Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit) der WHO wird die Partizipation (Teilhabe) und die Ausführung von Aktivitäten auch von Kontextfaktoren beeinflusst. Umwelt und soziales Umfeld können diese behindern oder unterstützen. Für die Partizipation von Jugendlichen mit Autismus Spektrum Störung (ASS) ausserhalb der Schule und des häuslichen Umfeldes ist wenig zu diesen Umwelt-und Umfeldfaktoren bekannt. Mit einer qualitativen Fallstudie in Kanton Zürich als definierter Kontext wurde untersucht, wo, wie und warum Jugendliche mit ASS bei der Partizipation ausserhalb von zuhause und der Schule die Umwelt und das Umfeld als unterstützend oder belastend/hemmend erfahren. Acht Jugendliche zwischen 14 und 21 Jahren nahmen an dieser qualitativen Studie teil. Fotos der Jugendlichen und Transkripte von vertiefenden Interviews wurden im sieben Schritte Prozess nach Ying analysiert und die Resultate in acht Themenbereichen beschrieben. Die Jugendlichen beschreiben eine Vielzahl von unterschiedlichen Partizipationsfeldern wie z.B. das Einkaufen, Tramfahren, Spaziergänge oder das Volleyballspiel. Diese Erfahrungen wurden immer als soziale Aktivitäten von den Jugendlichen wahrgenommen. Der Vortrag stellt diese anhand von fünf die Partizipation vorbereitende Umfeldaspekten und drei die Partizipation unterstützende Aspekte vor. Die acht auf die Umwelt und das Umfeld fokussierte Prinzipien könnten die Partizipation von Jugendlichen mit ASS ausserhalb von zuhause und der Schule nachhaltig erleichtern und verbessern, wenn sie bei den Unterstützungsmassnahmen beachtet würden.

Introduction Rationale: Activity and participation measures for children and adolescents such as the Young Children Participation and Environment Measure (YC-PEM), the Participation and Environment Measure for Children and Youth (PEM-CY), and Pediatric Evaluation Disability Inventory-Computer Adapted Test (PEDI-CAT) are highly valued in research and practice. Although evidence highlights the necessity of using this kind of assessments, their implementation specially in other cultural contexts remains challenging. By considering the perspectives of stakeholders in the translation and adaptation process into other cultural contexts, the practicability of an assessment can be enhanced. Objectives: The presentation summarizes results of various studies in which stakeholder perspectives during cultural adaptation processes of the three participation measurements were included. Method: Translation and back translation procedures, discussions among stakeholders such as health professionals, translators, and parents are analyzed. Qualitative think-aloud interviews with parents on translated and adapted YC-PEM, PEM-CY and PEDI-CAT were performed. Results: Findings illustrate how stakeholders' perspective supports the adaptation and practicability of those assessments in other cultural contexts. Ideas and suggestions to implement them further into practice are highlighted. Application to Practice: Health professionals such as occupational therapists, who are aiming to evaluate activity and participation every day life situations of children and youth, will be introduced into the content and construct of the three assessments. Conclusion: More attention should be paid to the reasoning process, when translating and adapting an assessment. Involving cultural sensitive stakeholders into the adaptation process increases the probability of using assessments more frequently in practice.

Introduction: Adolescents with Autism Spectrum Disorder (ASD) are an established client group of occupational therapists. Our profession embraced the implementation of the bio-social-medical view of the ICF and shifted the focus from function to participation and environment. However, the paradigm shift to understand participation patterns of adolescents with ASD through an environment-focused perception and construct interventions based on this is yet to come. Objectives: The goal of this presentation is to elaborate novel ways for occupational therapy practice by focusing on environmental aspects during interventions with adolescents with ASD. Method: We conducted a series of studies with multiple methods (scoping review, case study, qualitative study, and cross-sectional study) and looked at how the environment can be changed to present a more inviting world to adolescents with ASD. Results: Security and connection represent meaningful, subjectively relevant, and feasible aspects of how the environment shapes participation. Adolescents with ASD express different needs before attending participation domains than while engaging in these. Getting together with other adolescents remains one of the biggest desires. Environmental barriers as consistent throughout all settings. Application to Practice: Environmental-focused interventions to support the participation of adolescents with ASD address hindering environmental features and strengthen those which are experienced by adolescents and their parents as inviting. Conclusion: Interventions should focus on strategies to make the environment more inviting and on understanding how the inclusion of adolescents with Autism Spectrum Disorder can be supported.

The influence of a person’s environment and its modifying potential on participation (at home, at school or in the community) is well recognized for most childhood disabilities, but scarcely studied for adolescents with autism spectrum disorder (ASD). The aim of this dissertation was to deepen the understanding of the role of environment on the participation of adolescents with ASD. Within a mixed method methodology, five consecutive studies were conducted. The empirical parts were performed in the German-speaking part of Switzerland. Results highlight the importance of the parental and family environment and adolescents’ need for company during participation. They further point to the special role that information and knowledge play for adolescents with ASD, the effect of physical aspects of the environment, and adolescents’ need for motivation and nudges to connect and engage socially. Combatting negative attitudes is another important characteristic of an engaged, active, and supportive environment. The main role of environments is to make adolescents feel secure and help them to connect.

Environments have a modifying effect on the participation of children and adolescents with autism spectrum disorder (ASD) in all areas of life. This cross-sectional study investigated parental perspectives on supportive or hindering environments and the daily contextual strategies parents used to enhance their children's participation. Qualitative and quantitative data gathered from 115 parents from German-speaking Switzerland using the participation and environment measure-child and youth (PEM-CY) were analyzed. Results revealed 45 environmental supports and barriers at home, at school, and in the community. Contextual strategies were identified in combination with people, activities, time, objects, and places. Parental perspectives on participation and their contextual strategies should be considered in environmental-based interventions to support the participation of children and adolescents with ASD.

Background: Derived from the concept of neurodiversity, neurodivergence is an umbrella term for various conditions such as Autism-Spectrum Disorder (ASD), Attention-deficit/hyperactivity Disorder (ADD/ADHD), Dyslexia or Dyspraxia which affect approximately 22% of the population. Sensory difficulties and overload are a common symptom. The provision of physical workplace adjustments for neurodivergent workers, such as workplace design solutions, have become popular in practice, yet their utility remains unsubstantiated. Purpose: This review evaluates the evidence for physical workplace adjustments and their link to occupational longevity, performance, and health/well-being in neurodivergent workers. Method: A systematic review (PRISMA guidelines) of studies published in English between 2000 and 2021 focused on these inclusion criteria: adult office workers clinically considered neurodiverse, their families, colleagues, employers, experts, and vocational program staff; at least one physical workplace adjustment; all types of empirical study designs. The theoretical framing was based on the ecological model of Person-Environment fit supplemented by the International Classification of Functioning, (ICF) Disability and Health and environmental stress theory. Quality assessment and data synthesis were undertaken. Results: Of the 319 studies identified, 20 met the eligibility criteria; the majority addressed ASD. Most studies described a combination of adjustments to address different environmental stimuli. The most frequent adjustments addressed sound distractions (e.g. single-person offices) and light sensitivity (e.g. light control), which were related to occupational longevity, performance and health/well-being. A range of other adjustments addressed aspects such as environmental control, crowding, or decompression rooms. There is insufficient evidence to fully evaluate the usefulness of adjustments, partially due to methodological shortcomings. Conclusions: Despite the

Aim: Participation of adolescents with autism spectrum disorder hardly occurs in settings outside of home and school. Little is known about how their participation is influenced by environmental factors. This study explored how and why adolescents with autism spectrum disorder perceive aspects of their environment as facilitators or barriers to their participation outside of home and school. Method: This explanatory case study explored the participation experiences of adolescents with autism spectrum disorder (15-21 years) from Zurich and surroundings with in-depth interviews and photo-elicitation, using photos made by the participants during activities outside of home and school. Data was analysed with a 7-step procedure. Result: The presence of two main themes seemed necessary to facilitate participation outside of home and school: "environmental prerequisites to attend activities", which consists of five subthemes, such as "the company of trusted persons" and "the provision of knowledge and information", and "social interchange and engagement", which consists of three subthemes and describes how actual involvement can be supported. Conclusion: Our findings highlight the influence of trusted persons on adolescents with autism spectrum disorder, and the need to extend the support network for these adolescents to other individuals, services and society so that their participation in activities can be encouraged. IMPLICATIONS FOR REHABILITATION: Adolescents with autism spectrum disorder perceive every kind of participation outside of home and school as social. We recommend using the company of trusted persons to encourage adolescents with autism spectrum disorder to actively participate outside of home and school. Rehabilitation professionals should promote environment-based approaches to achieve participation of adolescents with autism spectrum disorder. Rehabilitation professionals should actively approach, acknowledge and gently guide adolescents with autism spect

Sind intensive Frühinterventionen bei frühkindlichem Autismus wirksam und dazu geeignet, die Situation der betroffenen Kinder und Familien zu verbessern? Führen sie sogar zu Kosteneinsparungen? Das wollte das BSV in einem Pilotversuch wissen. Der Beitrag referiert zentrale Erkenntnisse aus dem Schlussbericht der ZHAW.