Understanding Parents' Experiences With Mainstream Schooling for Their Children With Autism Spectrum Disorder: A Meta-Analysis.

Importance: Children with autism spectrum disorder (ASD) face school-related occupational challenges. Attending a mainstream school offers benefits for children's learning and their development of social skills; however, parents express frustration with ensuring their child's unique needs and preferences are met. Objective: To gain insight into parents' experiences with the mainstream preschool and primary educational system for their children with ASD. Data Sources: Eleven electronic databases were systematically searched, and processes were followed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study Selection and Data Collection: Study eligibility was determined through the use of selection criteria and paired independent reviewers. Critical appraisal was conducted using a qualitative research hierarchy and a modified version of the Critical Appraisal Skills Programme tool. Two reviewers synthesized the data into themes, following the Joanna Briggs Institute meta-aggregation process. Twenty-six qualitative studies, representing the voices of 397 parents, are presented in this review (spanning 2013–2021). Articles were set in Westernized and non-Westernized settings and represented culturally and linguistically diverse population groups. Findings: Parents of children with ASD reported a lack of awareness and understanding of their children's unique learning needs in the mainstream school system at all levels. Conclusions and Relevance: This review has various occupational therapy practice implications for supporting school-age children with ASD, their parents, and school staff. These include adopting family-centered and ecological approaches, raising awareness, influencing policy, and facilitating collaboration. What This Article Adds: This review provides guidance for occupational therapists working in schools about their practice in working at the individual, targeted, and whole-school levels to address occupational barriers faced by children with ASD. The main implication of this review is that parents perceive a lack of awareness and understanding of the unique learning needs of their children with autism spectrum disorder (ASD) at all school levels. This review offers practice recommendations for occupational therapists working with school-age children with ASD, their parents, and school staff. [ABSTRACT FROM AUTHOR]