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Coughlan M, Lynch H. "Can I Play Too?" A Qualitative Study of Outdoor Play and Participation Among Autistic Preschoolers. Am J Occup Ther 2024; 78:7804185130. [PMID: 38801677 DOI: 10.5014/ajot.2024.050732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
IMPORTANCE Outdoor play in homes, schools, and communities provides children with unique opportunities to explore their worlds, develop fundamental life skills, and experience belonging. However, few studies have explored outdoor free play among autistic preschoolers in natural settings from a neurodivergent-informed perspective. OBJECTIVE To explore the play preferences, opportunities, and challenges in outdoor play for autistic preschoolers. DESIGN In this qualitative study, the authors used a multimethod approach to data collection using visual, verbal, and projective techniques and thematic analysis to identify and describe outdoor play occupation as expressed by autistic preschoolers. SETTING Home, community, and preschool environments in a city in Ireland. PARTICIPANTS Seven autistic children and their parents, from seven diverse preschool settings in Ireland. RESULTS Two overarching themes were identified: (1) outdoor play preferences and meaning and (2) the physical and social environments of outdoor play. The findings suggest that autistic preschoolers demonstrate distinctive play styles and preferences when playing freely outdoors, with physical and social barriers to outdoor play existing in community and educational contexts. CONCLUSIONS AND RELEVANCE The findings suggest that autistic preschoolers' outdoor play styles and preferences require support from adult advocates. Although the importance of relationships and social play cannot be overlooked, infrastructural accommodations for parents and schools are required if we are to create supportive and inclusive outdoor play environments and opportunities for freedom of expression for autistic children. Plain-Language Summary: This study explored the distinctive outdoor play preferences, opportunities, and challenges for autistic preschoolers. The findings show that autistic preschoolers face physical and social barriers to outdoor play and that they need parents, schools, and communities to create supportive and inclusive play environments and opportunities for freedom of expression.
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Affiliation(s)
- Maeve Coughlan
- Maeve Coughlan, MSc Research, BSc OT, is Senior Paediatric Occupational Therapist, Central Cork Children's Disability Network Team, Cope Foundation, Cork, Ireland
| | - Helen Lynch
- Helen Lynch, PhD, MSc, Dip COT, Dip Montessori, is Senior Lecturer and Graduate Studies Programme Director, P4play Coordinator, University College Cork, Cork, Ireland;
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Davy G, Barbaro J, Unwin K, Clark M, Jellett R, Date P, Muniandy M, Dissanayake C. Leisure, community, workforce participation and quality of life in primary and secondary caregivers of autistic children. Autism Res 2024; 17:799-811. [PMID: 38414177 DOI: 10.1002/aur.3113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
Parents of Autistic children often modify their participation in leisure, social, and employment activities to meet the caregiving needs of their child. However, few studies have examined the impact this has on caregiver quality of life (QoL). The aim in the current study was to examine the role of participation in a range of activities on QoL amongst primary and secondary caregivers of school-aged Autistic children. Eighty-eight primary (93% mothers) and 63 secondary (91% fathers) caregivers of Autistic children (aged 7- to 12-years) participated in this cross-sectional study, with time pressure, participation, social support, parenting stress, and QoL measured via an online questionnaire. Compared to secondary caregivers, primary caregivers reported fewer employment hours, increased time pressure, less participation in desired activities, and higher perceived responsibility of domestic and child-rearing tasks. Similar levels of leisure frequency, parenting stress, and QoL were identified by both caregivers. Hierarchical regression revealed caregiver participation as important for QoL in both primary and secondary caregivers. However, when measures of caregiver well-being were added to the model, the unique contribution of participation to QoL was reduced, particularly for secondary caregivers. Overall, the findings demonstrate that despite differences in caregiver roles and responsibilities, participation in meaningful activities was important for QoL in all caregivers.
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Affiliation(s)
- Gemma Davy
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Katy Unwin
- Department of Psychology, Counselling & Therapy, La Trobe University, Bundoora, Victoria, Australia
| | - Megan Clark
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Rachel Jellett
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Perrin Date
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Melanie Muniandy
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Bundoora, Victoria, Australia
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Lense M, Liu T, Booke L, Crawley Z, Beck S. Integrated parent-child music classes for preschoolers with and without autism: Parent expectations and experiences. Ann N Y Acad Sci 2022; 1517:78-87. [PMID: 35979848 PMCID: PMC9671817 DOI: 10.1111/nyas.14875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Integrated recreational programs designed to support neurodiverse children and their families are important vehicles for community participation. In this mixed-methods study, we investigated the mechanisms by which parent-child music classes for autistic and neurotypical children can support community participation. Parents of autistic (n = 33) and typically developing (TD; n = 28) preschoolers were interviewed about their expectations for and experiences of participating in a 12-week psychoeducational parent-child music program. Parents completed ratings of momentary affect and social connection, and researchers coded children's behavioral engagement during classes at multiple time points throughout the program. Primary motivations for enrolling in an integrated music class included children's interest in music and opportunities for child socialization. Parent-focused reasons were less frequently endorsed as primary motivations for participation. Yet, momentary ratings indicated that music classes supported parents' affect regulation and social connection with other parents at the level of individual classes and across the program. These in-class experiences were echoed by interviews following program completion, which additionally highlighted the use of new parenting strategies through the musical activities. Since parental emotional experiences of activities, supportive community relationships, and parenting confidence are all linked with increased community participation, integrated music classes may support participation and satisfaction with community experiences.
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Affiliation(s)
- Miriam Lense
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- The Curb Center for Art, Enterprise, and Public Policy, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt Kennedy Center, Nashville, Tennessee, USA
| | - Talia Liu
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Lauren Booke
- In Tune Music & Wellness, Bellevue, Tennessee, USA
- Augsburg University, Minneapolis, Minnesota, USA
| | - Zoe Crawley
- Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Psychology & Human Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Sara Beck
- Department of Psychology, Randolph College, Lynchburg, Virginia, USA
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Davy G, Unwin KL, Barbaro J, Dissanayake C. Leisure, employment, community participation and quality of life in caregivers of autistic children: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1916-1930. [PMID: 35765798 DOI: 10.1177/13623613221105836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT We searched a wide range of academic journals for published information on the participation levels of caregivers of autistic children in activities relating to leisure, social, community and employment contexts, and the impact that participation may have on caregiver quality of life. Overall, we found that the impact of parenting an autistic child is broad with caregivers often prioritising their child's needs over their own, particularly in occupational participation, which impacts their quality of life. Findings also highlighted a need for further research to investigate the experience of caregivers, and the relationship between participation and quality of life in caregivers of autistic children, as the results can inform the development of better supports for them.
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Clément MA, Lee K, Park M, Sinn A, Miyake N. The Need for Sensory-Friendly "Zones": Learning From Youth on the Autism Spectrum, Their Families, and Autistic Mentors Using a Participatory Approach. Front Psychol 2022; 13:883331. [PMID: 35800952 PMCID: PMC9254619 DOI: 10.3389/fpsyg.2022.883331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Differences in sensory processing were linked to a diagnosis of autism spectrum disorder (ASD) before its inclusion as a core characteristic in the revised DSM-V. Yet, research focused on sensory processing and meaningful participation of children and youth with ASD remains relatively scarce. Although refinement of the International Classification of Functioning and Disability (ICF) relies on first-person accounts, longitudinal studies that foreground sensory experiences and its impact on involvement in a life situation from first-person perspectives are largely missing from this body of research. Objectives In this sub-study, we drew from a longitudinal participatory research project consisting of two separately funded studies with children and youth with ASD and their families between 2014 and 2021. The participatory project used photovoice (PV) methods to identify the primary concerns related to socio-spatial exclusion (PV-1) and the action steps needed to redress them (PV-2). The objective of this sub-study was to understand what really mattered to children with autism, their parents, autistic youth and an adult mentor to consider how their experiential knowledge could deepen understanding of meaningful participation. Materials and Methods We used an overarching narrative phenomenological and aesthetic theoretical framework to focus data analysis on the bodily sensing experiences related to significant moments or events, followed by an inductive thematic analysis of what mattered about those moments. Results The topical areas of concern that emerged from analyses were: (1) the relationship between sensory experiences and mental health (motion madness); (2) the indivisibility or layering of sensory and social experiences (squishing and squeezing); (3) the impact when "tricks" to stay involved are categorically misunderstood (When you don't respond in the correct way), and (4) how care and consideration of others can lead to innovative solutions for inclusion (I can't be the only one). Listening to the bodily-sensing experiences of children with ASD, autistic youth and adults, and their families in their own terms has implications for remapping the ICF and envisioning sensory curb-cuts to access, initiate and sustain occupational participation for all.
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Affiliation(s)
- Marc-André Clément
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
| | - Keven Lee
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
- Lady Davis Institute, Montreal, QC, Canada
| | - Melissa Park
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation, Montreal, QC, Canada
- Lady Davis Institute, Montreal, QC, Canada
| | - Anabel Sinn
- addtothenoise, Los Angeles, CA, United States
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Factor RS, Rea HM, Dahiya AV, Albright J, Ollendick TH, Laugeson EA, Scarpa A. An Initial Pilot Study Examining Child Social Skills, Caregiver Styles, and Family Functioning in the PEERS® for Preschoolers Program for Young Autistic Children and their Caregivers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104152. [PMID: 34942441 DOI: 10.1016/j.ridd.2021.104152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and worsen as the child matures. Though many interventions for young children exist, few specifically target social skills and involve caregivers. AIMS This pilot study examined PEERS® for Preschoolers, focusing on temporal change in child social skills, caregiver style, and family functioning in the context of a caregiver-assisted social skills intervention. This extension of the PEERS® program builds on the success of the intervention for older children, presenting skills in a developmentally appropriate manner to young autistic children and their caregivers. METHODS AND PROCEDURES The present pilot study used a non-concurrent multiple baseline design to examine the above variables with 15 autistic children (Mage = 4.87, SD = 1.25; 11 boys). Children and caregivers participated in PEERS® for Preschoolers groups, with each group randomly assigned three different baseline periods (1.5, 2, or 2.5 weeks) before beginning. OUTCOMES AND RESULTS Simulation Modeling Analysis (SMA) revealed concurrent improvements in social and caregiving skills, with subsequent changes in family functioning occurring over the course of this 16-session intervention. CONCLUSIONS AND IMPLICATIONS Future research will need to examine mechanisms of change in PEERS® for Preschoolers for children and caregivers. WHAT THIS PAPER ADDS There is a dearth of research that specifically examines social skills interventions for young autistic children that incorporates caregivers and examines family functioning as well. This paper is one of the first to evaluate the PEERS® for Preschoolers (P4P) intervention by: 1) exploring changes in child social skills, caregiver efficacy, and family functioning, and 2) analyzing the sequence of improvements in the aforementioned variables to measure systematic change. This pilot study presents results using appropriate methodology for a small sample size of children and caregivers. Results suggested concurrent improvements in social and caregiving skills and subsequent changes in family functioning. These can be built upon for further research on the PEERS® for Preschoolers intervention. This study supports PEERS® for Preschoolers as a feasible intervention that likely contributes to improvements for the child, caregiver in their relationship with their child and parenting styles in general, as well as functioning of the entire family. In sum, this work is essential to furthering the provision of a much needed service of social skills interventions for young autistic children.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA 98195, United States
| | - Angela V Dahiya
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Thomas H Ollendick
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
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Private music teachers' knowledge of and attitudes toward students with autism spectrum disorder. J Autism Dev Disord 2021; 51:4551-4559. [PMID: 33559017 DOI: 10.1007/s10803-020-04809-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
Although extracurricular music activities are common in Hong Kong, private music teachers' perceptions of children with autism spectrum disorder (ASD) are underexplored in research in this context. This study examined private music teachers' knowledge of ASD and their attitudes toward students with ASD in Hong Kong, and the relationship between these two factors. The study collected data from a questionnaire survey (n = 200) and eleven individual interviews. Unexpectedly, the findings showed that the teachers had a good understanding and a marginally positive perception of ASD, despite some anxiety about teaching students with ASD. Furthermore, knowledge of and attitude toward ASD were positively correlated. Teachers with previous training in special education needs had a better understanding of ASD and a more positive attitude toward ASD than those without related training. These results imply that further formal and public education could promote acceptance of and equal learning opportunities for students with ASD.
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Chien CW, Lai YYC, Lin CY, Graham F. Occupational Performance Coaching With Parents to Promote Community Participation of Young Children With Developmental Disabilities: Protocol for a Feasibility and Pilot Randomized Control Trial. Front Pediatr 2021; 9:720885. [PMID: 34805034 PMCID: PMC8604024 DOI: 10.3389/fped.2021.720885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: High rates of restricted community participation have been reported in young children with developmental disabilities. Occupational performance coaching (OPC), grounded in self-determination theory, aims to facilitate children's participation in life situations through coaching parents. However, there have been limited randomized controlled trials demonstrating the efficacy of OPC, especially with a specific focus on children's community participation. The proposed study is the first step in evaluating the feasibility and acceptability of conducting a pilot randomized controlled trial of OPC in Hong Kong and testing its initial efficacy (in comparison to parent consultation) in promoting children's community participation. Method/Design: A feasibility and pilot double-blind randomized controlled trial will be undertaken. Fifty children aged 6 years or below with developmental disabilities and their parents will be recruited from early intervention centers and/or through social media in Hong Kong. Parents will be randomly assigned to receive OPC or consultation, and will be blinded to group allocation. Outcomes will be assessed by blinded assessors at baseline, pre-intervention, post-intervention, and follow-up. Predetermined success criteria will be used to assess the feasibility of the trial. Qualitative interviews will be conducted with parents to explore the acceptability and perceived impact of OPC. Discussion: This trial will test whether the study protocol and OPC are feasible and acceptable, as well as assess the initial efficacy of OPC to obtain effect size estimates. The results of the trial will inform future preparations for conducting a full-scale efficacy trial of OPC. Trial Registration: ClinicalTrials.gov, U.S. National Library of Medicine, National Institutes of Health (#NCT04796909), Registered on 15th March 2021.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Yuen Yi Cynthia Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, Department of Medicine, University of Otago, Wellington South, New Zealand
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Lense MD, Beck S, Liu C, Pfeiffer R, Diaz N, Lynch M, Goodman N, Summers A, Fisher MH. Parents, Peers, and Musical Play: Integrated Parent-Child Music Class Program Supports Community Participation and Well-Being for Families of Children With and Without Autism Spectrum Disorder. Front Psychol 2020; 11:555717. [PMID: 33192810 PMCID: PMC7662132 DOI: 10.3389/fpsyg.2020.555717] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 09/22/2020] [Indexed: 01/23/2023] Open
Abstract
Opportunities for meaningful community participation may influence the development and well-being of individuals with autism spectrum disorder (ASD) and their families as well as impact how community members perceive and understand ASD. In the current study, we aimed to understand how a parent-child integrated music class program could be used to promote community participation and family well-being. Caregivers of preschoolers (2-5 years of age) with ASD and those of peer children with typical development (TD) were interviewed about their participation in a parent-child integrated music class program. Thematic analysis of interviews revealed that all caregivers viewed program participation as positive. Caregivers emphasized increasing connections within families, such as through strengthening parent-child bonds, as well as connections across families, including increased understanding of ASD and sensitivity to the experience of parenting. Many caregivers perceived the class as supporting their parenting and impacting their children's behavior in meaningful ways. Interview themes were supported by measures of caregiver and child program receipt, including questionnaires about family music engagement throughout their time in the class program and behavioral coding of children's engagement during music classes. Findings suggest that integrated community experiences such as parent-child music classes may impact whole family well-being, highlighting the value of integrated community participation experiences at the level of the family system. Parent-child music classes may provide a productive and accessible context for supporting integrated community experiences.
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Affiliation(s)
- Miriam D. Lense
- Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt University, Nashville, TN, United States
| | - Sara Beck
- Vanderbilt University, Nashville, TN, United States
- Randolph College, Lynchburg, VA, United States
| | - Christina Liu
- Vanderbilt University Medical Center, Nashville, TN, United States
- Michigan State University, East Lansing, MI, United States
| | | | - Nicole Diaz
- Vanderbilt University, Nashville, TN, United States
| | - Megan Lynch
- Vanderbilt University, Nashville, TN, United States
| | - Nia Goodman
- Vanderbilt University, Nashville, TN, United States
| | - Adam Summers
- Belmont University, Nashville, TN, United States
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Chien CW, Lai YYC, Lin CY, Graham F. Occupational Performance Coaching with Parents to Promote Community Participation and Quality of Life of Young Children with Developmental Disabilities: A Feasibility Evaluation in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217993. [PMID: 33143189 PMCID: PMC7662925 DOI: 10.3390/ijerph17217993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
Participation in community activities contributes to child development and health-related quality of life (HRQOL), but restricted participation has been reported in children with disabilities. Occupational performance coaching (OPC) is an intervention that targets participatory goals in child performance through coaching parents, with evidence of effectiveness for pediatric populations. Little is known about the feasibility of OPC in Hong Kong, or its effect on children's community participation and HRQOL. A mixed-methods case study design was applied to explore Hong Kong parents' experience of OPC in relation to goal achievement, community participation, and HRQOL change in children. Four parents of young children with developmental disabilities (aged five to six years) received OPC for three to eight sessions within one to three months. Quantitative pre- and post-intervention data were analyzed descriptively. Semi-structured interviews with parents were conducted at post-intervention, and analyzed using content analysis. Results showed a trend of improvement in goal performance, child involvement in community activities, and specific aspects of HRQOL among most participants. Parents perceived undertaking OPC positively, described gaining insights and skills, and felt supported. The findings suggest that OPC warrants further investigation for use in Hong Kong, to promote children's community participation and quality of life.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
- Correspondence: ; Tel.: +852-2766-6703; Fax: +852-2330-8656
| | - Yuen Yi Cynthia Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (SAR), China; (Y.Y.C.L.); (C.-Y.L.)
| | - Fiona Graham
- Rehabilitation Teaching and Research Unit, University of Otago, Wellington South 6242, New Zealand;
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Ng CKM, Lam SHF, Tsang STK, Yuen CMC, Chien CW. The Relationship between Affiliate Stigma in Parents of Children with Autism Spectrum Disorder and Their Children's Activity Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051799. [PMID: 32164271 PMCID: PMC7084220 DOI: 10.3390/ijerph17051799] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/27/2022]
Abstract
Children with autism spectrum disorder (ASD) are reported to participate less in everyday activities, and their parents face stigma on account of having a child with ASD, which they often internalize as affiliate stigma. Studies have examined the impact of affiliate stigma on parents’ psychological well-being and social behaviors, but little is known about how affiliate stigma impacts their children’s activity participation. This study aimed to investigate the relationship between parents’ affiliate stigma and activity participation of their children with ASD. Sixty-three parents of children with ASD (aged 2–6 years) were recruited. They completed questionnaires, which captured affiliate stigma, their child’s participation (frequency and involvement) in home, preschool, and community activities, and demographic characteristics. Results indicated that these parents had a moderate level of affiliate stigma, which did not correlate with the frequency of their children’s participation in activities. However, the parents’ affiliate stigma was found to have negative impacts on their children’s involvement in overall community participation and participation in one particular activity at home. The findings highlight the importance of destigmatization of parents of children with ASD in order to promote their children’s participation in community activities.
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Affiliation(s)
| | | | | | | | - Chi-Wen Chien
- Correspondence: ; Tel.: +852-2766-6703; Fax: +852-2330-8656
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Chien CW, Leung C, Schoeb V, Au A. A Chinese version of the young children's participation and environment measure: psychometric evaluation in a Hong Kong sample. Disabil Rehabil 2020; 43:3061-3069. [PMID: 32096426 DOI: 10.1080/09638288.2020.1727032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the psychometric properties of a Chinese-translated version of the Young Children's Participation and Environment Measure. MATERIALS AND METHODS The Young Children's Participation and Environment Measure was translated into Chinese using cultural adaptation by adding/replacing with activities relevant to Chinese culture. Parents of 53 children aged 2-5 years with developmental disabilities and of 50 typical developing children completed the questionnaires. Internal consistency, test-retest reliability, known-group validity, and discriminant validity were examined using Cronbach's alpha, intraclass correlation coefficient, Mann-Whitney U tests, and Spearman's rank correlation coefficients respectively. RESULTS Internal consistency was acceptable for most scales (α = 0.42-0.89). Test-retest reliability of the summary scores was moderate to high for all scales (intraclass correlation coefficient = 0.65-0.90). Known-group validity was supported by demonstrating significant differences by disability status in all community participation scales, two daycare/preschool participation scales, and one home participation scale. Low or negative correlations between the scores of some scales and children's cognition (ρ = 0.27-0.32; -0.36-to-0.35) and parental stress (ρ = -0.42-to-0.31) supported discriminant validity. CONCLUSION This study provided psychometric evidence supporting the use of the Young Children's Participation and Environment Measure to assess Chinese children's participation and environmental support.IMPLICATIONS FOR REHABILITATIONThe Young Children's Participation and Environment Measure is translated into Chinese using a cultural adaptation process.The Chinese version of the Young Children's Participation and Environment Measure demonstrates evidence for internal consistency, test-retest reliability (including the minimal detectable change).The Chinese version of the Young Children's Participation and Environment Measure demonstrates evidence for known-group validity and discriminant validity.The Chinese version of the Young Children's Participation and Environment Measure holds promise for use in children aged 2-5 years to assess their participation and identify environmental barriers warranting intervention.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Cynthia Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Veronika Schoeb
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Delémont, Switzerland
| | - Alma Au
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
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Factor RS, Ollendick TH, Cooper LD, Dunsmore JC, Rea HM, Scarpa A. All in the Family: A Systematic Review of the Effect of Caregiver-Administered Autism Spectrum Disorder Interventions on Family Functioning and Relationships. Clin Child Fam Psychol Rev 2019; 22:433-457. [DOI: 10.1007/s10567-019-00297-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Chien CW, Li-Tsang CWP, Cheung PPP, Leung KY, Lin CY. Development and psychometric evaluation of the Chinese version of the Participation and Environment Measure for Children and Youth. Disabil Rehabil 2019; 42:2204-2214. [PMID: 31081396 DOI: 10.1080/09638288.2018.1553210] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To adapt the Participation and Environment Measure for Children and Youth for use with Chinese children and youths, and to investigate its psychometric properties.Materials and methods: The Participation and Environment Measure for Children and Youth was translated into Chinese using a cultural adaptation process. Parents of 69 children aged 5-12 years with disabilities and 319 children without disabilities completed the questionnaires. Internal consistency, test-retest reliability, factorial structure, and known-group validity were examined using Cronbach's alpha, intraclass correlation coefficient, confirmatory factor analysis and t-test, respectively.Results: We added and/or replaced activities with culturally-relevant activities in the Chinese version. Internal consistency was acceptable for most of the scales (0.55-0.86). Test-retest reliability of the summary scores was moderate to high (0.70-0.84). Data-model fit was confirmed in a one-factor structure for the participation scales and a two-factor structure for the environment scales. There were also significant differences in the summary scores between 65 gender- and age-matched pairs of children with and without disabilities on the school participation scales and all the environment scales.Conclusion: This study provides psychometric evidence supporting the use of the Participation and Environment Measure for Children and Youth to assess Chinese children's participation and environmental supports/barriers.Implications for rehabilitationThe Chinese version of the Participation and Environment Measure for Children and Youth was developed through a rigorous translation and cultural adaptation process.There is evidence for the reliability (internal consistency and test-retest reliability) and construct validity (factorial structure and known-group validity) of the Chinese version of the Participation and Environment Measure for Children and Youth.The Chinese version of the Participation and Environment Measure for Children and Youth can be used to assess children's participation in home, school and community settings and to identify environmental barriers that require further intervention.
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Affiliation(s)
- Chi-Wen Chien
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Cecilia W P Li-Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Phoebe Pui Pui Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Ka-Yan Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong (SAR), China
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Kirby AV, Williams KL, Watson LR, Sideris J, Bulluck J, Baranek GT. Sensory Features and Family Functioning in Families of Children With Autism and Developmental Disabilities: Longitudinal Associations. Am J Occup Ther 2019; 73:7302205040p1-7302205040p14. [PMID: 30915965 DOI: 10.5014/ajot.2018.027391] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Children with autism spectrum disorder (ASD) and other developmental disabilities (DD) commonly display unusual responses to sensory input. Previous work has suggested concurrent associations linking sensory features with aspects of family functioning, including activity participation and caregiver strain. What is unknown, however, is the extent to which sensory features affect family functioning over time, as well as the influence of received services on these relationships. OBJECTIVE To assess hypothesized longitudinal associations between sensory features and family functioning and examine interactions by group and service usage (i.e., educational and therapy services). DESIGN Multigroup longitudinal observational study. SETTING Community. PARTICIPANTS A volunteer sample of 81 children (50 with ASD, 31 with DD; 76% male), ages 2-12 yr, and their caregivers participated in assessments at two points, 3.3 yr apart on average. OUTCOMES AND MEASURES Key measures included the Sensory Experiences Questionnaire, Sensory Profile, Sensory Processing Assessment for Young Children, Tactile Defensiveness and Discrimination Test-Revised, Caregiver Strain Questionnaire, and Home and Community Activities Scale. We also measured the amount of time children received educational and therapy services. RESULTS Regression analyses confirmed long-term associations linking sensory features with aspects of activity participation and caregiver strain in this population; group and service usage interactions were also identified. CONCLUSIONS AND RELEVANCE Sensory features can affect the everyday experiences of both children and caregivers. It is important for practitioners to understand the potentially enduring effects of children's sensory features on family functioning so as to begin to identify supportive interventions with more optimal long-term effects.
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Affiliation(s)
- Anne V Kirby
- Anne V. Kirby, PhD, OTR/L, is Assistant Professor, Department of Occupational and Recreational Therapies, University of Utah, Salt Lake City;
| | - Kathryn L Williams
- Kathryn L. Williams, MS, OTR/L, is Doctoral Candidate, Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill
| | - Linda R Watson
- Linda R. Watson, EdD, CCC-SLP, is Professor, Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill
| | - John Sideris
- John Sideris, PhD, is Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles. At the time of this study, he was Scientist, Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - John Bulluck
- John Bulluck, BA, was Research Systems Analyst, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, at the time of this study
| | - Grace T Baranek
- Grace T. Baranek, PhD, OTR/L, FAOTA, is Associate Dean, Chair, and Mrs. T. H. Chan Professor of Occupational Science and Occupational Therapy, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles. At the time of this study, she was Professor and Associate Chair for Research, Department of Allied Health Sciences, University of North Carolina at Chapel Hill
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16
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Participation of Children and Youth with Autism Spectrum Disorder: A Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2014. [DOI: 10.1007/s40489-014-0040-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2014; 45:752-65. [DOI: 10.1007/s10803-014-2231-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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18
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Little LM, Sideris J, Ausderau K, Baranek GT. Activity participation among children with autism spectrum disorder. Am J Occup Ther 2014; 68:177-85. [PMID: 24581404 PMCID: PMC4012568 DOI: 10.5014/ajot.2014.009894] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE. The purpose of this study was to empirically derive dimensions of activity participation among a sample of school-age children with autism spectrum disorder (ASD; n = 713). Additionally, we examined the associations between dimensions of activity participation and child characteristics (i.e., chronological age, autism severity, gender) and family demographics (i.e., maternal education). METHOD. Exploratory factor analysis was used to determine the factors on the Home and Community Activities Scale (HCAS). Multiple regression was used to examine the extent to which child characteristics and family demographics were related to HCAS dimensions. RESULTS. A six-factor model best characterized activity participation among the school-age children with ASD, and child characteristics and family demographics were differentially associated with HCAS dimensions. CONCLUSION. The findings have implications for how activities may be categorized for children with ASD and suggest that the frequency of specific activities is affected by child characteristics and maternal education.
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Affiliation(s)
- Lauren M Little
- Lauren M. Little, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy Education, University of Kansas Medical Center, 3901 Rainbow Blvd, MS2003, Kansas City, KS 66160. At the time of the study, she was Postdoctoral Research Associate, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC;
| | - John Sideris
- John Sideris, PhD, is Scientist, Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Karla Ausderau
- Karla Ausderau, PhD, is Assistant Professor, Department of Kinesiology, Occupational Therapy Program, University of Wisconsin-Madison
| | - Grace T Baranek
- Grace T. Baranek, PhD, is Professor and Associate Chair for Research, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy, University of North Carolina at Chapel Hill
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Mak C, Zhang KC. Teachers’ perceptions of a community participation programme for preschoolers with autism. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2013. [DOI: 10.1080/13632752.2012.695535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Parent and family impact of autism spectrum disorders: a review and proposed model for intervention evaluation. Clin Child Fam Psychol Rev 2012; 15:247-77. [PMID: 22869324 DOI: 10.1007/s10567-012-0119-6] [Citation(s) in RCA: 369] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.
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Current World Literature. Curr Opin Neurol 2011; 24:183-90. [DOI: 10.1097/wco.0b013e32834585ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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