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Ghahramani S, Hassani Mehraban A, Alizadeh Zarei M, Ghahramani S. Occupational Therapy Outcome Measures in Preschool Children With Autism Spectrum Disorders: A Scoping Review. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:568-576. [PMID: 38682488 DOI: 10.1177/15394492241246547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
With the rising prevalence of autism spectrum disorder (ASD), early assessment of preschool children is vital for occupational therapists. This scoping review aimed to provide detailed information about outcome measures used in occupational therapy interventions in preschool children with ASD and map the focus of the outcome measures based on the International Classification of Functioning, Disability, and Health (ICF) components. A thorough search from 2000 to 2022 was conducted that employed ICF linking rules to categorize the outcome measures. Seventy-four outcome measures were identified. They predominantly targeted body function and activity/participation, with less emphasis on environmental factors, and none assessed body structure. The most common measures were Vineland Adaptive Behavior Scale (VABS-2), Canadian Occupational Performance Measure (COPM), and Parenting Stress Index-Short Form (PSI-SF). This study offers a diverse array of outcome measures and underscores the potential of the ICF framework in enhancing evaluations, particularly concerning broader environmental components as one of the primary facilitating/hindering factors in the participation of children with ASD.
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Bölte S, Alehagen L, Black MH, Hasslinger J, Wessman E, Lundin Remnélius K, Marschik PB, D’Arcy E, Crowson S, Freeth M, Seidel A, Girdler S, Zander E. The Gestalt of functioning in autism revisited: First revision of the International Classification of Functioning, Disability and Health Core Sets. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2394-2411. [PMID: 38351521 PMCID: PMC11402269 DOI: 10.1177/13623613241228896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
LAY ABSTRACT Autistic people experience individual strengths and challenges as well as barriers and facilitators in their environment. All of these factors contribute to how well autistic people can cope in everyday life, fulfill the roles they choose, and meet their needs. The World Health Organization has developed a system aiming to capture the many factors within people (like how someone thinks and feels) and outside of people (things around a person) that influence their daily living, called the International Classification of Functioning, Disability and Health. The International Classification of Functioning, Disability and Health can be used for different purposes in research and practice to assess people's situations and plan support measures. Previously in 2019, the International Classification of Functioning, Disability and Health was adapted to autism by developing so-called Core Sets, which are shorter International Classification of Functioning, Disability and Health versions for use in specific conditions. Here, we present the first revisions of the International Classification of Functioning, Disability and Health Core Sets for autism, based on research, development results, and community feedback. Some factors influencing daily life for autistic people were added to the Core Sets, and other factors deemed less relevant were removed. Changes were also made in Core Sets designed for different age groups (0-5, 6-16, and ⩾17 years). Particularly, contents for sensory processing (like smell, touch, seeing, hearing) were added. We recommend these updated Core Sets for future use in autism research and practice. These changes to the Core Sets after 4 years indicate that there should be ongoing updates based on research and experience from practice and involvement of stakeholders.
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Affiliation(s)
- Sven Bölte
- Karolinska Institutet, Sweden
- Region Stockholm, Sweden
- Curtin University, Australia
| | | | | | | | - Elina Wessman
- Karolinska Institutet, Sweden
- Region Stockholm, Sweden
| | | | - Peter B Marschik
- Karolinska Institutet, Sweden
- University Medical Center Göttingen and Leibniz Science Campus Primate Cognition, Germany
- Medical University of Graz, Austria
| | | | | | | | | | - Sonya Girdler
- Karolinska Institutet, Sweden
- Curtin University, Australia
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Rosenbaum PL, Imms C, Miller L, Hughes D, Cross A. Perspectives in childhood-onset disabilities: integrating 21st-Century concepts to expand our horizons. Disabil Rehabil 2024:1-11. [PMID: 39185771 DOI: 10.1080/09638288.2024.2394647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/12/2024] [Accepted: 08/16/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE A powerful aphorism states: "If I hadn't believed it, I wouldn't have seen it!" This challenging notion reminds us how strongly we are influenced by prevailing ideas, and how we interpret things according to current fashions and teachings. MATERIALS AND METHODS In this paper we present and discuss contemporary perspectives concerning childhood-onset disability and the evolving nature of how people are thinking and acting. We illustrate these ideas by reminding readers of how we have all traditionally been trained and acculturated to think about many dimensions of neurodevelopmental disability ("What?"); reflect on the impact of these ways of thinking in terms of what we have conventionally "seen" and done ("So What?"); and contrast those traditions with contemporary concepts that we believe or know impact the field ("Now What?"). RESULTS Many of the concepts discussed here will be familiar to readers. In taking this analytically critical perspective we aim to illustrate that by weaving these individual threads together we are able to create a coherent fabric that can serve children with childhood-onset NDD, their families, service providers, the community, and policy-makers. We do not purport to offer a comprehensive view of the whole field. CONCLUSIONS We encourage readers to consider the integration of these new ways of thinking and acting in our still-evolving field of "childhood-onset disability".
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Affiliation(s)
| | - Christine Imms
- Apex Australia Chair of Neurodevelopment and Disability, Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Laura Miller
- Occupational Therapy School of Allied Health, Australian Catholic University, Virginia, Australia
| | - Debra Hughes
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Andrea Cross
- Department of Pediatrics, Institute of Applied Health, Sciences, McMaster University, Hamilton, Ontario, Canada
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Hill J, Copley J, Donovan S, Ashburner J, Taylor J, Bobir N. What supports do autistic adolescents and adults need? Perspectives of self-reporting adults and caregivers. Aust Occup Ther J 2024. [PMID: 39020514 DOI: 10.1111/1440-1630.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/18/2024] [Accepted: 06/23/2024] [Indexed: 07/19/2024]
Abstract
INTRODUCTION Increasingly, autistic adolescents and adults are accessing occupational therapy. However, limited evidence exists on the type of supports that are important to them. Examining the patterns of supports valued by autistic adolescents and adults will inform the design of occupational therapy services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important. METHODS This study involved two anonymous online surveys. Survey one involved 54 items and was distributed to caregivers of autistic adolescents and/or adults. Survey two included 41 items and was distributed to self-reporting autistic adults. Surveys sought closed and open-ended responses about the support needs of autistic individuals living in Australia. Quantitative data were analysed as counts and frequencies of responses, whereas short-answer responses were analysed through content analysis. COMMUNITY AND CONSUMER INVOLVEMENT There was no consumer or community involvement in the completion of this project. RESULTS A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Quantitative data from both autistic adolescents' and adults' closed-answer responses showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Content analysis of open-ended responses, performed separately for each participant group, revealed six categories: employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. CONCLUSION Results highlight that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy practice. Differences between the priorities of autistic individuals and their caregivers highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs. PLAIN LANGUAGE SUMMARY Increasingly, autistic adolescents and adults are accessing occupational therapy services. However, limited information exists regarding the type of supports that are important to them. Understanding what supports are valued by autistic adolescents and adults will support occupational therapists deliver effective and individualised services. Therefore, this study aimed to identify what supports autistic adolescents and adults believed to be the most important to them. This study involved two anonymous online surveys. Survey one was completed by caregivers of autistic adolescents and/or adults. Survey two was completed by self-reporting autistic adults. Surveys included both open-ended and closed-answer responses to better understand the support needs of autistic individuals living in Australia. A total of 68 caregivers of autistic adolescents or adults and 59 self-reporting adults completed the survey resulting in 127 responses. Closed-answer response questions from both the caregivers and self-reporting autistic adolescents and adults showed that the highest support needs were for supporting participation in employment and supporting health and wellbeing. Open-ended response questions revealed six main priorities including, employment, promoting independence, supporting positive social and communication experiences, supporting health and wellbeing, caregiver support, and promoting autism acceptance. This study found that autistic individuals and their caregivers have a diverse range of priorities, all of which align with the scope of occupational therapy. Further, participant responses highlight the importance of therapists providing person and family-centred approaches tailored towards both the autistic person's and their caregiver's needs.
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Affiliation(s)
- Jessica Hill
- The School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jodie Copley
- The School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Sophie Donovan
- The School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Jill Ashburner
- Autism Queensland Limited, Brisbane, Queensland, Australia
| | | | - Natasha Bobir
- Autism Queensland Limited, Brisbane, Queensland, Australia
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Chamberlain A, D'Arcy E, Whitehouse AJ, Wallace K, Hayden-Evans M, Girdler S, Milbourn B, Bölte S, Evans K. Reliability, Validity and Acceptability of the PEDI-CAT with ASD Scales for Australian Children and Youth on the Autism Spectrum. J Autism Dev Disord 2024:10.1007/s10803-024-06366-7. [PMID: 38678516 DOI: 10.1007/s10803-024-06366-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE The PEDI-CAT (ASD) is used to assess functioning of children and youth on the autism spectrum; however, current psychometric evidence is limited. This study aimed to explore the reliability, validity and acceptability of the PEDI-CAT (ASD) using a large Australian sample. METHODS Caregivers of 134 children and youth on the spectrum participated in clinical assessments involving the administration of the PEDI-CAT (ASD), Vineland-3, PEDI-CAT (Original) and a feedback instrument. The PEDI-CAT (ASD) content was compared to the ICF Core Sets for ASD to summarize areas of functioning assessed and relevance to autism. RESULTS The PEDI-CAT (ASD) demonstrated good to excellent internal consistency and test-re-test reliability. Parallel forms reliability with the PEDI-CAT (Original) included significant correlations (good to excellent), however, t-tests showed significantly higher Social/Cognitive scores for the ASD version. Convergent validity results demonstrated that most PEDI-CAT (ASD) and Vineland-3 core domains were significantly correlated (poor to good). Content analysis revealed that the PEDI-CAT (ASD) covered less than half of the ICF Core Sets for ASD (mostly Activities and Participation codes). Just over half the codes assigned to the PEDI-CAT (ASD) were represented in the ICF Core Sets for ASD. Feedback on the acceptability of the measure was mixed, but overall was it was considered user-friendly and efficient. CONCLUSION The PEDI-CAT (ASD) had adequate psychometric properties and acceptability as a measure of Activities and Participation codes. However, it lacks comprehensiveness and relevance when compared to the ICF Core Sets for ASD and has the potential to overestimate functioning.
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Affiliation(s)
- Angela Chamberlain
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Emily D'Arcy
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Andrew Jo Whitehouse
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
- Stockholm Health Care Services, Stockholm, Sweden
| | | | - Maya Hayden-Evans
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Sonya Girdler
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
- Karolinska Institutet, Solna, Sweden
- The University of Western Australia, Perth, Australia
| | - Benjamin Milbourn
- Curtin University, Perth, Australia
- Telethon Kids Institute, Perth, Australia
- Autism CRC, Brisbane, Australia
| | - Sven Bölte
- Curtin University, Perth, Australia
- Karolinska Institutet, Solna, Sweden
- Stockholm Health Care Services, Stockholm, Sweden
| | - Kiah Evans
- Curtin University, Perth, Australia.
- Telethon Kids Institute, Perth, Australia.
- Autism CRC, Brisbane, Australia.
- The University of Western Australia, Perth, Australia.
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Evans K, Whitehouse AJO, D’Arcy E, Hayden-Evans M, Wallace K, Kuzminski R, Thorpe R, Girdler S, Milbourn B, Bölte S, Chamberlain A. Perceived Support Needs of School-Aged Young People on the Autism Spectrum and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15605. [PMID: 36497683 PMCID: PMC9737194 DOI: 10.3390/ijerph192315605] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
With increasing demands for health, disability and education services, innovative approaches can help distribute limited resources according to need. Despite an increased focus on support needs within the clinical pathway and policy landscape, the body of research knowledge on this topic is at a relatively early stage. However, there appears to be a sense of unmet support needs and dissatisfaction with the provision of required support following an autism diagnosis amongst caregivers of young people on the spectrum. The primary aim of this study was to explore the perceived support needs of Australian school-aged young people on the spectrum and their caregiver(s). This was achieved using a phenomenographic Support Needs Interview conducted by occupational therapists during home-visits with caregivers of 68 young people on the spectrum (5-17 years). Qualitative data analysis resulted in two hierarchical outcome spaces, one each for young people and their caregivers, indicating interacting levels of support need areas that could be addressed through a combination of suggested supports. These support needs and suggested supports align with almost all chapters within the Body Functions, Activities and Participation and Environmental Factors domains of the International Classification of Functioning, Disability and Health. The overall goals of meeting these complex and interacting support needs were for the young people to optimize their functioning to reach their potential and for caregivers to ensure the sustainability of their caregiving capacity. A series of recommendations for support services, researchers and policy makers have been made to position support needs as central during the assessment, support and evaluation phases.
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Affiliation(s)
- Kiah Evans
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Andrew J. O. Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
| | - Emily D’Arcy
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Maya Hayden-Evans
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- School of Psychological Science, University of Western Australia, Perth 6009, Australia
| | - Kerry Wallace
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Rebecca Kuzminski
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Rebecca Thorpe
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
| | - Sonya Girdler
- School of Allied Health, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
| | - Benjamin Milbourn
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
| | - Sven Bölte
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 104 31 Stockholm, Sweden
| | - Angela Chamberlain
- Telethon Kids Institute, University of Western Australia, Perth 6009, Australia
- Autism CRC, Long Pocket, Brisbane 4068, Australia
- Curtin Autism Research Group and School of Allied Health, Curtin University, Perth 6102, Australia
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