Date Presented 04/22/2023

Examining practice patterns is an important step in determining adherence to evidence-based practice recommendations. This study describes practice patterns of OTs working with autistic clients and examines consistency with published recommendations.

Primary Author and Speaker: Renee Watling

Contributing Authors: Natalie Daughton

PURPOSE: As an evidence based profession, external healthcare providers, policy makers, consumers, and insurance companies expect that occupational therapy services reflect current knowledge and adhere to recommended practices. We examined characteristics of current OT practices for autistic clients and determined the degree of alignment with published recommendations.

DESIGN: This study used descriptive survey methodology. A systematic websearch was used to identify a national sample of agencies (N = 250) providing OT for autistic clients. After confirming eligibility via phone, recruitment materials and a link to the questionnaire were sent via email.

METHOD: Data were collected via an online questionnaire then analyzed with descriptive statistics. Questions were based on the original questions used in Watling et al (1999) and Case-Smith and Kuhaneck (1999) as well as recommendations in published practice guidelines of the AAP, APA, and AOTA. Questions addressed pragmatic aspects of practice, assessment tools, theoretical approaches to intervention, interprofessional collaboration, characteristics of intervention, post-professional training, and issues related to client outcomes.

RESULTS: Pilot data (n = 20) indicate that OT practitioners always provide direct services (98%), frequently use sensory approaches to intervention (87%), and always target client-specific goals (99%). Only half (53%) reported including clients in intervention planning. Full results and degree of adherence to recommendations will be presented.

CONCLUSION: OT practitioners deliver services for autistic clients that generally align with published recommendations. Practitioners can access practice guidelines to inform their clinical decision making and increase adherence to EBP.

IMPACT: This study reveals gaps in knowledge translation and informs practitioners in what they can do to better align their services for autistic clients with published evidence and practice guidelines.


Case-Smith, J. & Miller, H. (1999). Occupational therapy with children with pervasive developmental disorders. American Journal of Occupational Therapy, 53, 506–513.

Watling, R., Deitz, J., Kanny, E. M., & McLaughlin, J. F. (1999). Current practice of occupational therapy for children with autism. American Journal of Occupational Therapy, 53, 498–505.

Tomchek, S. D., & Koenig, K. (2016). AOTA Occupational Therapy Practice Guidelines for Individuals with Autism Spectrum Disorder. Bethesda: AOTA Press.

Hyman, S. L., Levy S. E., Myers, S. M., AAP Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1):e20193447