Date Presented 03/23/24

This study examined the family experience of receiving OT services for their autistic child and the degree to which those OT services were client centered. Findings identify family preferences and the aspects of OT services that they value most.

Primary Author and Speaker: Renee Watling

Additional Authors and Speakers: Kylie Darby, Natalie Daughton

Autistic individuals have expressed frustration with the services they receive, citing lack of individual choice and rigidity in institutionalized systems of care. Occupational therapy (OT) values a client-centered approach. However, systems of care can impose barriers that interfere with this aim. The purpose of this study was to understand the family experience of receiving OT services for an autistic child and the degree of client centeredness in services provided. This study used a descriptive design employing survey research and follow-up interviews. Therapists were recruited from respondents to a 2022 survey of OT practice patterns and through posts to pediatric OT social media groups. Participating therapists nominated client families. An investigator-developed questionnaire examining use of client centered care approaches and the caregiver and therapist versions of the Measure of Processes of Care (MPOC) were used. The MPOC tools enable direct comparison of caregiver and therapist report. Links to the online questionnaires were sent to the therapist and family via email. Follow-up interviews occurred in person or online and allowed for member checking of responses. Therapists reported using client-centered approaches (100%) and helping caregivers feel competent in their roles (87%) to a great or very great extent. Families reported perceived use of client-centered approaches (87%) and feeling empowered to make decisions about their child’s care (87%) to a very great extent. Families (87%) identified the therapeutic relationship between therapist and child as most highly valued. Therapists and families report that client-centered care commonly occurs in OT service delivery and that this is highly valued by families. Findings can guide OT providers in ways to modify their service delivery to better meet the needs of their autistic clients and families. Findings expose how institutionalized systems of care impact recipients of services.

References

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl.2), eArticle 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

Autistic Self-Advocacy Network. (2021). Position Statements: Our Motto: What is “Nothing About Us Without Us.”? https://autisticadvocacy.org/about-asan/position-statements/

Taylor, R. R. (2017). Kielhofner’s Research in Occupational Therapy: Methods of Inquiry. FA Davis Co.