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There are well-documented play deficits in autism beginning with infant object and social play. To create effective interventions, the predictors of play deficits in autism must be established. Individuals with autism spectrum disorder (ASD) frequently report sensory processing difficulties including poor praxis; however, these are potential predictors of play that have not been well studied. Using a data set of 162 individuals with ASD, this study examined the direct and indirect relationships between sensory processing and social play performance via structural equation modeling. The best fitting model suggested that sensory system functions predict praxis and play in combination, providing preliminary evidence that sensory functions are related to social play in combination with praxis in children with ASD. The findings suggest future avenues for research.

The increasing prevalence of autism spectrum disorder (ASD) suggests that dental practices will be seeing patients with this diagnosis more frequently. Although patients with ASD have similar dental needs to other patients, the symptoms of the disorder may influence the ability of dental practitioners to provide necessary care. Dental professionals may be unaware of the difficulties with sensory processing common to patients with ASD. However, awareness of sensory processing issues and knowledge of strategies to improve the sensory experience for individuals with ASD may improve dental visits for these patients and allow for enhanced dental care provision.

Changes in federal legislation guiding occupational therapy practice in educational environments have required modifications in the way therapists evaluate children in these settings. New methods in turn require new tools. This article will describe one new tool designed to assist school-based practitioners in their assessment of the impact of sensory processing and praxis difficulties on educational performance. The Sensory Processing Measure is an assessment tool that promotes team collaboration by examining performance across multiple natural environments and also considers the relationship between sensory processing, praxis and social participation. Part One of this paper provides a description of the assessment tool and its proposed uses while in Part Two, examples of the use of the measure will be presented.

This cross-sectional survey research investigated play preferences of children with and without developmental delays who were between 3 and 7 years old. Parents completed questionnaires regarding their child's play activity and context preferences. Valid results were obtained for 166 children, 83 of whom had developmental delays. Preference ratings were compared by gender, age, and delay status. Play preference did not differ by gender. Rough-and-tumble play and computer/video game play increased with age, whereas object exploration decreased. Children with developmental delays had higher preferences for rough-and-tumble play and object exploration and lower preferences for drawing and coloring, construction, and doll and action figurine play than typically developing children. This comparison of children's play preferences across ages, gender, and developmental status enhances our understanding of how these variables influence children's play.

This systematic review describes the published evidence related to the effectiveness of frequency modulation (FM) devices in improving academic outcomes in children with auditory processing difficulties. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were used to identify articles published between January 2003 and March 2014. The Cochrane Population, Intervention, Control, Outcome, Study Design approach and the American Occupational Therapy Association process forms were used to guide the article selection and evaluation process. Of the 83 articles screened, 7 matched the systematic review inclusion criteria. Findings were consistently positive, although limitations were identified. Results of this review indicate moderate support for the use of FM devices to improve children’s ability to listen and attend in the classroom and mixed evidence to improve specific academic performance areas. FM technology should be considered for school-age children with auditory processing impairments who are receiving occupational therapy services to improve functioning in the school setting.

Importance: Play is an area of difficulty for autistic children, and occupational therapy practitioners need evidence to guide interventions to improve play for this population. Ayres Sensory Integration® (ASI) intervention has not yet been studied for its impact on play outcomes.Objective: To examine the impact of ASI intervention on play types in autistic children.Design: Nonconcurrent, multiple-baseline design across subjects.Setting: Outpatient occupational therapy clinic in New England.Participants: Three autistic children, ages 5, 6, and 6 yr.Intervention: Twenty-four ASI sessions.Outcomes and Measures: Frequency of play type was coded using partial interval coding. Progress monitoring used Goal Attainment Scaling.Results: All three participants demonstrated changes in the frequency of specific types of play, but changes varied among them.Conclusions and Relevance: Findings suggest that ASI intervention may alter a child’s patterns of play.What This Article Adds: This study is the first to examine the impact of ASI on play and the third that documents the feasibility of single-subject research for studying ASI. If confirmed in future studies, ASI could become an evidence-based intervention for improving play, an important outcome for autistic children and the profession of occupational therapy.Positionality Statement: This article uses the identity-first language autistic people. This nonableist language describes their strengths and abilities and is a conscious decision. This language is favored by autistic communities and self-advocates and has been adopted by health care professionals and researchers (Bottema-Beutel et al., 2021; Kenny et al., 2016).

Play in children with autism spectrum disorder (ASD) is often atypical, yet consensus regarding effective occupational therapy strategies for improving play is not established. To examine the efficacy of strategies used in occupational therapy to improve play in ASD, authors completed a systematic review of papers from January 1980 through January 2019. Search terms included autism, Asperger’s, ASD, autistic in combination with play, playfulness, pretend, imagination, praxis, creativity, and generativity. Twenty papers met inclusion criteria and were reviewed. Reviewed interventions included parent education, modified play materials or environments, imitation of the child, and modeling by an adult, a peer, or video. Moderate to strong support exists for the specific strategies of imitation of the child and modeling for the child, with lesser or mixed support for other strategies. Certain strategies commonly used in occupational therapy may be effective in improving the occupation of play in ASD.

School-based and early intervention occupational therapy evaluation is influenced by federal policy and prevailing ideas regarding best practice. Current best practice considers a child's performance in appropriate contexts and natural environments, as well as the impact of the environment on occupational functioning and participation across settings. As a recent report suggested 3.4% to 15.6% of children in a community sample of 4-year-olds may demonstrate sensory processing difficulties, occupational therapists should be familiar with multiple methods of assessment to address these concerns. One such assessment tool, the Sensory Processing Measure–Preschool (SPM-P) for children 2- to 5-years old, provides 8 scaled scores: Vision, Hearing, Touch, Body Awareness, Balance and Motion, Total Sensory System Score, Planning and Ideas, and Social Participation. Through discussion on the development, usage, and implementation of both Home and School forms, this article illustrates how the SPM-P provides a mechanism for preschool educational teams to meet best practice initiatives.

Over a decade ago, researchers surveyed pediatric occupational therapists regarding their use of play and concluded that play was addressed inconsistently in the evaluation and treatment of preschool-age clients. Play was primarily used as a modality to achieve a desired performance in another skill area. In the intervening years, a significant body of literature has been published in occupational therapy promoting the use of play as a meaningful outcome of occupational therapy intervention; therefore, practice patterns may have changed. Five hundred pediatric occupational therapists were randomly selected from members of the school system and sensory integration special interest sections of the American Occupational Therapy Association (AOTA) to be surveyed regarding their current usage of play with children ages 3 to 7 years. They received a mailed survey, adapted from the original work of Couch, Dietz, and Kanny with the permission of the primary author. There were 198 surveys returned (40%). Similar to earlier findings, play was used primarily as a means of eliciting improvement in another area, such as fine-motor skill. Although some therapists assessed play, few focused on play as an outcome of importance, or included goals for play. Minimal changes have occurred in the role of play in pediatric occupational therapy. Despite the profession's promotion of our role in play and the suggestion that play is one of the most important occupations of childhood, practitioners continue to report a limited focus on play as an occupation.

This systematic review examined the literature published from January 2006 to April 2013 related to the effectiveness of occupational therapy interventions for children with autism spectrum disorder (ASD) and their parents to improve parental stress and self-efficacy, coping, and resilience and family participation in daily life and routines. From the 4,457 abstracts, 34 articles were selected that matched the inclusion criteria. The results were mixed and somewhat inconclusive because this body of literature is in its infancy. Studies of children with ASD do not routinely measure parental and family outcomes. Recommendations include an emphasis on family measures other than parental stress and a greater focus on measures of parental and family functioning in all future studies of pediatric interventions to more fully understand the impact of interventions in a wider context.

The American Occupational Therapy Association (AOTA) asserts that occupational therapists and occupational therapy assistants, through the use of occupations and activities, facilitate clients' cognitive functioning to enhance occupational performance, self-efficacy, participation, and perceived quality of life. Cognitive processes are integral to effective performance across the broad range of daily occupations such as work, educational pursuits, home management, and play and leisure. Cognition plays an integral role in human development and in the ability to learn, retain, and use new information to enable occupational performance across the lifespan. This statement defines the role of occupational therapy in evaluating and addressing cognitive functioning to help clients maintain and improve occupational performance. The intended primary audience is practitioners1 within the profession of occupational therapy. The statement also may be used to inform recipients of occupational therapy services, practitioners in other disciplines, and the wider community regarding occupational therapy theory and methods and to articulate the expertise of occupational therapy practitioners in addressing cognition and challenges in adapting to cognitive dysfunction.

OBJECTIVE. The history and development of the Sensory Processing Measure–School are detailed, and findings of initial pilot studies are reported.METHOD. Multiple reviews, focus groups, case studies, and two pilot studies were used to develop the early versions of the tool. Internal consistency and discriminatory ability were examined.RESULTS. Internal consistency measured with Cronbach’s alphas ranged from .93 to .99 in the first pilot study and .70 to .99 in the second pilot study. Children who were typically developing were correctly classified 92.3% of the time, and children with sensory issues were correctly classified 72% of the time.CONCLUSION. Initial results suggest that the tool is reliable and valid and discriminates children with and without sensory processing issues. Further research is under way with larger samples.

A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers’ perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified that included coping strategies such as “me time,” planning, knowledge is power, sharing the load, lifting the restraints of labels, and recognizing the joys. The information from this study may benefit mothers of children with ASD and inform pediatric therapists providing services to children with ASD and their families.

Occupational therapists view play through a unique lens. Considering play as a human occupation, and one to which all people have a right, places occupational therapists among a special group of professionals championing play. This State of the Science article seeks to increase awareness regarding the occupational therapy profession’s contributions and to situate those contributions within the larger body of literature on play while also promoting further study of play as an occupation.

Pediatric occupational therapy practitioners frequently provide interventions for children with differences in sensory processing and integration. Confusion exists regarding how best to intervene with these children and about how to describe and document methods. Some practitioners hold the misconception that Ayres Sensory Integration intervention is the only approach that can and should be used with this population. The issue is that occupational therapy practitioners must treat the whole client in varied environments; to do so effectively, multiple approaches to intervention often are required. This article presents a framework for conceptualizing interventions for children with differences in sensory processing and integration that incorporates multiple evidence-based approaches. To best meet the needs of the children and families seeking occupational therapy services, interventions must be focused on participation and should be multifaceted.