Le numéro de septembre/octobre 2015 de l’American Journal of Occupational Therapy est consacré à l’autisme.

1. Kuhaneck HM, Watling R. Occupational Therapy : Meeting the Needs of Families of People With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905170010p6905170011-6905170015.

Occupational therapy has much to offer to families of people with autism spectrum disorder (ASD). However, people outside the profession may be unaware of occupational therapy’s breadth and scope. It is our responsibility and our duty to express the full range of occupational therapy services through research, clinical practice, advocacy, and consumer education. This special issue of the American Journal of Occupational Therapy, with its focus on autism, embarks on this endeavor by highlighting research and theoretical articles that address the various aspects of occupational therapy practice that can help to fully meet the needs of people with ASD and their families.

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2. Tanner K, Hand BN, O’Toole G, Lane AE. Effectiveness of Interventions to Improve Social Participation, Play, Leisure, and Restricted and Repetitive Behaviors in People With Autism Spectrum Disorder : A Systematic Review. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905180010p6905180011-6905180010p6905180012.

People with autism spectrum disorder (ASD) commonly experience difficulties with social participation, play, and leisure along with restricted and repetitive behaviors that can interfere with occupational performance. The objective of this systematic review was to evaluate current evidence for interventions within the occupational therapy scope of practice that address these difficulties. Strong evidence was found that social skills groups, the Picture Exchange Communication System, joint attention interventions, and parent-mediated strategies can improve social participation. The findings were less conclusive for interventions to improve play and leisure performance and to decrease restricted and repetitive behaviors, but several strategies showed promise with moderately strong supporting evidence. Occupational therapists should be guided by evidence when considering interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with ASD. Additional research using more robust scientific methods is needed for many of the currently available strategies.

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3. Weaver LL. Effectiveness of Work, Activities of Daily Living, Education, and Sleep Interventions for People With Autism Spectrum Disorder : A Systematic Review. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905180020p6905180021-6905180020p6905180011.

OBJECTIVE : To examine interventions addressing work, activities of daily living (ADLs), instrumental activities of daily living (IADLs), education, and sleep for people with autism spectrum disorder. METHOD : A total of 23 studies were identified, and 9 work-, 11 ADL/IADL-, and 3 education-related interventions were examined. No sleep studies were identified. RESULTS : Use of mobile and tablet technologies for vocational skills was supported. Support for ADL/IADL intervention is variable, with indications that Cognitive Orientation to Occupational Performance, sensory integration, and contextual interventions may increase occupational performance. Preliminary evidence suggests that daily yoga and brief exercise may improve classroom performance and behavior ; group physical activities may assist with school readiness variables. Evidence for using technologies for IADLs was limited, as was evidence determining effective interventions for feeding and eating issues. CONCLUSIONS : Studies investigating interventions related to sleep are lacking. More studies are needed in all areas, presenting opportunities for the expansion of science-driven occupational therapy practice and research for people with ASD.

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4. Watling R, Hauer S. Effectiveness of Ayres Sensory Integration((R)) and Sensory-Based Interventions for People With Autism Spectrum Disorder : A Systematic Review. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905180030p6905180031-6905180030p6905180012.

This systematic review examines the literature published from January 2006 through April 2013 related to the effectiveness of Ayres Sensory Integration((R)) (ASI) and sensory-based interventions (SBIs) within the scope of occupational therapy for people with autism spectrum disorder to improve performance in daily life activities and occupations. Of the 368 abstracts screened, 23 met the inclusion criteria and were reviewed. Moderate evidence was found to support the use of ASI. The results for sensory-based methods were mixed. Recommendations include performing higher level studies with larger samples, using the Fidelity Measure in studies of ASI, and using carefully operationalized definitions and systematic methods in examination of SBIs.

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5. Kuhaneck HM, Madonna S, Novak A, Pearson E. Effectiveness of Interventions for Children With Autism Spectrum Disorder and Their Parents : A Systematic Review of Family Outcomes. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905180040p6905180041-6905180040p6905180014.

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.

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6. Schaaf RC, Cohn ES, Burke J, Dumont R, Miller A, Mailloux Z. Linking Sensory Factors to Participation : Establishing Intervention Goals With Parents for Children With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185005p6905185001-6905185008.

Parents often focus on independence in activities of daily living and social participation when setting goals for their children with autism spectrum disorders. Occupational therapy practitioners use clinical reasoning to translate these goals to define occupation-based outcomes. This article describes an exploratory analysis of 160 parent-identified goals for children with autism. We identified sensory integrative factors hypothesized to influence each goal and then categorized the goals using the Occupational Therapy Practice Framework : Domain and Process and the International Classification of Functioning, Disability and Health (ICF). Most goals were at the ICF participation and activity levels. Activities of daily living were the most common area of occupation identified, followed by social participation and play. Sensory reactivity and somatopraxis were the most frequently occurring sensory integrative factors. The value of addressing parent goals using a systematic reasoning process to identify factors affecting participation and the importance of measuring participation outcomes are discussed.

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7. Blanche EI, Diaz J, Barretto T, Cermak SA. Caregiving Experiences of Latino Families With Children With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185010p6905185011-6905185010p6905185011.

OBJECTIVE : Prior research has documented caregiving difficulties in families of children with autism spectrum disorder (ASD). However, Latino families may encounter unique challenges. The purpose of this study was to understand the caregiving experiences of Latino families with children with ASD, including daily activities, coping strategies, and service utilization. METHOD : Fifteen Latino parents of children with ASD were interviewed. The interviews were transcribed for analysis to identify themes of experiences unique to this population. RESULTS : Latino families of children with ASD encounter many similar issues as non-Latino families but also unique issues that affect service utilization. Four themes were identified : dealing with the diagnosis, dealing with stigma and isolation from family and community, understanding the role of mothers in changing family routines, and utilizing services. CONCLUSION : To meet the unique needs of Latino families, services need to be provided in culturally sensitive context that address children’s needs within family units.

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8. Santoso TB, Ito Y, Ohshima N, Hidaka M, Bontje P. Resilience in Daily Occupations of Indonesian Mothers of Children With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185020p6905185021-6905185028.

This qualitative study investigated how resilience functions in the context of daily occupations for mothers of children with autism spectrum disorder (ASD). Fourteen mothers of children with ASD participated in two focus groups that were used to elicit stories of the mothers’ resilience in daily occupations. A constant comparative method was used for data analysis. A model of resilience in daily occupations of mothers of children with ASD was developed consisting of four categories : (1) creating and re-creating accepting conditions, (2) finding solutions, (3) striving for balance among daily occupations, and (4) thinking about the child’s future. Sources of resilience were found to reside in both the mothers themselves and their social environments. Occupational therapy practitioners can use these findings in developing supportive approaches aimed at mothers, family members, and other people in the lives of children with ASD.

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9. Swinth Y, Tomlin G, Luthman M. Content Analysis of Qualitative Research on Children and Youth With Autism, 1993-2011 : Considerations for Occupational Therapy Services. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185030p6905185031-6905185039.

OBJECTIVE : Through a content analysis of qualitative research published 1993-2011, we sought to determine how qualitative research can inform clinical reasoning among occupational therapy practitioners to support evidence-based, occupation-focused services for children and youth with autism and their families. METHOD : A qualitative literature search of journals inside and outside occupational therapy, including international journals, yielded 125 articles. We reviewed 110 articles that met inclusion criteria, 79 of which were coded by four occupational therapists with experience working with families with a child or youth with autism. RESULTS : Nineteen content codes were initially derived. Three themes were identified : (1) service challenges for the family, (2) day-to-day experience of autism, and (3) reframing family. CONCLUSION : This content analysis illustrates how qualitative research may help occupational therapy practitioners make comprehensive, occupation-based intervention decisions by considering the lived experience of children and youth with autism and their families.

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10. Tomchek SD, Little LM, Dunn W. Sensory Pattern Contributions to Developmental Performance in Children With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185040p6905185041-6905185040p6905185010.

Sensory processing differences in preschool-age children with autism spectrum disorder (ASD) affect their engagement in everyday activities, thereby influencing opportunities to practice and develop skills such as social communication and adaptive behavior. The purpose of this study was to investigate the extent to which specific sensory processing patterns relate to aspects of development (i.e., adaptive behavior, expressive and receptive language, fine and gross motor skills, social behavior) in a sample of preschool-age children with ASD (N = 400). A retrospective chart review was used to gather clinical data. Results suggest that sensory processing patterns differentially affect children’s developmental skills and adaptive behavior. Certain sensory processing patterns predicted children’s development of language, motor, and adaptive skills. These findings have clear implications for occupational therapy practice with young children with ASD. Practitioners should consider how sensory processing in ASD both supports and limits children’s ability to engage in social communication and learning opportunities.

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11. Bodison SC. Developmental Dyspraxia and the Play Skills of Children With Autism. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185060p6905185061-6905185066.

OBJECTIVE : This study sought to investigate the impact of developmental dyspraxia on the play skills of children with autism spectrum disorder (ASD). METHOD : The praxis abilities of 32 children with ASD (mean age = 7.5 yr) were assessed using two subtests of the Sensory Integration and Praxis Tests and the Planning and Ideas domain of the Sensory Processing Measure Home Form. Play and leisure skills were measured with the Vineland Adaptive Behavior Scales, Second Edition. Utilizing correlation coefficients, we investigated the relationship between developmental dyspraxia and the play skills of children with ASD. RESULTS : Children with ASD demonstrated definite dysfunction in imitative praxis abilities, the generation of ideas, and participation in age-appropriate play and leisure activities. CONCLUSION : Praxis problems in children with ASD greatly affect their successful participation in play and leisure activities.

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12. Heathcock JC, Tanner K, Robson D, Young R, Lane AE. Retrospective Analysis of Motor Development in Infants at High and Low Risk for Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905185070p6905185071-6905185079.

OBJECTIVE : To measure upper-extremity and gross motor skill development in infants with and without risk factors for autism spectrum disorder (ASD). METHOD : Data were coded retrospectively from 39 infants who participated in longitudinal structured early developmental assessments. Twenty-five infants were at high risk for ASD, and the remaining 14 infants were classified as low risk. Upper-extremity and motor skill development were coded at ages 2, 4, and 6 mo. Five infants went on to receive an ASD diagnosis at age 2-4 yr. RESULTS : Infants at high risk for ASD demonstrated fewer midline behaviors with the upper extremities and delayed motor skill development than the low-risk group. Differences in motor skills were most apparent at age 4 mo. CONCLUSION : Early monitoring for motor delay in infants at high risk for ASD is warranted. Midline control and play with the upper extremities and overall motor skill development are possible assessment and therapeutic targets.

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13. Tomlin GS, Swinth Y. Contribution of Qualitative Research to Evidence in Practice for People With Autism Spectrum Disorder. Am J Occup Ther ;2015 (Sep-Oct) ;69(5):6905360010p6905360011-6905360014.

Appraising the best available evidence substantiating and informing occupational therapy practice is a commonly expressed obligation for the profession (American Occupational Therapy Association [AOTA], 2007). In this article we argue for the full inclusion of qualitative research, on parity with quantitative research, as a source for evidence of relevant and effective occupational therapy practice, review the limitations of quantitative research, and outline the distinctive contributions of qualitative studies to the practice of occupational therapy for people with autism spectrum disorder (ASD). In addition, we describe the role of qualitative studies in the fulfillment of the Centennial Vision (AOTA, 2007) and recommend three action steps for the profession.

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