Current Practices of OT for Children With Autism Spectrum Disorder in Jordan

PURPOSE: Although several worldwide studies have been done on practices of occupational therapy with children with ASD, such studies have not been conducted in Jordan. The study of such practices should have a pronounced impact on monitoring outcomes for intervention, conducting comparative intervention studies, and identifying areas of professional development and continuing education. In addition, the results of this study should reflect on the extent of evidence-based practices which in return would have an impact on occupational therapy universities curricula. Thus the current study aimed at describing current practices with identifying assessment and intervention methods, as well as identifying continuing education needs for occupational therapists in Jordan working with children with autism

METHODS: This was a survey-based study with a self-administered questionnaire. The questionnaire was adapted from two other questionnaires; the one used by Walting et al. (1999) in the United States and the one used by Kader et al. (2012 & 2015) in Australia and Malaysia, respectively. Permission to use was granted by both authors. Questionnaires were selected for guidance and considerable modifications were required to match the most recent occupational therapist framework, include more current assessment tools and intervention techniques, and ensure cultural validity. Five Jordanian occupational therapist with working experience of over 10 years with children with ASD reviewed the questionnaire for face and content validity.

The respondents to this survey were qualified occupational therapist currently working in centers/hospitals/schools/institutions or as a freelance with children with ASD for at least 6 months. The age of children with ASD served should be up to 18 years.

Questionnaire were distributed in sealed envelopes and respondents had a week to fill it. All surveys were then returned in sealed envelopes ensuring confidentiality of data. There were no personal identifiers in the survey itself. Data was entered in SPSS 18 and descriptive analyses of counts, frequencies, and percentages were calculated.

RESULTS: Forty two therapists returned the questionnaire. Almost all the respondents had a bachelor degree in occupational therapy. More than half of them worked in special education/developmental center and had at least 1-2 years of working experience with children with ASD. High percentage of respondents reported interviewing parents/caregivers for evaluation purposes, and the evaluation focused on school readiness, motor, process, and sensory processing skills. Non-standardized assessments seem to be more utilized compared to standardized assessments. Interventions were mainly on 1:1 basis mostly focusing on school readiness, motor, process, and sensory processing skills. Major reason for discharge was exhausted funds. Almost all therapists indicated the need for continuing education with hands-on mentoring by expert therapists being the most preferred learning method.

CONCLUSION: Results of the study were partially consistent with previous research in terms of setting, evaluation and intervention focus, as well as continuing education delivery method. The results have highlighted many issues that needs to be emphasized and addressed including best practices in evaluation (i.e. parent involvement) and intervention (i.e. understanding and implementing sensory integration intervention process). The study highlighted underutilization of several approaches and strategies that have some evidence to support children with ASD occupational performance. Although this study is limited by the low number of respondents, it sheds the light on the importance of modifying curricula and increasing knowledge regarding best practices.

References

Watling, R., Deitz, J., Kanny, E. M., & McLaughlin, J. F. (1999). Current practice of occupational therapy for children with autism. The American Journal of Occupational Therapy, 53(5), 498-505

Kadar, M., McDonald, R., & Lentin, P. (2012). Evidence-based practice in occupational therapy services for children with autism spectrum disorders in Victoria, Australia. Australian Occupational Therapy Journal, 59(4), 284-293.

Kadar, M., McDonald, R., & Lentin, P. (2015). Malaysian occupational therapists’ practices with children and adolescents with autism spectrum disorder. British Journal of Occupational Therapy, 78(1), 33-41.