Abstract
This study describes OT services provided to autistic children in an outpatient medical setting, related to the frequency of visits, level of effort of the child during the visits, time addressing focus areas, and specific intervention types provided.
Primary Author and Speaker: Jamie L. Donovan
Additional Authors and Speakers: Collin Nissen, Rebecca L. Weisshaar
Contributing Authors: Mariann Strenk, Amy F. Bailes
Autism is a neurodevelopmental disorder affecting 1 in 36 children in the US. Occupational therapy (OT) is a key service for autistic individuals. The AOTA care guidelines recommend services to address mental health development, self-determination, self-advocacy, ADLs, IADLs, rest/sleep, work, education, play, leisure, social participation, and health management. There is limited information on what services autistic children are receiving during usual care. The purpose of this retrospective study was to describe autistic children receiving outpatient services and therapy dose (frequency, intensity, time, and type of intervention) delivered at one pediatric hospital. Retrospective data was collected from an electronic medical record where therapists document elements of dose in a standardized flowsheet. Outpatient visits (Frequency) were collated. Therapists documented the child’s level of effort at each session (Intensity), minutes spent (Time) addressing specific focus areas, and specific interventions (Type) from unique categories. Descriptive statistics including frequencies and percentages are reported. From 2022-2023, 1942 children received 19,164 outpatient OT treatment sessions with a mean of 10 (SD 9.7). Mean age was 6.5 years. 73.1% male, 67.8% white; 92.3% non-Hispanic. The median effort was 3, IQR 8.00 (3-13). The greatest amount of minutes were spent in pre-functional (27.2%), play/leisure (25.1%), and social participation (17.0%). The top three intervention types include education/training (96.3%), rehearsal of daily life activities (92.7%), and sensory/perceptual (85.4%). The time spent in these focus areas align with the AOTA guidelines, however more emphasis on mental health development, self-determination, and self-advocacy should be considered. This is the first study that describes OT services for the autistic population using a large sample in an outpatient medical setting. This data can be used to understand current practice and improve care.
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