Optimizing participation of children with autism spectrum disorder experiencing sensory challenges: a clinical reasoning framework.
BACKGROUND
Remedial sensory interventions currently lack supportive evidence and can be challenging to implement for families and clinicians. It may be timely to shift the focus to optimizing participation of children with autism spectrum disorders (ASD) through accommodation and self-regulation of their sensory differences.


OBJECTIVE
A framework to guide practitioners in selecting strategies is proposed based on clinical reasoning considerations, including (a) research evidence, (b) client- and family-centredness, (c) practice contexts, (d) occupation-centredness, and (e) risks.


RESULTS
Information-sharing with families and coaching constitute the basis for intervention. Specific strategies are identified where sensory aversions or seeking behaviours, challenges with modulation of arousal, or sensory-related behaviours interfere with participation. Self-regulatory strategies are advocated. The application of universal design principles to shared environments is also recommended.


CONCLUSIONS
The implications of this framework for future research, education, and practice are discussed. The clinical utility of the framework now needs to be tested.
Jill K
JK
Ashburner
Sylvia A
SA
Rodger
Jenny M
JM
Ziviani
Elizabeth A
EA
Hinder
D001521:Behavior Therapy; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000534:rehabilitation*; D003142:Communication; D004777:Environment; D005190:Family; D006266:Health Education / Q000458:organization & administration; D006801:Humans; D009788:Occupational Therapy / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D012678:Sensation Disorders / Q000453:epidemiology* / Q000534:rehabilitation*