Occupational therapy services for children with Autism Spectrum Disorder on the primary healthcare platform

Authors

DOI:

https://doi.org/10.17159/2310-3833/2023/vol53n2a3

Keywords:

Early identification of Autism Spectrum Disorder, Early career occupational therapists, Community context, Clinical competencies, Community based occupational therapy, Critical knowledge

Abstract

INTRODUCTION: The diagnosis of Autism Spectrum Disorder (ASD) is complex. In a low middle income country, like South Africa, early recognition of ASD rarely occurs on the primary health care (PHC) platform.To mitigate late diagnosis of ASD, which has a poorer prognosis, the purpose of this study was to identify the knowledge and clinical competencies required by inexperienced occupational therapists to improve early detection of and service delivery for children with ASD at the PHC level METHODS: A descriptive qualitative design explored the perceptions of occupational therapy experts as to the required knowledge and clinical competencies necessary for inexperienced occupational therapists to deliver services to children with ASD on the PHC platform. Thematic inductive analysis was used to analyse the data FINDINGS: Two themes emerged: Theme one: the perceived critical knowledge for early identification, assessment and treatment of children with ASD.Theme two: the clinical competencies required forassessment and effective treatment of children with ASD on the PHC level CONCLUSION: This study identified the perceived knowledge and clinical competencies needed to improve early identification and service community-based delivery for children with ASD on the PHC platform by early career occupational therapists IMPLICATIONS FOR PRACTICE ■ This study provides critical knowledge and clinical competencies to occupational therapists to facilitate effective therapeutic services to children with ASD on the PHC platform. ■ The study identified appropriate screening, assessment and intervention that could assist occupational therapy service planners to reduce the gap of service delivery for children with ASD within the concept of UHC provision on a community-based level in SA. ■ Faculty at tertiary educational institutions may utilise the findings in order to adapt curriculums to better prepare inexperienced occupational therapists with working with children with ASD on the community-based level.

Downloads

Download data is not yet available.

References

Department of Health. General Household Survey. 2020 https://www.statssa.gov.za/publications/P0318/P03182020.pdf

Department of Health. National Health Act Guide. 2019. https://section27.org.za/wp-content/uploads/2019/07/Stevenson-National-Health-Act-Guide-2019-1.pdf

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publications; 2013.

Newschaffer CJ, Croen LA, Daniels J, Giarelli E, Grether JK, Levy SE, Mandell DS, Miller LA, Pinto-Martin J, Reaven J, et al. The epidemiology of autism spectrum disorders. Annual Review of Public Health. 2007;28:235-258. doi: https://doi.org/10.1146/annurev.oublhealth.28.021406.144007

Pang YL, Lee CM, Wright M, Shen J, Shen B, Bo J. Challenges of case identification and diagnosis of Autism Spectrum Disorders in China: A critical review of procedures, assessment, and diagnostic criteria. Research in Autism Spectrum Disorders. 2018;53(May):53-66. doi:https://doi.org/10.1016/j.rasd.2018.06.003

Ruparelia K, Abu ba kar A, Badoe E, Bakare M, Visser Κ, Chugani DC, Chugani HT, Donald KA, Wilmshurst JM, Shih A, et al. Autism Spectrum Disorders in Africa: Current Challenges in Identification, Assessment, and Treatment. Journal of Child Neurology. 2016;31(8):1018-1026. doi: https://doi.org/10.1177/0883073816635748

National Department of Health. Framework and Strategy for Disability and Rehabilitation Services in South Africa 2015-2020. 2015:3-25. https://www.google.com/search?client=firefox-b-d&q=ramework+and+Strategy+for+Disability+and+Rehabilitation+Services+in+South+Africa

Grinker RR, Chambers N, Njongwe N, Lagman AE, Guthrie W, Stronach S, Richard BO, Kauchali S, Killian B, Chhagan M, et al. "Communities" in Community Engagement: Lessons Learned From Autism Research in South Korea and South Africa. Autism Research. 2012;5(3):201-210. doi: https://doi.org/10.1002/aur.1229

Chiri G, Warfield ME. Unmet need and problems accessing core health care services for children with autism spectrum disorder. Maternal and Child Health Journal. 2012;16(5):1081-1091. doi: https://doi.org/10.1007/sl0995-011-0833-6

DeLany J. Scope of Occupational Therapy Services for Individuals With Autism Spectrum Disorder Across the Life Course. The American Journal of Occupational Therapy. 2015;69(Supplement_3):6913410054pl-6913410054pl2. doi: https://doi.org/10.5014/ajot.2015.696sl8

Mubashir S, Farrugia M, Coretti L, Pessia M, D'adamo MC. Autism spectrum disorder. Malta Medical Journal. 2020;32(3):56-66. doi: https://doi.org/10.3329/jbcps.v28i3.6506

van Stormbroek K, Buchanan H. Community Service Occupational Therapists: thriving or just surviving? South African Journal of Occupational Therapy. 2016;46(3):63-72. doi: https://doi.org/10.17159/23103833/2016/v46n3a11

Ametepee LK, Chitiyo M. What We Know about Autism in Africa: A Brief Research Synthesis. Journal of the International Association of Special Education. 2009;10(1):11-13. http://search.proquest.com/docview/618677327accountid=12347%5Cnhttp:/sfx.scholarsportal.info/mcmaster?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&genre=article&sid=ProQ:ProQ:ericshell&atitle=What+We+Know+about+Autism+in+Africa:+A+Brief+

Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M. Global prevalence of autism: A systematic review update. Autism Research. 2022. doi: https://doi.org/10.1002/aur.2696

Baxter AJ, BrughaTS, Erskine HE.Scheurer RW, Vos T, Scott JG. The epidemiology and global burden of autism spectrum disorders. Psychological Medicine. 2015;45(3):601-613. doi: https://doi.org/10.1017/S003329171400172X

World Health Organization. World Report on Disability. Geneva: WHO Press; 2011. https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/world-report-on-disability

De Vries PJ. Thinking globally to meet local needs: Autism spectrum disorders in Africa and other low-resource environments. Current Opinion in Neurology. 2016;29(2):130-136. doi: https://doi.org/10.1097/WCO.0000000000000297

Autism South Africa. Autism South Africa. 2014. https://aut2know.co.za/

World Health Organization. Autism. Sixty-Seventh World health Assembly. Agenda item 12.3.2014. https://apps.who.int/gb/ebwha/pdf_files/WHA67-RECVA67_2014_RECl-en.pdf

Atun-Einy O, Ben-Sasson A. Pediatric allied healthcare professionals' knowledge and self-efficacy regarding ASD. Research in Autism Spectrum Disorders. 2018;47(June 2017):1-13. doi: https://doi.org/10.1016/j.rasd.2017.12.001

Moosa AI. Exploring Occupational Therapy Intervention for Young Children with Autism Spectrum Disorder in South Africa. 2013. https://researchspace.ukzn.ac.za/handle/10413/12080

Rutherford M, McKenzie Κ, McClure I, Forsyth K, O'Hare A, McCartney D, Finlayson I. A national study to investigate the clinical use of standardised instruments in autism spectrum disorder assessment of children and adults in Scotland. Research in Autism Spectrum Disorders. 2016;29-30:93-100. doi: https://doi.org/10.1016/j.rasd.2016.05.003

TheAmerican Occupational Therapy Association. Occupational therapy practice framework: Domain & process fourth edition. American Occupational Therapy Association Bethesda; 2020.

Durkin MS, Elsabbagh M, Barbara J, Gladstone M, Happe F, Hoekstra RA, Lee LC, Rattazzi A, Sta pel-Wax J, Stone WL, et al. Autism screening and diagnosis in low resource settings: Challenges and opportunities to enhance research and services worldwide. Autism Research. 2015;8(5):473-476. doi: https://doi.org/10.1002/aur.l575

Kadar M, Mcdonald R, Lentin P. Evidence-based practice in occupational therapy services for children with autism spectrum disorders in Victoria, Australia. Australian Occupational Therapy Journal. 2012;59(4):284-293. doi: https://doi.org/10.1111/j.l440-1630.2012.01015.x

Chambers NJ, Wetherby AM, Stronach ST, Njongwe N, Kauchali S, Grinker RR. Early detection of autism spectrum disorder in young isiZulu-speaking children in South Africa. Autism. 2017;21(5):518-526. doi: https://doi.org/10.1177/1362361316651196

Sulek R,Trembath D, Paynter J, Keen D, Simpson K. Inconsistent staffing and its impact on service delivery in ASD early-intervention. Research in Developmental Disabilities. 2017;63:18-27. doi: https://doi.org/10.1016/j.ridd.2017.02.007

Jejelaye A, Maseko L, Franzsen D. Occupational therapy services and perception of integration of these at primary healthcare level in South Africa. South African Journal of Occupational Therapy. 2019 Dec;49(3):46-53.

Schreibman L, Dawson G, Stahmer AC, Landa R, Rogers SJ, McGee GG, Kasari C, Ingersoll Β, Kaiser AP, Bruinsma Y, et al. Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2015;45(8):2411-2428. doi: https://doi.org/10.1007/sl0803-015-2407-8

Landa RJ. Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders. International Review of Psychiatry. 2018;30(1):25-39. doi: https://doi.org/10.1080/09540261.2018.1432574

vinen Z, Clark M, Paynter J, Dissanayake C. School Age Outcomes of Children with Autism Spectrum Disorder Who Received Community-Based Early Interventions. Journal of Autism and Developmental Disorders. 2018;48(5):1673-1683. doi: https://doi.org/10.1007/sl0803-017-3414-8

Franz L, Adewumi K, Chambers N, viljoen M, Baumgartner JN, de Vries PJ. Providing early detection and early intervention for autism spectrum disorder in South Africa: stakeholder perspectives from the Western Cape province. Journal of Child and Adolescent Mental Health. 2018;30(3):149-165. doi: https://doi.org/10.2989/17280583.2018.1525386

EstesA.Swain DM.MacDuffie KE. The effects of early autism intervention on parents and family adaptive functioning. Pediatric Medicine. 2019;2(April):21-21. doi:https://doi.org/10.21037/pm.2019.05.05

AshburnerJ, Rodger S, Ziviani J, Jones J. Occupational therapy services for people with autism spectrum disorders: current state of play, use of evidence and future learning priorities. Australian occupational therapy journal. 2014;61(2):110-120. doi: https://doi.org/10.1111/1440-1630.12083

Thompson-Hodgetts S, Magill-Evans J. Sensory-based approaches in intervention forchildren with autism spectrum disorder: Influences on occupational therapists' recommendations and perceived benefits. American Journal of Occupational Therapy. 2018;72(3). doi: https://doi.org/10.5014/ajot.2018.024729

James LW, Pizur-Barnekow KA, Schefkind S. Online survey examining practitioners perceived preparedness in the early identification of autism. American Journal of Occupational Therapy. 2014;68(l):el3-e20. doi: https://doi.org/10.5014/ajot.2014.009027

Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies: Guided by Information Power. Qualitative Health Research. 2016;26(13):1753-1760. doi: https://doi.org/10.1177/1049732315617444

South African Government. Regulations and Guidelines -Coronavirus COVID-19 | South African Government. 2020.

Moser A, Korstjens I. Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis. European Journal of General Practice. 2018;24(1):9-18. doi: https://doi.org/10.1080/13814788.2017.1375091

Lowe A, Norris AC, Farris AJ, Babbage DR. Quantifying Thematic Saturation in Qualitative Data Analysis. Field Methods. 2018;30(3):191-207. doi: https://doi.org/10.1177/1525822X17749386

Babbie J, Mouton E.The practice of social research. Cape Town:.: Oxford University Press Southern Africa; 2001.

Traboulsi El, Maurhenee IH. Ophthalmologic findings in mucolipidosis III (pseudo-hurler polydystrophy). 1986. doi: https://doi.org/10.1016/0002-9394(86)90529-5

The Makaton Charity. Makaton. 2022. https://makaton.org/

Bondy AS, Frost LA. The Picture Exchange Communication System. Focus on Autism and Other Developmental Disabilities. 1994;9(3):1-19. doi: https://doi.org/10.1177/108835769400900301

Greenspan SI, Wieder S. The developmental individual-difference, relationship-based (DIR/Floortime) model approach to autism spectrum disorders. Clinical manual for the treatment of autism. 2007:179-209.

Frick S, Hacker C. Listening with the whole body: Clinical concepts and treatment guidelines for Therapeutic Listening. Madison: Vital Links; 2001.

Robins DL, Fein D, Barton M. Modified Checklist for Autism in Toddlers, Revised , with Follow-Up ( M-CHAT-R /F)TM.2009. https://drexel.edu/-/media/Files/autismlnstitute/EDI/M-CHAT-R_F.ashx

Schopler E, Van Bourgondien, ME Wellman G, Love S. Childhood Autism Rating Scale 2. Western Psychological Services. 2010. https://www.carautismroadmap.org/childhood-autism-rating-scale/

Rosenbaum Μ, Gabrielsen TP. Decision factors for community providers when referring very young children for autism evaluation. Research in Autism Spectrum Disorders. 2019;57(March 2018):87-96. doi: https://doi.org/10.1016/j.rasd.2018.09.009

Kaur Μ, M. Srinivasan S, N. Bhat A. Comparing motor performance, praxis, coordination, and interpersonal synchrony between children with and without Autism Spectrum Disorder (ASD). Research in Developmental Disabilities. 2018;72:79-95. doi: https://doi.org/10.1016/j.ridd.2017.10.025

Wallace K, Franzsen D, Potterton J. Development of an Occupational Performance Questionnaire for preschool children with Autistic Spectrum Disorder. South African Journal of Occupational Therapy. 2016;46(2):23-30. doi: https://doi.org/10.17159/2310-3833/2016/v46n2a5

Lord C, Luyster R, Gotham K, Guthrie W. Autism Diagnostic Observation Schedule. Torrance: Western Psychological Services; 2012. doi: https://doi.org/10.1007/springerreference_184220

Robins D. MCHATTranslations. 2022. https://mchatscreen.com/mchat-rf/translations/

Naidoo D,Van WykJJoubert RWE. Exploring the occupational therapist's role in primary health care: Listening to voices of stakeholders. African journal of primary health care & family medicine. 2016;8(1):e1-e9. doi: https://doi.org/10.4102/phcfm.v8i1.1139

Salomone E, Beranová S, Bonnet-Brilhault F, Briciet Lauritsen M, Budisteanu M, Buitelaar J, Canal-Bedia R, Felhosi G, Fletcher-Watson S, Freitag C, et al. Use of early intervention for young children with autism spectrum disorder across Europe. Autism. 2016;20(2):233-249. doi: https://doi.org/10.1177/1362361315577218

Patriquin M, MacKenzie D, Versnel J. Occupational Therapy Interventions for Restricted and Repetitive Behaviors in Children with Autism Spectrum Disorder. Occupational Therapy in Mental Health. 2020;36(1):85-104. doi: https://doi.org/10.1080/0164212X.2019.1662361

Nielsen SK, Hektner JM. Understanding the psychosocial knowledge and attitudes of school-based occupational therapists. Journal of Occupational Therapy, Schools, and Early Intervention. 2014;7(2):136-150. doi: https://doi.org/10.1080/19411243.2014.930615

Akhter N, Mumtaz N, Saqulain G. Autism cognizance: A dilemma among medical and allied medical practitioners. Pakistan Journal of Medical Sciences. 2020;36(4):678-682. doi:https://doi.org/10.12669/pjms.36.4.1703

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. American Journal of Occupational Therapy. 2015;69(5). doi: https://doi.org/10.5014/ajot.2015.017806

Martinez-Pedraza F de L, Carter AS. Autism Spectrum Disorders in Young Children. Child and Adolescent Psychiatric Clinics of North America. 2009;18(3):645-663. doi:https://doi.org/10.1016/j.chc.2009.02.002

Juraszek, K., Kalisz,Z., Maszudzinska, Α., Kucharczuk, M. and Kalisz, J. 2019. Healthcare professionals knowledge of autism spectrum disorders. Journal of Education, Health and Sport, 9(8), pp.103-120 doi: http://dx.doi.org/10.5281/zenodo.3371694

Health Professions council of South Africa. The minimum Standards for the Training of occupational therapists. 2020

Downloads

Published

22-08-2023

Issue

Section

Research Articles

How to Cite

Occupational therapy services for children with Autism Spectrum Disorder on the primary healthcare platform. (2023). South African Journal of Occupational Therapy, 53(2), 18-31. https://doi.org/10.17159/2310-3833/2023/vol53n2a3
Views
  • Abstract 173
  • PDF 183