Home and community activities: dimensions and associations with patterns of sensory response among children with autism spectrum disorders

Activity participation is integral to the study of occupational science. Children's participation in activities provides them with learning opportunities that positively impact their development; however, children with autism spectrum disorders (ASD) experience decreased activity participation as compared to children with typical development. Among children with ASD, four sensory response patterns (hyporesponsiveness, hyperresponsiveness, sensory seeking, enhanced perception) characterize the extreme behavioral responses to the sensory elements of activities, which potentially impact the frequency of activity participation. Research has not yet investigated the home and community activities in which children with ASD participate, or examined the differential effects of sensory response patterns on activity participation. The purpose of this study was to empirically derive dimensions of home and community activities that characterized the participation of a large sample of school-aged children with ASD (n=713). This study also examined the link between the sensory response patterns and dimensions of activity participation among children with ASD, as moderated by child characteristics (i.e., chronological age, developmental age, autism severity). In order to derive dimensions of activity participation, exploratory factor analysis was utilized on a measure of children's activity participation, the Home and Community Activities Scale (HCAS; adapted from Dunst, Hamby, Trivette, Raab, & Bruder, 2002). The associations with dimensions of activity participation and children's sensory response patterns, as moderated by child characteristics, were analyzed using mixed model regression. The results suggested that a six factor model characterized the activity participation among school-aged children with ASD, and included: Parent-Child Household Activities; Community Activities; Routine Errands; Neighborhood Social Activities; Outdoor Activities; and Faith-based Activities. Hyperresponsiveness was negatively associated with each dimension of activity participation, while enhanced perception supported participation in each activity dimension. Hyporesponsiveness and sensory seeking differentially impacted activity participation based on children's chronological age. The findings have implications for an occupational science conceptualization of how activities are categorized, as well as demonstrate that the sensory response patterns among children with ASD play a key role in their home and community activity participation. Implications for occupational therapy research and future research directions are discussed