Factors Impacting Participation in the Sensory Environment for Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) may have difficulty feeling at ease in and engaging with their sensory environment. The combined expression of three closely related features (i.e. constructs of interest, or COIs): 1) sensory hyperresponsiveness, 2) restricted interests and repetitive behaviors, and 3) anxiety, may be a sign that participation is particularly challenging for these individuals. Factors such as the ability to control and predict stimuli, and generate a sense of familiarity in one’s surroundings have been previously identified as important facilitators to engagement. The overall purpose of my dissertation was to more thoroughly investigate relational factors between children with ASD and the sensory environment that impact participation. In accordance with an embodied perspective (Hass, 2008), the three COIs were considered across the dissertation to provide insight into the effects of these factors on participation outcomes. In the first study, an integrated systematic review was conducted to identify current explanations for associations among the three COIs. The second study used a quantitative approach to assess 1) evidence for control-based subcategories of hyperresponsiveness in the tactile domain, 2) differential associations between each subcategory with RRBs and anxiety, and 3) whether the presence of RRBs modulates the association between each control-based subcategory and anxiety. In the third study, a qualitative case study was conducted to explore the experiences of a 5-year-old boy with ASD in three different locations with varying levels of familiarity: at home, at a familiar neighborhood playground, and at an unfamiliar playground. Findings across the three studies identified supports and barriers to participation in the sensory environment for children with ASD, which were then contextualized within broader theoretical concepts in occupational science. Implications for further addressing these supports and barriers in occupational science and occupational therapy were discussed.Doctor of Philosoph