Social Participation Patterns and Preferences of Children on the Autism Spectrum

Occupational therapy interventions addressing social participation of children on the autism spectrum often have focused on motor and sensory processing skills without a clear understanding of children’s patterns of or preferences for social participation. The purpose of this study was to explore social participation patterns and preferences from the perspective of 8 to 12 year-old children on the autism spectrum. This knowledge is important, as gaining children’s perspective provides insight into their values, preferences and motivations related to social participation. This study used a concurrent triangulation mixed methods approach incorporating descriptive quantitative data and qualitative case study design. The quantitative phase utilized the Children’s Assessment of Participation and Enjoyment and Preferences for Activities of Children to measure social participation patterns and preferences of 32 children on the autism spectrum. Data were analyzed using descriptive statistics and t-tests. The qualitative phase incorporated interviews, drawings, and observations of social interactions to understand the perceptions of six of these children’s experiences with and their preferences for social participation occupations. Transcribed interviews and field notes were coded for emergent themes. A matrix of quantitative and qualitative data within each case and across cases facilitated constant comparative analyses. The Person-Environment-Occupation-Performance model guided the interpretation of the results. Findings indicated that the children had significantly restricted access to social opportunities, primarily participating in activities with their family members and within the home environment. The children were interested in social activities with peers, despite having difficulty articulating strategies to do so. Their social participation patterns did not match their preferences for social activities. Younger children indicated greater preferences for social activities than did the older children. Conflict with others, the need to follow rules, and limited opportunities emerged as barriers to social participation. This study brings to the fore two important issues. First, giving children a chance to voice their perceptions of social participation promotes a greater understanding of what is meaningful to them and what factors limit their social access. Second, children’s clearly identified discrepancies between social participation patterns and preferences emphasized the importance of foundational social development during childhood. Findings highlighted the importance of understanding children’s preferences for the number, intensity, and context of social activities to maximize their opportunities for full participation in life