EXPLORING EVERYDAY FUNCTIONING AND ENVIRONMENTAL CONTEXTS IN THE DEVELOPMENT OF CHILDREN WITH ASD: A FOCUS ON THE PRESCHOOL YEARS

Abstract

This dissertation explores the functioning and participation of children with autism spectrum disorder (ASD) in their natural environments, with a focus on the preschool years. Chapter 1 provides the context for this dissertation through introducing the theoretical frameworks that were used, exploring function-based measures, and social communication functioning. Chapter 2 is a qualitative evidence synthesis of the literature to identify the cultural factors that are associated with parents’ engagement in their children’s healthcare services. This chapter highlights the challenges that parents of children with ASD faced and the importance of health providers to be culturally competent in family-centered care. Chapter 3 is a descriptive study that aims to explore the participation patterns of preschool children with ASD at home and in the community. The association of environmental factors and social communication abilities on children’s participation are also explored. This chapter emphasizes that children with ASD participated in a variety of activities at home and in the community. It also highlights the importance of supporting parents to engage their children in activities and the need for community to support their participation. Chapter 4 examines the stability of a function-based categorization system – the Autism Classification System of Functioning: Social Communication (ACSF:SC). Children’s social communication abilities were rated using the ACSF:SC at baseline and six months. This chapter indicates that rating of social communication abilities can vary over time. Therefore, frequent assessment using the ACSF:SC is recommended for accurate identification of the child’s current social communication abilities. Chapter 5 discusses the clinical and research implications of this dissertation work. It also discusses knowledge translation opportunities and potential future work.