A clinical reasoning framework for children with autism spectrum disorder experiencing sensory challenges

  • The clinical reasoning framework aims to guide practitioners in selecting strategies in approaching sensory challenges in order to optimize participation of children with autism spectrum disorder. Several clinical reasoning considerations are based on this framework, and these include research evidence, client- and family-centeredness, practice contexts, occupation-centeredness, and risks. This framework emphasizes on the use of mutual information-sharing and coaching to empower families or teachers and develop their own solutions to supporting children’s participation. Workable solutions can be then produced because the strategies will be more compatible with the children’s routine and be more readily to be generalized to other situations in daily lives. By using the clinical reasoning framework, the nature of problem is identified in the beginning. For children with sensory seeking behaviors or sensory aversions that interfere with participation, adaptive strategies may be used. For example, using earmuffs to screen out excessive noise. If the modulation of arousal interferes with the children’s capacity, sensory input embedded within daily routines (like calming or alerting sensory input) may be used to modulate arousal (e.g., a movement break to settle a hyperaroused child). If maladaptive challenging behaviors related to sensory processing persist, it may be helpful to adapt behavioral strategies in relation to sensory processing. If the children have the ability to reflect on own responses, self-regulatory strategies should be considered. Universal design principles are the other approaches that can be used simultaneously to support a group of children in shared environment. This universal design approach is to modify the environment in optimizing sensory properties of the shared environments. The ultimate goal of the clinical reasoning framework is to advocate self-regulatory strategies of children with autism spectrum disorder experiencing sensory challenges, with or without universal design principles, in order to optimize their participation in everyday activities.

Summarized by

  • Macey Cho

Type

  • Framework

Population

  • Child

Disability

  • Sensory processing disorder

Domain of occupation

  • Unspecified

Application Note

  • It aims to guide practitioners in selecting strategies for optimizing participation of children with autism spectrum disorder experiencing sensory challenges.

Key Reference

  • Ashburner, J. K., Rodger, S. A., Ziviani, J. M., & Hinder, E. A. (2014). Optimizing participation of children with autism spectrum disorder experiencing sensory challenges: A clinical reasoning framework. Canadian Journal of Occupational Therapy, 81, 29-38.

Year Published

  • 2014

Primary Developer

  • Jill Ashburner

Primary Developer Email

  • jill.ashburner@autismqld.com.au

Related Models

Model of Resilience in Daily Occupations

  • This model focuses on resilience in daily occupations of the mothers of children with autism spectrum disorder, which consists of four categories: (1) creating and re-creating accepting conditions, (2) finding solutions, (3) striving for balance among daily occupations, and (4) thinking about her child’s future. Resilience serves to help the clients in finding solutions to problems and strive for balance among daily occupations. First, creating and re-creating accepting conditions forms a solid base for the client’s resilience in daily occupations.

Partnering for Change Model (P4C)

  • The Partnership for Change (P4C) model emphasizes the therapists’ partnership with the educators and parents to change the life and environment of a child who has motor difficulties (or developmental difficulties). The partnership focuses on the collaboration of building capacities for the teachers and parents in enhancing daily environment for the child. The core activities of occupational therapists under the P4C model are relationship building and knowledge translation with the school and parents. It consists of three steps. The first step is universal design for learning.

Cognitive Strategy Use Framework

  • This framework describes different aspects of cognitive strategy use to support practitioners’ clinical reasoning about clients’ reasoning and successful strategy use. It divides strategy use into four aspects, relevant to the task, each rated by therapists’ observation. The first aspect, prerequisites for effective cognitive strategy use, relevant prior to a task, includes the person’s strategy knowledge, strategy repertoire, strategy beliefs, anticipation and recognition of needs, and strategy generation and selection.

Dunn’s Model of Sensory Processing

  • The Dunn’s Model of Sensory Processing proposes four basic patterns of sensory processing which are emerged from the interaction of the neurological threshold and self-regulation. Neurological threshold is a personal range of threshold for noticing and responding to different sensory events in everyday life. People who have low sensory threshold would notice and respond to stimuli more often because their neurological system activates easier and more readily to sensory events.

Model Type

Population

Disability

Domain of Occupation

  • © 2024 HOTheory - All rights reserved.