The purpose of occupational therapy is to enable individuals to achieve health, well-being, and participation in life through engagement in occupation, as described in the Occupational Therapy Practice Framework (AOTA, 2014). To achieve this objective, occupational therapy practitioners may address client factors, such as higher-level mental processes, and performance skills, including a client’s ability to “modify performance when problems are encountered” (p. S25). Often children and teens with autism struggle with the executive function (EF) skill of cognitive flexibility, which may negatively impact their ability to cope when they face unexpected change (Strang et al., 2017). In turn, their occupational performance suffers in areas of academics, social interactions, and activities of daily living (Panerai et al., 2014). In pediatric occupational therapy practice, treatment of EF has been identified as an area of intervention which needs further attention and development (Case-Smith et al., 2015; Cramm et al., 2013). Yet, studies across many disciplines reflected that occupational therapy practitioners (OTs) are not typically identified as either practitioners or researchers in addressing cognitive flexibility skills acquisition among children and teens with autism. Investigators reported that pediatric OTs express both a lack of knowledge and a lack of confidence in treating EF skills, which they explain stems from limited formal education in this subject area, lack of professional development coursework, and availability of few EF treatment tools. This reveals a documented gap in knowledge and service provision within occupational therapy practice.
In this doctoral project, three literature searches were completed. Results obtained supported (a) an increased prevalence of cognitive flexibility difficulties among children and teens with autism, (b) a negative impact of cognitive flexibility limitations on the occupational performance of individuals with autism, and (c) evidence that select meaningful therapeutic approaches work to improve cognitive flexibility among children and teens with autism. Through this doctoral work, the Helping Kids Master Surprise program was developed for OTs to promote cognitive flexibility skills in children and teens with autism, to improve clients’ occupational performance, and to increase clinician knowledge and confidence in addressing EF deficits.
Emphasized in the Helping Kids Master Surprise program is an underlying respect for children and teens with autism, acknowledging that this diagnosis reflects neurologically-based differences in information processing and that these individuals typically have average to above average intelligence. With this consideration in mind, and in keeping with the Occupational Therapy Code of Ethics (2015), all elements of Helping Kids Master Surprise have been developed to be child- or teen-centered, to be non-triggering of anxiety, and to promote the joyful engagement of participants.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/41429 |
| Date | 26 September 2020 |
| Creators | Marnell, Lisa |
| Contributors | Slater, Craig |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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