Occupational performance of children with autistic spectrum disorder in Malaysia : review of practice, parents' perspective and goals
thesisposted on 01.03.2017, 00:32 by Kadar, Masne
The ability of children with Autistic Spectrum Disorder (ASD) to achieve independence in their daily living activities may be affected by the characteristics of their underlying condition. The main characteristics of children diagnosed with ASD include impairments in communication, socialisation and behaviour. These impairments are likely to hinder children’s ability to learn and experience life like their typically developing peers. Often, enabling their participation in daily life requires extra support and guidance for successful integration into school and family routines, as well as being active participants in community life. The issues and impairments that children with ASD have are life long, and, consequently, children with ASD and their family members need support throughout their whole life. Occupational therapy is one of the healthcare professions involved in providing services to these children and their family members. Services for children with ASD in Malaysia are developing, but are much less advanced than in Western countries. This thesis (a) explored how occupational therapy services were provided in Malaysia, (b) compared these to services in Victoria (Australia) given the considerable differences in socioeconomic, cultural, educational and healthcare systems in both regions, and (c) evaluated whether services that children received in Malaysia met the identified needs and goals of parents of children with ASD. Points (a) and (b) were addressed in phase one of the research, through a descriptive survey design study. Point (c) was addressed in a cross-sectional mixed methods study, using standardised assessments and qualitative interviews of the parents of children with ASD. In the first phase of the study, occupational therapy participants from Malaysia and Victoria (Australia) were recruited through their respective professional organisation and were send a questionnaire regarding the services they provided for children with ASD. The questionnaire was developed to gain information regarding the frames of reference, models of practice, assessments and interventions provided, trainings and professional development needed in the occupational therapy services for children with ASD. In phase two of the study, parents of children with ASD were asked about their child’s abilities in managing daily living activities through a mix-methods survey. It was found that occupational therapy services in both regions were similar in terms of the focus given in the aspects of assessments and interventions used and professional development needed. The services provided and continuing professional development that the practitioners felt they needed tended to focus on managing sensory issues in children with ASD and less on the functional aspects of daily occupation. In summary, this research provided preliminary information regarding the occupational therapy services provided for children with ASD in Malaysia. The occupational therapy services for children with ASD in Malaysia was found to be closely similar to the services offered by the occupational therapists in Victoria (Australia). In the second phase of the research, it was found that there were disparities between the occupational therapy services provided and the parents’ priorities for their children with ASD. In order for occupational therapy services to be relevant, they should be tailored to meet the needs of the clients and culturally valid for the population receiving the service. The utilization of the gold standard standardized assessment of the Vineland-II was able to identify the areas that needed attention in the studied domains of communication, socialisation and daily living skills. This gold standard assessment paired with the client- and occupational-centred assessment tool, the COPM, facilitated the creation of a more accurate and detailed problem list to guide the occupational therapy goals and intervention planning according to the specific and unique needs of the children with ASD and their families.