Emerging as Leaders in Autism Research and Practice: Using the Data-Driven Intervention Process

Abstract

Erna Imperatore Blanche, PhD, OTR/L, FAOTA, is Associate Professor of Clinical Practice, Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles. I t is an honor to serve as guest editors for this special issue of the American Journal of Occupational Therapy (AJOT) on autism. Autism is one of the most prevalent developmental disorders, affecting 1 in 110 children (Centers for Disease Control and Prevention, 2010) and having an estimated annual cost of care nearing $90 billion (Jarbrink & Knapp, 2001), yet its causes are not well understood, and no scientifically recognized cure or prevention is available. Occupational therapists have been widely recognized as playing a pivotal role in the treatment of people with autism spectrum disorders (ASD) since autism was first described by Leo Kanner in 1943. This special issue spotlights occupational therapy’s central position in the scientific dialogue on autism. A review of AJOT articles that have addressed autism provides a perspective on the role of occupational therapy in autism. Early on, occupational therapy interventions often addressed stereotypic behaviors and facilitated independence in activities of daily living. In the 1970s, A. Jean Ayres revolutionized occupational therapy intervention practices for people with ASDs with the Theory of Sensory Integration (Ayres, 1972). She was pivotal in shifting the focus of occupational therapy intervention to include consideration of the neurobiological substrates of successful participation in life activities. This approach became one of the most used approaches by occupational therapists working with people with ASD (MillerKuhaneck & Watling, 2010), and it is one of the top three interventions requested by parents of children with ASD (GoinKochel, Mackintosh, & Myers, 2007; Green et al., 2006; Mandell, Novak, & Levy, 2005). A review of articles published in AJOT between 1980 and 2010 revealed that of the 22 articles that used autism as a key word, 13 addressed sensory processing, sensory integration, or both. Today, occupational therapy services are a valued component of the health and educational care of people with ASD. Occupational therapy brings expertise in the facilitation of successful participation in daily life across the lifespan. Occupational therapists’ ability to analyze activities and craft individually tailored interventions based on person and environmental factors is unparalleled. We must continue to clearly articulate this unique expertise, use it systematically, and evaluate its impact on participation and quality of life of people with ASD and their families.