Participation of children and adolescents with autism spectrum disorder at home, at school, and in the community settings

Abstract

Introduction: Participation is essential for development and health, but evidence shows that children and adolescents with autism spectrum disorder (ASD) participate less in everyday activities than their typically developing peers and are more strongly influenced by environmental factors. In Spain, evidence specifically addressing participation among children and adolescents with ASD is very limited. Objectives: To describe participation at home, at school, and in the community and identify the environmental factors that facilitate or hinder such participation among Spanish children and adolescents with ASD. Methods: A cross-sectional study based on the completion of a sociodemographic questionnaire, the Child and Adolescent Scale of Environment (CASE), and the Child and Adolescent Scale of Participation (CASP). Primary caregivers of Spanish children and adolescents with ASD who were aged 8–17 years and resided in Spain were recruited. A descriptive analysis was conducted. Results: The sample included 46 children and adolescents (84.8% male; median age = 10.5 years). The scores obtained were as follows: total CASP, Mdn = 67.50 (IQR = 58.44–78.29); subsections: Home, Mdn = 79.17 (IQR = 66.66–87.50), School, Mdn = 75.00 (IQR = 65.00–85.00), and Neighborhood and Community, Mdn = 56.25 (IQR = 39.58–75.00); total CASE, Mdn = 50.00 (IQR = 42.00– 61.50). Conclusion: According to parent reports, participation among children and adolescents with ASD was highest at home, followed by school and the community. Family and school support facilitated participation, whereas the limited availability of public services and resources, societal attitudes, and the cognitive, sensory, and physical demands of the environment constituted barriers.