THE PARTICIPATION OF HOME AND COMMUNITY SETTINGS AND PREDICTION FOR FUTURE PARTICIPATION IN TAIWANESE CHILDREN WITH AUTISM SPECTRUM DISORDER

C.-Y. Lin^1,2, H.-F. Liao³, T.-H. Liou⁴, C.-F. Yen⁵, L.-J. Kang⁶, Y.-T. Wu¹

¹National Taiwan University, School and Graduate Institute of Physical Therapy, Taipei, Taiwan, ²Shin Kong Wu Ho-Su Memorial Hospital, Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Taipei, Taiwan, ³Taiwan Society of International Classification of Functioning, Disability and Health (TSICF), Taipei, Taiwan, ⁴Taipei Medical University - Shuang Ho Hospital, Ministry of Health and Welfare, Taipei, Taiwan, ⁵Tzu-Chi University, Department of Public Health, Hualien, Taiwan, ⁶Chang Gung University, Graduate Institute of Early Intervention, Taoyuan, Taiwan

Background: Autism spectrum disorder (ASD) is a communication and interaction disorder that causes individuals to have limited, repetitive interests and experience difficulties when participating in activities. Research has shown that children with ASD participate less in family and community activities, and less than 30% of those with ASD develop work experience during adulthood. Nevertheless, few studies have explored the participation patterns of children with ASD in family and community activities and followed up on their participation in the long term.

Purpose: We investigated the participation patterns of Taiwanese children with ASD (aged 6–17 years) in family and community activities; analyzed the correlation between the participation level of adolescents with ASD (aged 13–17 years) and their social adaptation during young adulthood (18–25 years); and explored whether the participation patterns in adolescence can predict the level of difficulty in participation during adulthood.

Methods: The study data comprised the responses of 8,793 children with ASD to the Functioning Disability Evaluation Scale – Child Version (FUNDES-Child) collected in 2012–2021. The data encompassed the frequency of children’s participation in family, school and community activities in relation to four domains (i.e., Daily living, Mobility, Learning, and Community) and children’s level of independence regarding two domains of participation (i.e., Daily living and Social participation). Among the participants, 678 adolescents with ASD aged 13–17 years received the FUNDES-Adult assessment when they entered adulthood. We performed Pearson’s correlation analysis to estimate the correlations between the participants’ participation scores during adolescence and adulthood and employed multinominal logistic regression to predict the level of difficulty in activity participation during adulthood.

Results: Among the four domains of participation frequency, children with ASD scored the highest in the Community participation, followed by the Daily living, Learning, and Mobility. In other words, the children participated the least frequently in community activities. For participation independence, the children showed less independent in Social participation than in Daily living participation, implying that children with ASD need more supports in social activities. The participants’ total scores for participation frequency (r = .62–.64, p < .0001) and participation independence (r = .54–.55, p <.0001) in their adolescence were moderately correlated with participation scores in their adulthood. Furthermore, with each 1-point increase in the total score for participation frequency or independence, the odds ratio between a medium or high level of participation difficulty and a normal or low level of participation difficulty increased by 1.03–1.08 times (all p < .0001).

Conclusions: The long-term data revealed that the participation patterns of adolescents had moderate and positive correlations with those of adults, and the extent to which adolescents’ participation level was limited could predict the level of participation difficulty during their adulthood.

Implications: The data retrieved are highly representative of the participation patterns of Taiwanese children with ASD. The results can inform caregivers and medical or educational professionals of the need to increase opportunities for children with ASD to participate in community activities and the need to promote children’s social participation.

Funding acknowledgements: This study was unfunded.

Keywords:
Autism Spectrum Disorder
Participation
FUNDES-Child

Topics:
Paediatrics
Disability & rehabilitation
Globalisation: health systems, policies & strategies

Did this work require ethics approval? Yes

Institution: Taipei Medical University - Shuang Ho Hospital

Committee: Research Ethics Committee

Ethics number: N202107095