Grant Baker

Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy

First Advisor

Sarah Nielsen


Autism spectrum disorder (ASD) is a developmental disability that is currently estimated to be diagnosed in 1 in every 59 children (Baio et al., 2018). It has been established that it is important for individuals with a diagnosis of ASD to receive occupational therapy services (McGuire et al., 2015). Due to the high prevalence of an ASD diagnosis and the importance of occupational therapy services for children with this diagnosis there is a need for occupational therapy practitioners in all settings that work with these children to be competent in evidencebased approaches. Currently, students with ASD are receiving occupational therapy services within the school setting with most of these services being provided through a Multi-Tiered System of Support (MTSS; Clark, 2018). Due to these tiers these students are receiving these services both through direct and indirect interventions. This is because school-based occupational therapists are well equipped to offer both direct interventions to students and indirection interventions such as support to teachers working with children with different diagnosis due to their understanding of the factors that inhibit the child from being able to participate in school tasks (Hui et al., 2016). However, there are very few guidelines or resources available for how to best provide interventions across all three tiers of MTSS. Due to the lack of guidelines or resources for providing interventions across all three tiers of MTSS there is a need for how to best implement interventions across all three tiers of MTSS to increase occupational performance for students with a diagnosis of ASD. The purpose of this project is to assist occupational therapy practitioners and school professionals to facilitate

increased occupational performance for children with ASD within the school setting. A literature review was completed and utilized to collaborate with an agency to determine a need to address best practices for the ASD population in schools. The information gathered in the literature review and constructs from the Person Environment Occupation (PEO) model (Law et al., 1996) were utilized in the development of the product. The product consists of 6 tables and 3 case studies as well as a multitude of manualized and originally developed interventions. Table 1 consists of assessments found in the literature that are commonly used for students with ASD and the tier that they are most often implemented at. Table 1 also organizes these assessments by the construct of PEO that they most evaluate. Tables 2, 3, and 4 provide an outline for how to complete an occupational performance evaluation of a student with ASD. Table 5 provides examples of how to utilize information gathered during the occupational performance evaluation and how to translate that into a PEO transaction (Law et al., 1996) and how to use that transaction to select an intervention from Table 6. Although increasing occupational performance for students with ASD within the school setting was the purpose of this product, there were some limitations. The first being the author of this product also has limited clinical experience working with this population, which may impact credibility or the ability for the tables and product to be properly disseminated. This product also only addresses the role of occupational therapy practitioners within the school setting and not the large number of other professionals that work with these same students. Lastly, a limitation of the product is that due to the complex and unique needs of each student with ASD specific interventions were unable to be included. Instead, tips and strategies for a multitude of

interventions and methods of implementing interventions at all three tiers of MTSS were created and provided so that the occupational therapy practitioner can utilize their clinical reasoning to apply those intervention principles to that student’s individual situation. It is hoped that this product can be implemented within the school system to expand the use of evidence-based interventions across all three tiers of MTSS to increase occupational performance for students with ASD.