Autism spectrum disorders in children--Treatment; Parents of children with disabilities; Self-care, Health; Children with disabilities--Care--United States


The purpose of this study was to identify caregiver-implemented modifications of routines and home environments in families of children with an autism spectrum disorder throughout the U.S. that are believed to facilitate the child’s enhanced participation in daily life. A survey was completed by 50 primary caregivers of children with an autism spectrum disorder in the western, northeastern, and southern regions of the U.S addressing the type and frequency of modifications. Routines for dressing (42%), bathing/grooming (52%), and sleep-related activities (86%) were the most commonly reported modifications used sometimes to always within each area of occupation. Other frequently used modifications included (1) using elastic to avoid buttons and zippers (38%), (2) using a particular toothpaste (44%), (3) allowing the child to use a preferred bathroom (26%), (4) allowing the child to eat with hands or preferred utensils (50%), (5) serving only the child’s preferred food (46%), and (6) providing the child with a favorite object during sleep-related activities (59%). Across all examined areas of occupation, sleep-related activities were the most commonly modified sometimes to always (48%). A history of receiving in-home therapy services, including occupational therapy, was associated with a higher frequency of implementing home modifications. In conclusion, the establishment of routines and implementation of environmental modifications may be so frequently used by caregivers because of their impact on the child’s participation in daily activities.

First Advisor

Marge Luthman, MS, OT/L

Second Advisor

George Tomlin, PhD, OTR/L

Date of Completion

Spring 2013

Degree Type







Degree Name

Master of Science in Occupational Therapy (MSOT)

Date of Award



Occupational Therapy


University of Puget Sound