Autism spectrum disorders in children--Treatment; Parents of children with disabilities; Children with disabilities--Care--United States; Medical personnel--caregiver relationships; Caregivers--Family relationships--United States


This study had a 3-fold purpose; it attempted to extend Gray’s (2001) study to U.S. occupational therapists by investigating how parental “narratives,” or reactions to having a child with autism spectrum disorder (ASD), influence occupational therapy intervention, to examine which of the six most commonly used therapeutic modes identified by Taylor (2008) are employed by therapists, as well as to identify ways in which parents and therapists contribute to, or interfere with, the parent-therapist relationship. A survey was mailed to 100 currently practicing occupational therapists in the U.S. Twenty-four returned surveys met the inclusion criteria and were used in this study.

Respondents indicated they felt Gray’s assessment of parental “narratives,” or reactions to the diagnosis of ASD were somewhat accurate, and cited denial as the most common parental reaction not mentioned by Gray. Therapists report they are best at employing the therapeutic modes of collaborating and instructing and needed the most improvement on the advocacy mode. Respondents identified collaboration/communication as ways therapists can contribute to parenttherapist relationships, and lack of communication/collaboration as ways they interfere with parent-therapist relationships. They identified collaboration/participation as ways parents can contribute to the parent-therapist relationship, and doubt in occupational therapists/the occupational therapy process as ways they can interfere with the parent-therapist relationship.

Most therapists reported they felt competent in forming a rapport with parents but also indicated their entry-level education did not adequately prepare them to handle this aspect of occupational therapy. There was a statically significant association between the number of years practicing occupational therapy and the perceived competency level in developing rapport with parents of children with an ASD.

First Advisor

Martins Linauts, PT, PhD

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