Participation Patterns of Israeli Children with and without Autism, and the Impact of Environment

Figures & data

Table 1. Demographic characteristics of the participants.

		Children with ASD		Children without ASD
		n	Mean (SD)	n	Mean (SD)
Child’s age		30	8.95 (1.96)	48	8.61 (2.01)
		n	%	n	%
Child’s sex	Boys	26	86.7	32	66.7
	Girls	4	13.3	16	33.3
ASD support required	Level 1	5	16.7	----	----
	Level 2	18	60.0	----	----
	Level 3	7	23.3	----	----
Child’s difficulties	Attention	11	36.6	2	4.17
	Learning	8	26.6	1	2.0
	Speech and communication	13	43.3	3	6.2
	Motor	6	20	----	----
	sensory	11	36.6	----	----
	Emotional and behavioral	18	60	----	----
	Social	19	63.3	----	----
Parents’ marital status	married	21	70.0	43	89.6
	Divorced/single parents	9	30.0	5	10.4
Family income	Below average	4	13.3	0	0
	Average	14	46.7	25	52.1
	Above average	12	40.0	23	47.9
Father’s education	high school education	2	6.7	2	4.2
	Professional education	6	26.7	1	2.1
	Academic education	22	73.3	45	93.7
Mother’s education	high school education	3	10.0	4	8.3
	Professional education	8	26.7	2	4.2
	Academic education	19	63.3	42	87.5

ASD support required determined by the support needed for functioning and adaptation as reported, according to the definition of the qualified professional based on the DSM-5: Level 1 – “assistance required”, Level 2 – “extensive assistance required”, Level 3 – “very extensive assistance required”; Child’s main difficulties as reported by parents.

Table 2. Comparison of participation patterns (frequency, involvement), desire for change and overall environmental support in the different settings between the two groups.

		Children with ASD (n = 30)	Children without ASD (n = 45–47)
Measure	Setting	Mean (SD)	Mean (SD)	F(1,74)	η²
Frequency (8-point scale)	Home	5.05 (.91)	5.98 (.53)	32.06***	0.30
	School	3.56 (1.32)	4.46 (1.02)	8.80**	0.11
	Community	2.51 (1.16)	3.50 (.89)	17.44***	0.19
Involvement (5-point scale)	Home	3.47 (.58)	4.26 (.34)	53.91***	0.42
	School	3.43 (.79)	4.34 (.59)	33.50***	0.31
	Community	3.38 (.83)	4.20 (.61)	26.39***	0.26
		Percentage (SD)	Percentage (SD)	F(1,75)	η²
Desire for change	Home	82 (17.50)	49.86 (24.90)	37.94***	0.34
	School	75.33 (28.13)	32.41 (31.15)	37.44***	0.33
	Community	64.10 (28.50)	27.87 (23.14)	37.42***	0.33
		Mean (SD)	Mean (SD)	F(1,73)	η²
Overall environmental support	Home	82.41 (11.86)	90.74 (11.98)	8.78**	0.11
	School	80.72 (12.32)	92.81 (9.17)	23.73***	0.25
	Community	78.33 (13.96)	91.35 (11.31)	19.44***	0.21

**p < .01, ***p < .001.

Table 3. Comparison of environmental factors that support or limit participation between the two groups.

		Children with ASD (n = 30)		Children without ASD (n = 46–48)
		Mean (SD)	Median	Mean (SD)	Median	z	η²
Limiting environmental factors	Home	0.13 (0.19)	0.08	0.04 (0.10)	0.00	−2.83*	0.08
	School	0.15 (0.17)	0.11	0.04 (0.08)	0.00	−3.42***	0.13
	Community	0.17 (0.17)	0.12	0.07 (0.13)	0.00	−3.49***	0.14
Supporting environmental factors	Home	0.36 (0.20)	0.33	0.29 (0.19)	0.25	−1.48	0.03
	School	0.40 (0.21)	0.41	0.32 (0.19)	0.35	−1.51	0.03
	Community	0.33 (0.17)	0.25	0.29 (0.21)	0.25	−0.89	0.01

*p < .05, ***p < .001.

Table 4. Percentage of environmental factors reported by parents as supports and inhibits the participation of children with ASD in all settings.

Item	Home (%)		School (%)		Community (%)
	Supports	Inhibits	Supports	Inhibitors	Supports	Inhibitors
Physical layout	13.3	3.3	26.7	0.0	16.7	16.7
Sensory qualities	16.7	10.0	6.7	46.7	6.7	46.7
Physical demands	10	16.7	6.7	26.7	10	23.3
Cognitive demands	10	40.0	13.8	48.3	13.3	33.3
Social demands	16.7	30.0	13.3	23.3	10	36.7
Relationships	46.7	13.3	33.3	13.3	16.7	36.7
Attitudes of others	55.2	3.4	66.7	6.7	40	10.0
Adequate services	40	13.3
Supplies	63.3	6.7	70	6.7	55.2	10.3
Safety			40	3.3	16.7	6.7
Information	44.8	13.8	60	6.7	62.1	6.9
Personal transportation			76.7	6.7	72.4	3.4
Public transportation			26.7	6.7	34.5	0.0
Time	53.3	6.7	70	13.3	57.1	7.1
Money	70	0.0	73.3	3.3	75.9	3.4
School policies and procedures			53.3	16.7
Programs and services			41.4	17.2	41.4	13.8
Weather			6.7	20.0	7.1	10.7

Relationships – Home: Relationships with family members; School and Community: Relationships with peers;

Attitudes – Home: Attitudes of others and professionals; School: Attitudes of educational staff; Community: Attitudes and actions of others.

Table 5. Categories and example of strategies to promote participation of children with ASD by parent’s report.

Category	Explanation	Examples
(a) Planning and maintaining a regular daily schedule	Maintaining a well-known daily schedule of habits and routines, with appropriate preparation for activities, helped promote the children’s home participation	“We maintain regular habits, such as a family dinner every Friday or a shopping list at the supermarket”; “We prepare for school activities so that the child knows in advance what to expect.”
(b) Providing reinforcement and support	Children participated better in activities when they were provided with mediation, guidance, and positive feedback (encouragement and reinforcement of success).	“We give him clear and concise instructions, and reinforce him when he is functioning well and remembering to do things on his own”; “We mediate the incident for our child, and we are with him if he needs us.”
(c) Encouraging activities that include social interactions	Parental initiation and encouragement helped the child to participate in varied activities with others.	“If there is an appropriate activity, we take him along with all his siblings”; “We encourage him to attend classes such as art, basketball, and bicycling along with his peers.”
(d) Adapting the sensory environment.	An appropriate level of sensory stimuli was reported as more inviting to promote child participation	“We walk outside in the evening when the light is not too strong”; “We try to get to school early when it is not yet crowded with children.”
(e) Communication with educators and professionals	Maintaining continuous communication with school staff (educators and professionals), and sharing information, promoted child participation	“I am in contact with the teacher regarding difficulties in the child’s school and providing appropriate support”; “We attend all parent-teacher meetings and other meetings with the educational staff.”

Data availability statement

Not applicable.