A Mixed Methods Study of Social Participation Patterns and Preferences of Children with Autism

Background:  For all children, engagement in the occupation of social participation at home, in school and in the community is critical to healthy development. For children on the autism spectrum, social participation is especially challenging, due to core deficits in pragmatic language skills and understanding social cues. Social patterns and preferences of children with autism have not been identified, limiting effectiveness of programming and intervention outcomes.

Objectives:  The purpose of this study was to explore social participation patterns and preferences from the perspectives of 8- to 12-year-old children with autism. This knowledge is important, as gaining children’s perspectives provides insight into their values, preferences and motivations related to social participation, which can form the basis of optimal programming.

Methods:  A concurrent triangulation mixed methods approach (Creswell & Plano-Clark, 2007) incorporated descriptive quantitative data and a qualitative case study design. The quantitative phase utilized the Children’s Assessment of Participation and Enjoyment and the Preferences for Activities of Children (King, et al., 2004) to measure social participation patterns and preferences of 32 children with autism. Data were analyzed using descriptive statistics and t-tests. The qualitative phase incorporated interviews, drawings, and observations of social interactions to understand the perceptions of six of these children’s experiences with and preferences for social participation occupations. Transcribed interviews and field notes were coded for emergent themes. A matrix of quantitative and qualitative data within each case facilitated constant comparative analyses across cases.

Results: Children in this study had significantly restricted access to social opportunities, primarily participating in activities with their family members and within the home environment. The children were interested in social activities with peers, despite having difficulty articulating strategies to do so. Their social participation patterns did not match their preferences for social activities. Younger children indicated greater preferences for social activities than did the older children. Girls (n=4) demonstrated different patterns than boys (n=28). Conflict with others, strict rule adherence, and limited opportunities emerged as barriers to social participation. 

Conclusions: This study brings to the fore two important issues. First, giving children a chance to voice their perceptions of social participation promotes a greater understanding of what is meaningful to them and what factors limit their social access. Second, the clearly identified discrepancies between children’s social participation patterns and preferences emphasize the importance of foundational social development during childhood. Findings highlighted the importance of understanding children’s preferences for the number, intensity, and context of social activities to maximize their opportunities for full participation in life.

Creswell, J. W., & Plano Clark, V. L. (2007). Designing and conducting mixed methods research. Thousand Oaks, CA: Sage.

King, G., Law, M., King, S., Hurley, P., Rosenbaum, P., Hanna, S., et al. (2004). Children's Assessment of Participation and Enjoyment & Preferences for Activities of Children. Texas: Harcourt Assessments.