The Leisure Participation Profiles of Australian Adolescents with ASD: The Interest-Participation Gap

Background: Adolescence is characterized as a time of social development during which peers become increasingly important. Adolescents typically spend a large proportion of their time engaging in various leisure pursuits important to their development, health and well-being. While previous research has examined differences in the participation of adolescents with Autism spectrum disorder (ASD) and their peers in leisure activities, little in known in regard their levels of interest in various leisure pursuits, nor if there is an interest participation ‘gap’.

Objectives: To describe the interest and participation profiles of Australian adolescents with ASD in leisure activities and compare these profiles with those of their neurotypical peers.

Methods: A modified version of the Pediatric Interest Profiles (PIP) (Henry, 2000) captured the interest and participation profiles of adolescents with and without ASD, in the leisure domain including areas of clubs/community, socializing, creative, intellectual, relaxation, outdoor, exercise and sporting activities. PIP provides a measure of interest, level of engagement, and with whom activities are undertaken across 85 activities. A total of 143 Australian adolescents (118 with ASD, 25 typically developing (TD)) between the ages of 12-17 years (62% male) participated. For ASD participants diagnosis was confirmed via the ADOS with the PIP completed during a face-to-face interview. TD adolescents completed the PIP online. Activity participation rates between groups were compared using Chi-square test for independence.

Results: Both Adolescents with ASD and their neurotypical peers reported high levels of interest in the activity areas of socializing and relaxation activities, with listening to music and taking vacations of most interest across both groups. While adolescents with ASD had high levels of interest in various activities there emerged a significant interest/participation gap. TD adolescents participated in all activities (p<0.05) more than adolescents with ASD, with the exception of sporting activities (p>0.05). In relation to ‘who they do the activities with’, adolescents with ASD more frequently participated on ‘their own’ or with ‘their families’ than ‘with friends’ compared to their TD counterparts in intellectual activities (playing with computer (ρ=0.005); math (ρ=0.009); politics (ρ=0.006); History (ρ=0.005); debates (ρ=0.028); literature (ρ=0.034); reading (ρ=0.009)). This pattern was repeated in socializing activities where TD peers participating more frequently with friends (going to: arcades (ρ=0.003); cinema (ρ<0.001); parties (ρ=0.035); shopping mall (ρ=0.002) and sporting events (ρ<0.001)).

Conclusions:

While adolescents with ASD show high levels of interest in a range of activities, particularly those social in nature, their participation rate falls significantly below that of their TD peers, with the exception of sporting activities which were most frequently engaged in at school. Clearly, despite high levels of interest in leisure activities adolescents with ASD experience significant participation restrictions. It is likely that challenges in social communication and interaction experienced by adolescents with ASD act as barriers to participation, particularly with friends. These findings highlight the importance of developing interventions which bridge the interest participation gap for adolescents with ASD.