Introduction / Rationale: Children with Autism Spectrum Disorder (ASD) face significant challenges with occupational engagement, and preschool-aged children (2 years – 5 years, 10 months) in South Africa are especially vulnerable due to limited support from the public sectors of education and social development. Occupational therapists working in the public health sector are well-positioned to address these needs, yet their approaches to supporting children with ASD have not been explored in this context.
Objectives: The study aimed to explore and describe the practice patterns of occupational therapists working with preschool-aged children diagnosed with ASD in the Western Cape’s public health sector. It also sought to identify the factors influencing these practices and the barriers to effective service delivery.
Methods / Approach: A multi-phase, sequential, exploratory mixed methods design was used. In phase one, 92 case files from four public health sites were reviewed to identify practice patterns. In phase two, interviews were conducted with six occupational therapists from these sites, and the data was analysed using thematic analysis to understand the factors impacting their practice.
Results / Practice Implications: Findings revealed that therapists commonly used sensory profiles and self-developed screening tools, focusing on fine and gross motor development. Two key themes emerged: Building an understanding, where therapists used a child-driven approach, and Constructing a plan together, emphasizing collaboration with caregivers to address contextual factors affecting therapy.
Conclusion / Contribution to the occupational therapy profession: The study highlights the challenges faced by occupational therapists in South Africa’s public health sector in addressing the diverse needs as well as provides valuable insights into enhancing occupational therapy interventions for children with ASD.