{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:46:14Z","timestamp":1788590774490,"version":"build-2803163510"},"reference-count":58,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Hamilton Health Sciences New Investigator Fund &amp; the Hamilton Health Science Research Early Career Award","award":["NIF-19462"],"award-info":[{"award-number":["NIF-19462"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Participation in everyday activities at home and in the community is essential for children\u2019s development and well-being. Limited information exists about participation patterns of preschool children with autism spectrum disorder (ASD). This study examines these participation patterns in both the home and community, and the extent to which environmental factors and social communication abilities are associated with participation. Fifty-four parents of preschool-aged children with ASD completed the Participation and Environment Measure for Young Children and the Autism Classification System of Functioning: Social Communication. The children had a mean age of 48.9 (8.4) months. Patterns of participation were studied using descriptive statistics, radar graphs, and Spearman correlations. Children with ASD participated in a variety of activities at home and in the community, but showed a higher participation frequency at home. Parents identified different barriers (e.g., social demands) and supports (e.g., attitudes) in both settings. There was a moderate positive association between children\u2019s social communication abilities and their levels of involvement during participation and the diversity of activities. This study highlights the importance of social communication abilities in the participation of preschool children with ASD, and the need to support parents while they work to improve their child\u2019s participation, especially within their communities.<\/jats:p>","DOI":"10.3390\/ijerph17165677","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T09:41:21Z","timestamp":1596706881000},"page":"5677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Exploring the Participation Patterns and Impact of Environment in Preschool Children with ASD"],"prefix":"10.3390","volume":"17","author":[{"given":"Ghaidaa","family":"Khalifa","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada"},{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Georgiades","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Duku","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Briano","family":"Di Rezze","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada"},{"name":"CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,6]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2001). International Classification of Functioning, Disability and Health: ICF, World Health Organization."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3109\/17518423.2011.633108","article-title":"Participation and environmental aspects in education and the ICF and the ICF-CY: Findings from a systematic literature review","volume":"15","author":"Maxwell","year":"2012","journal-title":"Dev. Neurorehabilit."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S84","DOI":"10.1097\/PHM.0b013e31823d5376","article-title":"Differentiating activity and participation of children and youth with disability in Sweden: A third qualifier in the International Classification of Functioning, Disability, and Health for Children and Youth?","volume":"91","author":"Granlund","year":"2012","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3109\/09638288.2011.603017","article-title":"Development of the participation and environment measure for children and youth: Conceptual basis","volume":"34","author":"Coster","year":"2012","journal-title":"Disabil. Rehabil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/dmcn.12932","article-title":"\u2018Participation\u2019: A systematic review of language, definitions, and constructs used in intervention research with children with disabilities","volume":"58","author":"Imms","year":"2016","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1111\/dmcn.13959","article-title":"Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: A systematic review","volume":"60","author":"Adair","year":"2018","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.3109\/01942638.2014.957427","article-title":"A Comparative ICF-CY\u2013Based Analysis and Cultural Piloting of the Assessment of Preschool Children\u2019s Participation (APCP)","volume":"35","author":"Nina","year":"2015","journal-title":"Phys. Occup. Ther. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/dmcn.13360","article-title":"Environmental impact on young children\u2019s participation in home-based activities","volume":"59","author":"Albrecht","year":"2017","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/20473869.2017.1378160","article-title":"The role of environment in explaining frequency of participation of pre-school children in home and community activities","volume":"65","author":"Guichard","year":"2019","journal-title":"Int. J. Dev. Disabil."},{"key":"ref_10","unstructured":"Bandura, A., and Walters, R.H. (1977). Social Learning Theory, Prentice-Hall."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1007\/s10826-012-9619-8","article-title":"Personal and environmental factors predict participation of children with and without mild developmental disabilities","volume":"22","author":"Rosenberg","year":"2013","journal-title":"J. Child Fam. Stud."},{"key":"ref_12","unstructured":"Data and Statistics on Autism Spectrum Disorder|CDC (2020, July 01). Centers for Disease Control and Prevention, Available online: https:\/\/www.cdc.gov\/ncbddd\/autism\/data.html."},{"key":"ref_13","unstructured":"Public Health Agency of Canada (2020, March 27). Autism Spectrum Disorder among Children and Youth with ASD in Canada 2018-Canada.Ca. Canada.ca. Available online: https:\/\/www.canada.ca\/en\/public-health\/services\/publications\/diseases-conditions\/autism-spectrum-disorder-children-youth-canada-2018.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.chc.2020.01.001","article-title":"Diagnosis of Autism Spectrum Disorder across the Lifespan","volume":"29","author":"Shulman","year":"2020","journal-title":"Child Adolesc. Psychiatr. Clin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.rasd.2010.01.002","article-title":"Parenting in families with a child with autism spectrum disorder and a typically developing child: Mothers\u2019 experiences and cognitions","volume":"4","author":"Meirsschaut","year":"2010","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1037\/h0074524","article-title":"Social participation among pre-school children","volume":"27","author":"Parten","year":"1932","journal-title":"J. Abnorm. Soc. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3109\/01942638.2012.662584","article-title":"The assessment of preschool children\u2019s participation: Internal consistency and construct validity","volume":"32","author":"Law","year":"2012","journal-title":"Phys. Occup. Ther. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"457","DOI":"10.5014\/ajot.52.6.457","article-title":"Creating opportunities for occupation: An intervention to promote the self-care independence of young children with special needs","volume":"52","author":"Kellegrew","year":"1998","journal-title":"Am. J. Occup. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3928\/15394492-20100823-01","article-title":"Participation patterns in preschool children with an autism spectrum disorder","volume":"31","author":"LaVesser","year":"2011","journal-title":"OTJR Occup. Particip. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20","DOI":"10.4276\/030802211X12947686093567","article-title":"The routines and rituals of families of typically developing children compared with families of children with autism spectrum disorder: An exploratory study","volume":"74","author":"Rodger","year":"2011","journal-title":"Br. J. Occup. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/j.rasd.2010.01.015","article-title":"Sensory processing abilities and their relation to participation in leisure activities among children with high-functioning autism spectrum disorder (HFASD)","volume":"4","author":"Hochhauser","year":"2010","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1007\/s10803-010-1173-x","article-title":"A pilot study examining activity participation, sensory responsiveness, and competence in children with high functioning autism spectrum disorder","volume":"41","author":"Reynolds","year":"2011","journal-title":"J. Autism Dev. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"424","DOI":"10.5014\/ajot.57.4.424","article-title":"The significance of being occupied: The social construction of childhood occupations","volume":"57","author":"Lawlor","year":"2003","journal-title":"Am. J. Occup. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1111\/cch.12735","article-title":"Parents\u2019 perspectives on participation of young children with attention deficit hyperactivity disorder, developmental coordination disorder, and\/or autism spectrum disorder: A systematic scoping review","volume":"46","author":"Coussens","year":"2020","journal-title":"Child CareHealth Dev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1080\/09687599.2011.529667","article-title":"\u2018They say every child matters, but they don\u2019t\u2019: An investigation into parental and carer perceptions of access to leisure facilities and respite care for children and young people with Autistic Spectrum Disorder (ASD) or Attention Deficit, Hyperactivity Disorder (ADHD)","volume":"26","author":"Thompson","year":"2011","journal-title":"Disabil. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s40489-014-0040-7","article-title":"Participation of children and youth with autism spectrum disorder: A scoping review","volume":"2","author":"Askari","year":"2015","journal-title":"Rev. J. Autism Dev. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1037\/0003-066X.32.7.513","article-title":"Toward an experimental ecology of human development","volume":"32","author":"Bronfenbrenner","year":"1977","journal-title":"Am. Psychol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1080\/11038128.2016.1198419","article-title":"Community participation and environment of children with and without autism spectrum disorder: Parent perspectives","volume":"24","author":"Egilson","year":"2017","journal-title":"Scand. J. Occup. Ther."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1177\/1362361316685555","article-title":"Parent perspectives on home participation of high-functioning children with autism spectrum disorder compared with a matched group of children without autism spectrum disorder","volume":"22","author":"Egilson","year":"2018","journal-title":"Autism"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1207\/s15326888chc3503_2","article-title":"Predictors of the leisure and recreation participation of children with physical disabilities: A structural equation modeling analysis","volume":"35","author":"King","year":"2006","journal-title":"Child. Health Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.3109\/09638280902971406","article-title":"Characteristics influencing participation of Australian children with cerebral palsy","volume":"31","author":"Imms","year":"2009","journal-title":"Disabil. Rehabil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"191","DOI":"10.3233\/NRE-2004-19303","article-title":"Developing a follow-up survey focused on participation of children and youth with acquired brain injuries after discharge from inpatient rehabilitation","volume":"19","author":"Bedell","year":"2004","journal-title":"NeuroRehabilitation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1111\/j.1469-8749.2011.04094.x","article-title":"Psychometric evaluation of the Participation and Environment Measure for Children and Youth","volume":"53","author":"Coster","year":"2011","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Khetani, M.A., Coster, W., Law, M., and Bedell, G.M. (2013). Young Children\u2019s Participation and Environment Measure (YC-PEM), Colorado State University. (Copyright to Authors).","DOI":"10.1037\/t66239-000"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"640","DOI":"10.5014\/ajot.56.6.640","article-title":"Participation in the occupations of everyday life","volume":"56","author":"Law","year":"2002","journal-title":"Am. J. Occup. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1093\/jpepsy\/jsr106","article-title":"Academic, physical, and social functioning of children and adolescents with chronic physical illness: A meta-analysis","volume":"37","author":"Pinquart","year":"2012","journal-title":"J. Pediatr. Psychol."},{"key":"ref_37","unstructured":"Tajik, D.-P., Hidecker, M.J.C., Selvakumaran, S., Fan, L., Batth, S., Fang, H., Ross, B., Stone, A.C., Reed, B., and Kunitz, C. Operationalizing Social Communication in Autism Research: A Scoping Review over 20 years. Curr. Dev. Disord. Rep., Under review."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jaac.2018.12.010","article-title":"The need for a developmentally based measure of social-communication skills","volume":"58","author":"Bishop","year":"2019","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/J006v23n01_05","article-title":"A conceptual model of the factors affecting the recreation and leisure participation of children with disabilities","volume":"23","author":"King","year":"2003","journal-title":"Phys. Occup. Ther. Pediatr."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5\u00ae), American Psychiatric Pub.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/20473869.2016.1219101","article-title":"Social skills characteristics of students with autism spectrum disorder","volume":"64","author":"Agaliotis","year":"2018","journal-title":"Int. J. Dev. Disabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/cch.12483","article-title":"Participation of children on the autism spectrum in home, school, and community","volume":"44","author":"Simpson","year":"2018","journal-title":"Child CareHealth Dev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1111\/cch.12045","article-title":"Community participation patterns among preschool-aged children who have received Part C early intervention services","volume":"39","author":"Khetani","year":"2013","journal-title":"Child CareHealth Dev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4276\/030802213X13603244419112","article-title":"Participation in the home environment among children and youth with and without disabilities","volume":"76","author":"Law","year":"2013","journal-title":"Br. J. Occup. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"464","DOI":"10.3109\/09638288.2013.798360","article-title":"Differences in patterns of participation in leisure activities in Swedish children with and without disabilities","volume":"36","author":"Ullenhag","year":"2014","journal-title":"Disabil. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-1130.2006.00047.x","article-title":"Everyday activity settings, natural learning environments, and early intervention practices","volume":"3","author":"Dunst","year":"2006","journal-title":"J. Policy Pract. Intellect. Disabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.apmr.2014.09.031","article-title":"Psychometric properties of the young children\u2019s participation and environment measure","volume":"96","author":"Khetani","year":"2015","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1111\/cch.12679","article-title":"Investigating the participation of children on the autism spectrum across home, school, and community: A longitudinal study","volume":"45","author":"Simpson","year":"2019","journal-title":"Child CareHealth Dev."},{"key":"ref_49","unstructured":"(2020, February 28). ACSF: SC Tool_User Guide. Canchild.ca. Available online: https:\/\/canchild.ca\/en\/resources\/254-autism-classification-system-of-functioningsocial-communication-acsf-sc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1111\/dmcn.13152","article-title":"Developing a classification system of social communication functioning of preschool children with autism spectrum disorder","volume":"58","author":"Rosenbaum","year":"2016","journal-title":"Dev. Med. Child Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1016\/j.apmr.2010.04.027","article-title":"Measurement of participation: Intersecting person, task, and environment","volume":"91","author":"Mallinson","year":"2010","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.dhjo.2017.05.005","article-title":"The effect of child, family and environmental factors on the participation of young children with disabilities","volume":"11","author":"Tremblay","year":"2018","journal-title":"Disabil. Health J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5014\/ajot.54.3.269","article-title":"The orchestration of occupation: The dance of mothers","volume":"54","author":"Larson","year":"2000","journal-title":"Am. J. Occup. Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"543","DOI":"10.5014\/ajot.58.5.543","article-title":"The everyday occupation of families with children with autism","volume":"58","author":"DeGrace","year":"2004","journal-title":"Am. J. Occup. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/10538151000230030501","article-title":"Everyday family and community life and children\u2019s naturally occurring learning opportunities","volume":"23","author":"Dunst","year":"2000","journal-title":"J. Early Interv."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/1539449216659859","article-title":"Participation in out-of-home environments for young children with and without developmental disabilities","volume":"36","author":"Lim","year":"2016","journal-title":"OTJR Occup. Particip. Health"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1080\/01942638.2017.1280870","article-title":"Measuring participation of children and environmental factors at home, school, and in community: Construct validation of the Korean PEM-CY","volume":"37","author":"Jeong","year":"2017","journal-title":"Phys. Occup. Ther. Pediatr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.1007\/s10803-015-2460-3","article-title":"Activity participation and sensory features among children with autism spectrum disorders","volume":"45","author":"Little","year":"2015","journal-title":"J. Autism Dev. Disord."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/16\/5677\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:57:02Z","timestamp":1760176622000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/16\/5677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,6]]},"references-count":58,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["ijerph17165677"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17165677","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,6]]}}}