Rehabilitation and Therapy Commons^™

Aquatic Therapy And Its Impact On Perceived Caregiver Strain, Amanda J. Carter, Cynthia Haynes, Katherine O'Hara

Summer 2026 OTD Capstone Symposium

Children with Autism Spectrum Disorder (ASD) frequently experience sensory dysregulation that significantly impairs their participation in daily occupations and increases caregiver strain (Lawson et al., 2020; Passarello et al., 2022). Although aquatic therapy has shown promise in improving sensory processing, motor skills, and social participation, there is limited research examining its specific impact on the caregivers’ ability to provide support at home (Butzman et al., 2022; Caputo et al., 2018; Güeita-Rodríguez et al., 2021).

This study is a mixed-methods, quasi-experimental pre/post-design. This study sought to investigate the impact of six weeks of aquatic therapy intervention on sensory regulation and its …

Calm, Confident, Capable: An Educational Manual To Support Effective Oral Care For Children With Autism, Jared D. Morgan, Leah I. Stein Duker, Carrie Alvarado, Angela Labrie Blackwell

Summer 2026 OTD Capstone Symposium

Dental health professionals report limited confidence, perceived competence, and preparedness when providing oral health care to autistic children, which can significantly impact patient participation, quality of care, and overall dental experience. Autistic children are more likely to have dental conditions compared to their neurotypical peers. The methods of this project consisted of four phases being development, preview, revision, and dissemination. The purpose of this project was to develop an educational manual that provides dental health professionals with practical knowledge, skills, and abilities to address the needs of autistic children, to ensure effective oral health care. The expected outcomes of this …

Exploring Illuminate Academy’S House Of Growth Framework: An Immersive Capstone Experience And Literature Review, Claire Grobe

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Illuminate Academy in Nashville, an educational program providing a homeschool-based alternative for children with autism and developmental disabilities. The purpose of this project was to address the agency’s need for improved understanding and communication of the House of Growth Framework among educators, families, and community partners. The primary goal of this project was to improve understanding and consistent use of the House of Growth Framework to support student engagement, regulation, and overall development. The project included a needs assessment, a comprehensive literature review, and immersive participation within the learning environment to …

Occupational Justice In The Classroom For Children With Developmental Disabilities: A Program For Child-Led Play Interactions, Rayah Kassis, Cynthia Haynes

Spring 2026 OTD Capstone Symposium

Play and education are important occupations in students’ lives; however, there is a lack of resources in schools to enhance social and communication skills that impact occupational engagement for children with developmental disabilities. The purpose of this capstone project is to develop and provide resources to registered behavioral technicians (RBTs) that will inform them about how to use child-led principles to enhance the social and communication skills of students with developmental disabilities so that the students can meet their occupational roles in school and play participation.

The Power Of Connection: Evidence-Based Strategies For Supporting Learners With Autism At Illuminate Academy, Sloan E. Sylvan

OTD Capstone Projects

This doctoral capstone project was completed in partnership with Illuminate Academy, an alternative educational program serving children with autism and developmental disabilities. The project aimed to provide evidence-based support for the organization’s classroom strategies and improve communication of these approaches to families and staff. Key outcomes included the development of a parent-friendly, evidence-based overview of Illuminate Academy’s core strategies, highlighting their role in supporting regulation, engagement, and participation. A concise literature synthesis was created to reinforce these approaches, focusing on sensory processing, co-regulation, play, and participation. Additional contributions included observing a learner during a classroom transition and developing individualized supports …

A Polyvagal And Sensory Integration And Processing Approach To Supporting Development In Young Children With Autism, Catherine Cavaliere, Nadia Rust, Michelle Rogowski, Alyssa Calderone, Rebecca Marash, Amy Zdrodowski, John Damiao

The Open Journal of Occupational Therapy

Background: The polyvagal theory presents a framework for understanding the autonomic nervous system’s role in influencing behavior, engagement, and connection. Children with autism experience regulation and sensory integration and processing differences that impact their sense of felt safety and engagement in their environment. The Safe and Sound Protocol (SSP) is an auditory program designed to stimulate the vagal system and support nervous system regulation.

Methods: A retrospective multiple subject pretest-posttest design was used to examine the impact of the SSP on regulation, engagement, and skill acquisition in children with autism ages 2 to 3 enrolled in an early intervention center …

More Than Covering Ears: A Clinical Inventory For Characterizing Decreased Sound Tolerance (I-Dst) In Autism, Tana B. Carson, Angela Medina, Katherine L. Long, Yuxi Qiu, Monica Noriega

The Open Journal of Occupational Therapy

Background: Decreased sound tolerance (DST) is among the most common and distressing forms of sensory over-responsivity experienced by children with autism spectrum disorders. DST includes hyperacusis and misophonia, among others, and can limit participation in daily activities. Recently, a new screening tool, the Pediatric Hyperacusis and Misophonia Questionnaire (PMHQ-4) has been developed to allow health professionals to better identify and differentiate these conditions using a single assessment. Additional clinical tools are needed to further characterize DST symptoms to facilitate treatment planning after diagnosis.

Methods: In this mixed-methods study n = 15 parents of autistic children 6 to 17 …

The Role Of Occupational Therapy In Developing Aquatic Programs For Children Diagnosed With Autism, Giavanna Stavros

Occupational Therapy | OTD Capstone Projects

There is a need for inclusion in therapeutic aquatic programming for children diagnosed with autism (ASD), as their increased participation in aquatic interventions and activities promotes safety and well-being for this population. Pediatric occupational therapists (OTs) are vital to fill this gap in skill, as pediatric OTs consistently work with children diagnosed with ASD (Jaicks, 2024), and core principles of the occupational therapy (OT) profession include enhancing one’s safety and well-being (American Occupational Therapy Association (AOTA), 2025). Children diagnosed with ASD must have the opportunity to engage in swimming and aquatic therapy, as this population is at a higher risk …

Organized Sports-Based Interventions And Motor Outcomes In Children Diagnosed With Autism Spectrum Disorder: A Systematic Review, Kailash Ram, Maeren Hill, Caitlyn Stewart, Kaitlin P. Hardy Md, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Aim

To evaluate the effectiveness of organized sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).

Method

Four databases were searched from inception to November 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) reporting motor outcomes of organized sports-based interventions in children with ASD. Risk of bias was evaluated using ROB-2 (Cochrane Risk of Bias Tool, Version Two) for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) for NRCTs.

Results

Eleven studies (six RCTs, five NRCTs) were included and categorized as martial arts (n = 5), aquatic training (n = …

A Mixed Methods Exploration Of Autistic Adults' Leisure Experiences, Sevia Raelson, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Across ages and populations, leisure participation is essential to humans and associated with improved well-being, and both mental and physical health (Bishop-Fitzpatrick et al., 2017; Coster & Khetani, 2008; Lapa, 2013). The American Occupational Therapy Association [AOTA] formally defines leisure as intrinsically motivating, non-obligatory, self-chosen, and enjoyable activities done in one’s free time (AOTA, 2020). Leisure participation trends for autistic populations are better understood in pediatric populations than adults, but studies rely on neurotypically defined leisure activities. Given the differences between neurotypical and neurodivergent brains, it is likely that leisure activities are experienced differently by autistic adults; thus, …

Toward A Nuanced Understanding Of Health And Human Services Students' Perceptions Of Autism, Leslie A. Meskin, Annemarie Connor, Sarah Fabrizi, Ann Tilman, Joanna Salapska-Gelleri, Noelle Balsamo

Journal of Human Services: Training, Research, and Practice

Continually increasing rates of autism necessitate research-informed preparation of pre-service professionals who will work with this population. This mixed-method study examined health and human services students’ autism knowledge, bias, and interaction to inform training and education needs. Results extend the extant literature suggesting autism knowledge and interaction are necessary but insufficient in mitigating bias. Specifically, the nature of prior interaction, positive or negative, shapes both bias and proclivity for additional interaction. Lastly, self-reflection was identified as a latent and potentially impactful factor in shaping a more nuanced and less biased understanding of autism. Recommendations for education and research are discussed.

Helping Children Cope With Sensory Overstimulation At Theme Parks: An Educational Video Series For Parents, Ashley M. Garcia, Steven M. Gerardi Phd, Otd, Mss, Otr

Summer 2025 OTD Capstone Symposium

Parents of children with sensory processing challenges often feel overwhelmed and unprepared when visiting high-stimulation environments such as theme parks. Loud sounds, bright lights, crowded walkways, and unpredictable routines can contribute to sensory overload, creating distress for both children and caregivers. Although theme parks aim to provide joyful family experiences, they may not fully account for the needs of neurodivergent children, including those with autism spectrum disorder, attention-deficit/hyperactivity disorder, or sensory processing disorder. Parents of children with debilitating sensory issues are unsure and uncertain on how to prepare to assist their child to cope with the overwhelming sensory stimuli at …

The Impact Of Kinesthetic Attunement On Parents And Their Children With Autism: An Exploration, Ritu Shree

Expressive Therapies Dissertations

This study explored the impact of kinesthetic attunement as experienced through dance movement therapy (DMT) with parent-child dyads on parental stress, children’s adaptive skills and joint attention. A qualitative reflective account of parents was also studied to understand the depth of parents’ experience of dance movement therapy with their children with autism. The research emphasized the importance of collective parent-child dance therapy sessions, that especially focused on attunement and connection that built its way up from sensory-motor, social-communicative, and relational play and engagement.

A total of six parent-child dyads participated in the study that lasted over eight DMT sessions. Parents …

Making A Splash: Exploring The Effectiveness Of Aquatic Occupational Therapy For Children With Autism Spectrum Disorder, Avery Brockberg

Occupational Therapy Capstone Presentations

According to the American Psychiatric Association, autism spectrum disorder is one of the most common developmental disabilities in the world. Approximately 90% of children with ASD experience atypical sensory processing which can lead to increased difficulties in daily occupations including play, academic activities, feeding, self-care, and sleep. Aquatic therapy (AT) is an effective intervention that has a role in addressing social, emotional, physical, and sensory needs in children with ASD. There is limited research on the role of occupational therapy in providing AT for children with ASD. The purpose of this capstone was to evaluate the effectiveness of aquatic occupational …

Increasing Access To Adequate Care For Low-Resource Children With Autism Spectrum Disorder, Breanna A. Culver, Rebecca King

Spring 2025 OTD Capstone Symposium

Exploring and understanding the barriers to accessing adequate neurodivergent affirming care for autistic children and their families. Taking steps to decrease financial barriers, poor health literacy, and lack of available resources by developing a non-profit organization that will increase access to adequate care for these families. Participating in community outreach to raise awareness of and education about autism spectrum disorder in the local community of Corsicana, Texas on the needs of the autistic community.

Development Of A Mobile App For Parents And Caregivers Of Children With Autism, Laurie Tison

Post-Professional Occupational Therapy Doctorate - Innovations in OT Symposium: Transforming Possibilities into Practice

Background: Caring for children with autism who experience sensory challenges often leads to increased caregiver stress and reduced self-efficacy. Research suggests that smartphone apps can effectively mitigate stress and empower parents. A needs assessment highlighted the necessity for an app centered on sensory processing tools and strategies, considering the limited resources available for addressing children’s emotions and behaviors.

Objective: This project aimed to develop and evaluate a comprehensive app to support parents and caregivers of children with autism, focusing on reducing stress and enhancing parental efficacy. Objectives included: 1) designing the app with relevant resources, 2) assessing the app’s content, …

An App-Based Education Course Empowering Coaches To Support Neurodivergent Athletes, Caroline Morton, Karen Park

Spring 2025 OTD Capstone Symposium

Neurodivergent children face significant barriers to participation in youth sports due to a lack of coach education and inclusive practices, which limits access to the physical, cognitive, and social-emotional benefits of recreational activities. This doctoral capstone project aimed to address these barriers through the development and implementation of CoachAbility, an app-based educational course designed to equip youth sports coaches with neurodiversity-affirming approaches. The course includes interactive modules, scenario-based quizzes, and downloadable resources covering key areas such as sensory processing, communication, emotional regulation, inclusion, family collaboration, and motor skill development. Participating coaches at KidStrong Carlsbad completed the course over four …

Learning What To Say Through Theater And Play: A Theater Arts Communication And Conflict Resolution Program For Neurodivergent Children, Elena Corsair, Steven M. Gerardi

Spring 2025 OTD Capstone Symposium

Joshua’s Stage is a theater-based enrichment program for children with special needs. Joshua’s Stage provides developmentally appropriate activities for their students, but they do not address clinical or functional problems. Problem: Joshua’s Stage does not provide specialized programming to meet the needs of neurodivergent children with communication problems and conflict resolution, making it difficult for these children to participate fully. Purpose: The purpose of this project was to create a theater arts communication and conflict resolution program for neurodivergent children to be integrated into Joshua’s Stage enrichment program. A four-week program, consisting of eight sessions, was developed over a 14-week …

Building Awareness, Access, And Advocacy Through Kham's Klub, Morgan E. Guidry

Occupational Therapy Doctorate Capstone Posters

During my doctoral capstone and applied leadership experience, I partnered with
Kham’s Klub, a nonprofit in Richmond, Kentucky, whose mission is to empower and
elevate families with autism. The project's primary ACOTE focus area is program
development, education, and advocacy within a community-based setting. The aim of this project was to strengthen the organization’s capacity to promote early diagnosis, provide support for inclusive environments at Kham’s Klub events and cultivate donor and community engagement. Through literature review and collaboration with the founders/CEO of Kham’s Klub Non-profit for Autism there were gaps revealed in caregiver understanding of autism, limited community participation, …

Physical Activity For Anxiety For Autistic People: A Systematic Review, Kathryn Riis, Brittany Samulski, Kristina A. Neely, Patricia Laverdure

Rehabilitation Sciences Faculty Publications

Clinical anxiety is a common comorbidity in autistic people. Due to the prevalence of anxiety in the autism population and the adverse effects it causes, there is a critical need to develop effective interventions which address anxiety symptoms for autistic people. Therefore, the purpose of this systematic review was to examine the effectiveness of the use of physical activity as an intervention to reduce anxiety in autistic people. Three databases PubMed, PsychInfo, and Cochrane RCTs, were searched utilizing key terms. PRISMA systematic search procedures identified 44 studies meeting predetermined inclusion criteria. Participant characteristics, the type of physical activity performed, the …

Autistic Young Adults' Experiences And Recommendations For Strength Training, Ashlyn Barry, Justin A. Haegele, Daniel Schaefer, Kristen A. Pickett, Luis Columna

Human Movement Studies & Special Education Faculty Publications

Strength training can be a beneficial form of physical activity (PA), but little research has examined how autistic individuals experience it or what makes programs accessible and supportive. Therefore, the purpose of this study was twofold: (1) to explore autistic young adults’ experiences with strength training, and (2) examine their recommendations for designing programs that meet their needs. Thirteen autistic young adults (ages 22–25) participated in semi-structured interviews about their strength training experiences and preferences for program design. A qualitative descriptive approach with a constructivist lens guided reflexive analysis. Participants described key factors that influenced their participation in strength training, …

Interventions To Improve Community Mobility In Autistic People: A Systematized Review, Sydney Maddox, Jada Ford, Heather Olson, Danielle Westmark, Stacy Smallfield, Molly Whitlow

Student Systematized Reviews: Occupational Therapy

Importance: Community mobility (CM) enables access to locations outside the home, allowing participation in work, leisure, and social environments. Autistic adults have reported less access to public transportation and driving than the general population (Wilson et al., 2021), impacting their community participation, life satisfaction, and likelihood of employment and further education (Egilson et al., 2016, Song et al., 2022, Wilson et al., 2021). Occupational therapists can support autistic people by providing interventions to increase CM.

Objective: To evaluate the effectiveness of interventions to improve CM in autistic people.

Methods: We collaborated with a medical librarian to conduct a systematic review …

Facilitators And Barriers For Occupational Therapy Using Ayres Sensory Integration® (Ot-Asi) For School-Aged Autistic Students: Special Education Team Perspectives, Brooke E. Loughery, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy using Ayres Sensory Integration® (OT-ASI) is an evidence-based approach that addresses sensory integration differences to support participation for autistic students in daily occupations, including education (Hume et al., 2021; Schaaf & Mailloux, 2015). However, its evidence for its use in school-based practice is still emerging (Whiting et. al., 2023; Whiting et al., 2025). A recent study showed that occupational therapists feel this approach is valuable and are interested in using it in schools (Cerase McKeon et al., 2024), but more information is needed to explore teacher and school administrators’ perception of its use.

Objectives: To explore the …

The Benefit Of Creative Arts-Based Interventions For Children With Autism Spectrum Disorder, Marissa Patrick, Zeida Gutierrez

Fall 2024 OTD Capstone Symposium

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that significantly affects emotional regulation, social communication, and executive functioning. Addressing emotional regulation in children with ASD is essential for enhancing mental health, quality of life, and functional independence in occupations such as social participation. Despite evidence supporting the use of creative arts-based interventions to improve mental health, limited research exists on their specific application for emotional regulation in this population.

This project aimed to implement and evaluate a creative arts-based intervention program designed to improve emotional regulation skills in children with ASD within occupational therapy (OT) practice. Conducted over five weeks …

Moving Toward Neurodiversity-Affirming Occupational Therapy For Autistic People: Key Questions And Next Steps, Aaron Dallman, Kathryn Williams, Jacklyn Boheler, Greg Boheler

The Open Journal of Occupational Therapy

With the rise in popularity of neurodiversity-affirming practices in occupational therapy, specifically with the autistic population, there is a need to establish a more robust theoretical underpinning for this work. A neurodiversity framework is different from the prevailing medical model that informs current practice in much of Westernized health care, and interested occupational therapists are now asking questions about how to apply it to their work. Occupational science is well-suited to generate research outside the medical model that can serve as a basic science foundation to inform practice. The purpose of this Opinions in the Profession paper is to suggest …

Consideration Of Language, Culture-Education, And Advocacy For Latino Families Who Use Therapy Services, Melina Rodriguez, Rachael Fox, Mary Greer

Summer 2024 OTD Capstone Symposium

Latino families of children with ASD face additional barriers within society compared to other families, including surrounding stigma within the culture, language barriers, lack of resources, and lack of education on how to access these resources. One of the focuses of occupational therapy is to provide education and advocacy to individuals and their families who face occupational barriers. This program was created to provide education to Latino families of children diagnosed with ASD through participation in weekly sessions that cover various topics related to ASD.

Early Identification Of Autism Spectrum Disorder Markers In Infants Using The Infant And Motor Engagement Scale, Cesley L. Taft

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Pawsitive Purpose: The Impact Of Autism Assistance Dogs On The Occupations Of Autistic Children, Morgan Starkweather, Amie E. Germain, Christine A. Kivlen

The Open Journal of Occupational Therapy

Background. The World Health Organization recognizes that participation is important to individuals’ well being; yet, autistic children participate in fewer activities compared to neurotypical children. This article aims to describe the role of autism assistance dogs (AADs) in promoting participation and engagement in occupations and activities of daily living (ADLs) for autistic children.

Method. A qualitative interpretative phenomenological design was used. Two semi-structured interviews from a narrative perspective were conducted with each participant. Four volunteer parents and primary handlers of their child’s AAD participated in the study. Inductive analysis was used to interpret open-ended questions. Following transcription, Creswell’s …

Improved Motor Skills In Autistic Children After Three Weeks Of Neurologic Music Therapy Via Telehealth: A Pilot Study, Nicole M. Richard Williams, Corene Hurt-Thaut, Jessica Brian, Luc Tremblay, Marija Pranjic, Jessica Teich, Melissa Tan, Julia Kowaleski, Michael Thaut

Faculty Scholarship

Background: Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)^® sessions via telehealth would improve motor and attention skills in autistic children.

Methods: Five autistic children between five …

Sens"Ability" Coaching: Inspire And Empower Parents With Occupational Performance Coaching Using Dunn’S Model Of Sensory Processing – A Manualized Education Program For Clinicians, Kelby Christian

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The current literature found a need for improved collaboration styles and programs that can adapt to the needs of the various mental health diagnoses. This capstone project focused on creating a manualized education program called SensABILTY Coaching, which aims to improve clinicians’ confidence in educating caregivers of children with autism spectrum disorder (ASD) on Dunn’s Model of Sensory Processing using principles of Occupational Performance Coaching (OPC). Improving clinicians' confidence increases positive reactions and enhances caregiver and clinician collaboration. This capstone project outlines the benefits of using the principles of OPC intervention styles and sensory-based strategies for their effectiveness when …