Doing occupational transitions: a constructivist grounded theory from the viewpoint of adults on the autism spectrum<sup/>

Aeberhard, Renate; Sy, Michael Palapal; Kramer-Roy, Debbie

doi:10.1590/2526-8910.ctoAO278136222

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Original Article • Cad. Bras. Ter. Ocup. 32 • 2024 • https://doi.org/10.1590/2526-8910.ctoAO278136222 copy

Doing occupational transitions: a constructivist grounded theory from the viewpoint of adults on the autism spectrum¹ 1 Ethical clearance: BASEC-Nr: Req-2021-01412; Cantonal Ethics Committee Bern, Switzerland.

Fazendo transições ocupacionais: teoria fundamentada construtivista a partir do ponto de vista de adultos no espectro do autismo

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

People on the autism spectrum often struggle to transition smoothly between occupations in daily life.

Objective

This qualitative inquiry aimed to understand the human and non-human factors that influence occupational transitions from the perspectives of adults on the autism spectrum.

Method

Using a constructivist grounded theory design, this study purposively gathered data from eight adults on the autism spectrum who shared their viewpoints via semi-structured interviews and self-produced written texts. Framed by the Cultural Historical Activity Theory, an iterative process of constant comparative analysis was employed, yielding six categories that constituted the assembly of a working theory on occupational transitions among adults on the autism spectrum.

Results

Drawn from eight participants, the six categories were: 1) getting ready, 2) the attributes of the occupation, 3) the others, 4) strategies of the moment, 5) cumulative stress, and 6) possible ends of the process.

Conclusion

Our findings revealed a nuanced understanding on occupational transitions for adults with autism. First, materiality (non-human entities) serves various purposes in occupational transitions, implying that in some cases, intangible materials (tacit knowledge) would be enough to initiate, aid, or terminate occupational transitions. Second, doing transitions together through the optimization of social support and resources can make occupational transitions more meaningful for adults in the autism spectrum. It is our ambition that these propositions be tested and emphasized in occupational therapy, healthcare, and social care practices.

Keywords:
Autism Spectrum Disorder; Occupational Therapy; Human Activities

Open questions unrelated to CHAT:
1. Describe the transition between ... and .... Explain everything to me in detail.
2. What happened during the transition?
3. What influenced the transition?
4. (What influenced the transition positively?
5. What influenced the transition negatively?)
6. What are you doing to influence the transition?
7. What do you think is influencing the transition?
8. What are others doing to influence the transition?
*Mediating Artifacts (mediating objects/tools):*
1. What did it look like there?
2. Describe the environment. Did the environment have an impact on the transition? Did the environment change from one activity to the next?
3. What objects played a role in the transition?
4. What objects are present?
5. Which of your thoughts accompanied the transition? What did you think?
6. What knowledge was present? What did you know about the transition, the activity after or before?
7. What knowledge was missing? What did you not know about the transition, the activity before or after?
*Rules*
1. What rules apply during the transition or in the activity before or after?
2. Do the rules influence the transition?
Object/Outcome (only if not obvious)
1. What was the task/goal of the activity before the rather difficult transition?
2. What was the task/goal of the activity after the rather difficult transition?
3. What was the result of the activities?
*Community and Division of Labour*
1. What people were around during the transition? What was the task of these people?
2. Who had what role in the activities before and after the transition?
3. What are the others doing to influence the transition?
*Final Question*
Is there anything else you would like to say about the transitions?

Participant^* * Pseudonym.	Gender	Age	Living Situation	Daily structure	Option chosen	Interview mode
Roman	male	57	alone	no work, 6/7 days lunch at a community facility; once a week one afternoon in a streetworker organisation	only interview	video call
Helga	female	63	with partner	part-time work (40%) in own company	list	video call
Alice	female	62	alone	part-time work (one day)	diary	video call
Yvonne	female	47	alone	no work, on sick leave since 3 months, hobbies	list	video call
Daria	female	56	with partner	part-time work (every morning)	list	live meeting
Bente	non-binary	18	supportive housing with peers	full-time apprenticeship	list	email
Lukas	male	53	with partner and children	no work, structure through family life	diary	video call
Karin	female	52	alone	no work, engagement in volunteer projects	list	video call

	Category	Subcategory	Focused codes (examples)
1	Getting ready	Using and organising implements	Using lists, maps, and planners
			Alarm clock
			Putting objects ready
			Autism identification card
			Dressing
		Thinking through	Knowing options
		Thinking through	Giving a frame
		Adapting time	Avoiding crowds
			Arriving early
			Coming late, going late
2	Strategies of the moment	Rewarding (before or after)	Eating chocolate
		Rewarding (before or after)	Occupying with preferred interest
		Soothing	Holding objects
		Soothing	Folding laundry
		Changing position or visual fixation	Looking at specific positions
		Changing position or visual fixation	Changing place
3	The attributes of the occupation	Agreeing on	Favourable vs disliked
		Agreeing on	Clear vs unclear
		Feeling ambivalent or disagreeing	Indefinite vs predefined
		Feeling ambivalent or disagreeing	On your own vs with/for others
4	The others	Assuming nudging roles	Being a starter
			Being a connector
			Not understanding
5	Cumulative stress	Exhaustion	Fear
			Demands on yourself
			Sensory input
			Clutter
			Age
		Thoughts from before	Switching off thoughts needs energy
		Refraining	Not doing
			Postponing
			Forgetting

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] All authors approved the final version of the text.

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Doing occupational transitions: a constructivist grounded theory from the viewpoint of adults on the autism spectrum1 1 Ethical clearance: BASEC-Nr: Req-2021-01412; Cantonal Ethics Committee Bern, Switzerland.

Fazendo transições ocupacionais: teoria fundamentada construtivista a partir do ponto de vista de adultos no espectro do autismo

Abstract

Introduction

Objective

Method

Results

Conclusion

Doing occupational transitions: a constructivist grounded theory from the viewpoint of adults on the autism spectrum¹ 1 Ethical clearance: BASEC-Nr: Req-2021-01412; Cantonal Ethics Committee Bern, Switzerland.