Barriers and enablers to school participation for children with ASD : the perceptions of school based occupational therapists and learning support educators

Abstract

Background: Children with Autism Spectrum Disorder (ASD) often face barriers to participate in school due to challenges with communication, sensory processing, and social interaction. Participation is essential for emotional, cognitive, and social development. Despite this, limited research has explored the perspectives of School Based Occupational Therapists (SBOTs) and Learning Support Educators (LSEs), particularly in Malta, where the role of SBOTs is still relatively new. Aim: This study explored the perceptions of SBOTs and LSEs regarding the school participation of children with ASD, identifying key factors that facilitate or hinder their inclusion. Method: A qualitative design was used, involving semi-structured interviews with four SBOTs and five LSEs working in Maltese state primary schools. Participants were recruited through purposive sampling, and data was analysed using thematic analysis. Findings: Five main themes emerged: environmental barriers, social barriers, interprofessional collaboration, effective strategies, and lack of educator training. Noisy classrooms, overcrowded spaces, and limited access to sensory-friendly environments were noted as key barriers. Enablers to participation included visual aids, structured routines and strong, supportive relationships between children with ASD, their peers, and educators. Challenges such as limited time for collaboration and insufficient training on the wide spectrum of autism also emerged. Discussion: The findings highlight the importance of sensory-adapted classrooms, improved collaboration between professionals, and ongoing educator training. While results mirror international findings, they also point to local challenges, including the limited presence of multisensory rooms and the evolving role of SBOTs. Recommendations for future research, practice, and policy are provided to foster more inclusive school environments for children with ASD.