Variable patterns of daily activity participation across settings in autistic youth: A latent profile transition analysis

Participation in daily activities is often linked to functional independence and well-being, yet individual variability in participation and factors associated with that variation have rarely been examined among autistic youth. We applied latent profile analysis to identify subgroups of youth based on parent-reported activity participation frequency at home, school and community, as well as associations with youth characteristics, family demographics and environmental supportiveness among 158 autistic youth (aged 11-14 years at baseline). Three-, three- and two-profile solutions were selected for home, school and community settings, respectively; the most prevalent profiles were characterized by frequent home participation (73%), low participation in non-classroom activities at school (65%) and low community participation, particularly in social gatherings (80%), indicating participation imbalance across settings. More active participation profiles were generally associated with greater environmental support, higher cognitive and adaptive functioning and less externalizing behaviour. Latent transition analysis revealed overall 75% stability in profile membership over approximately 1 year, with a different home participation profile emerging at the second time-point. Our findings highlighted the variable participation patterns among autistic youth as associated with individual, family and environmental factors, thus stressing the need for optimizing person-environment fit through tailored supports to promote autistic youth's participation across settings. Lay abstract What people do or engage in in their daily lives, or daily life participation, is often linked to their state of being happy and healthy, as well as potential for living independently. To date, little research has been conducted on daily activity participation by autistic youth at home, at school or in the community. Learning more about individual differences in participation levels and what might influence them can help to create custom supports for autistic youth and their families. In this study, 158 caregivers of autistic youth were asked how often their children took part in 25 common activities at two assessments, about one year apart. The analysis showed three profiles for each of the home and school settings and two profiles for the community setting. These profiles reflected distinct patterns in how often autistic youth took part in various daily activities, particularly in doing homework, school club activities and community gatherings. Most autistic youth were in profiles marked by often taking part at home but less often at school and in the community, and about three-fourths of them tended to stay in the same profile over time. Autistic youth with limited participation profiles were more likely to have lower scores on measures of cognitive ability and daily life skills and more challenging behaviour, and faced more barriers in their environment. These findings show how important it is to think about each autistic person's strengths and weaknesses, and changing needs, to better support their daily life participation.