Independence in Activities of Daily Living Among Autistic Toddlers

A Pilot Study Using Ecological Momentary Assessment

Bibliographic Data

ID15716873
AuthorsShani Hillel (0009-0009-9917-1101, Hebrew University of Jerusalem, corresponding author), Ben Aaronson (Hebrew University of Jerusalem), Yafit Gilboa (0000-0002-0734-3626, Hebrew University of Jerusalem)
Year2025
Volume12
Issue10
Pages1316-1316
Publication date2025-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueChildren (JOURNAL)
Journal identifiersISSN: 2227-9067 • E-ISSN: 2227-9067
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/children12101316
PMID41153498
OpenAlexW4414706264
LanguageEN
References cited45

Background: The acquisition of adaptive skills is critical for independence and participation in activities of daily living (ADL). While caregiver perceptions provide valuable insights, most studies on autistic participation have focused on older children and relied on one-time clinic-based assessments. As a result, little is known about how autistic toddlers function in their natural environments across time. Ecological momentary assessment (EMA) is a real-time, context-sensitive method in which parents can report behaviors at multiple time points in the child's natural environment. This pilot study aimed to examine ADL independence in autistic toddlers compared to their typically developing (TD) peers, to assess the feasibility of using EMA in early childhood, and to compare EMA-based assessments with a one-time standardized report. Methods: 23 autistic toddlers and 28 TD toddlers (aged 18-40 months) participated in the study. Parents completed a one-time report on the self-care scales of the Pediatric Evaluation of Disability Inventory (PEDI) and the Functional Independence Measure for Children (WeeFIM) and then rated their child's independence on the WeeFIM twice a day for two weeks via their smartphones. Results: EMA was feasible with high response rates (ASD: 91.1%, TD: 88.55%). Autistic toddlers showed different participation profiles, with less independent performance in ADL compared to TD peers. In the autism group, the average EMA scores ( M = 16.53, SD = 6.58) were significantly higher than the one-time WeeFIM scores ( M = 13.74, SD = 5.23), t (22) = 3.23, p r > 0.80), indicating convergent validity. In the autism group only, greater variability in EMA was moderately associated with higher functional independence ( r = 0.46, p Conclusions: These findings indicate that autistic toddlers demonstrated higher levels of participation in their natural environment than reflected by the one-time assessment, emphasizing the limitations of single-time-point evaluations. This underscores the importance of collecting data across multiple time points to accurately assess adaptive functioning and ADL participation. The EMA technique demonstrated in this study provides exploratory evidence of feasibility as an ecologically valid approach to assessing functional independence in autistic toddlers, offering a richer and more context-sensitive alternative to traditional one-time clinical assessments

Activities of daily living · Autism · Independence (probability theory · Independent living · Perception · Typically developing · Autism Spectrum Disorder Research · Child Nutrition and Feeding Issues · Family and Disability Support Research

Tools

Open DOIOpen Access