Performance of Daily Living Activities of Autistic Children With Sensory Processing Difficulties: Caregivers' Perceptions.

Background: Sensory integration difficulties are common among autistic children and can significantly affect their occupational performance, particularly in activities of daily living (ADLs). Despite the increasing recognition of these challenges, few studies have specifically examined how sensory and praxis difficulties interfere with functional autonomy in daily routines.

Objective: This study is aimed at analyzing caregivers' perceptions of sensory processing difficulties and their impact on the performance of autistic children in basic ADLs.

Methods: A qualitative, descriptive study was conducted with caregivers of children aged 3-8 years diagnosed with autism spectrum disorder (ASD), recruited from a private pediatric rehabilitation clinic in Brazil. Data were collected through semistructured interviews focusing on children's engagement in and performance of ADLs. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis with the support of MAXQDA software to systematically identify and categorize recurring sensory and motor-related difficulties reported by caregivers.

Results: Caregivers consistently reported that sensory processing difficulties had a significant negative impact on multiple domains of daily living activities, notably feeding, personal hygiene, dressing, bathing, and toileting, resulting in a restricted active and independent participation. Sensory modulation difficulties, including patterns of hyperresponsiveness and hyporesponsiveness, affected performance across all assessed activities. Sensory discrimination difficulties were particularly evident in dressing and toileting tasks. Praxis-related difficulties were identified in all children and manifested as challenges in ideation, motor planning, and motor execution, which collectively compromised functional performance across daily activities and increased dependence on caregivers during daily routines.

Conclusions: Sensory processing difficulties involving modulation, discrimination, and praxis substantially limit functional independence and occupational engagement in children with ASD. These findings highlight the importance of individualized occupational therapy interventions tailored to each child's sensory and motor profile, with the aim of supporting participation, autonomy, and engagement in everyday activities.