Please read instructions below:

For the questions below, please circle the appropriate answer to the best of your ability. You have the option to withdraw from the study at any time, or to refrain from answering any questions you choose. The purpose of this study is to collect information from caregivers of children diagnosed with autism spectrum disorder (ASD) to determine what occupational therapy activities are being used in the home, how confident caregivers are with these activities, and the purpose behind these activities. The research will provide occupational therapists with an insight into what concepts are most challenging for caregivers to incorporate, as well as what types are the most helpful. Please answer based on your overall experience receiving OT services. By completing this questionnaire, I give consent to the researchers to use my responses in the research study.

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* 1. How long has your child been seeing an OT? 

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* 2. In what setting has your child received OT services? (mark all that apply)

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* 3. Marital status:

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* 4. Work/Job

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* 5. Highest degree attained:

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* 6. How often does your OT explain what they are doing in therapy? 

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* 7. How often does your OT give you educational materials (i.e. handouts, videos) about activities to do at home? 

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* 8. Do you know what sensory integration is?

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* 9. Do you know what social skills training is?

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* 10. Do you know what behavioral modifications are? 

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* 11. How comfortable are you doing the OT activities at home?

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* 12. How often has your OT given you activities to do at home? 

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* 13. How often are you able to do the recommended OT activities at home? 

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* 14. What is the biggest problem you face when trying to do OT activities at home?

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* 15. Do you have the materials and equipment that are needed to do the OT activities at home?

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* 16. How did your OT check your understanding of OT activities to do at home? (mark all that apply)

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* 17. What could the OT do to make it easier for you to do activities at home? (mark all that apply)

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* 18. Do you get to be a part of the OT sessions with your child?

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