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This systematic review examined the literature published from January 2006 to April 2013 related to the effectiveness of occupational therapy interventions for children with autism spectrum disorder (ASD) and their parents to improve parental stress and self-efficacy, coping, and resilience and family participation in daily life and routines. From the 4,457 abstracts, 34 articles were selected that matched the inclusion criteria. The results were mixed and somewhat inconclusive because this body of literature is in its infancy. Studies of children with ASD do not routinely measure parental and family outcomes. Recommendations include an emphasis on family measures other than parental stress and a greater focus on measures of parental and family functioning in all future studies of pediatric interventions to more fully understand the impact of interventions in a wider context.

Background: New, small-target (<1°) random dot stereogram (STRDS) and binocular suppression (STBS) tests appropriate for preschool vision screening were developed to correct the shortcomings of previous such tests, particularly missed cases of anisometropic amblyopia such as found with some RDS-based testing. Methods: In Experiment 1, the tests were administered to 14 patients with current or a recent history of moderate (≤ 20/60) anisometropic amblyopia, or with accommodative esotropia or monofixation syndrome. All subjects had good binocularity (≤100" contour stereoacuity). In Experiment 2, the new tests were administered in a screening setting to a group of 112 three- to five-yearolds to determine testability. Visual acuity, cover testing, and photoscreening were administered as control measures. Results: In Experiment 1, eleven of the 14 patients failed both tests. Two anisometropic amblyopes passing one or both tests had an acuity ≤20/30 in the worse eye and ≤25" stereoacuity. Three anisometropic amblyopia patients failing the STRDS passed another RDS test with similar disparity but a larger target size, confirming a report34 that anisometropic amblyopes may pass RDS testing with parafoveal stereopsis despite the presence of central suppression. The STRDS and STBS tests indicated 80% and 96% specificity, respectively, with the original methodologies; STRDS specificity increased to 95% with retesting with a different methodology. Administration time was 30 sec to 60 sec per test. Conclusion: Small-target RDS or suppression testing may be more effective for strabismus and amblyopia screening of preschoolers than previous RDS test formats.