Exploring Occupational Therapists’ Sleep Intervention Approaches and Perspectives for Children With Autism Spectrum Disorder: A Malaysian Qualitative Study

INTRODUCTION: Children with autism spectrum disorder (ASD) frequently experience significant sleep disturbances, adversely affecting their health and family well-being. Despite the high prevalence, limited research exists on sleep interventions employed by pediatric occupational therapists (OTs) in Malaysia. This study explores the types of sleep interventions used and the perspectives of pediatric OTs in managing sleep disturbances among children with ASD. METHODS: An exploratory qualitative design was adopted. Data were collected through two focus group discussions (FGDs) with 10 pediatric OTs from private rehabilitation centers in northern Malaysia. Thematic analysis followed Braun and Clarke's six-step process, with researcher reflexivity and collaborative coding employed to ensure rigor. RESULTS: Participants identified a multimodal approach including behavioral strategies (e.g., visual schedules), sensory-based techniques (e.g., deep pressure), physical activity, and environmental modifications. A structured clinical decision pathway emerged, prioritizing sensory regulation as a physiological prerequisite for behavioral success. Parental involvement was highlighted as critical, though moderated by socioeconomic and cultural factors such as cosleeping. Notably, therapists perceived improvements in children's sleep quality and reductions in parental stress. CONCLUSION: This study underscores the value of a culturally responsive and modular approach to sleep interventions within the private pediatric OT landscape of northern Malaysia. The findings provide a foundational framework for future quantitative research to establish objective effectiveness. The results advocate for enhanced awareness, specialized training, and framework-aligned assessment tools to support families and therapists.