What is occupational therapy?
The role of occupational therapy for autism is to help the child participate in the things they want and need to do through the therapeutic use of everyday activities. (“About Occupational Therapy,” 2019) Occupational therapy takes a holistic approach to the client’s wellbeing. It addresses the physical, psychological, and cognitive aspects of the clients’ functionally. Clients are assessed in all their environments. You can expect assessments in your home, school, in the community, and virtually. (Gee, Nwora, & Peterson 2018)
What an occupational therapist does
According to the Bureau of Labor Statistics, “Occupational therapists treat patients who have injuries, illnesses, or disabilities through the therapeutic use of everyday activities.” (“Occupational Therapists: Occupational Outlook Handbook,” 2019). Your child’s occupational therapist will assess his/her abilities and help him/her reach his/her full potential. The occupational therapist will tailor his/her approach to your child’s learning style. Younger children might learn best through play and role-plays. An older child might learn better through role-play, community mentors, or using apps to assist with executive planning.
In Volume 71 of the American Journal of Occupational Therapy, a study was published explaining how a 17-year-old boy with autism utilized occupational therapy. In this case study, Jimmy utilized group-based social skills training, video modeling, and participating in an interest-based culinary club to practice his social skills. After attending individual sessions three times per month with his school-based occupational therapist, Jimmy increased his attendance in the culinary club from 25 to 90 percent over the course of a semester. He also gained the skills to prepare meals and earned an internship in the food industry. Jimmy works with a friend from his social group with whom he shares similar interests (Tomchek, Koenig, Arbesman, & Lieberman, 2017).
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Occupational therapy assessment for autism
When an occupational therapist assesses your child, he/she will typically start with a discussion with you (and your child, if appropriate) about your child’s goals. The therapist might also ask your child’s teacher for input. The therapist might visit your child’s home or school for further observation. He/she will assess your child’s capabilities and challenges. You should bring a copy of your child’s Childhood Autism Rating Scale and sensory profile.
Once the occupational therapist has a clear understanding of your child’s goals and abilities, he/she will create a comprehensive intervention plan. The therapist might make recommendations for adaptive equipment. If so, the therapist will train you and your child to use the equipment. Depending on your child’s needs, communication devices, visual supports, or adaptive educational equipment might be appropriate. According to the American Occupational Therapy Association, “occupational therapy practitioners have a holistic perspective, in which the focus is on adapting the environment to fit the person, and the person is an integral part of the therapy team.” (“About Occupational Therapy,” 2019).
Occupational therapy interventions for autism
Your child’s occupational therapist will provide interventions, as necessary, to address social skills, communication, sensory processing, and behavior. Deepam Pawar and Payal Mehta Pawar, occupational therapists in India, explain that they provide interventions to help their clients respond to sensory input. Common interventions include sensory integration, motor developmental activities, and play activities to boost cognition and perception skills. Sensory integration therapy helps children to “register, modulate, and act on sensory input…[sic] The occupational therapist uses different sensory strategies to promote self-regulation and motor planning.” They also utilize interventions to help children: regulate arousal level, decrease distractibility, decrease anxiety, and improve the performance of activities of daily living (Pawar & Pawar, 2017).
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Occupational therapy activities for autism
Occupational therapy activities range from play-based to skills-based tasks. Depending on your child’s goals and abilities, occupational therapy might consist of individual sessions, group sessions, or a mixture of both. Some common activities the Pawars practice with their clients include proprioceptive and vestibular sensory integration activities such as:
- Push, pull games like tug of war
- Wheelbarrow walking
- Playdough/theraputty that offers high resistance
- Ropes or dynamic ladder climbing
- Theraband activities
- Sand play for tactile sensitivity
Children in group sessions might dance or play games such as musical chairs (Pawar & Pawar, 2017). Your child’s occupational therapist will teach you how to help your child practice these activities at home.
Speech and occupational therapy for autism
In addition to occupational therapy, speech therapy might be beneficial for your child with autism. Speech-language pathologists work closely with occupational therapists. The overlap in their practices includes helping clients with feeding, swallowing, cognition, posture, and language learning difficulties. If your child struggles to communicate verbally, your child’s occupational therapist will likely recommend enlisting the help of a speech-language pathologist.
The Speech Pathology Graduate Program organization explains that while both occupational therapists and speech-language pathologists are concerned with a child’s ability to communicate verbally, their approaches and focuses are different. An occupational therapist’s main area of focus will be the child’s attention span and social abilities. They might teach sound creation skills but also focus largely on socialization exercises and sensory integration therapy. A speech-language pathologist will focus on building language-learning skills and teaching the child to form sounds and build them into words and sentences (“How Occupational Therapy is Used to Complement SLP,” 2019).
Speech therapy might be appropriate for your child if he/she is completely nonverbal, has trouble with pronunciation, or postural issues that affect enunciation. Your child’s occupational therapist will likely have recommendations for speech-language pathologists in your area. If your child receives services through a hospital, you might be able to have joint appointments with both providers as necessary. If this is not possible, your child’s providers should be in frequent contact to collaborate on your child’s care plan.
Effectiveness of speech therapy and occupational therapy for children with autism
A study published in Issue 12 of the Journal of Pakistan Psychiatric Society examined the effectiveness of speech and language therapy for children with autism spectrum disorders. While the study had a small sample size of only two children, it evaluated them for six and a half months. At the beginning of the study, the children were evaluated by a psychologist and a speech-language pathologist and assigned scores on the Childhood Autism Rating Scale (CARS). After six months of speech and language therapy, both children’s scores went up. The first child’s score raised to 2.23/.651 (M/SD) from an original score of 2.67/.816 (M/SD). The second child began with a score of 2.50/.462 (M/SD) and finished with a score of 2.03/.399 (M/SD). The study concluded that “speech and language therapy helps [sic] to enhance speech, vocabulary, verbal and [sic] non-verbal communication as well as sentence building in children with [sic] ASD.” (Batool & Ijaz, 2015)
What are the benefits of occupational therapy for autism?
A second study published in Volume 66 of the Australian Occupational Therapy Journal sought to prove the effectiveness of occupational therapy for children with disabilities. The study included children with a range of diagnoses, several of whom have autism. The researchers found 39 effective occupational therapy interventions. Top-down approaches “confer larger clinical gains than bottom-up approaches, when aiming to improve a child’s function.” Researchers also noted that involving parents in a child’s occupational therapy is “effective and worthwhile.” (Novak & Honan, 2019).
The role of occupational therapy for parents of children with autism
Your child’s occupational therapist might recommend that you participate in the therapy with your child. This can be beneficial so that you are on the same page as your child and his/her care provider. Playing an active part in your child’s sessions will help you implement the therapy at home.
Karen Razon, an occupational therapist in Orlando, Florida, explained in her article published in Issue 74 of Autism Parenting Magazine that parents with high-stress levels might benefit from occupational therapy. Razon explains that occupational therapists view “an emotionally-overwhelmed parent though a holistic pair of glasses.” An occupational therapist can help parents improve their physical, emotional, spiritual, or social wellbeing. “Whether it be helping parents find coping mechanisms that fit their family lifestyle, creating weekly routine that schedules ‘spouse-time’ or ‘alone-time’ while meeting their child’s needs, or searching for local parental support groups,” Razon says that occupational therapists can help parents find balance in their life (Razon, 2019). She suggests asking your child’s occupational therapist for advice or a referral to an occupational therapist for yourself. A psychologist might also be an appropriate fit for some parents.
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How can you advocate for occupational therapy for your child with autism?
If you have decided to pursue occupational therapy for your child with autism, you will likely need a referral from your child’s pediatrician or psychologist. If your child is on private insurance, you will need to contact your insurance company for approval before seeking occupational therapy. Most companies have a list of approved providers available online. If your child is on Medicaid, his/her caseworker should be able to provide you with a list of in-network providers. Providers affiliated with research or teaching hospitals might be able to offer your child access to newer technologies or research studies. Private practice or small clinic-based providers might be able to offer more individualized attention due to smaller caseloads. Interviewing several occupational therapists is essential to find the best provider.
About Occupational Therapy. (2019). Retrieved October 28, 2019, from https://www.aota.org/About-Occupational-Therapy.aspx.
Batool, I., & Ijaz, A. (2015). Journal of Pakistan Psychiatric Society. Retrieved October 28, 2019, from http://jpps.com.pk/article/effectivenessofspeechandlanguagetherapyforautismspectrumdisorder_2455.html.
Gee, Bryan M., et al. Occupational Therapy’s Role in the Treatment of children with autism Spectrum Disorders. 5 Nov. 2018, https://www.intechopen.com/books/occupational-therapy-therapeutic-and-creative-use-of-activity/occupational-therapy-s-role-in-the-treatment-of-children-with-autism-spectrum-disorders. Accessed 28 Oct. 2019.
How Occupational Therapy is Used to Complement SLP. (2019). Retrieved October 28, 2019, from https://www.speechpathologygraduateprograms.org/occupational-therapy/.
Novak, I., & Honan, I. (2019, April 10). Effectiveness of paediatric occupational therapy for children with disabilities: A systematic review. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/1440-1630.12573.
Occupational Therapists: Occupational Outlook Handbook. (2019, September 4). Retrieved October 28, 2019, from https://www.bls.gov/ooh/healthcare/occupational-therapists.htm.
Pawar, P. M., & Pawar, D. (2017, April 23). Occupational Therapy for Autism – Assessment and Intervention. Retrieved from https://occupationaltherapyot.com/occupational-therapy-autism/.
Razon, K. (2019, October 21). Interesting Ways Occupational Therapy Can Help Parenting Stress. Retrieved October 28, 2019, from https://www.autismparentingmagazine.com/occupational-therapy-help-stress/.
Tomchek, S., Koenig, K. P., Arbesman, M., & Lieberman, D. (2017, January 1). Occupational Therapy Interventions for Adolescents With Autism Spectrum Disorder. Retrieved October 28, 2019, from https://ajot.aota.org/article.aspx?articleid=2593025.