Occupational therapists work withautisticchildren and adults to help them better perform activities of daily living. Occupational therapy is one of the three most commonly offered therapies in the school setting (along with speech therapy and behavioral therapy); occupational therapists may work toward a huge range of goals, from better handwriting to play skills tosensory integration.
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What Is an Occupational Therapist?
Occupational therapists are individuals who have completed a master’s degree and received a license to practice. They have a wide range of skills and may work in any setting—from a hospital or clinic to a school, home, or community setting.
Their general focus is on improving the client’s ability to participate in activities of daily living, but those activities may include anything from schoolwork to play to toothbrushing.
Why Occupational Therapists Work With Autistic Children
Occupational therapists often work with children who have physical challenges resulting from disorders such ascerebral palsyor traumatic brain injury. Autistic children may not have major physical disabilities, but many are struggling with specific challenges including:
All of these challenges can be addressed (though rarely cured) through different forms of occupational therapy. Occupational therapists who work with autistic children may specialize in (for example) play therapy, handwriting therapy, sensory integration therapy, social skills therapy, or even behavioral therapy.
How Occupational Therapists Develop Treatment Plans
Because every child is different, occupational therapists who work with autistic children develop individualized plans to meet each child’s needs. It’s important to note that occupational therapists who work in schools must focus on needs identified through a child’s Individualized Educational Plan while therapists who work in the home or community have a broader range of options.
Typically, occupational therapists use well-established tests and evaluations to determine a child’s support needs. One such test is the Modified Checklist for Autism in Toddlers (M-CHAT); others include:
In addition to testing, occupational therapists often observe children in a range of settings to see how well they are able to complete tasks of daily life. For example, they may watch to see if a child is able to put on and button a jacket, write in a notebook, play appropriately on the playground, cut with scissors, or participate in a group activity. They may also watch to see whether specific sensory inputs such as florescent lights, buzzers, or strong smells create difficulties for the child.
Once tests and observations are complete, therapists develop a set of individualized goals for the child. These are very personal and depend on the child’s support level and specific needs. Some are likely to relate to personal hygiene and life skills, others to academics and still others to functioning in the social environment. For example:
How Occupational Therapists Work with Autistic Children
Typically, occupational therapists work with autistic children in school. They may work in the classroom or pull the child out to work with them one on one. In some cases, schools have"sensory rooms"where children can interact with indoor swings, balls, trampolines, and other equipment. In other cases, the therapist may bring along exercise balls, jump ropes, and other equipment. In addition, therapists may:
In some cases, particularly with very young children, therapists come to the child’s home. They may even work directly with parents, showing parents how to continue therapeutic intervention even when the therapist is not present.
The Role of Sensory Integration Therapy
Before 2013, occupational therapy was commonly offered to autistic children but sensory dysfunction was not part of the criteria forautism spectrum disorder(ASD). In 2013, with the publication of the DSM-5, new criteria were created and sensory issues were added to the list of autism traits.
The list of sensory issues now includes hyper- or hypo-reactivity to stimuli (lights, sounds, tastes, touch, etc.) or unusual interests in stimuli (staring at lights, spinning objects, etc.). This change was because most autistic people, including those with low support needs, have and/or crave strong reactions to sensory input.
Sensory integration therapy uses a range of techniques such as swinging, brushing, jumping, pushing, squeezing, rolling, and exposure to selected sounds to help children (and adults) with sensory processing issues to lessen their over-reaction to (or need for) intense physical sensation.
According to the STAR Institute (one of the foremost centers for Sensory Integration research and treatment): “Sensory Processing Disorder or SPD (originally called Sensory Integration Dysfunction) is a neurological disorder in which the sensory information that the individual perceives results in abnormal responses.”
The Role of Occupational Therapy in Social Settings
Occupational therapists are not necessarily trained in social skills therapy, but many occupational therapists use a multi-disciplinary approach that combines occupational therapy with other traditional and innovative social teaching tools. For example:
Occupational Therapy for Autistic Adults
Many autistic adults receive occupational therapy. For some, occupational therapy is a tool for building skills of daily living such as cooking, cleaning, dressing, folding, etc. For others, it’s a means for managing stress, building physical stamina, or increasing recreational skills.
Finding an Occupational Therapist
Most autistic children qualify for free occupational therapy through early intervention or school. The therapists and therapy provided may or may not be at the level and/or quantity that parents prefer; if that’s the case, insurance will often support at least some level of private therapy.
To find a private occupational therapist, it’s helpful to start with recommendations from your local school, other parents of autistic children, or your local chapter of the Autism Society. You can also search through a database of licensed occupational therapists through theAmerican Occupational Therapy Association website.
Summary
When searching for or evaluating occupational therapists, it’s important to determine whether the therapist has experience and training in working with autistic people. Autism is quite different from other developmental disorders, and it is critical that your child’s therapist understands and can communicate well with your child.
In many cases, a trained and licensed therapist will set up an occupational therapy program and then turn over the day-to-day work to a paraprofessional. While a licensed therapist can and should set goals and select appropriate therapeutic approaches, many paraprofessionals are more than capable of working well with autistic children.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American Occupational Therapy Association.Occupational therapy in school settings.Hannant P, Tavassoli T, Cassidy S.The role of sensorimotor difficulties in autism spectrum conditions.Front Neurol. 2016;7:124. doi:10.3389/fneur.2016.00124Grapel JN, Cicchetti DV, Volkmar FR.Sensory features as diagnostic criteria for autism: sensory features in autism.Yale J Biol Med. 88(1):69–71.Understanding sensory processing disorder. STAR Institute for Sensory Processing DisorderAdditional ReadingArky B.Treating sensory processing issues. Child Mind Institute.Case-smith J, Arbesman M.Evidence-based review of interventions for autism used in or of relevance to occupational therapy.Am J Occup Ther. 2008;62(4):416-29. Updated 2018. doi:10.5014/ajot.62.4.416Case-Smith J, Weaver LL, Fristad MA.A systematic review of sensory processing interventions for children with autism spectrum disorders.Autism.2015;19(2):133-148. doi:10.1177/1362361313517762
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.The American Occupational Therapy Association.Occupational therapy in school settings.Hannant P, Tavassoli T, Cassidy S.The role of sensorimotor difficulties in autism spectrum conditions.Front Neurol. 2016;7:124. doi:10.3389/fneur.2016.00124Grapel JN, Cicchetti DV, Volkmar FR.Sensory features as diagnostic criteria for autism: sensory features in autism.Yale J Biol Med. 88(1):69–71.Understanding sensory processing disorder. STAR Institute for Sensory Processing DisorderAdditional ReadingArky B.Treating sensory processing issues. Child Mind Institute.Case-smith J, Arbesman M.Evidence-based review of interventions for autism used in or of relevance to occupational therapy.Am J Occup Ther. 2008;62(4):416-29. Updated 2018. doi:10.5014/ajot.62.4.416Case-Smith J, Weaver LL, Fristad MA.A systematic review of sensory processing interventions for children with autism spectrum disorders.Autism.2015;19(2):133-148. doi:10.1177/1362361313517762
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
The American Occupational Therapy Association.Occupational therapy in school settings.Hannant P, Tavassoli T, Cassidy S.The role of sensorimotor difficulties in autism spectrum conditions.Front Neurol. 2016;7:124. doi:10.3389/fneur.2016.00124Grapel JN, Cicchetti DV, Volkmar FR.Sensory features as diagnostic criteria for autism: sensory features in autism.Yale J Biol Med. 88(1):69–71.Understanding sensory processing disorder. STAR Institute for Sensory Processing Disorder
The American Occupational Therapy Association.Occupational therapy in school settings.
Hannant P, Tavassoli T, Cassidy S.The role of sensorimotor difficulties in autism spectrum conditions.Front Neurol. 2016;7:124. doi:10.3389/fneur.2016.00124
Grapel JN, Cicchetti DV, Volkmar FR.Sensory features as diagnostic criteria for autism: sensory features in autism.Yale J Biol Med. 88(1):69–71.
Understanding sensory processing disorder. STAR Institute for Sensory Processing Disorder
Arky B.Treating sensory processing issues. Child Mind Institute.Case-smith J, Arbesman M.Evidence-based review of interventions for autism used in or of relevance to occupational therapy.Am J Occup Ther. 2008;62(4):416-29. Updated 2018. doi:10.5014/ajot.62.4.416Case-Smith J, Weaver LL, Fristad MA.A systematic review of sensory processing interventions for children with autism spectrum disorders.Autism.2015;19(2):133-148. doi:10.1177/1362361313517762
Arky B.Treating sensory processing issues. Child Mind Institute.
Case-smith J, Arbesman M.Evidence-based review of interventions for autism used in or of relevance to occupational therapy.Am J Occup Ther. 2008;62(4):416-29. Updated 2018. doi:10.5014/ajot.62.4.416
Case-Smith J, Weaver LL, Fristad MA.A systematic review of sensory processing interventions for children with autism spectrum disorders.Autism.2015;19(2):133-148. doi:10.1177/1362361313517762
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