Q: How can occupational therapy help my child with Autism?

A: Children with Autism, or Autism Spectrum Disorder (ASD) have a large range of problems that interfere with their full participation in school, home and community activities. Common issues associated with ASD include: limited social interaction, delayed or deficit language, behavioral problems, and sensory-processing difficulties. Occupational therapy helps children with ASD by improving the quality of life for the individual through successful and meaningful experiences.

Occupational therapists are trained professionals who use meaningful, functional activities to enable people to participate in daily occupations, such as taking care of oneself (dressing, grooming), contributing to society (work, school) and enjoying life (hobbies, sports). Occupational therapy with children with ASD begins with an evaluation that aims to understand the individual’s abilities and difficulties in performing daily occupations such as play, school, leisure and personal care activities. Long term and short term goals are created alongside the family to ensure a collaborative family centered approach to treatment.

In young children with ASD, occupational therapists often focus on enhancing children’s sensory processing skills (ability to regulate our senses, proprioception and vestibular system), social-behavioral performance (coping skills, socialization skills), self-cares and participation in play. In older children and adolescents, occupational therapy goals may focus on social and behavioral performance, transition to work, and independence in the community. To achieve these goals, such things as increasing fine motor, gross motor, balance, coordination, attention to task skills, organizational skills, and visual skills are addressed.

Occupational therapists use a variety of strategies to address these goals. Such approaches include: developmental theories, learning theory, model of occupational performance, sensory integration, and play theories. Choosing a therapeutic method is as individualized as the child and depends on the specific needs of the child and the Occupational Therapist’s background. I personally find that employing a combination of approaches provides a more holistic and successful approach to meet our goals. For example, I often pair sensory-based interventions with functional tasks in which the child practices the targeted performance outcome, such as unbuttoning his pants to use the toilet after singing the itsy bitsy spider song to warm up fingers, or writing his or her name in shaving cream to promote handwriting/fine motor skills. To an observer, this looks like play and it is, but the type of play is specifically geared towards a just right challenge for the child to work towards our goals.

Occupational therapy treatment has proven effective in the treatment of ASD. Although the treatment varies as much as children with ASD do, the goal remains the same: to help promote quality of life within the home, school and community by introducing, maintaining and improving skills so that a child with autism can be as independent as possible.

Q: Does my child need Occupational Therapy?

A: Your child may require an occupational therapy evaluation if he/she exhibits difficulties in any of the following areas:

• Fine motor skills
• Gross motor skills
• Attention and concentration
• Visual perceptual skills
  
• Sensory processing
• Play and social skills

Q: How do I know if he/she has these difficulties?

A: Children with fine motor difficulties may:

• Avoid pencil and paper tasks
• Not demonstrate a dominant hand for drawing, cutting, brushing teeth, etc. when peers have (4-6 years)
• Hold pencils, crayons etc with an awkward or immature grasp
  
• Have messy handwriting
• Be unable to tie their shoelaces
  
• Be clumsy manipulating small objects and placing things with precision
  
• Fatigues and/or complains of pain in hand after only a short amount of writing

Children with gross motor difficulties may:

• Have difficulty executing age appropriate motor skills including walking on toes, balancing, jumping, skipping, hopping, etc.
  
• Have poor ball skills
  
• Avoid play outside
• Appear clumsy, breaking things often and bumping into things and people

Children with attention difficulties may:

• Be unable to maintain attention to complete tasks set by the teacher
  
• Be unable to sit still and listen
  
• Have difficulty following instructions
  
• Become distracted easily
  
• Behave impulsively without thinking about consequences

Children with visual perceptual skill difficulties may:

• Have poor spacing in their handwriting
  
• Have difficulty copying from the blackboard
  
• Reverse letters and numbers
  
• Find it hard to find things in drawers, cupboards, etc.

Children with sensory processing difficulties may:

• Dislike being touched, or touch all objects and people
  
• Have difficulty with changes in routine
  
• Always spin and rock themselves
  
• Not like having their feet leave the ground
  
• Dislike grooming activities such as teeth brushing and hair washing
  
• Avoid messy or noisy play
  
• Roughhouse play; disturbing other children

Children with play and social skill difficulties may:

• Play alone
• Dislike participating and withdraw from group situations
• Have no concept of personal space
  
• Have no imaginative play skills
  
• Have difficulties making friends

Q: What is Occupational Therapy?

A: Occupational therapy uses meaningful, functional activities that are common in daily life to enable people to live life as independently as possible, no matter what challenges, either physical, emotional, or environmental, they may face. In the schools, occupational therapists help children that may have physical, cognitive, or mental health challenges perform important school related activities. This may include social participation skills, writing skills, self help skills (such as eating, dressing and toilet habits), and pre-vocational skills.